IMAGE EVALUATION TEST TARGET (MT-3) V r.^ ^A 1.0 1.1 La 121 ■2.5 itt Kii 12.2 lit u 14.0 12.0 nil 105 ,u 11^ ^ , : ^' >■ ^ ^ ""S % •V % 'm Fhotograplnc Sciences Corporation •N5 \ '^^^ <> ^ 23 WEST MAIN STRIET WIBSTIR.N.Y. USM (71«)«7a-4S03 ;\ Kk^ CIHM/ICMH Microfiche Series. CIHIVI/ICIVIH Collection de microfiches. Canadian Institute for Historical Microreproductions / Institut Canadian de microraproductions historiquas Tschnical and Bibliographic Notas/Notas tacliniquaa at bibliographiquaa Tha tot Tha Inatituta haa attamptad to obtain tha boat originai copy avaiiabia for fiiming. Faaturaa of thia copy which may ba bibliographicaiiy uniqua, which may altar any of tha imagaa in tha raproduction, or which may significantly changa tha usual mathod of filming, ara chjckaid balow. 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Thi poi ofl fiirv Orij bas tha sioi oth lira aioi ori The aha TIN whi Ma dm ^ rigl raq ma Thia item is filmad at tha raduction ratio chacked balow/ Ca document est film* au taux da rMuction indiqu* ci-daaaous. 10X 14X 1SX 22X 26X 30X 7 12X 16X aox 24X 2IX 32X Th« copy film«d hor* has bMn r«pro (meaning "CON- TINUED"), or the symbol ▼ (meaning "END"), whichever applies. Un des symboies sulvants apparattra sur la darnlAre image de cheque microfiche, selon le cas: la symbols — ► signifle "A SUIVRE". le symbols ▼ signifle "FIN". Maps, plates, charts, etc., mey be filmed at different reduction retios. Those too large to be entirely included in one exposure ara filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diegrams illustrate the method: Les cartes, planches, tableaux, etc., peuvent Atre filmAs A des teux de reduction diffArents. Lorsque le document est trop grand pour Atre reprodult en un seul clichA, 11 est fllmA A partir da I'angle supArieur geuche, de gauche A drolte. et de haut en bes, en prenant le nombre d'Images nAcessaire. Las diagrammes sulvants illustrent la mAthode. 1 2 3 1 2 3 4 5 6 CARPENTEB OM ALCOHOLIC LIQUORS / \\ PRIZE ESSAY. ON THB USE AND ABUSE ov ALCOHOLIC LIQUORS, IN HEALTH AND DISEASE. By WILLIAM B. CARPENTER, M.D., P.TI.S., «XAllUrkB IN PBTSIOLOGY IN THE VNIVERSITT OF LONDON, PR0FB8HOR 0*]flIIOAt •VUBISPRUDENCB IN UNIVERSITY COLLEGE, AND AUTaOR Of '*TEX PRINCIPLES OF PHYSIOLOGY," BtC. lA • J>»M<^VM>^<^#M«M»*^ WITH A PREFACE, By D. F. CONDIE, M.D., HPUTART or THE COLtEOB OF PBTSICIANS OP PHILADELPHrA, AND AUTIIOK OT A "PBACTIOAL TREATISE ON THE DiaEASES OP CHILDREN," BTO. ETC. PHILADELPHIA: HENRY C. LEA. 18 66. /- PREFACE BY DR. CONDIE. *IMMM»rfMMM»^^*MM»^M^W»^^^W^^^^^^^^^^ '% The opiDion that Alcobolio Liquors afford to the human system a stimulus, which, if not absolutely necessary to its well-being, is. nevertheless, beneficial, by promoting in the several organs a vigor* ous and healthful exercise of their respective functions, and Dy enabling them, thus, to resist more effectually the various disturbing agencies to which they are daily subjected, is one that has been long entertained, and of the correctness of which a large portion'of the public still entertains a firm conviction. To the influence of this opinion may be ascribed much of the intemperance that has prevailed in the world, and it even now presents a formidable barrier to tho success of every effort at reform in respect to the use of intoxicating liquors as a beverage. All are agreed as to the baneful influence upon health and morals resulting from the excessive use of alcoholic drinks, and of the im- portance of guarding against this abuse of them by every means within our power. But so long as the opinion prevails, that in moderate quantities the use of these drinks is both proper and salutary, it will scarcely be possible to guard the masses against indulgence in them to excess — every effort to stay the progress of intemperance, with its attendant evils, disease, poverty, insanity and crime, will be unavailing. 1* (O IDITOa's PRErAOB. To test tho truth of tbe opinion referred to, by an ezaminaticn of tbe effcctii produced upon tbe human frame by tbe use of alco> bolio drinks, whctbor in moderate or excessive doses, is tbe object of the present Essay. And we know of nothing that has been written upon this important question better calculated to eradicate the prejudices which still exist in respect to intoxicating liquors, and to prevent tho habitual abuse of them, by showing that their occasional moderate use, so fur from promoting the health and vigour of the human frame, or increasing its capacity to sustain bodily or mental labour, or to resist tbe extremes of cold and beat, and other depressing ogencies, is, on the contrary, under all circum- stances, rather injurious than beneficial. The author of the Essay is one in every respect well qualified to accomplish satisfactorily the task he has undertaken, by his acknow- ledged familiarity, os a physiologist, with the functions of tho human system in a state of health, and by his acquaintance, as an able and skilful practitioner of medicine, with tbe different agencies by which those functions are disturbed or impeded, and the normal condition of the living organism replaced by one of disease. He brings to the investigation all tbe light which science can shed upon it, as well as tho accumulation of facts derived from experience and observation. Although we may differ from him as to the value of alcoholic drinks as a remedy for the cure of disease, still, in all his leading conclusions, ai to the effects of these liquors upon tbe corporeal, mental and moral functions of tbe healthy human system, he is fully borne out by the results of our own observations and experience, acquired during a long series of years' practice as a physician, and as an active participator in the effort at temperance reform, which, originating with a few philanthropists in tbe United States, speedily enlisted the co-operation of " thousands of tbe best and most talented individuals'' of our own and other lands. IDITOR S PREFACE. ▼n Believing that the promotion of Temperance may be effectually accomplished by enlightening men's understandiiigs in regard to the actual effects of alcoholic drinks upon the body and the mind, and thus enlisting in its favour the strongest motives by which human actions are influenced — the promotion of happiness, the preserva- tion of health and vigour of frame, and the prolongation of life— we recommend to all the present Essay of Dr. Carpenter, as one of the best text-books of Temperance extant. We are persuaded that its extensive circulation will do much towards bringing about the only result by which drunkenness can be banished from our midst — namely, entire abstinence from all alcoholic drinks. By the publication of the present cheap edition, Messrs. Blanchard and Lea have placed the work within the reach of every one ; and their effort thus to aid in the diffusion of sound temperance doctrines will, we trust, be seconded by the advocates of those doctriues througLjiu our country. To popularize as far as possible this edition, the various technical phrases which occur in it have been explained, so as to render their meaning familiar to the unscientific reader. Philadelphia, October, 1853. D. F. C. HIS ROYAL HIGHNESS PRINCE ALBERT, ^liiB €s5at| (BY PERMISSION) MOST RESPECTFULLY DEDICATED; AS AN IXPRBBSIOR OF THB AUTHOR'S ADHIBATIOB 09 BIS ROYAL BianNESS's ENDEAVODRS TO BLEVATB VHB SOCIAL CONDITIO!! OF BIS ADOPTED C0D5TRT) AND WITH THE FIRM BELIEF THAT THE PATRONAGE NOW SO ORACIOnSLY CONCEDBOf WILL AID IN CALLING THE ATTENTION OF THB PUBLIO TO THE SUBJECT OF THE PRESENT ENQUIRT, XS A DEGREE COHHENSCRATB WITH ITS IHPORTANCB. w 4th. 1 befc ADVERTISEMENT ISSUED BT DIRECTION OF THE DONOR OF THE PBIZl. ^A PRIZE OF ONE HUNDRED GUINEAS WILL BE GIVEN FOR THE BEST ESSAY ON THE USE OF ALCO- HOLIO LIQUORS IN HEALTH AND DISEASE. The Essay must contain answers to the following questions :— Ist. — What nre the effects, corporeal and mental, of Alcoholic Liqaon on the healthy human «iyBtem 7 2nd. — Does physiology or experience teach us, that Alcoholic Liauon should form part of the ordinary sustenance of Man, particu* larly under circumstances of exposure to severe labour or to extremes of temperature? Or, on the other hand, is there reason for believing that such use of them is not sanctioned by the principles of science, or the results of practical obser- vation ? 8rd. — Are there any special modifications of the bodily or mental condi- tion of Man, short of actual disease, in which the occasional or habitual use of Alcoholic Liquors may be necessary or bene- ficial ? 4th. — Is the employment of Alcoholic Liquors necessary in the practice of Medicine 7 If so, in what diseases, or in what forms and stages of disease, is the use of them necessary or beneficial 1 The Essay must be delivered to the undersigned address, on or before the 30th day of September, 1849. («) iii ADVERTISEMENT. Dr. John Forbes, F.R.S., Physician to the Queen's House- hold, Prince Albert, and the Duke of Cambridge ; Dr. G. L. Rou- PELL, F.R.S., Physician to St. Bartholomew's Hospital; and Dr. W. A. Guy, M.B., Cantab., Professor of Forensic Medicine, King's College, London, have kindly consented to act as Adjudicators. Signed on behalf of the Donor, Charles Gilpin, Thomas Begqs. 6, BUhopagate Street Without, London, April, 1848. ADJUDICATION. From the fifteen MS. Essays on the Use and Abuse of Alco- holic Liquors, transmitted to us by Messrs. Beggs and Gilpin for adjudication, we have unanimously selected as the best, the one bearing the motto — Mens sana in corpore sano. We accordingly adjudicate to its author the Prize of One Hundred Guineas. We also think it due to the Author of the Essay bearing the motto — Quot Ttomines tot sententiaej to record our opinion of- its great merits. We further deem it right to speak in terms of commendation of the Essay having five mottoes, the first of which is — How use doth breed a habit in a man, John Forbes, M.D. (Signed) G. L. Roupell, M.D. William A. Gut, M.B. liondon, December 6th, 1849. leen's House- a. G. L. Rou- ital; and Dr. dicine, King's judicatoTS. LE8 Gilpin, (iS Begos. TABLE OF CONTENTS. \ Abuse of Alco- and Gilpin for e best, tbe one We accordingly juineas. 5say bearing the ir opinion of its ommendation of — How use doth lES, M.D. •ELL, M.B. L. Guy, M.B. CHAPTER I. Mfll I^HAT ABK THE EFFECTS, CORFOREAL AND MEMTAli, OF AlCOHOUO LiQCORa ON THE HEALTHY HUMAN SYSTEM? 26 Sect. I. — Influence of Alcohol upon the Physical, Chemical and Vital Properties of the Animal Tissues and Fluids 25 Corrugation of Tissues 25 Coagulation of Albumen 26 Impairment of solidifiability of Fibrine 27 Irritating action on Living Tissues 27 Temporary exaltation of Nervous Power 28 Change in red Corpuscles 29 Sect. II. — Immediate Consequences of the Excessive Use of Alcoholic Liquors on the General System 30 Phenomena of Alcoholic Intoxication 80 Symptoms and Post-mortem appearances of Alco- holic poisoning 82 Pathology of Alcoholic Intoxication 84 Sect. III. — Remote consequences of the excessive Use of Alco- holic Liquors 88 Diseases of the Nervous System 88 Delirium Ebriosnm 98 2 Cxiii) K u SIT CONTENTS. PAOI Deliriam Tremens 89 Insanity 42 Oinomania 45 Mental Debility in the Offspring 48 Inflammatory Diseases of the Brain 60 Apoplexy 60 Paralysis ond Epilepsy 62 Diseases of the Alimentary Canal 63 Irritation and Inflammation of the Mucous Mem- brane of the Stomach 64 Inflammatory Gastric Dyspepsia 67 Disorders of the Intestinal Mucous Membrane .. 68 Diseases of the Liver 59 Acute and Chronic Inflammation of the Liver ... 69 Hypertrophy and Atrophy of the Liver 60 Diseases of the Kidneys <'l Diseases of the Skin 62 General Disorders of Nutrition 68 Tendency to the Deposition of Fat 64 Diminished Power of Sustaining Injuries by Disease or Accident 66 Liability to Epidemic Diseases 67 Gout and Rheumatism 68 Diseases of the Heart and Arteries 69 Spontaneous Combustion 69 BxOT. IV — General effect of the Excessive Use of Alcoholic Liquors on the Duration of Life 71 Experience of Insurance Offices 72 Specially injurious influence of Excess in Warm Cli- mates 78 Statistics of the Indian Army 76 CONTENTS yi PAOI 39 42 45 48 50 50 , 62 68 as Mem- 64 57 nbrane.. 58 59 5 Liver ... 59 00 n 62 , 68 64 jjuries by 65 67 68 69 69 Alcoholic 71 72 Warm Cli- 78 76 CHAPTER II. Does Phtsioloot oa Experience teach us that Alcoholic Liquors should form fart of the ordinary sustenance or MAN, particularly UNDER CIRCUMSTANCES OF EXPOSURE TO SEVERE LABOUR, OR TO EXTREMES OF TEMPERATURE 7 OR, ON THE OTHER HAND, IS THERE REASON FOR BELIEVINQ THAT SUCH USE OF THEM IS NOT SANCTIONED BY THE PRINCIPLES OF SCIENCE, OR BY THE RESULTS OF PRACTICAL OBSERVATION? 81 Sect. I. — Endurance of Bodily Exertion 81 Sect. XL — i'ldurance of Mental Exertion 92 Sect. III. — Endurance of Cold. 96 Sect. IV. — Endurance of Heat 108 Sect. V. — Resistance to Morbific Agencies 118 Sect. VI. — Consequence of the Habitual "Moderate" Use of Alcoholic Liquors 128 Effect upon the Stomach 128 Effect upon the Nervous System 180 Effect upon the Circulation 132 Effect upon Nutrition 135 CHAPTER III. Are there any special modifications of the bodily or mental condition of man, short of actual disease, in which the occa- sional or habitual use of alcoholic liquors may be neces- sary or beneficial ? 138 Sect. I. — Demand for Extraordinary Exertion 138 Sect. II. — Deficiency of other Adequate Sustenance 142 Sect. III. — Deficiency of Constitutional Vigour 145 Pregnancy 160 Lactation 151 Childhood 154 Old Age 166 I ( zyi OONTENTH. .r CHAPTER IV. lAOl Is THB Employment or Aiooholio Liquobs nxcessaiit im th> Pbao* TIOB OF MbDIOIME ? IF SO, IN WHAT DISEASES, OB IN WHAT FOBM AND STAQES OF DISEASE, IS THE TTSB OF THEM NE0E8SABT OR BENEFICIAL ? 161 Sect. I. — Recovery from Shock 161 Sect. II. — Treatment of Acute Diseases 162 Resistance to the depressing influence of Morbific Agents 162 Recovery from states of Prostration 164 Support under Exhausting Drains 16G Forms of Alcoholic Liquors most desirable 167 8lOT. III. — Treatment of Chronic Diseases 16& Appendix A 17'a «« B 176 M C 176 PREFACE. The circumstances under which the following Essay is given to the Public, are sufficiently explained by the preceding Advertise- ment and Adjudication ; but the Author takes this opportunity of offering a short statement of the objects which he bad especially in view in its composition. The questions set forth in the Advertisement having been evi- dently drawn up with great care, and having been obviously in- tended to bring the whole subject of the ordinary as well as the medical employment of Alcoholic Liquors under discussion, tho Author judged it advisable to follow the plan which they had narked out, by answering each of them seriatim ; ' although he wan iware that, by so doing, a certain amount of repetition would be ilmost necessarily involved. He found, as he proceeded, that it I70uld be impossible to maintain such a continuity in his argument, IS would be desirable for its effectiveness ; and he would therefore vequest his readers, in limine^ to keep the following issue in view, as those to which he is desirous of leading them. In the first place, — That from a scientific examination of k'he m')dus operandi^ of Alcohol upon the Human body, when taken In ft poisonous dose, or to such an extent -as to produce Intoxication we may fairly draw inferences with regard to the specific* effectn * Seriatim — in order. • In limine — at the outset. • Modut operandi — the mode or way in which it toti * Specific — peculiar. 2* (xvii) n' xvni PREVACE. II ! li': ivhich it is likely to produce, when ropoutodiy tukoo in excess, but not to an immediately-fatal amount, Secondli/f — That the consequences of tbo rxrenntve use of Alco- holic liquors, as proved by the cxporionco of the Medical Profes- eion, and universally admitted by medical writers, being precisely £ucb as the study of its effects in poiHonous and imroediately-futal doses would lead us to anticipate, wo arc further justiGcd in ex- pecting that the habitual use of smaller quBOtitics of these liquors, if sufficiently prolonged, will ultimately be attended, in a large pro- portion of cases, with consequences prejudicial to the human sys- tem, — the morbid actions thus engendered \im\g likely rather to be chronic,' than acute,' in their character. Thirdly f — ^That as such morbid actionn are actually found to be among the most common disorders of persooi advanced in life, who have been in the habit of taking a '< modcrato" allowance of alco- kolie liquors, there is very strong ground for regarding them as in great degree dependent upon the asserted oauflo ; although the long postponement of their effects may render it impossible to demon- strate the existence of such a connexion. Fourthly, — That the preceding conclusion is fully borne out by the proved results of the " moderate" U8© of Alcoholic liquors, in producing a marked liability to the acute forms of similar diseases in hot climates, where their action is accelerated by other condi- tions; and also by the analogous facts now universally admitted, in regard to the remotely-injurious effects of slight excess in diet, im- perfect aeration of the blood,'* insufficient repose, and other like violations of the Laws of Health, when habitually practised through a long period of time. Fifthly, — That the capacity of the healthy Human system to sustain as much bodily or mental labour m it can be legitimately called upon to perform, and its power of reHi^ting the extremes of Heat and Cold, as well as other depressing ngeuiies, are not aug- mented by the use of Alcoholic liquors ; but thnt, on the other • Chronit — slow: of long continuance. ' Acute — rapid in progress. * Aeration of the blood — the change produced iti the blood by its being brought in contact with the atmospborio air during its passage through the lungs. PREFACE. XIX cess, but of Alco- il Profe8- precisely itely-fatal cd in ex- \e liquors, large pro- 11 man sys- ther to be lund to be 1 life, who ce of alco- tbem as in b the long to demon' rne out by liquors, in ar diseases her condi- Imitted, in in diet, im- other like ed through system to cgitimately xtremes of •e not aug- the other by its being age through hand, their use, under such circumstances, tends positively to the impairment of that capacity. Sixthly, — That where there is a deficiency of power, on the part of the system, to carry on its normal' actions with the energy and regularity which constitute health, such power can rarely be im- parted by the habitual use of Alcoholic liquors ; its deficiency being generally consequent upon some habitual departure from the laws of health, for which the use of Alcoholic liquors cannot compen- sate; and the employment of such liquors, although with the tem- porary effect of palliating the disorder, having not merely a re- motely-injurious effect per se,* but also tending to mask the action of other morbific' causes, by rendering the system more tolerant of them. Seventhly, — That, consequently, it is the duty of the Medical Practitioner to discourage as much as possible the habitual use of Alcoholic liquors, in however " moderate" a quantity, by all per- sons in ordinary health ; and to seek to remedy those slight depar- tures from health, which result from the "wear and tear" of active life, by the means which shall most directly remove or antagonize their causes, instead of by such as simply palliate their effects. £i(jhthli/f — That whilst the habitual use of Alcoholic liquors, even in the most " moderate" amount, is likely (except in a few rare instances) to be rather injurious than beneficial, great benefit may be derived in the treatment of Disease, from the medicinal use of Alcohol in appropriate cases; but that the same care should be employed in the discriminating selection of those cases, as would be taken by the conscientious practitioner in regard to the administra- tion of any other powerful remedy which is poisonous in largo doses. The foregoing appear to the Author to be the conclusions Icgiti raately deducible from the facts and arguments which he has brought forwards; it will be for his Professional -readers to decide, how far the case which he has made out is sufliciently strong to lead theip * Normal — appropriate; proper; healthy. * Per se — by or of themselves. * Morbific — disease-producing. 17 / I u PREFACE. to the lamo rcituhs. Thia much, however, he would add; that when ho finit entered upon the investigation, some years ago, he had adopted no foregone conclusion, and had, consequently, no temptation to make the facts square with preconceived views ; that he has constuntly endeavoured to treat the subject as one of purely Bcientifie inquiry, and has avoided mixing up any other considcra* tions with those which presented themselves to him as a Physiologist and a Physician ; and that, for the sake of keeping himself free from even the appearance of partizanship, he has never allied him- self with any one of the Societies, which have been formed to carry into practical cHcct the Total Abstinence principle, but has pre- ferred to follow n perfectly independent course. He ventures to hope *hat on those grounds he may claim some right to being candidly heard, by those to whom this Essay is more especially addressed. lie cannot allow it to go forth, however, without expressing his- convictinn, that, whilst there are adequate Medical reasons for Ab< Htinence from the habitual use of even a " moderate " quantity of Alcoholic liquors, there are also strong Moral grounds for Abstineuco from that occaHionul use of them, which is too frequently thought to be requisite for social enjoyment, and to form an essential part of the rites of hofpitulity. The experience of every Practitioner roust bring the terrible results of Intemperance frequently before his eyes ; but whilst he is thus rendered familiar with its conse- queuccH as regords individuals, few, save those who have expressly enquired into the subject, have any idea of the extent of the social evils resulting from it, or of the degree in which they press upon every member of the community. The Author believes that he is justified in the assertion, that among those who have thus enquired, there is but one opinion as to the fact, that, of all the causes which are at present connpiring to degrade the physical, moral, and intel- lectual condition of the mass of the people, there is not one to bo ooni pared in potency with the Abuse of Alcoholic liquors; and that, if this could be done away with, the removal of all other causes would be immeasurably promoted. Every one who wishes well to his kind, therefore, must be interested in the enquiry how this monster-evil can be best eradicated. Now the Author considers, that the best answer to this enquiry bus been found in the results of experience. A fair trial has been ' PREFACE ZXI [(1 add; that e years ago, sequently, no 1 views ; that one of purely her considera- a Physiologiat r himself free ,cr allied him- )rmed to carry but has pre- mtures to hope )eiug candidly y addressed, expressing his- •easons for Ab- e" quantity of for Abstineuco uently thought I essential part ry Practitioner equently before with its conse- have expressly nt of the social hey press upon ieves that he is 3 thus enquired, he causes which noral, and iutel- is not one to bo ic liquors; and ?al of all other one who wishes the enquiry how to this enquiry ir trial has been given, both in this country and in the United States, to soeiotics which advocated the principle of Temperance, and which enlisted in their support a large number of intelligent and influential men ; but it has been found that little or no good has been effected by them, among the classes on whom it was most desirable that their iufluenco should be exerted, except where those who were induced to join them really adopted the Total Abstinence principle. Though ho agrees fully with those who maintain, that i/ all the world would be really temjieratef there would be no need of Total Abstinence Societies, the Author cannot adopt the inference that those who desire to promote the Temperance cause may legitimately rest satisfied with this measure of advocacy. For sad experience has shown, that a large proportion of mankind cannot, partly for want of the self-restraint which proceeds from moral and religious culture, be temperate in the use of Alcoholic liquors ; and that the reforma- tion of those who have acquired habits of intemperance cannot be accomplished by any means short of entire Abstinence from fer- mented liquors. Further, experience has shown that, in the present dearth of eficctual education among the masses, and with the ex- isting temptations to Intemperance arising out of the force of example, the almost compulsory drinking-usages of numerous trades, and the encouragement which in various ways is given to the abuse of Alcoholic liquors, nothing short of Total Abstinence can prevent the continuance, in the rising generation, of the terrible evils which we have at present to deplore. And lastly, experience has also proved that this reformation cannot be carried to its required extent, with- out the co-operation of the educated classes; and that their influence can only be effectually exerted by example. There is no case in which the superiority of example over mere precept is more decided and obvious, that it is in this. "I practise total abstinence my self," is found to be worth a thousand exhortations; and the lament abld failure of the advocates who cannot employ this argument, should lead all those whose position calls, upon them to exert theiir influence, to a serious consideration of the claims which their duty to society should set up, in opposition to their individual feelings of taste or comfort. Among the most common objections brought against the advo- cates of the Total Abstinence principle, is the following, — " That \ XXll PREFACE. I the abuse of a thing good in itself does not afford a valid argu* mcnt ngiiinst the right use of it." This objection hos been so well mt't by the late Archdeacon Jeffreys of Bombay, (in a letter to the liomhny Courier,) that, as it is one peculiarly likely to occur to the luind of his Mudicul readers, the Author thinks it desirable to quote a part of his reply. — "The truth is," he says, "that the odti|;;c is only true under certain general limitations; and that out of these, so far from being true, it is utterly false, and a mischievous fallficy. And the limitations are these: — If it be found by expe- rience, that, in the general practice of the times in which we live, the abuse is only the solitary exception, whereas the right use is the general rule, so that the whole amount of good resulting from its right use exceeds the whole amount of evil resulting from its pnrtial abuse, then the article in question, whatever it be, is fully entitled to the benefit of the adage ; and it would not bo the abso- lute and imperative duty of the Christian to give it up on account of its partial abuse. This is precisely the position in which stand all the gifts of Providence, and all the enjoyments of life; for there is not one of them which the wickedness of man does not more or less abuse. But, on the other bund, if it be found by ex- perience that there is something so deceitful and ensnaring in the nrticio itself, or something so peculiarly untoward connected with the use of it in the present age, that the whole amount of crime, and misery, and wretchedness connected with the abuse of it greatly exceeds the whole amount of benefit arising from the right use of it; then the argument becomes a mischievous fallacy, the article in question is not entitled to the benefit of it, and it becomes the duty of every good man to get rid of it." After alluding to the evi- dence that this is pre-eminently the case with regard to Alcoholic liquors, the Archdeacon continues, — " "We have then established our principle, in opposition to the philosophic adage; taking the duty of the citizen and the patriot, even on the lowest ground. But Christian self-denial and Christian love and charity, go far be- yond this. St. Paul accounted one single soul so precious, that he would on no account allow himself any indulgence that tended to endanger a brother's soul. ' If meat make my brother to oflend, I will cat DO meat while the world standeth, lest I make my brotbev PREFACE. xim to offend.' — * It is good neither to eat fit >h nor to drink wino, nor anything whereby thy brother stuinbli'th, or is MffoiuleJ, or is m.ido weak.' And wo must bear in mind that fl< sh and wii -^ are hero mentioned by Paul as 'good creatures of God;' 'hoy are not in- tended to designate things evil in thomsLivca. This saying of St. Paul is the Charter of Tcetotalism; and will rcinain the charter of our noblo cause so long as the world endures, so long as there re- mains a single heart to love and revere this declaration of the holy self-denying Paul." If, then, the Author should succeed in convincing his readers, that the " moderate" habitual use of Alcoholic liquors is not bene- ficial to the healthy Human system, — still more, if they should be led to agree with him that it is likely to bo injurious, he trusts that they will feel called upon by the foregoing considerations, to advo- cate the principle of Total Abstinence, in whatever manner they may individually deem most likely to bo effectual. He believes it to be in the power of the Clerical and Medical Professions com- bined, so to influence the opinion and practice of the educated classes, as to promote the spread of this principle among the "masses," to a degree which no other agency can effect. And he ventures to hope that, whether or not he carries his readers with him to the full extent of his own conclusions, he will at any rato have succeeded in convincing them that so much is to be said oik his side of the question, that it can no* longer be a matter of indit- fei-ence what view is to be taken of it ; and that as " universal experience" has been put decidedly in the wrong with regard to many of the supposed virtues of Alcohol, it is at any rate possible, that its other attributes rest on no better foundation. In hia general view of the case, he has the satisfaction of finding himself supported by the recorded opinion of a large body of his Profes- sional brethren ; upwards of two thousand of whom, in all grades and degrees, — from the court physicians and leading metropolitan surgeons, who are conversant with the wants of the upper ranks of society, to the humble country practitioner, who is familiar with the requirements of the artizan in his workshop, and the labourer m the field, — have signed the following certificate :— - n i : 'III SZ17 PREFACE. " We, the undersigned, are of opinion — " 1. That a very large proportion of human misery, including poverty, disease, and crime, is induced by the use of Alcoholic or fermented liquors as beverages. " 2. That the most perfect health is compatible with Total Ab- stinence from all such intoxicating beverages, whether in the form of ardent spirits, or as wine, beer, ale, porter, cider, &c., &c. " 3. That persons accustomed to such drinks may, with perfect safety, discontinue them entirely, either at once, or gradually after a short time. " 4. That Total and Universal Abstinence from Alcoholic bever- ages of all sorts would greatly contribute to the health, the pros- perity, the morality, and the happiness of the human race." No medical man, therefore, can any longer plead the singularity of the Total Abstinence creed, as an excuse for his non-recognition of it; and although a certain amount of moral courage may be needed for the advocacy and the practice of it, yet this is an attri- bute in which the Author cannot for a moment believe his brethren to be deficient. Judging from his own experience, indeed, he may say that he has found much less difficulty in the course he has taken, than he anticipated when he determined on it; and that he has met with a cordial recognition of its propriety, not merely on the part of those who participated in his opinions but did not feel called upon to act up to them in their individual cases, but also among others who dissented strongly from his scientific conclusions, and who consequently had no more sympathy with his principles Llian with his practice. London, March, 1850. Clg (ppovl^ots "Kiyu, xpivars u/xsig t (|>i)fM. 'ga;a;.'tStg'lii by the nervous matter, and incorporated with its substance, in nuob a manner as even to change (when in sufficient amount) its physical us well ns its chemical properties. It is important also to observe, tliut this affinity is obviously such, as will occasion the continual prcHonco of alcohol in the blood, even in very minute proportion, to modify the nutrition of the nervous substance more than that of any other tissue; for the alcohol will seek ovt (as it were) the nervous matter, and will fasten itself upon it, — just as we see that other poisons, whose remltii become more obvious to our senses, (although the poisons themselves may exist in such minute amount as not to be detcctible by the most refined analysis,) will localize themselves in particular organs, or even in particular spots of the same organ. ' 20. The selective power of Alcohol appears to lead it in the first instance to attack the Cerebrum,* the intellectual powers being uft'rcfed before any disorder of sensation or motion manifests itself; and to this it seems to be limited in what has been here described as \\\iiJirH( stage of intoxication. But with the more complete perver- sion of the intellectual powers, which characterises the second stage, we have also a disturbed function of the Sensory Ganglia,^ upon which the cerebral hemispheres* are superposed; this disturbance being indicated by the disorders of sensation, and also by the want of that control over the muscular movements which require sensa- tion for their guidance. In the third stage, the functions of the Cerebrum ond Sensory Ganglia appear to be completely suspended ; and those of the Medulfa Oblongata^ and Sjrinal Cord' now begin to bo affected, as we see to be indicated by the difficulty of respira- tion, the strabismus, the dilated pupil, and the tetanic spasms. As already stated, the admixture of alcohol with the blood has a ten- dency to give a venous character even to that of the arteries; and when this tendency is augmented by imperfect respiration, the blood will become more and more venous, until its influence upon the medulla oblongata is so directly poisonous, that its functions are ;:ompletely suspended, the respiratory movements are brought to a statid, and death takes place by Asphyxia, precisely as in narcotic poisoning by other substances. 21. This tendency, however, is more completely antagonized by ' See for illustrations of tliis doctrine, now generally admitted by physi- ologists, Dr. W. Budd's paper on Symmetrical Diseases, in Med. C'hir. ■ Tram., vol. xxv. ; and Mr. Puget's Lectures on Nutrition, in Medical Ga- gctte, 1847. » Cerebrum — the upper and anterior portion of the brain. * Sensory gavglia — portions of the nervous system from which the nerves of eennation proceed. * Cerebral hevmpheres — the two lateral portions of the brain. * Medulla oblongata — the commencement of the spinal marrow at tho Onsis of the brain within the scuU. * Spinal cord — the spinal marrow. •■it ON niE HEALTHY 8T8TEM r ice, in nuob its physical to observe, e continual oportion, to that of any the nervous J that other a, (although int as not to I themselves same crgan.' it in the first (owcrs being lifests itself; ! described as iplete pervcr- second stage, vglia,^ upon is disturbance » by the want require sensa- ctions of the y suspended ; d' now begin ty of respira- ! spasms. As ad has a ten- arteries; and ion, the blood nee upon the "unctions are brought to a IS in narcotic itagonized by litted by physi- in Med. Chir. in Medical Ga- rhich the nerves rain, marrow at tho (lie efforts which the system makes (so to speak) to get rid of the piiisnn ; which efforts, if siu-cessful, will carry it off in tho e(»urse of H few hours, leaving nothing behind it but the disordered condition which it has produced. We have seen that an increased secretion ' takes place by the kidneys and skin ; and the former of these is certainly a means of eliminating" the alcohol, which has been de- tected in the urine, by Dr. Percy, (np. rit., p. 104,) — contrary to the statenjents of many physiologists, who liave denied that it ever finds its way into that secretion. It is indeed a general rule, that when a niedicinul or toxic' agent produces a special deterniinntion to some particular gland, that determination is the means of elimi- nating it from the blood; as is seen in the diuretic action of the neutral salts. And it would not seem improbable, therefore, that the nkin also should be concerned in the exhalation * of the alcohol;* more especially since an alcoholic odour may often be observed, not merely in the breath, but proceeding from the person generally. Dr. Percy has also shown, that alcohol may be detected in the hile of animals poisoned by it. The alcoholic odour of tho breath is a sufficient indication that alcoholic vapour is exhaled from the lungs in the act of respiration ; — but the quantity of this is probably small in comparison with that which is carried off in another way, namely, by the combustive process, which takes place in the blood at the expense of the oxygen it contains, and which converts the alcohol into carbonic acid and water; both of which are set free by exhala- tion from the lungs. The readiness with which alcohol is thus oxi- dized, in fact, is probably one cau.se of its influence in giving a venous a.spect to arterial blood; since it will withdraw the oxygen from other substances, which are waiting to be eliminated by the combus- tive process, and the accumulation of which will deteriorate the cha- racter of the fluid. 22. By all these channels, then, the Alcohol is rapidly carried out of the system ; so that recovery may be certainly expected, if life can be sufficiently prolonged by warmth to the surtiice, by arti- ficial respiration, by the administration of animonia,® and by other such measures. The depresahiij character of the influence of alct)- hol, when carried to this extent, is sufliciently indicated by the fact • Increased secretion bij the kidneys and skin — increases separation from the blood of urine and sweat. * Eliminating — separating, removing. * Toxic — poisonous. * Exhalation — giving but in the form of n fine vapour. • Dr. Macnish states, (Anatomy of Drunkenness, p. 17-5), that he lias met with two instances, the one in a Claret, the other in a Port drinker, in which the cutaneous perspiration after a debauch had the hue of the liquor they had drunk. • Ammonia — volatile alkali, hartshorne. 4 ■fell 1 m H 88 EFFECTS OF ALCOHOL V\ j '; 1 1 |i '. : i \ 't! that copious depletion ' cannot be borne ; and it is on this account very important to distinguish between alcoholic poisoning and con- gestive apoplexy, for which it may be easily mistaken if its cause be not known. It would be easy to extend the foregoing description by a more particular account of the varieties of the modvs operandi of Alco- iiol presented by different individuals; but it has not been thought necessary to do so, the great general facts presented by its ordinary operation being those of prime importance in our further investiga- tions. — We have now to inquire into the various forms of disease, the production of which may be assigned, with more or less proba- bility, to the prolonged or repeated action of alcohol on the human system. III. REMOTE CONSEQUENCES OF THE EXCESSIVE USE OF ALCO- HOLIC LIQUORS. Diseases of the Nervous System. 23. From the peculiar tendency which the Alcohol in the blood has to disorder the functions of the Nervous System, it might be expected that the habitual ingestion of alcoholic liquors in excess, would bring about a more permanent derangement of this apparatus ; and more particularly of its Encephalic' portion, — which seems to be singled out by alcohol, almost to the exclusion of the spinal cord, just as the spinal cord is affected by strychnine,* almost to the ex- clusion of the encephalon," This we shall find to be the case. There are, in fact, scarcely any diseases of the Encephalon, except such as are of a purely constitutional nature, (such as tubercular • or cancer- ous affections,) which are not so much more frequent among the habitually intemperate than among the habitually sober, as to justify us in regarding the excessive use of alcoholic liquors as among the most eflScacious of the conditions of their production. It will be proper, therefore, to pass the principal diseases in review before us, and to inquire into the mode in which habitual excess in the use of alcoholic drinks tends to produce each of them. 24. Delirium Ebriosum.'' — Considering that the state of intoxi- cation is itself, strictly speaking, a transient paroxysm of insanity, it can excite no surprise that a confirmed state of mental derange* ' Depletion — removal or loss of blood or of its constituents by blecdiag; purging, &c. » Modus operandi — mode or manner in which it acts. » Encephalic portion — the portion within the head. « Strychnine — the active principle of nux vomica. • Encephalon — the brain. • Tubercular — scrofulous, consumptive. Delirium ebriosum — the delirium of drunkenness. ON THE HEALTHY SYSTEM. 80 ALOO- nicnt sLould frequently result from the repetition of the cause \rhich produces the single paroxysm. There are, in fact, some individuals in whom a fit of positive madness, persisting for some little time after the immediate eflFects of the stimulus have subsided, is brought on by every excess in drinking. The head becomes extremely hot, the face flushed, the pulse very frequent, full, and hard, the temper is excessively violent, the individual sometimes attacking every one who comes in his way, and being always prone to ferocity against any one who opposes him ; and all sense of danger being lost, he is not deterred from violence by the fear of personal injury, but rushes madly upon what may prove bis destruction. This condition, the delirium ebriosum of Darwin, is obviously an exaggeration of one of the ordinary forms of excitement in common intoxication ; and it usually subsides in a day or two, if the individual be simply re- strained from doing mischief to himself or others. It is sometimes accompanied, however, with tremors,' even in the midst of violent excitement; and this form constitutes the transition to the disorder next to be noticed. The frequent repetition of this paroxysm, of which, as of ordinary drunkenness, the stimulating action of alcohol on the nervous centres must be regarded as the immediate cause, is almost certain, like the recurrence of regular maniacal paroxysms, to end in some settled form of Insanity. 25. Delirivm Tremens} — The habitual drunkard, who has ex hausted his nervous power by continual over-excitement, is liable to another form of disordered action of his brain, which is commonly known from one of its most marked symptoms, — the peculiar tremor of the limbs, — as delirium tremens. This state is in many respects the opposite of the preceding. There is little or no heat of the head or flushing of the face, the skin is cool and humid, and even chilly; the pulse, though frequent, is small and weak ; and the temper, though very irritable, is not violent, — the prominent disposition, in- deed, being anxiety and apprehension of injury or danger. There is an almost entire want of sleep; and even if repose be obtained, it is very imperfect, being interrupted by frightful dreams. On the other hand, the waking state is frequently so disturbed by illusions of a disagreeable or frightful nature, that it differs but little fiom that of sleep, save in the partial consciousness of external things. The following is the vivid picture of this condition, given by one who has himself experienced it.* " For three days I endured more agony than pen could describe, even were '^t guided by the hand of a Dante. Who can tell the horrors of that horrible malady, aggra- vated as it is by the almost ever-abiding consciousness that it \» Belf-sought? Hideous faces appeared on the walls, and on the ceil- * Tremors — an unsteady, tremulous motion of the limbs; shaking. * Delirium tremens — delirium with tremors of the limba ; mania & potu. * Autobiography of J. B. Gough, p. 70. l-H 11 Ivf 40 EFFECTS OF ALCOHOL 19^1! M ing, and on the floors ; foul things crept along tlie bed-clothea, and glaring eyes peered into mine. I was at one time surrotinded hy nuUions of monstrous spiders, who crawled slowly, slowly over every limb; whilst beaded drops of perspiration would start to my brow, and my limbs would shiver until the bed rattled again. Strange lights would dance before my eyes, and then suddenly the vi'vy blackness of darkness would appal me by its dense gloom. All at once, whilst gazing at a frightful creation of my distempered mind, I seemed struck with sudden blindness. I knew a candle was burn- ing in the room, but I could not see it. All was so pitchy dark. I lost the sense of feeling too, for I endeavoured to grasp my arm in one hand, but consciousness was gone. I put my hand to my side, my head, but felt nothing, and still I knew my limbs and frame were there. And then the scene would change. I was falling — falling swiftly as an arrow far down into some terrible abyss; and so like reality was it, that as I fell I could see the rocky sides of the horrible shaft, where mocking, gibing, mowing, fiend-like forms were perched; and I could feel the air rushing past me, making my hair stream out by the force of the unwholesome blast. Then the paroxysm sometimes ceased for a few moments, and I would sink back on my pallet drenched with perspiration, utterly exhausted, and feeling a dreadful certainty of the renewal of my torments." 26. With this disturbed condition of the brain, a more or less disordered state of the digestive apparatus is commonly associated. The tongue is furred, the stomach unable to bear food without vomiting or a sense of oppression ; the bowels are usually consti- pated, or, if they bis reJaxed, the stools are dark and oflFensive, and the urine is scanty. Sometimes the disease proceeds to a fatal termination, which is generally preceded by contracted pupil, occa- sionally strabismus, incessant low delirium, increase in the muscular tremor almost amounting to subsultus tendinum,' and other indi- cations of nervous exhaustion ; the pulse becomes thready, and at the same time more rapid, so that it sometimes can scarcely be counted ; cold sweats break out upon the skin, and the chillness (»f the surface increases, proceeding from the extremities to the trunk. Sometimes a calm supervenes shortly before death ; whilst in other instances the patient is carried oflf in a convulsion. On the other hand the bad symptoms may gradually abate, and the supervention of profound sleep gives to the exhausted energies of the nervous system the means of restoration. Sometimes, however, the recovery is never complete, but the patient remains in a state of Melancholia, with more or less of deficiency of intellectual power; and this more especially happens after repeated attacks of the disease. 