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H 
 
 ON THE 
 
 \ 
 
 USE AND ABUSE 
 
 07 
 
 ALCOHOLIC LIQUORS, 
 
 IN HEALTH AND DISEASE. 
 
 ^5rijj feaii. 
 
 BY WILLIAM B. CARPENTER, 
 
 H.D. F.B.8. F.O.B. 
 
 EXAMINER IN PHYSIOLOGY IN THE UNIVERSITY OP LONDON, AND 
 
 FROPESSOR OP MEDICAL JURISPRUDENCE IN 
 
 UXn'ERSlTY COLLEGE. 
 
 BOSTON : 
 
 P U D L I 8 II E D FOR THE 
 
 MASSACHUSETTS TEMPERANCE SOCIETY 
 
 BY WM. CROSBY & II. P. NICHOLS, 
 111, Washington Street. 
 
 1851. 
 
 l-:^.^xj^^,,^^. 
 
: BOSTON: 
 
 PRINTED BY JOHN WILSON, 
 No. 21, School-itreet 
 
 W 
 
OFFICERS 
 
 OiTTHB 
 
 MASSACHUSETTS TEMPERANCE SOCIETY, 
 
 1860-61. 
 
 w 
 
 JOHN C. WARREN, M.D. . . 
 HON. STEPHEN FAIRBANKS 
 
 MOSES GRANT, Etq 
 
 REV. ANDREW L. STONE . 
 REV. JOSEPH BANVARD . 
 RICHARD OIRDLER, E»q. . 
 BENJAMIN P. RICHARDSON, 
 
 . President. 
 
 . Vice-President. 
 
 , Secretary and Treasurer. 
 
 Esq.. 
 
 ' Councillors. 
 
u 
 
PREFACE TO THE BOSTON EDITION. 
 
 Thb name of Dr. Carpenter has become well known 
 in the United States by his valuable and beautiful work 
 on the Principles of General and Comparative Physiology, 
 by his Principles of Human Physiology, and by various 
 other writings. The studies to wliich the production of 
 tliese works led, qualified him to undertake an inves- 
 tigation of the ejects of alcohol on the human body. 
 When, therefore, it was announced that the prize of one 
 hundred guineas, which the liberality of a gentleman in 
 England had oflfered for the best Essay on the Use of 
 Alcoholic Liquors in Health and Disease, had been ga'n vi 
 by him, those who felt an interest in the subject lookc ! 
 with eagerness for the results of his labors ; and, when 
 they appeared, the highly wrought expectation was not 
 disappointed. Accordingly, we were pleased to find that 
 an edition was soon issued in this country by Messrs. 
 Lea and Blanchard, of Philadelphia, and that physicians 
 and others would be able to avail thousolves of the pro- 
 ducts of Dr. Carpenter's talent and researches. 
 
n PREFACE TO TUB BOSTON EDITION. 
 
 Many persons have thought that the work could bo 
 rendered more generally UHoful by the insertion of expla- 
 natory notes, which should make it intelligible to the mass 
 of readers. This has been hero accomplished under the 
 direction of the Massachusetts Temperance Society, — 
 the word "Author" having been usually affixed to the 
 notes of Dr. Carpenter, to distinguish them from those 
 in the present edition. 
 
 It has been intimated, that some medical men on the 
 continent of Europe, highly distinguished for learning 
 and benevolence, have not gone as far in the absolute and 
 unexceptionable exclusion of alcoholic liquids as many 
 temperance physicians and others in this country con- 
 sider themselves justified in doing. We must admit 
 that our experience is in favor of the expediency and 
 safety of their unqualified prohibition at every period of 
 life, excepting always their medicinal use under medical 
 prescription. This exporiouco, somewhat extensive and 
 protracted, among the young and the old, among the 
 rich and the poor, including a krgo hospital observation, 
 has not made known to us permanently unfavorable con- 
 sequences from the sudden relinquishment of the use of 
 spirituous and fermented liciuors ; provided, however, that 
 the change lias boon accompanied by a judicious manage- 
 ment of food, of medicinal tonics, and of the moral con- 
 dition of the subject. In this remark wo do not mean 
 to include intemperate persons who meet with great 
 
PREFACE TO THE BOSTON EDITION. 
 
 YU 
 
 accidents; for we know that, when compelled by a 
 severe injury to intermit their bad habit, they often suf- 
 fer greatly and fatally. DeUrium tremens, mortification, 
 and the worst forms of inflammation, occurring under 
 these circumstances, render abortive all the skill or inge- 
 nuity of the surgeon and physician. Such conditions in 
 an alcoholic patient often demand, as the indispensable 
 remedy, a recurrence to the poison which has been the 
 source of his suffering and danger. When it is thus 
 used, we would recommend that the earliest opportunity 
 should be employed for discontinuing the practice, and 
 warning the patient against a return to it. 
 
 We have adverted to the use of stimulant drinks in 
 the latter part of life, and expressed an unfavorable 
 opinion. This is quite contrary to the common belief, 
 and will be thought injudicious and the result of over- 
 heated zeal. " Vinum lac senum" is a favorite adage, 
 and is too congenial to the tastes and wishes of most 
 men to become unpopular. Instances, however, have 
 constantly presented themselves to our notice of old men 
 who complained that wine, which they had formerly 
 taken as they thought with advantage, though still agree- 
 able, had ceased to be salutary. Formerly, they ex- 
 perienced from it no particular inconvenience ; but, at a 
 later period of life, it caused acidity of stomach, heat 
 about the head and hands, pain in the head, and other 
 inconveniences. When the wine was abandoned, the 
 
till 
 
 PRBPACB TO THB BOSTON BDITION. 
 
 •ymptoms disappeared, and they were reluctantly brought 
 to the oonolusion that they were better without it. Theae 
 well-established facts are supported by an investigation 
 into the physical changes of advanced life. Observation 
 has shown, that the pulse, instead of becoming slower in 
 proportion to age, as generally believed, does, ailer a 
 certain period, begin to quicken, and continues to do so 
 to the end of life. This disposition in the system to an 
 increase of the heart's action is still farther excited by 
 the use of stimulants ; and the condition which was favor- 
 able to health, under the influence of natural powers, 
 becomes morbid from the over-excitement of artificial 
 stimulants. 
 
 On the whole, we should recommend, aa a general 
 rule, the sudden and total abandonment of the habit oi 
 employing spirituous and fermented liquors, both by the 
 young and the aged, the weak and the strong. 
 
 The work of Dr. Carpenter we consider to be the 
 most valuable contribution to the aid of temperance 
 which it has received since the productions of L. M. 
 Sargknt, Esq. ; and we heartily recommend its perusal 
 to all classes of people, particularly to gentlemen of the 
 medical profession. 
 
 J. C. W. 
 
 BosTOR, D«eeinber, 1840. 
 
TO 
 
 HIS ROYAL HIGHNESS 
 
 PRINCE ALBERT, 
 
 €{)i0 €bu^ 
 
 (by febmission) 
 MOST RESPECTFULLY DEDICATED, 
 
 At AW 
 
 EXPRE8BI0N OP THE AUTHOR'S ADMIRATION 
 
 OF HIS ROYAI. HIOHNESS'S ENDEAVORS 
 
 TO ELEVATE 
 
 THE SOCIAL CONDITION OP HIS ADOPTED COUNTRY, 
 
 AND WITH THE FIRM BELIEF 
 
 THAT THE PATRONAGE NOW SO ORACIOUSLT CONCEDED 
 
 WILL AID IN CALLING THE ATTENTION OP THE PUBLIC 
 
 TO THE SUBJECT OF THE PRESENT INQUIRY 
 
 IN A DEGREE COMMENSURATE 
 
 WITH ITS IMPORTANCE. 
 
 6« 
 
dr 
 
>I>VERTISEMENT 
 
 ISSUED BT DIBBCTIOM OF THE DOKOB OP THB FBIZE. 
 
 A PRIZE OF ONE HUNDRED GUINEAS 
 
 WILL BE GIVEN rOR THB BEST ESSAY ON THB USB OF ALCOHOLIC 
 LiaCOBS IN HEALTH AND DIBBA8B. 
 
 The Essay must contain answers to the following 
 questions : — 
 
 1. What are the effects, corporeal and mental, of alcoholic 
 
 liquors on the healthy human system ? 
 
 2. Does physiology or experience teach us that alcoholic liquors 
 
 should form part of the ordinary sustenance of man, par- 
 ticularly under circumstances of exposure to severe labor, 
 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 observation ? 
 
 3. Are there any special modifications of the bodily or mental 
 
 condition of man, short of actual disease, in which the 
 occasional or habitual use of alcoholic liquors may be 
 necessary or beneficial ? 
 
 4. Is the employment of alcoholic liquors necessary in the 
 
 practice of medicine ? If so, in what diseases, or in what 
 forms and stages of disease, is the use of them necessary 
 or beneficial i 
 
 The Essay must be delivered to the undersigned ad- 
 dress, on or before the 30th day of September, 1 849. 
 
xu 
 
 ADVERTISEMENT AND ADJUDICATION. 
 
 1 
 
 Dr. John Forbes, F.R.S., Physician to the Queen's 
 Household, Prince Albert, and the Duke of Cambridge ; 
 Dr. G. L. RouPELL, F.R.S., Physician to St. Bartholo- 
 mew's Hospital ; and Dr. W. A. Gut, M.B., Cantab., 
 Professor of Forensic Medicine, King's College, London, 
 have kindly consented to act as adjudicators, a.. 
 
 Signed on behalf of the Donor, 
 
 Chaeles Gilpin. 
 Thomas Beogs. 
 6, Bishopsgate Street Without, 
 London, April, 1848. 
 
 
 ADJUDICATION. 
 
 From the fifteen manuscript Essays on the Use and 
 Abuse of Alcoholic 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 bear- 
 ing the motto, Quot homines tot sententioe, to record our 
 opinion of its great merits. 
 
 We further deem it right to speak in terms of coiAmen- 
 dation of the Essay having five mottoes, the first of which 
 is, HotD use doth breed a habit in a man. • » 
 
 (Signed) 
 
 ' . ■ i ) 
 
 London, December 6th, 1849. 
 
 John Forbes, M.D. 
 G. L. RoupELL, M.D. 
 William A. Guy, M.B. 
 
PREFACE. 
 
 The circumstances under which the following Essay is 
 given to the public are suflSciently explained bj the pre- 
 cedii^ Advertisem^it and Adjudication ; but the author 
 takes this opportunity of offering a short statement of 
 the objects whicK he had specially in view in its com- 
 position. 
 
 The questi(His set forth in the Advertisement having 
 been evid^itly drawn up with great care, and having 
 been obviously intended to bring the whole subject of the 
 ordinary as well as the medical employment of alcoholic 
 liquors under discussion, the author judged it advisable 
 to follow the plan which they had marked out, by 
 answerii^ each of them seriatim ; * although he was 
 aware, that, by so doing, a certain amount of repetition 
 would be almost necessarily involved. He found, as he 
 proceeded, that it would be impossible to maintain such 
 a continuity in his argument as would be desirable for 
 its effectiveness; and he would therefore request his 
 
 * Seriatim^ in order. 
 
XIV 
 
 PREFACE. 
 
 readers, in limine,* to keep the following issues in view, 
 as those to which ho is desirous of leading them. 
 
 In the first place, That, from a scientific examination 
 of the modus operandi -f of alcohol upon the human 
 hody, when taken in a poisonous dose, or to such an 
 extent as to produce intoxication, wo may fairly draw 
 inferences with regard to the specific effects which it is 
 likely to produce, when repeatedly taken in excess, but 
 not to an immediately fatal amount. 
 
 Secondly, That the consequences of the excessive use 
 of alcoholic liquors, as proved by the experience of the 
 medical profession, and universally admitted by medical 
 writers, being precisely such as the study yof its effects 
 in poisonous and immediately &tal doses would lead us 
 to anticipate, we are further justified in expecting that 
 the habitual use of smaller quantities of these liquors, if 
 sufficiently prolonged, will ultimately bo attended, in a 
 large proportion of cases, with consequences prejudicial 
 to the human system ; the morbid actions thus engen- 
 dered being likely rather to be chronic X tlian acute || 
 in their character. 
 
 Thirdly, That, as such morbid actions are actually 
 found to be among the most common disorders of persons 
 
 * In limine, at the beginning. 
 
 t Modus operandi, action. 
 
 X Chronic, fixed, of long continuance. 
 
 II Acute, transient. 
 
' !T . » 
 
 PREFACE. 
 
 XV 
 
 advanced in life, who have been in the habit of taking a 
 " moderate" allowance of alcohohc liquors, there is very 
 strong ground for regarding them as in great degree 
 dependent upon the asserted cause, although the long 
 postponement of their effects may render it impossible to 
 demonstrate the existence of such a connection. 
 
 Fourthly, That the preceding conclusion is fully ] orne 
 out by the proved results of the " moderate " use of alco- 
 hohc liquors, in producing a marked liability to the acute 
 forms of similar diseases in hot climates, where their 
 action is accelerated by other conditions ; and also by the 
 analogous facts now universally admitted, in regard to 
 the remotely injurious effects of slight excess in diet, 
 imperfect aeration * of the blood, insuflScient repose, and 
 other like violations of the laws of he;ilth, when habitu- 
 ally practised through a long period of time. 
 
 Fifthly, That the capacity of the healthy human sys- 
 tem to sustain as much bodily or mental labor as it can 
 be legitimately called upon to perform, and its power of 
 resisting the extremes of heat and cold, as well as other 
 depressing agencies, are not augmented by the use of 
 alcoholic liquors ; but that, on the other hand, their use, 
 under such circumstances, tends positively to the impair- 
 ment of that capacity. 
 
 Sixthly, That, where there is a deficiency of power, 
 on the part of the system, to carry on its normal actions 
 * Aeration, vitalizing by the action of air. 
 
m 
 
 PRSFA<3a. 
 
 i 
 
 *. . 
 
 with the energy and regularity which ooDstitute health, 
 Buch power can rarely be imparted foy <^ habitual use 
 of alcoholic liquors ; its deficiency being generally con- 
 Bequeht upon some habitual departure firom tlie laws of 
 health, for which the use of alcoholic liquors cannot 
 compensate; and the employment of sudi liquors, 
 although with the temporary effect of palliating the dis- 
 order, having not merely a remotely injurious effect per 
 sCf* but also tending to mask the action of other morbific 
 cuuses, hy rendering the system more tolerant of them. 
 
 Seventhly f That, consequently, it is the duty of the 
 medical practitioner to discourage as much as possible 
 the habitual use of alcoholic liquors, in however " mode- 
 rate " a quantity, by all persons in ordinary healtii ; and to 
 seek to remedy those slight departures 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. 
 
 Eighthly, 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 
 
 * Per ae, in itself. 
 
 '■- 1 
 
PHIFAOI. 
 
 zm 
 
 regard to tbe administrfttioii of any other powerful 
 remedy which if poitonous in Urge doees. ^ ' 
 
 ■5 ''-^ 
 
 The foregoing appear to the author to be the conclu- 
 sions legitimately deducible from the facts and arguments 
 which he has brought forwards : it will be for his profes- 
 sional readers to decide how &r the case which he has 
 made out is sufficiently strong to lead them to the same 
 results. This much, however, he would add ; that, when 
 he first entered upon the investigation, some years ago, 
 he had adopted no fbregone conclusion, and had, conse- 
 quently, no temptation to make the facts square with 
 preconceived views ; that he has constantly endeavored 
 to treat the subject as one of purely scientific inquiry, 
 and has avoided mixing up any other considerations with 
 those which presented themselves to him as a physiolo- 
 gist and a physician ; and that, for the sake of keeping 
 himself free from even the appearance of partisanship, 
 he has never allied himself with any one of the societies 
 which have been tovmed to carry into practical e£fect the 
 total-abstinence principle, but has preferred to follow 
 a perfectly independent course. He ventures to hope, 
 that on these grounds he may claim some right to being 
 candidly heard by those to whom this Essay is more 
 especially addressed. 
 
 He cannot albw it to go forth, however, Vithout ex- 
 pressing his conviction, that, wliilst there are adequate 
 
zvu 
 
 PREFACE. 
 
 medical reasons for abstinence from the habitual use of 
 even a " moderate " quantity of alcoholic liquors, there 
 are also strong moral grounds for abstinence from that 
 occasional use of them which is too frequently thought 
 to be requisite for social enjoyment, and to form an 
 essential part of the rites of hospitality. The experience 
 of every practitioner must bring the t^ ible results of 
 intemperance frequently before his eyes ; but, "whilst he 
 is thus rendered familiar with its consequences as regards 
 individuals^ few, save those who have expressly inquired 
 into the subject, have any idea of the extent of the social 
 evils resulting from it, or of the degree in which they 
 pYess upon every member of the community. The author 
 believes that he is fully justified in the assertion, that, 
 among those who have thus inquired, there is but one 
 opinion as to the fact, that, of all the causes which are at 
 present conspiring to degrade the physical, moral, and 
 intellectual condition of the mass of the people, there is 
 not one to be compared in potency with the (dfuse of 
 alcoholic liquors ; and that, if this could be done away 
 with, the removal of all the other causes would be im- 
 measurably promoted. Every one who wishes well to 
 his kind, therefore, must be interested in the inquiry 
 how this monster-evil can be best eradicated. ^. 
 
 Now, the author considers that the best answer to this 
 inquiry has been found in the results of experience. A 
 fair trial has been given, both in this country and in the 
 
PRBFACB. 
 
 XIX 
 
 United States, to societies which advocated the principle 
 of temperance^ and which enlisted in their support a 
 large numher of intelligent and influential men ; but it 
 has been found that little or no good has been effected bj 
 them, among the classes on whom it was most desirable 
 that their influence should be exerted, except where 
 those who were induced to join them really adopted the 
 total-abstinence principle. Though he agrees fully with 
 those who maintain, that, t/all the world would be really 
 temperate^ 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 
 reformation of those who have acquired habits of intem- 
 perance cannot be accomplished by any means short of 
 entire abstinence from fermented liquors. Further, 
 experience has shovm, that, in the present dearth of 
 effectual 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 con- 
 
PMFAOli 
 
 
 tintuuioe; in the riling generation, of the terrible evils 
 which we have at present to deplore. And, lastly, ex- 
 perience has also proved, that this reformation cannot be 
 carried to its required extent, without 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 than it is in this. " I practise 
 total abstinence myself," is found to be worth a thousand 
 exhortations ; and the lamentable failure of the advocates 
 who cannot employ this argument should lead all those 
 whose position calls upon them to exert their 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 advocates of the total-abstinence principle, is the 
 following: "That the abuse of a thing good in itself 
 does not afford a valid argument against the right use of 
 it" This objection has been so well met by the late 
 Archdeacon Jeffreys of Bombay (in a letter to the Boni- 
 bay Courier), that, as it is one peculiarly likely to occur 
 to the mind of his medical readers, the author thinks it 
 desirable to quote a part of his reply. '^ The truth is," 
 he says, "that the adage is only true under certain 
 general limitations ; and that out of these, so far from 
 being true, it is utterly fiilso, and a mischievous fitllacy. 
 
 ^-rrvaSPiavL^je!^^^ 
 
PBBFACB. 
 
 ZXl 
 
 And the limitations are these : If it be found by experi- 
 ence, 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 partial abuse, 
 then the article in question, whatever it be, is fully 
 entitled to the benefit of the adage ; and it would not be 
 the absolute 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 hand, if it be found by expe- 
 rience that there is something so deceitful and ensnaring 
 in the article 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 ai'ising 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 evidence 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 
 
IZU 
 
 PBBPAOB. 
 
 ill 
 
 of the citizen and the patriot, even on the lowest 
 ground. But Christian self-denial and Christian love 
 and charity go far beyond this. St. Paul accounted one 
 single soul so precious, that he would on no account 
 allow himself in any indulgence that tended to endanger 
 a brother's soul : ' If meat make my brother to offend, I 
 will eat no meat while the world standeth, lest I make 
 my brother to offend.' ' It is good neither to eat flesh 
 nor to drink wine, nor any thing whereby thy brother 
 stumbleth, or is offended, or is made weak.' And we 
 must bear in mind that flesh and wine are here men- 
 tioned by Paul as ' good creatures of God ; ' they are 
 not intended to designate things evil in themselves. 
 This saying of St. Paul is the charter of teetotalism ; 
 and will remain the charter of our noble cause, so long 
 as the world endures, so long as there remains 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 beneficial to the healthy human system, 
 — still more, if they should be led to agree with him 
 that it is likely to be injurious, he trusts that they will 
 feel called upon, by the foregoing considerations, to 
 advocate the principle of total abstinence, in whatever 
 manner they may individually deem most likely to be 
 effectual. He believes it to be in the power of the 
 
PRBFAOB. 
 
 XXlll 
 
 elerioal and medical professions combined 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 conclu- 
 sions, he will at any rate have succeeded in convincing 
 them that so much is to be said on his side of the 
 question, that it can no longer be a matter of indifference 
 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 his general view of the case, he 
 has the satisfaction of finding himself supported by the 
 recorded opinion of a large body of his professional 
 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 require- 
 ments of the artisan in his workshop, and the laborer in 
 the field, — have signed the following certificate : — 
 
 •* 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. 
 
■'■■■' ^■\'i]\-trv:^rc^r' 
 
 xay 
 
 PRBFACB. 
 
 ** 2. That the most perfect health is compatible with 
 total abstinence 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 
 beverages of all sorts would greatly contribute to the 
 health, the prosperity, the morality, and the happiness 
 of the human race." 
 
 Mo 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 advo- 
 cacy and the practice of it, yet this is an attribute in 
 which the author cannot for a moment believe his bre- 
 thren to be deficient. Judging from his own experience, 
 indeed, ho may say, that he has found much less diffi- 
 culty 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 merelj 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 than with his 
 practice. 
 
 LoNiH)N, March, 1860. 
 
■t/i^r 
 
 ' <-v. 
 
 TABLE OF CONTENTS. 
 
 CHAPTER I. 
 
 What abb the Effects, Cobforeal and Mental, of Aloo* 
 HOLic Liquors on the Healthy Huican System? 
 
 Page 
 
 Sbot. I. — Influence of Alcohol upon the Physical, Che- 
 mical, and Vital Properties of the Animal 
 
 Tissues and Fluids 1 
 
 Corrugation of Tissues 1 
 
 Coagulation of Albumen 3 
 
 Impairment of Solidifiability of Fibrine . . 4 
 
 Irritating Action on Living Tissues . . 6 
 
 Temporary Exaltation of Nervous Power . 6 
 
 Change in Red Corpuscles .... 8 
 Sbot. II. — Immediate Consequences of the Excessive Use 
 
 of Alcoholic Liquors on the General System 9 
 
 Phenomena of Alcoholic Intoxication . , 9 
 Symptoms and Post-mortem Appearances of 
 
 Alcoholic Poisoning ..... 12 
 
 Pathology of Alcoholic Intoxication . . IS 
 Sect. HI. — Remote Consequences of the Excessive Use of 
 
 Alcoholic Liquors ..... 22 
 
 Diseases of the Nervous System ... 22 
 
 Delirium Ebriosum 23 
 
 ^* Delirium Tremens ...._2.4. 
 
 Insanity 28 
 
 Oinomania 33 
 
 Mental Debility in the Oflspring . . 39 
 
 Inflammatory Diseases of the Brain . 42 
 
ZXVl 
 
 CONTENTS. 
 
 Apoplexy 
 
 Paralysis and Epilepsy 
 Diseases of the Alimentary Canal . 
 
 Irritation and Inflammation of the Mu 
 
 coos Membrane of the Stomach . 
 Inflammatory Gastric Dyspepsia 
 Disorders of the Intestinal Mucous Mem 
 
 brane 
 
 Diseases of the Liver .... 
 
 Acute and Chronic Inflammation of the 
 
 Liver 
 
 Hypertrophy and Atrophy of the Liver 
 Diseases of the Kidneys .... 
 Diseases of the Skin .... 
 General Disorders of Nutrition 
 
 Tendency to the Deposition of Fat . 
 Diminished Power of Sustaining Injuries 
 
 by Disease or Accident . 
 Liability to Epidemic Diseases . . 
 Gout and Rheumatism 
 Diseases of the Heart and Arteries . 
 Spontaneous Combustion . 
 Sect. IV.— General Effect of the Excessive Use of Alco 
 holic Liquors on the Duration of Life . 
 Experience of Insurance Offices . . 
 Specially Injurious Influence of Excess in 
 
 Warm Climates 
 
 Statistics of the Indian Army , , 
 
 CHAPTER IL 
 
 Dobs Physioloqt or Experienob teach us that Alco- 
 holic LiciuoRS should form part of the ordinary 
 
 sustenance of HAN, PARTICULARLY UNDER CIRCUMSTANCES 
 OF EXPOSURE TO SEVERE LABOR, 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 BY THB 
 ftBSULTS OF FBACTICAI< OBSERVATION? . , . . 
 
 Page 
 
 43 
 46 
 
 47 
 
 48 
 63 
 
 55 
 56 
 
 67 
 58 
 59 
 62 
 64 
 66 
 
 67 
 69 
 71 
 72 
 73 
 
 77 
 77 
 
 79 
 83 
 
 &2 
 
CONTENTS. 
 
 XXVll 
 
 Page 
 Sect. I.— Endurance of Bodily Exertion ... 92 
 Sect. II. — Endurance of Mental Exertion . . . Ill 
 
 Sect. III. — Endurance of Cold 118 
 
 Sect. IV. — Endurance of Heat 138 
 
 Sect. Y. — Resistance to Morbific Agencies . . . 166 
 Sect. VI. — Consequence of the Habitual "Moderate" Use 
 
 of Alcoholic Liquors 163 
 
 Effect upon the General System and Excretory- 
 Organs 163 
 
 Effect upon the Stomach 171 
 
 Effect upon the Nervous System . . .176 
 Effect upon the Circulation . . . .178 
 Effect upon Nutrition 182 
 
 CHAPTER m. 
 
 AUE THERE ANT SPECIAL MODIFICATIONS OF THE BODILY 
 OR MENTAL CONDITION OF MAN, SHORT OF ACTUAL DIS- 
 EASE, IN WHICH THE OCCASIONAL OB HABirUAL USB OF 
 
 Alcoholic LiauoRS mat be necessary or benefi- 
 cial? 187 
 
 Sect. I. — Demand for Extraordinary Exertion . . 187 
 
 Sect. II. — Deficiency of other Adequate Sustenance . 194 
 
 Sect. III. — Deficiency of Constitutional Vigor . . . 199 
 
 Pregnancy 208 
 
 Lactation 210 
 
 Childhood 214 
 
 Old Age 217 
 
 CHAPTER rV. 
 
 Is the Employment op Alcoholic Liquors necessary in 
 the Practice of Medicine? If so, in what diseases, 
 
 or in what form and stages of disease, is the USB 
 
 of them necessary or beneficial? .... 226 
 
UVUl OONTBMTS. 
 
 PMg* 
 
 Sbot. I. — Recovery from Shook . • • • • 226 
 S^. II. — Trefttment of Acute DiseasM . . . .228 
 Resistance to the Deprewing Influence of Mor< 
 
 hiflc Agents 228 
 
 Recovery from States of Prostration . . 232 
 
 Support under Exhausting Drains . . . 234 
 
 Forms of Alcoholic Liquors most desirable . 237 
 
 Sect. IIL—Treatment of Chronic Diseases . . .238 
 
 Appendix A 245 
 
 " B 260 
 
 « C 263 
 
 Remarks on the Use op Aioohol fob thb Pbepabation 
 
 OF Medicines, by the Editor . . • . . . 267 
 Medical Cbbtifioatb ....... 202 
 

 Htt 
 
 • • 
 
 . 226 
 
 1 • 
 
 . 228 
 
 ieeofMor< 
 
 • 
 
 . 228 
 
 • 
 
 . 232 
 
 • 
 
 . 234 
 
 •irable 
 
 . 237 
 
 • 
 
 . 238 
 
 • 
 
 . 245 
 
 • 
 
 . 250 
 
 ' f 
 
 . 252 
 
 USE AND ABUSE 
 
 OP 
 
 ALCOHOLIC LIQUOES. 
 
 BPABATIOir 
 
 257 
 282 
 
 CHAPTER I. 
 
 WHAT ARE THE EFFECTS, CORPOREAL AND MEN- 
 TAL, OF ALCOHOLIC LIQUORS ON THE HEALTHY 
 SYSTEM ? 
 
 1. In replying to this question, it will be desirable to 
 proceed as systematically as possible ; since the results 
 of our inquiries upon the several points which it involves 
 will have to form the groundwork of our further investi- 
 gations. We shall commence, therefore, by examining 
 the influence of alcohol upon the physical^ chemical^ and 
 vital properties of the several components of the animal 
 fabric ; from a knowledge of which we shall derive im- 
 portant assistance in our appreciation of its effects upon 
 the human system as a whole. 
 
 I. INFLUENCE OF ALCOHOL UPON THE PHYSICAL, CHEMI- 
 CAL, AND VITAL PROPERTIES OF THE ANIMAL TISSUES 
 AND FLUIDS. 
 
 2. The most important physical change which the 
 
 contact of alcohol effects in the softer animal tissues, is 
 1 
 
i 
 
 I 
 
 
 2 EFFECTS OF ALCOHOL. 
 
 that of corrug-ation ; * which change is entirely due to 
 the difference in the capillary attraction of the tissue for 
 alcohol and for water respectively. If animal mem- 
 branes, a mass of flesh, or coagulated fibrine,t be placed 
 in alcohol in a fresh state (in which they are thoroughly 
 charged with water), there are formed, at all points 
 where water and alcohol meet, mixtures of the two ; and, 
 as the animal texture absorbs much less of an alcohohc 
 mixture than of pure water, a larger amount of water is 
 of course expelled, than of alcohol taken up ; and the first 
 result is a shrinking of the animal substance. *' Thus," 
 says Professor Liebig, " 9-17 grammes of bladder, fresh, 
 that is, saturated with water (in which are contained 
 6*95 gi-ammes of water and 2-22 of dry substance), when 
 placed in forty cubic centimetres of alcohol, weigh at the 
 end of twenty-four hours 4-73 grammes, and have con- 
 sequently lost 4*44 grammes. For one volume of alco- 
 hol, therefore, retained by the bladder, rather more than 
 three volumes of water have been expelled from it." % 
 
 3. Tliis corrugating effect of alcohol will be usually 
 increased by the coagulating influence which it will exert 
 on whatever soluble albumen || the tissues may contain. 
 Both these results will, of course, be proportioned in 
 their degree to the state of concentration of the alcohol : 
 bui some such physical change must always take place 
 in thg walls of the stomach, whenever alcohohc fluids are 
 introduced into it ; and in the soft tissues of the body at 
 
 ♦ Corrugation, a paickering-up or contraction of ioft parts, 
 t Fibrine, the substance of which muscular threads are com- 
 posed. 
 
 X On the Motion of the Animal Juices, p. 11. 
 
 II Albumen, the white and nutritive portion of the blood. 
 
ON THE UEAtTUY SYSTEM. 
 
 8 
 
 large, wherever alcohol liiw found its way into the cur- 
 rent of the circulation. And that such is actually the 
 case is proved by the experiments of Dr. Percy,* who 
 found tliat, when animals are poisoned by alcohol intro- 
 duced into the stomach, the coats of that organ become 
 so thoroughly imbued with it, throughout their whole 
 thickness, that no washing or maceration can remove it. 
 He found, also, tliat the tissues remote from the stomach 
 become impregnated with alcohol, when it has passed 
 into the current of the circulation ; but on this point we 
 shall dwell more at length hereafter. — ("5» IT.) 
 
 4. The physical change just described must have an 
 important influence upon the cltemical relations of the 
 tissues ; since it is impossible that alcohol can be substi- 
 tuted, in however small a proportion, for their constituent 
 water, without producing a decided alteration in their 
 chemical properties, which must disturb the normal series 
 of changes involved in their nutritive operations. Among 
 the most important of the chemical changes which alco- 
 hol has the power of effecting is the coagulation -f of 
 soluble albumen ; and although it will rarely, if ever, be 
 introduced into the- mass of the blood, or into the serous 
 fluids of the tissues, by any ordinary alcoholic potations, 
 in a sufficiently concentrated state o effect this, yet we 
 should anticipate tliat its presence, even in a very dilute 
 form, must affect the chemical relations of albumen, and 
 can scarcely do otherwise than retard that pecuhar trans- 
 formation by which it is converted into the more vitalized 
 substance, fibrine. That such is actually the case will be 
 
 * Experimental Inquiry concerning the Presence of Alcohol in 
 the Ventricles of the Uruln, p. 29. 
 
 t Coar/ukttion, hardening of fluids, like the curdling of milk. 
 
4 EFFECTS OF ALCOHOL 
 
 rendered probable by the considerations to be presently 
 adduced. 
 
 5. No considerable changes of a physical or chemical 
 nature can take place in any of the animal tissues, with- 
 out disordering their vital properties also ; and we have 
 now to inquire into the mode in which these properties 
 are affected by the contact of alcoholic liquids. In the 
 first place, it would appear that the sohdifiabihty of 
 the fibrine, which is its special vital endowment,* is im- 
 paired by the introduction of alcohol into the fluid which 
 contains it; for, when an animal has been killed by the 
 injection of alcohol into the blood-vessels, the blood often 
 remains fluid after death, or coagulates but imperfectly. 
 (See the experiments of Dr. Percy, op. cit) Now, as 
 it is probable that nearly all the organized tissues are 
 developed at the expense of the fibrine, it is obvious that 
 any thing which impairs its organizability must have an 
 injurious influence upon the general nutritive operations ; 
 and we shall hereafter find confirmation of this inference 
 in that peculiar condition of the system which results 
 from excessive habitual indulgence in alcoholic potations, 
 and of which the imperfect elaboration of the fibrine is 
 one of the special characteristics. — (§ 63.) But, sec- 
 ondly, we find that, when alcoholic Uquids are applied 
 to living tissues, especially to the vascular surface of 
 the skin or mucous membrane, they induce redness, 
 heat, and pain, indicating an increased determination of 
 blood to the part. These symptoms vary in intensity, 
 
 ♦ The coagulation of albumen and the fibrillation of fibrine are 
 two entirely diflferent processes ; the former being a simply physical 
 aggregation, the latter tending to produce an organized tissue, 
 and being therefore of a vital nature. — Author. 
 
ON THE HEALTHY SYSTEM. 
 
 5 
 
 according to the state of concentration of the liquiil, anil 
 the length of time during which it remains in contact 
 with the surface ; and they may pass on from this con- 
 dition of irritation to one of actual inflammation. 
 
 6. Our best knowledge, however, of the influence of 
 alcohol upon the vital actions of the animal tissues, is 
 derived from microscopic observations upon the circula- 
 tion of blood in the web of the frog's foot. If alcohol be 
 applied to this membrane in a veri/ dilute state, its first 
 effect is to quicken the movement of blood through the 
 vessels, which are at the same time rather contracted 
 tlian dilated. But this state of things gradually gives 
 place to the opposite ; for after a time, which varies with 
 the degree of the dilution of the alcohol, the circulation 
 becomes retarded, and the vessels dilated ; and a further 
 time elapses before the original condition is recovered. 
 If the alcohol have been applied at first, however, in a 
 less dilute form, the first stage is not observed ; but 
 a retardation of the flow of blood is immediately brought 
 about, and a considerable dilatation of the vessels takes 
 place. The retardation may be such as to amount, in 
 p'>me parts, to a complete stagnation; and here it is 
 noticed, that the red corpuscles * become crowded toge- 
 ther, and that their normal form is lost ; their coloring 
 matter also being diffused through the liquor sanguinis.! 
 Around the parts in which the stagnation is witnessed, 
 however, there is generally a border, in which the blood 
 ^ows with increased rapidity. Now, this perverted state 
 may gradually give place to the normal condition, $ if 
 
 * Red corpuscles, red portion of the blood, 
 t Liquor sanguinis, the blood. 
 X Normal condition, healthy condition. 
 1* 
 
6 
 
 EFFECTS OF ALCOHOL 
 
 the Stimulus bo only applied for a short time ; the circu- 
 lation being restored where it was deficient, and the 
 vessels gradually contracting to their proper size. But, 
 if the contact of concentrated alcohol be prolonged, it 
 becomes obvious tlmt the tissue has been killed ; for the 
 circulation is never re-established in it, and it is at last 
 separated by gangrene.* We rarely witness, in cold- 
 blooded animals, those consequences of the apphcation of 
 irritants which proiHjrly constitute the inflammatory 
 process ; but this process is liable to be excited in man, 
 and in warm-blooded animals, by the contact of alcohohc 
 fluids with living tissues, if the contact be suiRciently 
 prolonged, and the alcohol sufficiently concentrated. 
 
 7. Now, the inference to bo drawn from the preceding 
 details is these, — that alcohol, when applied to the hving 
 tissues in a sufficiently dilute form, exalts for a time 
 their vital activity ; but that this exaltation is temporally 
 only, and is followed by a correspcnding depression. 
 And further, that, when the alcohol is m a state of suffi- 
 cient concentration to act more potentially, its exhausting 
 or depressing effect is manifested, without any previous 
 stage of excitement. This inference we shall hereafter 
 find to be in precise accordance with that to which we 
 shall be conducted by ol)servation of the effects of alcohol 
 upon the system at large ; and we are justified, there- 
 fore, in regarding alcohol as belonging to the class of 
 stimulants, and as subject to the laws of their operation. 
 It has been affirmed by some, that alcohol in small doses 
 is tonic ; f but of this there is no adequate proof. The 
 
 • Gangrene, death of the part. 
 
 t Tonic. A tonic is whatovor increases the vigor of the diges- 
 tive powers. 
 
; the circu- 
 it, and the 
 size. But, 
 rolonged, it 
 ed ; for the 
 it is at last 
 Js, in cold- 
 plication of 
 lammatory 
 'd in man, 
 'f alcoholic 
 3uffic.'.ently 
 'aled. 
 preceding 
 ' the living 
 or a time 
 temporary 
 spression. 
 e of suffi- 
 xhausting 
 ■ previous 
 hereafter 
 which we 
 )f alcohol 
 d, there- 
 class of 
 peration, 
 all doses 
 ►f. The 
 
 he digcs- 
 
 ON THE HEALTHY SYSTEM. T 
 
 property of tonic remedies is to increase the vital contrac- 
 tility of the animal solids in general, hut more especially 
 that of the walls of the blood-vessels. Now, although 
 some shght effect of this kind is at first manifested, ttfter 
 the application of very dilute alcohol to a living mem- 
 brane, yet it is very transitory, and is succeeded by a 
 much longer period of diminution of the tonic contrac- 
 tiUty of the walls of the blood-vessels. And we shall 
 hereafter see, that the supposed tonic properties of alco- 
 hol in small doses (especially in the form of wine or malt 
 liquor) are really but a manifestation of ita stimulant 
 efiects. 
 
 8. Various other experiments confirm this view of the 
 effects of alcohol on the animal tissues ; and those of 
 Humboldt are particularly valuable, as regards its spe- 
 cial capability of producing a temporary excitement of 
 nervous power. " When the crural nerve," he says, 
 " of a full-grown and lively frog was immersed in alco- 
 hol, if the leg was already exhausted by galvanization, 
 the alcohol evidently increased its excitability ; and this 
 increase was lasting (i.e. for a time), when it was quickly 
 removed from the stimulating fluid. If the nerve was 
 left in it for some time, its excitability was completely 
 exhausted. Its application e.^ liausted instantaneously the 
 excitability of young animals, — birds, worms, and in- 
 sects. If the tail of an earthworm or leech be dipped 
 for only four seconds in alcohol, it becomes stiff and 
 inexcitable as far as it is immersed; and, although in 
 frogs and puppies this state of rigidity could sometimes 
 be removed, in these animals it never could." * 
 
 * Annals of Medicine, 1799, p. 265. 
 
i; 
 
 '' 
 
 EFFECTS OF ALCOHOL 
 
 9. There are some peculiar effects of alcohol upon 
 the hlood, besides its influence on the coagulability of the 
 fibrine, of which it is proper that special mention should 
 be made. When alcohol is mingled with fresh arterial 
 blood, it darkens its color, so as to give it more or less 
 of the venous aspect. — (j^ 118.) And, when this 
 admixture is made under the microscope, it is perceived 
 that the red corpuscles shrink, and that a considerable 
 part of their contents becomes mingled with the liquor 
 sanguinis. Now, although the pecuUar functions of the 
 red corpuscles have not yet been precisely determined by 
 physiologists, there is no doubt whatever that they are 
 among the most important constituents of the blood ; and 
 there is strong reason to believe, that they are subser- 
 vient on the one hand to the respiratory function, and on 
 the other, either directly or indirectly, to the elaboration 
 of the plasma or organizable material of the blood. It is 
 highly improbable, then, that any considerable effect can 
 be produced upon them, without seriously impairing the 
 processes of aeration and nutrition ; both of which, as we 
 shall hereafter see, are prejudicially influenced in other 
 ways, by the presence of alcohol in the blood. 
 
 Having thus considered the influence of alcohol upon 
 the properties and actions of the component tissues of the 
 animal fabric, we shall inquire into its effects upon 
 the living system as a whole. 
 
ON TUE HEALTUY SYSTEM. 
 
 
 
 II. IMMEDIATE CONSEQUEXCES OF THE EXCESSIVE USE 
 OF ALCOHOLK LIQUORS ON TUE GENERAL SYSTEM. 
 
 Phenomena of Alcoholic Intoxication. 
 
 10. The term Intoxication is sometimes employed in 
 this country to designate that series of phenomena which 
 results from the action of all such poisons as first produce 
 stimulation, and then narcotism : of these, however, alco- 
 hol is the tjipe ; and the term is commonly applied to 
 alcohoUc intoxication alone. It is worthy of notice, 
 however, that the designation is now given by French 
 writers to the series of remote or constitutional effects 
 consequent upon the introduction of ani/ poisonous agent 
 into the blood : thus we meet with the terms " arsenical 
 intoxication," "iodine intoxication," and even " purulent 
 intoxication." In fact, it is there considered an equiva- 
 lent (as its etymology denotes) of our word poisoning- ; 
 and the fact that such a term should be in common use in 
 this country, to designate the ordinary results of the in- 
 gestion of alcoholic liquors, is not without its significance ; 
 for, if the classical term " intoxication " be habitually 
 employed as the equivalent of the Saxon " drunkenness," 
 we are justified in turning that classical term into English 
 again, and in asserting that the condition of drunkenness ^ 
 in all its stages^ is one of poisoning. That such is 
 indeed the case will become obvious from an examination 
 of its symptoms, and from a comparison of them with 
 those of the cases in which a fatal result has supervened 
 upon excessive indulgence in alcoholic liquors. To such 
 an examination we shall now proceed ; first, detailing the 
 symptoms of the slighter forms of intoxication; then, 
 
10 
 
 EFFECTS OF ALCOHOL 
 
 those of the deeper ; and, lastly, those of the severest 
 cases ; and afterwards inquiring into the pathological 
 state from which those symptoms proceed, and the modus 
 operandi * of the agent that has produced it. 
 
 11. Among the^rs^ effects of the ingestion f of alco- 
 hohc liquors, in sufficient amount to produce their charac- 
 teristic influence, are, in most persons, an increase in the 
 force and rapidity of the heart's contractions ; producing 
 a full, frequent, and strong pulse. With this, there 
 seems to be a general exaltation of the organic functions ; 
 the appetite and the digestive power being increased, and 
 the secretions augmented, especially those of the skin 
 and kidneys. But it is obvious that the encephalic % 
 centres of the nervous system are specially acted on by 
 the stimulus ; for we observe all the manifestations of an 
 excited action in them, such as talkativeness, rapidity 
 and variety of thought, exhilaration of the spirits, ani- 
 mation of the features and gestures, flushed countenance, 
 and suffusion of the eyes. During slight intoxication, 
 the prevailing dispositions and pursuits are often made 
 manifest ; and hence the saying, " In vino Veritas^ || 
 The irritable and ill-tempered become quarrelsome ; the 
 weak and silly are boisterous with laughter and mirth^ 
 and profuse in offers of service ; and the sad and hypo- 
 chondriacal readily burst into tears, and dwell on mourn- 
 ful topics. It sometimes happens, however, that men 
 habitually melancholy become highly mirthful, when 
 they have drunk enough to excite them ; but this seems 
 
 * Modiis operandi, mode of operation. 
 
 t Ingestion, taking in or swallowing. 
 
 X Encephalic, connected with the brain. 
 
 II III vino Veritas, an inebriated person lets out the truth. 
 
 /^ 
 
ON THE HEALTHY SYSTEM. 
 
 11 
 
 the severest 
 
 pathological 
 
 id the modus 
 
 >n t of alco- 
 their charac- 
 3rease in the 
 ; producing 
 this, there 
 c functions ; 
 'reased, and 
 >f the skin 
 encephalic % 
 cted on by 
 itions of an 
 s, rapidity 
 pirits, ani- 
 untenance, 
 ^toxication, 
 ften made 
 
 ome; the 
 nd mirth, 
 ^nd hypo- 
 >n mourn- 
 that men 
 ul, when 
 lis seems 
 
 f 
 
 I 
 
 truth. 
 
 rather to be the case when the melancholy results from 
 external depressing influences than when it is constitu- 
 tional ; and hence it is that too many persons in circum- 
 stances of distress or difficulty have recourse to the 
 bottle for temporary solace from their cares. If no more 
 liquor be taken than is sufficient to produce this condi- 
 tion, it gradually subsides, and is followed by a state of 
 the opposite character ; the appetite, the digestive power, 
 and the organic functions in general, being lowered in 
 activity, the skin dry, the secretions diminished, the 
 spirits depressed, and the power of mental exertion for 
 a time impaired. For this condition, sleep and absti- 
 nence (not merely from a renewal of the stimulus, but 
 from more food than the stomach really demands) are 
 the most effectual remedies. 
 
 12. The state of mental excitement just described is 
 very similar to the incipient stage of phrenitis or mania. 
 It is not a uniform exaltation of the mental powers, but 
 in some degree a perversion of them ; for that voluntary 
 control over the current of thought, which is the distin- 
 guishing character of the sane mind of man, is consider- 
 ably weakened, so that the heightened imagination and 
 enlivened fancy have more unrestricted exercise ; and, 
 whilst ideas and images succeed each other in the mind 
 with marvellous readiness, no single train of thought can 
 be carried out with the same continuity as in the state of 
 perfect sobriety. This weakening of the voluntary con- 
 trol over the mental operations must be regarded, then, 
 as an incipient stage of insanity. 
 
 13. If the first dose of alcohol bo such as to produce 
 more potent effects, or if, as in ordinary intoxication, it 
 be renewed after the first effects have already been mani- 
 
12 
 
 EFFECTS OF ALCOHOL 
 
 fested, the second stage is induced, in "which not merely 
 the intellectual but the sensorial apparatus is disturbed. 
 The voluntary control over the direction of the thoughts 
 is completely lost, and the excitement has more the char- 
 acter of delirium ; the ideas becoming confused, the 
 reasoning powers disordered, and hallucinations some- 
 times presenting themselves. At the same time, vertigo, 
 double vision, tinnitus aurium,* and various other sensory 
 illusions, occur ; the muscular movements become tremu- 
 lous and unsteady, the voice thick, the eyes vacant, and 
 the face commonly pale. Vomiting frequently occurs 
 in this state ; and, when it does, the consecutive stage is 
 usually either cut short, or is abated in intensity. The 
 poisonous effects may proceed no further than this ; the 
 drunkard falling into a heavy sleep, from wliich he 
 awakes to feel the consequences of his transgression. 
 These consequences differ in some degree with the pre- 
 vious habits. Those unaccustomed to such excesses 
 usually suffer from headache and feverishness, with a 
 dry and furred tongue, complete anorexia,! Avith a par- 
 ticular loathing for alcoholic drinks, inability for mental 
 or bodily exertion, and depression of spirits ; and only 
 recover from this condition after prolonged repose and 
 abstinence. On the other hand, the man to whom it is 
 habitual, although his general condition is nearly the 
 same, craves for a further dose of his stimulant ; and, 
 when he has obtained it, he is able to take food, and to 
 proceed with his ordinary avocations. 
 
 14. In the third and most profound stage of intoxica- 
 tion, there is extreme diminution or entire suspension of 
 
 ♦ Tinnitus auritim, ringing in the ears. 
 
 t Anorexia, loss of appetite, aversion to food. 
 
ON THE HEALTHY SYSTEM. 
 
 13 
 
 h not merely 
 is disturbed, 
 the thoughts 
 ore the char- 
 onfused, the 
 itions some- 
 ime, vertigo, 
 ther sensory 
 Jome tremu- 
 vacant, and 
 ntlj occurs 
 ive stage is 
 'sity. The 
 this; the 
 winch he 
 nsgression. 
 h the pre- 
 h excesses 
 3s, with a 
 ith a par- 
 for mental 
 and only 
 'pose and 
 horn it is 
 early the 
 It; and, 
 1) and to 
 
 intoxica- 
 'nsion of 
 
 cerebral and sensorial power ; a state of coma * super- 
 vening upon that hist described. This state may vary 
 in intensity, however, between one of deep ordinary 
 sleep, from Avhich the individual can be so far aroused 
 as to give manifestations of sensibility, and a torpor a« 
 profound as tliat of apoplexy ; and, when the latter 
 manifests itself, it is an indication of danger, especially 
 when the respiratory movements are impeded. Accord- 
 ins to the observations of Dr. Ojj-ston.t the face is 
 sometimes pale, sometimes fluslied ; the eyes vacant and 
 suflfused, sometimes glazed : the pupils dilated, and con- 
 tracting very imperfectly, or not at all, to light : the 
 temperature of the head is generally above the natural 
 standard, but that of the extremities and of the surface 
 is in general considerably lowered, or but little affected 
 in milder cases ; the pulse, which was at first (juick and 
 excited; becomes feeble, small, and ultimately slow, or 
 even entirely wanting at the wrist, according to the 
 intensity of the intoxication : the respiratory movements 
 are less freipient than usual, and are imperfectly per- 
 formed, exhibiting, in the' severest cases, the convulsive 
 character of those of persons suffering from aspliyxia. X 
 Strabismus. || general tetanic •§> convulsions, or spasms 
 of particular parts, sometimes supervene in the more 
 advanced states. When a fatal termination occurs, it is 
 usually attributable, as in apoplexy, to tlie imperfect 
 aeration H of the blood ; the face becoming livid and 
 
 * Coma, torpid sleep. 
 
 t Edinburgli Medical and Surgical Journal, vol, xl. 
 X AspJiijxia, suffocation. || Strabismus, squinting. 
 
 § Tetanic, attended with rigid contractions. 
 II Aeration, process by which the blood is acted upon by the air. 
 2 
 
14 
 
 EFFEOTrf OF ALCOHOL 
 
 tumid, the eyes prominent, and the lipH l>kic. In some 
 instances, the complete prostration of the cerebral and 
 sensorial powers comes on suddenly, without any previous 
 stage of excitement ; and, in these ca»e8, it is noticed that 
 the pupil is usually contracted. 
 
 15. The unfavorable indications, in ca.so of poisoning 
 by large doses of alcohol, are profoundness of insensi- 
 bihty, insufficiency of respiratory movement, with conse- 
 quent failure of circulation and imi)erfect aeration of 
 blood, the pupils either nmch dilated or contracted, 
 coldness of the extremities, and the occurrence of stra- 
 bismus or tetanic spasms. When these symptoms do 
 not appear, the ill effects pass off, in a great measure, 
 witliin four and twenty hours ; but it is usually much 
 longer before the various functions regain their healthy 
 tone. 
 
 16. In fatal cases,* the ap[)earance8 usually resemble, 
 more or less closely, those of asphyxia ; the right side of 
 the heart, the pulmonary arteries, and the systemic veins 
 being loaded with blood : whilst the left cavities and the 
 arterial system are comparatively empty, the blood which 
 they do contain being dark. The sinuses f and the 
 whole venous system of the brain are turgid with dark 
 blood ; and serous effusion % is usujUly found within the 
 ventricles.f or beneath the arachnoid ; f this, however, 
 being variable in its amount. The substance of the brain 
 is unusually white and firm, as if it had lain in alcohol 
 
 * See Dr. Ogston, loc. clt. ; and Dr. Peters, in New York Jour- 
 nal of Medicine, voL iii. No. 9. 
 
 t Sinuses, ventricles, arachnoid, names of different portions of 
 the brain. 
 
 X Serous effusion, effusion of the watery portion of the blood. 
 
ON THE HEALTHY SYSTEM. 
 
 15 
 
 ^- In some 
 
 cerebral and 
 
 iiJiy previous 
 
 noticed that 
 
 ^f poisoning 
 of insensi- 
 Viith conse- 
 aeration of 
 contracted, 
 ice of stra- 
 mptoms do 
 t measure, 
 lally much 
 Jir healthy 
 
 f resemble, 
 ?ht side of 
 ;emic veins 
 » and the 
 ood wliich 
 and the 
 vith dark 
 within the 
 however, 
 the brain 
 1 alcohol 
 
 'ork Jour- 
 •ortions of 
 ! blood. 
 
 for an hour or two. The liver, spleen, and kidneys are 
 loadeil with venous blood; and the air-pa.ssages of the 
 lungs contain more or less of frothy mucus. The stom- 
 ach usually exhibits but little departure from its normal 
 con(liti<:)n, exee[)t in cases where drunkenness has been 
 habitual, or where the fatal dose has been taken in a 
 very concentrated form. In the former case, the nmcous 
 coat is usually found thicker, softer, and more Viiscular 
 than usual; this change sometimes extending even 
 throughout the entire length of the small intestines. In 
 rarer instances, the coats of the stomach are remarkably 
 thickened and hardened. Where death results from a 
 very concentrated dose, the intense injection, almost 
 amounting to black discoloration, of a powerful irritant 
 poison, is met with. This, however, has been rather 
 noticed in experiments on animals, into whose stomachs 
 rectified alcohol had been injected, than in human sub- 
 jects, by whom alcohol is very rarely taken in such a 
 form. Of the condition of the liver and kidneys found 
 in habitual drunkards, an account Avill be given hereafter. 
 The lilood, in most cases of alcoholic poisoning, — accord- 
 ing to the observations of Dr. Ogston upon drunkards, 
 and the experiments of Dr. Percy upon animals, — is 
 either fluid or imperfectly coagulated. 
 
 Patholog't/ of Alcoholic Intoxication. 
 
 17. The pathological character of intoxication by 
 alcohol, and the modus operandi of the poison, have 
 been fully made out from the experiments and observa- 
 tions just referred to; and it is very important for our 
 future impiiries, that the results of these should be right- 
 ly understood. That alcoholic liquors, when introduced 
 
16 
 
 EFFECTS OF ALCOHOL 
 
 into the stomacli, sliould undergo rapid absorption into 
 the sanguiferous system, is precisely what miglit be 
 anticipated from our knowledge of the conditions under 
 which that absorption takes place ; and there is ample 
 evidence that such is really the case. Thus Dr. Percy 
 was always able to detect the alcohol in the blood of the 
 animals which he had poisoned by injecting alcohol into 
 their stomachs, provided they did not live too long after- 
 wards; and MM. Bouchardat and Sandras have more 
 recently determined its presence in the blood of the 
 gastric * veins. The rapidity with which this absorption 
 takes place may be judged of by the ftujt, that in one of 
 Dr. Percy's experiments, in which the animal fell lifeless 
 to the ground immediately that the injection of the alco- 
 hol into the stomach was completed (the respiratory 
 movements and pulsations of the heart entirely ceasing 
 within two minutes), the stomach was found nearly void, 
 whilst the blood was strongly impregnated with alcohol, f 
 Hence it may reasonably be inferred, that in all cases of 
 ordinary intoxication, and in the greater number of cases 
 of death from the introduction of alcohol into the stomach, 
 the effects are produced by the passage of the alcohol 
 into the current of the circulation, so as to exert a direct 
 action on the nervous centres. And this influence is 
 confirmed by the fact that Dr. Percy has demonstrated 
 its presence, in considerable amount, in the substance of 
 the In'aUi ; thus confirming Dr. Ogston's assertion 
 (which had been called in question by Dr. Christison 
 and others) as to its presence in the fluid eff"used in the 
 ventricles of the brain. 
 
 * Gastric, pertaining to the stomach. 
 
 t Op. cit. p. 61. 
 
ox TIIK IIKAI/niY SY.STKM. 
 
 17 
 
 18, In some of tin; (j.vjjcrinicntH on alcoholic poisoning, 
 however, nuwle by Dr. (.'hrintiMon and others, it would 
 appear as if the total Iohh of innensibility and voluntary 
 power so instanlanconshf followed the introduction of 
 the poison into the Htoinaeh, — especially when it Avas 
 introduced in a corKHjntrated form, — as not to admit the 
 idea that absorption could have taken i)lace to a sufficient 
 extent for the p)'odu(;tioii of the effect hy the direct action 
 of the poison on the rKjrvous centres. In such instances, 
 the fatsil result would Hcujtn rather due to the violent im- 
 pression made ufxm the gastric nerves, especially those 
 of the sympathetic systc^tti ; Avhcreby the heart's action is 
 suspended, and <leatli takes place by syncope,* rather 
 than by asphyxia. Thi.s is the case with many other 
 poisons, when adininist^jred in large quantity and in con- 
 centrated form, eHp(!(;ially with such as exert a chemical 
 action upon the animal tissues ; the effect which they 
 produce ^Lhrough the tHtrvous system) upon the heart 
 closely resemblijig that of blows uj)on the epigastrium, 
 or extensive burns of the cutaneous surface. Now, as 
 the concentration of th«; al<;ohol will, on the one hand, 
 favor its physical and chemical action ujx»n the tissues, 
 whilst on the other it will l>e unfavorable to absorption, 
 which takes place jrni(!h more readily when it is diluted 
 with water, we are <'nabled rejixlily to account for this 
 difference in its moduH opnuuidi. 
 
 19. The f^enrraf Htinmlant action, which is for a time 
 exerted by alcohol introduced in small quantities, and 
 diluted by admixture with the general mass of the blood, 
 is easily explained uiKjn the ba«is of the observations 
 
 * Syncope, complete and »U(ldcn low of sensation and motion. 
 2* 
 

 18 
 
 EFFECTS OF ALCOHOL 
 
 fii-st detailed (*§> 17) ; but its special power of exciting 
 the nervous centres to augmented activity can only be 
 accounted for by the idea of some special relation between 
 alcohol and nervous matter. And this idea is fully 
 borne out by the fact, that Dr. Percy found alcohol to 
 exist in the substance of the brains of the dogs poisoned 
 by it, in considerably greater proportion than in an 
 equivalent quantity of blood. {Op. cU. p. 103.) — 
 This fact is one of fundamental importance, as showing 
 us how directly and immediately the whole nutrition and 
 vital axjtivity of the nervous system must be affected by 
 the presence of alcohol in the blood ; the alcohol being 
 thus specially drawn out of the circulating current by 
 the nervous matter, and incorporated with its substance, 
 in such a manner as even to change (when in sufficient 
 amount) its physical as well as its chemical propesties. 
 It is important also to observe, that this affinity is ob- 
 viously such as will occasion the continual presence 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 onf, 
 as it were, the nervous matter, and will fasten itself upon 
 it ; just as we see that other poisons, whose results 
 become more obvious to our senses (although the poisons 
 themselves may exist in such minute amount as not to 
 be detectible hy the most refined analysis), Avill localize 
 themselves in particular organs, or even in particular 
 spots of the same organ. =* 
 
 * See, for illustrations of this doctrine, now generally admittccl 
 by physiologists, Dr. W. Budd's paper on Symmetrical Diseases, 
 in Med.-Chir. Trans, vol. xxv. ; and Mr. Paget's Lectures on Nu- 
 trition, in Medical Gazette, 1847. — Authoe. 
 
 iii'irL(i.n>Mni*m 
 
ON THE HEALTHY SYSTEM. 
 