27. Between the Dtiirium Ebriosum and the proper Delirium " Subsultus tendinum — a starting or spasmodic twitching of the teudona. ON THE HEALTHY SYSTEM. 41 Tremens, there are several intermediate conditions; the former, indeed, being very apt to pass into the latter, if depleting measures' be imprudently adopted. The latter may present itself, like the former, as the direct and immediate consequence of the excessive use of Alcoholic liquors; but there is this important difference, — that while the former is but an exalted manifestation of the primary excitement ordinarily produced by alcohol, the latter, supervening at the end of a prolonged debauch, is the consequence of exhauatinn produced by continued excitement. Delirium Tremens more fre- quently occurs, however, when the accustomed stimulus is with- held ; and it is then no less obviously the result of the previously exhauafrd condition of the nervous system, which nothing save the renewal of the potent stimulus can excite to anything like regular action. In fact, this terrible state is the manifestation of the disor- dered condition to which the brain has been brought by habitual excess, and plainly exhibits the complete perversion of its functional power and of its nutritive operations. In fatal cases, no morbid Appearances are found, that in the least indicate turgescence of the vessels or inflammatory excitement, unless the delirium have par- taken of the characters of that which directly arises out of intoxica- tion. And it is manifest, therefore, that the disordered condition must be in the nervous pulp itself, and that it must be of a kind to keep up morbid and irritative activity, at the same time that the tissue is incapable of exercising those reparative functions, which are carried on in the healthy condition during the state of repose. 28. Although, in the vast majority of cases. Delirium Tremens 18 the immediate or the consecutive result of the excessive use of Alcoholic liquors, yet it may occur independently of them ; but its other causes are such as resemble the excitement of alcohol, in pro- ducing exhaustion or depression of the nervous power, — such, for instance, as excessive depletion, the shock of severe injuries, or ex- treme cold. But in most of the cases in which one or other of these appears to be the exciting cause, a predisposition has been established by habitual intemperance ; and this has been especially remarked of the delirium traumaticum} 29. It is important to remark, that a slighter form of this disorder, marked by tremors of the hands and feet, deficiency of nervous power, and occasional illusions, will sometimes appear as a cons© quence of habitual tippling, even without intoxication having been once produced. And a still slighter manifestation of the want of control over the muscular apparatus — the treuibling of the hands in the execution of a voluntary movement — is familiar to every one aa extremely frequent among the habitually intemperate. We thus ' Depleting meaauret — whatever empties the blood-vessels ; bleeding, purg- ing, &o. 'Delirium trauma ticum — delirium from wounds or iigurieg. 4* M I «! 42 E-TSCTS OF ALCOHOL $0.0 that the disease is at least as much dependent upon the rllson fjrrrd utate of nutrition, consequent upon the habitual presence of alcohol iu the blood, as it is upon that positive exhaustion of nerv- ous power consequent upon the violence of the excitement, which is the more immediate effect of the stimulus. 30, Insanitj/. — Such being the case, we have no difficulty in understanding how the habitual use of Alcoholic liquors in excess becomes one of the most frequent causes of Insamti/, properly so called, i. e. of settled Mental Derangement. Upon that point, all writers on the subject are agreed, however much they may diflFer in their appreciation of the relative frequency of this and of other causes. The proportion, in fact, will vary according to the character of the population on which the estimate has been formed ; and also according to the mode in which it has been made. Thus, in Pauper Lunatic Asylums, the proportion of those who have become insane from Intemperance, is usually much larger than it is in Asylums for the reception of Lunatics from the higher classes, among whom intemperance is less frequent, while causes of a purely moral and intellectual nature operate upon them with greater inten- fiity. And again, if in all cases in which habitual intemperance has been practised, it be set down as the cause of the mental disorder, the proportion becomes much larger than it will be, if (as happens in many cases,) some other cause have been in operation concur- rently, and the disorder be set down as its result, no notice what- ever being taken of the habit of intemperance. This omission must bo particularly allowed for, when the relative proportion of intem- perance to other causes is being estimated in regard to the middle and higher classes ; on account of the strong desire which usually exists among the friends of the patient,' to conceal the nature of his previous habits, and to lay his disorder entirely to the account of the cause from which it has seemed immediately to proceed. 31. There can be no doubt that those who have weakened and disordered the nutrition of the brain by habitual Intemperance, are far more liable than others to be strongly aflfected by those causes, moral or physical, to which the Mental Derangement is more imme- diately attributable; so that the habit of intemperance has con- tributed, as a predisposing cause, at least as much towards its pro- duction, as what is commonly termed the exciting cause has done. In fact, of predisposing causes generally, it may be remarked, that their action upon the system is that of slowly and imperceptibly modifying its nutritive operations, so as gradually to alter the che- mical, physical, and thereby the vital properties of the fabric ; and thus to prepare it for being acted on by causes which, in the healthy condition, produce no influence. And although that one of the sonditions in previous operation is often singled outasMccaMM. from which the result may seem most directly to proceod, yet it ON THE HEALTHY SYSTEM. 43 frequently happens that it has really bad a far smaller share in the production of the disorder, than those remoter causes whose opera- tion has-been more enduring and really more effectual.' 32. In the Statistical Tables, published by the Metropolitan Commissioners of Lunacy, in 1844, comprehending the returns from 98 Asylums in England and Wales, we find that out of 12,007 cases whose supposed causes were returned, 1799, or nearly 15 per cent., are set down to the account of Intemperance; but besides these, 551 or 4-6 per cent, arc attributed to vice and sensuality, in which excessive use of alcoholic liquors must have shared. Moreover in every case in which Hereditary Predisposition was traceable, this was set down as the cause ; notwithstanding the noto- rious fact that such predisposition frequently remains dormant until it is called forth by habitual intemperance. It is not more correct, therefore, to regard this as the cause of the disorder, in all the cases in which it is traceable, than it would be to regard intemperance in that light, in every case in which the patient had previously in- dulged in alcoholic excesses. Of the 2526 cases, then, in which the disorder is attributed to hereditary predisposition, a considerable proportion might with equal justice be set down to the account of intemperance. And there can be no doubt that the same practice had a great share in the production of the disease in the 3187 cases set down to bodily disorder, and in the 2969 for which moral causes are assigned. 33. If we turn from this general statement to the experience of individual Asylums, we frequently find the proportion much higher; and curious variations are sometimes observable between the returns for successive years. Thus in the Glasgow Lunatic Asylum, ac- cording to the report of Dr. Hutcheson, the following were the proportions which Intemperance bore to other causes during seven years : — 91 Cases where Cases where Cases where Proportion per Yc.ir. Total number the ilinease the cauEie intemperance cent, of intem- of patients. was here- was un- was the perance to other ditary, &c. known. cause. cauix>a. 1840 149 3 34 20 134 1841 157 20 44 30 19-1 1842 199 64 20 46 231 184;} 327 116 38 31 94» 1844 390 77 41 63 18-2 1845 364 47 38 . 90 24-7 184G 414 49 62 105 25-3 Total 1 1900 366 277 375 19-7 1 ' See Mr. J. S. Mill's Elements of Logic, vol. i. p. 398. * This marked diminution in the per centage of ctises attributable to Intemporauce is chiefly due to the admission into the Glasgow Asyluio. V 44 EFFECTS OF ALCOHOL Of the great increase which presents itself in the numher of cases attributable to intemperance during the last two years of this return, Dr. Hutcheson thus speaks in his report for 184^6 : — ** This cause appears to have operated on patients of all ranks ; and I am inclined to think that this has been owing, in a great measure, to the excitement in which the community was kept, by that universal spirit of gambling which seized on society like an epidemic mania. Q^here is a great connection between general excitement and the craving for stimulants, as may be every day seen during contested elections, public dinners, races, &c. It is also a fact well known to those who have minutely studied the subject, that over-exertion of the brain leads to a desire for stimulants, which, however, are easily enough abandoned when the brain is allowed to rest." For the reason already given, it is probable that the average proportion of 197 per cent, does not by any means represent the entire num- ber of cases in which intemperance was the principal cause of the disease ; and that we should be within the truth in assigning to it at least a quarter of the whole number of cases. 34. In the report of the Aberdeen Lunatic Asylum for 1847, we find Intemperance specified as the cause in 17 cases out of 93 admitted; but of these 93, there were 8 cases in which hereditfry predisposition, and 11 in which predisposition from previous at- tacks, was assigned as the cause ; and there can be no doubt that of these 19 cases a considerable proportion n^ight be set down in part to the account of intemperance. In the report of the Dundee Lunatic Asylum, we find that 8 out of 52 cases admitted are set down to intemperance; 7 were hereditary; and in 4 the cause was unknown. In other Asylums, the proportion of cases returned as during the year 1843, of a number of Lun.atics who had previously been confined at Arran, for the most part during several years. Of the origin of their Insanity very little was known ; and they were chiefly assigned to the head of " Hereditary and Constitutional Predisposition," thereby di- minisning the per centnge of the other causes. Among the recent cases admitted during the year, however, the per centage attributable to intem- perance was decidedly less than usual ; which circumstance is attributed by Dr. Hutcheson to the improved condition of trade, which caused an adequate demand for labour. On this point he makes the following re- marks, in his report for 1842, p. 36 : — "It may be said, that when wages are low and occupation difficult to be obtained, men will have less money to spend, and consequently will drink less. A pictty extensive observa- tion of the diflFerent grades of the working classes, for upwards of fifteen years, has convinced me that this opinion is erroneous ; for I have gene- rally found, thai want and intemperance go hand in hand. Whenever a man falis below a certain point in physical comfort, he becomes reckless, and sensual enjoyment forms his only pleasure. To this he will sacrifice everything ; and habits of intemperance are frequently acquired in seasons of distress, which the individual, in more favourable circumstances, finds it impossible to lay aside." ON THE HEALTHS SYSTEM 46 due to Intemperance is much greater than in those already referred to. Thus in the Commissioner's report already cited, we find that in nine Provincial private Asylums, the proportion which the cbhcs asjiigned to Intemperance alone bears to those assigned to other causes, is no less than 32 -62 per cent.; independently of 6*67 per cent, which are set down to the account of " Vice and Sensuality." There is an Asylum in the East of London, where the proportion of cases attributed to intemperance alone amounted to 41*07 per cent. ; and those arising out of this in combination with other vices, to 22 per cent, of the whole number whose causes were assigned. And it is stated by Dr. Macnish, (op. Hf,, p. 193,) that of 280 Lunatics at that time in the Richmond Hospital, Dublin, one half owed their madness to drinking. 35. Oinomania. ' — There is one form of Insanity, which has bo peculiar a relation to the use of alcoholic liquors, as to call for par- ticular consideration in this place ) and in order that its characteri> may be presented in the most unexceptionable manner, the authot avails himself of the excellent account of the disease which is given by Dr. Hutcheson in the Report of the Glasgow Lunatic Asylum for 1842, (pp. 39-44) ; deeming its value sufficient to justify him- in presenting it without abridgment. The designation Oivomanid, he would remark, has been substituted by Dr. H. for the less ap- propriate terra Dipsomania used by other authors. " This forpi of mania," he observes, " is quite different from drunkenness, which, however, may lead to itj the diagnostic' mark of the disease being the irresistible propensity to swallow stimulants in enormous doses, whenever and wherever they can be procured. There are indi- viduals who at the festive board invariably become excited, if not intoxicated, but who are otherwise habitually sober, and in the course of the year drink much less than others who never appear to be under the influence of stimulants. Others indulge in their potations in a regular manner, and daily consume a larger quantity of liquor than is consistent with good health or sobriety. All these, however, possess self-control, and can at any time refrain from stimulants ; but those aflfected with the disease cannot do so, however convinced they may be of the impropriety of yielding to their propensity, or however desirous they may be to subdue it. I repeat, that the disease does not consist in the mere act or habit of becoming intoxicated ; but in the irresistible impulse which drives the unhappy being to do that which he knows to be pernicious and wrong, and which, in the intervals of his paroxysms, ho views with loathing and disgust. He derives no pleasure from taste, for ho gulps down the liquor of whatever kind it may be ; or from society, N 4 Hf ! J « Oinomania — wiue mania; nu inonUnate excessive quantities of intoxicating drinks. * Diagnostic — distinguishing. and uncoutruUuble thirst for 46 EFFECTS OF ALCOHOL for he ge^e^ally avoids society ; but ho only dcrlvofi a temporary satisfiiction from the gratification of his inHunn impulse, or rather from freeing himself from the overwhelming niixcry which the non- gratification of his impulse inflicts on him. The dJHcase appears in three forms— the acute, the periodic, and the chrnnio. " The Acute is the rarest of the three. I have seen it occur from hemorrhage in the puerperal state, in recovery from fevers, from excessive venereal indulgence, and in Hotne forms of dyspepsia. Whec it proceeds from any of the fir»t three cauHon, it is easily cured by restoring the strength of the patient. When it arises from the fourth cause mentioned, it is not so easily removed, and is very apt to assume the chronic form. " The Periodic or paroxysmal form is much more frequent than the acute. This is often observed in iitdividuals who have suffered from injuries of the head, females during pregnancy, at the cata- menial periods, on the approach of the eritit^al period and after- wards, and in men whose brains are overworked. When it occurs from injury of the head, the case is hopeless. In the other in- stances it may be cured. In some cmem it occurs whenever the individual partakes of stimulants. In thone, total abstinence is the only remedy. Like the form about to be mentioned, it is frequently hereditary, being derived from a parent predisposed to insanity or addicted to intemperance. In such cases, the probability of cure is very small. The individual thus affected abstains for weeks or months from all stimulants, and frequently loathes them for the game period. But by degrees he becomes unear^'1 him, weak and tremulous, incapable of any exertion either 1 uiind or body, his first feeling is a desire for stimulants, with every fresh dose of which he recovers a certain degree of vigour both of body and mind, till he feels comparatively comfortable. A few hours pass without the craving being so strong; but it soon returns, and the patient drinks till intoxication is produced. Then succeed the rest- less sleep, the suffering, the comparative tranquillity, the excite- ment, and the state of insensibility; and, unless absolutely se- cluded from all means of gratifying the propensity, the patient continues the same course till he dies, or becomes imbecile. This is that fearful state portrayed by Charles Lamb, in which reason revisits the mind only during the transient period of incipient ia toxication. '' It must be remarked, that in all these forms of the disease the patient is perfectly incapable of self-control ; that he is impelled by an irresistible impulse to gratify his propensity; that while the paroxysm is on him, he is regardless of his health, bis life, and all that can make life dear to him ; that he is prone to dissipate his property, and easily becomes the prey of the designing ; and that in many cases he exhibits a propensity to commit homicide or sui- cide. He is thus dangerous to himself and others, and however responsible he may have been for bringing the disease on himself, his responsibility ceases as soon as he comes under the influence of the malady. The disease, however, may not be brought on by the act of the individual ; and then it is clear at once, that neither di- rectly nor indirectly can he be deemed responsible. Put suppose that it were the vesult of bis previous conduct, I repeat that bow- ever culpable he may have been for that, he is not a responsible being while afflicted with the malady ; for I can see no distinction between this form of the disease and any other which has been in duced by the habits or acts of the individual. " The only chance of cure or alleviation, is from attention to the health, and abstinence from intoxicating liquors. Neither can be secured so long as the patient is at large ; and no amendment can be depended on, unless he has undergone a long course of discipline and probation. Considering, then, that the individual is irresponsi- ble and dangerous to himself and others — that, jf left uncontrolled, he will ruin his family — and that his disease can be treated only in an Asylum, it is not only merciful to him and his relatives, but necessary for the security of the public, that he be deprived of the liberty which he abuses and perverts, and that he should be pre- vented from committing crimes instead of being punished, or I should rather say, being the object of vindictive infliciiou after he has per f, :ll '4 '■t: u \i : if ErrecTB of alcohol peintod thorn. 80 convinced are some affected with the periodical form of tho dJHenso, of tho ncccsHity of being controlled, that, when the first HyinptoniH of their paroxysm are felt, they voluntarily enter an Asylum, and remain till the attack has passed off. These, how- ever, are men of iitronger minds, though, with all their strength, incapable of rosiNting the diiicaHe; and, surely, what they feel to be their only refuge to avoid the impending evil, it cannot be unjust or harsh to force on others whose minds are more impaired. Such oases soon become rational in an Asylum ; and when the individual can so far control himself as voluntarily to surrender his liberty on the first premonitory nymptoms of the malady presenting themselves, ho may be diMmiHNcd after a shorter probation. It is otherwise with those who have not that self-control, or who fancy that they are un- justly interfered with when clircked in their career. They require a much longer probation, which should be increased at each return of their nmhtdy, "Of the chronic form, I have seen only one case completely cured, and that after u icolusion of two years' duration. In general it is not cured ; and no sooner is the patient liberated, than he mani- fests all the symptotns of his disease. Paradoxical though the state- ment may appear to bo, such individuals are sane only when confined in an Asylum." The Superintendent of the Dundee Asylum, in remarking upon the frequent causation of Insanity by Intemperance, makes a very similar statement of the results of his observations ; and regrets that there are not in this country such Asylums as are understood to exist in the United States, for the reception of those incorrigible drunkards, in whom the power of self-control has been altogether destruyed by their repeated yielding to the craving for Alcoholic Btimulantg. 86. Mental Debility in the Offspring. — It is scarcely necessary to accumulate further proof in support of the assertion, that, of all the single oausos of Insanity, habitual Intemperance is the most potent, and that it aggravates the operation of other causes. We have now to show that it has a special tendency to produce Idiocy, Insanity, or Mental Debility, in the offspring. Looking to the de- cided tendency to hereditary predisposition in the ordinary forms of Insanity j looking al^o to the fact that any perverted or imperfect conditions of tho nutritive functions established in the parent, are *^ also liable to manifest themselves in the offspring, (as shown in the transmission of tho goutv and tubercular diatheses ') ; we should expect to find that the oflmpring of habitual drunkards would share with those of lunatics in the predisposition to insanity, and that > Tubercular diathesU — a oondition of the system predisposing to Ecrofula ir ooDsumption. t i 1 ON THEIIEALTIIY SYSTEM. 40 ccessary t, of all he most We Idiocy, the de- forms n perfect ent, are* in the should d share ad that eorofula (hey would, moreover, he especially prone to intoniporatc haMts. That such is the case, is within the knowledge of all who havo enjoyed extensive opportunities of observation ; and the fact has cnnie down to us sanctioned by the experience of antiquity. TIiih Plutarch says, "One drunkard begets another;" and Aristotle remarks that " drunken women bring forth children like unto them- selves." Dr. W. A. F. Browne, the resident Phyf^itian of the Crichton Lunatic Asylum at Dumfries, makes the following state- ments: — ** The drunkard not only injures and enfeebles his own nervous system, but entails mental disease upon his family. His daughters are nervous and hysterical; his sons are weak, wayward, eccentric, and sink insane under the pressure of excitement, of some unforeseen exigency, or of the ordinary calls of duty. At present I have two patients who appear to inherit a tendency to unhealthy action of the brain, from mothers addicted to drinking; and an- other, an idiot, whose father was a drunkard." ' The author has learned from Dr. Huteheson, that the results of his observations are precisely in accordance with the foregoing. — On this point, however, the most striking fact that the writer has met with, is contained in the Report on Idiocy lately made by Dr. Ilowe to the legislature of Massachusetts. " The habits of the parents of 300 of the Idiots were learned ; and 145, or nearly one-half, are reported as ' known to be habitual drunkawls.' Such parents, it is aflSrmed, give a weak and lax constitution to their children; who are, consequently, 'de- ficient in bodily and vital energy,' and predisposed by their very organisation to have cravings for alcoholic stimulants; many of these children are feeble and live irregularly. Having a lower vitality, they feel the want of some stimulation. If they pursue the course of their fathers, which they have more temptation to fol- low, and less power to avoid, than the children of the temperate, they add to their hereditary weakness, and increase the tendency to idiocy in their constitution ; and this they leave to their children after them. The parents of case No. 62 were drunkards, and had seven idiotic children." ' 37. There is a prevalent impression that idiocy is particulaily liable to occur in the offspring of a procreation that has taken place when one or both of the parents were in a state of intoxication. A striking example of this kind is related in the Phrenolotjical Jovr- nal (vol. vii. p. 471) ; both the parents were he» Hhy and intelligent, and one at least habitually sober ; but both were partially intoxicated at the time of the intercourse, and the offspring was completely idiotic. There is every reason to believe that the monomania of inebriety not only acts upon, and renders more deleterious, whatever • Moral Statistics of Glasgow, by Willinm Logan, 1849, p. 20. * American Journal of Medical Sciences, April, 1849, p. 437. 60 EFFECTS OP ALCOHOL I m 'm latent taint may exist; but vitiates or impain tlio sourccR of hoaltfc for Hevcral generations. 1'hat the effeets of drunki'iiness are hijriilj itiiuiieiii to u permanent healthy state of tlic hrain, is often proved at u i^reat distaneo of time from the course of iuteuipcranee, and hmg after the adoption of reguhir habits. J{H. /njhnnmiitnrt/ Diseases of the JJrai'n. — All medical writers ngreo in regarding Intemperance as one of the conditions which tends to produce Inflammatory/ diseases of the Knccphalon, now diHtingnislied as Cmhritis^ and Mniimjitis ;* and this is precisely what might be anticipated, when it is considered how great must bo the derangement of the circulating and nutritive operations, ocea- nloned by the presence of alcohol in the blood. An attack of acute Knccphulitis" not unfrequently supervenes upon a debauch, which is then regarded as its exciting cause.* But it may occur quite iude« p(!ndently of any special act of excess, in consequence of the pre- difiposition arising from the perversion of the normal functions, by the habitual use of alcoholic liquors in quantities that may never produce actual intoxication. Perhaps, indeed, this is the more com- mon occurrence. We have seen that the state of excitement first produced in most persons by the ingestion of alcohol, would pass into Mcningitlsy (or rather inflammation of the convolutions^) if it were not to subside with the elimination of the alcohol from the blood. On the other hand, the state of torpor of the mental func- tions, which alcohol produces from the first in some individuals, and which comes on in all if the intoxication be carried far enough, is indicative of that congestion of the substance of the brain, which, if confirmed, and accompanied by a certain disturbance of the nutri- tive operations, would become Oerehriti's.' There can be no hesita- tion, therefore, in admitting the relation of cause and eFect, in cas«ea in which it is so obviously established by the sequence of the phc- Domeoa. 89. There is another class of diseases of the Brain, which arti usually dependent upon structural changes that require a longei period for their development ; yet whose frequent connection with habitual intemperance is established both by theory and observation. These are Apoplexy, Paralysis, and Epilepsy. 40. Aj)opU'xy. — The state of profo\tnd Coma, characteristic of the advanced stage of intoxication, may be considered to be identi- cal with that of congestive apoplexy, in every respect save the nature • Cerebritia — inflammation of the brain. • Meningitis — iniiammation of the membranes of the brain. ' Kncpphalilia — inflammation of the brain. • See, for example, a fatal case related by Dr. Percy, Op. cit., p. 54. • Convolutions — the surface of the brain, which has an appeare-ace of ')fting convoluted or thrown into folds. Cerebritia — ii.flammation of the brain. ON THE HEALTHY SYSTEM. 51 54. re-ace of of its cfiu.V!, nnd its diiratiMti.' A portain dogroc nf tondonoy to Apopli'xy may be said to exist in the Hli|;lit.'r form of intoxication; the ves.sels of the Hrain heiiij^ congested, as a ponseqiienee of in- creased action of the heart, and ot* ohstruction to the encephalic circulation, such as ia occasioned by in»p 'rfcet discharge of the func- tions of the brain; and this obstruction being also favoured by that partial stagnation of blood in the lungs, which takes place whenever the respiratory movements are interfered with. This apoplectic tendency seems to render the intoxicated man peculiarly liable to imffer from causes, which would not otherwise produce rupture of the vessels; thus, there are numerous instances on record, in which blows received in pugilistic encounters, or other comparatively slight injuries, have occasioned fatal hemorrhage within the cranium ;' the sufferer having been previously dosed with spirits in such quantity as of itself to produce a state of congestion bordering on apoplexy. And it occasionally happens, though this is contparatively rare, that cerebral hemorrhage occurs without any external violence, after an excessive indulgence in spirituous potations. 41. But the influence of Alcoholic Liquors in the causation of Apoplexy is usually of a much more gradual nature. A large pro- portion of the cases of Apoplexy occurring in plethoric' sulyects, and not connected with disease of the heart or softening of the arterial coats, are traceable to intemperance in eating as well as in drinking; the latter, however, being the chief cause, inasmuch as, without the habitual assistance of alcoholic liquors, continual excess in eating would generally soon correct itself. Hence we find that such cases are rather apt to occur among those who take considerable quantities of wine or malt-liquor with full meals of solid food, than among the drinkers of spirits, who are seldom great eaters. It is not dif^oult to see the reason of this. For, on the one hand, the hab'i of excess in eating and drinking ha? a tendency to produce thut condition of Plethora,* which is most peculiarly prone to favoui hemorrhagic effusions; whilst; on the other, the ingestion of a large quantity of solid food, by causing pressure on the vessels of the abdominal viscera,* and by impeding the descent of the diaphragm,* • Although, as we have already seen, (§ 14,) the phenomena are so nearly identical, the difference in the etiology involves an important difference iu the treatment ; the comatose drunkard not requiring, nor bearing, the free depletion that is proper in a case of true congestive apoplexy. ' Hemorrhage within the cranium — an escape of blood from the vessels within the skull. ' Plethoric — faW of blood; full habit. • Plethora — fullness of blood. • Abdominal viscera — the stomach, intestines, liver, &c. ; the organs con- tained within the belly. " Diaphragm — a muscular partition which divides the cavity of the chest from that of the belly. ^ 62 EFFECTS OF ALCOHOL it I 'lill nwtM Sr.JfWi "i tends to force an unusual quantity of blood into the encephalic vessels, as well as to obstruct its return from them. Such an habitual derangement of the circulation may well be supposed to occasion a progressive weakening of the vessels of the brain ; and in this man- ner it happens that after a persistence for months or years in this course, Apoplexy may supervene, and be its legitimate consequence, without the attack being traceable to any extraordinary indulgence.' 42. Of the strength of the general opinion of the Medical Prt)- fession, — as to the tendency of Alcoholic stimulants to produce the sthenic* form of Apoplexy, it is impossible to give a stronger proof than the rigidity of the rule of abstinence which is laid down for those, in whom a disposition to it has already manifested itself. Now if it be necessary to lay down such rules to prevent the recur- rence of the disease, is it not most obvious that we are justified in attributing to an habitual violation of them its first occurrence? And if habitual excess be so obviously a predisposing cause, can we reasonably deny that the long-continued even " moderate" use of stimulants is likely to exert a slow, but in the end a decided in- fluence ? It is surely in vain here to reply, that as food is whole- some in moderation, but is hurtful in excess, so may alcohol be also ; for alcohol (as will be more fully shown hereafter) can never properly act as food, save when other alimentary matters are defi- cient; and even in the smallest and most diluted doses, alcohol exerts an influence on the vital properties of the tissues with which it is brought into contact, that is never manifested by proper ali- mentary matters. 43. Paraly&is^ and Epilepsy*. — As the conditions upon which the cerebral forms of Paralysis depend, are so nearly the same with those which induce Apoplexy, we cannot doubt that the con- tinual intemperate use of Alcoholic liquors must predispose to this disease, especially when it accompanies intemperance in eating; and should expect, too, that an attack of it may sometimes be traced to some particular excess, as its exciting cause. All medical writers accord in stating that such is the result of actual observa- tion; and here, again, we find in the rules of treatment laid down, an additional evidence of the general conviction of the tendency of alcoholic liquors, even in small quantities, to induce a recurrence of paralytic attacks. The writer has had opportunities of noticing ' There is evidence that habitually excessive use of Alcoholic liquors haa a tendency to produce Hemorrhages elsewhere, probably by diminishing the plasticity of the blood, and by impairing the nutrition of the walls of the blood-vessels.— (See §§ 52 and 68.) * Sthenic — attended with strength and not debility. ' Paralysis — palsy. * Epilepsy — a convulsive disease popularly Vnown as th« falling sick uesd. • ON THE HEALTHY SYSTEM. 58 ause, can (liis, in the case of two gentlemen advanced in life, each of whom suffered from repeated attacks of paralysis, which almost invariably supervened upon a violation of the habitual rule of abstinence from fermented liquors and of extreme moderation in diet. — Pre- cisely the same, too, may be said of Epilepsy/, which disease is now generally attributed to a disordered state of iiutrition of the brain, of which the paroxysm is the manifestation. Of this disordered Btato of nutrition, intemperance in eating and drinking is among the most frequent of the predisposing causes, especially when the disease occurs in persons advanced in life ; whilst in those who are already predisposed from these or other causes, the excessive use of fermented liquors is frequently the immediate or exciting cause of the paroxysm. 44. Besides these positive diseases, a premature exhaustion of Nervous power, manifested in the decline of mental vigour and of nervo-muscular energy, are ranked by common consent among the consequences of habitual excess in the use of Alcoholic liquors; «nd reasons will be given hereafter for the belief, that it is occasion- ally the direct, but more frequently the indirect consequence of the habitual employment of what is considered a very moderate allow- ance.— (See §§ 177, 178.) 45. In regard to all the forms of Encephalic disorder which result from the long-continued action of causes that impair its nutrition, it is to be observed that the habitual use of Alcoholio liquors has, — in addition to its direct action upon the functions of circulation and nutrition, — an important indirect agency; inasmuch as, by the temporary support it affords, it sustains the nervous ap- paratus under a degree of exertion that is in the end most injurious to it, and renders the whole system more tolerant of morbific causes of various kinds ; the manifestation of whose action, however, is only postponed, and becomes more severe in the end, in proportion to the duration of the agency. This indirect operation of alcoholio liquors, however, will be more fitly considered at a future period.— • C§ 198.) Diseases of the Alimentary Canal. 46. The disorders of the Nervous system, whose symptoms are among the most obvious and characteristic results of Alcoholic In toxicution, having been now considered, we proceed to examine the influence of Alcoholic liquors on the produ(^tion of diseases of the Digestive Apparatus. This influence is exerted in two ways; — first, by the direct irritating action of the fluid upon the mueous lining' of the Alimentary Canal*; and second, by the general de- ^Mucous lining — tho innermost coat. *Aliintntarij canal -•^\. oJu-nach tind intestines. ■Ill 89 j| ' J 64 EryECTS OP ALCOnOL tcrioration of the nutritive processes, resulting in various ways from the entrance of Alcohol into Blood. 47. Irritation and Injlammation of the Mucous Membrane of the Stomach. — That irritation would be produced in the very vas- cular mucous membrane of the Stomach, by the direct contact of Alcoholic liquors, and that this would vary in its intensity with the amount, concentration, and duration of the application of the irri- tant, is precisely what we should anticipate, from what has been already shown by observation to be the result of the application of alcohol to a living membrane. A small quantity of alcoholic liquor, diluted by the fluids already in the stomach, appears to produce only the first efi^ect, namely, a quickening of the circulation, and a tem- porary exaltation of the functional activity of the organ, as shown in the increase of appetite and of digestive power. But when a larger quantity is introduced, and especially when successive doses are taken so as to keep up the irritation, or when the alcohol is in a state of high concentration, and the stomach contains but little other fluid, all the effects of an irritant are produced, varying from moderate congestion ' with diminished functional activity, to intense congestion passing into inflammation, and even to a gangrenous state. The more severe effects, however, are not often seen; in consequence, it may be surmised, of the rapidity with which the alcohol has been absorbed, (§ 18), and the brevity of the duration of its contact with the membrane, shielded as this is with its coat of mucus. Hence a repetition of the dose seems more likely to produce a state of high irritation, or of inflammation, than any single dose, unless this have been too great '^^o be quickly absorbed. 48. The morbid appearances found in the Stomachs of men or animals killed by narcotic' poisoning, and attributable at first sight to the direct influence of the irritant, can seldom be fairly regarded in that light ; since they are for the most part such as are producible by the Asphyxia, which has been the immediate cause of death. When we find general injection of the mucous membrane, local patches of extreme congestion, numerous minute extravasations,' or hemorrhagic patches* of large extent, these are more likely to have been the result of the stagnation of the pulmonary circulation, act- ing backwards upon the whole venous system, than to have been the immediate result of the contact of alcohol j since appearances precisely similar are found when death has taken place from sufl'o- cutiou in other modes, — e. g. in Criminals executed by hanging. In ' Congestion — too great fullness of the blood-vesselb * Narcotic — having the power to dimi.iish sensibility and consciousness i — opium may be taken as the type of the narcotic poisons. ^Extravasations — spots where blood has escaped from the vessels be- neath or within the substance of the membrane. * .Uemorrhagic patches — siir/.lar extravasations of greater extent. ON THE HEALTHY SYSTEM. 55 the case of animals poisoDed by Alcohol, it frequently happens that scarcely any positively morbid appearances are discernible in the stomach ; and the departures from the healthy character which are noticed in the stomach of the human subject after death from alco- holic poisoning, are most frequently such as indicate an altered state of its nutrition, consequent upon habitual irritation. Of these de- partures, a ihickened state of the mucous membrane seems to be the most constant; the membrane being sometimes softened (as stated by Dr. Ogston); sometimes unusually firm, corrugated,' and pale ("as observed by Dr. Peters). These last appearances seem to have been most common, when a quantity of undiluted Spirits had been taken shortly before death, and to have resulted from that physical action exerted by them upon the membrane, to which reference has already been made (§ 2, 3). It sometimes happens, however, that after the narcotic eflPects of the Alcohol have passed off, another set of symptoms appears, indicative of inflammation of the Alimentary Canal ; and if these proceed to a fatal termination (as now and then occurs), the usual appearances indicative of that state are found in the gastro-intestinal mucous membrane.' In one example of tlii. 'cind, cited by Dr. Christison, the whole villous coat' of the stumc ' vni^ in a gangrenous state, the colon* was much inflamed, and th s. ^:. intestines red along their whole length. 49. Our best ^uiormation as to the efiect of Alcoholic liquors upon the condition of the Gastric mucous membrane during life, is derived from the well-known observations of Dr. Beaumont in the case of Alexis St. Martin. This man appears to have been habitu- ally temperate and healthy ; but to have occasionally indulged in excess both in eating and drinking, the results of which could be seen by direct observation through the fistulous opening in the parictcs of his stomach. Thus, says Dr. Beaumont, under the date July 28th, 1833, — "Stomach not healthy, some erythema," and aphthous^ patches on the mucous surface. St. Martin has been drinking ardent spirits pretty freely, for eight or ten days past, — complains of no pain, nor shows symptoms of general indisposition, — says he feels well, and has a good appetite. August 1st, — Inner membrane of the Stomach morbid; considerable erythema, and some aphthous patches on the exposed surface ; secretions vitiated. August 3rd, — Inner membrane of Stomach unusually morbid ; the ' Corrugated — thrown into folds, puckered. " Gastro-intestinal mucous membrane — the lining mdmbrane of the stomach and jf^testines. ' Villous coat — the innermost or lining membrane; its surface being supposed to resepible velvet. • Colon — the largest of the intestines. • Erythema — superficial inflammation like erysipelas. • Aphthous patches — small ulcers, covered with a whitish matter. \ b-l rm 06 EFTECTS OP ALCOHOL ih erythematous appearance raorc extensive, and spots more YiwJt than usual, from the surface of which exuded small drops of grumous' blood; the aphthous patches larger and more numerous; the mu- cous covering thicker than common, and the secretions much more vitiated. The gastric fluids extracted this morning were mixed with a large proportion of thick, ropy mucus, and considerable muco-purulent* matter, slightly tinged with blood, resembling the discharge from the bowels in some cases of chronic dysentery." Now, it is very important to remark, that all this disorder was proved by direct observation to be actually existing in the Mucous coat of the stomach, without any such manifestation of it by general or local symptoms, as would by themselves have been thought in- dicative of its presence. — " For," continues Dr. Beaumont, " St. Martin complains of no symptoms indicating any general derange- ment of the system, except an uneasy sensation, and a tenderness at the pit of the stomach, and some vertigo, with dimness and yel- lowness of vision on stooping down and rising again ; has a thin yellowish brown coat on his tongue, and his countenance rather sallow ; pulse uniform and regular, appetite good, rests quietly, and sleeps as well as usual." By the 6th of August, the inner surface of the stomach had recovered its healthy appearance; the patient having in the meantime entirely abstained from all alcoholic liquors, and having been confined to low diet. Dr. Beaumont further states that <' diseased appearances similar to those mentioned above, have frequently presented themselves in the course of my experiments and observations. They have generally, but not always, succeeded to some appreciable cause. Improper indulgence in eating and drinking has been the most common precursor of these diseased conditions of the stomach. The free use of ardent Spirits, Winef Beer, or any intoxicating liquor, when continued for some days, huH invariably produced these morbid changes." 50. From the precise concurrence of these Observations with what Theory would lead us to expect, in regard to the action of Al- coholic liquors on the Mucous membrane of the stomach, it is obvi- ous that we have no right to suppose that the peculiar condition of St. Martin gave him any peculiar liability to suffer in the manner above described. On the contrary, such disorders of the circula- tion, nutrition, and secretion might be anticipated to occur in every case ; and it is only because they are not immediately indicated by pain and heat in the stomach, by loss of appetite, or by general febrile disturbance, that they are presumed not to exist. This pre- sumption, however, has been shown to be altogether fallacious ; and wc have adequate reason to believe that some sucb condition must ' Grumous — clotted, thick. ' Muco-j)urulenl — a mixture of mucus and matter. i Ik! I ?1 ON TIIS UEALTIIY SYSTEM. 57 bo tbe result of e^ery excess in the use of alcoholic liquors, however little it may be indicated by the local or general symptoms. 