 19 
 
 20. The selective power of alcohol apiMjars to lead it 
 in the fii*st instance to attack the cerebrum^* the intel- 
 lectual powers being affected be** -^ any disorder of sen- 
 sation or motion manifests itself; and to this it seems to 
 be hmited in what has been here descrilx3d as the first 
 stage of into.xication. But with the more complete jwr- 
 version of the intellectual powers, which characterizes 
 the second stage, we have also a distui-bed function of the 
 sensory g'ang'/ia,'f upon which the cerebral hemispheres! 
 are superposed ; this disturbance being indicated by the 
 disorders of sensation, and also by the want of that con- 
 trol over the muscular movements which require sensation 
 for their guidance. In the third stage, the functions of 
 the cerebrum and sensory ganglia appear to be completely 
 suspended; and those of the medulla ob/ongataW ^^'^ 
 spinal cord now begin to be affected, as we see to be 
 indicated by the difficulty of respiration, the strabismus, 
 the dilated pupil, and the tetanic spasms. As already 
 stated, the sidmixture of alcohol with the blood has a 
 tendency to give a venous character even to that of the 
 arteries ; and, when this tendency is augmented by im- 
 perfect respiration, the blood Avill become more and more 
 venous, until its influence upon the medulla oblongata is 
 so directly poisonous, that its functions are completely 
 suspended, the respiratory movements are brought to a 
 stand, and death takes phice by asphyxia, precisely as in 
 narcotic poisoning by other substances. 
 
 21. This tendency, however, is more or less com- 
 
 * Cerebrum, the brain, f Sensnrij ganglia, centres of sensation. 
 X Cerebral hemispheres, the two halves of the brain. 
 II Medulla oblongata, prolongation of the brain to the spinal 
 marrow. 
 
EFFKCTH OF ALCOHOL 
 
 pletely antagonizecl hy tlio oflTortH wliich the system 
 makes (so to s[)cak) to get rid of tlio poison; which 
 efforts, if successful, will carry it off in the course of a 
 few hours, leaving nothing l)e]iitHl it but the disordered 
 condition which it has prtMluced. Wo have seen that an 
 increased secretion * takes phico by the kidneys and 
 skin ; and the former of these is certainly a means of 
 eliminating f the alcohol, which has been detected in the 
 tirine by Dr. Percy {op. cit. \). 104), — contrary to 
 the statements of many physiologists, who have denied 
 that it ever finds its way into that secretion. It is 
 indeed a general rule, that, when a medicinal or toxic 
 agent X produces a special <lotcrmi nation to some particu- 
 lar gland, that determination is the means of eliminating 
 it from the blood ; as is seen in the diuretic action of the 
 neutral salts. And it would not seem improbable, there- 
 fore, that the skin also should })o concerned in the exha- 
 lation of the alcohol ; || more especially since an alcoholic 
 odor may often be observed, not merely in the breath, 
 but proceeding from the i)crson generally. Dr. Percy 
 has also shown, that alcohol may bo detected in the bile 
 of animals poisoned by it. The alcoholic odor of the 
 
 * Increased aecrelion, &C. incroMO of urino and sweat. 
 
 t Eliminatinr/, separating. 
 
 % Medicinal or toxic affent, kc, Tho procons of combustion takes 
 up oxygen, and forms carbonic acid, which is expired from the 
 lungs. Alcohol, being compoHcd of carbon, oxygen, and hydro- 
 gen, is resolved into carbonic acid, which is corbon and oxygen, 
 and into water, which is oxygon ond hydrogen. 
 
 II Dr. Macnish states (Anatomy of Drunkenness, p. 175), that 
 he has met with two instances — tho one in a claret, the other in 
 a port drinker — in which tho cutaneous perspiration after a de- 
 bauch had the hue of tho liquor they had drunk. — Author. 
 
 u. 
 
ON THE IIEAl.TIIY SYSTEM, 
 
 21 
 
 breath is a snflRcient indicatiorij tlmt alcoltolic va[)or i.s 
 exhaletl from the lungs in the act of respiration ; but the 
 quantity of this is probably small in compsnison with 
 that which is carried off in another way, namely, by the 
 combustivc jjrocess, which takes place in the blood at 
 the expense of the oxygen it contains, and which con- 
 verts the alcohol into carbonic acid and water ; ])Oth of 
 which are set free by exhalation from the lungs. The 
 readiness with which alcohol is thus oxidize<], in fact, is 
 probably one cause of its influence in giving a venous 
 aspect to arterial blood ; since it will withdraw the oxy- 
 gen from other substances, which are waiting to be elimi- 
 nated by the combustive process, and the accumulation of 
 which will deteriorate the character of the fluid, 
 
 22. By all these channels, then, the alcohol is rapidly 
 carried out of the system ; so that recovery may be cer- 
 tainly expected, if hfe can Imj sufficiently prolonged by 
 warmth to the surface, by artificial respiration, by the 
 administration of ammonia, and by other such measures. 
 The depressing character of the influence of alcohol, 
 when carried to this extent, is sufficiently indicated by 
 the fact that copious depletion cannot be borne ; and it 
 is on this account very important to distinguish between 
 alcoholic poisoning and congestive 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 
 modus operandi * of alcohol proscrted by different indi- 
 viduals ; but it has not been thought necessary to do so, 
 
 * Modus operandi, mode of operation. 
 
22 
 
 EFFECTS OF ALCOHOL 
 
 the gi'cat general facts presented by its ordinary opera- 
 tion being those of prime importance in our further 
 investigations. We have now to inquire into the various 
 forms of disease, the production of which may lie assigned, 
 with more or less probability, to the prolonged or repeated 
 action of alcohol on the human system. 
 
 
 III. REMOTE CONSEQUENCES OF THE EXCESSIVE USE OF 
 ALCOHOLIC LIQUORS. 
 
 Diseases of the Nervous Sijsleni. 
 
 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 strych- 
 nine,* almost to the exclusion of the encephalon.f 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 
 cancerous affections), which are not so much more fre- 
 quent among the habitually intemperate than among the 
 habitually sober, as to justify us in regarding the excess- 
 ive use of alcoholic liquors as among the most efficacious 
 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 
 
 * Strychnine, extract of nux vomica, a violent poison, 
 t Encephalon, the brain. % Tubercular, scrofulous, consumptive. 
 
 mmimmmm^mmigm 
 
ON THE HEALTHY SYSTEM. 
 
 28 
 
 in the use of alcoholic drinks tcJida to produce each of 
 them. 
 
 24. Delirium Ebriosum. * — Considering that the 
 state of intoxication is itself, strictly speaking, a transient 
 paroxysm of insanity, it can excite no surprise that a 
 confirmed state of mental derangement should frecjuently 
 result from the repetition of the cause which j)ro<luces 
 the single paroxysm. There are, in fact, some indivi- 
 duals in whom a fit of positive madness, y)ersisting for 
 some little time after the immediate effects of the stimulus 
 have 8ul)sided, 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 ex- 
 cessively violent, the individual sometimes attacking 
 every one who comes in liis way, and being always prone 
 to ferocity against any one who opposes liim ; and, all 
 sense of danger being lost, he is not deterred from vio- 
 lence by the fear of personal injury, but rushes madly 
 upon what may prove his destmction. This condition, 
 the delirium ebriosum of Darwin, is obviously an exag- 
 geration 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 restrained from doing 
 mischief to himself or others. It is sometimes accom- 
 panied, however, with tremors, even in the midst of 
 violent excitement ; and this form constitutes the transi- 
 tion 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 
 
 Delirium ebriosum, drunken madness. 
 
/ , 
 
 24 
 
 EFFECTS OF ALCOHOL 
 
 cause — is almost certain, like the recurrence of regular 
 maniacal paroxysms, to end in some settled form of in- 
 sanity. 
 
 25. Delirium Tremens, — The habitual drunkard, 
 Avho has exhausted his nervous power by continual over- 
 excitement, is hable to another form of disordered action 
 of his brain, which is connnonly 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 fre- 
 quent, is small and weak ; and the temper, though very 
 irritable, is not violent, — the prominent disposition, 
 indeed, 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 diflFers but 
 little from 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 it guided by the hand of 
 a Dante. Who can tell the horrors of that horrible 
 malady, aggravated as it is by the almost ever-abiding 
 consciousness that it is self-sought? Hideous faces 
 appeared on the walls, and on the ceihng, and on the 
 floors ; foul things crept along the bed-clothes, and glar- 
 
 * Autobiography of J. B. Qough, p. 70. 
 
ON THE HEALTHY SYSTEM. 
 
 25 
 
 / 
 
 i 
 
 ing eyes peered into mine. I was at one time surrounded 
 by millions of monstrous spiders, who crawled slowly, 
 slowly over every limb ; whilst beaded drops of perspira- 
 tion would start to my brow, and my limbs would shiver 
 until the bed rattled again. Strange lights Avould dance 
 before my eyes, and then suddenly the very blackness of 
 darkness Avould appall me by its dense gloom. All at 
 once, whilst gazing at a frightful creation of my distem- 
 pered mind, I seemed struck with sudden blindness. I 
 knew a candle was burning in the room, but I could not 
 see it ; all was so pitchy dark. I lost the sense of feel- 
 ing, too ; for I endeavored 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 kne vv my limbs and 
 frame were there. And then the scene would change. I 
 was falling, — falhng swiftly as an arrow far down into 
 some terrible abyss ; and so hke 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 perspira- 
 tion, utterly exhausted, and feehng 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 com- 
 monly associated. The tongue is furred, the stomach 
 unable to bear food without vomiting or a sense of 
 oppression ; the bowels are usually constipated, or, if 
 they be relaxed, the stools are dark and offensive, and 
 
 the urine is scanty. Somethnes the disease proceeds to 
 3 
 
ire 
 
 EFFECTS OF ^ALCOHOL 
 
 b: 
 
 / 
 
 a fatal termination, which is generally preceded by con- 
 tracted pupil, occasionally strabismus, incessant low 
 delirium, increase in the muscular tremor almost amount- 
 ing to subsultus tendinum, * and other indications 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 chilhness of the surfaee increases, proceed- 
 ing from the extremities to the trupk. Sometimes a 
 calm supervenes shortly before death; whilst in other 
 instances the patient is carried off 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 melan- 
 cholia, with more or less of deficiency of intellectual 
 power ; and this more especially happens after repeated 
 attacks of the disease. 
 
 27. Between the delirium ebriosum and the proper 
 delirium tremens, there are several intermediate condi- 
 tions ; 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 thb important differ- 
 ence, — that, while the former is but an exalted manifes- 
 tation of the primary excitement ordinarily produced by 
 alcohol, the latter, supervening at the end of a prolonged 
 debauch, is the consequence of cxhmistion produced 
 by continued excitement. Delirium tremens more frc- 
 
 * Subsultus tendinum, twitching of tlie tendons. 
 
ON THE HEALTHY SYSTEM. 
 
 27 
 
 quently occurs, however, when the accustomed stimulus 
 is withheld ; and it is then no less obviously the result 
 of the previously exhausted condition of the nervous 
 system, which nothing save the renewal of the potent 
 stimulus can excite to any thing like regular action. 
 In fact, this terrible state is the manifestation of the 
 disordered 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 dehrium have 
 partaken of the characters of that which directly arises 
 out of intoxication. And it is manifest, therefore, that 
 the diser >ved condition must be in the nervous pulp 
 itself, I { it it must be of a kind to keep up morbid 
 and irriiauve 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 is the immediate or the consecutive result of the 
 excessive use of alcoholic hquors, yet it may occur inde- 
 pendently of them ; but its other causes are such as 
 resemble the excitement of alcohol, in producing exhaus- 
 tion or depression of the nervous power, — such, for 
 instance, as excessive depletion, the shock of severe 
 injuries, or extreme cold. But in most of the cases in 
 which one or other of these appears to be its exciting 
 cause, a predisposition has been estabhshed by habitual 
 intemperance ; and this has been especially remarked of 
 the delirium traumaticum. 
 
EFFECTS OP ALCOHOL 
 
 29. It is important to remark, that a wli^hter form of 
 this disorder, marked by tremors of the luiiids and feet, 
 deficiency of nervous power, and occaaional illusions, 
 will sometimes appear as a consequenco 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 trembling 
 of the hands in the execution of a voluntary movement — 
 is familiar to every one as extremely frciquent among 
 the habitually intemperate. We thus sec that the 
 disease is at least as much dependent upon the dis- 
 ordered state of nutrition^ consequent upon the habitual 
 presence of alcohol in the blood, as it is UfKin that posi- 
 tive exhaustion of nervous power consequent upon the 
 violence of the excitement, which is the more immediate 
 effect of the stimulus, v)^ 
 
 30. Insanity. — Such being the case, we have no 
 difficulty invunderstanding how the liabitual use of alco- 
 holic liquors in excess becomes one of the most frequent 
 causes of insanity, 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 wliich 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 intemi>eranco is less 
 frequent, while causes of a purely moral and intellectual 
 
ON THE HEALTHY SYSTEM. 
 
 nature operate upon thera with greater intensity. 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 be^-omes much larger than it will 
 be if (as happens in many cases) some other cause have 
 been in operation concurrently, and the disorder be set 
 down as its result, no notice whatever being taken of the 
 habit of intemperance. This omission must be particu- 
 larly 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 weak- 
 ened 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 immediately attributable ; 
 so that the habit of intemperance has contributed, as a 
 predisposing cause, at least as much towards its pro- 
 duction as what is commonly termed the exciting cause 
 has done. In ftict, 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 chemical, physi- 
 cal, 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 conditions in previous opera- 
 tion is often singled out as the cause, from which the 
 8« 
 
80 
 
 EFFECTS OP ALCOHOL 
 
 result may seem most directly to proceed, yet it fre- 
 quently happens that it has really had a far smaller 
 share in the production of the disorder than those re- 
 moter causes whose operation has been more enduring 
 and really more effectual.* 
 
 32. In the Statistical Tables, published by the Metro- 
 politan Commissioners of Lunacy in 1844, comprehending 
 the returns from ninety-eight asylums in England and 
 Wales, we find that, out of 12,007 cases whose supposed 
 causes were returned, 1,799, or nearly 15 per cent, are 
 set down to the account of intemperance ; but, besides 
 these, 551, or 4*6 per cent, are attributed to vice and 
 sensuahty, 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 notorious 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 dis- 
 order, in all the cases in which it is traceable, than it 
 would be to regard intemperance in that hght, in every 
 case in which the patient had previously indulged in 
 alcoholic excesses. Of the 2,526 cases, then, in which 
 ^he 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 3,187 cases set down 
 to bodily disorder, and in the 2,969 for which moral 
 causes are assigned. 
 
 ♦ See Mr. J. S. Mill's Elements of Logic, vol. i. p. 398. 
 
ON THE HEALTHY SYSTEM. 
 
 &1 
 
 83. If we turn from tl>i» general statement to the 
 experience of individual aHylums, we fretjuently find 
 the proportion much higher ; and curious variations are 
 sometimes observable iKJtwecn the returns for successive 
 years. Thus, in the Ghwgow Lunatic Asylum, accord- 
 ing to the report of Dr. Ilutcheson, the following we:*e 
 the proportions which i^tc^ -nnce bore to other causes 
 during seven years : - 
 
 Tmt. 
 
 ptliMl*. 
 
 Cmm ■tHtni ttw 
 
 lUauM* «M 
 t)ir»ttl»rt, k», 
 
 3 
 
 20 
 5i 
 
 no 
 
 77 
 47 
 49 
 
 Ol«M wt»«T« th« 1 €tMi wh*re fn. 
 known. | Ui« eauM. 
 
 ! 
 
 Proportion per wnt \ 
 
 uf ihtemperanoe to 
 
 other causes. 
 
 1840 
 1841 
 1842 
 1843 
 1844 
 1845 
 1846 
 
 149 
 
 1/57 
 109 
 327 
 390 
 304 
 414 
 
 34 
 44 
 
 20 
 38 
 41 
 38 
 62 
 
 20 
 30 
 46 
 31 
 63 
 90 
 105 
 
 13'4 
 19-1 
 23-1 
 9-4* 
 18-2 
 24-7 
 25-3 
 
 Total 
 
 2000 
 
 300 
 
 277 
 
 375 
 
 19-7 
 
 Of the great increase which presents itself in the 
 number of cases attributoble to intemperance during 
 
 * This marked diminution in the per centage of cases attri- 
 butable to intompcrancti in chiefly due to the admission into the 
 Glasgow ARylurn, during the year 1843, of a number of lunatics 
 who had previouHly been conAned at Arran, for the most part, 
 during several yearn. Of the origin of their insanity very little 
 was known ; and they were chioiiy assigned to the head of " He- 
 reditary and CouHtitutionnl Predisposition," thereby diminishing 
 the per centage of the other causes. Among the recent cases 
 admitted during the year, however, the per centage attributable 
 to intemperance was decidedly less than usual ; which circum- 
 stance is attributed by Dr. Ilutcheson to the improved condition 
 of trade, which caused an nde(iuato demand for labor. On this 
 point he makes the following remarks, in his report for 1842, p. 36 : 
 " It may be said, that when wages are low, and occupation diffi- 
 
EFFECTS OF ALCOHOL 
 
 II 
 
 the last two years of this return, Dr. Hutcheson thus 
 speaks in his report for 1846 : " 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. There is a great 
 connection between general excitement and the craving 
 for stimulants, as may be every day seen during con- 
 tested 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 aban- 
 doned when the brain is allowed to rest." For the reason 
 already given, it is probable that the average proportion 
 of 19'7 per cent does not by any means represent the 
 entire number 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 
 
 cult to be obtained, men will have less money to spend, and con- 
 sequently will drink less. A pretty extensive observation of the 
 different grades of the working classes, for upwards of fifteen years, 
 has convinced me that this opinion is erroneous ; for I have gen- 
 erally found, that want and intemperance go hand in hand. 
 Whenever a man falls below a certain point in physical comfort, 
 he becomes reckless, and sensual enjoyment forms his only plea- 
 sure. To this he will sacrifice every thing ; and habits of intem- 
 perance are frequently acquired in seasons of distress, which the 
 individual, in more favorable circumstances, finds it impossible to 
 lay aside." — AuTuoit. 
 
ON THE HEALTHY SYSTEM. 
 
 33 
 
 seventeen cases out of ninety-three admitted; but, of 
 these ninety-three, there were eight cases in which lie- 
 reditary predisposition, and eleven in which predisposition 
 from previous attacks, was assigned as the cause; and 
 there can be no doubt that of these nineteen cases a con- 
 siderable proportion might be set down, in part, to the 
 account of intemperance. In the report of the Dundee 
 Lunatic Asylum, we find that eight out of fifty-two 
 cases admitted are set down to intemperance ; seven were 
 hereditary; and in four the cause was unknown. In 
 other asylums, the proportion of cases returned as 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 cases assigned to intemperance 
 alone bear to those assigned to other causes is no less 
 than 32-62 per cent ; independently of 5-67 per cent, 
 which are set down to the account of " vice and sen- 
 suality." 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. cit. p. 193), that, of 
 286 lunatics at that time in the Richmond Hospital, 
 Dublin, one-half owed their madness to drinking. 
 
 35. Oinomunia. — There is one form of insanity 
 which has so peculiar a relation to the use of alcoholic 
 liquors as to call for particular consideration in this 
 place ; and, in order that its characters may be presented 
 in the most unexceptionable manner, the author avails 
 himself of the excellent account of the disease which is 
 
EVVKCVa OF ALCOHOL 
 
 given by Dr. IIutchcHoii in the rcfKirt of the Glawgow 
 Lunatic Awyluin for 1842 (pp. 89 — 44) ; deeming its 
 value sufficient to juHtify him in presenting it without 
 abridgment. The <lcHignjition Oinomaniay ho would 
 remark, lias been subHtituted hy Dr. Ilutcheson for the 
 less appropriate toitn Dijmmiania, used by other au- 
 thors. " This form of nuiiiia," he observes, " is quite 
 different from drunkenuesH, which, however, may lead 
 to it ; the diagnostic * mark of the disease lacing the 
 irresistible propensity to swallow stimulants in enormous 
 doses, whenever and wherever they can be procured. 
 There are individuals who, at the festive board, inva- 
 riably become excited, if not inttjxicated, but who are 
 otherwise habitually solier, and in the course of the year 
 di-ink 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 liijuor than is consistent with good 
 health or sobriety. All these, however, possess self- 
 control, and can at any time refrain from stimulants ; 
 but those affected with the <lisojwe cannot do so, however 
 convinced they may bo of the impropriety of yielding 
 to their propensity, or however desirous they may be to 
 subdue it. I repeat that the <lisea»o does not consist in 
 the mere act or habit of l)ecoming 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, he views with 
 loathing and disgust. He derives no pleasure from taste, 
 for he gulps down the licjuor, of v/hatever kind it may 
 
 * Diagno$tlc, dUtinguiahing. 
 
 f. 
 
ON THE HEALTHY SYf?TEM. 
 
 85 
 
 be ; or fi'om society, for he generally avoids society ; l>ut 
 he only derives a temporary satisfaction from the grati- 
 fication of his insane impulse, or rather from freeing 
 himself from the overwhelming misery which the non- 
 gratification of his impulse inflicts on him. The disease 
 appears in tliree forms, — the acute, the periodic, and 
 the chronic. 
 
 " The acute is the rarest of the three. I have seen it 
 occur from hemorrhage in the puerperal stiite, in recovery 
 from fevers, from excessive venereal indulgence, and in 
 some forms of dyspepsia. When it proceeds from any 
 of the first three causes, it is easily cured by restoring 
 the strength of the patient. When it arises fiom 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 indi- 
 viduals who have suffered from injuries of the head, 
 females during pregnancy, at the catamenial periods, on 
 the approach of the critical jKMiod and afterwards, and 
 in men whose brains are overworked. When it occurs 
 from injury of the head, the case is hopeless. In the 
 other instances, it may be cured. In some cases, it 
 occurs whenever the individual paiiakes of stimulants. 
 In these, total abstinence is the only remedy. Like the 
 form about to lie 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 same period. But by 
 degrees he becomes uneasy, listless, and depressed, feels 
 
86 
 
 EFFECTS OF ALCOHOL 
 
 incapable of application, and restless, and at last begins 
 to tb-ink till he is intoxicated. He awakes from a rest- 
 less sleep, seeks again a repetition of the intoxicating 
 dose, and continues the same course for a week or longer. 
 Then a stjite of apathy and depression follows, during 
 which he feels a loathing for stimulants, is the prey of 
 remorse, and regrets bitterly liis yielding to his malady. 
 This is followed by fresh vigor, diligent application to 
 l)Lisiness, and a determined resolution never again to give 
 way. But, alas ! sooner or later the paroxysm recurs ; 
 and the same scene is re-enacted, till ultimately, unless 
 the disefise be checked, he falls a victim to the physical 
 effects of intemperance, becomes maniacal or imbecile, 
 or affected with the form of the disease next to be men- 
 tioned. 
 
 " Of all the forms of Oino7nania, the most common 
 is the chronic. The causes of this are injuries of the 
 head, diseases of the heart, hereditary predisposition, 
 and intemperance. This is by far the most incurable 
 form of the malady. The patient is incessantly under 
 the most overAvheh^ing desire for stimulants. He will 
 disregard every impediment, sacrifice comfort and reputa- 
 tion, withstand the claims of affection, consign his family 
 to misery and disgrace, and deny himself the common 
 necessaries of life to gratify his insane propensity. In 
 the morning, morose and fretful, disgusted with himself, 
 and dissatisfied with all around him, weak and tremu- 
 lous, incapable of any exertion either of mind or body, 
 his first fechng is a desire for stimulants, with every 
 fresh dose of which he recovers a certain degree of vigor 
 both of body and mind, till he feels comparatively com- 
 fortable. A few hours pass without the craving being 
 
ON THE HEALTHY SYSTEM. 
 
 87 
 
 so strong ; but it soon returns, and the patient drinks 
 till intoxication is produced. Then succeed the restless 
 sleep, tlie suffering, the comparative tmnc^uillity, the 
 excitement, and the state of insensibility; and, unless 
 absolutely secluded 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 resison revisits the 
 mind only during the transient period of incipient intoxi- 
 cation. 
 
 " 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 graiify 
 his propensity ; that, while the paroxysm is on him, he 
 is regardless of his health, his life, and all that can make 
 life dear to him ; that he is prone to dissipate his pro- 
 perty, and easily becomes the prey of the designing; 
 and that, in many cases, he exhibits a propensity to 
 commit homicide or suicide. He is thus dangerous to 
 himself and others; and, however responsible he may 
 have been for bringing the disease on himself, his respon- 
 sibility 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 directly nor indirectly c^s he be 
 deemed responsible. But, suppose that it v\jre the 
 result of his previous conduct, I repeat that, however 
 culpable he may have been for that, he is not a respon- 
 sible being while afflicted with the mala».iy ; for I can see 
 no distinction between this form of the disease and any 
 other which has been induced by the habits or acts of 
 the individual. 
 
 iOBii 
 
38 
 
 EFFECTS OF ALCOHOL 
 
 " The only cliance of cure or allevi.ation is from atten- 
 tion 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 indi\adual is 
 irresponsible and dangerous to himself and others ; that, 
 if 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 prevented from committing crimes instead of being 
 punished, or, I should rather say, being the object of 
 vindictive infliction after he has perpetrated them. So 
 convinced are some, affected ■with the periodical form of 
 the disease, of the necessity of being controlled, that, 
 when the first symptoms of their paroxysm are felt, they 
 voluntarily enter an asylum, and remain till the attack 
 has passed off. These, however, are men of stronger 
 minds, though, with all their strength, incapable of 
 resisting the disease ; 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 cases 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 symptoms of the malady presenting 
 themselves, he may be dismissed after a shorter proba- 
 tion. It is otherwise with those who have not that 
 self-control, or who fancy that they are unjustly inter- 
 fered with when checked in their career. 7/hey require 
 
ON THE HEALTHY SYSTEM. 
 
 39 
 
 a much longer probation, which should be increased at 
 each return of their malady. 
 
 " Of the chronic form, I have seen only one case 
 completely cured, and that after a seclusion of two years' 
 duration. In general, it is not cured ; and no sooner is 
 the patient liberated than he manifests all the symptoms 
 of his disease. Paradoxical though the statement may 
 appear to be, such individuals are sane only when con- 
 fined in an asylum." 
 
 The superintendent of the Dundee xVsylum. in remark- 
 ing u ^on the frequent causation of insanity by intempe- 
 rance, makes a very similar statement of the results of 
 his observations, and regrets that there are not in this 
 country such asylums as ai-e understood to exist in the 
 United States, for the reception of those incorrigible 
 drunkards in whom the power of self-control has been 
 altogether destroyed by their repeated yielding to the 
 craving for alcoholic stimulants. 
 
 36. Mental Debility in the Offspring: — It is 
 scarcely necessary to accumulate further proof in sup- 
 port of the assertion, that, of all the single causes 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 pro- 
 duce idiocy, insanity, or mental debihty, in the offspring". 
 Looking to the decided tendency to hereditary predis- 
 position in the ordinary forms of insanity ; looking also 
 to the fact, that any perverted or imperfect conditions of 
 the nutritive functions established in the parent are also 
 liable to manifest themselves in the offspring, as shown in 
 the transmission of the gouty and tubercular diatheses ; * 
 
 * Tubercular diathesis, scrofulous or consumptive condition of 
 the body. 
 
40 
 
 EFFECTS OF ALCOHOL. 
 
 '« ■( 
 
 we should expect to find that the offspring of habitual 
 drunkards would share with those of lunatics in the pre- 
 disposition to insanity, and that they would, moreover, be 
 especially prone to intemperate habits. That such is the 
 case is within the knowledge of all who have enjoyed exten- 
 sive opportunities of observation ; and the fact has come 
 down to us sanctioned by the experience of antiquity. 
 Thus Plutarch cays, "One drunkard begets another;" 
 and Aristotle remarks, that " drunken women bring 
 forth children hke unto themselves." Dr. W. A. F. 
 Browne, the resident physician of the Crichton Lunatic 
 Asylum at Dumfries, makes the following statements : 
 " 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 another, an idiot, whose father was a 
 drunkaixl."* The author has learned from Dr. Hutche- 
 son, 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. 
 Howe to the legi, 'nture of Massachusetts : " The habits 
 of the parents of three hundred of the idiots were 
 learned ; and a hundred and forty-five, or nearly one' 
 half, are reported as ' known to be habitual drunkards. ' 
 
 * Moral Statistics of Glasgow, by William Logan, 1849, p. 20. 
 
ON THE HEALTHY SYSTEM. 
 
 41 
 
 n 
 
 Such parents, it is affirmed, give a weak and lax consti- 
 tution to their children ; who are, consequently, ' deficient 
 in bodily and vital energy,' and predisposed by their very 
 organization to have cmvings for alcoholic stimulants : 
 many of these children are feeble, and live irreguhirly. 
 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 follow, and less 
 power to avoid, than the children of the temperate, they 
 add to their hereditary weakness, and increase the ten- 
 dency 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 par- 
 ticularly 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 Phrenological Journal (vol. vii. 
 p. 471) : Both the parents were healthy and intelligent, 
 and one at least habitually sober ; but both were partially 
 intoxicated at the time of the intercourse, and the off- 
 spring was completely idiotic. There is every reason to 
 believe, that the monomania of inebriety not only acts 
 upon, and renders more deleterious, whatever latent 
 taint may exist, but vitiates or impairs the sources of 
 health for several generations. That the effects of drunk- 
 enness are highly inimical to a permanent healthy state 
 of the brain is often proved at a great distance of time 
 from tlie course of intemperance, and long after the 
 adoption of regular habits. 
 
 * American Journal of Medical Sciences, April, 1849, p. 437. 
 
 4.* 
 
1 1 
 
 42 
 
 EFFECTS OF ALCOHOL 
 
 38. Injlammatory Diseases of the Brain. — All 
 medical writers agree in regarding intemperance as one 
 of the conditions which tend to produce injlammatory 
 diseases of the encephalon, now distinguished as cere- 
 britis * and 'meningitis ; f and this is precisely what 
 might be anticipated, when it is considered how great 
 must be the derangement of the circulating and nutritive 
 operations occasioned by the presence of alcohol in the 
 blood. An attack of acute encephaUtis not unfreciuently 
 supervenes upon a debauch, which is then regarded as its 
 exciting cause. | But it may occur quite independently 
 of any special act of excess, in consequence of the predis- 
 position ai-ising from the perversion of tlie normal 
 functions, by the habitual use of alcoholic li(|Uors in 
 quantities that may never produce actual intoxication. 
 Perhaps, indeed, this is the more common occuiTcnce. 
 We have seen that the state of excitement first produced 
 in most persons by the ingestion of alcohol would pass 
 into meningitis (or rather inflammation of the convohi' 
 tions), if it were not to subside with the eliminntion of 
 the alcohol from the blood. On the other liand, the 
 •state of torpor of the mental functions wliieh alcohol pro- 
 duces from the first in some individuals, and which comes 
 on in sill if the intoxication be carried far enoudi, is 
 indicative of that congestion of the substance of the brain 
 which, if confirmed, and accompanied hy a cei-tain dis- 
 turbance of the nutritive operations, would ])ecoi»ie cere- 
 bi'itis. There can be no hesitation, therefore, in admit- 
 
 * Cerebritis, inflammation of the brain. 
 t Meningitis, inflammation of the membranos of the brain. 
 % See, for example, a fatal case related by Dr. Percy, op. cif. 
 p. 64. — AuTHoii. 
 
ON THE HEALTHY SYSTEM. 
 
 48 
 
 ting the relation of cause and effect, in cases in which it 
 is so obviously established by the sequence of the pheno- 
 mena. 
 
 39. There is another class of diseases of the brain, 
 which are usually dependent upon structural changes 
 that require a longer 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. Apoplexy. — The state of profound coma, cha- 
 racteristic of the advanced stage of intoxication, may be 
 considered to be identical with that of congestive apo- 
 plexy, in every respect save the nature of its cause, and 
 its duration.* A certain degree of tendency to apoplexy 
 may be said to exist in the slighter form of intoxication ; 
 the vessels of the brain being congested, as a consequence 
 of increased action of the heart, and of obstruction to the 
 encephalic circulation, such as is occasioned by imperfect 
 discharge of the functions of the brain ; and tliis obstruc- 
 tion being also favored 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 
 suffer from causes wliich would not otherwise produce 
 rupture of the vessels : thus, there are numerous in- 
 stances on record in which blows received in pugilistic 
 encounters, or other comparatively slight injuries, have 
 
 i 
 
 ctt. 
 
 * Although, as we have already seen ({ 14), the phenomena 
 are so nearly identical, the difference in the etiology involves an 
 important difference in the treatment ; the comatose drunkard not 
 requiring nor bearing the free depiction that is proper in a case of 
 true congestive apoplexy. — Author. 
 
44 
 
 EFFECTS OF ALCOHOL 
 
 occasioned fatal hemorrhage within the cranium ; * the 
 sufferer having been previously dosed with spirits in such 
 quantity as oi itself to produce a state of congestion bor- 
 dering on apoplexy. And it occasionally happens, though 
 this is comparatively rare, that cerebral hemorrhage oc- 
 curs without any external violence, after an excessive 
 indulgence in spirituous potations. 
 
 41. But the influence of alcoholic liquors in the cau- 
 sation of apoplexy is usually of a mi^ jli more gradual 
 nature. A large proportion of the cases of apoplexy 
 occurring in plethoric subjects, and not connected with 
 disease of the heart or softening of the arterial coats, are 
 traceable to intemperance in eating as well as in drink- 
 ing ; 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 sohd food, than among 
 the drinkers of spirits, who are seldom great eaters. It is 
 not difficult to see the reason of this. For, on the one 
 hand, the habit of excess in eating and drinking has a 
 tendency to produce that condition of plethora f wliich 
 is most peculiarly prone to favor 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, || tends to force an unusual quantity of blood 
 
 * Homorrhage, bleeding ; cranium, skull. 
 
 t Plethora, full habit. 
 
 % Abdominal viscera, the bowels and digestive organs. 
 
 II Diajihragm, dividing screen between the chest and the bowels. 
 
 1*1 
 
ox THE HEALTHY SYSTEM. 
 
 45 
 
 into the cncepliulic vchhcIh, a« well as to obstruct its 
 return from tliern. Such an ha)»itual derangement of 
 the circuliition may well be supposed to occasion a pro- 
 gressive weakening of the vessels of the brain ; and in 
 this manner it hap|KniM, that, after a persistence for months 
 or years in this course, ajK»plexy may supervene, and be 
 its legitimate constMjuerice, without the attack being trace- 
 able to any exti-aordinary indulgence.* 
 
 42. Of the strength of the general opinion of the medi- 
 cal profession as to the tendency of alcoholic stimulants 
 to produce the sthenic form f of apoplexy, it is impossi- 
 ble to give a stronger prcwf than the rigidity of the rule 
 of abstinence which is laid down for those in whom a 
 disposition to it luis alrca/ly manifestc \ itself. Now, if 
 it be necessary to lay down such rules to prevent the 
 recurrence of the disciwe, is it not most obvious that we 
 are justified in attributing to an habitual violation of 
 them its first occurrence 'I And if habitual excess be so 
 obviously a prc<Us[»OHing cause, can we reasonably deny 
 that the long-continued even "moderate" use of stimu- 
 lants is likely to exert a slow, but, in the end, a decided 
 influence 'I It is surely in vain here to reply, that, as 
 food is wholesome in moderation, but is hurtful in ex- 
 cess, so may alcohol Ik? also ; for alcohol (as will be more 
 fully shown hereaft<jr) can never properly act as food, 
 save when other ulimcntary matters are deficient; and, 
 
 * There in ovldonco that habitually excessive use of alcoholic 
 liquors has a tendency to produce hemorrhages eheiohcre, probably 
 by dimininhiuf; the plasticity of the blood, and by impairing the 
 nutrition of the walli of the blood-vessels. — (See \\ 52 and 68.) 
 — Author. 
 
 t Sthenic form, attended with strength, and not debility. 
 
46 
 
 EFFECTS OF ALCOHOL 
 
 even in the smallest and most diluted doses, alcohol ex- 
 erts an influence on the vital properties of the tissues 
 with which it is brought into contact, that is never mani- 
 fested by proper alimentary matters. 
 
 43. Paralysis and Epilepsy. — As the conditions 
 upon which the cerebral forms of paralysis depend are 
 so nearly ths same with those which induce apoplexy, we 
 cannot doubt that the continual intemperate use of alco- 
 hohc liquora 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 observation; 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 para/- 
 lytic attacks. The writer has had opportunities of no- 
 ticing this in the case of two gentlemen advanced in life, 
 each of whom suflfered from repeated attacks of paralysis, 
 which almost invariably supervened upon a violation of 
 the habitual rule of abstinence from fermented liquor:, 
 and of extreme moderation in diet. Precisely the same, 
 too, may be said of epilepsy, which disease is now gener- 
 ally attributed to a disordered state of imtriiion of the 
 brain, of which the paroxysm is the manifestation. Of 
 this disordered state of nutrition, intemperance in eating 
 and drinking is among the most frequent of the predis- 
 posing causes, especially when the disease occurs in per- 
 sons 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 ex- 
 citing cause of the paroxysm. 
 
ON THE HEALTHY SYSTEM. 
 
 47 
 
 no- 
 
 44. Besides these positive diseases, a premature ex- 
 haustion of nervous power, manifested in the decline of 
 mental vigor and of nervo-muscular enei'gy, is ranked by 
 common consent among the consequences of habitual ex- 
 cess in the use of alcoholic liijuors ; and reasons will be 
 given hereafter for the belief that it is occasionally the 
 direct, but more frequently the indirect, consecjuence of 
 the habitual employment of what is considered a very 
 moderate allowance. — (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 alcoholic hquors has — in addition to its 
 direct action upon the functions of circulation and nutri- 
 tion — an important indirect agency ; inasmuch as, by 
 the temporary support it affords, it sustains the nervous 
 apparatus 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 mani- 
 festation 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 alco- 
 holic liquors, however, will be more fitly considered at a 
 future period. — (§ 198.) 
 
 Diseases of the Alimentary Canal. 
 
 46. The disorders of the nervous system, whose symp- 
 toms are among the most obvious and characteristic 
 results of alcoholic intoxication, having been now con- 
 sidered, we proceed to examine the influence of alcoholic 
 liquors on the production of diseases of the digestive 
 apparatus. This influence is exerted in two ways : first, 
 
 1 
 
 ( 
 
48 
 
 EFFECTH OP ALCOHOL 
 
 by the direct in'itutliig fiction of tlie fluid upon the mu- 
 cous lining * of the uhinentury canal ; f and, second, by 
 the general deterioration of the nutritive processes, result- 
 ing in various ways from the entrance of alcohol into the, 
 blood. 
 
 47. Irritation and Jnjlammation of the Mucous 
 Membraud of the Stomach. — That irritation would be 
 produced in thu very vascular mucous membrane of the 
 stomach by the direct contiujt 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 wo should anticipate from what 
 has been already shown by oljscrvation to be the result 
 of the application of alcohol to a living membrane. A 
 small quantity of alcoholic li(juor, dilutee! by the fliuids 
 already in the stomach, apfKjars to produce only the first 
 effect, namely, a quickening of the circulation, and a 
 temporary exaltation of the functional activity of the 
 organ, as shown in the increase of ajipetite and of diges- 
 tive 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 tlie stomjvch contains but little 
 other fluid, all the effects of an iri'itant are produced, 
 varying from moderate congestion % with diminished 
 functional activity, to intense congestion passing into in- 
 flammation, and even to a gangrenous state. The more 
 severe effects, however, are not often seen; in conse- 
 
 * Mucous lining, tho innor cofit. 
 
 t Alimentary canal, tho whole channel through which the food 
 passes. 
 
 X Congestion, too great fulnoM. 
 
'■=11 
 
 ON THE HEALTHY .SYSTEM. 
 
 40 
 
 and 
 
 quence, it may be surmised, of the rapidity with which 
 the alcohol has been absorbed (^ 18), and the brcnty 
 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, un- 
 less this have been too great to be quickly absorl "d. 
 
 48. The morbid appearances found in the stomachs of 
 men or animals killed by narcotic * poisonin''. and attri- 
 butable at first sight to the direct influence of tlic in'itant, 
 can seldom be fairly regarded in that light ; since they 
 are for the most part Huch 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, f or hemorrhagic | patches of large extent, 
 these are more likely to have been the result of the 
 stagnation of the pulmonary circulation, acting back- 
 wards upon the whole venous system, than to have been 
 the immediate result of the contact of alcohol; since 
 appearances precisely similar are found when death has^ 
 taken place from suffocation in other modes, e. g*. in 
 criminals executed by hanging. In the case of animate 
 poisoned 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 btomach of the human subject 
 after death from alcoholic poisoning, are most frequently 
 such as indicate an altered state of its nutrition, con- 
 
 * Narcotic, sleep-producing. 
 
 t Extravasation, escape of fluid from its vesaola.. 
 
 X Hemorrhagic, marked with blood. 
 
50 
 
 EFFECTS OF ALCOHOL 
 
 sequent upon habitual irritjition. Of these departires, a 
 thickened state of the mucous membrane seems to Ik; the 
 most constant ; the membrane being sometimes soitened 
 (as stated Ijj Dr. Ogston) ; sometimes unusually firm,' 
 corrugated, and pale (as observed by Dr. I^etei-s). 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 some- 
 times happens, however, that, after the narcotic effects 
 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 this kind, cited by Dr. 
 Christison, the whole villous coat of the stomach was in 
 a gangrenous state, the colon was much inflamed, and 
 the small intestines red along their whole length. 
 
 49. Our best information as to the effect of alcoholic 
 liquors upon the condition of the gastric mucous mem- 
 brane during life, is derived from the well-known ob- 
 servations of Dr. Beaumont in the case of Alexis St. 
 Martin. This man appears to have been habitually 
 temperate and healthy; but to have occasionally in- 
 dulged in excess both in eating and drinking, the results 
 of which could be seen by direct observation through the 
 fistulous opening in the parietes of his stomach. Thus, 
 says Dr. Beaumont, under the date July 28th, 1833, 
 
 * Gastro-intestinal, &c. inner lining of the stomach and bowels. 
 
ON THE HEALTHY SYSTEM. 
 
 61 
 
 " Stomach not healthy, some erythema, * and aphthous f 
 patclies on the mucous surface. St. Martin has been 
 (h'inking ardent spirits pretty freely, for eight or ten 
 "days past; complains of no pain, nor shows symptoms 
 of general inihsi)osition ; says he feels well, and has a 
 good apj)etite. August 1st. Inner membrane of the 
 stomach morbid ; considerable (irythema, and some aph- 
 thous patches on the exposed surfjice ; secretions vitiated. 
 August 3d. Inner membrane of Btomach uimsually 
 morbid ; the erythematous appcjirance more extensive, 
 and spots more livid than usual, from the surface of 
 which exuded small drops of grumousj 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 tliis 
 morning were mixed with a large proportion o^ thick, 
 ropy mucus, and considerable muco-purulent || matter, 
 shghtly 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 mani- 
 festation of it by general or local symptoms as would by 
 themselves have been thought indicative of its presence. 
 " For," continues Dr. Beaumont, " St. Martin com- 
 plains 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, 
 
 ♦ Erythema, inflammation. 
 
 t Aphthous, studded with minute ulcers. 
 
 % Grumous, clotted, thick. 
 
 II Mxico-ptirulent, diseased matter. 
 
52 
 
 EFFECTS OF ALCOHOL 
 
 with dimness and yellowness 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 ha^^ng been con- 
 fined to low diet. Dr. Beaumont further states, that 
 "diseased appearances, similar to those mentioned above, 
 have frequently presented themselves in the coui-se of my 
 experiments and observations. They have generally, but 
 not always, succeeded to some appreciable cause. Impro- 
 per indulgence in eating and di'inking has been the most 
 common precursor of these diseased conditions of the 
 stomach. The free use of ardent spirits, ivine, beer, or 
 any intoxicating liquor, ivhen continued for some days, 
 has invariably produced these morbid changes. '''' 
 
 50. From the precise concurrence of these observa- 
 tions with what theory would lead us to expect in regard 
 to the action of alcoholic liquors on the mucous mem- 
 brane of the stomach, it is obvious that we have no right 
 to suppose that the peculiar condition of St. Martin gave 
 him any peculiar hability to suffer in the manner above 
 described. On the contrary, such disorders of the circu- 
 lation, 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 presumption, 
 however, has been shown to be altogether fallacious ; and 
 we have adequate reason to believe, that some sucli con- 
 
ON THE HEALTHY SYSTEM. 
 
 58 
 
 dition must be tlic result of every excess in the use of 
 alcoholic liquors, however little it may be indicated by 
 the local or general symptoms. 
 
 51. hijlammatory 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 unfit- 
 ting 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 dyspeptic disorder, termed injlammatory 
 g-astric dyspepsia, being well known to practical men as 
 common among those who have freely indulged in alco- 
 hohc potations. Of this disorder, the follovring are the 
 symptoms, as enumerated by Dr. Todd : * " Painful 
 digestion,, sense of heat, tenderness, or pain at the epi- 
 gastrium,! increased upon taking food, or on pressure ; 
 thirst ; tongue more or less of a bright red color, some- 
 times brownish red, sometimes dry, glossy, and adhe- 
 sive ; taste saltish or alkaline, occasionally like that of 
 blood; bowels generally confined; urine high-colored; 
 skin dry, with occasionally profuse, partial sweats, chiefly 
 in the direction 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 frequently hot, dry, 
 and burning: aggravation of the symptoms under the 
 use of stimulants or of irritating ingesta. t. " The vari- 
 
 * Cyclopaedia of Practical Medicine, Art. IiuUgestion, 
 t Epi(jastriumy region of the stomach. 
 t Ingesta, -whatever is taken into the stomach. 
 6* 
 
 11 
 
54 
 
 EFFECTS OF ALCOHOL 
 
 :^ 
 
 
 ous stages and degrees of the disease are cliaracterized 
 by various modifications of these symptoms, many of 
 them the consequences of the disturbance of the nutritive 
 functions produced by the disorder of the stomach ; 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 cutaneous 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 
 depression of spirits, with inability for active mental ex- 
 ertion, passing on, in the more confirmed states, to com- 
 plete hypochondriasis. Although excess in eating may 
 aid in the production of this wretched condition, jct, as 
 Dr. Todd remarks, it is rather due to the stimulating 
 quality of what 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 pota- 
 tions; "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; notwithstanding that, in the more 
 chronic forms of it, a temporary alleviation is sometimes 
 obtained from small quantities of alcoholic licjuors. 
 
 * Soo the observations of Sir Philip Crampton on this subject, 
 in Dublin Hospital Reports, vol. i. p. 349. 
 
ON THE HEALTHY SYSTEM. 
 
 55 
 
 52. Disorders of the Intestinal Mucous Membrane. 
 — The disordered state of the gastro-intestinal mucous 
 membrane * is not limited, as we have seen, to the sto- 
 mach, and it may extend itself along the whole coui-se of 
 the alimentary canal, to parts with which the alc()h<jlic 
 liquors themselves have not come in contact : so as to be 
 attributalilc rather to the general imperfection of the nu- 
 tritive operations, than to the local effects of the stimulant. 
 Thus we find that habitually intemperate persons are sub- 
 ject to soreness, redness, and ulceration of the membrane 
 of the nose, and of that of the lower part of the intes- 
 tinal canal ; and hemorrhages from various parts of this 
 memlirane, as well as from the mouth itself, arc of no 
 unfrequent oeciirrence, — the escape of blood being obvi- 
 ously dependent in part on its own insufficient plasticity, f 
 and in part upon the softened condition of the walls of the 
 vessels. It is important to bear this in mind, as increas- 
 ing 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 v> 41.) 
 
 53. Where, in place of excessive indulgence, v.hai is 
 commonly considered a moderate use has beci raxiio of 
 alcoholic licpiors, we caimot, with the same confidence, 
 attribute to it any decided departure froi.i the healiij/ 
 condition of the stomach ; and it is cert-nn that the mu- 
 cous mem1)rano becomes in time so habituated to its pre- 
 sence, 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, thai; 
 
 * Gasf.ro- intrsfinal mucous membrane, the inner coat of the sto- 
 mach, bowels, &c. 
 
 t Plasticity, adhesiveness. 
 
56 
 
 EFFECTS OF ALCOHOL 
 
 ill 
 
 such habitual use is not without itH consequences, al- 
 though these may be very remote ; the continual over- 
 excitement of the vital activity of the gjwtric mucous 
 membrane being probably one of the causes of tliat pre- 
 mature loss of functional power which is observable in a 
 great number of those who have accustomed themselves 
 to the use of alcohohc liquors. This cause, however, 
 will seldom act alone ; being usually combined Avith ex- 
 cess in diet, and with "wear and tear" of the general 
 system, as will be shown in its proper place ; so that its 
 operation 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; certain diseases 
 of the liver, will be questioned by no one who considers 
 their mode of introduction into the system, and their 
 influence on the condition of the blood. The blood which 
 returns from the gastric veins charged with alcohol is 
 immediately transmitted through the liver : nnd it stimu- 
 lates this gland for a time to increased activity, one effect 
 of which is to eliminate a portion of the alcoliol from the 
 blood, — this substance, according to Dr. Pei'cy's obser- 
 vations, being detectible in the bile of anlirjuls poisoned 
 by alcohol. Hence, the liver, like the stomach, is sub- 
 ject to habitual over-stimulation from tlie direct contact 
 of alcohol with its substance. But we have seen tliat the 
 presence of alcohol in the blood prevents It from ac(|uiring 
 its proper arterial character by passages througli the lungs ; 
 and we shall hereafter find that it causes the undue re- 
 tention in it of hydro-carbonaceous matt<!rs, Avliicli ought 
 to be removed by the respiratory process. Hence an 
 
ON THE HEALTHY SYSTEM. 
 
 57 
 
 undue amount of labor is thrown upon the liver, — one 
 of the functions of this gland being to separate from the 
 blood such hjdro-carbonaceous 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 InJlammaUon of the Liver. 
 — In tropical climates, acute inflammatory diseases of 
 the liver are among the most common of these disorders ; 
 and thoy 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 w^hich 
 are no less clearly traceable to chronic inflammation 
 and degeneration, resulting from the excessive use of 
 fermented lic^uors, especially when these arc taken in the 
 form of distilled spirits. The following is the account of 
 the state of the hver given by Dr. Peters {loc. cit,), as 
 presented in the seventy cases which he had an oppor- 
 tunity of examining : "In * moderate drinkers,' the liver 
 was geneiaiiy found to be somewhat larger than usual, 
 its texture softened, and its outer surface spotted, with 
 patches of fatty infiltration extending two or three lines 
 into the parenchymatous* substance; the rest of the 
 viscus retaining its natural color, ard its edges their nor- 
 mal sharpness. In those who had been more addicted to 
 the use of spirits, the hver was still larger, its edges 
 were more obtuse, and the patches of fat on its surface 
 
 * rarencJiymatous, glandular tissue. 
 
58 
 
 EFFECTS OF ALCOHOL 
 
 were larger and more numerous. In old drunkards the 
 liver was very large, weighing at least six or eight pounds, 
 often from ten to twelve ; the edges were very thick and 
 much rounded ; the parenchyma almost white with fat, 
 soft, fragile, and the peritoneal covering could be torn oflF 
 with ease." It is evident that in all these cases the Tver 
 was the subject of various degrees oi falty degeneration. 
 which takes place, on the one hand, as the result of 
 <leficient functional 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 '•' gra- 
 nular liver," and " hob-nailed Hver," or " gin liver," 
 ^^ ere comparatively rare in Dr. Peters' s experience, being 
 observed only in four or five cases ; but they seem to be 
 much more common in tliis country; and its greater 
 prevalence may possibly be due to a difference in the 
 character of the spirit usually employed by drinkers 
 among the lower classes, gin being here the most com- 
 mon, rum and brandy in the United States. These 
 conditions appear to be dependent upon atrophy of the 
 proper hepatic substance, with hypertrophy of the con- 
 necting areolar tissue : the former being apparently the 
 resiilt of the exhaustion of the functional power of the 
 liver by over-excitement; and the latter to continual 
 attacks of chronic inflamiTifition, which produce the false 
 membranes, adhesiour.^ puckerings, £:c. that give rise to 
 the second of the d- -'.gnations just cited. Between the 
 state of contraction (in which the liver is frequently not 
 more than half its usual size), and the state of enlarge- 
 ment just described, there is not that opposition Avhicli 
 might at first sight appear; for in both is there dimin- 
 
ON rilK HKALTIIY SYSTEM. 
 
 rliicli 
 
 ishcd functional arul nutntivc activity of the proper sub- 
 stsmce o( the gland ; and the »tatc of enlargement, which 
 is simply dejKjndent uiK)n the accumulation of fatty mat- 
 ter, not unfVe<ju<'ntly givc^ place to one of contraction. 
 In fact, it wouM not Hcetii improbahle that each state 
 may have a relation to the general disposition to the de- 
 velopment of fat in the individual : for, v hilst in many 
 habitual di'unkardw i\unv is a great tendency to the 
 production of fat, atid to its def)Osition in various parts^^ of 
 the body (»$< 01), there is an cjual tendency in othei.i 
 to a leanness which no fattening pi-ocess will overcome. 
 Certain it is, however, that the habitual use of alcoholic 
 liquors lias a ttTid<;ncy first to excite and then to diminish 
 the functional jictivity of the liver: and thus predisposes 
 in the first instance to inflammatory diseases of the organ, 
 whilst Its more remot<! operation is to induce atrophy or 
 degeneration. This will Ikj especially the case in tropical 
 climates, where sevc^ral causes concur (as will be shown 
 hereafter) to augment the injurious influence of alcohol 
 upon the liver, and conse<jucntly to incresise the amount 
 and severity of the distsises of that organ induced by its 
 habitual use, < H' (;r)urse, every disturbance of the func- 
 tion of the liver n»ust Ikj an a<lditional source of disorder 
 in the digestive ojM;rations, in which the action of this 
 gland has so imiHjrtaiit a shaj'e. 
 
 Duramen of the Kidneys. 
 
 57, We have se(;i: that a special determination of 
 blood to the kidmjys tsikes place as one of the results 
 of the reception of ah^jholic liquors into the blood ; and 
 these organs are thereby excited to augmented action, 
 one of the purjHmeH of which would seem to be the re- 
 

 
 60 
 
 EFFECTS OF ALCOHOL 
 
 moval 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 sanguineous 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 appears to be frequently the ca, e), 
 when the predisposition has been established by other 
 agencies. But we should expect, that the 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 morbid condition commonly 
 known a.s Brighfs disease^ or granular degenera- 
 tion 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, albuminous, 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 Edinburgh were in persons who were habitual 
 drunkards, or who, without deserving this appellation, 
 M ere in the constant habit of using ardent spirits several 
 times in the course of the day; and the experience of 
 
ON THE HEALTHY SYSTEM. 
 
 61 
 
 English hospitiil practice is (.so far as the writer has 
 been able to ascertain) precisely similar. The tiisensc is 
 verj rarely met with in the i)rivatc practice of those 
 ■whose patients are of a class not given to excessive spirit- 
 uous potations. Here, too, it would seem as if the une of 
 malt spirit (gin or whiskey) gives a greater jtredisposi- 
 tion to tlie disease than that of rum or hrandy; the 
 former liaving a more diuretic effect than the latti.'r, that 
 is, producing a greater temjiorary activity in the kidneys. 
 and having a greater tendency to bring aljout a state of 
 chronic irritation. 
 
 58. But we 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 
 conse([Uonces of long-continued and habitual excitement 
 would manifest themselves in subsequent impairment of 
 functional power, even if no obvious structural disease be 
 ensjendercd : and there can be little douljt that such is 
 the case, since we find that persons advanced in life, 
 who have habitually indidgcd freely, even if not exces- 
 sively, in alcoholic li({Uors, are extremely apt to suffer 
 from scoci, 7'heumatlsm, and other disorders, which 
 mainly (k'|:end upon the insufficient elimination of such 
 morbid matters from the blood as ought to jje carried 
 forth through this channel (§ GG). Excesses in diet, 
 wdiich, at an early period of life, are counteracted ]:)y the 
 activity of the excretory apparatus, are no longer thus 
 prevented from giving rise to an accumulation of morbi- 
 fic * products in the blood, when the kidneys begin to 
 fail in the performance of their duty ; and {dthough we 
 
 •: f 
 
 * Morbific, proflucing disease. 
 
G2 
 
 KFl'ECTH OF AU.'oJlOL 
 
 
 I 
 
 may not 1)o able, wltli ponitivc certainty, to attribute 
 this failure to free induli^eiiee In alcoholic li(|Uor», vet it 
 cannot be reaHoimbly (jU(!Htione<l tliat hucIi habit;-, must 
 tend to product. It, wince w<! find that over-excitement of 
 any organ is rej^ularly followed, Hooner or later, l)y de- 
 pression of its functional iK)wer, and have seen that the 
 continual stimulation of th(! kidney ))y alcohol has a 
 special tendency to prodiu;(! peiveited nutrition, and 
 thus to render it entirely iiniit for the performance of 
 
 its duties. 
 
 Dismscs of the S/du. 
 
 59. The detenuination of bhxnl to the skin, which has 
 been noticed as one of the rertultH of the ingestion of 
 alcoholic li(|Uois, has a tendency, when frequently re- 
 peated, to produce variouH diHorders in its nutrition, 
 chiefly those resulting IVoni congestion or inflammation 
 of its several tisHiics. Such disorders show themselves 
 especially in l].c !«kin of the face ; and this for two 
 reason.5 : ]»v cause, in the first i)lace, the face partakes 
 in the general detcrnu nation of ])]<)(A towards the head, 
 so that it ])ocomes more flushed than any other part of 
 the surface ; and also Ijecausc the exposure of this part 
 of the cutaneous surface disposes it to be more afiected 
 than that of the body and limbs by external cold, which 
 will always tend, l)y lowerin^^ the vital activity of any 
 tissue, to increase the vs'iU rcsuiting from too copious a 
 determination of blood towards it. Hence we find the 
 skin of the face es[»e(Mally ilisposed to exhibit those car- 
 buncles, boils, &c. wliich may be considered, in a large 
 proportion of ca.ses, as the dire(;t result of habitual in- 
 temperance; it is iUso the paj't in which the erysipelatous 
 attacks, so common among the intemperate, most fre- 
 
 
ON THE HEALTHY SYSTEM. 
 
 03 
 
 attribute 
 rs, vet It 
 jits must 
 tement of 
 r, l)j de- 
 , tliat the 
 ol has a 
 tion, and 
 mance of 
 
 yhich has 
 jcstion of 
 ently re- 
 nutrition, 
 ammation 
 lemselves 
 for two 
 partakes 
 the head, 
 r part of 
 this part 
 3 aflfected 
 d, which 
 y of any 
 opious a 
 find the 
 lose car- 
 a large 
 itual in- 
 ipelatous 
 aost fre- 
 
 (juontly commence, wlion thoy arc not imme(hi»tel y ex- 
 cited by some injury el.newhero; and it is on the face, 
 too, that we most frcipiently meet with various forms of 
 acne, of wliich the acne rosacea is, in a very hirge 
 proportion of cases, directly attributable to intemperate 
 habits. We have alresidy noticed other <liseavses of the 
 skin (*§> 51), which seem to be rather .MTjuent upon 
 the disorder of the digestive aj)paratii idu.ed by the 
 habitual free use of alcoholic Tupiors. due to the 
 
 direct agency of the alcohol upon its tissue. There is a 
 disease, however, noticed by Dr. Darwin under the name 
 of psora ebriormn, A^hich may be attributed with great 
 probability to a chronic though slight perversion of the 
 nutritive operations of the skin, in consecpienee of the pre- 
 sence of alcohol in the blood. Of this disease, Dr. Dar- 
 win says : " Elderly people who have been much a<ldicted 
 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 their bodies to another, with 
 their own nails, by scratching themselves." Dr. Macnish 
 states, that he has himself seen many cases of this dis- 
 ease. * Most other cutaneous f disorders, which are 
 less directly traceable to intemperate hal)its, are greatly 
 aggravated by them : so that strict abstinence from fer- 
 mented liquors is an almost invariable rule in the treat- 
 ment of them, unless the use of these in small quantities 
 should be thought requisite to improve the state of the 
 digestive function. 
 
 * Anatomy of Drunkenness, p. 178. 
 t Cutanom, belonging to the skin. 
 