51. Injlammalory Gastric Dyspepsia. — It might be anticipated, then, that habitual excess would convert this state of occasional and transient disorder, which only requires rest and abstinence for its cure, into one of a more persistent and obstinate character ; which, by unfitting the stomach for the discharge of its normal functions, would seriously impair the general nutritive operations. Such has been shown by experience to be the case ; a special form of dys- peptic disorder, termed Inflammatory Gastric Dyspepsia^ being well known to practical men, as common among those who have freely indulged in alcoholic potations. Of this disorder, the follow- ing are the symptoms, as enumerated by Dr. Todd : ' — '' Painful digestion, sense of heat, tenderness, or pain at the epigastrium,' in- creased upon taking food, or on pressure; thirst; tongue more or less of a bright red colour, sometimes brownish red, sometimes dry, glossy, and adhesive ; taste saltish or alkaline, occasionally like that of blood; bowels generally confined; urine high-coloured; skin dry, with occasionally profuse, partial sweats, chiefly in the direc- tion of the extensor muscles ; temperature of the trunk increased, of the extremities diminished, except occasionally in the palms of the hands and soles of the feet, which, especially at night, are fre- quently hot, dry, and burning ; aggravation of the symptoms under the use of stimulants or of irritating ingesta." ^ The various stages and degrees of the disease are characterized by various modifications of these symptoms, many of them the consequences of the disturb- ance of the nutritive functions produced by the disorder of the sto- mach ; but of all such consequences it may be remarked, that they are probably aggravated by the previous disturbance of the nutritive and secretory operations, consequent upon the habitual introduction of alcohol into the blood. Thus we find a special tendency to cuta- neous eruptions, such as Erysipelas,* Lichen,* Erythema,* Urticaria,' Psoriasis,^ and Pityriasis ; ^ to sluggish and imperfect action of the Liver; to scantiness in the secretion of the Kidneys; and to de- pression of spirits, with inability for active mental exertion, passing on, in the more confirmed states, to complete Hypochondriasis. Although excess in eating may aid in the production of thia ' Cyclopaedia of Practical Mediciue, Art. Indiyestion. ^Epigastrium — the region of the stomach. ' Ingeala — substances taken into the stomach. , * Erysipelas — inflammation of the skin. * Lichen — an eruption upon the skin of red pimples. • Erythema — superficial inflammation. '' Urticaria — the nettle rash. • Psoriasis — a disease of the skin attended with patches of rough scaK'S. ^Pityriasis — a disease of the skin characterized by irregular putchcB of tliia scales. ii ll 68 EFFECTS OF ALCOHOL ill wretched condition^ yet, as Dr. Todd remarks, it is rather due to the stimulatiDg quality of \7hat is taken into the stomach, than to its quantity ; and although it may occasionally arise from the habitual use of highly-seasoned food without the proper dilution by bland liquids, yet it is much more frequently brought on by indulgence in alcoholic potations ; " it is the dyspepsia of the Dram Drinker and Opium Eater, and belongs altogether more to the Drunkard than to the Glutton." In the treatment of this disease, the complete disuse of stimulants is found to be of the greatest importance; not- withstanding that, in the more chronic forms of it, a temporary alle- viation is sometimes obtained from small quantities of alcoholic liquors.' 52. Disorders of the Intestinal Mucous Membrane. — The disor- dered state of the gastro-intestinal mucous membrane' is not limited, as we have seen, to the stomach, and it may extend itself along the whole course of the Alimentary Canal, to parts with which the Al- coholic liquors themselves have not come in contact; so as to be pttributable rather to the general imperfection of the nutritive ope- rations, than to the local effects of the stimulant. Thus we find that habitually intemperate persons are subject to soreness, redness, and ulceration of the membrane of the nose, and of that of the lower part of the intestinal canal; and hemorrhages* from various parts of this membrane, as well as from the mouth itself, arc of no unfre- quent occurrence, — the escape of blood being obviously dependent in part on its own insufficient plasticity,* and in part upon the soft- ened condition of the walls of the vessels. It is important to bear this in mind, as increasing the probability of the same cause being concerned in the production of a similar softening elsewhere ; as, for example, in the vessels of the Brain. — (See § 41). 53. Where, in place of excessive indulgence, what is commonly considered a moderate use has been made of Alcoholic liquors, we cannot with the same confidence attribute to it any decided depar- ture from the healthy condition of the Stomach ; and it is certain that the mucous membrane becomes in time so habituated to its presence, that its contact no longer produces the same effects as it does on a membrane unaccustomed to it. But we shall hereafter (§ 160-162) find reason to believe, that such habitual use is not without its consequences, although these may be very remote ; the continual over-excitement of the vital activity of the gastric mucous membrane being probably one of the causes of that premature loss ' See the observations of Sir Philip Crampton on this subject, in Dublin Hospital Reports, vol, i. p. 349. ^Gastro-intestinal mucous membrane — inner or lining membrane of the stomach and intestines. » Ilemorrhagea — discharges of blood. * Flasticiiy — consistence, capacity to become organized. of fur who This with tcui, very ON THE HEALTHY SYSTEM. fiO of functional power, which is observable in a great number of those who have accustomed themselves to the use of alcoholic linuors. This cause, however, will seldom act alone; being usually combined with excess in diet, and with "wear and tear'* of the general sys- tem, as will be shown in its proper place ; so that its operution is very liable to be overlooked. Diseases of the Liver. 54. That habitual excess in the use of Alcoholic liquors must have a direct tendency to produce i/^rt?'*' seases of the Liver, will be questioned by no one who co -^erB t mode of intrcdu( i*>n into the system, and their influence on the condition of the blood. The blood which returns from the gastric veins charged with Alco- hol, is immediately transmitted through the Liver; and it stimulates this gland for a time to increased activity, one effect of which is to eliminate a portion of the alcohol from the blood, — this substance, according to Dr. Percy's observations, being detectible in the bile of animals poisoned by alcohol. Hence the Liver, like the stomach, is subject to habitual over-stimulation from the direct contact of alco- hol with its substance. But we have seen that the presence of alco- hol in the blood prevents it from acquiring its proper arterial chunic- ter by passage through the lungs ; and we shall hereafter And that it causes the undue retention in it of hydro-carbonaceous matters,' which ought to be removed by the respiratory process. Hence an undue amount of labour is thrown upon the Liver, — one of the functions of this Gland being, to separate from the blood such hydro-carbona- ceous matters as are not carried off by the respiratory organs ; and this continual over-work must predispose it to various disorders, 55. Acute and Chronic Inflammation of the Liver.— In tropical climates acute injiammatory diseases of the Liver are among the most common of these disorders; and they are distinctly traceable, in a large proportion of cases, to that excess both in eating and drinking, to which Europeans are unfortunately but too prone; being rare among the Natives, and almost equally rare among the Europeans who adopt the native manner of living. In this country such acute diseases are comparatively rare ; but there are certain remote consequences which are no less clearly traceable to chnmic iiijlammation and degeneration, resulting from the execssive use of fermented liquors, especially when these are taken in the form of distilled spirits. — The following is the account of the state of tho Liver given by Dr. Peters (loc. cit.), as presented in the sevcuity cases which he had an opportunity of examining. **In 'inodcmto drinkers,' the liver was generally found to be somewhat largcir tli;in HI ' Hydro-carbonaceom matters — substances composed of liyJrogPii jiixJ carbon. fiO EFFECTS OF ALOOIIOL usual, its texture softened, and its outer Hurfaco ipottcd, with pntchcf of fatty infiltration extending two or three linos into the parenchy- matous' substance; the rest of the vIhcus rotnining its natural colour, and its edges their normal sharpnoM. In those who had been more addicted to the use of spiritH, tho liver wan still larger, its edges were more obtuse, and the patchog of fat on hn surface were larger and more numerous. In old drunkardn the liver was very large, weighing at least six or eight poundi, often from ten to twelve ; the edges were very thick and much rounded ; the paren- chyma* almost white with fat, soft, fragile, and the peritoneal cover- ing could be torn oflF with ease." It is evident that in all these cases, the Liver was the subject of various degroei of fatfj/ (fpf/eneration, which takes place, on the one hand, as the reiuit of deficient func- tional activity of the Gland, whilst on the other it is indicative of an excess of fatty matter in the system. 56. The peculiar conditions of the Liver known as "granular liver," and " hob-nailed liver," or "gin liver," were comparatively rare in Dr. Peters's experience, being obtiervod onlv in four or five cases; but they seem to be much more common jn this country; and its greater prevalence may possibly be due to ft difference in the character of the spirit usually employed by drinkers among the lower classes. Gin being here the most common, nitm and Brandy in the United States. These conditions appear to be dependent upon atrophi/'' of the proper hepatic BubBtunce, with hypertrophy* of the connecting areolar tissue ; the former being apparently the result of the exhaustion of the functional power of the liver by over- excitement; and the latter to continual attacki of chronic inflamma- tion, which produce the false membranes, adhesions, puckerings,&c., that give rise to the second of the designations just cited. Between the state of contraction (in which the Liver is frequently not more than half its usual size), and the state of enlargement just described, there is not that opposition which might at first sight appear ; for in both is there diminished functional and nutritive activity of tho proper substance of the gland ; and the state of enlargement, which is simply dependent upon the accumulation of fatty matter, not un- frequently gives place to one of contraction. In tact, it would not seem improbable that each state may have a relation to the general disposition to the development of fat, in the individual ; for whilst ir. many habitual drunkards there is a great tendency to the produc- tion of fat, and to its deposition in various parts of the body (§ 61), (here is an equal tendency in others to a leanness which no fatten- » Parenchymatous substance — the substance or tl«9U0 of the gland. * Parenchyma — see the preceding note. * Atrophy — a wasting away, diminution of bulk. Hypertrophy — excessive growth, augmentation of balk. ON THE HEALTHY SYSTEM. 61 ing p/'occss will overcome. — Certain it is, however, that the habitual use of Alcoholic liquors has a tendency 6rst to excite and then to diminish the functional activity of the Liver; and thus predisposes in the first instance to inflammatory diseases of the organ, whilst its more remote operation is to induce atrophy or degeneration. This will be especially the case in tropical climates; where several causes concur (as will be shown hereafter) to augment the injurious influ. ence of Alcohol upon the Liver, and consequently to increase the amount and severity of the diseases of that organ induced by its habi- tual use. — Of course, every disturbance of the function of the Liver must be an additional source of disorder in the digestive operations, in which the action of this gland has so important a share. Diseases of the Kidneys. 57. We have seen that a special determination of blood to the Kidneys takes place as one of the results of the reception of Al- coholic liquors into the blood ; and these organs are thereby excited to augmented action, one of the purposes of which would seem to be the removal of the alcohol from the current of the circulation. As the blood of the Kidneys is derived from the arterial system, in which the alcohol becomes diluted by the whole mass of san- guineous fluid; and as the alteration in the constituents of the blood which it tends to produce, has less relation to the function of the kidneys than to that of the liver; it might be expected that excess in alcoholic liquors should not have the same tendency to produce acute inflammatory attacks in this organ as in the other, although it may act as the exciting cause of such attacks (as ap- pears to be frequently the case), when the predisposition has been established by other agencies. But we should expect that tho habitual use of alcoholic liquors in excess would have a special tendency to produce a state of chronic irritation, passing into chronic inflammation, with various consequent alterations in the structure, and deterioration in the function, of the Kidneys. — Such we have every reason to believe to be the usual origin of that mor bid condition commonly known as Bright's Disease, or Granular Deyeneration of the Kidneys, which is now generally considered by Pathologists as a result of chronic inflammation and atrophy of the proper substance of the Kidney, with deposits of fatty, albu- minous, or other unorganizable matters, — a state, in fact, very closely resembling the degenerated conditions of the Liver already described. Now of this disease Dr. Christison states that from three-fourths to four-fifths of the cases which he met with in Edin- burgh, were in persons who were habitual drunkards, or who, with- out deserving this appellation, were in the constant habit of using ardent spirits several times in the course of the day; and the ex- perience of English Hospital practice is (so far as the writer has 6 A" 'It i li 1^ m KFFKCTH OP ALCOHOL beon ablo to Mcarin'm) prnciMcly sitnilur. The disease is very rarely met w"*S in the privuto practice of those, whose patients are of a class not given to cxccHsive spirituous potations. Here, too, it would seem as if the use of mult spirit (Gin or Whiskey) gives a greater predisposition to the disease, than that of Rum or Brandy; the former having a more diuretic effect than the latter, that is, producing a groutcr toniporarv activity in the kidneys, and having a greater tendency to brmg about a state of chronic irritation. 68. But wo arc not to suppose that, if this severe form of renal disease be not developed, the Kidneys escape altogether free. We should expect that the consequences of long-continued and habitual excitement would manifest themselves in subsequent impairment of functional power, even if no obvious structural disease be engen- dered ; and there can be little doubt that such is the ease, since we find that persiuw advanced in life, who have habitually indulged freely, even if not excossively, in Alcoholic liquors, are extremely apt to suffer from Gout, Rln umntism, and other disorders, which mainly depend upon the insufficient elimination of such morbid matters from the blood, as ought to be carried forth through this channel (§ 00). Excesses in diet, which, at an early period of life, are counteracted by the activity of the excretory apparatus, are no longer thus prevented from giving rise to an accumulation of morbific' products in the blood, when the Kidneys begin to fail in the perfor»)anco of their duty; and although we may not be able with positive certainty to attribute this failure to free indul- gence in alcoholic liquors, yet it cannot be reasonably questioned that such habits must tend to produce it, — since we find that over- excitement of avi/ organ is regularly followed, sooner or later, by depression of its functional power, and have seen that the continual stimulation of the Kidney by alcohol has a special tendency to produce perverted nutriti(»n, and thus to render it entirely unfit for the performanco of its duties. DUcascs of the Skin. 59. The determination of blood to the Skin, which has been noticed as one of the results of the ingestion of Alcoholic liquors, hability to a chronio though slight perversion of the nutritive operations of the skin, in consequence of the presence of alcohol in the blood. Of this dis- ease Dr. Darwin says : " Elderly people who have been much ad- dicted to spirituous drinks, as beer, wine, or alcohol, are liable to an eruption all over their bodies, which is attended with very afflicting itching, and which they probably propagate from one part of thtir bodies to another, with their own nails, by scratching them- selves." Dr. Macnish states that ho has himself seen many cases of this disease.' Most other cutaneous* disorders, which are less directly traceable to intemperate habits, are greatly aggravated by them ; so that strict abstinence from fermented liquors is an almost invariable rule in the treatment of them, unless the use of these in small quantities should be thought requisite to improve the state of the digestive function. General Disorders of Nutrition. 60. Having thus considered the principal forms of disease which the intemperate employment of Alcoholic liquor has a tendency to induce in tho several parts of the Excretory apparatus, to winch tliey seem to give a special determination, we have now to consider those General Disorders of Nutrition, which are traceable to the same cause, whtch manifest themselves either as substantive dis- eases, as modifying the course of other diseases, or as giving a special liability to the action of other morbific causes. — We have ' Acne rosacea — red pimples or tubercles upon the nose and face. ^ Psora ebriorum — the drunkard's itch. 'Anatomy of Drunkenness, p. 178. * Cutaneous — appertaining to the skin. 64 EFFECTS OP A T, C II O L ftlrondy spnkon of tho dotorioratlnj;; cffoft of the adinlxtnro of AUo- hoi with tlio IJlood ; how it lowers the plasticit)^ of tho (ibrino, k'tuls to empty tho rod corpuscles, and in vurious ways impedes tho process of aeration ; and another less direct but not l<'*is important source of deterioration, is to be found in the imperfect elimination' of tho constituents of the Bile and Urine, which must bo the con- scqucnco of functional inactivity, still more of structural degene- ration,' of tho Liver and Kidneys. Ilenco it would seem impos- niblo that by such a pabulum the formation of tho solid tissues can bo normally sustained ; and we should expect to find that tho nutritive processes are not performed with the same energy and completcneHs in tho habitually intemperate, that they are in tho habitually abstinent. NotwithstJinding some appearances to the contrary, there is abundant evidence that such is the case Although a high degree of bodily vigour seems to bo exhibited by certain classes of men, who consume large quantities of fermented liquors, yet this is extremely deceptive, as the facts to be presently stated will clearly indicate ; and the general result is evidently on the other side. (11. Tf^tJcnn/ to the Dej)ositlon of Fat. — The immediate effects of Alcoholic liquors upon the general appearance of the body, especially as regards the deposition of fat, vary with their nature, and with the circumstances under which they are habitually used. Thus it is generally to be noticed that those who indulge largely in malt. liquors become fat, and often exceedingly corpulent; the large consumers of wine commonly share the same tendency; but the .spirrt-drinkcr is more commonly lean and even emaciated. This difference may partly depend upon the constitution of the liquoi-s ; thus ale, boor, &c., contain a c. isiderable amount of saccharine * matter, which is either consumed in respiration, leaving the fatty matters of the blood to be deposited as fat, or is itself converted into fat; in wine, again, there is more or less of solid matter, which furnishes materials for combustion ; whilst in distilled spirits, there is scarcely anything save the alcohol. But it also depends in part upon the amount of solid food habitually taken with the drink; thus the beer-drinker, if he be leading a life of great muscular exertion, may find his appetito but little impaired by his excess; tho wine-drinker also usually feeds high ; whilst the spirit- drinker, especially among the poorer classes, takes his dram instead of solid food, for whigh he has neither appetite nor pecuniary means. The corpulence of the beer and wine-drinker, however, (seldom continues to old age; and. the parts which first begin to shrink are the logs, after which the shoulders generally give way, ' Elimination — separation, removal. • Structural dcyeneralion — diseased state of the substance of the organ. ' Saccharine — having the sweetness and characters of sugar. 1 1 ON THE II K A T, T H Y H Y 8 T E M . CO ami thft wliolft body bopomoa looso, flabby, and inolastic, tho nbdo- iin'ii nloiiu retaiuiriMT its itrntubcriincc, in ('(»nstM|U('n(M! of tlio Iar;j:t» deposition of fiit in tho omentum, ' wliieh is riircly al)sorb(vl. SucI' a deposition of fat is almost invariably found in thu omentum of confirmed Hpirit-drinkers,' notwithstanding its absence elsewhere. 62. A general corpulence of the body, however, can by no means be admitted as an indication of healthy nutrition; indeed it must be regarded as very much tho reverse. No animal in a state of nature exhibits any considerable deposit of fat, except for some special purpose (as in the case of Cetaeea' and otiior warm-blooded animals inhabiting the water, where tho coating of fat serves as a non-conductor; or in the case of hybcrnating mammals,* as also of many birds, whose autumnal accumulation of fat is destined . ) make up for the deprivation or deficiency of food in the winter) : and when by a change of habits the dopositicm of fat is artificially promoted, it is obvious that the niuseulai vigour and general '' hardiness" of the system are much impaired, the animal becoming liable to many disorders from which it was previously exempt, and requiring much more careful treatment to keep it in good condition. When, indeed, wo find a tendency to the deposition of fat, not in addition to, but instead of, the normal tissues, the case is one of •' fatty degeneration," and must be regarded as a positive disease, — involving as it does, a general functionary inactivity.® 63. Diminished Power of Sustainin;/ Injuries hy Disease or Accident. — The classes of men among whom there is an appearance of remarkable bodily vigour, notwithstanding habitual excess in tho use of Alcoholic liquors, are those who are continually undergoing great muscular exertion, and who not only drink largely, but cat heartily. Of this class, the London Coal-heavers, Ballasters, and Brewers' Draymen are remarkable examples; many of them drink from two to three gallons of porter daily, and even spirits besides , » Omentum — a fatty membrane covering the bowels in front. * Dr. Peters, loc. cit. » Cetacea — the wLale kind. * Hybernatinff — animals that sleep or become torpid during the winter , Uammala — animals that suckle their j'oung. * The following interesting case is recorded by Dr. Kob'^ridon (Treatise ^n Diet, 4th Edition, vol. i. p. 272). The subject of it was a very young man, who died thus early from the intemperate use of spirits. For several months before his death, he had been unable to eat, more than a very small quantity of food, and his powers were almost exclusively maintained by frequent dram-drinking. The immediate cause of death was cerebnil ♦' ramollissement (softening) ;" but although the body was much attenuated, the muscular fibre of the system much wasted, and the sub-outaueous fiit of the extremities had almost disappeared, on cutting througli the abdomi- nal walls to examine the condition of the liver, at least three times the usual thickness of fat had to be divided. 6* H ! III -y " \ '■ 60 EFFECTS OF ALCOHOL they are for the most part large, gross, unwieldy men, and are c'a]»a. ble of great bodily exertion, — so long, at least, as their labour is carried on in the open air,' But it does not hence follow that they are in a condition of real vigour ; for the constitutions of such men break down before they are far advanced in years, even if they do not earlier fall victims (as a large proportion of them do) to the results of disease or injury '/hich were at first apparently of the most trifling character. It is well known to those who have ob- served the practice of the London Hospitals, that when such men suffer from inflammatory attacks, or from local injuries, these arc peculiarly disposed to run on to a fatal termination ; in consequence, it is evident, of the deficient plasticity* of the blood, of the low assimi- lative power of the solids, and of the general depression of the whole vital energy, resulting from habitual over-excitement. The want of plasticity of the blood gives to the inflammatory processes an asthenic* instead of a sthenic * character ; there is no limitation by plastic efl'u- sion,* but they spread far and wide through the tissues ; depletion cannot be borne ; and the only hope of success lies in the use of opium and stimulants with nutritious diet, to sustain so far as possi- ble the prostrated energy. Thus we see that in such men the slight- est scratch or bruise will not unfrequently give rise to a fatal attack of Erysipelas ; and that internal organs affected with inflammation rapidly become infiltrated with pus,' or pass into a gangrenous' state. Hence the Surgeon is very unwilling to perform severe ope- rations upon them, knowing that their chance of recovery is but small. — The condition of these men in regard to recovery from inju- ries, is in remarkable contrast to that of men who have been " trained " to pugilistic encounters ; the latter having been brought to a condition of the highest possible health, by active exercise, abundance of nutritious food, occasional mild purgation, and either entire abstinence from fermented liquors, or by the very sparing use of them. Men thus "trained" recover with remarkable rapidity from the severe bruises which they are liable to receive, 64. Although there are now few men who habitually take %cln6 to a corresponding extent, or who maintain by active exercise in the open air any thing like the same muscular vigour, yet such exam- ples are occasionally met with among the fox-hunting country ' See Appendix A, » Plasticity — adhesiveness, disposition to become organized, » Asthenic — wanting strength ; attended with debility, * Sthenic — vigorous ; unattended with debility, » Plastic effusion -^ a separation from the blood of an adhesive substance, which, by uniting together the parts surrounding the inflammation, pre- vents its spreading. '^ Pus — matter produced by ulceration or in a certain stage of inflam- inatioa. ' Gangrenous — mortified ; dead and decomposed. ON THE HEALTHY SYSTEM. 67 stjuires, who spend their whole days on horseback, and pas» their evenings in drinking port wine. Of these, also, the same remark may bo mnde ; that notwithstanding their appearance of vigour, they are bad subjects for medical or surgical treatment, owing to the imperfect condition of their nutritive functions.' Among the spirit- drinkers of our large towns, it is notorious that the nutritive and reparative powers are low; and of this fact we have a remarkable illustration, in the frequency, among the intemperate, of a certain form of phagedenic'' ulceration, whose origin is suflSciently indicated by the term " Geneva-ulcer," by which it is commonly known at Guy's and other Metropolitan Hospitals. This ulcer, usually com- mencing on the leg, begins as a red, angry, and painful spot, which passes into an open sore; and this increases rapid' j, both in depth and breadth, so as even to involve the whole surface of the calf, laying bare the muscles, tendons and nerves. It is not con6ned, however, to ^'ui-drinkers, but is occasionally met with in the bloated, plethoric, rec. aced wine-bibber. 65. LiahiUty to Epidemic Diseases. — Another most important indication of the disordered state of Nutrition, consequent upon habitual excess in the use of intoxicating liquors, is the liability of the intemperate to suffer from various other morbific causes,' espe- cially those of an Epidemic or Pestilential nature. On this last point, there is, the writer believes, no difference of opinion amongst Medical Practitioners in any part of the world ; all being agreed that the habitual drunkard is far more likely to suffer from such agen- cies, than the habitually sober or temperate man. Whether habi- tual abstinence is still safer than habitual moderation, is a point which cannot be so easily ascertained ; some considerations on this subject, however, will be offered hereafter (§ 144-150). The pecu- liar liability of the habitually intemperate to suffer from the Cholera- poison, is well known. The following circumstance, which occurred during the former epidemic of Cholera, is very significant on this point; especially showing that the state ui depression which follows excitement is the one in which the system is most readily affected. The nurses in the Cholera Hospital at Manchester wert at first worked six hours, and allowed to go home the other six ; and the mor- tality was so great amongst then*, that there were fears of the failure of trie supply. It was found, however, that they were much given to Alcoholic potations (with the idea, probably, of increasing their power of resisting the malady) during their leisure hours ; and they were therefore confined to the Hospital, anr^ debarred from obtaining more than a small allowance of alcoholic drink ; after which not a ^ Nutritive functions — functions concerned in building up the solid part* of the body, and in repairing the waste constantly taking place in them. ' Phagedenic — spreading, corroding, eating in. * Morbific causes — causes producing disease. !(? ?■ iii ■ 'M 08 EFFECTS OF ALCOHOL single fresh case occurred among them. During the present epi- demic, the writer has learned from various sources that a considera- ble proportion of those, in whom the liability to the disease was not evidently produced by the condition of the locality in which they resided, might be considered as deriving a predisposition to it from habitual Intemperance; — many establishments having lost those men, and those only, who had been accustomed to free indulgence in the use of alcoholic liquors. The general connection between the intemperate habits of a population, and its high rate of mortality from various causes, will be shown hereafter; and a high rate of mortality is always indicative of a large amount of eickiiesSf although the ratio between the tr^? 's by no means constant. 66. Gout and Rhev.m'^thm. — Among the general disorders of nutrition, to which the intemperate use of Alcoholic liquors certainly predisposes, although it may not of itself cause them, are Gout and Rheumatism. The former is most common among those who have been accustomed both to eat and to drink freely ; and it is favoured by such a use of alcoholic liquors, as stimulates the stomach to digest more azotized ' aliment than the system can appropriate. This may be regarded as the fundamental cause of the disease, when it occurs in its sthenic form. Of the ulterior stages of it, we yet know too little to enable us to trace with certainty the effect of alcohol upon each of them; but this much is pretty certain, — that an impaired condition of the nutritive operations will be favourable to the pro- duction of the materies morbl,^ whatever be its nature ; — that this will be further promoted by any impediment to the due oxidation of the constituents of the blood, such as the admixture of Alcohol has been shown to occasion ; and that the elimination of this morbid matter will be obstructed by that torpid condition of the Liver and Kidneys, to which these organs are especially liable in those who habitually over-excited them in earlier life (§ 58). In the produc- tion of Rheumatism, also, we may clearly trace the aggravating in- fluence of habitual excess in the use of alcoholic liquors, especially if the materies morhi* be, as many suppose, Lactic Acid," or one of its compounds. For whilst the disordered condition of the assimila- tive and nutritive operations will give a special tendency to the pro- duction of this substance, the impediment to its oxygenation* pre- sented by the presence of alcohol in the blood will cause it to be retained and to accumulate there, instead of being burned off (which it ought to be, as fast as formed) and escaping from the lungs in the condition of carbonic acid and water.* Here, again, the torpor of ' Azotized — containing nitrogen, as animal flesh. ' Materies morbi — the matter or material causing disease. * luetic acid — an acid obtained from milk. ' Ojcjigcnation — being supplied with oxygen. ' This idea of the influence of alcohol in conducing to the retention of ON THE HEALTHY SYSTEM, the Liver and Kidneys, and the disordered action of tbo Skin, in the habitually intemperate, will present an additional obstacle t<^ the proper elimination of the morbific matter; and in Rheumatism, as in Gnut, the intensity of the inflammation can scarcely but bo aug- mented by the diathesis ' induced by the habitual presence of alco- hol in the blood. — All these predictions are verified by the experi- ence of every practical man. 67. Diseases of the Heart and Arteries^. — Closely connected with the gouty and rheumatic diatheses are Diseases of the Heart ami Arteries; of which some obviously arise out of these constitutional states, and are thus indirectly favoured by the abuse of Alcoholic liquors; whilst others seem to be more directly dependent upon the introduction of alcohol into the blood. The continual but irregular excitement of the contractile action of the heart and arteries, which is the result of habitual use of stimulants, must of itself predis- pose their tissues to disease ; iind this predisposition will of course be increased by the contact of blood charged with alcohol with their lining membrane, as well as by the general disordered condition of the nutritive operations. Now attacks of acute Arteritis ' seem not unfrequently traceable to alcoholic intoxication; and it cannot therefore, be regarded as improbable, that those more chronic dis- orders of their walls, which give rise to Aneurism,^ softening, fatty degeneration, and other structural changes, and which thereby pre- dispose to hemorrhage, should be favoured, if not absolutely pro- duced, by the habitual presence of alcohol in the circulating current. Accordingly we find the intemperate use of alcoholic liquors specified by authors on the Diseases of Arteries, as among the most important of their predisposing causes. 68. Spontaneous Combustion. — Although the phenomenon termed " Spontaneous Combustion" of the Human body is one of such rarity, that it might seem scarcely to deserve to be ranked among the ordinary results of habitual excess in the use of Alcoholic liquors, yet it should not be passed by in any enquiry into the consequences of such excess; more especially since it may be regarded with much probability, as resulting from the same kind of perverted nutrition, carried to an extreme degree, as that to which we have already traced various other consequences. It would be more correct to speak of these cases as instances of unusual comhmtibiUti/ of the lactic acid, and thereby favouring the rlieumatic diathesis, is confirmed ly the success of Dr. G. O. Kees's method of treatinj^ Rheumatism by Lemon juice; the rationale of which seems to be, that 'tlie citric acid alford i a large and ready supply of oxygen, whereby the lactic acid (or maln-ien morbi, whatever it be,) is burned olF. ' Diathesia — condition of body. ^ Arteritis — inflammation of arteries. ' Aneuriftm — tumour resulting from the dilatation of an artery ir. some part of its course. i ro EFFECTS OF ALCOHOL I M I ! body, than of really spontaneous combustion ; since in scarcely any of them, perhaps in none, does there seem adequate evidence that the combustion originated without the contact of external flame; their real peculiarity consisting in this — that whereas an ordinary human body requires a large amount of wood, coal, or other inflam- mable material for its combustion, — the body in the subjects of this accident takes fire very readily, and burns as if it were itself highly itiflammable. In some instances it has appeared as if a very inflam mable gas were given oflF from the body ; a flame having darted towards it from some distance. In all or nearly all the cases in which the pre- vious habits of the individuals were known, they had been intemperate ; and it is remarkable that the greater number of recorded instances occiirrcd among fat old people who had been spirit-drinkers. — The chief source of this peculiar combustibility is probably to be found in the impregnation of the fluids and solids of the body with Phos- phorus, which is perhaps united with hydrogen, so as to form some highly inflammable compound. This may be conceived to result frorti the habitual ingestion of Alcohol, in the following way. The normal mode in which the phosphorus set free by the waste or dis- integration ' of Nervous matter, is extricated from the system, is through the urine, after having been converted by oxidation into phosphoric acid. Now if there be not oxygen enough in the blood to effect this conversion, it is to be expected that the phosphorus would be retained in the fluids, and possibly deposited again in the solids ; and since we have seen that the continual presence of alco- hol in the circulation gives even to arterial blood a venous character, it is not difficult to understand how much a retention of the phos phorus destined for excretion should be favoured by habitual intem- perance. It is a remarkable confirmation of this view, that the breath of drunkards has been sometimes observed to be luminous, as if it contained the vapour of phosphorus or of some of its com- pounds ; and that it has been found by experiments upon dogs, that if phosphorus be mixed with oil and injected into the blood-vessels, it escapes unburned from the lungs, if time be not given it to unite with the oxygen of the blood.* The foregoing are the principal disorders, local and constitutional, in the production of which we can trace the operation of the ha- bitually excessive use of Alcoholic stimulants, with tolerable direct- ness. It would be easy to extend this catalogue by the inclusion of other diseases which are manifestly aggravated by intemperate habits; but this, in fact, would require the enumeration of almost * Dmntegration — breaking up ; reduction into very minute particles. ' See Cuspcr's Wochenschrift, 1849, No. 15. — The luminosity observed hy Sir Henry Marsh in the faces of two phthisical patients, was probably Uno to the same cause — the imperfect oxidation of phosphorus within the bi'dy, and its consequent extrication from the skin iu a vaporous condition. tl ON THE HEALTHY SYSTEM, 71 every disease to which the human body is subject, more especially if luflaramation participate in it. But the writer thinks it prefer- able to limit bis statements to the cases in which the chain of causation is most continuously and obviously traceable. It has been his object throughout to show what consequences might be expected to arise from habitual "intemperance;" regard being had to the facts which have been fully ascertained, with respect to tho modus operandi of alcohol on the system at large, and on special organs. It has been shown, that a variety of disordera of the nervous system, of the digestive apparatus, of the secreting organs, of the skin, of the heart and arteries, and of the organic fluids and solids in general, might be thus anticipated ; and that such antici pations are all completely verified by the results of practical obsei vation. — We might now push the investigation further, and inquir / what evidence we have in regard to the consequences of the habitu- ally "moderate" use of alcoholic liquors on the human system. It must be freely admitted, however, that we have not the same data for the determination of this question, as that on which we have been hitherto engaged ; and this on two accounts, — first, that the consequences will be naturally remote, and will be often such as appear fairly attributable, in great part, if not entirely, to other causes ; — and second, that the very general prevalence of the " mo- derate" or "temperate" use of alcoholic liquors, and the shortness of the time during which Total Abstinence has been hitherto prac- tised by any large number of individuals, render it difficult, if not impossible, to draw any valid inference, as yet, from comparative observation. But the writer would argue, that if we have such a complete accordance between the predictions of Theory and the results of Observation, in regard to the consequences of habitual " excess," as establishes the relation of cause and effect beyond dispute; we have a strong case in favour of such a relation, when, the cause being in less active operation, the predicted eflFects do occur, even though at a period so remote as apparently to disconnect them from its influence. For various reasons, however, he deems it advisable to carry out this inquiry under the second head, where it will be more conveniently discussed. IV. GENERAL EFFECT OF THE EXCESSIVE USE OP ALCOHOLIC LIQUORS ON THE DURATION OF LIFE. 69. We shall close this part of the inquiry by examining into the general tendency of the excessive use of Alcoholic liquors to shorten life; either by themselves giving rise to the diseases above enumerated, or by increasing the suscoptibi]i*^y of the system to other morbific causes. That sui-h a tendency exists, cannot for a moment be questioned. No Life Insurance Office will accept an Insurance 'jd an individual whose habits are known to be mtcnipcrate; and U' 'j; i i . in a m i' ;■ ■ ■ I ill* 72 EFFECTS OF ALCOHOL if it be discovered after bis death tbat be bas been accustomed to the excessive use of alcoboh'c lif(uors, contrary to his statement in his proposal for insurance, the Policy is declared void. And it is, doubtless, owing in part to the superior sobriety of the great bulk of Insurers over that of the average of the population, that a lower rate of mortality prese-:t8 itself amongst them, than that whi«*h might be expected according to the calculations founded on the entire mortality of the country, — to the great profit of the Office. Thus at the ago of 40 years, the annual rate of mortality among the whole population of England, is about 13 per 1000 ; whilst among the lives insured in the Life Offices, it is about 11 per 1000 ; and in those insured in Friendly Societies, it is about 10 per 1000. — Now the average mortality for all ages between 15 and 70 years, is about 20 per 1000; whereas in the Temperance P: evident Insti- tution, after an experience of eight years, and with several lives above 70 years of age, the average mortality has been only G per 1000, up to the present season, in which it has undergone a slight increase from the Cholera epidemic. It is worthy of remark, how- ever, that although many of the insurers in this Office are of the poorer class, whose condition and employments expose them much more than the middling classes generally to the endemic ' causes of Cholera, no more than 8 have died of this disease, out of the total of about 3500 insurers. As a means of furt'.ur comparison, the following table may be subjoined, in which the mortality of the insurers in the Temperance Provident Institution, for the first five years, is compared with that of the insurers in other Offices during the corresponding period of their existence. I.irE POLICIES. DEATHS. A issued 944 and had 14 ; being equal to 15 per thousand. u 14 <> « 13 t« " 26 " During the sixth year of its existence, only two deaths occurred out of the whole number of insurers in the Temperance Provident Institution, by which its annual average of mortality was reduced still lower, 70. Such comparisons, however, must not be regarded as demon- strating that the usual rate of mortality among "moderate" or "temperate" men, is reduced to half its amount by "total absti- nence;" since other causes have doubtless concurred to keep down the mortality in the Temperance Provident Institution, — such as a more healthful condition of the class which has furnished most of the insurers — or a more favourable distribution of ages. I3ut it ' Endemic — local; connected with particular localities or occupationu. B " 1901 (i 27 C " 838 << 11 D " 2470 <( 05 TPI " 1596 <( 12 •y ON THE HEALTHY SYSTEM 78 will be seen to be impossible that either of these Boparately, or both conjointly, should have occasioned the whole of the difference above pointed out; the annual average, 6 per 1000, being no higher than that of the age of 15, which is more favourable than that of any other period of life. And we appear fully justified, therefore; in attributing a part of the result to the ohntinrnt system practi&ed by the Insurers in the Temperance Provident OflBce. 71. The influence of excess in the use of Alcoholic liquors in directly producing sickness and mortality, or in predisposing to it, is most remarkable in tropical climates, and especially in such as are otherwise unhealthy. It would seem, indeed, that the more unhealthy the station, the more freely do the residents at it indulge in the use of alcoholic stimulants; cither from the mistaken idea that they enable them to withstand the effects of the climate, or from the desire that their life, if short, hhall be a merry one. Some years since, the writer, being himself in the Island of St. Vincent in the West Indies, met with a gentleman resident in Tobago, who informed him that the average annual mortality amongst the Euro- peans of that island was about one in three. Upon in(iuiry into the habits of the residents, it was found that intemperance prevailed to a most fearful extent among them ; few getting up in the morning without their glass of sangaree (wine and water), and the strength of their beverage gradually increasing during the day, until it ar- rived at neat brandy at night. Ho further spoke of it as no un- common occurrence for a party of friends who had met at a drinking- bout, to be summoned within two or three days, to the funeral of one or two of their number. This gentleman was himself appa- rently quite indisposed to recognize between these occurrences any relation of cause and effect; being obviously under the belief that, if it were not for the protecting influence of good wine and brandy, his life would be worth a yet shorter purchase. Wc shall be led, however, by the evidence abDut to be adduced, to a different con- clusion. 