IMAGE EVALUATION 
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 (716)872-4503 
 
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u 
 
 EFFECTS OF ALCOHOL 
 
 General Disorders of NiUrition. 
 60. Having thus considered the principal forms of 
 disease which the intemperate employment of alcoholic 
 liquors has a tendency to induce in the several parts of 
 the excretory apparatus, to which they seem to give a 
 special determination, we have now to consider those 
 general chsorders of nutrition which are traeerble to the 
 same cause, and wliich manifest themselves either as 
 substantive diseases, as modifying the course of other 
 diseases, or as giving a special habihty to the action of 
 other morbific causes. We have already spoken of the 
 deteriorating effect of the admixture of alcohol with the 
 blood ; how it lowers the plasticity of the fibrine, tends 
 to empty the red corpuscles, and in various ways impedes 
 the process of aeration ; and another less direct, but not 
 less important, source of deterioration is to be found in 
 the imperfect elimination * of the constituents of the bile 
 and urine, which must be the consequence of functional 
 inactivity, still more of structural degeneration,! of the 
 liver and kidneys. Hence it would seem impossible, 
 that by such a pabulum the formation of the sohd tissues 
 can be normally sustained ; and we should expect to find, 
 that the nutritive processes are not performed with the 
 same energy and completeness in the habitually intem- 
 perate, that they are in the habitually abstinent. Not- 
 withstanding some appearances to the contrary, there is 
 abundant evidence that such is the case. Although a 
 high degree of bodily vigor seems to be exhiliited by 
 certain classes of men, who consume large quantities of 
 fermented liquors, yet this is extremely deceptive, as the 
 
 Elimination, separation. 
 
 t Degeneration, diaense. 
 
ON THE HEALTHY SYSTEM. 
 
 65 
 
 facts to be presently stated will clearly indicate ; and the 
 general result is evidently on the other side. 
 
 61. Tendency to the Deposition of Fat. — The im- 
 mediate eflFects of alcoholic liquors upon the general 
 appearance of the body, especially as regards the deposi- 
 tion of fat, vary with their nature, and with the circum- 
 stances 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 corpu- 
 lent ; the large consumers of wine commonly share the 
 same tendency ; but the spirit-drinker is more commonly 
 lean, and even emaciated. This difference may partly 
 depend upon the constitution of the liquors; thus ale, 
 beer, &c. .wntain a considerable 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 sohd matter, which furnishes materials for 
 combustion ; whilst, in distilled spirits, there is scarcely 
 any thing 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 
 gi-eat muscular exertion, may find his appetite but little 
 impaired by his excess; the wine-drinker also usually 
 feeds high ; whilst the spirit-drinker, especially among 
 the poorer classes, takes his dram instead of solid food, 
 for which 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 legs, after which the shoulders 
 generally give way, and the whole body becomes loose, 
 flabby, and inelastic ; the abdomen alone retaining its 
 
 6* 
 
66 
 
 EFFECTS OF ALCOHOL. 
 
 protuberance, in consequence of the large deposition of 
 fat in the omentum,* which is rarely absorbed. Such a 
 deposition of fat is almost invariably found in the omen- 
 tum of confirmed spirit-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 the 
 reverse. No animal in a state of nature exhildts any 
 considerable deposit of fat, except for some special pur- 
 pose (as in the case of cetacea and other warm-blooded 
 animals inhabiting the water, where the coating of fat 
 serves as a non-conductor ; or in the case of hybernating 
 mammals, | as also of many birds, whose autumnal accu- 
 mulation of fat is destined to make up for the deprivation 
 or deficiency of food in the winter) : and when, by a 
 change of habits, the deposition of fat is artificially pro- 
 moted, it is obvious that the muscular vigor and general 
 " hardiness " of the system are much im|)aired ; the ani- 
 mal 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, we 
 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 fr tional in- 
 activity. II 
 
 * Omenhim, fatty membrane covering the bowels, ■^ 
 
 t Dr. Peters, foe. cit. 
 
 % IlybernatiiKj mammals, quadrupeds which become torpid in 
 ■winter. 
 
 II The following interesting case is recorded by Dr. Robertson 
 
ON THE HEALTHY SYSTEM. 
 
 07 
 
 we 
 
 to, 
 
 of 
 
 tive 
 in- 
 
 63. Diminished Power of Sustaining' Injuries by 
 Disease or Accident. — The classes of men among 
 whom there is an appearance of remarkable bodily ^^gor, 
 notwithstanding habitual excess in the use of alcohohc 
 liquors, are those who are continually undergoing great 
 muscular exertion, and who not only drink largely, but 
 eat heartily. Of this class, the London coal-heavers, 
 ballasters, and brewers' draymen, are remarkal)lc exam- 
 ples : many of them drink from two to three gallons of 
 porter daily, and even spirits besides ; they are for the 
 most part large, gross, unwieldy men, and are capable 
 of great bodily exertion, — so long,, at least, as their labor 
 is carried on in the open air.* But it does not hence 
 follow that they are in a condition of real vigor ; 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, which were at first apparently of 
 the most trifling character. It is well known to those 
 who have observed the practice of the London hospitals, 
 that, when such men suffer from inflammatory attacks 
 
 (Treatise on Diet, fourth edition, vol. i. p. 272). The subject of it 
 was a very young man, who died thus early from the intemperate 
 nse of spirits. For several months before his death, ho had been 
 unable to oat 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 cerebral " ramol- 
 lissemcnt ; " but, although the body was mucli attenuated, the 
 muscular fibre of the system much wasted, and the subcutaneous 
 fat of the extremities had almost disappeared, on cutting through 
 the abdominal walls to examine the condition of the liver, at least 
 three times the usual thickness of fat had to be divided. — AurHou. 
 
 :son 
 
 See Appendix A. 
 
68 
 
 EFFECTS OF ALCOHOL 
 
 or from local injuries, these are peculiarly disposed to 
 run on to a fatal termination ; in consequence, it is evi- 
 dent, of the deficient plasticity of the blood, of the low 
 assimilative 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 f character ; there is no limitation by 
 pkstic effusion, 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 possible, the 
 prostrated energy. Thus we see that in such men the 
 slightest scratch or bruise will not unfrequently give 
 rise to a fatal attack of erysipelas ; and that internal 
 organs affected with inflammation rapidly become infil- 
 trated with pus, X or pass into a gangrenous state. 
 Henco the surgeon is very unwilling to perform severe 
 operations upon them, knowing that their chance of 
 recovery is but small. The condition of these men, 
 in regard to recovery from injuries, is in remarkable 
 contrast to that of men who have been " trained " to 
 pugilistic encounters; the latter having been brought 
 to a condition of- lae highest possible health, by active 
 exercise, abundance of nutritious food, occasional mild 
 purgation, and either entire abstinence from fermented 
 liquore, 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. 
 
 * Asthenic, wanting strength. f Sthenic, vigorous. 
 
 X Pus, matter, as from sores. 
 
ON THE HEALTHY SYSTEM. 
 
 69 
 
 64. Although there are now few men who habitually 
 take winn to a corresponding extent, or who maintain by 
 active exercise in the open air any thing like the same 
 muscular vigor, yet such examples are occasionally met 
 with among the fox-hunting country sf^uires, who spend 
 their whole days on horseback, and pass their evenings 
 in drinking port- wine. Of these, also, the same remark 
 may be made; that, notwithstanding their appearance 
 of vigor, 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 re- 
 parative 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 " Ge- 
 neva ulcer," by which it is commonly known at Guy's 
 and other metropohtan hospitals. This ulcer, usually 
 commencing on the leg, begins as a red, angi*y, and 
 painful spot, which passes into an open sore ; and this 
 increases rapidly, 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 confined, how- 
 ever, to gin-drinkers, but is occasionally met with in the 
 bloated, plethoric, red-faced wine-bibber. 
 
 65. Liability to Epidemic Diseases, — Another most 
 important indication of the disordered state of nutrition, 
 consequent upon habitual excess in the use of intoxicat- 
 ing hquoi"s, is the liability of the intemperate to suffer 
 from various other morbific causes, especially those of an 
 epidemic or pestilential nature. On this last point there 
 is, the writer beheves, no difference of opinion amongst 
 
/ 
 
 / 
 
 70 
 
 EFFECTS OF ALCOHOL 
 
 medical practitioners in any part of the world ; all being 
 agreed that the habitual drunkard is fay more likely to 
 suffer from such agencies than the h^bitujilly sober or 
 temperate man. Whether hahitnal /hbsti7ie)}ce is still 
 safer than habitual moderation, is gr point which cannot 
 be so easily ascertained : some considerations on this 
 subject, however, will be offered hereafter (*§> 144 — 150). 
 The peculiar liability of the habitually intemperate to 
 suffer from the cholera-poison is well known. The fol- 
 lowing circumstance, which occurred during the fonner 
 epidemic of cholera, is very significant on this point; 
 especially showing that the state of depression which 
 follows excitement is the one in which the system is most 
 readily affected. The nurses in the Cholera Hospital at 
 Manchester were at first worked six hours, and allowed 
 to go home the other six; and the mortality was so 
 great amongst them that there were fears of the failure 
 of the supply. It was found, however, that they were 
 much given to alcoholic potations (with the idea, proba- 
 bly, of increasing their power of resisting the malady) 
 during their leisure hours ; and they were therefore 
 confined to the hospital, and debarred from obtaining 
 more than a small allowance of alcoholic drink; after 
 which, not a single fresh case occurred among them. 
 During the present epidemic, the writer has learned 
 from various sources, that a considerable proportion of 
 those invwhom the liability to the disease was not evi- 
 dently produced by the condition of the locality in which 
 they resided, might be considered as deriving a pre- 
 disposition to it from habitual intemperance, — many 
 establishments having lost those men, and those only, 
 who had been accustomed to free indulgence in the use 
 
ON THE HEALTHY SYSTEM. 
 
 71 
 
 
 of alcoholic liquors. The general connection between 
 the intemperate habits of a population, and its high rate 
 of mortality from various causes, will \)e shown here- 
 after ; and a high rate of mortalily is always indicative 
 of a large amount of sickness, although the ratio between 
 the two is by no means constant. 
 
 66. Gout and Rheumatism. — Among the general 
 disorders of nutrition, to wliich 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 
 favored by such a use of alcoholic liquors as stinmlates 
 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 tliis much is pretty cer- 
 tain, — that an impaired condition of the nutritive ope- 
 rations will be favorable to the production of the mater ies 
 morbi,-f whatever be its nature ; that tliis 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 ehmination of 
 this morbid matter will be obstructed by that torpid 
 condition of the liver and kidneys, to wliich these organs 
 are especially liable in those who have habitually over- 
 excited them in earlier life (•§» 58). In the production 
 of rheumatism, also, we may clearly trace the aggravat- 
 
 - * Azotized, containing much, nitrogen, as in animal food, 
 t Materiea morbi, material of disease. 
 
72 
 
 EFFECTS OF ALCOHOL 
 
 ing influonco of habitual excfcL'8 in the use of alcoholic 
 liquors, especially if the materies morbi be, as many- 
 suppose, lactic acid, * or one of its compounds. For, 
 whilst the disordered condition of the assimilative and 
 nutritive operations will give a special tendency to the 
 production of this substance, the impediment to its oxy- 
 genation t presented by the presence of alcohol in the 
 blood will cause it to be retained and to accumulate there, 
 instead of being burned oflf (which it ought to be, as fast 
 as formed) and escaping from the lungs in the condition of 
 carbonic acid and Avatcr.^ Here, again, the torpor of the 
 liver and kidneys, and the disordered action of the skin, 
 in the habitually intemperate, will present an additional 
 obstacle to the proper elimination of the morbific mat- 
 ter ; and in rheumatism, as in gout, the intensity of the 
 inflammation can scarcely but be augmented by the dia- 
 thesis II induced by the habitual presence of alcohol in 
 the blood. All these predictions are verified by the 
 experience of every practical man. 
 
 67. Diseases of the Heart and Arteries. — Closely 
 connected with the gouty and rheumatic diatheses are 
 diseases of the heart and arteries ; of which some obvi- 
 ously arise out of these constitutional states, and are 
 
 * Lactic acid, acid found in milk. 
 
 t Oxijgonation, process by which oxygen is supplied. 
 
 % This idea of the influence of alcohol in conducing to the 
 retention of lactic acid, and thereby favoring the i-heumatic diathe- 
 sis, is confirmed by the success of Dr. G. O. Ilees's method of 
 treating rheumatism by lemon juice ; the rationale of which seems 
 to be, that the citric acid aiFords a large and ready supply of oxy- 
 gen, whereby the lactic acid (or materies morbi, whatever it be) is 
 burned off. — Author. 
 
 II Diathesis, condition of body. 
 
ON THE HEALTHY SYSTEM. 
 
 78 
 
 thus imiirectly favored hy tlie alnisc of ulcoliulic liiiuors ; 
 wliilst otliers seem to be more tlirectly tlepeiKloiit upon 
 the introUiiction of alcohol into the blood. The continual 
 but irregular excitement of the contractile action of the 
 heart and arteries, Avhich is the result of the habitual use 
 of stimulants, must of itself predispose their tissues to 
 disease ; and tliis predisposition will, of course, be in- 
 creased by the contact of blood charged with alcohol 
 with their lining membrane, as Avell as by the general 
 disordered condition of the nutritive operations. Now, 
 attacks of acute arteritis* seem not unfrecjuently traceable 
 to alcohohc intoxication ; and it cannot, therefore, be 
 regarded as improbable, that those more chronic disorders 
 of their walls, which give rise to aneurism, f softening, 
 fatty degeneration, and other structural changes, and 
 wliich thereby predispose to hemorrhage, should be 
 favored, if not absolutely produced, by the habitual 
 presence of alcohol in the circulating current. Accord- 
 ingly, 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 phe- 
 nomenon 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 re- 
 sults of habitual excess in the use of alcoholic liquors, 
 yet it should not be passed by in any inquiry into the 
 consequences of such excess ; more especially since it may 
 be regai-ded, with much probability, as resulting from the 
 same kind of perverted nutrition, carried to an extreme 
 
 * Arteritis, disease of the arteries, 
 t Aneurism, tumor of the arteries. 
 
 I 
 
74 
 
 EFFECTS OF ALCOHOL 
 
 degree, as that to which wc have ah'cady traced various 
 other consefjuences. It would be more correct to speak 
 of these cases as instances of unusual combustibility of 
 the 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 pecu- 
 liarity consisting in this, — that, whereas an ordinary 
 human body requires a largo amount of wood, coal, or 
 other inflammable material, for its combustion, the body 
 in the subjects of this accident takes fire very readily, 
 and bums as if it Avcre itself highly inflammable. In 
 some instances, it has appeared as if a very inflammable 
 gas were given off" from the body ; a flame having darted 
 towards it from some distance. In all, or nearly all, the 
 cases in which the previous habits of the individuals 
 were known, they had been intemperate; and it is re- 
 markable that the greater number of recorded instances 
 occurred 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 phosphorus, which is per- 
 haps united with hydrogen, so as to form some highly 
 inflammable compound. This may be conceived to result 
 from the habitual ingestion of alcohol, in the following 
 way : The normal mode in which the phosphorus, set 
 free by the waste or disintegration 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 
 eflFect this conversion, it is to be expected that the phos- 
 phorus would be retained in the fluids, and possibly depo- 
 
\ r 
 
 ON THE HEALTHY SYSTEM. 
 
 75 
 
 sited again in tlio solids ; and, since we have seen that 
 the continual presence of alcohol in the circulation gives 
 even to arterial hWl a venous character, it is not difTi- 
 cult to understand how such a retention of the phosphorus 
 destined for excretion should l)e favored hy hahitual in- 
 temjKJrance. It is a reniarkuble confirmation of this 
 view, that the breath of drunkards luia been sometimes 
 observed to bo luminous, an if it contained the vajwr of 
 phosphorus or of some of its compounds ; and that it hag 
 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 wliich we can trace 
 the operation of the habitually excessive use of alcohohc 
 stimulants, with tolerable directness. It would be easy 
 to extend this catalogue by the inclusion of other dis- 
 eases which are manifestly aggravated by intemperate 
 habits ; but this, in fact, would require the enumeration 
 of almost every disease to which the human body is 
 subject, more especially if inflammation participate in it. 
 But the writer thinks it preferable to limit his state- 
 ments 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 
 
 ♦ See Casper's Wochenschrift, 1849, No. 15. The luminosity 
 observed by Sir Henry Marsh in the faces of two phthisical 
 patients was probably due to the same cause, — the imperfect 
 oxidation of phosphorus within the body, and its consequent 
 extrication from the skin in a vaporous condition. — Author. 
 
76 
 
 EFFECTS OF ALCOHOL 
 
 !l 
 
 be expected to arise from habitual " intemperance ; " 
 regard being had to the facts which have been fully 
 ascertained, with respect to the modus operandi of al- 
 cohol on the system at large, and on special organs. 
 It has been shown, that a variety of disorders of the 
 nervous system, of the digestive apparatus, of the secret- 
 ing 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 anticipations are all com- 
 pletely verified by the results of practical observation. 
 We might now push the investigation further, and 
 inquire what evidence we have in regard to the con- 
 sequences of the habitually "moderate" use of alcoholic 
 liquors on the human system. It must be freely ad- 
 mitted, however, that we have not the same data for 
 the determination of this question, as of 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 " moderate " or " tem- 
 perate" use of alcohohc liquors, and the shortness of the 
 time during which total abstinence has been hitherto 
 practised by any large number of individuals, render it 
 difiicult, 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 accord- 
 ance 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, Ave have a strong case in favor of such 
 a relation, when, the cause being in less active operation, 
 
/ M 
 
 ON THE HEALTHY SYSTEM. 
 
 77 
 
 . " 
 
 the predicted effects 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 OF ALCO- 
 HOLIC LIQUORS ON THE DURATION OF LIFE. 
 
 69. We shall close this part of the inquiry by examin- 
 ing into the general tendency of the excessive use of 
 alcohoUc hquors to shorten life ; either by themselves 
 giving rise to the diseases above enumerated, or by in- 
 creasing the susceptibihty of the system to other morbific 
 causes. That such a tendency exists cannot for a moment 
 be questioned. No life-insurance office will accept an 
 insurance on an individual whose habits are known to be 
 intemperate ; and if it be discovered after his death that 
 he has been accustomed to the excessive use of alcoholic 
 liquors, contrary to his statement in his proposal for 
 insurance, the jjolicy 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 presents itself 
 amongst them, than that which might be expected ac- 
 cording to the calculations founded on the entire mor- 
 tality of the country, — to the great profit of the office. 
 Thus, at the age 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 life offices, it is 
 about 11 per lOQO ; and in those insured in friendly 
 societies, it is about 10 per 1000. Now, the average mor- 
 tality for all ages between 15 and 70 years is about 20 
 7* 
 
T8 
 
 EFFECTS OF ALCOHOL 
 
 per 1000 ; whereas, in the Temperance Provident Institu- 
 tion, 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 epi- 
 demic. It is worthy of remark, however, that, altliough 
 many of the insurers in this office are of the poorer 
 class, whose condition and employments expose them 
 much more than the middling classes gener.ally to the 
 endemic causes of cholera, no more than eight have died 
 of this disease, out of the total of about 3,500 insurers. 
 As a means of further comparison, the following table 
 may be subjoined, in Avhich the mortahty 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 exist- 
 ence : — 
 
 Life Piilicies. Deaths. 
 
 A issued 914, and had 14; being equal to 13 per thou'and. 
 B „ 1901, „ 27; „ 11 
 
 C ,, 838, „ 11 ; „ 13 „ 
 
 D „ 2170, „ 65; „ 26 
 
 TPI„ lo96, „ 12; „ 7i 
 
 M 
 
 During the sixth year of its existence, only iivo deaths 
 occurred out of the whole number of insurers in the Tem- 
 perance I*rovidcnt Institution, l)y which its annual aver- 
 age of mortality Avas reduced still lower. 
 
 70. Such comparisons, however, must not be regarded 
 as demonstrating that the usual rate of mortality among 
 " moderate" or ''temperate"' men is reduced to half its 
 amount by "total abstinence; " since other causes have 
 dou])tless concuired to keep down the mortality in the 
 Temperance Provident Listitution, — such as a more 
 
■IT 
 
 ON THE HEALTHY SYSTEM. 
 
 79 
 
 Idcatlis 
 Tem- 
 sivcr- 
 
 ^ardcd 
 imong 
 tilf its 
 
 have 
 5n the 
 
 more 
 
 healthful condition of the class which has furnished 
 most of the insurers, or a more favorable distribution 
 of ages. But it will be seen to be impossible, that either 
 of these separately, or both conjointly, should have occa- 
 sioned the whole of the difference above pointed out; 
 the annual average, G per 1000, being no higher than 
 that of the age of le5, which is more favorable than that 
 of any other period of life. And we appear fully justi- 
 fied, therefore, in attributing a part of the result to the 
 abslinent system practised by the insurers in the Tem- 
 perance Provident Office. 
 
 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 cli- 
 mates, and especially in such as are otherAvisc 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 ; either from the mistaken 
 idea that they enable them to withstand the effects of the 
 chmate, or from the desire that their life, if short, shall 
 be a merry one. Some years since, the writer, being 
 himself in the Island of St. Vincent in the "West Indies, 
 met Avith a gentleman resident in Tobago, who informed 
 him that the average annual mortality amonirst the Eu- 
 ropeans of that island was about oie in fJircc. Upon 
 inquiry into the halnts of the residents, it was found that 
 intemperance prevailed to a most fearful extent among 
 them ; few getting up in the morning witliout their glass 
 of sangaree (wine and water), and the strength of their 
 beverage gradually increasing during the day. until it 
 arrived at neat brandy at night. He further sp<^ke of it 
 as no uncommon occurrence for a party of friends who 
 
80 
 
 EFFECTS OF ALCOHOL 
 
 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 apparently 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. We shall be led, however, by the 
 evidence about to be adduced, to a different conclusion. 
 
 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 modera- 
 tion, if not total abstinence. 
 
 73. At the Statistical Section of the British Associa- 
 tion, in the year 1848, a paper by INIr. 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 found to add but 
 a small proportion to the deaths from chmatorial diseases, 
 but that the special liability of Europeans to the diseases 
 of hot climates arises from their unsuitability of consti- 
 tution to any climate widely different from that of their 
 own country, — an important discussion took place, in 
 the course of which some valuable facts were cstaT)lished 
 by the testimony of several officers present (medical and 
 otherwise), who had served in India and elsewhere. The 
 returns contained in the paper showed a marked differ- 
 ence in rate of morality between the ordinary soldiers 
 and the officers ; a difference which was greater accord- 
 ing to the unhealthiness of the station. Now, a certain 
 
ON THE UEALTHY SYSTEM. 
 
 81 
 
 part of this difference must be admitted to be due to the 
 superior character of the officer's lodging, and to his 
 partial exemption from the fatigue and the exposure to 
 which the soldier is lialjlo. But the difference is chiefly 
 to be accounted for by the difference in the manner of 
 living between the soldiers and the 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 ; »ivits, and this to a mach less extent 
 than formerly. With regard 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 
 officers to drink bitter ale in place of wines or spirits, 
 the rate of mortality among them is so greatly dimin- 
 ished, that promotion is no longer expected to take place 
 more rapidly in the Indian army than in other depart- 
 ments 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 discontinuance of temperance 
 societies,* he had/or^// cases of delirium tremens in his 
 own regiment. 
 
 74. That the haljility to chmatorial disease is by no 
 means inevitable, and that it is especially to be avoided 
 by the adoption of the habits in regard to diet, &c.^of the 
 
 * The authorities at the Horse Guards, -vvho have taken the ex- 
 traordinary step of putting down temperance societies in the army, 
 on the ground that every organization but the regimental is con- 
 trary to the discipline of the service, can scarcely be supposed 
 cognizant of what they have to answer for. — Author. 
 
82 
 
 EFFECTS OF ALCOHOL 
 
 native population, where that is healthy, is the testimony 
 of all those who have had most extensive opportunities of 
 forming a judgment on the subject. The two following 
 citations from diflferent publications — the one by Lieute- 
 nant-Colonel Sykes, who was himself long resident in 
 India ; the other by Dr. Daniell, assistant-surgeon to the 
 forces, who has had the superintendence for a consider- 
 able time of some of the most unhealthy stations on the 
 western cost of Africa — will carry with them great 
 weight. " I never followed a farinaceous or vegetable 
 regiment myself in India," says Colonel S. " nor do I 
 recommend it to others ; but I ate moderately and drank 
 little, and I have a strong conviction that much of Euro- 
 pean disease in India is traceable 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 temper- 
 ance is for the benefit of his body, libraries for the benefit 
 of his mind, exercise for the benefit of his health, and 
 savings' banks for the benefit of his purse. The climate 
 of India is less to blame than individuals ; for^ in case 
 foreigners find the people in a country healthy, they 
 sliould, to a certain extent, conform to the habits of the 
 natives to be healthy 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 conse- 
 quences (resulting from the reprehensible indulgence of 
 dissipated courses) might be unreservedly thrown, without 
 
 * Vital Statistics of the Indian Army, in Journal of the Statis- 
 tical Society, vol. x. p. 184. 
 
ON THE HEALTHY SYSTEM. 
 
 88 
 
 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 diet, exercise, and attention to 
 the due perforaiance of the cutaneous functions."f 
 
 75. The evidence of statistics, however, is more valua- 
 ble on this point than the mere aflfinnation of individuals, 
 however trustworthy ; 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, 
 has averaged as follows : — 
 
 Bengal. 
 
 Native 1-79 
 
 European 7*38 
 
 This table presents some very remarkable features. 
 In the first place, the striking contrast between the rate 
 of mortality of the European and of the native troops, 
 serving together, and exposed to the same morbific causes. 
 Secondly, the great difference between the mortality of 
 the troops serving in the difierent presidencies. And, 
 thirdly, the circumstance that in the Madras Presidency 
 the rate of mortality is highest amongst the native troops, 
 and lowest among the Europeans. 
 
 76. Now, on the first point, Colonel Sykes remarks : 
 
 * Sketches of the Medical Topography and Native Diseases of 
 the Gulf of Guinea, Western Africa, p. 13. 
 t Op. cit. p. 61. 
 
 Bombay. 
 
 Madras, 
 
 1-291 
 
 2-095 
 
 6-071 
 
 3-846 
 
84 
 
 EFFECTS OF ALCOHOL 
 
 " I -svill not say that the (|uestion is absolutely solved by 
 the reply, ' Habits of life ; ' but I will say, reasoning 
 from analogy, that the reply goes a great way to solve 
 it. The European soldier in India is over-stimidated by 
 food, over-stimulated by drink, and under-stimulated in 
 mind and body. The European soldier eats a quantity 
 of animal food every day of his life ; he drinks a quan- 
 tity of alcohol every day of his life to the amount of a 
 bottle of spirits in every five days, two drams being 
 served out to him daily ; and he has not any mental and 
 httle bodily exercise. Happily the pernicious practice 
 has been recently discontinued ; but time was when the 
 European soldier Avas compelled to take liis drjim by 
 eight o'clock in the morning, with the thermometer 
 varying from 70^ to 90° or more, at different seasons 
 of the year, leaving him in a state of nervous irritation 
 and thirst, which could only be relieved, as ho thought, 
 by further potations : indeed, I have been assured, within 
 the last few days, by a pensioned artillery staff-sergeant, 
 vjho never drank in India, and ivas only in hospital 
 five days during" tiserdy-onc years' service, that he has 
 known, out of a detachment of one hundred artillery 
 men, no less than eight men in strait jackets at one time, 
 absolutely mad from drink. Now, animal food, with 
 the assistance of such an auxiliary, and combined with 
 mental vacuity, go far to account for the excess of mor- 
 tahty amongst Europeans." 
 
 77. The question next arises, why the mortality of 
 the European troops in the IMadras Presidency should be 
 so much less than that of the others, being about three- 
 fourths that of the Bombay troops, and but little more 
 than half that of the Bengal army ; whilst, on thje other 
 
ON THE HEALTHY SYSTEM. 
 
 85 
 
 hand, the mortality of the native troops in the Bombay 
 army is but liltle more than two-thirds of that of the 
 
 Bengal 
 
 army, 
 
 and less than two-thirds that of the 
 
 Madras army. There does not seem to be any such 
 diflference in the climatorial diseases, or in the character 
 of the military stations, of the three presidencies, as are 
 by any means sufficient to account for this discrepancy ; 
 and, if there were, Ave should expect them to manifest 
 themselves ahke in the native and in the European 
 army. That the reverae is the case must be admitted 
 to be a cogent argument, if not a complete proof, in 
 favor of the insufficiency of any such account of the 
 discrepancy. The following are the causes assigned by 
 Colonel Sykes : The Bengal European array has no 
 supply of porter, but is furnished with rum, a spirit not 
 so wholesome as arrack. On the other hand, the Ma- 
 dras army consume large quantities of porter, and drink 
 comparatively little spirit ; what they do consume being 
 arrack. The Bombay troops have only recently com- 
 menced the consumption of porter ; and the spirit they 
 drink is understood to be more wholesome than rum, and 
 less so than arrack. "These results," says Colonel 
 Sykes, " are certainly not conclusive ; but I cannot help 
 associating the increased consumption of malt-liquor by 
 the Madras Europeans with their comparative healthi- 
 ness ; and the gradations of the moi*tality in the Bengal 
 and Bombay European troops as partly influenced by 
 the quality (no doubt much more by the quantity) of the 
 spirits they respectively consume."' 
 
 78. On the other hand, the excess of mortahty in the 
 native army of Madras above that of the Bengal and 
 Bombay troops is equally attributable to a diffijrence in 
 the habits of the individuals composing it. " Of the 
 
86 
 
 EFFECTS OF ALCOHOL 
 
 Bombay army," says Colonel Sykes, " six-eighths con- 
 sist of Hindoos, and considerably more than half of the 
 whole army are Hindostanees. These men never taste 
 meat, fish, or spirituous liquors, but live, I may from 
 personal observation venture to say, almost exclusively 
 upon unleavened cakes of wheat or other cerealia, baked 
 upon an iron dish, and eaten as soon as cooked. The 
 great majority of the Bengal army consists of a similar 
 class of men. The Madras army, in its constituents, 
 is the reverse of the other two. In the cavalry there 
 are from six to seven Mussulmans to one Hindoo, and 
 in the infantry there is one Mussulman to every 1^ 
 or If Hindoos ; but amongst the latter there is a con- 
 siderable number of low castes, without prejudices about 
 food, and unrestrained by the prejudices of caste : there- 
 fore the majority of the native troops of the Madras 
 army can eat and drink like Europeans." Thus, then, 
 we see that, whereas in the Madras army, in which 
 the European and native habits most closely assimilate, 
 the mortality of the former is less than double (about 38 
 to 21) that of the latter, the mortality of the Bengal 
 Europeans is nearly six times (about 74 to 13) that of 
 the Bombay natives ; this difiFererice bearing such a rela- 
 tion to the greater abstemiousness of the native soldiers, 
 and the larger consumption of spirits by the Europeans, 
 that it is scarcely possible to avoid the inference that they 
 must be connected in the relation of effect and cause. 
 
 79. The following returns are of value, as showing 
 the proportion of sickness between the members of Tem- 
 perance Societies * in the European regiments serving 
 
 * In these societies, the pledge simply held the members to 
 abstinence from distilled spirits, and from excess in the uae of 
 any fermented liquor. — Author. 
 
ON THE HEALTHY SYSTEM. 
 
 87 
 
 ; they 
 
 in India, and the soldiers not members of these societies ; 
 the average daily number of men in hospital of each 
 class being state<l for each of the first six months of 
 1838, and the per centage being calculated with refer- 
 ence to the strength of each division. 
 
 MooUs. 
 
 Sirtiiiith of 
 
 ttM Temp<>rftnoe 
 
 BocietiM. 
 
 Htrrngth 
 
 of remmin<ler of 
 
 Regiment. 
 
 KcUtire pnpnrtloai admilUd Arert^v lUlljr mt mnt- | 
 la HtivDrtli. •)!« of men In HoiplMl. 
 
 TrraprrMm 
 8mI<Ij. 
 
 Rrm&inilrr of 
 Regiment. 
 
 Temperance 
 Society. 
 
 Remainder 
 
 of 
 Re«)raenl. 
 
 Jan. 
 
 Feb. 
 
 March 
 
 April 
 
 May 
 
 June 
 
 1953 
 1840 
 1542 
 1359 
 1282 
 1364 
 
 2569 
 2639 
 2879 
 3081 
 3161 
 3075 
 
 1 in 18-77 
 1 in 20-10 
 1 in 14-44 
 1 in 10-9 
 1 in 18 44 
 1 in 19-53 
 
 1 in 9-22 
 1 in 9.24 
 1 in 714 
 1 in 5- 26 
 1 in 6-35 
 1 in 6-37 
 
 2-54 
 2-27 
 2-94 
 5-47 
 5-24 
 4-65 
 
 815 
 
 8-27 
 
 8-66 
 
 10-28 
 
 10-66 
 
 10-35 
 
 Total 
 
 9340 
 
 17,404 
 
 1 in 16-47 
 
 1 in 7-28 
 
 3-65 
 
 10-20 
 
 Thus it appears, that, on the whole, the daily per 
 centage of invalids among the members of the temi)er- 
 ance societies was but 3-65, whilst in the remainder of 
 the troops it was 10*20, or nearly three times as great. 
 The Cameronian regiment, stationed in Fort William in 
 the years 1837 and 1838, lost only twenty-six men 
 in the first of these years, and twenty-two in the second ; 
 whereas the average mortality in Fort William, for a 
 period of fourteen years previously, had been nearly 
 seventy'two. The proportion of the regiment which 
 belonged to the Temperance Society was continually 
 varying ; but the general result of its operation was, 
 that, since the arrival of the regiment in India, its an- 
 nual consumption of spirits diminished from 10,000, 
 12,000, and even 14,000 gallons, to 2,516 ; the amount 
 drunk in 1837 having been 9,673 gallons less, and in 
 
88 
 
 EFFECTS OF ALCOUOL 
 
 1838, 8,242 gallons less, than the regiment was entitled 
 to draw. On the other hand, a considerable amount of 
 beer and wine had been drunk ; but these beverages are 
 far less injurious to health, especially in India, than 
 distilled 8])irits. 
 
 80. Having learned that the 84th Regiment of Her 
 Majesty's Foot has for some time enjoyed the reputation 
 of l)eing one of the most temperate and well-conducted 
 regiments in the European portion of the Indian army, the 
 writer has consulted the Army Medical Returns, for the 
 purpose of ascertaining whether its rate of mortaUty has 
 diflfered in any marked degree from the average given 
 above; more especially since it has been quartered at 
 Secunderabad, which lies under the bad repute of being 
 one of the most unhealthy stations in the Madras Presi- 
 dency. That this bad repute is well deserved is shown 
 by the fact, that the annual mortality, for an average of 
 fifteen years previously to 1846-7, has been 7*5 per 
 cent ; nearly double the average of the whole presi- 
 dency, and more than double the average of the other 
 stations. The evil seems traceable to the insuflScient 
 barrack-accommodation rather than to the condition of 
 the surrounding country ; for one-third of the men are 
 obliged to sleep in the verandahs, and the remainder 
 have by no means a due allowance of fresh air ; whilst 
 the officers of the regiment quartered there, and the 
 artillery company, who are better lodged, have not shown 
 any excess of mortality above the average. 
 
 81. Now, in the year 1846-7, the average strength of 
 her majesty's troops in the Madras Presidency was 5,963, 
 and the number of deaths was 251, or 4 21 per cent; which 
 is rather above the average mortality in this presidency, 
 
ON THE HEALTHY SYSTEM. 
 
 89 
 
 calculated by Colonel Sykcs from tlic return;^ of twenty 
 years. During the first eight niontlis of this j.diod, 
 the 84th regiment was (quartered at Fort St. George, 
 Madras, which is considered a healthy station ; it then 
 performed a march of between four and five hundred 
 miles to Secunderabad, in an unusually wet season, the 
 roads (such as they were) being in some parts knee-deep 
 in water ; * and it took up its quartera at Secunderabad, 
 about two months previously to the date of the return 
 (April Ist, 1847). The medical return of the regiment 
 for this year presents us with the almost unprecedentedly 
 low number of thirteen deaths in an average strength of 
 1,072 men ; the mortality being thus at the rate of only 
 1*21 per cent. Now, during the same period, the 63d 
 regiment, which was quartered at Secunderabid up to 
 February Ist, 1847 (or nine months out of the twelve), 
 lost seventy-three men, which was at the rate of 788 
 per cent for the entire year ; whilst the moi-tality for all 
 the other stations in the Mjidras command was only 3*02 
 per cent for the same year. Hence we see that the 
 mortality of the 84th regiment for the year 1846-7 was 
 only two-fifths of that of the average of the healthier 
 stations in the Madras Presidency, which average its 
 own very low rate contributed to reduce. 
 
 82. During the year 1847-8, the total mortality in 
 the Madras Presidency was 227 to 6,040 of average 
 strength, or 8*76 per cent ; but this reduction from the 
 preceding year was not due to any considerable difference 
 in the rate of mortality at the other stations, being 
 almost entirely consequent upon the diminution in the 
 
 * Of this march a more particular account wU be given fur- 
 ther on (§ 140). 
 8* 
 
90 
 
 EFFECTS OF ALCOHOL 
 
 number of deaths at Secunderabad. For the 84th 
 regiment, which remained at that station during the 
 whole year, lost in that time no more than thirty-nine 
 men out of an average strength of 1,139, so that it« per 
 centage mortality was only 3-42 ; which was below the 
 general average of the presidency, and less than half 
 the average rate at Secunderabad for fifteen years 
 previously. It seems impossible to attribute these re- 
 markable results to any thing but the abstinent habits 
 of the soldiers of this regiment; a large proportion of 
 them being total abstainers^ and those who were not go 
 being very moderate in their consumption of alcoholic 
 liquors. 
 
 83. The comparison of the returns of this regiment 
 with those of others less remarkable for sobriety, affords 
 a full confirmation of the dediiCtions drawn from the 
 statistics of crime in this country, as well as from indi- 
 vidual observation, in regard to the influence of habitual 
 intemperance upon the moral conduct. That a large 
 proportion of offences amenable to punishment, both in 
 the civil population and in the military and naval ser- 
 vices, 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 respgcts 
 almost precisely the same, adds to the confidence with 
 which we may assert that intemperance is the chief 
 cause of crime. For, besides the immediate provocation 
 which alcoholic excitement may induce, it is indubitable 
 that habitual excess has a tendency to debase the moral 
 tone, and to weaken the controlhng power of the will ; an 
 
ON THE HEALTHY SYSTEM. 
 
 91 
 
 ^^ 
 
 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 Col. 
 Reid, who was for some years governor of the Bermudas, and 
 subsequently of the Windward Islands, in favor of the beneficial 
 effects of total abstinence, in improving the physical condition, 
 and in promoting the general welfare, of a tropical population 
 composed of a mixture of Europeans with colored people. To 
 Col. Rcid belongs the high credit of being one of the few indivi- 
 duals, occupying situations of high ofRcial responsibility, 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 gover- 
 nors of colonies which are laid before Parliament, and published, 
 Col. lleid speaks as follows, with reference to Barbadoes : " I en- 
 deavored, on my first arrival here, to revive a temperance society 
 which had been before unsuccessfully attempted. This society 
 has now taken root in the midst of distilleries, and promises to 
 effect a great social revolution in West Indian habits." — Author. 
 
92 
 
 CHAPTER n. 
 
 DOES PHYSIOLOGY OR EXPERIENCE TEACH US 
 THAT ALCOHOLIC LIQUORS SHOULD FORM PART 
 OF THE ORDINARY SUSTENANCE OF MAN, PAR- 
 TICULARLY UNDER CIRCUMSTANCES OF EXPO- 
 SURE TO SEVERE LABOR, 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 PRINCI- 
 CIPLES OF SCIENCE, OR BY THE RESULTS OF 
 PRACTICAL OBSERVATION? 
 
 The reply to this question will be best furnished, in the 
 opinion of the writer, by considering seriatim * how far 
 science and experience lead to the belief, that the use of 
 alcoholic liquors is advantageous, as fitting the system 
 for the better endurance, — 1st, Of severe bodily exer- 
 tion ; 2d, Of severe mental exertion ; 3d, Of extreme 
 cold ; 4th, Of extreme Iieat ; 5th, Of morbific ag'en- 
 cies. From the results of these inquiries it will be 
 found not diflficult to draw deductions as to the pro- 
 priety, or otherwise, of making alcoholic liquors foim 
 part of the sustenance of man under ordinary circum- 
 stances. 
 
 I. ENDURANCE OF BODILY EXERTION. 
 
 85. All bodily exertion is performed by the instru- 
 mentahty of the muscular apparatus, which is called 
 
 * Seriatim, in order. 
 
SUPPOSED USES OF ALCOHOL, ETC. 
 
 93 
 
 into play by tlio agency of the nervous system. It is 
 requisite, therefore, tliat we should begin by inquiring 
 into the conditions under which their powers are 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 sliall be ade- 
 quately supplied with the materials of growth 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 develop new tissue, 
 to meet increasing demands upon their functional ac- 
 tivity. 
 
 II. The functional activity y both of the nervous and 
 muscular systems, involves the disintegration ■\ of a 
 certain amount of their component tissues, by the agency 
 of oxygen : the evolution of their 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 compounds 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 provided for. 
 Both these systems consequently require, as the condition 
 of their highest activity, that they shall receive an ade- 
 quate supply of blood charged with oxygen, and purified 
 
 ♦ liegencration, new formation. 
 
 t Disintegration, separation into parts. 
 
94 
 
 SUPPOSED USES OF ALCOHOL 
 
 from the contaminating 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, 
 cceieris 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 nour- 
 ished, 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 per- 
 formance of those chemical changes which are involved 
 in every action of the muscular and nervous apparatus. 
 And if, besides being deficient in oxygen, the blood be 
 charged with carbonic acid, biliary matter, urea,f 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 ; and 
 all our present knowledge of the subject tends to prove, 
 
 * Cceteris paribus, other things being equal, 
 t Urea, matter of urine. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 95 
 
 Irove 
 
 that the albuminous * f matters of the blood, which con- 
 stitute the pabulum X 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 
 alcoholic liquors, then, as contributing to the nutrition of 
 muscular tissue ; except in so far as they may contain 
 albuminous matters in addition to the alcohol, which is 
 especially the case with " malt-hquors." But these mat- 
 ters 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 impossibility of any assistance being af- 
 forded 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 nitro- 
 gen : II and since alcohol is regarded by the chemist as 
 approximating the oleaginous *§> class of substances in its 
 
 * Albuminotis, nutritious. The white of egg is albumen. 
 
 t This term is here used to designate what are commonly known 
 as the protein compounds ; late researches ha^Hng tended to show 
 the incorrectness of the basis on which that appellation was 
 founded. — Author. 
 
 X Pabulum, food, nourishing matter. 
 
 II It is usually stated, on the authority of Fremy, that the fatty 
 acids of the nervous substance contain nitrogen. This, however, is 
 probably an error, arising from the substance of the brain or nerves 
 being submitted to analysis en masse ; for this substance consists 
 not merely of the fatty contents of the cells and tubes, but of their 
 albuminous walls ; and, thus regarded chemically, it is a mixture of 
 oleaginous with a small quantity of albuminous matter, which last, 
 when included in the analysis, would give to the former ingredient 
 the appearance of containing azote. (See Valentin's Lehrbuch der 
 Physiologic, Band i. p. 174.) — Author. 
 
 § Oleaffinous, oily, fatty. 
 
96 
 
 SUPPOSED USES OF ALCOHOL 
 
 ! 
 
 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 decay or decomposi- 
 tion ; yet this may be affirmed to be the case with alco- 
 hol, since the alcoholic fermentation is the first of a 
 series of degrading changes, which, if allowed to con- 
 tinue unchecked, terminates in the putrefactive process ; 
 and we can scarcely imagine, therefore, that it can be an 
 appropriate material fo/ the formation of the most ac- 
 tive 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 tis- 
 sues, 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 pabula for the several tissues are perfectly 
 innocuous whilst they retain their normal constitution ; 
 and their pretrence in the blood, in larger amount than 
 usual, though it may in various modes be a source of 
 functional derangement, never exercises any special dele- 
 terious influence upon the vital properties of the nervous, 
 muscular, or any other tissue. On these grounds, then, 
 it may be almost positively affirmed, that, notwithstand- 
 ing the chemical relation which alcohol bears to nervous 
 matter, it cannot serve, either in its original condition or 
 under any other guise, as a pabulum for the generation 
 of nervous tissue. 
 
 87. We seem justified by the laws of physiology, 
 therefore, in assuming that alcoholic hquors cannot sup- 
 
IN SUSTAINING THE VITAL POWERS. 
 
 97 
 
 Qstances 
 jan ever 
 )lace, we 
 id being 
 
 tissues, 
 jomposi- 
 ith alco- 
 rst of a 
 
 to con- 
 process ; 
 an be an 
 most ac- 
 chanism. 
 cation of 
 imal tis- 
 lecidedly 
 sen to be 
 Is which 
 perfectly 
 titution ; 
 mt than 
 ource of 
 ;ial dele- 
 nervous, 
 ds, then, 
 ithstand- 
 
 nervous 
 dition or 
 
 neration 
 
 jrsiology, 
 inqt sup- 
 
 ply the first of the requisites already enumerated for the 
 development of the physical power of the nervous and 
 muscular apparatus ; and we have next to consider 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 essen- 
 tial to the functional activity of the nervous and mus- 
 cular systems : on the contrary, its presence 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 influence 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 functional activity ; but it will also tend to check 
 the removal, by oxygenation, of those products of de- 
 composition whose continuance in the blood is attended 
 with most serious injury to the system. In so far, in 
 fact, as the presence of alcohol in the circulating current 
 tends to give to arterial blood a venous character, it must 
 thereby impair its power of serving as the e citing fluid 
 (for so we may term it) of the nervous and muscular 
 battery. And this it does, in the first instance, by 
 obstructing the ehmination of carbonic acid, as will be 
 shown hereafter (<§» 118) ; but more remotely by that 
 interference with the proper functional activity of the 
 liver and kidneys, which we have seen to be among the 
 most ordinary consequences of the free and liabitual use 
 of alcoholic liquors (§*§• 54 — 58). 
 
 88. But, although we are led by the preceding con- 
 
08 
 
 SUPPOSED USES OF ALCOHOL 
 
 t 
 
 siderations to regard the regular employment of alco- 
 holic liquors as rather a detriment 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 alco- 
 hol, 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 
 important to keep in view the difference between a tem- 
 porary and a sustained 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 condi- 
 tions will be favorable 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 influ- 
 ence of alcoholic stimulants ; or we may prolong its 
 generation by the same kind of assistance, when it would 
 otherwise have failed. But as every exertion of nervous 
 power, like that of muscular, involves the death and 
 decay of a certain amount of the tissue by which it is 
 evolved, there is a limit to the possibility of its genera- 
 tion ; so that we find the continuance, or even the in- 
 crease, of the stimulus ceasing after a while to produce 
 any effect ; and the exhausted power can only be recov- 
 ered by a lengthened period of repose, which shall allow 
 time and opportunity for the regenerating processes to 
 he performed, at the expense of nutrient material drawn 
 
IN SUSTAINING THE VITAL I'OWEIIS. 
 
 99 
 
 from the blood. Until this has been cfFectually accom- 
 plished, the nervous power is at least as much below par 
 as it previously was above it ; so that the loss is cer- 
 tainly 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 and duration of that subsequent de- 
 pression which speaks so unmistakably of the need of 
 rest and reparation. 
 
 89. Hence, therefore, we should anticipate, that, al- 
 though the use of alcoholic stimulants may enable a 
 greater amount of physical force to be put forth within 
 a given time than could otherwise be generated, they 
 can be of no assistance in the suslentation 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, severe bodily labor will be better 
 borne without alcoholic stimulants than with them, — 
 provided always that the digestive apparatus be in good 
 working ord'^r, and be adequate to prepare that amount 
 of alimentary material which is required for the regen- 
 eration of the tissues disintegi'ated by use. 
 
 90. We have now to inquire how far the results of 
 practical experience are coincident with these theoretical 
 views; and whether it is found, on actual trial, that 
 complete abstinence from alcoholic liquors is favorable, 
 or the reverse, to the endurance of severe bodily labor. 
 It cannot be denied, that the ideas current, among the 
 laboring classes more especially, as to the teachings f»f 
 experience on this point, are opposed to our theoretical 
 deductions. But there are many circumstances whicli 
 
100 
 
 SUPPOSED USES OF ALCOHOL 
 
 
 should lead us to mistrust the popular voice on such a 
 question, and to seek for proofs of a kind that may be 
 more firmly relied on. The "universal experience" of 
 former generations might be quoted in favor of a multi- 
 tude of absurd notions, which we now treat as simply 
 ridiculous ; and when there is this additional complica- 
 tion, that the liking for alcoholic liquors is such as very 
 readily to make " the wish father to the thought," we find 
 an additional ground for suspicion. But the chief cause 
 of our mistrust is this, — that there is no appreciation, in 
 the popular mind, of the connection between the immediate 
 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 increase the bodily 
 vigor for a time; and this increase is set down as so 
 much positive gain, no account being taken of the sub- 
 sequent depression, which is considered as ordinary fa- 
 tigue. 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 labor executed with and without the aid 
 of fermented hquors, 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 vigor of the system, rather than of its power in 
 a state of excitement. 
 
 91. It would be easy to cite several modern testi- 
 monies to the superiority of the abstinence principle (to 
 8iiy 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 working 
 
IN SU8TAININ(1 THE VITAL POWERS. 
 
 101 
 
 >) 
 
 of 
 
 as a pressman in a London printing-house, an<l takinj^ 
 only bread and water instead of the porter which his 
 companions drank (as they said) to acquire strength for 
 their work, to carry a large form of letters in each hantl 
 up and down stairs, to the astonishment of his porter- 
 drinking companions, Avho found one of them a sufficient 
 load; whilst the latter assures us, that, in a recent 
 excursion amidst the mountains and valleys of Switzer- 
 land, which were chiefly traversed on foot, he found his 
 own " sexagenarian " vigor, sustained by cold water only, 
 quite on a par with that of his younger companions, who 
 indulged in a moderate allowance of wine.* Such 
 examples, however, might be regarded as exceptional 
 because individual, and as affording no contradiction of 
 the supposed general result of experience. They prove, 
 however, that there is nothing positively incompatible 
 in the habit of total abstinence from alcohohc liquori 
 with the sustenance of a high degree of nervo-muscular 
 power. And it may be well to fortify this position Avith 
 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 wri- 
 ter, that, after five years' experience of the abstinence 
 system, he "found hard work easier, and long houi-M 
 more readily to be endured; " and that, being a member 
 of the Fire Brigade, he was on one occasion called upon 
 for continuous exertion for seventy-three hours, which he 
 endured, with no other beverage than coffee and ginger- 
 beer, while all his comrades were "beat and fell away."' 
 The following statement, forwarded to the writer from 
 
 * Physician's Holiday, p. 26, and passim. 
 
 9* 
 
102 
 
 SUPPOSED USES OF ALCOIIOIi 
 
 Leeds, was signed bj thirty-four men engaged in la- 
 borious employments ; out of whom twelve belonged to 
 the class whose occupations are commonly regarded aa 
 peculiarly trying, seven of them being furnace-men at 
 foundries and gas-works, two of them sawyers, one a 
 whitesmith, one a glass-blower, and the last a railway 
 guard : " We, the undersigned, having practised the 
 principles of total abstinence from all intoxicating liquors 
 during periods ranging from one to ten years, and hav- 
 ing, during that time, been engaged in very laborious 
 occupations, voluntarily testify, that we are able to per- 
 form our toil with greater ease and satisfaction to our- 
 selves (and, we believe, more to the satisfaction of our 
 employers also) than when we drank moderately of these 
 liquors ; our general health and circumstances have also 
 been considerably improved." * With regard to har- 
 vest-work, again, which is extremely trying to the 
 strength, both from the continuity of the exertion re- 
 quired, and the heat of the weather at 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 endeavor to support 
 their strength upon fermented liquors ; and that, if an 
 adequate supply of nutritious food be provided for them, 
 the former will even increase in weight, whilst going 
 through this severe toil. In some parts of the county 
 of Cornwall, where the "abstinence system" is more 
 extensively practised than in any other county in Eng- 
 land, it is the general practice to get in the harvests 
 without any allowance of fermented liquors ; — many 
 
 * See Appendix B. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 103 
 
 laborers who are habitually m(xlerato drinkers feeling the 
 benefit of the " abstinence system " at such times. 
 
 93. The following example, drawn from another 
 source, is of peculiar 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 labor, not merely of the crew, but also of 
 the oflScers and passengers, to keep her afloat during the 
 remainder of her voyage, a period of nearly three months. 
 At first, the men were greatly fatigued at the termina- 
 tion 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 vigor was decidedly diminishing, and their 
 feehng of fatigue increasing, as might be expected on the 
 principles already laid down. By the directions of their 
 commander (who, although very moderate in his own 
 habits at the 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, with the biscuit and meat, at the con- 
 clusion of every watch. It was then found that the men 
 felt inchned for a good meal of the latter, wiien the more 
 direct but less effective refreshment of the alcoholic liquor 
 was withdrawn ; their vigor returned ; their fatigue di- 
 
104 
 
 SUPPOSED USES OF ALCOHOL 
 
 
 minished; and, after twelve weeks of incessant and 
 severe labor (with no interval longer than four hours), 
 the ship was brought into port with all on board of her 
 in as good condition as they ever were in their lives. 
 
 94. Numerous examples might be cited of compara' 
 five trials between two sets of laborers, as nearly as 
 possible alike in other respects, but the one practising 
 total abstinence, whilst the other has rehed upon the 
 assistance of alcohohc liquors. So far as the writer is 
 aware, all these contests have given results in fcivor of 
 the abstinence system, when the period of the experi- 
 ment has been sufficiently protracted to give its merits a 
 fair trial; and, although it may be asserted that such 
 results are one-sided, as having been made known to the 
 public by the professed advocates of a system^ yet, con- 
 sidering the very large interests involved in the main- 
 tenance of the existing state of things in regard to the 
 use of fermented liquors, it might be reasonably expected 
 that their upholders would make known to the world 
 any results of an opposite description, had they really 
 occurred. The following statement, furnished to the 
 writer by a gentleman at Uxbridge, has the advantage of 
 being the comparative return of the regular labor of a 
 whole year, performed by two sets of men, the one work- 
 ing on the "abstinent," the other on the "moderate" 
 system, but not pitted against each other in a contest for 
 victory. It relates to brick-making, which is commonly 
 accounted one of the most laborious of all out-door em- 
 ployments. " (^ut of upwards of twenty-three milhons 
 of bricks made in 1841 by the largest maker in the 
 neighborhood, the average per man made by the beer- 
 drinkers in the season was 760,269 ; wliilst the average 
 
 
IN SUSTAINING THE VITAL POWERS. 
 
 105 
 
 for the teetotalers was 795,400, which is 35,131 in 
 favor of the latter. The highest number made by a 
 beer-drinker was 880,000 ; the highest number made by 
 a teetotaler was 890,000; leaving 10,000 in favor of 
 the teetotaler. The lowest number made by a beer- 
 drinker was 659,500; the lowest number made by a 
 teetotaler was 746,000 ; leaving 87,000 in favor of the 
 teetotaler. Satisfactory as the account appears, I believe 
 it would have been much more so, if the teetotalers could 
 have obtained the whole 'gang' of abstainers; as they 
 were very frequently hindered by the drinking of some 
 of the gang ; and, when the order is thus broken, the 
 work cannot go on." 
 
 95. The experience of large bodies of men, which 
 becomes matter of public notoriety, is in many respects 
 preferable, as demonstrating (to say the least) the per- 
 fect compatibility of abstinence from alcoholic liquora 
 with the highest degree of physical vigor, and with the 
 greatest power of endurance of bodily labor. Thus 
 almost every traveller who has visited Constantinople has 
 been struck with the remarkable muscular powers of the 
 men engaged in the laborious out-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 rowers in the 
 world, drink nothing but water; and they drink pro- 
 fusely during the hot months of summer. The boatmen 
 and water-carriers of Constantinople are decidedly, in 
 my opinion, the finest men in Europe as regards their 
 physical development, and they are all water-drinkers." * 
 
 • Sanitary Report, 1840, p. 252. 
 
j 
 
 106 
 
 SUPPOSED USES OF ALCOHOL 
 
 And several other observers bear testimony to the exti-a- 
 ordinary strength of the porters of Constantinople, who 
 are accustomed to carry loads far heavier than EngUsh 
 porters would undertake, even under the stimulus of 
 alcoholic beverages ; yet these Turkish porters never 
 drink any thing stronger than coffee. 
 
 96. The following statement, made upon the authority 
 of Mr. Tremenhere, one of the commissioners employed 
 to report on the state of the mining population, shoAvs 
 how completely the doctrines of the reputedly " universal 
 experience," in regard to the support afforded by alco- 
 holic liquors to the laborious artisan, are negatived by the 
 results of a change of habit, forced upon those most 
 unwilling to adopt it. "A remarkable and most satisfac- 
 tory instance," says Mr. T., "of a successful attempt to 
 put a check upon the indulgence in ardent spirits, has 
 occurred at the iron-works of Messrs. Houldsworth, of 
 Coltness, employing about eight hundred colliers, miners, 
 furnace-men, &c. Much loss and annoyance had fre- 
 quently been occasioned by the negligent or wilful mis- 
 conduct of workmen under the influence of this habit ; 
 and the Messrs. Houldsworth, having in vain endeavored 
 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 the furnace-men should not be allowed to 
 di'ink spirits during their hours of labor. 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 remon- 
 strated strongly, and affirmed that it was impossible for 
 
IN SUSTAINING THE VITAL POWERS. 
 
 107 
 
 them to do their work without this quantity of whiskey. 
 They were not long, however, 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 or 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 afterwards informed, that, 
 among the colliers and miners, there was a marked im- 
 provement from the same cause." 
 
 97. The experiment has now been carried on upon a 
 still larger scale, for many years, amongst the seamen of 
 the merchant-service, both of this country and the United 
 States ; and the result has been, with few exceptions, 
 so favorable to the abstinence principle, that it is now 
 adopted by a very large proportion of American trading 
 vessels ; to whose general superiority in equipment and 
 management over the mercantile marine of this country, 
 in the greater part of which the employment of alcoholic 
 liquora is still continued, a large body of evidence was 
 recently given before a committee of the House of Com- 
 mons. The exceptions just alluded to relate to the 
 reputed liability of . " temperance" seamen to suffer from 
 endemic* or malarious f diseases. Into this point we 
 shall inquire under a subsequent head; and the writer 
 thinks that it will there appear that this liability, if it 
 really exist, results from the deficiency of any measures 
 that shall serve as a substitute for the alcoholic stimulus, 
 
 * Endemic, arising from the locality, 
 t Malivious, arising from noxious vapors, as from awamps. 
 
i I 
 
 i [ 
 
 108 
 
 SUPPOSED USES OF ALCOHOL 
 
 in rendering the system less obnoxious to the influence 
 of the poisonous emanations to which it is exposed 
 {§§ 145—147). 
 
 98. The writer has had the opportunity of ascertain- 
 ing from ship-owners who have adopted the "temperance" 
 system (Avhich, on board ship, is equivalent to " total ab- 
 stinence" — no other alcoholic liquor being substituted for 
 spirits), that they have found no difficulty in obtaining 
 the services of excellent seamen, when a fair compensa- 
 tion is made in the superior quality of the provisions and 
 allowances, or in the rate of wages, for the " stopping of 
 the grog." In fact, such ships are in positive request 
 among seamen of the best character; proving that, in 
 spite of the well-known attachment of their class to 
 spirituous liquors, they are sensible of the advantages of 
 habitual abstinence from them. The writer, having him- 
 self made a voyage to the "West Indies and back, some 
 years since, in a "tempeitmce ship," had the opportu- 
 nity of remarking, that, during a heavy gale of nearly 
 three days' duration, which was continually taxing to the 
 uttermost the strength of a crew far too small for the size 
 of the ship, the men were at least as ready for the renewal 
 of their exertions as they would have been if supported 
 by alcoholic stimulants ; whilst in various rowing matches 
 which took place between them and the crews of other 
 ships, whilst lying in port, they were generally the victors. 
 This last fact is not cited as proving the superiority of the 
 abstinence system, since the difference might be attributed 
 to the superior physical power of the crew ; but it suffi- 
 ciently indicates that there is in the " abstinence system" 
 nothing" unfavorable to the maintenance of that power 
 during the vicissitudes of a seaman's life. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 109 
 
 influence 
 exposed 
 
 iscertain- 
 perance" 
 total ab- 
 ituted for 
 obtaining 
 lompensa- 
 isions and 
 topping of 
 '^e request 
 g that, in 
 r class to 
 antages of 
 Lving him- 
 )ack, some 
 B opportu- 
 of nearly 
 dng to the 
 for the size 
 he renewal 
 supported 
 ng matches 
 rQ of other 
 the victors, 
 ority of the 
 ) attributed 
 fut it suffi- 
 ce system" 
 that power 
 
 99. The following extract from a private letter from a 
 captain in the merchant-service, contained in the " Ad- 
 viser" for October, 1849, gives a valuable testimony in 
 favor of this conclusion: "I harbored in Newfoundland 
 on the 23d of December last, the coldest day that had 
 been registered there for the last six years ; the thermo- 
 meter on shore indicating twenty degrees below zero. I 
 can honestly say, it was the most severe frost I ever was 
 in on the water, during the twenty-nine years that I have 
 been employed in the Newfoundland trade. I remained 
 on shore from the time mentioned above until the 2d of 
 March, and then embarked for Bi*azil, where, in April, 
 we had the thermometer ranging from 80° to 87°, and 
 remained in that climate till the middle of July. All 
 that time, the whole of my crew, with two exceptions, 
 were strictly teetotal, and all able to eat their alloAvance, 
 and do their share of hard work, in the sun and out of it, 
 taking in and out cargo. The two exceptions did, in one 
 solitary instance, infringe the law ; and they paid the 
 penalty in severe headache and debilitj? for some days.*' 
 
 100. It is rare for any occasion to present itsell, during 
 the march of an army, of testing the power of sustain- 
 ing this kind of prolonged exertion, without the supposed 
 assistance derived from the use of alcoholic liquors ; but 
 opportunities of this kind have occurred, the abstinence 
 having been in some instances voluntary, whilst in others 
 it was compulsory ; and the results have in both cases 
 been most completely confirmatory of the principles for- 
 merly laid down. Two of the most striking examples 
 of this kind within the writer's knowledge will be men- 
 tioned hereafter, under the head of "Endurance of Heat" 
 
 iiese marches having been performed 
 
 (§^ 
 
 141) 
 
 10 
 
no 
 
 SUPPOSED USES OF ALCOHOL 
 
 under an elevation 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 Corunna, the army was found to improve in 
 health and vigor, 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 operated unfavorably 
 (according to the invariable experience of retreating 
 armies) upon their physical powers. 
 