72. The writer has on various occasions sought for information from those who had preserved their health during a long residence in tropical climates, as to their habits in the use of Alcoholic liquors; and has almost invariably found that they had practised extreme moderation, if not total abstinence. 73. At the Statistical Section of the British Association, in the year 1848, a paper by Mr. Balfour having been read, on the " Means of maintaining the Health of Troops in India," — in which paper the author attempted to show that Intemperance would be /ound to add b'lt a small proportion to the deaths from climatorial diseases j ' but that the special liability of Europeans to the diseases of hot n m :«i» 11 11 ' Climatorial diseases — diseases deponiout on climate. m mm 74 EFFECTS OF AhCOUOh i''i,M climates arises from their unsuitabiljty of conNtitution to any climnto widely diiferent from that of their own country,— (in important dis- cussion took place, in the course of which dome valuable facts were established by the testimony of several officorM present, (medical and otherwise) who had served in India and elHOwhere. The returns contained in the paper, showed a marked difference in rate of mor- tality, between the ordinary Soldiers and the Officers ; a difference which was g'-eater according to the unhoulthincHM of the station Now a certain part of this difference must bo admitted to be due to the superior character of the Officer's lodging, and to his partial exemption from the fatigue and the exposu;' ' to which the Soldier is liable. But the difference is chiefly to be .ccounted for by tbs difference in the manner of living between the Soldiers and tbs Officers ; the former being allowed a regular ration of spirits, and many of them getting as much more as they can ; whilst the latter are now comparatively abstemious, drinking wine or beer in place of spirits, and this to a much less extent than formerly. With re- gard to the Indian service, it was specially asserted by Lieutenant- Colonel Sykes, who has paid great attention to the Statistics of the Indian Army, that since it has become the custom among the Offi- cers to drink bitter ale in place of wines or spirits, the rate of mor- tality among them is so greatly diminished, that promotion is no longer expected to take place more rapidly in the Indian Army than in other departments of the service. In illustration of the extreme injury done by Intemperance to the Indian troops, a Medical Officer stated that within a month after the arrival of the order for the dis- continuance of Temperance Societies,* bo hud forf^ cases of Deli- rium Tremens in his own Regiment, 74. That the liability to climatoriul disease is by no means inevi table, and that it is especially to be avoided by the adoption of the habits in regard to diet, &c., of the Native Population, where that is healthy, — is the testimony of all these who have had most exten- sive opportunities of forming a judgment on thi subject. The two following citations from different publications,— tho one by Lieute- nant-Colonel Sykes, who was himself long resident in India, — the other by Dr. Daniell, Assistant Surgeon to the Force.i, who has had *ihe superintendence for a considerable time of some of the most unhealthy stations on the Western Coast of Africa,- will carry with them great weight. " I never followed a farinaceous or vegetable regimen myself in India," says Colonel 8., " nor do I recommend it to others; but I ate moderately and drunk little, and I have a » The Authorities at the Horse GuardH, who bavo tivketi the ext,raordinnry step of putting down Temperance Societies in the At'iny, on the ground that every organization but the regimental is contrary to the discipline of the service, can scarcely be supposed cognizant of what they have to an- iiwer for. I ON THE HEALTHY SYSTEM. 75 Hf-*ng conviction that much of European disease in India is trace- able to over-stimulus, and that the mortality among the European troops will not be lessened until the European Soldier is improved in his habits ; until he is made to understand that temperance is for tlie benefit of his body, libraries for the benefit of his mind, exer- cise for the benefit of his health, and Savings' Banks for the benefit of his purse. The cUmate of India is less to biame than imUvi' duals ; for, in case Forctijners fnd the people in a counti'i/ healthj/, the}/ should, to a certain extent, conform to the habits of the Nativrs to be healthtj also} So with regard to Africa, Dr. Daniell says, " It is a well-known fact that the notorious insalubrity of Africa has frequently served as the scape-goat on which the blame of those evil consequences (resulting from the reprehensible indulgence of dissi- pated courses) might be unreservedly thrown, without the risk of their being disputed or questioned."' And again, when describing the Bight of Benin, one of the most pestilential localities on the surface of the globe, he says, " And yet, amid these regions so rife with disease and death, I have known Europeans reside for a number of years in the enjoyment of good health, from the simple secret of moderately conforming to the habits of the natives as regards their di , exercise, and attention to the due performance of the cutaneous functions ^"* 75. The evidence of Statistics, however, is more valuable on this point, than the mere affirmation of individuals, however trust- worthy ; and to this, as set before us by Colonel Sykes, we shall now proceed. — The per-centage annual mortality from sickness of the three armies of Bengal, Bombay, and Madras, for the last twenty years, ha* averaged as follows : — Native .... £uropro|>irllon« uilinitti'U to ,Stifii){lli. Avcrnirc dully f>«r ('(■ritiivc)! oC in«n in lloHpitiil. Tt-niporiiiice 8o«l..ty. Ki'iniiliMli'r uf IU-)!iuiuiit Trmpur- iiiiri) Skx-loty. Itfinnlii- (l.'r 83. The comparison of the returns of this Regiment with those of others less remarkable f;)r sobriety, affords a full confirmation of the deductions drawn from the statistics of crime in this country, as well as from individual observation, in regard to the influence of habitual Intemperance upon the moral conduct. That a large pro- portion of oflfences amenable to punishment, both in the civil popu- lation, and in the military and naval services, are committed under the direct excitement of Alcoholic liquors, there can be no kind of doubt ; and the comparison of the insubordination and criminality of a drinking regiment, with the orderly and reputable conduct of an abstinent one circumstanced in other respects almost precisely the same, adds to the confidence with which we may assert that In- temperance is the chief cause of Crime. For besides the imme- diate provocation which alcoholic excitement may induce, it is indu- bitable that habitual excess has a tendency to debase the moral tone, and to weaken the controlling power of the will ; — an effect for which the statements already made as to its action on the mind, through its organ the brain, leave us at no loss to account' ' The author is happy to be able to add the testimony of Colonel Reid. who was for some years Governor of the Bermudas, and subsequently of the Windward Islands, in favour of the beneficial effects of Total Absti- nence, in improving the physical condition, and in promoting the general welfare, of a tropical population composed of a mixture of Europeans with coloured people. To Colonel Reid belongs the high credit of being one of the few individuals occupying situations of high official responsi- bility, who have employed their influence in promoting this great measure of social reform. The author is informed by him, that the habit of Total Abstinence now prevails in the Bermudas to such an extent, that in some parishes there are no public-houses; the feeling of the people being so much against these, that no one will come forward to give the collateral security which is required from those who seek licenses for them. — In the Annual Reports of the Governors of Colonies which are laid before Par- liament, aad published. Colonel Reid speaks as follows, with reference to Barbadoes: — " I endeavoured, on my first arrival here, to revive a Tem- perance Society which had been before unsuccessfully attempted. This Society has now taken root in the midst of Distilleries ; and promises to effe-^t a great social revolution iu West Indian habits." ft SUPPOSED USES OF ALCOHOL SI CHAPTER II. DOES PirVSTOLOGYOR EXPERIENCE TEACH US niAT ALCOHOLIC LIQUORS SHOULD FORM PART OF THE ORDINARY SUSTENANCE OF MAN, PARTICULARLY UNDER CIRCUMSTANCES OF EXPO- SURE TO SEVERE LABOUR, OR TO EXTREMES OF TEMPERA- TURE? OR, ON THE OTHER HAND, IS THERE REASON FOR 15E- LIEVING THAT SUCH USE OF THEM IS NOT SANCTIONED RY THE PRINCIPLES OF SCIENCE, OR BY THE RESULTS OF PRAC- TICAL OBSERVATION ? The reply to this question will be best furnished, in the upiniiin of the writer, by considering seriatim^ how far science and experi- ence lead to the belief, that the use of Alcoholic Liquors is advan- tageous, as fitting the system for the better endurance, — 1st, (jf severe bocUfj/ exertion; — '2nd, Of severe mental exertion; — 3rd, Of extreme cold ; — 4th, Of extreme heat; — 5th, Of morbific agen- cies} From the results of these enquiries it will be found not diffi- cult to draw deductions as to the propriety, or otherwise, of making Alcoholic Liquors form part of the sustenance of Man under ordi- nary circumstances. I. — ENDURANCE OF BODILY EXERTION. 84. All bodily exertion is performed by the instrumentality of the muscular apparatus, which is called into play by the agency of the nervous system. It is requisite, therefore, that we should begin by enquiring into the conditions under which their powers arc respec- tively put forth ; and the following may be stated as fundamental positions, in which all the most eminent Physiologists are now agreed. I. Both the Nervous and Muscular systems require, for the energetic development and due maintenance of their respective powers, that their tissues shall be adequately supplied with the Materials of groioth and regeneration ;^ whereby they shall be able to repair the effects of the loss, which every exercise of their vital endowments involves; and also to devel(>[)e new tissue to meet in- creasing demands upon their functional activity. II. The functional activiti/, both of the Nervous and Musculai systems, involves the disinteij ration* of a certain amount of tlieii component tissues, by the agency of Oxyycn : the evolution of theii • Seriatim — in order. » Morbific agencies — agencies productive of disease. • Regeneration — re.'jrmation ; reconstruction. • Disintegration — breaking up; a reduction to very minute particles. ;:il| it- H ■ ■■ i 82 SUPPOSED USES OP ALCOHOL peculiar forces being apparently dependent upon the return of the living tissue to the condition of dead matter, and upon the union of this matter with the oxygen supplied by the blood ; whereby new con) pounds are formed, the retention of which in the circulating current would be detrimental to the vivifying qualities of the blood, and the continual elimination of which, therefore, is especially pro- vided for. — Both these systems consequently require, as the con- dition of their highest activity, that they shall receive an adequate supply of blood, charged with Oxygen, and purified from the con taminating matters which it has taken up in the course of its circulation through the system. III. For the fullest evolution of physical power, it is requisite that the Muscular system should receive an adequate excitation from the Nervous ; and the amount of muscular force put forth on any occasion depends, ceteris paribus,^ on the degree of nervous power which is caused to operate on the muscles, — a strong Emotional excitement, for example, being sometimes effectual in accomplishing that which the will could not effect. 85. If the Nerves and Muscles be inadequately nourished, it is impossible that their normal power can be developed, except under the influence of stimulants, and then only for a short time. If, on the other hand, the blood be imperfectly charged with Oxygen, it cannot supply a sufficient amount of that element for the perform- ance of those chemical changes, which are involved in every action of the muscular and nervous apparatus. And if, besides being defi- cient in Oxygen, the blood be charged with carbonic acid, biliary mat 1', urea,'' or other products of the disintegration of the body, the functional power of the nervous and muscular systems must undergo a marked diminution, in consequence of the deleterious influence which such matters exert upon their tissues. 86. Now it may be accepted as an indubitable fact in Organic Chemistry, that there is not the slightest relation of composition between Alcohol and Muscular tissue j and all our present knowledge of the subject tends to prove, that the albuminous* ''matters of the blood, which constitute the pabulum^ of that tissue, cannot be generated within the body of man, or of any other animal, but are derived immediately from the food. We cannot regard Alcoholio liquors, then, as contributing to the nutrition of Muscular tissue; except in so far as they may contain albuminous matters in addition « Ceteris paribus — . other things being equal. ' Urea — a substance forming an essential part of the urine. ' AUmminous — of the nature of albumen ; albumen is the nutritive por- tion of the blood. * This terra is iiere used to designate what are commonly known as the protein compounds ; late researches having tended to show the incorrectness if the basis on which that appellation was founded. ' Pa^tulum — food, aliment, nutriment. IN SUSTAINING THE VITAL POWERS. 83 it litioQ |e por- is the IctnesB lo tlu. Alcohol, which is especially the case with " malt liquors." But these matters would have the same nutrient power, if they were taken in the form of solid food. 87. We cannot speak with the same confidence, in regard to the imposnliility of any assistance being afforded by Alcohol to the nutrition of the Nervous system ; since Nervous matter is essentially composed of fatty substances, which, though peculiar as containing a large quantity of phosphorus, do not seem to contain nitrogen ; ' and since Alcohol is regarded by the Chemist as approximating tlie oleaginous* class of substances in its chemical relations. — But there are two circumstances, which render it highly improbable that Alcohol can ever be converted into Nervous matter. In the first place, we have no other example of an organic compound being found applicable to the nutrition of the animal tissues, which is the product of incipient decoy or decomposition ; yet this may be affirmed to be the case with Alcohol, since the Alcoholic fermenta- tion is the first of a series of degrading changes, which, if allowed to continue unchecked, terminates in the putrefactive process; and we can scarcely imagine, therefore, that it can be an appropriate material for the formation of the most active and important part of the whole animal mechanism. Again, we have no other example of the application of an organic compound to the nutrition of the animal tissues, which exerts upon any of them such a decidedly poisonous influence in large doses, as we have seen to be exerted by Alcohol (§§ 13-16). The materials which constitute the pabnla for the several tissues, are perfectly innocuous whilst they retain their normal constitution j and their presence in the blood, iu larger amount than usual, though it may in various modes be a source of functional derangement, never exercises any special delo* ; 'ous influence upon the vital properties of the nervous, muscular, v>r any other tissue. On these grounds, then, it may be almost po? tiv( ly affirmed, that notwithstanding the chemical relation which Alcohol bears to Nervous matter, it cannot serve, either in its original con- dition, or under any other guise, as a pabulum for th.j generation of nervous tissue. 87. We seem justified by the laws of Physiology, therefore, in assuming that Alcoholic liquors cannot supply the first of the requi- ' It is usually stated, on the authority of Fremy, that the fatty acids of the nervous substance contain nitrogen; this, however, is probably nn error ; arising from the substance of the bniin or fterves being subniittod to analysis en 7«a«sp ; for this substance consists not nierply of the fatty contents of the cells and tubes, but of their albuminous walls; and thua regarded chemically, it is a mixture of oleaginous with a small quantity of albuminous mutter, which last, when included in the analysis, would give to the former ingredient tlie appearance of containing azote. — 'riee Valentin's Lehrbuch der Physiologic, Band. I., p. 174.) * OtfUflinous — oily or fatty. 1! :H • I, 64 SUPPOSED USES OF ALCOHOL wt«'s already enumerated for the development of the physiciil power of the nervous and muscular apparatus ; and we have next to con- 8i(lcr what is its capacity in regard to the second. It may be safely affirmed that the introduction of Alcohol into the blood cannot stand in the place of the Oxygen which is essential to the functional acti- vity of the nervous and muscular systems ; on the contrary, its pnisence in the blood would rather tend to impede the oxidation of their organic components, both by the more cogent demand for oxygen which it will itself set up, and also by the preventive influ- ence which it is well known to exercise over the oxidation of other organic substances (§§ 117, 118). In both these modes, it will not only interfere with that action of the Oxygen of the blood upon the Nervous and Muscular substances, which is essential to their func- tional activity ; but it will also tend to check the removal by oxygen- ation, of tho.se products of decomposition, whose continuance in tlio blood is attended with most serious injury to the system. In so far, in fact, as the presence of alcohol in the circulating current tcnd.s to give to arterial blood a venous character, it must thereby impair its power of serving as the exciting fluid (for so we may term it) of the nervous and muscular battery. And this it does in the first instance, by obstructing the elimination of Carbonic Acid, as will be shown hereafter (§ 118); but more remotely, by that inter- ference with ihe proper functional activity of the Liver and Kidneys, which we have seen to bo among the most ordinary consequences of the free ond habitual use of Alcoholic liquors (§§ 51-58). 88. Hut although we arc led by the preceding considerations to regard the regular employment of Alcoholic liquors as rather a de- triment than an aid to the development of nervo-muscular power, there is a third point towards which we have to direct our inquiry ; namely, whether the peculiar stimulating effect of Alcohol, which is especially exerted upon the Nervous system, may not enable a greater amount of nervous energy to be produced, and a greater amount of muscular power to be thereby called forth, than could be generated without its aid. In considering this question, it is most iinpoitant to keep in view the diflference between a tenijiorariy and a SHHtaincd effort. We have seen that the usual effect of a moderate dose of Alcohol is, in the first instance, an increase in the force and rapidity of the Circulation, and in the activity and energy of the functions of the Nervous system ; and both these conditions will be favourable to the development of Muscular power, so long as they continue. But such a state cannot long endure. We may increase the amount of Nervous power developed in a given time, by the in- fluence of Alcoholic stimulants ; or we may prolong its generation by the same kind of assistance, when it would otherwise have failed. liut as every exertion of Nervous power, like that of Muscular, in- volves the death and deci.y of a certain amount of the tissue by TN SUSTAIN' I XG THE VITAL POWERS. 85 tor ir, in- by which it is evolvoi], there is .1 limit to the pnssihility of its gotiora- tion ; so that we find the continuance, or even the increase, of the sfiumhis ceasing after a while to produce any effect; and the ex- hausted power can only be recovered by a lengthened period of repose, which shall allow time and opportunity for the regenerating processes to be performed, at the expense of nutrient matnriid drawn from the blood. Until this has been effectually accompli!?hed, the Nervous power is at least as much hrhic par, as it previously was ahove it; so that the loss is certainly equivalent to the gain. And the more the Nervous system has been forced, by the influence of Alcoholic stimulants, to give forth its powers beyond their natural limit, whether as to duration or intensity, the greater will be the degree ai:d duration of that subsequent depression, which speaks so unmistakeably of the need of rest and reparation. 89. Hence, therefore, we should anticipate that although the use of Alcoholic stimulants may enable a greater amount of physical force to be put forth within a given time, than could otherwise bo generated, they can be of no assistance in the snstcntatlon of nervo- muscular power ; and if the previous considerations be also taken into the account, we should be led to expect that, in the long run, eevere bodily labour will be better borne without alcoholic stimu- lants than with them, — provided always that the digestive apparatus be in good working order, and be adequate to prepare that amount of alimentary material, which is required for the regeneration of the tissues disintegrated by use. 90. We have now to inquire how far the results of practical cx- perie.ice are coincident with those theoretical views ; and whether it is found on actual trial, that complete abstinence from Alcoholic liquors is favourable, or the toverse, to the endurance of severe bodily labour. It cannot be denied that the ideas current, among the labouring classes more especially, as to the teacliings of expe- rience on this point, ;ire opposed to our theoretical deductions. But there are many circumstances wiiich should lead us to mistrust the popular voice on such a question, and to seek for proofs of a kind that maybe more firmly relied on. The "universal experience" of former generations might be quoted in favour cf a multitude of absurd notions, which we now treat as simply ridiculous; and wlien there is this additional complication, that the liking for alcoholic liquors is such as very readily to make " the wish father to tiie thought," we find an additional ground for suspicion. IJut tlio chief cause of our mistrust is this,— =^that there is no appreciation in the popular mind, of the connexion between the immcdinfe and the remote effects of Alcoholic stimulants. A glass of malt liquor, or a small quantity of spirits, repeated three or four times a day, is found to incriase the bodily vigour for a time; and this increase is ect down as .= .) much positive gain, no iccount beint; taken of the I Mi i m ^liJ M wi;"!! .3 -i': '■• :'! :3!; ] m "pi 'iiv M i :%\ S6 SUPPOSED USES OF ALCOHOL BiiDsequcnt depression, which is considered as ordinary fatigue. Evidence of this kind is therefore of little or no value; and the only facts that can be admitted as having any weight, are those which bring into comparison the total amount of labour executed with and without the aid of fermented liquors, during lengthened periods of severe toil ; these being the indications, not of the amount of force which may be temporarily set forth, but of that which can be habitually exerted ; and therefore of the general vigour of the system, rather than of its power in a state of excitement. It would be easy to cite several modern testimonies to the supe- riority of the Abstinence principle (to say nothing of the ancient ones), from Benjamin Franklin down to Dr. Forbes; — the former of whom tells us in his Autobiography, that he was accustomed, when worki.j;^ as a Pressman in a London printing-house, and taking onl}* bread und water instead of the porter which his companions drank (as tlj' y said) to acquire strength for their work, to carry a large form of letters in each hand up and down stairs, to the astonish- ment ol his porter-drinking companions, who found one of them a suili'jien- load; — whilst the latter assures us that in a recent excur- si'ih amidst the mountains and valleys of Switzerland, which were chie-iy i,, versed on foot, he found his own "sexagenarian" 'vigour, sustaiue 1 by cold water only, quite on a par with that of hia younger companions, who indulged in a moderate allowance of wine.* Such examples, however, might be regarded as exceptional, because indi- vidual ; and as affording no contradiction of the supposed general result of experience. They prove, however, that there is nothing jtositively incompatible, in the habit of total abstinence from alco- holic liquors, with the sustenance of a high degree of nervo-mus- cular power. And it may be well to fortify this position with a few additional testimonies, relating to cases in which the power of endurance was very severely tried. 92. Thus, a nail-maker at Glasgow assured the writer, that after five years' experience of the abstinence system, he *' found hard work easier, avd long hours more revdily to be endured ;" and that being a member oi the Fire Brigade, he was on one occasion called upon for continuous exertion for sevenfi/-three hours, which he en- dured, with no other beverage t! :;n cof" -> and ginger-beer, while all his comrades were " beat and feii ;.way.'' The fi>llowiug statement, forwarded to the writer from Le< 'i<, was signed l;^ tbirty-foir men engaged in laborious employmetit.s; out of whom twelve belonged to the class whose occupations are commonly regarded as peculiarly trying, seven of them being furnace-meu at foundries atid gas- works, two of them sawyers, one a whitesmith, one a glass-blower, • Sexagmnrian — one sixty years old. •"Physician's Holiday," p. 20 and passim. after hard that ailed ? en- le all neiit, men ng<'d iarly gas. wer, IN SUSTAINING THE VITAL I» OWE 11 8. 87 and the last a railway guard '' Wo, the underxignod, liaving practised the principles of total abstinence fnnu all iiitoxicatiiij; liquors during periods ranging from one to ten ytsars, and having, during that time, been engaged in very laborious oc(!Upafions, vol- untarily testify that we are able to ptu'forin our toil with greater ease and satisfaction to ourselves (and we bjlieve more to the satis- faction of our employers also) than when we drank moderalrli/ of these liquors j our general health and circumstances have also beeu considerably improved." ' With regard to harvest-work, again, whicb is extremely trying to the strength, both froni tlic continuity of the exertion required, and the heat of the weather ut the time of its performance, there is ample testimony that those who go through It upon the abstinence principle, are better able to sustain it, than those who endeavour to support their strength upon fer- mented li(|Uor8; and that if an adequate supply of nutritious food be provided for them, the former will even inrrfdHn in w(!ight, whilst going through this severe toil. In some parts of the county of Cornwall, where the 'abstinence' system is more cxten.sively practised than in any other county in England, it is the general practice to get in the harvests without any allowance of fcrnjcnted liquors; many labourers, who are habitually moderate drinkers, feeling the benefit of the 'abstinence system* at such times, 93. The following example, drawn from another source, is of pe- culiar value, as showing the comparative effect of the two systems upon the same individuals. — The writer was acquainted, some years since, with a gentleman who had been for some years at sea in the Merchant-service, and who not long previously had commanded a vessel during a voyage from New South Wales to England. After passing the Cape of Good Hope, the ship had sprung so bad a leak, as to require the continued labour, not merely of the crew, but also of the officers and passengers, to keep her afloat during the re- mainder of her voyage, a period of nearly three months. At first the men were greatly fatigued, at the termination of their ** spell" at the pumps; and after drinking their allowance of grog, would "turn in," without taking a proper supply of nourishment. The consequence was, that their vigour was decidedly diminishing, and their feeling of fatigue increasing, as might be expected on the principles already laid down. By the directions of their Com- mander (who although very moderate in his own habits, at tlie time of the writer's acquaintance with him, was by no means a disciple of the Total Abstinence school, which renders his testimony the more valuable), the allowance of grog was discontinued, and coffee and cocoa were substituted for it ; a hot " mess" of these beverages being provided, \yith the biscuit and meat, at the aonclusiou of i \ i I? Mi il 'I '' m 1 X 6 i ' See Appendix B. 88 SUPrOSED USKH OV AUdOUOh every watch. It was tlioti found tliaf tli« ni(!ti felt inclined for a good meal of the latter, when tlio uioro direct hut Ichh cffoctive re- freshment of the alcoholic lif|iior wiim witlidniwn ; their vij^our returned; their fatigue diiniiiislud ; mid iificr twelve weeks of in- cessant and pevcre labour (with no iriti rviil longer than four hours), the ship was brought into port with till on board of her in as good condition as they ever were in their livcH, 94. Numerous examples niiglit be cited of comparative trials between two sets of labourers, as nearly uh po»«ible alike in other respects, but the one practising Total Almtinonco, whilst the other has relied upon the assistance of Alcoholic li(juorH. So far as the writer is aware, all these contests have givftn rcnults in favour of the abstinence system, when the period of fho cxpcirinient has been sufficiently protracted to give its nieritH u fair trial j and although it may be asserted that such results are orie-Midtfd, an having been made known to the public by the profeHKed advocates of a s//stf"in, yet considering the very large interests involved in the maintenanei of the existing state of things in regard to the use of fermented liquors, it migh^ be reasonably expected that tlufir upholders would make known to the world any resultH of an oppoi^ite description, had they really occurred. The following Htateuient, furnished to the writer by a gentleman at Uxbridge, IniH the advantage of being the comparative return of the rfyii/ar lahonr of a whole year, per- formed by two sets of men, the one working on the "abstinent," the other on the 'Mnoderate" system, but not pitted against each other iu a contest for victory. It relatcH to brick-making, which is com'iionly accounted one of the niOHt laborious of all out-door employments. " Out of upwards of twenty-three millions of bricks made in 1841, by the largest maker in the neighbourhood, the average pen- man made by the beer-drinkerH in the neuson was 760,- 2G'J ; whilst the average for the teetotahrn wa« 79.3,400 — which is o5,181 in favour of the latter. The highest number mad9 by a beer-drinker was 880,000; the highest number made by a teetotider was 800,000; leaving 10,000 in favour of the teetotaler. The lowest number made by a beer-drinker wuh 059,500; the lowest number made by a teetotaler was 740,090; leaving 87,000 in favour of the teetotaler. Satisfactory ai* the account appears, [ believe it would have been much more ho, if the teetotalers could have obtained the whole 'gang' of abstainurn; as they were very fre- queutly hindered by the drinking of gomo of the gang ; and when the order is thus broken, the work cannot go ow." 95. The experience of lanje hoJies of mofi, which becomes matter of public notoriety, is in many respects profcrable, as demonstrating (to say the least) the perfect compatibility of Abstinence from alco- holic liquors with the highest degree of physical vigour, and with 'he greatest power of endurance of bodily labour. Thus, almost IN SUSTAININQ THE VITAL POWERS. 89 natter rating alco- with liuost evftry traveller who has visited Constantinople, has been struck with the remarkable muscular powers of the men engaged in the laborious ,>ut-door employments of that city. Mr. W. Fairbairn, an eminent machine-maker at Manchester, remarked that ** the boatmen or rowers to the caiques, who are perhaps the first ro\vcrs in the world, drink nothing but water; and they drink profusely during the hot months of summer. The boatmen and water-carriers of Constanti- nople are decidedly, in my opinion^ the finest men in Europe as regards their physical development, and they are all water-drink- ers." ' And several other observers bear testimony to the extraor- dinary strength of the porters of Constantinople, who are accustomed to carry loads far heavier than English porters would undertake, even under the stimulus of alcoholic beverages; yet these Turkish porters never drink anything stronger than coflfoe. 96. The following statement, made upon the authority of Mr. Tremenhere, one of the Commissioners employed to report on tho state of the Mining population, shows how completely the doctrines of the reputedly '* universal experience," in regard to the ouppori afforded by Alcoholic liquors to the laborious artisan, are negatived by the results of a change of habit, forced upon those most un- willing to adopt it. " A remarkable and most satisfactory instance," says Mr. T., "of a successful attempt to put a check upon the in- dulgence in ardent spirits, has occurred at the iron-works of Messrs. Houldsworth of Coltness, employing about eight hundred colliers, iiiners, furnace-men, &c. Much loss and annoyance had frequently been occasioned by the negligent or wilful misconduct of workmen under the influence of this habit; and the Messrs. Houldsworth, having in vain endeavoured to put an end to it by persuasion and advice, resolved to do what they could by removing the temptation. They accordingly, about three years ago, forbade the sale of spirits at the store, and at the inn at their works, and ordered that tho furnace-men should not be allowed to drink spirits during their hours of labour. These men had been accustomed to drink four or five glasses of whiskey during each ' shift,' in addition to what they might choose to drink at their own homes. They remonstrated strongly, and affirmed that it was impossible for them to do theii work without this quantity of whiskey. They were not long, how- ever, before they found their error; they now drink nothing but water during their work, and tea and coffee at their meals ; what they spent on whiskey they now spend in wholesome and nutritious food ; they allow that they do their work better, and that the change has been a great blessing to themselves and their families; and that it is the best thing that ever happened to them. I was after- 8* Sanitary Report, 1840, p. 252. 'B V" M I 9 I 'Mi I |«S1 I t t : hi , . fl •1^1 -1., .1 uo BU1'1»()8ED USES OF ALCOHOL J if Trarcls inforrnod tlittt. uiiiong the colliers and iuincrf<, there wij k marked improvoiijciit from the Haine cause." 97. The cx[Mrim(Mit has now been carried on upon a still larger 8cak', fur imiuy years, amongst the seamen of the Merchant-servico, botli of thJH country and the United States; and the result has been, with few cxceptionM, ho favourable to the Abstinence principle, that it is now adopted by u very large »)roportion of American trading vcsscIh; to whoHO ijencral supwiority in equipment and management over the mercantile marine of this country, in the greater part of which tlio employment of alcoholic liquors is still continued, a lanro body of ovidoiico was recently given before a Committee of the House of C!(tmmoiifl. The exceptions just alluded to relate to the reputed liability of "temperance" soumen to suffer from endeujic' or malariouH* diwMiHcs. Into this point we shall enquire under a subsequent h(!ad; and the writer thinks that it will there appetir that this liability, if it really exist, results from the deficiency of any measures that Hhall servo as a substitute for the alcoholic stimulus, in rendering the system loss obnoxious to the influence of the poi- sonous eniuuations to which it is exposed. (§§ 145-147.) 98. The writer has had the opportunity of ascertaining from Ship- owners who have adopted the ** temperance " system (which on board ship, is equivalent to "total abstinence" — no other alcoholic liquor being substituted for spirits), that they have found no difficulty in obtaining the sorvicos of excellent seamen, when a fair compensation is made in the Buporior qui^lity of the provisions and allowances, or in the uito of wjgCH, for ttie * stepping of the grog." In fact, such ships are in poKitivt' rcquijst among seamen of the best character; proving that in npite of the well-known attachment of their class to spirituous liquors, they arc sensible of the advantages of habitual abstinence from them. The writer having himself made a voyage to the West Indies and back, some years since, in a " temperance ship," had the opportunity of Remarking that during a heavy gale of nearly throo dayw' duration, which was continually lading to the uttermost the strength of a crew far too small for the size of the ship, the men were ut least as ready for the renewal of their exer- tions, as they would have been if supported by alcoholic stimulaikts ; whilst in yariou!^ rowing-matches, which took place between them and the crows of other ships, whilst lying in port, they were gene- rally the victors. This last fact is not cited as proving the supe- riority of the abstineDCO system, since the difference might be attri- buted to the superior physical power of the crew ; but it sufficiently •nJicates that there is in the " abstinence system " nothing unfavonr- ' Endemic — rcBulting from local causes. * JUulamu» — rcHUltiug from a bad state of the air. IN SUSTAINING THE VITAL POWERS. »1 \ ilh \o tlio maintcuancc of that power during the vicissitudes of a fiuuman's lifu. 90. The following extract from a private letter from a Captain in the Merchant-service, contained iu the " ..If/y/s^r" for October, 181'.), gives a valuable testimony in favotir of this conclusion : — "I har- boured in Newfoundland on the 2od of Deccraber last, tho coldest day that had been registered there for the last six years, the ther- mometer on shore indicating twenty dosrrees below Zero. I can honestly say, it was the most severe frost T ever was in on the water, during the twenty-nine years that I have been employed in the New- foundland trade. I remained on shore from the tn- mentioned above, until the 2d of March, and then embarked for .razil, where, in April, we had the thermometer ranging from b - ^o .^7°, and remained in that climate till the middle of July A 'hat time, the whole of my crew, with two exceptions, were st. .j teetotal, and all able to eat their allowance, and do their t^hare (jf hard work, in the sun and out of it, taking in and out cargo. The two excep- tions did, in one solitary instance, infringe the law ; and they paid the penalty in severe headache and debility for some days." 100. It is rare for any occasion to present itself, during the march of an army, of testing the power of sustaining this kind of prolonged exertion, without the supposed assistance derived from the use of Alcoholic liquors j but opportunities of this kind have occurred, the abstinence having been in some instances voluntary, whilst in otliers it was compulsory ; and the results have in both cases been most com- pletely contirmatory of the principles formerly laid down. Two of tho most striking examples of this kind within the writer's knowledge, will be mentioned hereafter under the head of" Endurance of Heat" (§§ 140, 141); these marches having been performed under an ele- vation of temperature which rendered them peculiarly trying. And he will here confine himself to the mention of the fact, that during Sir John Moore's retreat to Corunua, the army was found to improve in health and vigour, as soon as the usual allowance of spirits was unattainable. This fact is the more remarkable, as the circumstances under which this march was performed must have been peculiarly depressing to the feelings of the men, and could not but have ope- rated unfavourably (according to the invariable experience of retreat>- iug arnjics) upon their physical powers. 101. The experience of whole nations, previously to the intro- duction of Alcoholic liquors amongst them, is equally in favour of the assertion, that prolonged and severe rauScular exertion may be at least as well borne without their assistance as with it. AVhere. for example, shall we meet with greater power of endurance of toil, than was displayed by the North American Indians iu *' fol- lowing a trail," before their race became deteriorated by European vices f id I I I -i 1- % m IMAGE EVALUATION TEST TARGET (MT-3) // 1.1 f^KS ^ """ IJ& L25 IBM 11.6 <% ^ ^j>- ^ '/ /A Photographic Sciences Corporation 23 WfST MAIN STRIET WIBSTER.N.Y. 14SS0 (716)«72-4503 % ^ 02 SUPPOSED USES OF ALCOHOL 102. Tho question, it may again be remarked in conclusiou, ia not to be decided by the amount of strength which may be put forth at a single effort. It may be freely admitted that when the body is exhausted by fatigue, an Alcoholic stimulus, which excites the Nervous system to increased exertion, may impart a temporary strength, which shall enable the next effort to be successful in doing that which could not have been accomplished without it. But there is reason to believe that the power of sustained exertion is thereby impaired; and that those who have habitual recourse to this stimulus are really doing themselves more harm than good. This will be most assuredly the case, when they allow it to take the place of the solid food, which their nervuus and muscular systems require for their regeneration ; and the tendency of the habitual employment of alcoholic liquors, when the body has been fatigued with severe and prolonged muscular exertion, is generally to di- minish rather than to increase the desire for solid aliment, — as the examples above quoted clearly indicate. And as it is the latter alone that can afford real and permanent support, it is obvious that any habit which diminishes the natural disposition to profit by it, must be positively injurious in its influence upon the bodily vigour. II. — ENDURANCE OF MENTAL EXERTION. 103. All that has been said of the influence of Alcoholic liquors on the development and sustentation of Physical force, will equally apply to Mental power ', since, whatever may be our views as to the relation between Mind and Matter, it is not now questioned by any Physiologist, that the Brain is the instrument by which all mental power is exercised, in Man's present state of existence, and that the continued development of this power is consequently de- pendent upon those conditions, which are favourable to the mainte- nance of the functional activity of the Nervous system in general. These conditions we have seen to be (I) — The healthy nutrition of the nervous substance ; and (II) — The due supply of highly oxy- genated and depurated blood.' The former process is certainly not dependent upon the assistance of alcoholic liquors; and from the considerations already urged (§ 87), it seems in the highest degree improbable that they can be of the least advantage to it. The latter cannot in any degree be improved, but must be rather im- paired, by the use of fermented liquors ; which, as already stated, tends to deteriorate the quality of the blood, and to obstruct its oxy- genation. 104. That the use of Alcoholic stimulants, however, is attended in most persons with a temporary excitation of mental activity, — ' Depurated blood — blood from which all refuse, deleterious and worn-out matters have beeu removed IN SU8TAININ0 THE VITAL POWERS. 08 lighting up the sciotillations of genius into a hrilliant flame, or as- sisting in the prolongatioD of mental effort when the powers of the nervous system would otherwise be exhausted, — may be freely con- ceded ; and it is upon such evidence as this, that the common idea is based, that it supports the system under the endurance of mental labour. This idea, however, is probably as erroneous, as the no less prevalent fallacy of regarding alcoholic liquors as capable of in- creasing the power of physical exertion. No physiological fact is better established, than that of the depression of the mental energy consequent upon the undue excitement of it, by whatever causes that excitement may have been occasioned ; and the rapid and bril- liant flow of thought which may have been called forth by the alco- holic stimulants, gives place, usually after a few hours, to the oppo- site state of languor and despondency. 105. The influence of Alcoholic stimulants seems to be chiefly exerted in exciting the activity of the creating and combining powers ; such as gives rise to poetical imaginations, to artistic con- ceptions, or to the sallies of wit or humour. It is not to be won- dered at, then, that men possessing such powers, should have re- course to alcoholic stiumlunts as a means of procuring a temporary exaltation of them; and of escaping from the fits of depression to which most persons are subject, in whom the imaginative and emo- tional tendencies are predominant. Nor is it to be denied, that many of those mental productions which are most strongly marked by the inspiration of genius, have been thrown off under the stim- ulating influence of alcoholic liquors. But, on the other hand, it cannot be doubted that the depression consequent upon the high degree of mental excitement which is thus produced, is peculiarly great in such individuals, completely destroying for a time the power of mental effort; and hence it does not at all follow, that either the authors of the productions in question, or the world at large, have really benefited thereby. Moreover, it is the testimony of general experience, that where men of genius have habitually had recourse to alcoholic stimulants for the excitement of their powers, they have died at an early age, as if in consequence of the premature exhaus- tion of their nervous energy ; Mozurt, Burns, and Byron may be cited as remarkable examples of this result. Hence, although their light may have burned with a brighter glow, like a combustible substance in an atmosphere of oxygen, the consumption of material is more rapid; and though it may have shon^ with a soberer lustre without such aid, we cannot but believe that it would have been steadier and less prematurely quenched. 