 101. The experience of whole nations, previously to 
 the introduction of alcohohc liquors amongst them, is 
 equally in favor of the assertion, that prolonged and 
 severe muscular exertion may be at least as well borne 
 without their assistance as with it. Where for example, 
 shall we meet with greater power of endurance of toil 
 than was displayed by the North American Indians in 
 " following a trail," before their i*ace became deteriorated 
 by European vices 7 
 
 102. The question, it may again be remarked in con- 
 clusion, is not to be decided by the amount of strength 
 which may be put forth at a single eflfort. 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 eflfort to be success- 
 ful in doing that which could not have been accomphshed 
 without it. But there is reason to believe, that the power 
 of sustahicd exertion is thereby impaired, and that those 
 who have habitual recourse to this stimulus are really 
 doing themselves more harm than good. This jvill be 
 
IN SUSTAINING THE VITAL POWERS. 
 
 Ill 
 
 most assuredly the case, when they allow it to take the 
 place of the solid food, which their nervous 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 muscu- 
 lar exertion, is generally to diminish rather than to in- 
 crease the desire for solid aliment ; as the examples above 
 quoted clearly indicate. And, as it is the latter alone 
 that can aflford 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 vigor. 
 
 II. ENDURANCE OF MENTAL EXERTION. 
 
 103. All that has been said of the influence of alco- 
 holic 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 phy- 
 siologist, that the brain is the insirument by which all 
 mental power is exercised, in man's present state of ex- 
 istence, and that the continued development of this power 
 is consequently dependent upon those conditions which are 
 favorable to the maintenance of the functional activity of 
 the nervous system in general. These conditions we have 
 seen to be — (I.) The healthy nutrition of the nervous sub- 
 stance; and (II.) The due supply of highly oxygenated 
 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 degi-ee improbable that they can be of the 
 
112 
 
 SUPPOSED USES OF ALCOHOL 
 
 i 
 
 ! 
 
 least advantage to it. The latter cannot in any degree 
 be improved, but must be rather impaired, by the use 
 of fermented hquors ; which, as already stated, tends to 
 deteriornte the quality of the blood, and to obstruct its 
 oxygen' *ion. 
 
 104. That the use of alcoholic stimulants, however, is 
 attended in most persons with a te7}iporary excitation 
 of mental activity, lighting up the scintillations of genius 
 into a brilliant flame, or assisting in the prolongation of 
 mental effort when the powers of the nervous system 
 would otherwise be exhausted, may be freely conceded ; 
 and it is upon such evidence as this that the common 
 idea is based, that it supports the system under the 
 endurance of mentul labor. This idea, however, is pro- 
 bably as erroneous as the no less prevalent fallacy of 
 regarding alcohohc liquors as capable of increasing the 
 power of physical exertion. No physiological fact is 
 better estabhshed than that of the depression of the men- 
 tal energy consequent upon the undue excitement of it, 
 by whatever causes that excitement may have been occa- 
 sioned ; and the rapid and brilliant flow of thought which 
 may have been called forth by the alcohohc stimulants 
 gives place, usually after a few hours, to the oj^posite 
 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 conceptions, or to the sallies of 
 wit or humor. It is not to be wondered at, then, that men 
 possessing such powers should have recourse to alcoholic 
 stimulants as a means of procuring a temporary exalta- 
 tion of them, and of escaping from the fits of depi-ession 
 
IN SUSTAINING THE VITAL POWERi?. 
 
 113 
 
 to which most persons are subject in whom the imagina- 
 tive and emotional 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 stimulating 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 
 pecuharly great in such individuals, completely destroy- 
 ing for a time the power of mental effort ; and hence it 
 does not at all follow, that either the authors of the pro- 
 ductions 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 habit- 
 ually had recourse to alcoholic stimulants for the excite- 
 ment of their powers, they have died at an early age, as 
 if in consequence of the premature exhaustion of their 
 nervous energy : Mozart, 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 shone 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 distin- 
 guished for that combination of intellectual powers which 
 is known as talent are disposed to make such use of 
 alcoholic stimulants for the purpose of augmenting their 
 mental powers ; for that spontaneous activity of the mind 
 itself, which it is the tendency of alcohol to excite, is not 
 favoraljle to the exercise of the observing and purely 
 10* 
 
1 
 
 114 
 
 SUPrOSED USES OF ALCOHOL 
 
 reasoning faculties, or to the steady devotemcnt of con- 
 centrated attention 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 labor which has most extended the domain of 
 human knowledge has been performed by men of re- 
 markable sobriety of habit, many of them having been 
 constant water-drinkers. Under this last category, it is 
 said,* may be ranked Demosthenes and Ilaller ; Dr. 
 Johnson, in the latter part of his life, took nothing 
 stronger than tea, while Voltaire and Fontenelle used 
 coffee ; and NcAvton and Hobbes were accustomed to 
 solace, not to excite, themselves with the fumes of 
 tobacco. In recrard to Locke, whose lonj; life was 
 devoted to constant intellectual labor, and who appears, 
 independently of his eminence in his special objects of 
 pursuit, to have been one of the best-informed men of his 
 time, the following very explicit and remarkable testi- 
 mony is borne by one who knew him well: "His diet 
 was the same as other people's, except that he usually 
 drank notliinn; l)ut water: and he thoudit that his absti- 
 nence in this respect had preserved his life so long, 
 although his constitution vras so Aveak." | 
 
 * Macnish's Anatomy of Drunkenness, p. 36. 
 t Life by Lord King, vol. ii. p. 60. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 115 
 
 107. Having, for several years past, been himself 
 performing an amount of steady mental labor, wliich to 
 most persons would appear excessive, the writer may be 
 allowed to refer to his own experience, which is alto- 
 gether in favor of total abstinence from alcoholic liquors, 
 as a means of sustaining the power of perfijrming it. 
 Having been brought up as a water-drinker, he never 
 accustomed liimself to the habitual use of alcoholic 
 liquors ; scarcely ever tasting them, except wlicn occa- 
 sionally led to do so by social influences, or Avhen he 
 believed that a small amount of stimulus would improve 
 the "tone" of his system, which is liable to a peculiar 
 relaxation in certain states of the atmosphere. On 
 determining, about four years since, to give up the oc- 
 casional use of wine, o,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 his system ; and 
 for some time he continued to have occasional recourse 
 to alcoholic stimulants (never exceeding a single gjass of 
 wine, or lialf a tumbler of bitter ale), when he felt him- 
 self suffering under the peculiar depression just referred 
 to. He gradually, however, found reason to doubt the 
 utility of tlic remedy, and has for the last two years 
 entirely given it up. During these two years, he has 
 gone tlnonu'h a larger amount of mental labor than he 
 ever did Ix'fore in the same period of time ; and he does 
 not hesitate to say, that he has performed i^ with more 
 ease to liiiuH^elf than on his former system, and that he 
 has been iiioro free than ever from tliosc states of depres- 
 sion of mental energy which he Avas accustomed to regfird 
 as indicating the need of a temporary support to antago- 
 nize tlic depressing cause. In fact, he now finds, that, 
 
116 
 
 SUPPOSED USES OF ALCOHOL 
 
 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 attri- 
 butes this change to his entire disuse of alcoholic liquors 
 under all other circumstances ; and he cannot but beheve, 
 that the results which ho 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 them- 
 selves as deriving from their use, arises from their simply 
 removing for a time the depression which results (at a 
 long interval, it may be) from tlieir previous employ- 
 ment. 
 
 108. Two remarkable cases have recently fallen within 
 the author's knowledge, in which individuals leading a 
 hfe of considerable intellectual exertion, and long habitu- 
 ated to the moderate use of stimulants, have derived 
 considerable benefit from their relinquishment. In one 
 of these cases, a pint of ale was the usual daily allow- 
 ance ; to which a little spirits and water at night was 
 occasionally added. The relinquishment was commenced 
 as an experiment, and without any intention of perse- 
 vering should it not succeed ; but the benefit has been 
 so great that the abstinence has been subsequently con- 
 tinued 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 ; 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 
 
IN SUSTAINING THE VITAL POWiiUH. 
 
 117 
 
 point at wliicli ho left off the night hefor j. In the other 
 instance, the usual daily allowance was from two to four 
 glasses of wine ; and this was affirmed to l)e necessary to 
 keep dotrn a state of mental excitement to which the 
 individual was sulyect, and to hracc the mind to steady 
 exertion. Failing health, however, having occasioned a 
 recourse for a time to the hydropathic treatment, this 
 gentleman, on returning in a state of renewed vigor to 
 his usual avocations, wisely determined to persevere in 
 the disuse of stimulants ; and he has since continued 
 to pmctise the abstinent system, with great benefit to 
 his bodily and mental health. 
 
 109. Even if we admit, however, that a certain amount 
 of mental laljor may be performed with more facility in a 
 limited time under the moderate use of alcoholic stimu- 
 lants, it is still questionable, whether we do not, on the 
 whole, rather lose than gain by their employment. For, 
 if they cannot afford pabulum* for the fomiation of 
 nervous matter, and if their influence is exerted rather 
 in producing its disintegration than its growth, its de- 
 struction rather than its construction, it follows that 
 every excess of exertion performed under their influence 
 must be followed by a corresp;">ndingly long period of 
 incapacity, during which the regenerating processes have 
 to be performed, and the brain again fitted for the dis- 
 charge of its duties ; and, if it should be forced into acti- 
 vity 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 in- 
 creased. These theoretical predictions are, it is believed, 
 
 ♦ Pabulum, food, material of growth. 
 
118 
 
 SUPPOSED USES OF ALCOHOL 
 
 II 
 
 in full accordance with what observation teaches with 
 respect to the results of rehance upon alcoholic stimu- 
 lants for support during mental labor ; although, for 
 obvious reasons, it is not possible to obtain the same 
 pointed and decisive evidence on this topic a« in regjird 
 to the endurance of physical exertion, or of extremes of 
 temperature. But it is frequently urged, that although 
 the use of alcoholic liquors to produce a stimulating 
 action upon the brain is injurious, yet that bencifit 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 exhaustion of nervous 
 power prevents it from duly appropriating. This doc- 
 trine, which equally applies to the state of imperfect 
 indigestion resulting from other causes, will be better 
 considered when we have inquired into the reputed effi- 
 ciency 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 OF COLD. 
 
 110. The power of alcoholic liquors to enable the kxly 
 to resist the depressing influence of external cold, is per- 
 haps the best established of all its attributes, not merely 
 in the estimation of the uninformed public, but in the 
 opinion of those who have scientifically 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 affijrd uimiis- 
 takable evidence of its heat-producing power ; and* the 
 
IN SUSTAINING THE VITAL POWERS. 
 
 119 
 
 chemical 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 affords 
 the material for that combustive process by which the 
 heat of the body is sustained in a form peculiarly suita- 
 ble 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 state- 
 ments than they legitimately support. For his argu- 
 ments 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, as 
 they exert no stimulating influence, the objection raised 
 against alcohol cannot apply. That we may place this 
 question 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 appro- 
 priated to this purpose, — are positions in which there is 
 now such a general agreement amongst physiologists, 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 -f and the 
 
 * Non-azotized, containing no nitrogen, 
 t Saccharine, sweet, sugary. 
 
120 
 
 SUPPOSED USES OF ALCOHOL 
 
 oleag'inoiis ; the former including 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 proportion- 
 als 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 combustion they re- 
 quire 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 soUd fats, consists 
 of 136 carbon, 132 hydrogen, and 10 oxygen. Multiply- 
 ing the numbers of the former by llf, so as to bring them 
 better into comparison with the latter, f we find that — 
 
 lis equiv. of starch = 140 carbon, 105 hydrogen, 105 oxygen. 
 1 equiv. of stearine =136 carbon, 132 hydrogen, 10 oxygon. 
 
 Now, in the former case, the number of equivalents of 
 oxygen necessary for the conversion of the starch into 
 
 * Hydrates of carbon, compounds of carbon with hydrogen. 
 
 t We thus make the sum total of the weights of carbon and 
 hydrogen very nearly the same in the two cases ; for 
 
 140 equiv. of carbon (140 X 6) = 840 
 and 105 equiv. of hydrogen (105 X 1) = 105 
 
 whilst 136 equiv. of carbon (136 X 6) 
 and 132 equiv. of hydrogen (132 X 1) 
 
 [AUTHOK.] 
 
 945 
 
 816 
 132 
 
 948' 
 
IN SUSTAINING THE VITAL POWERS. 
 
 121 
 
 laceous 
 e latter 
 er may 
 )ortion- 
 water ; 
 ; much 
 ic acid, 
 le latter 
 hey re- 
 jon into 
 
 of the 
 iviously 
 r starch 
 
 whilst 
 consists 
 iultiply- 
 ng them 
 hat — 
 
 5 oxygen. 
 
 oxygon. 
 
 alents of 
 Tch into 
 
 ogen. 
 irbon and 
 
 3 
 5 
 
 carbonic acid and water will be no more than that required 
 for the change of its carbon 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 Avith 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 combustive pro- 
 cess is required, therefore, for the conversion of stearine 
 into carbonic acid and water, than for effecting the same 
 conversion upo" starch; for not only is the quantity 
 of free oxygen "o xoaeA much larger, but the amount of 
 heat generated j- e much greater; since much more 
 heat is produced by the combustion of hydrogen thin 
 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 alcohol by 31| , 
 which will bring the total weight of its carbon and hy- 
 drogen exactly to the same figure with that of 11 1 of 
 starch.* 
 
 314 equiv. of alcohol = 126 carbon, 189 hydrogen, 63 oxygon. 
 
 * For 126 equivalents of carbon (126 X 6) 
 and 189 equivalents of hydrogen 
 
 11 
 
 [Author.] 
 
 7o6 
 
 189 
 
 no 
 
122 
 
 SUPPOSED USES OF ALCOHOL 
 
 Thus, then, in the combustion of this amount of alcohol, 
 there will not merely be required (126 X 2 =) 252 
 equiv. of oxygen, for the conversion of its carbon into 
 carbonic acid; but as (189 — 63) 126 equivalents of 
 hydrogen exist in the compound without any equivalent 
 of oxygen, that number of equivalents of oxygen will be 
 required to convert all the hydrogen into water, making 
 in all (252 + 126 =) 378. This amount is not far 
 from that required by an equivalent quantity of ^tearine ; 
 and, as a much larger proportion of it is consumed by the 
 hydrogen, it is obvious that the heat produced must be 
 greater than that evolved by the combustion of an equal 
 weight of hydro-carbon contained in the latter. 
 
 113. Considered, therefore, merely in the light of /we/, 
 alcohol is superior to oleaginous substances, whilst it is 
 of far higher value than any substance of the saccharine 
 group ; and of this the chemist is practically aware, for 
 he finds that a spirit-lamp gives more heat than an oil- 
 lamp. Were the human body simply a lamp or a fur- 
 nace, therefore, we should have no room for doubt as to 
 the efiiciency of alcohol in maintaining its heat ; and it is 
 because the influence of alcohol upon the vital functions 
 is too much disregarded, its share in the mere chemical 
 process of combustion being too exclusively kept in view, 
 that notions are entertained of its value, which are con- 
 tradicted by lengthened and extended experience. This 
 will be best understood, if we examine, in the first 
 instance, into the circumstances under which other non- 
 azotized substances taken in as food are made to contri- 
 bute to the maintenance of heat. 
 
 114. Of such substances, a certain amount is usuallv 
 circulating in the blood. All analyses indicate the ex- 
 
IN SUSTAINING THE VITAL POWERS. 
 
 12a 
 
 istence of fatty mattei*s in that fluid : their proportion, 
 however, varies considerably, being much greater after a 
 full meal, of which oleaginous matters have formed a part. 
 Although the amount is usually not too large to be held 
 in solution l)y the alkali of the blood, yet the serum of 
 blood, drawn within a few hours after such a meal, is 
 usually found to be rendered opa(j[ue or milky, by the 
 presence of an unusual quantity of oleaginous particles 
 suspended in it, in a siate of very fine division. These, 
 however, gradually diminish in amount; and, in a few 
 hours more, the serum becomes clear again, indicating 
 that these particles have been in some way disposed of. 
 This, we can scarcely doubt, is the consequence of their 
 having been "burned off" by the respiratory process, 
 which is every hour carrying away at least one-third of 
 an ounce of carbon from the blood. The evidence that 
 the saccharine elements of the food are used up in the 
 respiratory process with equal rapidity is not quite so 
 distinct ; since these elements appear to be usually intro- 
 duced into the blood in the condition of lactic acid,* the 
 detection of which is attended with some uncertainty. 
 But it has been sufficiently proved, that, when the sac- 
 charine ingredients of the food are unusually abundant, 
 they enter as such into the blood, where they may be 
 detected shortly after a meal, especially if that meal have 
 been preceded by a long fast. Like the superfluous fiitty 
 matters, however, they soon disappear ; being carried oft", 
 there can be little doubt, by the respiratory process. 
 
 115. In this manner, then, the heat-producing mate- 
 rials are usually supplied to the system from meal to 
 
 * Lactic acid, acid of milk. 
 
124 
 
 SUPPOSED USES OF ALCOHOL 
 
 
 meal ; the greater part of them being destined for ehmi- 
 nation from the blood within a short time after their 
 admission into it ; and the power of sustaining heat exist- 
 ing in its greatest vigor, 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 accustomed to refer the difference 
 to the condition of the stomach ; but the stomach may 
 have been emptied by the completion of the digestive pro- 
 cess long before the increased susceptibility to cold com- 
 mences ; so that it would be more correct to refer this 
 increase to the exhaustion of the supply of combustive 
 material last introduced into the blood, than to the vacuity 
 of the stomach. That an increase in the power of main- 
 taining heat should be almost immediately produced after 
 the ingestion of food into the stomach, is to be accounted 
 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 introduction of fatty sub- 
 stances, 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 circulation 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 combustive 
 
 * See, for the oxperimonts on which several of the foregoing 
 statements aro founded, the paper of Drs. Buchanan and II. I). 
 Thomson in the Medical Gazette, Oct. 10, 1845. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 125 
 
 process, just as albuminous matters constitute the pabu- 
 lum for the formative processes whereby the tissues 
 are generated. When they are present in excess, the 
 superfluity is withdrawn by the production of adiix)se * 
 tissue, which stores up the fatty mat+^^rs for future use. 
 When, on the other hand, th j^.^ 's not c(iuivaleiit 
 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 adipose 
 tissue. In this manner, the animial temperature is kept 
 up nearly to its usual standard, even in spite of the total 
 deprivation of food, so long as unconsumed fatty matter 
 remains in the body ; but death then speedily takes 
 place, in consequence of the coohng 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 circulating 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 animal has nothing whatever to fall back upon, 
 it is requisite that the supplies of new material intro- 
 duced into the system should suffer no intermission ; for, 
 immediately that they are exhausted, the temperature of 
 the body begins to fall, and death speedily supervenes 
 unless a fresh supply be aflforded.f 
 
 * Adipose, fatty, 
 t For the experiments on which the foregoing statements arc 
 11* 
 
126 
 
 SUPPOSED USES or ALCOHOL 
 
 
 117. We are now prepared, then, to inquire into the 
 question, how far alcohol may be advantageously em- 
 ployed habitually as a heat-producing material ; and 
 whether there are any peculiar or extraordinary circum- 
 stances 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 respira- 
 tory process. For our knowledge upon this point, we 
 are chiefly indebted to the experiments of Br. Prout 
 and to Vierordt. The former states,* that alcohol, and 
 all liquors containing it, which he had tried, have the 
 remarkable power of diminishing the quantity of car- 
 bonic acid gas f in the expired 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 confirms 
 Dr. Front's observations ; having found, that, in four 
 experiments, tlie per centage of carbonic acid fell, after 
 from half to a whole bottle of wine had been taken, from 
 4'54 to 401 ; and that this effect lasted between one and 
 two hours. He fiirther found, that, when he drank wine 
 with his diimer, the usual increase in the per centage 
 of carbonic acid expired after a full meal did not take 
 place. 
 
 118. These facts are of great importance. For, al- 
 though it may be very possible, that, as suggested by 
 
 
 founded, see the work of M. Cho8sat, entitled «• Rechcrches sur 
 rinanition." 
 
 * Annals of Philosophy, vols. ii. and iv. 
 
 t Carbonic acid gas, composed of carbon united with oxygen. 
 
 X Physiologic des Athmens, &c 
 
 I I 
 
IN SUSTAINING THE VITAL POWERS. 
 
 127 
 
 Liebig, the increased formation of water, which Avill 
 occur when alcohol is the combustivc material, compen- 
 sates for the diminution in the amount of carbonic acid 
 expired, and thus the normal amount of heat may be 
 generated; yet there are clear indications, tliat, when 
 thus present in the blood, with other materials which 
 ought to be excreted, alcohol exerts an injurious influ- 
 ence, by retarding their combustion. This it will do in 
 two ways : first, by taking their place as the more readily 
 combustible material ; and, secondly, in virtue of the 
 antiseptic * influence which it exerts upon other sub- 
 stances, preventing or retarding chemical changes in 
 them. That such is the case appears from the experi- 
 mei^.ts of Bouchardat ; who found, that, when alcohol is 
 introduced into the system in excess, the blood in the 
 arteries presents the aspect of venous blood, showing 
 that it has been prevented from undergoing the proper 
 oxygenating f process. J And the* experiments of Dr. 
 Prout aflford additional support to this conclusion ; for he 
 observed, that no sooner had the effects of the alcohol 
 passed off || (which they did in his case with frequent 
 yawnings, and a sensation as if he had just awoke from 
 sleep), than the amount of carbonic acid exhaled rises 
 
 * Antiseptic, preventing putrefaction. 
 
 t Oxi/ffenatinff, supplying with oxygen, vit.alizing. 
 
 J This result has been also noticed as a consequence of the 
 inhalation of the vapors of ether and of chloroform, which are 
 ^ied to alcohol in composition and properties ; and, in cases in 
 wnlch the state of anaisthesia has been very profound, the tem- 
 perature of the body has undergone a considerable depression. — 
 
 AUTHOK. 
 
 II Sailors can generally tell when the " grog is out of them." — 
 Author. 
 
128 
 
 SUPPOSED USES OF ALCOHOL 
 
 
 7nitch above the natural standard ; thus giving, it would 
 seem, unequivocal evidence of the previous abnormal 
 retention of carbonaceous matter in the system. 
 
 119. From the foregoing considerations, then, we may 
 conclude, that the effects of alcohol, as a heat-producing 
 material, will only be advantageously experienced, when 
 the blood does not contain a supply of other matters 
 waiting for removal by the respiratory pro^oss ; and this, 
 we believe, will be found entirely conformable to expe- 
 rience ; 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 already 
 given, the heat-producing power is much less than usual, 
 even although there should be no lack of material stored 
 up in the body. Tliis is well illustrated by the follow- 
 ing 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 Novem- 
 ber, 1821. We left Inverness at five in the morning, 
 when it was nearly pitch dark, and when the thermome- 
 ter 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 returning 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 ho- 
 siery alike at defiance. So situated, and whn-ling along 
 at the rate of nearly nine miles an hour, with a keen east 
 wind blowing upon us from the snow-covered hills, I do 
 
 * Anatomy of Drunkenness, p. 307. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 120 
 
 not exaggerate when I say, that some of us, at least, 
 oweil our lives to ardent spirits. The cold was so insuf- 
 ferable, that, on arriving at the first stage, we were 
 nearly frozen to death. Our feet were jterfectly be- 
 numbed ; and our hands, fortified as they were with 
 warm gloves, little better. Under such circumstjmces, 
 we all instinctively called for spirits, antl took a glass 
 each of raw whiskey and a little bread. The effect wiis 
 perfectly magical : heat diffused itself over the system, 
 and we continued comparatively warm and comfortable 
 till our arrival at Aviemore Inn, Avhere we breakfasted. 
 This practice was repeated several times during the 
 journey, and always Avith the same good effect. When 
 at any time the cold became excessive, we had recourse 
 to our dram, Avhich insured us warmth and comfort for 
 the next twelve or fourteen miles, without on any occa- 
 sion 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 be a doubt, that, without spirits or some 
 other stimulating liquor, the consequences of sueh severe 
 weather would have been highly prejudicijd to most of us." ' 
 This last statement cannot be admitted without an im- 
 portant reservation, sufficient to invalidate any inference 
 drawn from this or similar cases as to the iiecessity for 
 alcoholic liquors for the maintenance of the animal heat 
 under exposure to severe cold. For it will be observed, 
 that the party started on their journey after a fast of 
 several hours, no food having been iaken that morning ; 
 and there is every reason to believe, that, if Dr. Mac- 
 nish and his companions had breakfasted heartily before 
 
130 
 
 SUPPOSED USES OF ALCOHOL 
 
 
 the commencement of their journey, they would not have 
 found it necessary to have had such frequent recourse to 
 the spirit-bottle ; easily digested solid food, es[)ecially 
 such as includes oleaginous matter, taken in conjunction 
 with hot liquids (especially coffee), being at least as 
 efficacious, as a heat-producing material, as alcoholic 
 liquors can be. In proof of this assertion, we shall noAv 
 cite a series of facts which are, we conceive, quite ade- 
 quate to demonstrate it. 
 
 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 Ja- 
 nuary, 1838 ; a day memorable for the severity of its 
 temperature, and for that remarkable prediction of the 
 occurrence which gave a temporary celebrity to " Mur- 
 phy's Almanac." 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 : ace) ; and, though not ex- 
 posed to " a keen east wind from the snow-covered hills," 
 was subjected to a much lower atmospheric temperature, 
 the thermometer having stood during the day at 8°, or 
 twenty-four degrees below freezing point. Having forti- 
 fied 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 jour- 
 ney'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 fermented liquor 
 was taken by the writer on this journey ; and he cannot 
 
 \ 
 
IN SUSTAINING THE VITAL POWERS. 
 
 131 
 
 )t have 
 ursc to 
 K3cially 
 anction 
 iast as 
 coholic 
 ill now 
 te atle- 
 
 lis own 
 le of a 
 of Ja- ' 
 ' of its 
 of the 
 " Mur- 
 eceding 
 le miles 
 1, must 
 not ex- 
 hills," 
 ^rature, 
 ; 8°, or 
 ig forti- 
 having 
 Id by a 
 t suffer 
 e aid of 
 is jour- 
 s of the 
 rmth of 
 d liquor 
 J cannot 
 
 tliink that he could have derived any other benefit from 
 it than that, by accelerating the general circulation, it 
 might have possibly kept up a more rnpid 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 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 favor of the sui)erior efficacy of 
 the latter system, that he doubts if any man who had the 
 resolution 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 contains a considerable amount 
 of oleaginous matter, for his power of resisting cold ; and, 
 when amply supplied with food, does not dread the ex- 
 posure of his person to cold of the greatest severity. 
 Thus, Captain Parry mentions with surprise that he saAV 
 an Esquimaux female uncover her bosom, and give her 
 child suck, in the open air, when its temperature was 
 forty degrees be/oiv zero. And Sir J. Richardson, in 
 a letter to the writer, states that "plenty of food and 
 sound digestion are the best sources of heat ; " and that a 
 ' ' Canadian, 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 
 
 1; 
 
132 
 
 SUPPOSED USES OF ALCOHOL 
 
 i i I 
 
 i 
 
 not a strong wind." The inhabitants of Arctic regions 
 appear to have a natural relish for the very oleaginous 
 food which nature has provided for them, in the wliales, 
 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 Back in his overland expedi- 
 tion in search of Sir John Ross, informed the author, 
 that, whereas he had been previously accustomed to reject 
 every particle of fat, owing to the dislike he felt for it, he 
 found himself able, during his Arctic journey, to eat any 
 amount of it with rehsh, and even experienced a positive 
 craving for it ; and his experience led him to consider 
 himself as far better fortified against the cold by the use 
 of an oleaginous diet than by that of fermented liquors. 
 Testimony to the same eflFcct is given by Dr. J. D. 
 Hooker, who was one of the medical oflScers in the 
 Antarctic expedition under the command of Sir James 
 Ross. He says, in a letter to the author : " Several 
 of the men on board our ship, and amongst them some of 
 the best, never touched grog during one or more of the 
 Antarctic cruises. They were iiot one whit the worse for 
 their abstinence, but enjoyed the same perfect health that 
 all the crew did throughout the four years' voyage. Many 
 of our men laid in large stocks of coffee, and, when prac- 
 ticable, had it made for them after the watch on deck. 
 These men, I believe, would wiUingly have given up their 
 spirits in exchange for coffee ; but we could not insure 
 them the latter on the requisite occasions." 
 
 122. The foregoing statements appear sufiicicnt to 
 prove, that a sufiicient supply of heat-producing food 
 effects all that can be attributed to alcoholic liquors in 
 
IN SUSTAINING THE VITAL POWERS. 
 