106. We do not usually find that the men most distinguished for that combination of intellectual powers which is known as talenlf are disposed to make such use of Alcoholic stimulants for the pur- pose of augmenting their mental powers ; for that spontaneous ao i 04 SUPPOSED USES OF ALOOHOL tivity of the mind itself, which it is the tendency of alcohol tc excite, is not favourable to the exercise of the observing and purely reasoning faculties, or to the steady devotenaent of concentrated at* tention to any subject which it is desired to investigate profoundly. Of this we have a remarkable illustration in the habits of practised gamblers; who, when about to engage in contests requiring the keenest observation and the most sagacious calculations, and in- volving an important stake, always ''keep themselves cool," either by entire abstinence from fermented liquors, or by the use of those of the weakest kind in very small quantities. And we find that the greatest part of that intellectual labour which has most extended the domain of human knowledge, has been performed by men of remarkable sobriety of habit, many of them having been constant water-drinkers. Under this last category, it is said,' may be ranked Demosthenes and Haller; Dr. Johnson in the latter part of his life took nothing stronger than tea, while Voltaire and Fontenelle used coffee ; and Newton and Hobbes were accustomed to solace, not to excite, themselves with the fumes of tobacco. In regard to Locke, whose long life was devoted to constant intellectual labour, and who appears, independently of his eminence in his special ob- jects of pursuit, to have been one of the best.-informed men of his time, the following very explicit and remarkable testimony is borne by one who knew him well. " His diet was the same as othei people's, except that he usually drank nothing but water; and he thought that his abstinence in this respect had preserved his life so long, although his constitution was so weak." ' 107. Having for several years past been himself performing an amount of steady mental labour, which to most persons would ap- pear excessive, the writer may be allowed to refer to his own expe- rience, which is altogether in favour of Total Abstinence from alcoholic liquors, as a means of sustaining the power of performing it. Having been brought up as a water-drinker, he never accus- tomed himself to the habitual use of alcoholic liquors; scarcely ever tasting them, except when occasionally led to do so by social influences, or when he believed that a small amount of stimulus would improve the "tone" of his syste ' which is liable to a pe- culiar relaxation in certain states of atmosphere. On deter- mining, about four years since, to giv ap the occasional use of wine, &c., as a social indulgence, he still held himself free to employ it when he might think it likely to increase the general powers of bis system ; and for some time be continued to have oc- casional recourse to alcoholic stimulants (never exceeding a single ijrl3u»9 of wine, or half a tumbler of bitter ale), when he felt him- ' Macoish's Anatomy of Drunkenness, p. 36. ^ , ' ' _^ * Life by Lord King, vol. ii. p. 60. I 1 ^ ' IN SUSTAINING THE VITAL POWERS. 95 > a pe- I deter- use of free to general Have oc- single ;lt him- self suffering under the peculiar depression just referred to. He gradually, however, found reason to doubt the utility of thi) remedy ; and has for the last two years entirely given it up. During these two years, he has gone through a larger amount of mental labour than he ever did before in the same period of time ; and he does not hesitate to say, that he has performed it with more ease to himself than on his former system ; and that he has been more free than ever from those states of depression of mental energy, which he was accustomed to regard as indicating the need of a temporary support to antagonize the depressing cause. In fact, he now finds that when these do occur, the use of alcoholic stimulants (taken even in very small amount) is decidedly injurious to him ; diminishing, rather than increasing, his power of mental exertion at the time ; and leaving him still less disposed for it after their effect has gone off. He attributes this change to his entire disuse of alcoholic liquors under all other circumstances; and he cannot but believe that the results which he now experiences, and which have led him to relinquish these stimulants altogether, are the natural effect of them upon the healthy system ; and that the benefit which some persons consider themselves as deriving from their use, arises from their simply removing for a time the depres- sion which results (at a long interval it may be) from their ^eviot/^ employment. 108. Two remarkable cases have recently fallen within the au- thor's knowledge, in which individuals leading a life of considerable intellectual exertion, and long habituated to the moderate use of stimulants, have derived considerable benefit from their relinquish- ment. — In one of these cases, a pint of ale was the usual daily allowance ; to which a little spirits and water at night was occa- sionally added. The relinquishment was commenced as an experi- ment, and without any intention of persevering should it not succeed ; but the benefit has been so great, that the abstinence has been subsequently continued as a settled practice. This gentleman not only finds his general health improved, but declares that his power of intellectual exertion is much greater than formerly j and in particular, that he finds himself quite fresh and ready for work in the morning, instead of losing time, as formerly, in bringing himself up to the point at which ho left off, the night before. — In the ')ther instance, the usual daily allowance was from two to four glasses of wine ; and this was affirmed to be necessary to keep down, a state of mental excitement to which the individual was subject, and to brace the mind to steady exertion. Failing health, however, having occasioned a recourse for a time to the Hydropathic treat- ment, this gentleman, on returning in a state of renewed vigour to bis usual avocations, wisely determined to persevere in the disuse 06 SUPPOSED USES OF ALCOHOL of stimulants ; and he has since continued to practise the abstinent system, with great benefit to his bodily and mental health. 109. Even if we admit, however, that a certain amount of men- tftl labour may be performed with more facility in a limited time, under the moderate use of Alcoholio stimulants, it is still ques- tionable, whether we do not, on the whole, rather lose than gain by their employment. For if they cannot afford pabulum ' for the formation of nervous matter, and if their influ jtice is exerted rather in producing its disintegration than its growth, its efestruction rather than its construction, it follows that every excess of exertion performed under their influence must be followed by a correspond- ingly long period of incapacity, during which the regenerating pro- cesses have to be performed, and the brain again fitted for the discharge of its duties; and if it should be forced into activity before this renovation has been duly performed, the amount of stimulus required to bring it up to the working point will be greater, and all the consequent evils increased. These theoretical predic- tions are, it is believed, in full accordance with what observation teaches with respect to the results of reliance upon alcoholic stimu- lants for support during mental labour; although, for obvious reasons, it is not possible to obtain the same pointed and decisive evidence on this topic, as in regard to the endurance of physical exertion, or of extremes of temperature. — But it is frequently urged, that although the use of Alcoholio liquors to produce a stimulating action upon the brain, is injurious, yet that benefit is derived from the employment of a quantity sufficient to stimulate the stomach to the proper discharge of its duties, by digesting that amount of food which the system requires, but which the ex* haustion of nervous power prevents it from duly appropriating. This doctrine, which equally applies to the state of imperfect indi- gestion resulting from other causes, will be better considered when we have inquired into the reputed efficiency of Alcoholic liquors in supporting the system under exposure to the extremes of Cold and Heat, to which question we have next to proceed. . .> . ! III. — ENDURANCE OP COLD. 110. The power of Alcoholic liquors to enable the body to resist the depressing influence of external Cold, is, perhaps, the best es- tablished of all its attributes, not merely in the estimation pf the uninformed public, but in the opinion of those who have scientifi- cally considered the question. This is by no means surprising. The genial warmth which is experienced for a time, when a glass of spirits is taken on a cold day, appears to afford unmistakeable ' Pabulum — nutriment ; material adapted to form or sustain. 1 IN SUSTAINING THE VITAL POWERS. 97 to resist best es- pf the scientifi- evidcnoo of its heat-produciug power ; and the cheinioal properties of Alcohol would seem to indicate, that, under such circumstances, it does not merely act as a stimulant, increasing the activity of the circulation, and augmenting the nervous energy — but that it also nffords the material for that combustive process by which the heat of tlio body is sustained in a form peculiarly suitable for rapid and energetic appropriation to this purpose. The authority of Liebig is continually quoted in support of this view ; but more has been built upon his statements than they legitimately support. For bis arguments are rather directed to prove that Alcohol cannot become a pabulum for the tissues, and that its sole use, therefore, must be in maintaining the temperature of the body by the combustive process, than to show that it is superior to other materials, to whose employment, aa they exert no stimulating influence, the objection raised against alcohol cannot apply. That we may place this ques- tion upon its proper basis, it will be necessary to consider the circumstances under which the combustive process is usually carried on. 111. That the maintenance of Animal Heat is chiefly, at least, dependent upon the union of the carbon and hydrogen of certain materials contained in the blood, with oxygen taken in by the lungs; — and that the non-azotized * ingredients of the food are specially appropriated to this purpose; — are positions in which there is now such a general agreement amongst Physiologista, that they may be assumed as a basis for our further inquiries. The non-azotized ingredients of ordinary food may be grouped under two heads — the saccharine' and the o^mir/inou*;* the former in- cluding all those farinaceous matters which can be converted into sugar ; and the latter consisting of oil and fat in every form. The former may be considered as hydrates of carbon ; their proportional of oxygen and hydrogen being such as to form water ; so that in combustion they will only consume as much oxygen, as will convert their carbon into carbonic acid. On the other hand, the proportion of oxygen in the latter is comparatively small ; so that in combus- tion they require as much, as will not only convert their carbon into carbonic acid, but will also unite with that part of the hydrogen for which no equivalents of oxygen previously exist in the compound. Thus an equivalent of Starch consists of 12 Carbon, 9 Hydrogen, and 9 Oxygen ; whilst an equivalent of Stearine, the basis of the solid fats, consists of 136 Carbon, 132 Hydrogen, and 10 Oxygen ^Non-azotized — destitute of nitrogen. * Saccharine — resembling sugar. ' Oleaginoua — oily; fatty. /^ 1 ! ! ! J 98 SUPPOSED USES OF ALCOHOL Multiplying the numbers of the former by 111, so as to bring them better into comparison with the latter,' we find that, — llf equiv. of Starch — 140 Carbon, 106 Hydrogen, 106 Oxygen. 1 equiv. of Stearine =186 Carbon, 182 Hydrogen, 10 Oxygen. Now in the former case, the number of equivalents of oxygen necessary for the conversion of the starch into carbonic acid and water, will be no more than that required for the change of its car- bon into carbonic acid, namely, (140 X 2 =) 280; but in the latter case, the number required will not be merely that which will convert the 136 eq. of carbon into carbonic acid, namely, (136 X 2 =.) 272 ; but also that required for combination with those 122 equivalents of hydrogen, for which no equivalent of oxygen exists in the compound, making in all (272 + 122 =) 394. A much more energetic com« bustive process is required, therefore, for the conversion of Stearine into carbonic acid and water, than for effecting the same conversion upon Starch ; for not only is the quantity of free oxygen consumed much larger, but the amount of heat generated will be much greater ; since much more heat is produced by the combustion of Hydrogen, than by that of Carbon. 112. Now the atomic composition of Alcohol being 4 equivalents Carbon, 6 eq. Hydrogen, and 2 eq. Oxygen, it is intermediate, in regard to its proportion of oxygen, between the farinaceous and the oleaginous substances; bearing, however, a strong resemblance to the latter, in regard to the large proportion of Hydrogen for which it does not contain an equivalent of oxygen. This will be best seen by multiplying the equivalent of Alcobol by 31^, which will bring the total weight of its carbon and hydrogen exactly to the same figure with that of llf of Starch.' 81 J equiv. of Alcohol = 126 Carbon, 189 Hydrogen, 63 Oxygen. Thus, then, in the combustion of this amount of Alcohol, there will > We thus make the sum total of the weights of Carbon and Hydiop;oii very nearly the same in the two cases ; for 140 equiv. of Carbon (140x6) = 840 * ' and 105 equiv. of Hydrogen (105 X 1) = 106 ' ' ■ - 945 ' ■ whilst 136 equiv. of Carbon (136 X 6) x= 816 and 132 equiv. of Hydrogen (132 X 1) = 132 948 » For 126 equivalents of Carbon (120 X G) t:=: 756 and I6d equivalents of Hydrogen = 189 - 945 XN SUSTAINING THE VITAL POWERS. 99 not P>'^roly be required (126 X 2 =r) 252 equiv. of oxygen, for the C(»nvert!ion of its carbon iqto carbonic aci ments appear to be usually introduced into the lilood in the condition of lactic acid,' the detection of which is attended with some uncer- tainty. But it has been sufficiently proved that when the saccha- ii M ' Lactic aeid — an acid obtained from milk. 100 SUPPOSED USES OF ALCOHOL Hi rine ingredients of the food nrc untiRunlly abundant, they enter as »uch into the blond ; where they may be detected shortly after a meal, especially if that meal have been preceded by a long fast Like the superfluous fatty matters, however, they soon disappear ; being carried off, there can be little doubt, by the respiratory pro* cess. 115. Tn this manner, then, the Heatproducing materials are usually supplied to the system from meal to meal ; the greater part of them being destined for elimination from the blood within a short time after their admission into it; and the power of sustaining heat existing in its greatest vigour, only whilst some of them remain unconsumed. This inference is confirmed by ordinary experience ; for every one knows how much more severely Cold is felt after a fast of some hours' duration, than after a full meal. We are accus- tomed to refer the difference to the condition of the stomach ; but the stomach may have been emptied, by the completion of the digestive process, long before the increased susceptibility to cold commences ; so that it would be more correct to refer this increase to the exhaustion of the supply of combustible material last intro- duced into the blood, than to the vacuity of the stomach. That an in- crease in the power of maintaining heat should be almost immediately produced after the ingestion of food into the stomach, is to be ac- counted for, not merely by that augmented activity and energy of the general circulation which accompanies the digestive process, but also by the rapidity with which nutrient matters find their way into the blood, — the turbidity of the serum, consequent upon the intro- duction of fatty substances, having been observed as early as half- an-hour after the meal of which they have formed part.' 116. The admission of these matters into the current of the cir* culation cannot be discovered to produce any effect upon the system in general, otherwise than by sustaining the temperature of the body. In fact, they seem to be the legitimate pabulum for the com' bustive process, just as Albuminous matters constitute the pabulum for the formative processes whereby the tissues are generated. When they are present in excess, the superfluity is withdrawn by the production of adipose tissue ; which stores up the fatty matters for future use. When, on the other hand, the supply is not equiva- lent to the consumption required for the maintenance of the heat of the body, the fatty matters which are among the normal constituents of the blood are first drawn upon ; and as the proportion of these is diminished, it is supplied from the contents of the cells of adi- pose' tissue. In this manner, the animal temperature is kept up ' See, for the experiments on which several of the foregoing statements are founded, the paper of Drs. Buchanan and R. D. Thomson, in the Medi« ml Gazette, Oct. 10th, 1845. " ''Adipose — fatty. ' • » ' ^^ IN SUSTAININQ THE VITAL POWERS. 101 nearly to its usual standard, even in spito of the total deprivation of food, so long as uncoosumed futfy matter remains in the body; but death then speedily takes place, in consequence of the cooling of the body, unless the temperature be sustained by external warmth. And death may result also from the subjection of the body to a very low temperature, whilst there is still much fatty matter left in the tissues ; as if this matter could not be re-introduced into the c-ircu< lating current, with sufficient rapidity to supply the demand for an extraordinary quantity of heat-producing pabulum. Further, when the store of fatty matter has been entirely exhausted, and the ani- mal has nothing whatever to full back upon, it is requisite that the supplies of new material introduced into the system should suffer no intermission ; for immediately that they are exhausted, the tem- perature of the body begins to full, and death speedily supervenes unless a fresh supply be afforded.' 117. We are now prepared, then, to inquire into the question, how far Alcohol may be advantageously employed habitually as a heat-producing material ; and whether there are any peculiar or ex- traordinary circumstances, under which it is to be preferred to others. And as one means of arriving at the truth on this point, we must examine more particularly into the influence of the introduction of alcohol into the blood, upon the respiratory process. For our know- ledge upon this point, we are chiefly indebted to the experiments of Dr. Prout and to Yierordt. The former states ' that Alcohol and all liquors containing it which he had tried, have the remarkable power of dimininhing the quantity of carbonic acid gas in the ex- pired air, much more than any thing else which he had made the subject of experiment; this effect being most decided, when the liquor was taken upon an empty stomach. The latter ' fully con- firms Dr. Front's observations ; having found that, in four experi- ments, the per-centage of carbonic acid fell, after from half to a whole bottle of wine had been taken, from 4-54 to 4*01 ; and that this eflect lasted between one and two hours. He further found that, when he drank wine with his dinner, the usual increase in the per-centage of carbonic acid expired after a full meal did not tak^ place. 118. These facts are of great importance. For although it may be very possible that, as suggested by Liebig, the increased forma- tion of watery which will occur when Alcohol is the combustive material, compensates for the diminution in the amount of carbonio ncid expired, and thus the normal amount of heaj; may be generated, —yet there are clear indications that, when thus present in the ' For the experiments on which the foregoing statements are foundec), •ee the work of M. Ghossat, entitled " Rechercbes sur riaauition. * Annals of Philosophy, vols. ii. and iv, , ' Physiologie dea Athmens, &c, '^ .. 9* t02 SUPPOSED U8ES or ALCUIIOL blood, with other materials which ought to be excreted, ulcohol pxcrts an injurious influence, by retarding their combustion. This it will do in two ways; first, by taking their place as the mnre readily combustible material ; and secondly, in virtue of the anti- septic ' influence which it exerts upon other substances, preventing or retarding chemical changes in them. That such is the case, Mppears from the experiments of Bouohardat ; who found that, when alcohol is introduced into the system in excess, the blood io the trteries presents the aspect of venous blood, showing that it has beei) prevented from undergoing the proper oxygenating ' process." And the experiments of Dr. Prout aflFord additional support to this conclusion ; for ho observed that no sooner had the efiieots of the alcohol passed off ^ (which they did in his case with frequent yawn- ings, and a sensation as if he had just awoke from sleep), than the amount of carbonic acid exhaled rises much above the natural standard — thus giving, it would seem, unequivocal evidence of the previous abnormal retention of carbonaceous matter in the system. 1 19. From the foregoing considerations, then, we may conclude that tho cfi'ects of Alcohol as a heat-producing material, will only be advantageously experienced, when the blood does not contain b supply of other matters waiting for removal by the respiratory pro- cess ; and this, we believe, will be found entirely conformable to experience ; the greatest assistance being derived from it, when the body is exposed for a time to severe cold, after a long previous fast, and when, for the reasons uiready given, the heat-producing power is much less than usual, even although there should be no lack of material stored up in the body. This is well illustrated by the following incident, which Dr. Macnish relates of himself.' " I was travelling on the top of the Caledonian Coach, during an intensely cold day, towards the end of November, 1821. We left Inverness at five in the morning, when it was nearly pitch dark, and when the thermometer probably stood at 18° Fahr. I was disappointed of an inside seat, and was obliged to take one on the top, where there were nine outside passengers besides myself, mostly sportsmen re- turning from their campaigns in the moors. From being obliged to get up so early, and without having taken any refreshment, the cold was truly dreadful, and set fear-noughts, fur-caps, and hosiery, alike * Antiaeptie — preventing the occurrence of putrefaction. » Oxygenating — supplying with oxygen, which is the vitalizing principle of the blood. ' This result has been also noticed as a consequence of the inhalation of the vapours of Ether and of Chloroform, which are allied to Alcohol in bom- position and properties ; and in cases in which the state of Anaesthesia has Neen very profound, the temperature of the body has undergone a con* iiderable depression. * Sailors can generally tell when the " grog is out of them." . 'Anatomy of Drunkenness, p. 307. IN SUSTAINTNG THE VTTAL POWBRA. lOH %t defiance. So situated, and whirling along at the rate of nearly nine miles an hour, with a keen east wind blowing upon u^ from the snnw-covered liillN, I do not exaggerate when I suy that some of us, nt leasf, owed our lives to ardent Hpirits. The cold was so unsuffer- oble, that on arriving at the first stage wo were nearly frozen to death. Our feet were perfootly benumbed ; and our hands, fortified as they were with warm gloves, little better. Under such circum- stances, we all instinctively called for spirits, and took a glass each of raw whiskey, and a little bread. The effect was perfectly magical ; the heat diffused itself over the system, and we continued comparatively warm and comfortable, till our arrival at Aviemore Inn, where we breakfasted. This practice was repeated several times during the journey, and always with the same good effect. When at any time the cold became excessive, wo had recourse to our dram, which insured us warmth and comfort for the next twelve or fourteen miles, without on any occasion, producing the slightest feeling of intoxication. Nor had the spirits which we took, any bad effects either upon the other passengers or myself. On the contrary, we were all, so far as I could learn, much the better for it ; nor can there bo a doubt, that without spirits, or some other stimulating liquor, the consequences of such scver^^ weather would have been highly prejudicial to most of us." — This last statement cannot be admitted without an important reservation, sufficient to invalidate any inference drawn from this or similar cases as to the necemty for alcoholic liquors for the maintenance of the animal he&t under exposure to severe cold. For it will bo observed thut the party started on their journey after a fast of several hours, no food having been taken that morning ; and there is every reason to believe that if Dr. Macnish and his companions bad breakfasted heartily before the commencement of their journey, they would not have found it necessary to have had such frequent recourne to the spirit-bottle; easily-digested solid food, especially such as includes oleaginous matter, taken in conjunction with hot liquids (especially Coffee), being at least as efficacious as a heat-producing material, oa alcoholic liquors can be. In proof of this assertion, we shall now cite a series of facts which are, we conceive, quite adequate to demonstrate it. f- 120. In the first place, the author may relate his own experience of a journey performed on the outside of a stage-coach from Exeter to Bristol, on the 20th of January, 1838, a day memorable for the severity of its temperature, and for that remarkable prediction of the oecurrence which gave a temporary celebrity to " Murphy's Al- manack." The traveller, as in the preceding case, was "whirled along at the rate of nearly nine miles an hour " (which in these days of railroad speed must be accounted but a snail's pace) ; and though not exposed to " a keen cast wind from the snow-covered Z' 101 SUPPOSED USES OF ALCOHOL !i . iiills/ was subjected to a much lower atmospheric temperature, tbo thermometer having stood during the day at 8°, or twenty-four de» ffreee below freezing point. Having fortified himself with a hearty breakfast, however, and having been in some measure previously inured to the cold by a severe frost of a fortnight's duration, he did not suffer from it to any extraordinary degree ; and with the aid of a fresh supply of food at dinner, he arrived at his journey's end without any greater degree of numbness of the extremities, than a short exposure to the genial warmth of a good fire subsequently removed. . No fer* netited liquor was taken by the writer on this journey; and he cannot think that he could have derived any other benefit from it, than that, by accelerating the general circulation, it might have pos* mbly kept up a more rapid flow of blood through the surface and extremities. But this would have been a doubtful benefit, if at the same time the combustion of the materials supplied by the food had been retarded by the presence of the alcohol in the blood. 121. The writer has heard many of the now almost extinct race of Stage-coachmen, — who had been induced to give up their former habit of imbibing a glass of ale or brandy-and-water at every stage, and to substitute an occasional cup of hot coffee and a rasher of toasted bacon, — speak so decidedly in favour of the superior eflScacy of the latter system, that he doubts if any man who had the resolu- tion to adopt it, ever returned to his old habits except from the love of liquor. 121. Experience on a much larger scale, and under a greater severity of cold, leads to the same conclusions. The Esquimaux, Greenlander, or Canadian, relies upon his solid aliment, which con* tains a considerable aniiount of oleaginous matter, for his power of resisting cold ; and when amply supplied with food, does not dread the exposure of his person to cold of the greatest severity. Tiiui Captain Parry mentions with surprise that he saw an Esquimaux female uncover her bosom, and give her child suck, in the open air, when its temperature was /orti/ degrees below zero. And Sir J, Richardson, in a letter to the writer, states that " plenty Of food and good digestion are the best sources of heat," and that " a Ca- nadian with seven or eight pounds of good beef or venison in his stomach, will resist the greatest degree of natural cold, in the open air, and thinly clad, if there be not a strong wind." The inhabi> tants of the Arctic regions appear to have a natural relish for the very oleaginous food, which Nature has provided for them, in the whales, seals, bears, and other animals upon which they chiefly subsist ; and this taste is acquired by Europeans when exposed to the same conditions. Thus Dr. King, who accompanied Sir George Unck in his over-land expedition in search of Sir John Ross, in- formed the author that whereas he had been previously accustomed ro reject every particle of fat, owing to the dislike he felt for it^ h% in 8U8TAINING THE VITAL POWERS. 105 f/Hlw4 \i\ttifte\( able, during bis Arctic journey, to eat any amount of H wH\i feUnh, and even experienced a positive craving for it; and UU *^Mp('f\mnie led liini to consider himself a» far better fortified ^flfiUid the cold by the use of an oleaginous diet, tban by that of fer< in^Uimi ht\ti(irfi. — Testimony to the same effect is given by Dr. J. J)/ \iiitliUfff who was one of the medical officers in the Antarctic expe- 4JtJ ' m 106 SUPPOSED USES OF ALCOHOL recent over-land Arctic expeditions, sent out by the British Govern- nicnt, it has been expressly provided that do fermented liquors shall be used by the parties who proceed upon them; and that the Hudson's Bay Company have for many years entirely excluded spirits from the fur countries to the north, over which they have exclusive control, " to the great improvement," as Sir J. Richardson states, '< of the health and morals of their Canadian servants and of the Indian tribes." ' 123. That such are the teachings of sufficiently prolonged expe- rience, not merely in the frigid zone, but wherever the same condi- tions present themselves, will appear from the two following state- ments. — It is mentioned by Dr. Forbes,* as the result of his personal enquiries from the guides at Cbamouni, that when they are out upon their winter expeditions among the Alpine snows, they never find it advantageous to take any thing stronger than the weak wines of the country ; considering the use of spirits to be decidedly inimical to their power of sustaining exertion in an atmosphere of very low tem- perature. — The writer had the opportunity, about a twelvemonth since, of conversing with a very intelligent man of above seventy years of age, residing at Wareham in Dorsetshire, who had spent more than fifty winters as a fowler; in which vocation he had been exposed to the utmost severity of the winter's cold ; since it can of course be most profitably pursued, when the largest number of birds are driven southwards by the intensity of the frost m their northern residence. He stated that he had frequently been out for a fortnight at a time, without lying down save in his little boat, and scarcely ever obtaining warmth from a fire during that period ; and notwith- standing such severe trials, be was a remarkably hale and vigorous man for his years. Being himself the proprietor of a small public- house, he cannot be supposed to have any prejudice against the use of fermented liquors, in which he indulges in moderation ; but his testimony to the writer was most explicit to the following effect ; — ' To the above testimony, the author may add the following, with which Mr. Eiiton has favoured him. — The Rev. Richard Knill, for many years a Slissionary at Petersburgh, stated in a Public Meeting, in regard to the delusion which prompted people to use ardent spirits "to keep out the cold," that the Russians had long since found out the injurious effects of taking theiu in very cold weather. When a regiment was about to march, orders were issued over-night that no spirits were to be taken on the fol- lowing morning; and to ascertain as far as possible that the order had been complied with, it was the practice of their officials answering to our corporals, carefully to smell the breath of every man when assembled iu the morning before marching, and those who were found to have taken epirits wei-e forthwith ordered out of the ranks, and prevented from march- ing on that day ; it having been found that such men were peculiarly sulgeol to he "frost bitten," and otherwis* 'jijured. • Physician's Holiday, p. 20, note IN 8i;STAINING THE VITAL POWERS. 107 that although the use of ale or brandy might seem beneficial in causing the cold to be less felt at first, (so that when out for no mora than a day or two, he did not think it necessary to abstain from it,) the case was quite reversed when the duration of the exposure wai prolonged ; the cold being then most severely felt, the larger was the proportion of fermented liquors taken. And he further stated, that all the fowlers of his acquaintance, who had been accustomed ta employ brandy with any freedom, whilst out on prolonged expedi- tions, had died early ; he and his brother (who had practised the same abstinence as himself) having outlived nearly all their con temporaries. 124. Hence it may be argued upon scientific principles, that whilst the use of Alcoholic liquors may for a time afford assistance in maintaining the heat of the body, so as the better to enable it to resist the influence of severe cold, they have no such advantage over Oleaginous matter, in affording a pabulum for the respiratory pro- cess, as sufficiently compensates for their injurious effect in prevent- ing or retarding the oxygenation of those ingredients of venous blood, which ought to be continually eliminated by the respiratory process. Consequently, looking at the Chemical influence of alcohol merely, we might expect the prolonged employment of alcoholic liquors to induce, such a vitiation of the blood, as will impair its fitness for the manifold purposes which it is destined to answer. No such result will follow the ingestion of heat-sustaining food ; since this waits it? time for the corabustive operation, without interfering with the oxy- genation of other matters; and if not itself consumed, it is stored up within the body until the time of need. But again, although the stimulating effect of alcoholic liquors is less during the exposure to cold than it is under ordinary circumstances, yet it cannot be alto- gether prevented by the more rapid combustion which the alcohol undergoes ; and it might be anticipated, therefore, from what w^i know of the general action of stimulants, that the depression which follows upon their use would render the. body peculiarly obnoxious to the influence of cold ; so that, although they may help to keep up the temperature of the body for a time, by imparting increased energy to the circulation, yet when that energy is succeeded (as it must be sooner or later) by the opposite condition, the cold will be felt with greater intensity. 125. The predictions thus based on Physiological principles, are found, as we have seen, to be in most perfect harmony with Expe- rience. For this teaches in the first place, that although Alcoholic liquors may afford advantages equal or even superior, regarded simply as material for the combustive process, to those derivable from solid food, those advantages are not of long duration ; so that, for enabling the body to resist the continued influence of severe cold, alcoholic liquors are far inferior in potency to solid food >H ii 108 SUPPOSED USES OF ALCOHOL And, secondly, that although the increase in the energy of the circulation, resulting from the stimulating effect of alcoholic liquors, may prevent the depressing influence of the cold from having its ordinary action upon the system, provided that it be exerted only whilst that effect lasts ; yet that after it has subsided, the cold is felt with augmented severity, and its action upon the system is proportionately injurious.' 126. The question whether there are any circumstances under which the use of Alcoholic liquors can be positively advantageous for the purpose of enabling the body to resist Cold, will be om- sidered in the succeeding chapter (§§ 182-187). II it \ TV. — ENDURANCE OF HEAT. 126. Having thus concluded our enquiry how far the use of Alcoholic liquors is necessary or desirable for arming the body against the depressing effects of cold, we shall consider their agency in supporting the system under the enervating influence of extreme Heat. The belief in the existence of such an agency is scarcely less strongly or generally entertained, than that of their protective power against cold \ but it must be manifestly due, if it exist, to ' The author has preferred basing his conclusions upon informatior which he has obtained by his personal enquiries. He might easily hnvt brought together a considerable amount of published testimony to the same effect. The following statements, contained in the work, entitled *< Bacchus," are in complete harmony with those which he has himself adduced. "In 1619, the crew of a Danish ship of sixty men, well sup- plied wkh provision and ardent spirit, attempted to pass the winter at Hudsjn'sBay; but fifty-eight of them died before the spring: while in the case of an English crew of twenty-two men, in the same circum- stances, but destitute of distilled spirit, only two died. In another in- stance of eight Englishmen, also without spirituous liquors, who wintered in the same bay, the whole survived and returned to England ; and four Russians left without ardent spirits or provisions, in Spitsbergen, lived for a period of six years, and were at length restored to their country. In the winter of 1796, a vessel was wrecked on an island off the coast of Massachusetts ; there were seven persons on board ; it was night ; five of them resolved to quit the wreck and seek shelter on shore. To prepare for the attempt, four of them drank freely of spirits; the fifth would drink none. They all leaped into the water; one wos drowned before he reached the shore ; the other four came to land, and in a deep snow and piercing cold, directed their course to a distant light. All that drank spirits failed, and stopped, and froze, one after another; the man that drank none reached the house, and about two years ago was still alive." (p 374.) The evidence of Captain (now the Rev. Dr.) Scoresby, who was for many years the captain of a whaling ship, is precisely to the same effect with that of the Arctic travellers whose testimony has been already cited. He gives it as his decided opinion that spirits are injurious in cold slimates ; and speaks of the reaction as especially pernicious, in dimin- uhing the power of sustaining cold, as well as that of muscular exertion. ; ( IN SUSTAININCt THE TITAL POWERS. 109 •some modus operandi different from that which renders them ser* ^riceuble in the opposite condition. For it cannot ^c imagined that they can bo of any service by affording pabulum for the combustivo process, when that process is already generating more heat than the body, exposed to a high external temperature, can possibly need. Nor can it be supposed that the loss of the watery portion of the blood, by the perspiratory process, can be in any degree re- paired by the ingestion of ahoholic liquids. It must be presumed, then, that whatever energy their use may communicate to the body, must be derived from their stimulating properties ; and must be Dubject to there disadvantages, which are inseparable from the habitual empl jyment of stimulants. Each of these points, h jW* ever, requires' a fuller examination. 127. It is well known to the Physiologist, that the Respiratory process in warm-blooded animals is much less energetic at high temperatures thau at low ; the system having in itself the power of regulating the amount of matter which it shall burn off, in order thr^t its heat may be kept up to the proper standard. Thus it was ascertained by the experiments of Letellier,' that the amount of carbonic acid set free by Birds, whet, they arc breathing in an atmosphere of from 86° to 106° Fahr., is scarcely more than one- third of that which they generate in an atmosphere of 32° j and by similar experiments upon small Mammalia,' it was ascertained l^at they only give off, between 86° and 106°, about hal/siS much tarbonic acid, and between 59° and 68° about two-thirds as much, Bs they generate at 32°. The experiments of Vierordt' upon his own person lead to a similar conclusion in regard to Man ; although the difference is not so great. For he states that the average (mount of carbonic acid exhaled by him per minute, between the temperatures of 24° and 47° Fahr., was ISJ cubic inches ; whilst the average between the temperatures of 66° and 92° was but 15| cubic inches. It is obvious, then, that the demand for combustive material at high temperatures must be comparatively small ; and that the residents in hot countries cannot require the same supply of heat-producing aliment, as is needed by the inhabitants of the frigid zone. We see this indicated in the quality of the non- azotized * material which Nature has provided for their use ; for whilst the dwellers amid the Arctic and Antarctic seas derive their chief sustenance from these oleaginous articles which have the greatest heat- producing power, the vast population of the Equatorial • Comptes Rendus Tom. xx. p. 796 ; and Ann. de Chim. et de Phyu Tom. xiii. p. 478. ' Mammalia — animals that suckle their young. 'Op. cit. p 73-82. * Non-azotized — destitute 'f nitrocen. 10 no SUPPOSED USES OF ALCOOOL ■!''iii i Ml 'Hi mm mm region derives its principal support from these farinaceous/ vege- table products, whose non-azotizcd portion, belonging to the sac- charine class, has the lowest calorific agency (§ 111). ^ - 128. It is very necessary, however, to bear in mind, that the Respiratory process is not one of simple calorification ; ' for it is one of the most important of all those excretory operations, whereby the waste or eifete' matter of the system is eliminated^ from the blood. This, in fact, may be regarded as the essential part of the function, which is common to all animals; the combustion of an additional amount of hydro-carbonaceous matter, for the purpose of maintaining the temperature of the body at a fixed standard, beini; peculiar to the warm-blooded classes. It is evident, then, that from the diminution of the total quantity of carbonic acid exhaled at high temperatures, the excretory * part of the respiratory function will be more liable, than at low or moderate temperatures, to inter- ference from any agency which still further checks the oxygenation of the combustible matter of the blood. 129. Now as we have found that, under exposure to severe Cold, the stimulating effects of Alcoholic liquors (especially when taken at intervals, in small quantities at a time), are but little felt, the alcohol being burned off before it can accumulate so as to exert any considerable influence on the Nervous system ; — so might we ex- pect that, under the influence of external Heat, when the combustive process is greatly reduced in activity, the stimulant effects of alcohol should be more rapidly produced and more powerfully exerted. And further, if the views formerly stated be correct as to the effects of the absorption of alcohol into the blood, in preventing the elimi- nation of matters which ought to be carried off by the respiratory process, we should expect that the use of alcoholic liquors in warm climates would exert this obstructive influence in a peculiar degree. — Both these anticipations are confirmed by ample experience, which thus bears testimony to the soundness of our principles. For it is well known that a far smaller quantity of alcoholic liquor suffices to produce intoxication beneath a burning sun than in a frosty atmo- sphere ; so that individuals who are not aware of this fact sometimes become intoxicated, without having exceeded the allowance which they believed to be perfectly compatible with sobriety. Again, it has been continually observed that when Alcoholic liquors are taken during the performance of severe labour in an extremely high tern* \ ' Farinaceous — of the nature of meal or flour. ' Calorification — producing heat. • Effete — refuse matter; worn-out matter. • Eliminated — separated, removed. • Excretory — adapted to the removal and expulsion from Ihe body of all such matters as are no longer adapted for its support, or are if an iiijuriouK nature. IN SUSTAININQ THE VITAL POWEaS. Ill it perature, their temporary stimulation is followed by a very rapid and decided failure both of nervous and muscular power; so that men who drink largely of such liquors in the intervals of their work, are obliged to abstain from thorn whilst their labour is in progress. This result appears fairly attributable to vitiation of the circulating blood, consequent upon the retention of matters destined for excre- tion ; the -removal of which, by the oxygenating process, has been obstructed by the presence of alcohol. And the same inference ap- pears legitimately deducible from the peculiar tendency (already referred to, §§ 54, 55,) which the habitual use of alcoholic liquor? in warm climates has to engender diseases of the Liver ; the duty of separating those hydro-carbonaceous products of the waste of the flystem, which are poisonous if retained in the blood, being unduly thrown upon the liver, when their elimination by the lungs is inter- fered with. 130. That the use of Alcohol is especially necessary to support the system under its excessive loss by Perspiration at high temperatures, is an idea so commonly held, that it demands a serious refutiition ; although the fallacy of the notion, that because water is drawn off from the blood through the pores of the skin, alcohol must be taken into the stomach to replace it, would appear self-evident. The fundamental error seems to lie in the notion, that copious perspiration in itself really weakens the system ; whilst it is, in fact, nothing else than the means by which the ex- ternal warmth is prevented from raising the heat of the body above its normal standard. The determination of the blood to the skin, which that heat excites, appears to cause an unusual transudation ' of the watery part of the blood through the thin-walled capillaries' of the sweat-glands ; just as certain diuretic ^ medicines increase the quantity of water in the urine, by causing an increased determina* tion of blood to the kidneys ; but with this large amount of watery fluid, very little solid matter passes off, — none, in fact, but what in purely excrementitious. 131. That Perspiration, however abundant, has in itself no weak* ening effect, — except by diminishing the quantity of water in the blood (which is readily supplied by absorption from the stomach), — appears from the fact, that if persons exposed to a very high tem- perature make no bodily exertion, they do not experience any loss of vigour, if copiously supplied with cold water. In fact, such ex- posure may bo made to conduce very decidedly to the invigoration of the system. All travellers who have tried the Russian baths, speak of the feelings of renovation which tlie copious perspiration. * Transudation — passing through as perspiration. * Capillaries — very minute vessels, like hairs. * Diuretic — that which increases the secretion of urine. Ji2 SUPPOSED USES OF ALCOHOL m and the subsequent plunge into cold water, produce in the weaned frame. And those who have given a fair trial to the Hydropathic treatment, in appropriate cases, are unanimous in the same testimony. The writer has himself been in a stove-roon, in which delicate females were accustomed to remain for half-an-hour or more, when it was heated to a temperature of from 140° to 170° Fahr. ; their wrappings becoming saturated by copious perspiration, the material for which was supplied by the water administered to them internally from time to time ; and he has had ample assurance to the effect, that this process, when followed by the cold plunge, had usually an invigorating influence, which quite sets aside the idea that the act of perspiration is in itself exhausting, or that it removes from tho gystem any thing which it can be requisite for alcohol to supply. 182. The peculiar fatigue which usually results from muscular exertion at a high temperature, is generally set down as the conse- quence of the excessive perspiration ; although the fact is, that tho fatigue is chiefly to be attributed to the interference with the vapor- ous or " insensible" transpiration, which is produced by the accu- mulation of liquid or " sensible" perspiration on the surface of the skin, and by the saturation of the garments in contact with it. For the same fatigue is experienced when the atmosphere is loaded with dampness, even at a low temperature ; and it has been the uniform result of the attempt to use any muscular efibrt, when the body has been clothed in water-proof garments made after the fashion of or- dinary clothes, so as not only to keep out the rain, but to keep in the insensible perspiration. In either case the effect is the same ',-^ the due vaporization of fluid at the surface of the skin is checked ; the cooling influence of the perspiration is not exerted ; and the heat of the body itself is injuriously augmented.' And as an augmenta- tion of from 11° to 13° in the temperature of a warm-blooded ani- mal produces an invariably ^a^a/ result, so can it be readily under- Btoud that an increase of 2° or 3° must be attended with injurious consequences, so long as it lasts. 133. Among these consequences we may probably rank a still further diminution in the quantity of carbonic acid exhaled from the lungs ; as well as an obstruction to the cutaneous respiration,' ' Thus it was found by MM. Delaroche and Berger, that when animals were exposed to the temperature of 120°, their bodies being enveloped in close boxes, whilst their heads were free, a thermometer placed in the mouth showed an increase of 6° in the heat of the body, in the course of seventeen minutes ; this elevation being obviously due to the obstruction to the transpiration from the surface of the body. When by continued exposure to a heated atmosphere saturated with moisture, the temperature of the body was raised from 11° to 13° above the natural standard, the ani»- :xls uniformly died. * Cutaneous respiration — discharge »f vaporous and gaseous matter by tho skin. AV IV 8UBTAININ0 THE VITAL POWERS. 118 trhich, although its proportional amount has not yet been satisfac- torily ascertained, is certainly of no mean importance in the depura- tion ' of the blood. Hence an accumulation of excrementitious' matters will take place in the circulating fluid, such as affords quite a sufficient explanation of the peculiar fatigue which is experienced when muscular exertion is called for in a heated atmosphere already charged with moisture. And we should expect that such exertion could be performed with much less feeling of exhaustion in an atmo< sphere of dry air, though of very high temperature, — such as that of glass-houses, gas-works, or foundries, — than in the less heated atmosphere of tropical countries, which usually contains a couhidera- ble amount of watery vapour. This is undoubtedly the fact; and as a far larger amount of liquid will be carried off by insensible transpiration ' in the former case than in the latter, it proves the correctness of our position, that it is not the loss of liquid from the skin, which is the cause of the peculiar exhaustion that results from muscular exertion in a heated atmosphere ; * and that we are to look for the source of that exhaustion in the elevation of the temperature of the body itself, which will be produced with peculiar facility in a damp and heated atmosphere ; and in the accumulation of excre- mentitious matters in the blood, which will be especially likely to '■ake place when their elimination* through the lungs is being /becked, at the same time that an increased amount is being gene- .-ated by the waste of the muscular tissues. 134. If, then, our fundamental positions have been just, and our Argument correct, we should infer that, putting aside their peculiar influence upon the nervous system, the use of Alcoholic liquors during muscular exertion in a heated atmosphere, and especially when that atmosphere is charged with moisture, can be nothing else than injurious; as tending to interfere still more with that elimina- tion of excrementitious matters from the blood, which is peculiarly required when a continual production of such matters is taking place through the disintegration of the nervous and muscular tissues con- sequent upon their functional activity, and which is already nitarded by the diminution in the activity of respiration. We shall presently find that experience is here also in accordance with theory ; the re- sult of many trials having shown, that severe and long-continued Depuration — purification. * Excrementitious — worn-out, refuse, deleterious matters, which, unless regularly removed from the blood, impair its purity =■ Insensible transpiration — the continued discharge of vapour by the skio in an imperceptible form. * We are of course supposing throughout, that water is freely supplied in both cases. The exhaustion produced by the undue diminution of the liuids of the body, indicated by excessive thirst, is of quite a different sharacter. * Elimination — separation; removal. 10* 114 SUPPOSED USES OF ALCOnOL I) ; I U »' exertion in tropical climates can be better gustained tcitha 'f>vera1 unhealthy and marshy districts, the men wore tree from t«ickncs^ to an extent absolutely unprecedented in nur marches in India ; they had no cholera and no fever; and only two men were lost l»y dysentery, both of whom were old chronic cases taken out of hospiiil at Madras. With these exceptions, there was scarcely a .tfTious case of sickness during the whole march. The oflScers were surprised that the men marched infinitely better, with less fatigue and with fewer stragglers, than they had ever before known ; and it was noticed by every one that the men were unusually cheerful and contented. During the wbolo march, the regiment had not a single prisoner for drunkenness." A considerable proportion of the men (the writer has learned from bis informant) abstained entirely from arrack ; and the consumption of those who occasionally took it, was far below their usual allow- ance. Those who entirely abstained were certainly in no respect inferior, either in power of sustaining exertion, or in freedom from sickness, to those who occasionally took small quantities of spirits ; on the contrary, they rather seemed to have the advantage. That this remarkable result was not duo to any peculiar healthfulness of the season, or other modifying circumstance, is shown by the fact that the C3rd Regiment, which performed the same marchy at the very same time, though in the opposite direction, lost several men out of a strength of 400; and that it had so many sick, that when it met the 84th on its march, it was obliged to borrow the spare "dhoolies" (or palanquins for the sick) belonging to the latter.' 141. The foregoing account fully accorda with that given by Sir James (then Mr.) McGrigor, of the march in Egypt of a division of the British army sent from Hindustan to aid the main army in opposing the French under Buonaparte. After the Great Desert had been crossed, in July, 1801, no spirits were issued to the troopa in Upper Egypt, owing to a difficulty in procuring carriage for them. At this time there was much fatigue-duty to be performed ; which, for want of followers, was done by the soldiers themselves ; the other duties were severe upon them ; they were frequently ex- ercised, and were much in the sun ; the heat was excessive, the thermometer standing at 113° or 114® Fahr. in the soldiers' tenta in the middle of the day ; hut at no time was the Indian army more healthy.* ' The marked contrast between the rate of mortality in the 63rd and 84th Regiments, during tlieir respective residenoes at Secuuderabad during two consecutive years, has been already noticed (§§ 81, 82) ; but it may be as well here to remind the reader, that the former lost 73 men in nine months, which was at the rate of 78-8 per 1000 of average strength for the entire year ; whilst the latter lost but 39 men in the whole twelve months, being at the rate of 84'2 of average strength. ' Medical Sketches of the Expedition from India to Egypt, p. 86. M tilt m\ '"^ i ■■*!■'. ■n *'l m 1 m ii'l 118 SUPPOSED USES OF ALCOHOL 142. The intimate acquaintance of Sir Charles Napier with the habits and wants of the Indian soldier can be doubted by no one ; and the following is his testimony in favour of the abstinence sys- tem, (delivered in his own characteristic manner) as contained in his address to the 96th Regiment, when he reviewed it at Calcutta on the 11th of May, 1849. — "Let me give you a bit of advice — that is, don't drink. I know young men do not think much about advice from old men. They put their tongue in their cheek, and think that they know a good deal better than the old cove that is giving them advice. But let me tell you that you are come to a country where, if you drink, you're dead men. If you be sober and steady, you'll get on well; but if you drink, you're done for. You will be either invalided or die. I knew two regiments in this country, one drank, the other didn't drink. The one that didn't drink is one of the finest regiments, and has got on as well as any regiment in existence. The one that did drink has been all but destroyed. For any regiment for which I have a respect (and there is not one of the British regiments that I don't respect) I should always try and persuade them to keep from drinking. I know there are some men who will drink in spite of the devil and their officers; but such men will soon be in hospital, and very few that go in, in this country, ever come out again." 14.3. Whatever temporary advantage, then, is derived or sup- posed to be derived from the stimulating powers of Alcoholic liquors, when they are used with a view of sustaining the power of exertion in tropical climates, is dearly purchased by the in- creased liability to disease, which not only theoretically, but accord- ing to all competent evidence, actually results from their habitual use. And thus Theory and Practice are again completely agreed, in affording a decisive contradiction to the usually received idea, that Alcoholic liquors assist the body in the endurance of Heat. V. — EESISTANCE TO MORBIFIC AGENCIES.' 144. It is a common idea, and one apparently supported by adequate evidence, that such a use of fermented liquors as aids in keeping the body in " high condition," renders it less susceptible of the influence of pestilential miasmata,' of cold and damp, or of other morbific agencies; and this belief is entertained by many, who deprecate the habitual use of fermented liquors under other circumstances. Thus, says Dr. Macnish, "lam persuaded that while, in the tropics, stimulating liquors are highly prejudicial, and often occasion, while they never prevent disease; they are fre- ' Morbific agencies — disease-producing agencies. * Miatmala — the marbific, or disease-producing emanations from dO' mestic and personal impurities, decaying organic substances, marahos, ko. in SVSTAININO THE VITAL POWERS. 110 AH#ft(1jr (^ great service in accomplishing the latter object in ilamp H*/i(^y mxmir'wn, especially when fatigue, poor diet, agues, d}8en- i^V)ff*t Mh\ other diseases of debility are to be contended against/' *="/*» countries subject to intermittents, it is very well known iU^i th'we who indulge moderately in spirits are much less subject Ui tl«f«« difleoses than the strictly abstinent." ' These assertions f<« tfOdeftVours to justify by the two following statements. " At Wtt1(«h«ren it was remarked that those officers and soldiers who UhM M/hnflps, alian brandy drams, in the morning, and smoked, §#*«J*«d the fever which was so destructive to the British troops ; ftf((i ihe natives generally insisted upon doing so before going out i« ib« fnorning. ' Again, " A British regiment quartered on the Nltf^ra frontier of Upper Canada, in the year 1813, was pre- ^^M\m\ by some accident from receiving the usual supply of spirits; flft4 \u ft rery xhort time, more than two-thirds of the men were oa ♦l<# hU'k list from ague and dysentery ; while the very next year, 9M the same ground, and in almost every respect under the same ^i^l'dlustanccs, except that the men had their usual allowance of §\l^f\i^f (he sickness was extremely trifling. Every person ac- ^Hftifft^d with the circumstances, believed that the diminution of th(^ sk'k daring the latter period, was attributable to the men l*tt¥W»g received the quantity of spirits to which they had been kt^M dated/'* i4§/ Now it is obvious that neither of these facts proves that #*p^«re to tlic morbific agencies in question renders an allowance #f ^fjts necessary, or even beneficial, for those who have not been IM^HWt^ttied to make use of it under ordinary circumstances. On i\\^ (wrtltfary, the second instance is a valuable testimony to the dlw^tafifago of habitual dependence upon alcoholic stimulants; }Mf»mt(eh as it is evident that, when they were withheld from the ift^iH, the constitution of the men was rendered peculiarly sus- #^p/lW« to the causes of disease indigenous * to their locality. All il^ttt Jt M-oves is, that an unduly depressed state of the system is hmUHvAQ to attacks of ague and dysentery (of which every medi- #ttj |yfa«titioner ia aware), and that in persons who have habituated (fwiH^fllves to the use of spirits, such depression is liable to super- it^m when the allowance is withheld, and may be for a time kept iM iff Hn restoration. — And even the first example cannot be said Ut pfttife more than this; for it simply gives us the experience of itt/livMiials who took an early dose of spirits, as compared with Uiai of the individuals who abstained from this habit; without ' Anatomy of Drunkenness, pp. 277, 279. 'Glasgow MedicalJournal, No. xt. • Op. cit. * Indigenous — belonging to •ae place. ^Il.^i I 120 SUPPOSED USES OF ALCOHOL i ^;|i I -; ■ ?i m lelllng us that the latter adopted any of those substitutes, which prudential experience would dictate. 146. The writer is strongly impressed with the belief, that the result, in this and in many similar cases, is to be attributed to the neglect of such precautions. It is well known that in localities where zymotic ' poisons are indigenous, no condition of the healthy Bystem is so obnoxious to their influence, as that which is natural to it on first rising in the morning, when the stomach is empty, the pulse comparatively feeble, and the heat-producing power nearly at its minimum. The nutritive actions which have been taking place during repose, have prepared the nervous and muscular appa- ratus for renewed activity ; but this has been accomplished at the expense of the blood, from which there has been a continual drain, both for the regeneration of the tissues, and for the maintenance of the animal heat. It is within the experience of most persons, that nervous and muscular exertion are less efficiently sustained,' and external cold less fully resisted, at this period, than at any other ', and the recommendation of experience to " take something to keep the cold out of the stomach" is here fully justified upon physiological principles. But it does not hence follow, that alco- holic stimulants constitute the best means of protecting the system against the influence of morbific agencies; on the contrary, we shall find strong reason to believe that other means, properly em- ployed, would be as efficacious at the time, and would have a more permanently beneficial effect. 147. A man previously in the enjoyment of vigorous health, and not accustomed to depend upon alcoholic stimulants, will de- rive all the protection he can require, from taking his first solid meal before he exposes himself to the cold, damp, or pestilential miasmata, whose influence is to be resisted ; and the moderate use of hot tea, coffee, or cocoa, will help to diffuse a genial warmth through his body, which is more enduring than that which results from the ingestion of spirituous liquors. In this way the stomach will be wholesomely employed, new material will be supplied to the blood, the circulation will be quickened without being excited, the firmness of the pulse will be increased, and the heat-producing power will be augmented ; and all this, in a manner strictly ac- cordant with the normal economy of the bodily system. — On the other hand, although the use of spirits, by producing a temporary excitement of the circulation, will probably render the system less 'Zymotic — fermeutive. A term applied to the causes productive of endemic, epidemic, and contagious diseases. ' The writer can speak feelingly on this subject ; being himself unable to walk a couple of miles upon the empty stomach of early morning, without extreme languor almost amounting to syncope ; although four or five times that amount would usually be performed by him after breakfast with scarcely an approach to fatigue. ?N SUSTAINING THE VITAL POWERS. 121 uctive of obnoxious to morbific agencies, than if it be exposed to them before its dormant energies Lave been in any way aroused, yet we can scarcely anticipate that they can be as favourable to the sustenance of its energy (a previously healthy and vigorous condition being supposed), as persistence in the regular habits to which it has been accustonjed. For it has been already shown, that the continued endurattce of cold is not favoured by the use of alcoholic liquors, but on the contrary is impaired by it; and where cold, therefore, acts concurrently with zymotic poisons, and favours their operation by the depression of the vital powers which it induces, we should feel certain that those means would be most conducive to the re- sisting power of the system, which arc most efficient in maintaining its standard warmth. 148. So far as we are acquainted with the bearings of experience on this question, they are decidedly favourable to the view here advocated, namely, — that where a healthy state of the system has been previously maintained without the assistance of alcoholic liquors, the operation of morbific agents will be more efficiently warded off by a continuance of the abstinent plan, than by re- course to stimulants ; provided that the same precaution be exer- cised by the disciple of abstinence, as by the spirit-drinker, in not exposing himself to the morning air without a fortification of "the inner man." For we do not see that the circumstances of tropical or those of cold or temperate climates diflFer, as regards the sus- ceptibility of the system to zymotic poisons, in any other particular than their temperature ; but this will act in more than one way ; for whilst, on the one hand, the depressing influence of cold upon the body will tend to increase its susceptibility, the agency of heat, on the other, will augment the potency of the poison. Now, that abstinence from spirits diminishes instead of increasing the liability of the body to the influence of pestilential miasms in warm cli- mates, provided that other precautions be duly taken, we have not merely the individual experience of Mr. Gardner, Mr. Waterton, and others (§§ 138, 139), in addition to the testimony of many medical observers, but the important evidence derived from the march of the 84th Regiment along a road " proverbial for cholera and dysentery," without a single fresh attack of these complaints (§ 140). Here the "pint of hot coffee and biscuit" were cer- tainly to the full as efficacious as " the daily morning dram, which soldiers on the march in India almost invariably takej" and there is no adequate reason why the coffee should not have an equal value in colder countries, when employed with the larger ailowauco of heat-producing food which will be there required. 149. When the remote effects of the two systems are contrasted, there can be little hesitation in assigning the preference to the abstinent plan. For the object being to sustain the utmost equa- 11 m 122 SUPPOSED USES OF ALCOHOL billty of health, and especially to avoid t.hufc depressed condition which sooner or later supervenes upon states of undue excitement, il is obvious that when all the nutritive functions arc regularly and vigorously discharged, it is unwise to interfere with their per- formance by the use of Alcoholic liquors, which, if suflScient to pro- duce either general stimulation, or excitement of any one function, must involve as its consequence a corresponding diminution of tho normal activity at some subsequent period. It is quite triii. that this may not manifest itself at once ; so that for weeks, months, and years, the vigour of tho system may seenj to be efficiently main- tained, and morbific agencies to be perfectly kept at bay, by the habitual use of a small quantity of alcoholic stimulus; to which the beneficial result will then be probably attributed. But the trial ig not complete in weeks, months, or years ; it must last for the whole life ; and if it be true, as we shall presently endeavour to show, x\\»t the continued employment, however moderate, of small quantities of alcoholic liquors, favours, if it does not necessarily induce, an early exhaustion of the vital powers, it cannot be questioned that the system will then be left in a state of peculiar susceptibility to the influence of zymotic poisons and other morbific agencies. It is well known that persons of regular habits and good ordinary health, who have long resided in countries where intermittent fevers prevail, are frequently attacked by them when their vital powers begin to decline with advancing years ; and if that decline be hastened by the previous over-excitement of alcoholic liquors, the influence of these morbific causes will be earlier and more powerfully exerted. 150. These theoretical deductions are not merely sanctioned by such results of experience as can be brought to bear directly upon them ; for they are in complete harmony with the facts universally admitted, in regard to the peculiar susceptibility of habitually intem- perate persons, and especially of those whose constitutions have been broken down by the combined influence of intemperance and ad- vancing years, to the attacks of fever, cholera, and other pestilential disorders (§ 65). For, we again repeat, if the cause, when .acting with its greatest potency, is attended with a result which no one can hesitate in accepting, it is but reasonable to attribute to the same cause, acting with diminished intensity, but over a longer period of time, a result of a similar nature; even though this may be so long postponed, that its dependence on that cause is in danger of being overlooked. 151. We have abundant evidence, then, not merely in the expe- rience of individuals, but in that of large bodies of men, that the most vigorous health maj/ he maintained, under circumstances usually regarded as most trying to the power of bodily and mental endurance, without the assistance of Alcoholic stimulants. Such evidence is aflForded by the numerous ships that are travelling everv IN SUSTAINING THE VITAL I'OWERS. 123 SO long pnrt of the wide ocean, whose crews, pledged to the totul abstinence principle, maintain a degree of health and vigour which cannot be surpa^^8ed ; by the many workshops of every kind, in which the severest labour is endured, with a constancy at least equal to that of the drinkers of alcoholic beverages ; by troops executing toilsome inarches in the sultry heat of u torrid zone, and through the pesti- lential atmosphere of tropical marshes, who find the '* cup of cold water" more refreshing and sustaining than the spirituous drinks which hurry so many of their comrades to an early grave j and by numbers of men and women, in every rank of life, in every variety of condition, and subjected to every kind of mental and bodily exertion, who have given the principle of Total Abstinence a fair trial, and have borne their willing testimony to its beneficial results. And. where such is the case, there can scarcely be a question that this system is preferable to the habitual use, however moderate, of fermented liquors. For, if the appetite prompt to the use of an adequate amount of nourishment to repair the waste of the sytem ; if the stomach perform its action with due energy, and supply to the absorbent vessels the material for fresh blood in a state of due preparation j if the circulation be carried on with that equable regu- larity, which is most favourable to the actions to which it is subser- vient; if the various tissues draw from the current of nutritious fluid the materials which they severally require, and apply these materials to their own maintenance and regeneration ; if the lungs freely exha-le the carbonic acid which is evolved by their exercise, and introduce the oxygen which is needed for a renewal of the effort; and if the liver, kidneys, and skin, by the constant discharge of their respective offices, eliminate from the blood the other pro- ducts of the waste of the system, and thus keep it in the state of purity most favourable to the discharge of its multitudinous func- tions ; — in a word, if all the actions coucerned in the maintenance of the fabric be already discharged with that vigour and uniformity which constitute health, why should we attempt to alter them by means of agents, which, if they produce any effect whatever on the system, can only operate by producing a departure from that perfect balance of the several parts of the nutritive functions which it is so desirable to maintain, and so difficult to restore when perverted? Let us examine these questions iu more detail. VI. — CONSEQUENCES OF THE HABITUAL "MODERATE" USE OF ALCOHOLIC LIQUORS. ' 152. Effect upon the General System and Excretory Organs. — If the natural appetite be already good enough to give a relish to the food which the system requires, can the artificial production of an increased appetite be necessary or desirable? And if the sto ■hir' ;;l,il 124 SUPPOSED USES OF ALCOHOL ii'.v I Pi mach be already capable of digesting and preparing as much nutri- ment as is required to keep up the solids of the blood to their pro- per amount, can any but prejudicial consequences result from forcing it to dispose of more ? Two classes of evils may be cspected to proceed from such a system ; in the first place, the habitual intro- duction of more alimentary material into the circulating current than the nutritive functions can appropriate, must predispose to disorder of the system in general ; and secondly, by constant reliance upon an artificial stimulus, the natural powers of the stomach itself must be in danger of becoming gradually impaired. 153. The eflfect upon the system at large, of an habitual intro- duction of more alimentary material than the nutritive functions can appropriate, seems to vary with the temperament. In some in- dividuals, they are converted into blood, so that the normal amount of that liquid undergoes an augmentation ; thereby inducing a state of plethora,^ which is favourable to local congestions and inflamma- tory diseases of various organs, and which especially predisposes tci hemorrhage — this being an eflFort of nature to relieve the undue turgescence. But in other constitutions, the superfluous aliment would seem to be never so far vitalized and assimilated, but is from the first destined to excretion ; the lungs, the liver, the kidney, and the skin, are thus called upon to remove, not merely the products of the normal waste or disintegration of the system, but also the superfluous non-assimilated matter ; and hence they are brought into a state of undue functional activity, which cannot but render them peculiarly susceptible of derangement. The excretory action of the lungs, however, is chiefly regulated (as already shown, § 127), by the temperature ; so that, when it is diminished by external warmth, more remains to be accomplished by the other depurating* organs; and hence any excess in diet is more likely to have a prejudicial eflfect upon the latter in warm climates, and during the summer, than in a colder atmosphere. 154. This is precisely what experience teaches. From habitual excess in diet, in temperate climates, in persons not of the san- guineous temperament, disorders both of the Liver and Kidney are very apt to arise ; those being most liable to the former, who have not the powtr of generating fatty tissue at the expense of the sur- plus of non-azotized food ; and those being most liable to the latter, in whom the too free use of alcoholic liquors occasions an undue determination of blood to the Kidneys. On the other hand, habitual excess of food in warm climates usually manifests itself first in dis- orders of the Liver; since the diminished excretion of carbon hy the tungs causes the blood to proceed to the liver more highly chiirgo-l ' Plethora — overfulness of blood * Depurating — purifying. f. IN SUSTAININO THE VITAL POWERS. 125 1 nutri- eir pro- forcing •cted to il intro- int than disorder ce upon ilf must al intro- unctions some in- amoant 9 a state iflamma- ?pose8 t(i le undue aliment fc is from ney, and products* also the ight into der them m of the 127), by warmth, organs ; •ejudicial summer, habitual the san- idney are who have the sur- he latter, an undue , habitual •st in dis- on by the ^ ch'^ugcc. vitli that element, whilst at the same time the consumption of that part of the biliary secretion which should bo normally oxygenated and carried off through the lungs, is interfered with. On the other hand, the Skin, whose functions are greatly increased in activity, comes to the tissistance of the Kidneys in disposing of the super- fluity of azotized ' aliment; a considerable amount of uroa^ being daily excreted through the former channel.' This result of what ix accounted the " moderate" use of alcoholic liquors in warm climates, for the purpose of increasing the appetite and stimulating the diges- tive powers of the stomach, is much dwelt upon by writers on tro-» pical diseases ; who represent it as, in the long run, not less hurtful than that excess which produces effects more immediately and ob- viously pernicious. In this point of view it ranks with high-sea- soned dishes, and those other seducing provocatives to the diminished appetite and lessened digestive powers of the residents in such cli- mates, which, by occasioning the habitual ingestion of more food than the system requires^ are among the most fertile sources of tro- pical disease. 155. Now, as already remarked, almost every cause of disease acts on the human system with greater potency in tropical than in temperate regions; and we have opportunities, therefore, in the study of tropical diseases, of perceiving the agency of causes, whose tardiness of operation under other circumstances interferes with our recognition of their real results. It cannot, then, be imagined that even a small habitual excess in diet, induced by the stimulating action of fermented liquors, can be without its remote consequences upon the general system ; even thougb it may be for a time suffi- siently compensated by increased activity of the excreting organs.* And the disorders of the Liver and Kidneys, which are so frequent among those who have been accustomed to this mode of living for many years, without (as they believe) any injurious consequences, are as surely to be set down to it, as are those congestive and in- flammatory diseases of the abdominal viscera, which so much more speedily follow upon habitual excess in warm climates. For the excreting organs cannot be always kept i a condition of excessive activity ; like other parts of the system, they suffer sooner or later from too great an exaltation of their function ; and if this should not pass, as it often does, into an inflammatory condition, it is almost certain to be remotely followed by a state of depressed activity, in which the nutrition of the organ becomes impaired, so that it is left, ' Azotized aliment — aliment containing nitrogen. a fjrea — a substance forming an essential part* of the urine. ' See the experiments of Dr. Landerer of Athens, in Brit, and For. Med. Chir. Review, vol. i. p. 541. * Excreting organs — organs that separate the refuse, worn-out, and dele- terious matters from the blood. 11* '«:, 126 SUPPOSED USES OF ALCOHOL m If in US m ijik during the remainder of life, in a state by no means eqiml to the performance of its regular duties. 156. In asserting that to the ordinary use of fermented liquors in "moderate" quantity, during early and middle life, and to the habi« tual excess in diet (however slight) to which they prompt, we are to attribute many of the chronic disorders of the excreting organs which are amongst the most common ailments of advancing years, we may seem to go beyond the positive teachings of experience. The con- sequences are so remote, that we may not appear to be ju. taincd, whereby the effects of excess arc neutralized for a time, — but onli/ for a time ; for as surely as any organ is habitually exerted in an excessive degree, so surely must its vital powers be prematurely exhausted, the remoteness of the period at which the flagging of itd Eower begins to manifest itself, being inversely to the degree of abitual over-excitement. Hence wo have additional reason for imputing a considerable proportion of those chronic disorders of the excretory organs to which reference has been more especially made, to the habitual employment of alcoholic liquors, in what is ordinarily considered to be a <' moderate" amount, and regarded as perfectly consistent with health, if not required to maintain it. 159. It would be absurd, however, to affirm that such diseases alioays proceed from this cause j since those who practise Total Ab- «tinence from alcoholic liquors are by no means proof against other errors in dietetics ; and in so fur us they habitually take in more food than their system needs, they will be liable to suffer from dis- order of the organs whose duty it is to eliminate the waste. But they will be much sooner warned of the excess they have com- mitted, if the stomach refuses to digest the superfluity, instead of being forced by artificial stimulation to an undue exertion of its power; and an attack of indigestion, by early giving a salutary check to the practice, may ward off its remoter consequences. It is the freedom from such checks, up to a certain time of life, which encourages in those, who habitually use fermented liquors in "mo- deration," and who at the same time practise habitual though slight excess in the amount of solid food which they consume, the delu- sive belief that in neither case are they doing themselves any harm 160. Effect upon the Stomach. — Such, then, are the consequences to the system at large, which Theory and Experience join to indi- cate, as resulting from such an habitual use of Alcoholic liquors as stimulates the appetite to desire, and the stomach to digest, a larger amount of food than is necessary to supply the wants of the body ; and we have next to inquire into the effects it produces upon the Stomach itself. We have already described the admitted results of what is commonly regarded as " excess ;" and we shall therefore at present limit ourselves to the inquiry, whether the " moderate'' use of alcoholic liquors is likely to be productive of any injurious consequences, as regards this important organ. All our knowledge of the action of stimulants would lead to the conclusion, that when once the liabit of employing them has been established, and the stomach is come to rely (as it were) upon the extraneous aid which they afford, its power of performing its duty without such aid must he impaired. The case is very similar to that of sleep. A person ,n\ health, and not subjected to any unfavourable influences, is natu* l\ IS SUSTAINING THE VITAL 1' W E R 8 , 129 .tiUy disposed to pass as much time in reposo, as hi« system nepd» for its renovation ; but if he were long to accustom hinjself to the use ((f a narcotic, he would find himself completely unable to sleep without it. And experience shows, in like manner, that those who have long been habituated to the moderate use of Alcoholic beve- rages with their meals, are seldom able to discontinue them without a teniporary loss of appetite and of digestive power, — unless, in- deed, their place be supplied by the more wholesome excitement of fresh air and exercise. K>1. With many persons, the evil, so far as the Stomach is con- cerned, may seem to bo confined to the induction of this state of reliance on artificial aid. Year after year passes away, without anj indication that its powers have been overtasked, or that any un- healthy change has taken place in its circulation or nutrition ; and the usual dose of the alcoholic stimulant appears still to produce its wonted effect. But this does not show that the practice is really innocuous. We have seen that whilst a potent dose of a poison speedily manifests its action by the violence of its effects, the re- peated introduction of minute doses is not really inoperative, al- though the effects are not speedily apparent. If the stomach be not an exception to the general law of the action of stimulants upon the animal body, we should expect that by the habitual over-excite- ment of its function, in however trifling a degree, its vital energy will undergo a premature depression ; and that the result of the moderate use of alcoholic stimulants will manifest itself, sooner or later, in diminution of the digestive power. The earliest indication of this, in most instances, is the demand for the augmentation of the stimulus to produce the same result; the amount which was at first suflicient to whet the appetite and increase the digestive power, being no longer found adequate. If the demand be yielded to, and the quantity of the stimulus be augmented, the original benefit seems for a time to be derived from it; but after the stomach has become tolerant of the liquor, that which at first excited it to in- creased functional activity, does so no longer, and a further increase is called for ; until what began in " moderation" ends in positive excess, with all its consequent evils. But supposing this demand not to be felt, or not to be yielded to, the same " moderate" allow- ance being indulged in for a long course of years, we should antici pate that injurious consequences, though perhaps long po.«tpoiied, must ultimately show themselves; and that such is the ease, is un- fortunately the experience of a vast number, who suffer, by that '•loss of tone" of the stomach which is so common an attendant of advancing years, for the too great activity to which the organ has been previously forced, during the long period of early and middle life. And although the common idea, that alcoholic liquor.«- i ■-(< ill 130 SUPPOSED V SKA OF ALCOHOL when talicn in smuU quaiititica have a tonic^ property, may render it difficult for some to coincide in the conclusion that the real effect of the habitual use of even this small quantity must be of the op- posite kind, — exhaustive instead of tonic, — yet as this idea has no other foundation than the temporary assistance derived from the stimulating powers of alcohol, it ought not to prevent our recogni- tion of the consequences which might be theoretically expected to proceed from its long-continued action. IG'2. It is not here maintained, however, that the habitual em- ployment of alcoholic stimulants in small quantity, even when coupled with habitual excess in the amount of food ingested, uniformly stands to the loss of appetite and digestive power so frequent with the advance of years, in the relation of cause and effect; for there can be no doubt that the habit may be persevered in by some indi- viduals throughout a long life, without the manifestation of any injurious results ; whilst on the other band, it cannot but bo ad- mitted that the disorder in question may be induced in other ways. But the existence of exceptional cases by no means invalidates the argument based upon general experience ; any more than oui occa- sionally meeting with individuals who have daily consumed a bottle of spirits, and have yet enjoyed a hearty old age, warrants us in rejecting the evidence which indicates that such a consumption would have, in hy far the larger proportion of mankind, a decided tendency to shorten life. Nor does it follow, that because the loss of digestive power may be justly attributed to other causes when this one has been wanting, it has been inoperative when present. In fact, there can be little doubt that amongst the class of men who are engaged in active mental occupation, and who justify a moderate use of alco- holic liquors on the ground that it keeps them " up to their work," the expenditure of nervous power, consequent upon that undue exertion of the cerebral functions which has been aided by the con- tinual over-stimulation, has a large share in the result. 163. Effect upon the Nervous System. — Every medical man ia familiar with cases, in which the " wear and tear" of an over-active life has been sustained with little apparent loss of power for perhaps a long series of years ; but in which there is a sudden failure both of mental and bodily vigour, as manifested in deficiency of power of continued mental exertion, depression of spirits, want of appetite, enfeebled digestion, and the whole train of disordered actions which is consequent upon this condition. It is not to be denied that such u state may arise quite independently of the agency, direct or indi- rect, of habitual stimulation ; one instance, in particular, is strongly present to the writer's recollection, in which it supervened on a long •wurso of excessive mental exertion, in an individual who was most Tonic — imparting permanent strength and vigour. JV-- IN SUSTAINING THE VITAL POWERS. 131 a long moderate in overvthing but the labour of his bruin, and who rarely or never sought for arriticiul support from alcoholic Htiniulunts. Hut the most common case is that, in which two sets of causes are in action together. An habitual system of over-exertion of the nervous Hystem may be maintained for a longer time by many persons, with the assistance of alcoholic stimulants, than without them ; and thus the delusion is kept up, that the strength is not really overtasked ; xrhen the fact is, on the contrary, that the prolongation of the term of over-exertion, by the repeated application of the stimulus, ia really expending more and more of the powers of the norvoua system, and preparing for a more complete prostration at a later period. 164. The temporary advantage, then, which is thus gained, io very dearly purcliased. The mun who habitually abstains, not merely from alcoholic liquors, );ut from other artificial provocatives, (misnamed supports,) to the endurance of mental activity, is early warned by tho failure of his intellectual energy and cheerful tone of spirits, that he is over-tasking his brain ; whilst his stomach telia the same tale in another way, — the failure of power to digest that which the fabric really needs for its regeneration, being indicative of an exhaustion of nervous energy. A short period of rest and change, in such a condition, is usually sufficient for the renovation of the system, and for the recovery of the mental and bodily vigour. But the case is very different, when tho eftort has been sustained for a lengthened series of years, by means of the delusive support afforded by alcoholic liquors ; for as the excessive expenditure of nervous power has been greater, so is the exhaustion more complete ; •and as the stomach has been longer over-excited and over-tasked, ita tone is the more seriously injured, not merely by the depression consequent upon its own over-work, but by the impairment of the nervous power which is required for its due activity. Thus, then, although the consequences of habitual over-exertion of the brain may be less speedily felt, when the stomach is kept up, by alcoholic stimulants, to a state of extraordinary activity of supply, — and although, in like manner, the habitual use of alcoholic stimulants nmy cause the stomach to be less susceptible of the loss of the accustomed energy, — yet, when the crisis docs come, each condition aggravates the other; the effects of undue disintegration of the nervous matter being more difficult to repair, when the nutritive apparatus is depressed in functional power ; and the restoration of the tone of the stomach being impecied by the deficiency of nervous energy, when this has been Invored by excessive action of the brain. The length of time then required for the cure, is proportional to the duration of the causes which have induced tho malady ', and tedious and difficult is the process of restoration, an every medical man well knows. We shall hereafter have occasion 4 y ■( M i«fi rm 'i'i f:,.i ■^a 132 SUPPOSED USES OF ALCOHOL (§§ 227, 228,) to consider the best methods of medical and hygienic treatment forvthis condition ; and shall show that the measuroK which experience now proves to be the most efficacious means of restoring the vigour of the system, are precisely such as the phy» Biologist would recommend, under the guidance of the preceding views of the causation of the morbid state in question. 165. We have thus been led to consider the remote influences of the prolonged and habitual use of fermented liquors, in however " moderate " a quantity, upon the digestive apparatus, the excretory organs, and the nervous system ; and we have found that we may with the highest probability, if not with absolute certainty, attributo many of the chronic disorders which affect these organs in advancing life, — especially that loss of functional power, which is frequently the earliest stage of such disorders, and which, if appropriately treated in the first instance, might not proceed further, — to the excessive action to which they have been subjected, under tbo stimulating influence of alcoholic beverages. In so far, therefore, as the use of these beverages causes or favours such excessive action, it must in the end be hurtful, rather than beneficial, to the general health ; notwithstanding that its temporary effect may appear to be wholesome and exhilarating, or at any rate, if negative for good, to be also negative for evil. But we have further to consider, whether this inference is borne out by the effects of alcoholic liquors taken habitually in small quantities, upon the functions of circulation and nutrition. 166. Effect upon the Circulation. — It may be difficult to prove that the ingestion of a small quantity of Alcoholic liquor, taken in conjunction with food, has any decidedly stimulating influence upon* the general circulation ; since a certain acceleration of the pulse, and an increase in its fulness, normally occur during digestion ; and the augmentation produced by the alcohol may be so trifling as to be scarcely detectible. Such augmentation, however, is certainly produced by the imbibition of a quantity usually accounted " mode- rate;" and we have now to inquire, whether it can recur habitually through a long series of years, without producing injurious results, There cannot be a doubt that, in a healthy person, the rate of tho circulation is proportioned to the amount of functional activity of the principal organs of the body. We find that it depends in great degree upon muscular exertion, as put forth in the maintenance of the erect posture, and still more in active exercise ; but it may bo accelerated also by exalted activity of the nervous system, which 8et3 up an unusual demand for blood in the brain; and its increaso of rate during the digestive process appears to be connected with the • Hyyiemc — a proper regulation of exercise, mental and bodily; foo4» Jriok, clothing, bathing, and exposure to pure fresh air. IN ftUSTAlNINQ THE VITAL POWERS 133 ygtenio Tieasuroi leans of the pliy' ireccdiug lences of however jxcretory I; we may attributo idvancing requently ropriately , — to the nder the therefore, ve action, le general 3ear to be r good, tQ •, whether prs taken utioD and f to prove taken in iuce upon he pulse, ion; and ing as to certainly " mode, labitually 8 results, ite of the ctivity of s in great nance of t may bo m, which increase with the ily; food, Iftfiw *»lpply of blood then transmitted to the chylopoietic viscera,' Mi'i ^fi'juired for the due performance of their several oflBces. Now ¥iUi'tU'Vpr the circulation undergoes any considerable acceleration, iiiPfd in a tendency to a recurrence of local congestions, arising from tl<« W«ni of power, on the part of the vessels of some particular (ffjimti to allow their current to pass at the same rate with the rest. Of (li}» we have a familiar example in that accumulation of blood iti the pulmonary arteries, which is liable to take place in most Mntitia during violent muscular exertion, producing the feeling of if^UiU "out of breath ;" and which is particularly marked in those, U Whom there exists some disordered condition of the lungs^ that §l/»f fHct« the passage of blood through their capillaries.' 107< There are few persons, however, in whom there is not some i§1iii(iUcal UHU^mihon must operate with increased force in producing general iffftftllafity of the circulation, when the rate of movement is unduly MmeftkiMA } just as the outlets to a theatre, which suffice to dis- tflwftfe the entire audience in a few minutes, when the pressure to- ffttttw them i» uniform and regular, are speedily blocked up and }W«JU«e a stagnation of the entire current, whilst, under the in- JUetKfe (it an alarm of fire, every one is rushfng toward them with ' (Jhylnpiiielic vincera — organs which form chyle. * fJilfiilUriPs — very minute, hair-like vessels. 'I'ho wccelerntlon produced by muscular exercise, will of course be uu Ati# of protection, — as in the case of a traveller exposed to cold and wet on the top of a coach, — we seem justified in believing that if the chilling influence is powerful and likely to be of short duration, it may be better re- sisted by a stimulating dose of alcoholic liquor, than in any other way. But if the resisting power is to be prolonged, such a course is most undesirable ; for the system is never so obnoxious to the depressing influence of cold and dump, as when it is already in a state of depression resulting from previous over-stimulation ; and the use of coffee, cocoa, and other hot beverages, with solid food, which shall aid in permanently sustaining the heat of the system, is then unquestionably to be preferred. Here, again, we would remark, that the habitual abstainer has decidedly the advantage, since a very small amount of the stimulus is sufficient, as in the former case, to A" ' , ^1 ,1 I ' Idiosyncracy — constitutional peculiarity. 142 V\ USE OF AliCOlIOTi (iroduce the desired result ; and that if recourse be too frequently lad to it, the remote consequences of alcoholic excitement may bo expected to manifest themselves. II. DEFICIENCY OF OTHER ADEQUATE SUSTENANCE. 182. The second class of cases, in which the use of a small amount of alcoholic liquors scemei beneficial, or at any rate justifiable, is that in which there is a deficiency of the proper sustenance, so that the alcohol supplies the means of maintaining the animal heat, for which the animal tissues would otherwise be attacked. Under such circum- stances, too, the temporary elevation of the habitually-depressed state of the animal power seems rather beneficial than injurious. Of this we have a remarkable example in the well-known case of the Mutiny of the Bounty; from Captain Bligh's Narrative of which the following passages are extracted. " At daybreak I served to every person a tea-spoonful of rum, our limbs being so much cramped that we could scarcely move them." Further on — " being unusually wet and cold, I served to the people a tea-spoon- ful of rum each, to enable them to bear with their distressed situa- tion." And again, — "our situation was miserable ; always wet, and suffering extreme cold in the night, without the least shelter from the weather. The little rum we had was of the greatest service ; when our nights were particularly distressing, I generally served a tea-spoonful or two to each person, and it was always joyful tidings when they heard of my intention." Now, however decidedly we may give the preference to hot tea, coflFee, or cocoa, with plenty of nourishing food, over alcoholic liquors, in facilitating the endurance of such an exposure, it can scarcely be questioned that in circum- stances such as those of Captain Bligh's crew, the administration of the few drops of spirit was of the most important service, both as supplying combustible material, and as enabling the powers of their system, already seriously depressed, from being fatally reduced by the privations to which the party was subjected. 183. The beneficial influence of a small quantity of Alcoholio stimulus, in contributing to the endurance of bodily labour under circumstances peculiarly trying, and under the disadvantage of a deficient allowance of animal food, has been demonstrated on an extensive scale by the hygienic ' experience of the large prison at Nismes, called the " Maison Centrale," of which an account has been recently published by the chief physician, M. Boileau Castel- nau, who has been connected with the prison for the last twenty-five years.' Of this account an abridgment will be here given, as the * Hygienic — relating i"- the causes by which the health of the system la •naintain^d add improved *See the Annale- d'Hygifene Publique, Jan. 1849. < A- 1 IN EXCEPTION AL CASES. 113 lystem x« facts are considered by the writer as of very great importance, In disproving, by the experience of a large number of individuate, tiio position of those who assert that under no circuniHtaiiccs can the liabitual use of alcoholic liquors be otherwise than injurious. This prison usually contains a population of 1200 convicts, most of them adults, the minimum age being eleven. Its wards have been habitually over-crowded and ill-ventilated, and insufficiently heated in winter ; and the food of the prisoners has been coarse and in- nutritious, whilst more labour has been exacted from them than their strength has been adequate to perform. The prisoners, more- over, have been subjected to the tyranny of brutal keepers, fre- quently loaded with irons, and occasionally severely whipped. Under these circumstances, it ia not surprising that the rate of mortality in the prison has been always high, varying from 1 in 23-88 to 1 in 785, whilst the average rate of mortality amongst the inhabitants of the town of Nismes, of the same age and sex, amounted to 1 in 49 9. The rate of mortality in the prison un- derwent considerable variations in diflFerent years; and for these variations some definite cause could generally be assigned. Thus the winters of 1828-9, and of 1829-30 were unusually severe and prolonged; and the rate of mortality for 1829 was 1 in 940, whilst for 1830 it was 1 in 850; clearly proving the fatal influence of a low temperature upon systems debilitated by insufficient food, impure air, and \7ork disproportioned to their strength. With the exception of the year 1833, in which the mortality was again great, the rate was much less for several subsequent years, varying be- tween 1 in 11-35, and 1 in 15 62; but in 1839 it suddenly rose from 1 in 12-32 to 1 in 785. The cause of this terrible au)p;raen- tation (from 102 deaths to 162) seems to have lain in a mini'^terial ordinance issued on the 10th of May, 1839, limiting the alim«ntary articles allowed to be sold at the canteen to potatoes, cheese, and butter. Previously to that time, the convicts had it in their power to lay out a portion of their earnings, which was at their own dis- posal, in the purchase of wine and tobacco, in addition to the articles just named; but these were now prohibited. 184. " In order fully to appreciate," says Dr. J. Coxe (by whoni this case is cited in the ninth edition of Dr. A. Combe's Physiology of Digestion), " the amount of misery thus entailed upon the prisoners, the reader must be aware that in the south of France, wine is considered an absolute necessary of life. It is drunk by the poorest of the people, and appears essent>al to enable them to digest their coarse unstimulating food. Within the town of Nismes, it costs about a penny the litre, (IJ pint); and without the wall, where it is free from duty, the labourer may drink it at a penny the hour. Potatoes, butter, and cheese, could not replace its stim- ulus; and besides, the south of France containing no pastures, the II ■'■ -I I?. J % It-' ■ ''i ■ !, : \[ t W 144 USE OP ALCOHOL it m i butter was bad and dear; and the cheese also dear. Hence the pittance at :,he disposal of the prisoners was more than ever insuffi- cient to supply the deficiency of nutriment." 185. The rate of mortality was somewhat diminished in the following year, the diet being increased, and the prisoners receiving small supplies of wine and tobacco at exorbitant rates, principally through the connivance of the officials ; still, however, it remained very high, the number of deaths in 1840, being 135 out of 1216 prisoners, or 1 in 9 07. Attention being now attracted to the con- dition of the prisoners, an attempt was made to ameliorate it; the old keepers being removed, and their places being supplied by the *♦ Fr^res des dcoles chr^tiennes," ' who substituted moral persuasion for physical force ; and the diet being improved both in quantity and quality. In consequence of these measures, the mortality again began to diminish, and reached its lowest point in 1844, when the number of deaths was only 56 out of 1290 prisoners, or 1 in 23-88. The " Fr^res," however, being disgusted at the con- tinual obstructions which their measures received, gave up their charge; the old system of hard work and cruel punishments was again introduced; and the pittance at the disposal of the prisoners was diminished to a mere fraction. The effucl of this change speedily showed itself in the increased mortality, the average of deaths progressively increasing in the years 1845, 1846 and 1847, to 1 in 19-63, 1 in 16-52, and 1 in 13-57. One of the first acts, however, of the revolutionary government of February, 1848, was to put a stop to the system of convict-labour, as it was then carried on, and the result of this change was speedily apparent in the di- miuished mortality; for whilst the number of deaths during the seven months ending October 3l8t, 1847, had been 44, only 16 deaths took place during the corresponding months of 1848. 186. Now the priucipal lesson taught by this fearful history, is the dependence of the vital powers upon food, and the fatal effects of the exaction of severe lajitour from men insufficiently supplied with aliment, especially v^hen they are subjected to the additionally injurious influences of a low temperature, foul air, and ill treat- ment. But it seems obvious from the large increase in the rate of mortality which ensued upon the prohibition of wine — no extra- ordinary depression of temperature having existed to account for it, — that its deprivation exerted a positively injurious eflfect. If aa adequate measure of nutritious food had been supplied in its stead, the change would doubtless have been for the better; but the sup- port given by the wine, which was probably too weak and poor to have any decided stimulating effect in moderate quantities, bad be- « Frires des ecoles chrdliennes — brothers of the Christian schools — a re- ligious order. IN EXCKI'TIONAL CA8E8. U5 eoiiifi so r^roossary tr» the debilitated systems of these men, that it« witli'lriwal was fatal to many among tbom. 1S7. From tlu-se two eases, tlien, rnd from others which might bo cited to the same effect, we seem justified in concluding, that the use of Alcoholic liquors iu small quantity may assist in sustaining the powers of the system, when these have undergone an extreme depression from the combined influence of exposure or exertion, and of want of food ; so that under such circumstances the alcohol does decidedly more good than harm, and should therefore be employed when accessible. And this we may freely admit, without having in the least degree to qualify the doctrine previously advanced, that continual exposure and protracted exertion may be better sustained without the use of alcoholic liquors than with it, when an adequate supply of wholesome food is to be had, and the stomach is capable of digesting it. III. — DEFICIENCY OP CONSTITUTIONAL VIGOUR. 188. We have now to inquire into the third class of cases, in which a temporarily beneficial result appears to be derived from the occasional, or even (for a time at least) the habitual use of Alcoholic liquors; — those, namely, in which there is a want of sufficient vigour on the part of the system itself, to digest and assimilate the aliment which it really needs. Such cases present themselves in all ranks of life. In the higher, they too frequently result from heated rooms and late hours, from the want of regular exercise of mind and body, and from habits of self-indulgence and "coddling," which foster, especially in females, what may have been an heredi- tary weakness of digestive power. In the middle classes, it is usually traceable to the ** wear and tear" of professional or com mercial avocations; to undue cerebral labour, carried on, as this frequently is, in ill-ventilated apartmcuts; and to the anxieties in cident to the conscientious di^'cbarge of the duties of a profession or to the fluctuations of businoss Among the lower classes, on the , other hand, it is traceable rathvT to the condition of their dwellings, workshops, and persons; to tbj want of ventilation of the buildings in which they dwell or labour ; to the miasmatic atmosphere of their ill drained streets, and to the foulness of their skins and garments. 189. Now in the first of these groups, it is obvious that the want of appetite is a natural result of the reduction of demand for ali* ment to its lowest point ; for where neither the muscular nor the nervous systems are adequately exercised, arid where the body is habitually kept in a temperature not far below its own, there can be very little " waste" to be repaired, and a very small amount of oombustive action can be needed to keep up the heat of the body lo its proper standard. But the digestive powers are very liable, M i ' ■ 1* *,4%, Iff ! USE OP ALCOHOL when their natural use is too little called for, to sink helow the lova; at which the demands of the system should keep them ; and tlinf) an almost total want of appetite, and extreme debility of t\m stomach, are the result, which of course tends to augment the hahitci of self-indulgence, and to foster the whole system of "coddling," In such cases, an apparent benefit is derived from the habitual em* ployment of a glass or two of wine or a tumbler of bitter ale ; but this merely facilitates the persistence in a wrong course ; and eyery judicious practitioner would now assent to the truthfulness of tho advice given by Abernethy in a case of this kind, to " live on a shilling a day and earn it." It is utterly impossible that alcoholjo liquors can counteract the influence of heated rooms and late hours : that they can stand in the place of healthful exercise of mind ana body ; or that they can neutralize the evil results which are sure to proceed from the habitual direction of the attention to self. All that they can beneficially do is, to create for a time that appetita which ought to be naturally felt, and to urge the unwilling stomach to digest that food which the body really requires. But this they can only effect by their stimulating properties; and as the usual dose almost invariably ceases after a time to exert its original infiu> ence, it requires a gradual increase, until the evil effects of its bd* bitual use in such a state of the system are unmistakeably manU fested. 190. The true cure for conditions of this kind lies in such an entire change of habits, as shall place the system in the condition most favourable to the recovery of its vigour, or to the acquirement of that which it has never enjoyed ; — the substitution of fresh air and bracing breezes, for heated and ill-ventilated rooms ', of early and regular hours, for the system of turning night into day and day into night ; of plain but wholesome fare, for seasoned dishes and refined cookery; of the use of even a weakly pair of limbs, for that of a carriage and horses ; and of labour in behalf of others, for tho weariness of ennui or continual thought of one's-self. 191. Nevertheless it may happen that after all these means havo had a fair trial, and considerable improvement may have been pro* duced, the stomach may not be equal to its work ; and this is liable to be the case more particularly with those, to whom weak digestive powers have been transmitted from their parents (generally in con* sequence of their own unhealthful habits), or in whom they bavo been fixed (so to speak) by an erroneous system of bodily and mental training, and especially by the habitual use of stimulanti during childhood and youth. In such cases the writer believes that the habitual use of a small quantity of alcoholic stimulant, espd> cially when combined with a bitter tonic, may be of more service than any other form of medicine ; and if care be taken not to em* pioy it to such arc extent as to produce an artificial appetite, or Uf IN EXCEPTIONAL CASES. 147 fitfce the sfomnch to digest more than the system really needs, it (iiiCM iini appear likely to have the same permanently injurious t^ffcMin, an it exerts in most other cases. It will generally be found Iti 1/e »n indication of its beneficial use, that the dose does not re- tlH\re ificrcase; the small quantity originally taken, continuing to §MtfH \in good effects; and this benefit will be more likely to be ^fftlxtent, if the use of the alcoholic stimulant be intermitted, Whetieter the digestive powers seem adequate to the support of the ^iipin without it. 192. The want of appetite and feebleness of digestive power, so . itrttiimm among individuals in the middle classes, who go through ill tiiuUiO amount of cerebral labour, frequently under circumstancefl wl results of their habitual use, that it is found possible through their ':' means to prolong the health-destroying system ; and thereby, like the trader who bolsters up his failing credit with accommodation- bills, to carry onwards, from page to page of the book of life, a heavy balance which must be accounted for at some subsequent period. 194. Still the writer is by no means disposed to deny, that after all other practicable means have been taken for the invigoration of the system, the habitual use of a small or moderate quantity of Alco- holic liquors may be found beneficial in some individuals of the class referred to; enabling them to digest that food which the system really needs, and thus contributing to sustain their powers under an amount of exertion, to which they would not otherwise be equal. And this will be especially the case (as with the class first treated of), where, from hereditary predisposition, or the habits of early life, there is a fixed constitutional debility of the digestive powers. In such instances, the stimulating effects of the alcohol do not manifest themselves ; it is not found requisite to increase the dose ; and the practice is continued with apparent benefit through the whole of life. A characteristic example of the results of expe- rience in this respect is aflForded by the case of the late Dr. Joseph Clarke of Dublin, who lived to the age of 76 years, and who dis- charged the duties of a laborious profession, with scarcely an inter- mission to the end of his life.* 195. The craving which is felt for Alcoholic liquors among the classes whose labour is rather physical than mental, and the benefit which in many cases appears to be derived from it, proceeds from a different cause. Nothing can be conceived in itself more likely to whet the appetite and invigorate the digestive powers, than regular but not excessive muscular toil, with that moderate occupation of mind which the execution of the labour involves ; but in order that this may exert its proper effect, it must be carried on under circum- stances otherwise favourable tc health, and more especially in a pure atmosphere of moderate temperature. If, in place of this, the air be already loaded with carbonic acid, an obstruction is created to the unusually rapid exhalation of that gas which muscular exertion 'See the sKetch of Dr. Clarke's Life and Writings, by his, Nephew, Dr. CoUiae.. p. 81. IN EXCEPTIONAL CASES. 149 in\igORv iinie, for iiount of recourse istaining of alco- injurious igh their eby, like lodution- )f life, a bsequeot ;bat after ration of of Alco- is of the bich tbe r powers irwise be 3lass first babits of digestive Icohol do rease tbe through of expe- . Joseph who dis- an inter- [long the \e benefit Is from a likely to a regular )ution of rder that r circum- lu a pure the air reated to exertion >hew, Or. Involves; and the labour cannot be borne without the assistance of stimulants. And if the atmosphere of the dwelling be charged with the noxious emanations resulting from animal or vegetable putrefaction, the appetite and the digestive powers fail, the aliment which tbe <*ystem really needs for the regeneration of its " wasted " material is no longer prepared and supplied to the circulating current, and the strength consequently flags. Under such circumstances, recourse is had with apparent benefit to the use of alcoholic liquors ; for they spur on the stomach to its work, and cause it, for a time at least, to furnish what is needed for the maintenance of the various* functions of the body j the whole train of which depends, more or less directly, upon the due performance of the digestive operation. 196. Now, it is a remarkable characteristic of this condition, that the stimulus which was at first found sufficient very speedily ceases to produce its usual effect ; and that the feeling of necessity for it increases, the more it is used. Of this, we have an example, — which, though an extreme case, teaches the lesson with the force that extreme cases alone can do, — in the condition of tbe journey- men Ta.Io.- 'TTsnloyed in the large London workshops, as disclosed by the ino ;i whose results are published in the first '' Sanitary Report" ('S.-^y. The beat and closeness of tbe workshops were stated by the witnesses to be such, that on the coldest nights of winter, large thick tallow candles melted and fell over with the heat ; and fresh bands from tbe country fainted away. In order to get tbe strength up for the day's work, and to create an appetite for break- fast, it was customary to take a glass of gin at seven o'clock in the morning; and this was repeated three or four times in the subse- quent ten hours. Now the utter inability of the alcoholic stimulus to afford more than a temporary power of endurance under such a state of things, and the cumulative effect of the noxious atmosphere on the one hand, and of the habitual use of spirits on the other, are fearfully shown in the excessive mortality among this class of men, especially fram consumption ; their average age not being above thirty-two, and a man of fifty being considered as superannuated.' 197. Nothing can be more absurd, then, than to maintain that any real benefit is derived from Alcoholic liquors in such cases, oi that it can in the least degree supply the place of pure air, or enable the body to resist the influence of excessive heat. Nor can it be more potent in preventing the morbific influence of putrescent raiasmataj nor again, can it make up for the want of personal cleanliness. These agencies can only be remedied by their proper antagonistic measures; — hot and foul air by proper ventilation; ' The writer has been informed that these workshops have been greatly improved of late years, especially in regard to ventilation ; and that the craving for spirits, on the part of those employed in them, has graiuall^ ceased to manifest itself. 13* 'I rt I 1i 11 'W ,.*•'*! I' ■A m 1: ii 150 USE OP ALCOHOL noxious emanations from the soil by eiBcient sewerage ; fiitljinoHS of the skin and garments by the use of baths and wash-houses;— and if they be allowed to continue, they must exert their influence on the bodily system, all the alcohol in the world notwithstanding. When, on the other hand, they are removed, — the artizan's labour being prosecuted in pure air, and his home and garments being kept 2lean and fresh, so that his skin and lungs are allowed their duo exercise, — it will be seldom, if ever, that anything else will bo required to sharpen his appetite, and invigorate his digestive powers, for the consumption of as much food as his system may require. 198. On the whole, then, we may conclude that in by far the greater number of cases falling under one or other of the above categories, the influence of the habitual use of Alcoholic liquors, while it may seem temporarily beneficial, is in the end rather per- nicious than otherwise; and this not so much (in the cases now under consideration) by their own specific efiects on the system, as by causing the individual to /eel less need of the very change which is needed for the restoration of the body to its wonted vigour. The insensibility to the effects of various morbific causes, which the habitual use of these stimulants induces, and the toleration of them which it thus permits, may be regarded, indeed, as one of its most injurious results. Those who are prevented from feeling the imme' diate consequences of their improper course, flatter themselves that they are uninfluenced by them, and give to their wine, their spirits, or their beer, the credit of the escape. But this is far from being the case. The enemy is only baffled, not dispersed ; and although he lies concealed for a time, he only waits until his onslaught may be more effiectually made. Any systematic departure from the laws of health — all experience teaches — mxist exert its influence on the system, sooner or later; the sooner it does so, the more readily may the mischief usually be corrected; whilst the postponement of its effects tends to render the process of cure as protracted as the operation of the causes has been. It is one of the greatest benefits of the abstinent system, then, that by making the evils of such a departure less endurable, it sooner prompts the sufferer to seek a remedy. 198. Pregnancy. — Among the modifications of the bodily con- dition, short of actual disease, in which the occasional and even the habitual use of fermented liquors ncenu desirable in some instances, are the states of pregnancy and lactation. The state of pregnancy frequently occasions a peculiar irritability of the stomach (apparently of a purely nervous character), which indisposes it to retain the nutriment really required by the system, or which prevents it from properly digesting and preparing it when retained. This irritability ift occasionally so aggravated, as to become the subject of medical IN EXCEPTIONAL CASES 151 Irisai-ineat ; and the most powerful sedative medicines ' are some* times required to subdue it suflBciently for the retention of even small quantities of food. Sometimes even these are ineffectual ; and more relief is obtainable from small quantities of wine, frequently repeated, than from an^ xhing else. Dr. Meigs (of Philadelphia) mentions a case in which aotbing could be borne but champagne. In milder cases of the same kind, it often happens that a small quantity of fermented liquor, taken with the principal meal, seema to establish a tolerance of it in the stomach, and to promote its digestion, in a way which no ordinary sedative or tonic medicine can effect; and it certainly seems a less evil to employ this, even habit< ually, during the period of pregnancy, than to allow the system, both of mother and foetus, to be suffering for want of the aliment which this condition so peculiarly requires. And as the source of irritation is temporary, there is less danger than in other circum* stances, lest the demand should be rendered permanent, by tho habituation of the stomach to the stimulus. 199. But the evils attending its habitual use, even under such circumstances, can only be reduced to their minimum, by very careful attention to all the other conditions favourable to health during the pregnant state — especially fresh air, moderate exercise, early hours, adequate repose, and the avoidance of all sources of excitement; and also by the strict limitation of the quantity of the alcoholic liquor to that which is sufficient to produce the desired result. The writer has known cases, in which, under such watchful regulation, great benefit appeared to be derived from the very moderate use of alcoholic liquors, (especially of those in which the bitter and sedative properties of the hop are combined) without any corresponding disadvantage; the stomach being thereby enabled, so long as the pregnant state lasted, to receive and digest the food which the system really needed ; and the requirement not being felt after its termination. But it must not be forgotten that the habit of indulgence in fermented liquors, once established, is often felt by females, as well as by men, to be very difficult of relinquish- ment ; and where there is reason to believe that the individual does not possess self-command sufficient to break through the habit at the proper time, it might be advisable to endeavour to substitute a vnedicine for a heoerage, giving to the alcoholic compound such a form as may render it not peculiarly palatable or inviting. 200. Lactation.^ — The benefit derivable'from the use of Alco- holic liquors to support the system during lactation j is more doubt- ful. Certainly it may be affirmed that in every case in which tlin ' Sedative medicines — medicines whic)) reduce the vital actions. * Lactation — the period of suckling; the nourishment of the chid fr^m its mother's breast. I If ilS) : ,if " 1 \ ^ ♦ )f.2 USE OF ALCOHOL appetite is gooa and the general system healthy, the habitual us<* of these stimulants is no more called for, than at any other time ; and that they are likely to produce the same injurious effects, aa when unnecessarily given under ordinary circumstances. The regular administration of alcohol, with the professed object of sup- porting the system under the demand occasioned by the flow of milk, is " a mockery, a delusion, and a snare." For alcohol affords no single element of the secretion ; and is much more likely to impair than to improve the quality of the milk. The only mode in which It can contribute, even indirectly, to increase the amount of solid aliment which the secretion may contain, is by affording a supply of combustive material, the consumption of which may leave more oleaginous and saccharine matter to pass into the milk. But where the appetite already prompts to the ingestion, and the stomach is equal to the digestion, of an adequate amount of solid food, no such benefit can be looked for; and although it cannot be certainly affirmed that the character of the milk is always impaired by the habitual use of moderate quantities of alcoholic liquors, yet there can be little doubt that such is usually the case. For it is unquestionable that their excessive employment is highly prejudicial to the quality of the milk, and thereby to the health of the child ; having a special tendency to occasion derangements of the digestive organs, and convulsive complaints. ' This, indeed, might be fully expected ; since all that we know of the mode in which substances taken into the blood affect the mammary secretion, would lead us to expect that alcohol, if introduced into the circulation more rapidly than it can be consumed, would pass into the milk, and would consequently produce the same effecta upon the child as if directly given to it, — besides deranging by its presence, the act of secretion itself, in virtue of its tendency to produce coagulation of albuminous matters. And the fact that multitudes of women of good constitutions, whose general habits are conducive to health, go through the period of lactation without any feeling of debility, — simply finding their appetite increased during its continuance, — is a sufficient proof that this condition is not one, which in itself occasions a demand for alcoholic liquors. 201. But there are cases in which, notwithstanding all that can he done to promote the general health, the stomach does not seem capable of retaining and digesting the requisite amount of nutri- ment, except under the artificial assistance afforded by Alcoholic liquors; and in which it appears more desirable, for the welfare alike of mother and child, that such assistance should be afforded, than that lactation should be carried on without it. In one case of * Dr. North says (Practical Observations on the Convulsions of Infants) that he nas seen these almost instantly removed by the transference of tb« oliild to a temperate woman. r. more IN EXCEPTIONAL CASES. 158 this kind that fell particularly under the writer's notice, in which the mother was most anxious to avoid the assistance of fermented liquors, and began to nurse without their support, the milk was obviously too poor in quality, and not sufficient in quantity, for the nutrition of the infant; and the use of a single glass of wine, or a tumbler of porter, per day, was followed by a speedy and marked improvement in the condition of both mother and child ; and this small allowance did not require to be increased during the con- tinuance of the lactation, and was relinquished without difficulty soon after the weaning of the in" nt. In such cases the alcoholic liquor seems to have no n' ^ »,tion, than that of lu . "ag the stomach to digest the amouut of .^id aliment required uy the sys- tem ; whilst the smallncss of the quantity of alcohol introduced at any one time, prevents it from either itself passing into the milk, or exerting any injurious influence on the secreting process. But it may be questioned whether the practice is m the end desirable ; or whether it is not, like the same practice under other civcum- stances already adverted to, really detrimental, by causing lactation to be persevered in, without apparent injury at the time, by females whose bodily vigour is not adequate to sustain it. Such certainly appeared to be the case in the instance just referred to ] for the system remained in a very depressed state for some time after the conclusion of the first lactation ; and on subsequent occasions it has been found absolutely necessary to discontinue nursing at a very early period of the infant's life, owing to the inadequacy of the milk for its nutrition, and the obvious inability of the mother to bear the drain. Hence it may be affirmed with trierable certainty, that the first lactation, although not prolonged beyond the usual . period, and although apparently well sustained by the mother, was really injurious to her ; and the inability to furnish what was re- quired, without the stimulus of alcoholic liquors, was Nature'a warning, which ought not to have been disregarded. 202. Considering, then, that lactation (unlike pregnancy) may be put an end to at any period, should it prove injurious to the mother, the writer is disposed to give his full assent to the dictum of Dr. Macnish; that *'if a woman cannot afford the necessary supply without these indulgences, she should give over the infant to some one who can, and drop nursing altogether." — "The only cases," continues Dr. M., " in which a moderate portion of malt liquor is justifiable, are when the milk is deficient, and the nurse averse or unable to put another in her plarce. Here, of two evils, we choose the least, and rather give the iufant milk of an inferior quality, than endanger its health, by weaning it prematurely, or stinting it of its accustomed nohrishraent." ' Nuw upon this the writer would remark, '1 1 li'l HI*';: ' Anatomy of Drunkenness, p. 301. I fl 154 \ USE OF ALCOHOL that a j jdicinus system of feeding, gradually introduced from a verj early period in the life of u child, will generally be preferable to an imperfect supply of poor milk from the mother; ' and that if the mother be &o fooliph as to persevere in nursing her infant, when Nature has warned her of her incapacity for doing so, it is the duty of the medical man to set before her, as strongly as possible, the risk — the almost absolute certainty — of future prejudice to herself. The evils which proceed from lactation, protracted beyond the ability of the system to sustain it, may be to a certain degree kept in check by the use of alcoholic stimulants ; but the writer is convinced from observation of the above and similar cases, that its manifestation is only postponed. Under no circumstances, therefore, can he consider that the habitual or even occasional use of alcoholic liquors, during lactation, is necessary or beneficial. Childhood. — It has been maintained by some, that there are cer- trin states of the constitution in childhood, in which benefit is de- rived from the habitual use of small quantities of fermented liquors ; and this especially in those who inherit the scrofulous diathesis,' and in whom the nutritive functions are altogether imperfectly performed. Experience, it is said, demonstrates the benefit which is derivable from the judicious employment of stimulants, in exciting the diges- tive and assimilative processes to augmented activity, and in thus improving the general tone of the system. It is not denied that temporary benefit may be derived from such a course ; but this will be obtained at the risk of prospective evil, extending through the whole of life. For if the habit be begun thus early, it will seldom be found possible to discontinue it ; the stomach is rendered depen- dent upon artificial support ; and the improvement which this appears to produce will probably render the parent less anxious to avail him- self of other means of invigorating the system, and of promoting a more active and complete performance of the nutritive actions, which are more permanent in their character, because they act more natu- rally on the system. Every measure of this kind, therefore, — such as unlimited exposure to fresh air (avoiding damp and cold), plenty of exercise, warm but not too impervious clothing, the copious use of cold water with the addition of salt, sea-baihing, and other adju- meuta,^ — ought to have a complete trial, before recourse be had to the completely artificial support yielded by alcoholic liquors. 204. There cannot be any reasonable doubt that the habitual use of Alcoholic liquors by children in average health, is in every way ' The author has found in his own experience, that good Cow's milk Bomewhat diluted with water, and sweetened with a small quantity cf sugor (go as to be brought nearly to the composition of Human milk), has answered » itremely well even for very young infants. • Scrofulous diathesis — constitutionul tendency to scrofula. Adjvminta — assisting remedies. fuv fiiti IN EXCEPTIONAL :A8£S. 155 'and injurious.' In no period of life are the nutritive functions moro energetically carried on, if the child be only placed in circumslancei favourable to health ; and at no period of life is there such a dispo> eitioD to take just that amount of exercise of the nervo-inuscular apparatus which is beneficial to the system, without exceeding it, The motives which stimulate the adult to over-exertion in his battle with the world, do not operate upon the child : unless forced by the zeal of injudicious instructors, he will seldom be disposed to carry uis mental exertions beyond the stage at which they may be best intermitted; and whilst naturally prone to muscular exercise, he readily complains of fatigue, and is indisposed to persevere after thia warning of the failure of his powers. The chief thing to be watched for and avoided, therefore, is the excess in diet to which children are sometimes prone, more especially if their palates be tempted by arti- cles of which they are fond; and if this be duly restrained, and every natural means for the preservation and iirprovenn nt of health bejudiciousl;, and perseveringly employed, it is believed by the writer that more good will in the end be done, than will be accomplished by the assistance of alcoholic liquors. And in support of this belief, be can appeal to the large numbers of families now growing up in this country and in America, in the enjoyment of vigorous health, among whom no alcoholic liquor is ever consumed; and he can point to numerous cases within his personal knowledge, in which the apparent debility of constitution having been such, as in the opinion of some to call for the assistance of fermented liquors, the advice was resisted, and those other means adopted which have been already adverted to, with the effect of rearing to vigour and endurance, chil- dren that originally appeared very unlikely to possess either. 205. Old Aye. — It has been maintained again, by some of those who fully admit the undesirableness of the habitual use of Alco- holic liquors during the vigour of early and middle life, that they are requisite or useful for the support of old age. Now upon this point, also, the writer believes that much misconception is preva- ' In illustration of the injurious efiFects of the habitual use of fermented liquors upon healthy children, Lr. Mucnish (Anatomy of Drunkenness, p. 302,) relates the following experiment made by Dr. Hunter upon two of his children, both of them having been previously unused to wine. To one, a child of five years of age, he gave every day a full glass of sherry ; to the other, a child of nearly the same age, he gave an orange. In the course of a week, a very marked diflference was perceptible in the pulse, urine, and evacuations from the bowels of the two children. The pulse of the first child was raised, the urine high coloured, ahd the evacuations des- titute of their usual quantity of bile. In the other child, no change i.-hat ever was produced. He then reversed the experiment ; giving to the first the orange, and to the second the wine, and the results corresponded:' the child who had the orange continued well, and the system of the other ^* ftraightnay into disorder as in the first expenment. m 156 USE OF ALCOHOL lent, arising out of a disregard to the dictates of Nature ou the subject. During the most active period of life, the " waste" of the b^^'y is considerable; and the demand for fofxl, and the power of -jgesting it, are both adequate (in the healthy state) to supply that waste. But with the advance of years, the power of activity diminishes; the body (so to speak) lives much more slowly, as is proved by the Icnseued exhalation of carbonic acid and the dimin- ished excretion of urea ; and the waste being thus lessened, the demand for food, and the power of digesting it, are proportionably diminished. Now this abatement of the appetite and digestive power (like that which is felt by those who go from cold or tem- perate climates to reside in tropical regions) is a natural warning that a smaller amount of food should be taken in ; and if it be so received, and no more nutriment be habitually ingested than the appetite legitimately prompts, the digestive powers will be found as adequate as in a state of greater activity, to provide for the wants of the system. But this abatement is very commonly regarded as an indication of the failure of the powers of the stomach ; and re- course is had to alcoholic liquors wiih the view of re-exciting these. Now although from such a practice, when very moderately resorted to, less prospective evil may be anticipated, as regards merely the effects of the continual ingestion of alcohol upon the stomach, than it is liable to occasion when commenced earlier in life; yet it is very much to be deprecated on another account, — namely, that it forces admission into the st/stem (so to speak) for a larger amount of ali- mentary matter than it can appropriate; and as all the organs which are set apart for the elimination of the superfluity (the kidneys, the liver, the skin, and the glandulae of the intestinal canal,) are, less easily stimulated to increased activity in the decline of life than at an earlier period, it follows that habitual excess in diet, even though to no great amount, is yet more likely to be followed by the disor- ders which it tends to produce. And hence it is, more especially, that we find the lithic acid diathesis ' so prone to manifest itself in advanced life, and requiring such careful dietetic management for its correction. 2o6. The author would not take upon him to deny that cases may present themselves, in which the habitual use of a small quantity of Alcoholic liquors may be beneficial to persons advanced in life :}nd not suffering under any positive ailment, but experiencing abso- lute deficiency of digestive power beyond that which is in conformity with the general decline of activity ; in such cases, the benefit to be expected from their employment is, that, the stomach should be as- sisted in the digestion of the food which the system really requires ; ' Lithin acid diathesis — constitutional tendency to the formation of litbio acid, giving rise to stone m the bladder. IN £XC£rTIONAL CASE^S IftT and in so for as their use is carried beyond that point, it is hurtful in every v,ay. Such cuscs may be expected to be rare atnr)iig those who have habitually observed the laws of health, and who have not prematurely exhausted the powers of their digestive apparatus, by habitual excess in diet or in mental labour, or by the continual use of stimulants. Those, on the other hand, who have adopted the habit, early in life, of relying upon the aid of alcoholic liquors, for the performance of the digestive operation ; or who have overtasked thoir nervous systems, and thus deprived the stomach of the .lervoua power which it requires; or who have impaired their vigour by breathing a foul atmosphere, by irregularity and insufficiency in re- gard to the periods of repose, or by various other departures from the ordinances of Nature ; are more likely to suffer in advanced life from a loss of digestive power, which no treatment, medical or hygienic, can ever completely repair. 207. But here, as in all other instances, if the prolongation of life and the restoration of vigour be the paramount objects of oon< sideration, recourse should at first be had to all those measures of general Hygiene,' which prudential experience would recommend; and the assistance of Alcoholic liquors should be avoided, with a jealous apprehension of their prospective evils, until it shall appear that no other more natural means can bring about the desired result. Those who have been in the habit of employing them during the whole of life, are certainly those who are least likely to feel able tu dispense with them in old age; yet experience has demonstrated even here, that where the evil results of their continued use have begun to manifest themselves, decided and permanent benefit has folli^wed their abandonment; and where it was believed by the indi- vidual that he could not possibly dispense with their use, the sto- mach has recovered its healthy tone (especially under the copiouu external and internal use of cold water, and the influence of an in- vigorating atmosphere), so as to be able to discharge its duties for the remainder of life with greater ease than it ever previously had done." 208. For the results of experience on this and other points, any statements of which should be based rather on a wide and general survey, than on induction from a comparatively limited number of instances, the author has thought it safest to rely on the assnranceg of medical practitioners in the New England States ; since the en- tire disuse of fermented liquors has been now practised as a habit for some years, by a large proportion of thd population of those States, including those who are most subject to those influences (the * Hygiine — tho art of maintaining and improving health. ' For two remarkable cases of this kind, see Appendix ('. 14 i^. ■« 168 OSE OF ALCOHOL II " wear and tear" of sooinl life) which are usually regarded as most powerfully conspiring to render the asslHtance of gtimulanta de.^im- ble. — The following Htatemcnts on thia subject have been recently put forth by the Massachusetts Temperance Society, under the 8unc« tion of their distinguished President, Dr. Warren.' 209. " In regard to the habitual use of wine, it is probable that the change of opinion is greater here than in Europe. A vast num- ber of persons on this side of the Atlantic have wholly abandoned the Uf^e of wine, cider, and malt liquors; and many of those who continue to employ them have greatly diminished the quantity. Wine is no longer thought necessary in the convalescent stage of fever. Cider, formerly one of the household provisions of almost every fumily in the North, is rarely seen; and the very trees which produced it are either cut down for fuel, or converted to the produc- tion of fruits for food. The stronger beers are quite disused, except among emigrants ; and even the milder are employed only in some very light and unstimulating form to allay thirst, principally in the hot season.'' " The apprehension that a sudden disuse of fermented liquors might be injurious, has been dispelled by a vast number of cases, in which, after long-continued employment, a sudden and total ^abandonment has taken place, not only without impairing health and comfort, but with positive improvement in strength, activity, and agreeable sensations. How common is it amongst us to seo persons who in former times used wine freely, and who have now given it up, present an appearance of mental and bodily vigour they ad not exhibited before. The influence of such a change of habit in the wealthier classes has been great beyond calculation, in leading the mass of society to abandon the use of spirits, and to repeat an experiment already made y those whom they are accustomed to respect and follow. Such having been the consequences of the disuse of wine, how desirable is it that all those who have not aban- doned it, who wish well to their fellow-men, and are willing to show that they are capable of making the sacrifice they advise, should submit to a privation which they have sufficient reason to believe will be most salutary to themselves and others." 210. The extent of change of habit, in this respect, among tho middle and higher classes of society in Boston, and other great towns of New England, may be judged of from the fact, that many of those public festivities, at which the assistance of alcoholio liquors is considered indispensable in this country, are there con* ducted without any such artificial excitement. " Of late years " (we quote the same authority) '' we have had the gratification of witnessing so many exceptions to the former practice, that it appears ' Preface to the Reprint of an Essay on the Physiological effects of Al- eoholiv Oroks, from Dr. Forbes's Review, Boston, N. £. 1848. rei of Stil out TN EXCEPTIONAL CASKS, 150 rery probable thnt the rule will be revorsed, and the exception? clwinji'' to the opposite side. The great ft'«tivuls on the AnniverBary of N tinniil Indeprndcnceare in many places celebrated without other 8tiinu1u» than th it of patriotic feeling. The annual ceremonies of our liteniry institutions, too often stained by lavish draughts of the juice of the grape, are now purified by the effusions of chastened wit, and elevated by the flights of an unclouded imagination. Most of the Universities, and particularly the oldest, and we may perhaps venture to say the mo.st distinguished, have unshackled themselves from the chains of ancient habit. Under the influence of a master- tpirit (President Everett) the great annual festival of Commence- ment at Cambridge University has been accomplished without the oid of wine ; and the oldest of our literary fraternities, tht Phi Beta Kappa Society, has enjoyed the excitement of a social meeting «vi4iout the consequent depression from artificial stimulus. Wine is no longer admitted at the yearly convocation of the Clergy, or the assemblage of the Medical profession of this State. The grea^ association of mechanics of the metropolis hold a brilliant triennial feast, from which every kind of alcoholic, fermented, vinous, and other stimulating liquid is wholly excluded." ' s siievti con* Al- 211. On the whole, then, the writer thinks that Physiology and Experience alike sanction the conclusion, that although there are states of the stomach, in which the diminished appetite and digestive power prevent the reception of an adequate supply of aliment into the system, and in which the assistance of alcoholic liquors is ten- porarily beneficial, that assistance is rather a palliative, than a cure of the condition which calls for it; and, if perseveringly had recourse to, is likely to induce a train of evils of its own : whilst, at the same time, by the apparent support which it gives, and by rendering the system more tolerant of the unfavourable influences from which \i% depression of power may have proceeded, it renders the individual less disposed to seek, in a change of habit, the rerae^< ;^ virhich will be really effectual. '' Thus," as an American physician has remarked to the writer, " where you (the English practitioner) recommend to a man losing his digestive power from the fatigue and confinement of a city life, to take wine, porter, or bitter ale with his dinner, we ' In order to give a more exact idea of the impor,tance of the celebrations alluded to above, we have thought it w 11 to state the number of persons that attended them, as nearly as can be ascertained. Fourth of July Celebration in Faneuil Hall 1000 Commencement at Cambridge University 800 Festival of Phi Beta Kappa 150 Festival of the Clergy 200 Festival of the Massachusetts Medical Society 800 Festival of the Massachusetts Mechanics' Association 600 160 USE OF ALCOHOL order him out of town, to get fresh air, and the refreshment of idb ncss in the country." No man of observation can doubt which of these two systems is likely to, be most beneficial in the long run, 212. But, again, the writer believes that there are exceptional cases, arising chiefly from peculiarity of original constitution, in which the want of digestive power is more completely and permo* nently supplied by the habitual use of a small quantity of Alooholio liquors, than it can be by any other means within the power of tbd individual. It may be impossible to predicate in any individual instance, whether this shall be the case or not; but the resulti of observation appear sufficient to prove, that it would be erroneous to assert dogmatically that it never can be. Still, the evils resuUinjg^ from the unnecessary employment of stimulants are so great, tb»t recourse should never be had to them, until every other more natural method of sustaining the vital powers has been tried without sucoesH^ they should never be employed to replace any hygienic requirem^Dt^ isuch as fresh air, mental repose, muscular exercise, &c.; and they should be disused whenever it may appear that the neoesaifiy fw them no longer exists. IN THE TREATMENT OF DISEASE. 161 CHAPTER IV. ,fc fllB EMPLOYMENT OF ALCOHOLIC LIQUORS NECESSARY IN 'i'MB PRACTICE OF MEDICINE ? IF SO, IN WHAT DISEASES, OR in WHAT FORMS AND STAGES OF DISEASE, IS THE USE OF fll£M NECESSARY OR BENEFICIAL? ^ Sis. Those who maintain that Alcoholic liquors are not requisite ftif the ordinary sustenance of Man, or even tbat they are likely to W fflflier prejudicial than otherwise when habitually taken in small miAbiUm,—' th&tf in fact, Alcohol is to almost every one a true ptitimtf ower or more rapid in its operation, according to the rate Ui wllicb it 18 taken, — may still maintain with perfect consistency, (htti (tike many other poisons) it may be a most valuable remedtfy wli^tt fldtniaistered with caution and discrimination, in various forma of (JlsetiM. In replying to the above question, we shall first look fti ilie inferences which we may draw from the physiological action of Ai«oho], in regard to the conditions of the system in which it is m^i likely to be useful. I ill X I. — RECOVERY PROM SHOCK. 21 d< We have seen that Alcohol, when introduced into the cir- 6^\tii\ot\f acts as a stimulant in augmenting the force and rapidity ^ fhe heart's contractions, and that it also increases the excitability ^ the nervous system ; we have found, moreover, that it supplies iha ttieans of keeping up the Animal Heat, which may be advan- tA^^misly employed when other means are deficient. Hence wo ili(itil(l say that alcoholic liquors may be advantageously employed Ui itMist in rousing the system from the effects of agencies of vari- 9tt« kltids, which threaten for a time to produce a fatal depression §f the tltal powers; — such, for example, as severe injuries that pro* 4u^6 (I violent lilvock, under the primary effect of which the system ikppQVkH likely to sink. But great caution must be used in their Ailtllittifltriitioo, and they should not be given unless there appears t^y be ft positive necessity for doing so, (i. e. unless the patient ap- pftfi likely to sink without them); for it is tis certain that re-ac< lilWftfy excitement will follow a primary depression, as it is that d^f>femioa will be subsequent upon primary excitement; and if MiMulantii have been unnecessarily employed, the difficulty of con- ifdllffg the redaction will be increased. This caution is more espe- fiuWjl tieoetflary, where the brain is the part to which the injury blti Ot^ourred, since the special determination of alcohol to chi» 14* It-! ■hi J 162 U S K OF A I. C I) II I. orgnn will inoroRBo the viulonoo of the rc-aotion in a most diuigorouii mil n nor. ^ 214. Thoro \» no oliiss of nnnoa, porliups, in wlii(?h tlio gontl offootsi of slinuilunta in inniiitiiining tho lioiirt'H notion, and in kooping np thti nervous cxcitjibility, are nioro nmnifoHt, than in tlioHo Hovcru and oxtnnsivo burns of tho trunk of tho body, to wliioh tho chil- dron of tho lowor olu8so8 aro pooulinrly liablo, from their ulolhos taking iiro through cnrolossnoMM or nogligcnoo. Tho Nhook giv(>n by this injury to thu dulionta and imprcssiblo systom of tho child it; ofton rapidly fat4il ; tho hourt'8 action being cxtromoly is of equal im- portanco to keep up tho vital powers for a time; since, if they can be sustained for a few hours or days, the patient has a fair ehuneo for recovery. Of such wo have examples in many forms of Fever; es^H'cially ia those whioh run a tolerably determinate course, and which exert their noxious influence rather in producing a general depression of the vital powers, than in occasioning any decided local lesion. No two epidemics of fever are precisely alike ; and tho treatment which is of service in one may be found injurious in the other, notwithstauu.iig that the general type may be the same A severe epidemic of typhoid fever, which the writer witnessed in Edinburgh in the years 183G-7, afforded him an opportunity of seeing the decided efficacy of Alcoholic stimulants in one form at least of this fever; the opposite methods of treatment, followed by two physicians whose practice he watched, being attended with such ditfereut results, that as the oases wore of the same class, and the 3ther conditioiis identical, there wiis no other way of accounting for Morb\/ic agents — disease-producing agents. IN THE T U K A T M K N T () V IH H V. A 8 K . 1«8 tlio ililFon^nco. ^^y noitlior jdiyHiciim w<'ro any nctivo rnonNiircii tiikun (liiriiijij; tho curly ntiigtm of tlio fovor, for iiorio HiuMiKtd (;iillc(l for; but ill ono Hot of ciihch, tho huiiio ()xp(H!tniit prncticn wmh (tori' tiiMK'd to tho 011(1 ; wliilHt in tho othor, tho iidniiiilHtration of wino nnd Hpirit wiim coiiiiiienuod, iih hooii uh tho woakni'HH of thu piilm', and thu (MihinoHH of thu cxtroinitiuH, indicutud the incipient fnihiro of tho oiruuhiting und cidorifying poworH.' Tho quantity wiih in* crutiHcd iiH tho nocooHiticH of tho patient Hoomod to rcquiro; nnd in ono ciiHo (that of a woiimn whoHO hahitH had hnvu proviouHly iiitcm- poruto, and on whom a inoro potont HtiiniiluH waH thoroforo ncodod to niako an itiiproHHion,) a bottlo of nhorry with twolvo ouiicoh of whi«k(^y waH tho daily allowanco for a wottk or more, — tho patient ultiiiiatuly recovering. Now tho rcHult of thin wine-treatment watt, that tho mortality was tiof, ahove, a third of that of the Himpic ex- pectant treatment; tho pationtH dying under thu latter from actual exhauHtion and failuro of calorifying power, und uo local IcHioa' being detectiblo on poHt-mortem examination. 210. It IB by no mcuos difficult to give a Hatiafactory ralionah* of this benolleiul acti(m. Tho immediate cause of d(!ath in Hueh cascH appears to bo a fuilMro of tho power of thu heart, the contrac« tidiis of which, in the advanced etago of typhus and typhoid feveri*, bocoino progressively feebler and more rapid ; und it has been noticed by Drs. Stokes und Graves, us tho best indication for the nsc of wine, that tho impulso is greatly diminished, and that thu first sound becomes very feeble or is entirely extinguished. Now the efl'eet of wine, where it acts beneficially, is to render the heart's action more vigorous and at the same time slower. Again, with this state of the circulation we generally have a low muttering and rest- less delirium, with an approach to subsultus tcndinum;* and if th^ wine acts beneficially, it renders the patient more tranquil und dis- poses him to sleep. Under the influence of wine, too, in suitable cases, tho skin and ttmgue become moister, und the breathing nioru deep und slow; but if the wine bo acting injuriously, the skin and tongue become drier, and the rcspirutory movements more hurried. Concurrently with the failure (tf the heart's action, there seems otujj to be a deficiency of heat-producing material ; all that was previously contained in the body having been burned-otf during the earlier period of the fever; und little or none buving been taken in from without. Day by day, the fatty matter of the body is used up by the respiratory process; and thus, as in cases of simple K*iirvution. the patient must die of cold, unless some means be provided fur the ii i i • Calorifying powers — hent-producing powers. ' Lesion — change of structure or condUion produced by disease. • Rationale — explanation. • Bubtulttu tendinum — starting or spasmodic twitches of thu tendon* 164 USE OF ALCOHOL hi \ I + sustenance of the beat. In such a condition of the system, no ftiri> naceous or oleaginous matters could be digested or absorbed in soffi* cient quantity ; whereas alcohol is taken into the current of the cir- culation by simple endosmose,' without any preparation whatever, and can be immediately applied to the production of heat. 217. Now in the cases in which the Alcohol is thus useful, there is an entire absence of stimuloting effects. This is probably due in part to the fact, that the Alcohol is burned-off nearly as fast as it is introduced (the general rule in such cases being to give a small quan tity at a time, but to repeat this frequently) ) but it would also appear to result in part from this, — that the stimulating power of the Alco- hoi is expended in neutralizing (so to speak) the depressing influence of the fever-poison already in the system^ and that it simply tends, therefore, to restore both the heart and the brain to their condition of normal activity. Where the habits of the patient have been pre- viously intemperate, the ordinary doses of alcoholic stimulants have no perceptible effect; and it is necessary to go on increasing them, until some marked influence is exerted by them, — as in the case just now cited. 218. It is not only in the idiopathic typhoid and typhus fevers, that Alcohol thus becomes the must important remedy which the Physician has what calmative propertici of the hop aid in producing the desired cLect upon the stomach. in III. — TREATMENT OF CHRONIC DISEASES. 225. Of the use of Alcoholic liquors in the treatment of chronic ' diseases, however, it becomes us to speak with much greater cau* tion ; the condition of the system under the dcpremmj influence of "shock" or of poisonous agents, being very different from that which results from the exhaustion of its powers through chronic diseases, although debility is a characteristic of both. The writer's idea of the difference between the two states, and of the relations of each to alcoholic stimulants, may perhaps be best explained by a stmple illustration. When a vigorous man is prostrated by a vio- lent blow, he speedily rallies from it, and is all the better for the aid of a helping hand in getting on his legs again. But if the same man expend his powers in a prolonged pugilistic encounter, although he may not have received any one severe injury, he be- comes at last so exhausted that no helping hand can avail him any- thing, and he sinks beneath the slightest force put forth by his opponent, — nothing but time and rest being then effectual for hia restoration. In general, then, it is believed by the writer that little permanent good can be expected from the use of alcoholic stimu- lants in chronic diseases, so far, at least, as regards their stimulant operation upon the heart and nervous system ; and what benefit they are capable of conferring, will be obtained by their improve ment of the digestive power, and of the processes of primary as-* eimilation.' But it is very doubtful whether the temporary im- provement which can sometimes be thus obtaiiicd, is not really fallacious, — like that which we see in the burning of & lamp, just after the raising of the wick, when there is a deficiency of oil ; — since it is procured, not by the re-animation of power which existi^ • Chronic — slov; long-continued. * Atsimilation — conversion of food into living matter corresponding with (he organs o' th<3 body. IN THE TREATMENT OF DISEA8K. 169 ry as-' im- really \, just lexista in the body but has previously lain dormant, but by the more rapid oonHumptiou of the small stock of power left. And the questioa of their benefit or injury will often depend upon whether, by this more rapid consumption, new vigour can be infused into the system, by the introduntion of new material. 226. The use of Alooholio stimulants in such cases has been hitherto so customary with medical men, that it may seem to be running in the face of the established results of experience, to deny or even to doubt their eflScacy. But we have seen reason, within a recent period, to deny or doubt the e£Scacy of many systems of treatment of chronic diseases, which long-continued experience ap- peared to have sanctioned, and to believe that the via medicatrix ' of the system is often itself the great restorer, when time is given for its operation, and other circumstances concur to favour it. And it is especially important, in judging of the action of all reme- dies which must be persevered in for some time in order to produce any decided result, to take their remote consequences fully into ac- count, and to consider how far these are, or are not, favourable to our object. Now the writer has endeavoured to show that the re- mote consequences of the continued use of alcoholic liquors, even in small quantity, are all of them so unfavourable to health, that if the immediate invigoration of the digestive power and of the assimilative processes, which seems to be their onli/ beneficial effect under such circumstances, can be obtained in some other way, it will be most desirable tc avoid their use. 227. This will be more particularly the case, when the causes of the disordered state have been such as to exhaust the vital energy of the Stomach itself, — such as long-continued excess in diet, and habitual indulgence in a moderate allowance of fermented liquors, especially when accompanied by exhaustion of the nervous power by over-exertion or anxiety of mind. It is quite absurd to expect that any change or variety •£ direct stimulation can re-iuvigorate the digestive apparatus under such circumstances. We muy keep our patient in town at his usual occupations, practise all kinds of experi- ments upon his stomach, recommend fat bacon or lean chops, pre- scribe blue-pill and senna-draught, or quinine and calumbo, and ring the changes upon all the wines, spirits, and malt-liquors which the cellar CjEin furnish, without effecting any permanent benefit. Whereas, if he can be induced to give himself a complete holiday ; to betake himself to some agreeable spot, where there is sufficient to interest, but nothing to excite; to inhale the fresh and invigorating breezes of a mountainous country, in place of the close and deteriorated ; with * Vis msdieatriz — the inherent power of the animal system to repur anjr ii^Jary it may receive, or to remove the diseases with which it may be at taoked. 15 no USE or ALCOHOL atntoflphere of a town ; to promote the copious action of his skin bj exercise, sweating, and free ablution ; to wash out his inside and in- crease the tonic power of his stomach with occasional (but not ex- cesnive) draughts of cold water; and to trust to the natural call of appetite alone, in preference to artificial provocatives; — we shall be giving him the beat possible chance of permanent restoration to health. 228. There is perhaps no class of cases in which the benefits of the Hydropathic treatment are bo strikingly displayed, especially when it is carried on in a spot where all other aids concur to make it most effectual ; and reasoning from analogy, the writer is strongly inclined to believe that it would be of similar efficacy in re-invigo- rating the system exhausted by other forms of chronic disease, and would in most cases be preferable to any form of alcoholic stimu- lants for procuring an increase of digestive and assimilative power. So fur as the writer is acquainted with the' results of comparative experience, they are decidedly in favour of the Hydropathic treat- ment, moderately and judiciously applied, especially in cases of chronic Gout and Rheumatism ; but he would not be dogmatic enough to assert that there are not individual instances, in which (as in the class formerly adverted to, § 194), the long-continued or even the habitual use of alcoholic liquors, will promote the recovery from chronic diseases, by their influence on the digestive and assimi- lative apparatus. He does not see the possibility, however, of laying down any general rules, by which such cases can be distin- guished ; and it will be only from the results of an extended expe- rience of the comparative advantages and disadvantages of different modes of treatment, and of the immediate and remote consequences of the employment of alcoholic stimulants, as compared with those of the abstinent system, that any really valuable inferences can be drawn. Until these shall have been obtained, he believes that ab- stinence will in most cases be the safer plan ; except where the prostration of the vital powers has proceeded to such an extent, a^ to require temporary stimulation for the performance of any of th* nutritive and regenerative operation& ,. ■_, , . . . ^ .^ ■' ■ ' # ' \ . - .. :•• - - ■ :. -> =_ i.v 229. It may not be amiss to remark, in conclusion, that it if through the medium of the Water contained in the Animal Body, that all its vital functions are carried on. No other liquid than Water can act as the solvent for the various articles of food which are taken into the Stomach. It is Water alone which forms all the fluid portion of the blood, and thus serves to convey the nutritive material through the minutest capillary pores into the substance of the solid tissues. It is Water which, when mingled in various pro- portions with the solid components of the various textures, giveif to IN THE TREATMENT OF DISEASE, 171 them the consistence which they sevomlly require. And it is Water which takes up the products of their diK-ay, and conveys them, by a most complicated and wonderful Ryatem of sewerage, altogether out of the syHtem. It would seem most improbable, then, that the habitual admixture of any other fluid, — especially of one which, like Alcohol, possesses so marked a physical, chemical, and vital influence upon the other components of the Animal body, — can be otherwise than injurious in the great majority of oases; and where a benefit t« derivable from it, this will depend upon the fact thai the abnormal condition of the systeu) renders some one or more of the special actions of alcohol remedial instead of noxiouSp so that the tMlaDoe becomes on the whole in favour of its ust> ; •- X;;-., . • . ;..;•,■■ ,, ; •' . • • > ■ .. :■■ ' . ' ■ ■ '. ..M ' ■ " ■, ' - ' . '■'! 7 , ' ■ ' •• - ■ - " ■ ■ -■' ■ -1 ■ . , '■ ;"', , , -I ■■'---' •?■ II ii APPENDIX A, p. 66. ^^%A/V^W^^/W^\AAtV in it; I. II i Some veiy remarkable details regarding the condition of tba Imllasters and Cnal-whippers employed on tTie Thames, have lately been ascertained by the inquiries of the " Commissioner" employed by the Morning Chronicle, and have been made public in the columns of that newspaper. The drinking habits of these men have been in part engendered by the system under which they have worked ; which has involved, as the necessary condition of their employment, the expenditure of a large part of their earnings at the public-house. This system was done away with, a few years since, as regards the Coal-whippers ; but it still remains in force with respect to the Ballastcrs. Several of the former class are now Total Abstainers ; while others who adopted the Abstinence system for a time have returned to their former habits. The inquiries of Mr. Maybew, the "Commissioner," were specially directed to the experience of both these classes ; and we shall first quote the state- ment of one of the latter, by way of showing the extreme severity of the labour undergone by these men, and the circumstances under (rhicb the assistance of Alcoholic liquors is sought by them : — "I was a strict teetotaler for many years, and I wish I could be so now. All that time I was a coal-wbipper, at the heaviest work, and I have made one of a gang that has done as much as 180 tons in Oue day. I drank no fermented liquors the whole of the time. I had only ginger-beer and milk, and that cost me Is. Qd. It was in the summer time. I didn't ' buff it' that day ; that is, I didn't take my shirt off. Did this work at Regent's Canal, and there was a little milk-shop close on shore, and I used to run there when I was dry. I bad about two quarts of milk and five bottles of gin- ger-beer, or about three quarts of fluid altogether. I found that amount of drink necessary. I perspired very violently — my shirt was wet through, and my flannels wringing wet with the perspira- tion over the work. The rule among us is that we do twenty-eight tone on deck, and twenty-eight tons filling in the ship's hold. We go on in that way throughout the day, spelling at every 28 tons. The perspiration in the summer streams down our foreheads so rapidly, that it will often get into our eyes before we have time to 172 APPIS NHIX. 178 wipo it off This makes tho eyes very nnro. At night when we got home we cannot hour to sit with a candle. The pnrHpiration is of a very briny nature, for I often tante it as it runs down my lips. We are often ho healed over our work that the perspiration runs into the shoes; and often, from the dust and heat, jumping up and down, and the feet being galled with the small dust, I have had my BJioes full of blood. The thirst produced by our work is very rx« oessive. It is completely as if you had a fever upon you. The dust gets into the throat, and very nearly suffocates you. You can Borape the coal-dust off the tongue with the teeth ; and do what you will, it is impossible to get the least spittle into tho mouth. I have known the coal-dust to be that thick in a ship's hold, that I Lave been unable to see my mate, though he was only two feet from me. Your legs totter under you. Both before and after I was a teetotaler, I was one of the strongest men in the business. I was able to carry seven hundred weight on ray back for fifty yards, and I could lift nine half-hundreds with my right arm. After finishing my day's work I was like a child with weakness." To the foregoing account, the following may be added from another witness by way of finish to the picture : — " Then there's the coals on your back to be carried up a nasty ladder or some such contrivance, perhaps twenty feet — and a sack full of coals weighs 2 cwt. and a stone at least ; the sack itselfs heavy and thick. Isn't that a strain on a man ? No horse could stand it long. Then when you get fairly out of the ship you go along planks to the waggon, and must look sharp, 'specially in slippery or wet weather, or you'll topple over, and there's the hos- pital or work-house for you. Last week we carried along planks sixty feet at least. There's nothing extra allowed for distance, but there ought to be. I've sweat to that degree in summer that I've been tempted to jump into the Thames just to cool myself. The sweat's run into my boots, and I've felt it running down me for hours as I bad to trudge along. It makes men bleed at the nose and mouth, this work does. Sometimes we put a bit of coal in our mouths to prevent us biting our tongues." Now it cannot be questioned that such labour is greater than any man should be called on to perform ; and that even if it should be proved that assistance is derived in its execution from the use of Alcoholic liquors, the fact would not be in the least degree in their favour. For we might fairly anticipate that under this artificial stimulation, more work being got out of the frame than it is natu- rally capable of discharging, its powers would.be exhausted at an earlier period than that to which they would be preserved under a system of le.ss excessive labour, performed without artificial sup- port. And that such is the case, is abundantly proved by the fact, that such of these men as survive the attacks of acute disease, or 15* 1^ 174 APPENDIX. are not the subjects of accident, become prematurely old ; and thfl» an)ioDg the whole c!ass, there are few who have passed the age of fifty years. The amount of Alcoholic liquor habitually oonsuinad by them may be judged of from the fuUowing statements made to Mr. Mayhew, by two men who have remained firm to the Total Abstinence principle. — "Before I was a teetotaler I principally drank ale. I judged that the more I gave for my drink the better it was. Upon an average I used to drink from three to four pinti of ale per day. I used to drink a good drop of gin too. Tbo coal-porters are very partial to dog's-nose — that is, half-a-pint of ale with a pennyworth of gin in it ; and when they have got th^ money, they go up to what they term the * lucky-shop' for it. Thd coal-porters take this every morning through the week, when they can afford it. After my work I used to drink more than when X was at it. I used to sit as long as the house would let me bavQ any. Upon an average, I should say, I used to take three or four pints more of an evening ; so that altogether 1 think I may fairly say I drank my four pots of ale regularly every day, and about half-a-pint of dog's-nose. I reckon my drink used to cost me ISs, a week when I was in work. At times I was a noisy drunken gentleman then.'' Another coal-porter, who has been a teetotaler ten years on tha 25th of last August, told Mr. M. that before he took the pledge b(9 used to drink a great deal after he had done his work, but while bo was at his work he could not stand it. " I don't think I used to drink more than three pints and-a-half and a pennyworth of gin in tbo day time," said this man. " Of an evening I used to stop at tbo public-house generally till I was drunk, and unfit to work in t\m morning. I will vouch for it I used to take about three pots a day after I had done work. My reckoning used to come to about Is. 8q, per day, or including Sundays, about 10s. 6d. per week. At that time I could average all the year round 30s a week, and I used to drink away ten of it regularly I I did indeed, sir, more to my shame." It seems a legitimate inference, from the early decay of the phy* sical powers of these men, that no real support is given them by Alcoholic liquors, in the performance of their arduous labour ; and it is a remarkable point in the statements just quoted, that both agree in the assertion, that the principal part of the liquor consumed is taken in the evening, after the day's toil is over, as they "could not stand it" whilst at work. Thus it appears that the an.ount which can be effectively employed as a stimulus to nervo-muscuUr exertion is really small ; and it is further evident that there is an entire absence of proof that anything is in the end gained by tbeir use; — ^a conclusion which is in perfect harmony with the statemonti APPENDIX. 175 ffiftde In the Essay ^§§ 85-102), as to the incapacity of Alcoholio lk|tinr8 for maintaiDiDg the physical powers of the human system. That some of those who have tried the Total Abstinence system tiare gone bnck to their former habits, from a feeling of the necessity of support, is capable of being accounted for, not merely by the excessive amount of labour they are called on to perform, but also hy the want of adequate sustenance from solid food. A due allow- fttiee of (his is unquestionably essential to the maintenance of the ktrength ; and it appears from the testimony of other individuals limilnrlv employed (given iu the next Appendix), that where this eoarse has been followed, the labour has been performed with more WUBf and that ihe power of endurance has beeu increased. APPENDIX B, p. 87. ttm d(i I 8i that 1 to my phy. und both lued ould ourit iulrtf a iin tbujp outi The recent inquiries of the "Commissioner" of the Momu y Cfhroniele, not only reveal the circumstances under which a vast hnumni of excessive drinking takes place among men engaged in Ifthorious employments, but also confirm all that is stated in the text titi to the possibility of performing the severest labour without such Umniancef provided due support be obtained from solid food. The following is the statement made to Mr. Mayhew by a Goal-whipper, who had been a teetotaler of eight years' standing : — " It's food (^ly that can give real strength to the frame. I have done moro Work since I have been a teetotaler in my eight years, than I did in t«ti or twelve years before. I have felt stronger. I don't say that 1 do niv work better ; but this I will say, without fear of successful OOfifradiction, that I do my work with more ease to myself, and with More satisfaction to my employer, since I have given over intoxi- Oflfiftg drinks. I scarcely know what thirst is. Before I took the l^ledge 1 was always dry ; and the mere shadow of the pot-boy was ^tifte sufficient to convince me that I wanted something. I certainly hnVfi't felt weaker since I have left off malt liquor. I have eaten tliore and drank less. I live as well now as, any of the publicans do — and wbo has a better right to do so than the man who works ? 1 have backed as many as sixty tons in a day since I took the pledge, Ului have done it without any intoxicating drink with perfect ease to Itfyself, arti walked five miles to a temperance meeting afterwtrds. Dtit bef(/ro I became a teetotaler, after the same amount of work I •h(?uld scarcely have been able to crawl home. I should have been Mrtfliii to have lost the next day's work at least; but now 1 cau I 176 APPENDIX. I'.: back that quantify of coals week after week without losing a day I've got a family of six children under twelve years of age. Mv wife's a teetotaler, and has suckled four children upon the principle of total abstinence. Teetotulism has made my home quite happy, and what I get goes twice as far. Where I work now, four of us out of five are teetotalers. I am quite satisfied that the heaviest work that a man can possibly do, may be done with' ut a drop of fermented liquor. I say so from my own experience. All kinds of intoxicating drinks is quite a delusion. We teetotalers can do the work better, that is, with more ease to ourselves, than the drinkers can. Many teetot.alers have backed coals out of the hold, and I have heard them say over and over again that they did thuir work with more comfort and ease than they did when they drank intoxicating drink. Coal-backing from the ship's hold is the hardest work that it is possible for a man to do. Going up a ladder sixteen feet high, with 288 lbs. weight upon a man's back, is sufficient to kill any one; indeed, it does kill the men in a few years — they're soon old men at that work." aif( of an( mi( wit to at It appears from the statement of this man • — 1st, That he could do more work in the time, on the total abstinence system, than on his previous system ; — ^2nd, That he could do it with more ease and comfort to himself; — 3d, That at the end of his day's labour he was not too much fatigued to prevent him from voluntarily walking five miles to a temperance meeting; whilst (like the first witness i"'3d in the preceding Appendix, who spoke of himself j»s "like a colld with weakness" when his toil was over,) he was previously MHrcc able to crawl home. J m APPENDIX C, p. 157. On the efffct of Water-Drinking in th^ cure of Govt ; hy JoHN BosTOCK, M.D., F.R.S. — Communicated to the Medico- Chirur- gical Society. "The case to which I propose to direct the attention of the Society, is that of a gentleman seventy years of age, who had been, from a very early period of his life, subject to very frequent attacks of gout, the predisposition to which complaint is inherited from his parents. Connected with this, he has been a constant suflTerer from »«ioniach'afrections of various kinds; acidity, flatulence, heart-burn, Urcj^uidrity of the bowels, and in short, from every one of tho APPENDIX. 177 to the pen, bis hom Irn, tho affections which are enumerated in Gullen's well-known definition of dyspepsia. His mode of life was regular and moderately active, and bis diet what might be styled temperate, although not abate- minus. He bad, indeed, been advised by bis medical friends to take wine in moderate quantity ; he had occasionally employed ale, porter, and brandy-and-water, but never in what could be considered an ex- cessive quantity. In this way he had passed about forty years, seldom actually confined by indisposition, but almost always subject to a succession of ailments, which rendered it necessary to have re- course to medicines of various kinds, and, more especially, to alkalies, which were taken in large quantity, and, as the symptoms appeared to indicate, to purgatives or to sedatives, and to a variety of tonics and stimulants. During this period, the renal secretion was seldom in what could be considered a perfectly healthy state ', it was some- times loaded with deposits, and of high specific gravity; sometimes of low specific gravity, limpid and aqueous ; sometimes very copious, at other times scanty; while its chemical constitution was most variable both as to the nature and the proportion of its saline contents. " About four years ago, in consequence of the accession of certain alarming symptoms of a new description, which were supposed to require the antiphlogistic treatment, the patient was ordered by his medical attendants to reduce his system of diet, end, more especially, to abstain entirely from fermented liquors or distilled spirits of any description. By this restriction, and by other appropriate remedies, the threatened disease was averted. And besides this fortunate result, the patient found his general state of health and feelings so much improved by the change of diet, that the abstlrence from all kinds of liquors has been strictly adhered to up to the pi t rnt period. The effect has been that he has lost all the d^itpeptic k^ptorxs to tchich he had been subject for upwards of fort}f year^ ; &nd, what T am more particularly desirous of pointing out to tho Society, the renal secretion has been now, for a hug period, in a perfyfXjf notxiral state: it is nearly uniform in its speoife ,»ravity, nnd is totally free from all the morbid deposits, which were before seldom absent from it. And there is a circumstance connected with it, which I conceive to be particularly deserving of attention; that although of an average specific gravity, and containing the proper proportion of urea and saline ingredients, it is uniformly increased in quantity, so that there has been now, for several months, con- siderably more of these substances discharged from the system thau was formerly the case. It would appear, therefore, that the abstrac- tion of alcohol has produced a more healthy state of the digesln'o and secreting functions ; so that the functions of the kidney artt more actively and effectively performed." — Medical Gazette^ Feb. 23r(f, 1844. 178 APPENDIX. IB To this interesting case, ^rhich is understood to be that of Dr Bostock himself, may be added the following, from the Bristol Teni' perance Herald. " Kebecca Griffiths, the individual referred to, resided in this city (Bristol) the larger portion of her long life, and until her eighty' ninth year had daily taken as a beverage some kind of intoxicating drink. Beer, and' occasionally gin-and-water, had been commonly used ; but for a few years before practising total abstinence, she took daily a small portion of the best Madeira wine — having, perhaps, both as regarded the quantity and quality of the liquor, every advan- tage that any one could possess in using a stimulating drink. This practice she relinquished all at once in the eighty-ninth year of her age. For a time it was feared her health would suffer, but it was soon manifest that those fears were groundless ; her appetite im- proved with the change of diet, and occasional interruptions by a disordered stomach were much less frequent; she would at times observe, that she could eat, drink, and sleep, as well as at almost any period of her life ; nor did her spirits appear to suffer even tem- porarily. For nearly fifteen years she had been tried with a sore in one of her legs, which was troublesome, and at times appeared to be dangerous ; after practising teetotalism for about a year and a half, this sore began to diminish, and was soon perfectly healed. 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