 133 
 
 sustaining the heat of the body ; but we shall now go 
 further, and endeavor to establish the position, that the 
 use of alcoholic liquors is positively injurious when the 
 exposure to cold is prolonged, and especially when mus- 
 cular exertion is required. Thus, Dr. Hooker says, in 
 the communication just cited: "I do think that the 
 use of spirits in cold weather is generally prejudicial. I 
 speak from my OAvn experience. It is very pleasant. 
 The glass of grc -r warms the mouth, the throat, and the 
 abdomen ; and tiiis, when one is wet and cold, with no 
 fire, and just before turning into damp blankets, is very 
 enticing. But it never did me one atom of good ; the 
 extremities are not warmed by it ; and, when a continu- 
 ance of exertion or endurance is called for, the spirit 
 does harm, for then yon are colder or more fatigued a 
 quarter or half an hour after it, than you ivould have 
 been without it.'''' The testimony of othera who have 
 been subjected to still more trying exposure is to the 
 same eflFect. Thus Sir J. Richardson states, as the 
 result of liis most scycre experience : " I am quite satis- 
 fied that spirituous liquors, though they give a tem- 
 porary stimulus, diminish the power of resisting cold. 
 We found, on our northern journey, that tea was much 
 more refreshing than wine or spirits, which we soon 
 ceased to care for, while the craving for the tea increased. 
 Liebig, I believe, considers that spirits are necessary to 
 northern nations to diminish the waste of the solids of 
 the body, and that tea is less useful ; but my experience 
 leads me to a contrary conclusion." Dr. King's testi- 
 mony was piecisely to the same effect. In fiict, it would 
 appear that a very general concurrence exists on this 
 
 point among all those qualified to form an unprejudiced 
 12 
 

 Illili. 
 
 134 
 
 SUPPOSED USES OF ALCOHOL 
 
 judgment in regard to it ; since we find, that, in all the 
 recent overland Arctic expeditions sent out by the Brit- 
 ish government, it has been expressly provided that no 
 fermented liquors shall be ased by the parties who pro- 
 ceed upon them ; and that the Hudson's Bay Company 
 have for many yearc C'^+irely excluded spirits from the 
 fur-countries to the north, over which they have exclusive 
 control, "to the great improvement," as Sir J. Richard- 
 son states, " of the health and morals of their Canadian 
 servants and of the Indian tribes." * 
 
 123. That puch are the teachings of sufficiently pro- 
 longed experience, not merely in the frigid zone, but 
 wherever the same conditions present themselves, will ap- 
 pear from the two following statements. It is mentioned 
 by Dr. Forbes, f as the result of his personal inquiries 
 from the guides at Chamouni, that, when they are out 
 upon their winter expeditions among the Alpine snows, 
 they never find it advantageous to take any thing stronger 
 
 ♦ To the above testimony, the author may add the following, 
 "with -which Mr. Eaton has favored him : The Rev. Richard Knill, 
 for many years a missionary at Petersburg, 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 them in very cold 
 weather. When a regiment was about to march, orders were 
 issued over night that no spiiits were to be taken on the foUoAving 
 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 in the morning before marching, and those who were 
 found to have taken spirits were forthwith ordered out of the 
 ranks, and prevented from marching on tliat day ; it having been 
 found that such men were peculiarly subject to be '• frost-bitten," 
 and otherwise injured. — Auriioii. 
 
 t Physician's Holiday, p. 26, note. ' 
 
IN SUSTAINING THE VITAL POWERS. 
 
 135 
 
 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 in 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, notwithstanding such severe trials, he was a re- 
 markably 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 hquors, in which he indulges in moderation ; 
 but his testimony to the writer was most explicit to the 
 following effect : 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 more 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 
 was prolonged ; the cold being then more severely felt, 
 the'larger was the proportion of fermented liquors taken. 
 And he further stated, that all the fowlers of his ac- 
 quaintance, who had been accustomed to employ brandy 
 with any freedom, whilst out on prolonged expeditions, 
 hiul died early ; he and his brother (who had practised 
 

 136 
 
 SUPPOSED USES OF ALCOHOL 
 
 the same abstinence as himself) having outhved nearly 
 all their contemporaries. 
 
 124. Hence it may be argued upon scientific princi- 
 ples, that, whilst the use of alcohohc hquors may for a 
 time aflford 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 olea- 
 ginous matter, in affording a jmbuliim for the respiratory 
 process, as sufficiently compensates for their injurious 
 effect in preventing 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 in- 
 gestion of heat-sustaining food ; since this waits its time 
 for the combustive operation, without interfering with the 
 oxygenation 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 altogether 
 prevented by the more rapid combustion which the alco- 
 hol undergoes; and it might be anticipated, therefore, 
 from what we 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 in- 
 creased energy to the circulation, yet when that energy 
 
 I 
 
IN SUSTAINING THE VITAL TOWERS. 
 
 137 
 
 is succeeded (as it must bo sooner or later) by the 
 opposite condition, the cold will be felt with |];reater 
 intensity. 
 
 125. The predictions thus based on physiological 
 principles are found, as we have seen, to be in most 
 perfect harmony with experience. For this teaches, in 
 the first place, that, although alcoholic liquors may af- 
 ford advantages equal or even superior, regarded simply 
 as material for the combustive process, to those derivable 
 from sohd food, those advantages are not of long dura- 
 tion ; so that, for enabhng the body to resist the continued 
 influence of severe cold, alcoholic liquors are far inferior 
 in potency to sohd food. And, secondly, that, although 
 the increase in the energy of the circulation, resulting 
 from the stimulating effect of alcohohc liquors, may pre- 
 vent 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 Avith augmented severity, and 
 its action upon the system is proportionately injurious.* 
 
 * The author has proferrccl basing his conclusions upon infor- 
 mation which he has obtained by his personal inquiries. He might 
 easily have brought together a considerable amount of published tes- 
 timony 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 cre-srof a Danish 
 ship of sixty men, well supplied with provision and ardent spirit, 
 attempted to pass the winter at Hudson's Bay ; but fifty-eight of 
 them died before the spring : while in the case of an English crew 
 of twenty-two men, in the same circumstances, but destitute of 
 distilled spirit, only two died. In another instance of eight Eng- 
 lishmen, also without spirituous liquors, who wintered in the same 
 bay, the whole survived, and returned to England ; and four Rus- 
 sians, left without ardent spirits or provisions in Spitzbergen, lived 
 12* 
 
138 
 
 SUPPOSED USES OF ALCOHOL 
 
 126. The question .rhether there are any circum- 
 stances under which the use of alcoholic liquors can be 
 positively advantageous for the purpose of enabling the 
 body to resist cold, will be considered in the succeeding 
 chapter (^§ 182—187). 
 
 IV. ENDURANCE OF HEAT. 
 
 126. Having thus concluded our inquiry how far the 
 use of alcoholic hquors 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 pro- 
 tective power against cold; but it must be manifestly 
 due, if it exist, to some modus operandi different from 
 
 for a period of six years, and were at length restored to their coun- 
 try. 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 was 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 llev. 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 testi- 
 mony has been already cited. He gives it as his decided opinion, 
 that spirits are injurious in cold climates ; and speaks of the re- 
 action as especially pernicious, in diminishing the power of sus- 
 taining cold, as well as that of muscular exertion. — Author. ' 
 
IN SUSTAINING THE VITAL POWERS. 
 
 139 
 
 that which renders them serviceable in the opposite con- 
 dition. For it cannot be imagined, that they can be of 
 any service by affording pabulum for the combustive 
 process, Avhen that process is already generating more 
 heat than the body, exposed to a high external tempera- 
 ture, can possibly need. Nor can it be supposed, that 
 the loss of the watery portion of the blood, by the per- 
 spiratory process, can be in any degree I'cpaired by the 
 ingestion of alcoholic 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 subject to those disadvantages 
 which are inseparable from the habitual employment of 
 stimulants. Each of these points, however, 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 than at low ; the sys- 
 tem having in itself the power of regulating the amount 
 of matter which it shall burn off, in order that 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, when they are 
 breathing in an atmosphere of from 86° to 106* Fahr. 
 is scarcely more than one-third of that which they gene- 
 rate in an atmosphere of 32° ; and, by similar experi- 
 ments upon small mammalia,! it was ascertained that 
 they only give off, between 86° and 106°, about half 
 as much carbonic acid, and between 59° and 68° about 
 
 * Comptes Rendus, torn. xx. p. 795 ; and Ann. de Chim. et de 
 Phys., torn. xiii. p. 478. 
 
 t Mammalia, animals which suckle their young ; the first class. 
 
 .1 
 
J ,!| 
 
 140 
 
 SUPPOSED USES OF ALCOHOL 
 
 two-thirds as much, as they generate at 32*. The 
 experiments of Vierordt * upon his own person lead to a 
 similar conclusion in regard to man, although the difFer- 
 ence is not so great. For he states that the average 
 amount of carbonic acid exhaled by him p. v minute, 
 between the temperatures of 24® and 47" Fahr., was 18 J 
 cubic inches ; whilst the average between the temperatures 
 of 66® and 92* was but 15| cubic inches. It is obvi- 
 ous, 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 Anfcirctic Seas derive their chief suste- 
 nance from those oleaginous articles which have the 
 greatest heat-producing power, the vast population of 
 the Equatorial region derives its principal support from 
 those farinaceous f vegetable products whose non-azotized 
 portion, belonging to the saccharine 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 calori- 
 fication ; 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 func- 
 tion, which is common to all animals ; the combustion of 
 
 * Op. cit. §§ 73—82. 
 
 t Farinaceous, formed from grain, as meal or flour. 
 
 X Effete, used up, refuse. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 141 
 
 an additional amount of hydro-carlx>naceous matter, for 
 the purpose of maintaining the temperature of the body 
 at a fixed standard, being 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 func- 
 tion will be more liable, than at low or moderate tempera- 
 tures, to interference from any agency wliich still further 
 checks the oxygenation of the combustible matter of the 
 blood. 
 
 129. Now, as we have found, that, under exposure to 
 severo cold, the stimulating effects of alcoholic hquors 
 (especially when taken at intervals, in small quantities at 
 a time) are but little felt, the alcohol being burned oflF 
 before it can accumulate so as to exert any considerable 
 influence on the nervous system; so might we expect, 
 that, under the influence of external heat, when the com- 
 bustive process is greatly reduced in activity, the stimu- 
 lant effects of alcohol should be more rapidly produced 
 and more powerfully exerted. And further, if the views 
 formerly stated be correct as to the efiects of the absorp- 
 tion 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 alco- 
 holic liquor suffices to produce intoxication beneath a 
 burning sun than in a frosty atmosphere ; so that indi- 
 viduals who are not aware of this fact sometimes become 
 
142 
 
 SUPPOSED USES OF ALCOHOL 
 
 intoxicattHl, without having exceeded the allowance which 
 they beheved to bo perfectly compatible with sobriety. 
 Again, it has been continually observed, that, when alco- 
 holic liquors are taken during the performance of severe 
 labor in an extremely high temperature, their temporary 
 stimulation is followed by a very rapid and decided fail- 
 ure 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 them whilst their labor 
 is in progress. This result appears fairly attributable to 
 vitiation of the circulating blood, consequent upon the 
 retention of matters destined for excretion ; the removal 
 of which, by the oxygenating process, has been obstructed 
 by the presence of alcohol. And the same inference 
 appears legitimately deducible from the peculiar tenden- 
 cy (already referred to, §*§» 54, 55), which the habitual 
 use of alcoholic liquors in warm climates has to engender 
 diseases of the liver ; the duty of separating those hydro- 
 carbonaceous * products of the waste of the system, which 
 are poisonous if retained in the blood, being unduly 
 thrown upon the liver, when their elimination by the 
 lungs is interfered with. 
 
 130. That the use of alcohol is especially necessary to 
 support the system under its excessive loss by perspira- 
 tion at high temperatures, is an idea so commonly held, 
 that it demands a serious refutation ; although the fallacy 
 of the notion, that, because ivater 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 
 notiOi-, that copious perspiration in itself really weakens 
 
 * Ifj/dro-carbonaceous, composed of hydrogen and carbon. 
 
IN SUSTAINING THE VITAL POWEUS. 
 
 143 
 
 tho system; whilst it is, in fact, notliing else than the 
 means by which the external warmth is prevented from 
 raising tho heat of tho body above its normal standard. 
 Tho determination of the blood to tho skin, wliich that 
 heat excites, appears to cause an unusual transudation * 
 of the watery part of the blood through the thin- walled 
 capillaries f of the sweat-glands ; just as certain diuretic J 
 medicines increase tho quantity of water in the urine, by 
 causing an increased determination of blood to the kid- 
 neys ; but, with this large amount of watery fluid, very 
 little solid matter passes off", — none, in fact, but what is 
 purely excrementitious. 
 
 131. That perspiration, however abundant, has in 
 itself no weakening eflfect, — 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 temperature make 
 no bodily exertion, they do not experience any loss of 
 vigor, if copiously supplied with cold water. In fact, 
 such exposure may be made to conduce vt-ry decidedly to 
 the invigoration of the system. All travellers who have 
 tried the Russian baths speak of the feelings of renova- 
 tion wliich the copious perspiration, and the subsequent 
 plunge into cold water, produce in the wearied 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- 
 room, in which delicate females were accustomed to 
 
 * Transudation, passing out by sweat. 
 
 t Capillaries, very minute vessels. 
 
 X Diuretics, substances which increase the ui-ine. 
 
 II Hydropathy, water-practice. 
 
 J!- 
 1 
 
 %i\ 
 
144 
 
 SUPPOSED USES OF ALCOHOL 
 
 remain for half an hour or more, when it was heated to a 
 temperature of from 140° to 170° Fahr. ; their wrap- 
 pings 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 fol- 
 lowed by the cold plunge, had usually an invigorating 
 influence, which quite sets aside the idea that the act of 
 perepiration is in itself exhausting, or that it removes 
 from the system any thing which it can be requisite for 
 alcohol to supply. 
 
 132. The peculiar fatigue which usually results from 
 muscular exertion at a high temperature is generally set 
 down as the consequence of the excessive perspiration ; 
 although the fact is, that the fatigue is chiefly to be attri- 
 buted to the interference with the vaporous or "insensi- 
 ble " transpiration, which is produced by the accumulation 
 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 tem- 
 perature ; and it has been the uniform result of the 
 attempt to use any muscular effort, when the body has 
 been clothed in water-proof garments made after the 
 fashion of ordinary 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 
 
 * Thus it was found by MM. Delaroche and Berger, that, -when 
 animals were exposed to the temperature of 120% their bodies 
 
IN SUSTAININQ THE VITAL POWERS. 
 
 145 
 
 an augmentation of from 11* to 13* in the temperature 
 of a warm-blooded animal produces an invariably /a/a/ 
 result, so can it bo readily understood that an increase of 
 2* or 3* nmst 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,* which, although its propor- 
 tional amount has not yet been satisfactorily ascertained, 
 is certainly of no mean importance in the depuration f of 
 the blood. Hence, an accumulation of excremcntitious 
 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 per- 
 formed 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 coun- 
 tries, which usually contains a considerable amount of 
 watery vapor. This is undoubtedly the fact ; and, as a 
 
 being enveloped in close boxes, whilst tlieir heads were free, a 
 thermometer placed in the mouth showed an increase of 6" in the 
 heat of the body, in the com-se of seventeen minutes ; this eleva- 
 tion 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 animals uniformly died. — Authok. 
 
 * Cutaneous respiration^ perspiration, 
 t Depuration, purifying. 
 13 
 
1 
 
 X > 
 
 hi 
 
 1 1 
 
 i'i 
 
 li 
 
 146 
 
 SUPPOSED USES OF ALCOHOL 
 
 far larger amount of liquid will be carried off by insensi- 
 ble 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 ; f and that we are to look for 
 the source of that exhaustion in the elevation of the tem- 
 perature of the body itself, which will be produced with 
 peculiar facihty in a damp and heated atmosphere ; and 
 in the accumulation of excrementitious matters in the 
 blood, which will be especially hkely to take place when 
 their elimination % through the lungs is being checked, at 
 the same time that an increased amount is being gene- 
 rated 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 ner\'0U8 
 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 elimination 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 conse- 
 quent upon their functional activity, and wliich is already 
 
 * Insensible transpiration, continued imperceptible sweat. 
 
 f "We are of conrse supposing, throughout, that water is freely 
 supplied in both cases. The exhaustion produced by the undue 
 diminution of the fluids of the body, indicated by excessive thii'St. 
 is of qtiite a different character. — Authou. 
 
 X Elimitiation, separation, escape. 
 
 1} Excrcmcntitiotis, refuse. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 147 
 
 retarded by the diminution in the activity of respiration. 
 We shall presently find that experience is here also in 
 accordance with theory ; the result of many trials having 
 shown that severe and long-continued exertion in tropical 
 climates can be better sustained without alcoholic liquors 
 than ivith their habitual use. 
 
 135. The stimulative effects, from which alcoholic 
 liquors derive their reputation as supportera of bodily 
 vigor, during habitual exposure to a heated atmosphere, 
 are exerted in two ways : in the first place, by giv- 
 ing temporary assistance to the digestive process ; and, 
 secondly, by increasing, for a time, the nervous and mus- 
 cular power. It is commonly supposed, that the diminu- 
 tion of appetite which is experienced by most pei-sons 
 who change their residence from a temperate country to 
 a hot one is the result of the enervating influence of the 
 climate ; whereas the fact is evident to those who take 
 into account the proportionally smaller amount of car- 
 bonic acid exhaled as the external temperature rises, that 
 the diminished appetite chiefly results from diminution 
 in the demand for combustive material; and that it 
 ought, therefore, to be taken as an indication of the pro- 
 priety of lessening the amount of food ingested, rather 
 than of forcing the stomach to augmented activity for the 
 purpose of disposing of the superfluity which it has taken 
 in. All medical authorities on the diseases of tropical 
 climates are in accord upon this point, — that, next to 
 the injury derived from the abuse of fermented liquoi*s, 
 excess in diet is one of the most fertile of those sources 
 of disease which arise out of the personal habits of the 
 individual ; and such excess is in great degree due to 
 the use of alcoholic stimulants as an artificial provocative 
 
148 
 
 SUPPOSED USES OF ALCOHOL 
 
 I 
 
 li 
 
 I 
 
 to the appetite, whereby the blood becomes charged with 
 more ahmentary material than it can rightly dispose of; 
 so that the diminution in the activity of the respiratory 
 process throws the elimination of this superfluity upon 
 the liver, which organ consequently becomes pecuharly 
 liable to functional disorder. 
 
 136. We have continual opportunities of noticing the 
 same sequence of phenomena in our own country, though 
 in a less marked degree. A (hminution in the appetite is 
 experienced by most persons during the heat of summer ; 
 and, if the Avarning be not lost, the amount of food ingested 
 is proportioned to the demand. But those who from 
 habit continue to take in their usual supply are extremely 
 liable to be warned of the impropriety of such a course 
 by hepatic derangement ; and the bihous diarrhoea which 
 is so common in the latter part of summer, and which is 
 connected in the popular mind with the " plum season " 
 (although it frequently affects persons who have alto- 
 gether abstained from fruit), seems to find a rational 
 explanation in the accumulation of excrementitious mat- 
 ter, which must be the consequence of habitual excess in 
 diet, especially when the stomach is stimulated by alco- 
 holic hquors to digest more than could be appropriated 
 without such artificial aid. 
 
 137. There is no reason whatever to believe, that 
 (with the exception of the difference in regard to amount, 
 which has been already remarked upon, § 129) the 
 stimulating influence of alcoholic liquors upon the ner- 
 vous system, whereby it is enabled to put forth increased 
 power so long as this influence lasts, is exerted in any 
 other mode, when the body is habitually exposed to a 
 high temperature, than that in which it operates under 
 
IN SUSTAINING THE VITAL POWERS. 
 
 149 
 
 ordinary circumstances. That the excitement must Ije 
 followed by subsequent depression is as true in India as 
 in England ; and that this excitement, if habitually had 
 recourse to, will be followed in hot climates hj conse- 
 quences even more injurious than in cold or temperate 
 regions, might be inferred from all that has been already 
 stated in regard to its peculiar unsuitableness when the 
 activity of the respiratory process is diminished. 
 
 138. We shall now proceed to inquire, therefore, how 
 far the experience, both of individuals and of large bodies 
 of men, supports the idea that abstinence from alcoholic 
 stimulants, or at most the very sparing use of them, is fa- 
 vorable to the endurance of extreme heat, especially when 
 great bodily exertion is required. And we shall first cite 
 the evidence of the late Mr. Gardner,* a well-educated 
 surgeon, who spent several years of most active exertion 
 in the exploration of the botany of Brazil, into which 
 country he penetrated further than any scientific Euro- 
 pean had previously done. During thiee years' travelhng 
 in that climate, he tells us,f under constant fatigue and 
 exposure to \dcissitudes of weather and irregularity of 
 living, his only beverage, besides water, was tea, of wbioh 
 he had laid in a large stock previously to his departure 
 from Pernambuco. He was told when he arrived at Bra- 
 zil, that he would find it necessary to mix either wine or 
 
 * The author has been informed by an intimate friend of this 
 gentleman, that his lamented death, •which took place from a coup 
 de soldi, X whilst holding the appointment of Superintendent of 
 the Botanic Garden at Ceylon, was entirely due to the injudicious 
 and almost foolhardy exposure to which his confidence in his 
 vigor led him to subject himself. — Autiiok. 
 
 t Travels in Brazil, p. 402. 
 
 X Coup de soleil, stroke of the sun. 
 
150 
 
 SUPPOSED USES OF ALCOHOL 
 
 r 
 
 M li 
 
 I 
 
 ■ t 
 
 1 , 
 
 r. ■ J 
 
 1; 
 
 '•I 'it 
 
 brandy with the water which he drank ; but a very short 
 experience convinced him, not only that they are unneces- 
 sary, but that they are decidedly hurtful to those whose 
 occupations lead them much into the sun. " Whoever 
 drinks stimulating liquors," he says, " ai^d travels day 
 after day in the sun, will cei-tainly suffer from headache ; 
 and, in countries where miasmata prevail, he will be far 
 more likely to be attacked by the diseases which are 
 there endemic." 
 
 139. Equally explicit testimony is borne by Sir James 
 Brooke, the enterprising and skilful colonizer of Borneo ; 
 who speaks in his "Journal" of habitual abstinence 
 from alcoholic liquors as decidedly conducive to the 
 maintenance of health, and of the power of sustained 
 exertion, in the equatorial regions in which he had es- 
 tablished himself So, again, Mr. Waterton, the well- 
 known traveller, speaks of himself as confident that the 
 preservation of his vigor, during many years of toil and 
 •exposure in tropical climates, is mainly due to his total 
 abstinence from fermented liquors. And the writer has 
 been assured by Dr. Daniell, who was for a long time 
 stationed as medical officer in the equatorial portions of 
 Western Africa, that he found the use of the ordinary 
 alcoholic liquors decidedly inimical to the power of exer- 
 .tion ; the strongest beverage which could be habitually 
 made use of without injury being the "palm- wine" of 
 those countries, which is very little, if at all, more alco- 
 holic than our ginger-beer. The following testimony, 
 given by Dr. Mosely in his work on Tropical Diseases, 
 ■maybe added to the foregoing: "I have ever found," 
 he says, "from my own knowledge and custom, a^ well 
 as from the custom and observation of others, that those 
 
IN SUSTAINING THE VITAL POWERS. 
 
 151 
 
 exer- 
 
 ?j 
 
 of 
 
 who drink nothing but water, or make it their principal 
 drink, are but little affected by the chmate, and can 
 undergo the greatest fatigue without inconvenience." 
 Many other individual testimonies might be cited to the 
 same effect ; but, as these are open to the objection of 
 being influenced by pecuharities of individual constitu- 
 tion, it will be preferable to have recourse to cases in 
 wliich large bodies of men are included. 
 
 140. The following statement, which the writer has 
 received from an oflScer in the regiment to which it refers, 
 proves that our English soldiers in India not only do not 
 suffer from, but are absolutely benefited by, abstinence 
 from alcoholic liquors during a continuance of unusually 
 severe exertion: " In the early part of the year 1847, 
 the 84th regiment marched by wings from Madras to 
 Secunderabad, a distance of between four and five hun- 
 dred miles. They were forty-seven days on the road; and, 
 during this period, the men were, practically speaking, 
 teetotalers. Previously to leaving Madras, subscriptions 
 were made among the men, and a coffee-establishment 
 was organized. Every morning, when the tents were 
 struck, a pint of hot coffee and a biscuit were ready for 
 each man, instead of the daily morning dram which sol- 
 diers on the march in India almost invariably take. 
 Half-way on the day's march, the regiment halted, and 
 another pint of coffee was ready for any man who wished 
 it. The regimental canteen was opened only at ten and 
 twelve o'clock for a short time, but the men did not 
 frequent it ; and the daily consumption of arrack for our 
 wing was only two gallons and a few drams per diem, 
 instead of twenty-seven gallons, which was the daily 
 government-allowance. The conmianding ofiicer em- 
 
 
 H 
 
152 
 
 SUPPOSED USES OF ALCOHOL 
 
 i 
 
 y ■ i 
 
 ployed the most judicious precautions to prevent the 
 men from obtaining arrack in the villages on the route ; 
 and his exertions were eflFectively seconded by the zeal- 
 ous co-operation of the other officers, and by the admira- 
 ble conduct of the majority of the men, who were fully 
 persuaded of the noxious influence of ardent spirits during 
 exercise in the sun. The results of tliis water-system 
 were -shortly these : Although the road is proverbial fov 
 cholt ?'.) and dysentery, and passes through several un- 
 healthy and marshy districts, the men were free from 
 Juiciness to an extent absolutely unprecedented in our 
 maiv^^- ill India; they had no cholera and no fever; 
 and ohi V two men were lost by dysentery, both of whom 
 were old chronic cases taken out of hodpital at Madras. 
 With these exceptions, there was scarcely a serious case 
 of sickness during the whole march. The officers 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 whole march, the regiment had not a single 
 prisoner for drunkenness." A considerable proportion 
 of the men (the writer has learned from his informant) 
 abstained entirely from arrack : and the consumption of 
 those who occasionally took it v-as tar below their usual 
 allowance. Those who entire >j abstained were certainly 
 in no respect inferior, either in power of sustaining 
 exertion or in freedom from sickness, to those who occa- 
 casionally took small quantities of spirits : on the con- 
 trary, they rather seemed to have the advantiige. That 
 this remarkable result was not dae to any peculiar 
 liealthfulness of the season, or other modifying circum- 
 
IN SUSTAINING THE VITAL POWERS. 
 
 153 
 
 stance, is shown by the fact, that the 63d regiment, 
 which performed the same march ^ at the very same time, 
 though in the opposite direction, lost several nier out of a 
 strength f f four hundred ; and that it had so maiiy sick, 
 that, when it met the 84th on its mnrch, it was obliged to 
 borrow the spare " dhoolies " (or palanquins for the sick) 
 belonging to the latter.* 
 
 141. The foregoing account fully accords with that 
 given by Sir James (then Mr.) M'Grigor, 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 Bonaparte. After the Great Desert had been 
 crossed, in July, 1801, no spirits were issued to the 
 troops in Upper Egypt, owing to a diificulty in procuring 
 carriage for them. At this time there was much fa- 
 tigue-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 exercised, 
 and were much in the sun ; the heat was excessive, the 
 thermometer standing at 113* or 114° Fahr. in the sol- 
 diers' tents, in the middle of the day ; bxit at no time xvas 
 the Indian army more healthy, \ 
 
 * The marked contrast between the rate of morteility in the 
 63d and 84th regiments, during their respective residences at 
 Secunderabad during two consecutive years, has been already 
 noticed (§§ 81, 82) ; but it may be as well hfere to remind the 
 reader, that the former lost seventy-three men in nine months, 
 which was at the rate of 78*8 per 1,000 of average strength for the 
 entire yea** ; whilst the latter lost but thirty-nine men in the whole 
 twelve months, being at the rate of 34'2 of average strength. — 
 Author. 
 
 t Medical Sketches of the Expedition from India to Egypt, 
 page 86, 
 
 ii 
 
 i.i I'll 
 
 '<. lii 
 
 .■I • s 
 
 . . Ii 
 
 
154 
 
 SUPPOSED USES OF ALCOHOL 
 
 I'M: 
 
 lii;} 
 
 ti# 
 
 \m 
 
 I'M' 
 
 11 
 
 142. The intimate acciuaintance of Sir Charles Na- 
 pier with the habits and wants of the Indian soldier can 
 be doubted by no one ; and the following is his testimony 
 in favor of the abstinence system (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." 
 
 143. Whatever temporary advantage, then, is derived, 
 or supposed to be derived, from the stimulating powers 
 of alcoholic liquors, when they are used witli a view of 
 sustaining the power of exertion in tropical climates, is 
 dearly purchased by the increased liability to disease, 
 which not only theoretically^ but, according to all compe- 
 
IN SUSTAINING THE VITAL POWERS. 
 
 155 
 
 tent 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. RESISTANCE TO MORBIFIC AGENCIES. 
 
 144. It is a common idea, and one apparently sup- 
 ported 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 agen- 
 cies ; and this belief is entertained by many who deprecate 
 the habitual use of fermented liquors under other circum- 
 stances. Thus, says Dr. Macnish, "I am persuaded 
 that while, in the tropics, stimulating liquors are highly 
 prejudicial, and often occasion, while they never prevent, 
 disease, they are frequently of great service in accomplish- 
 ing the latter object in damp, foggy countries ; especially 
 when fatigue, poor diet, agues, dysenteries, and other 
 diseases of debility, arc to be contended against." — "In 
 countries subject to intermittents, it is very well known, 
 that those who indulge moderately in spirits are much 
 less subject to these diseases than the strictly absti- 
 nent." t These assertions he endeavors to justify by 
 the two following statements : "At Walcheren, it was re- 
 marked that those officers and soldiers who took schnaps, 
 alias brandy drams, in the morning, and smoked, escaped 
 the fever which was so destructive to the British troops ; 
 
 * Miasmata, seeds of disease. 
 
 t Anatomy of Drunkenness, pp. 277, 279. 
 
 !'.i 
 
 f\ t] 
 
I] 
 
 
 156 
 
 SUPPOSED USES OF ALCOHOL 
 
 and the natives generally insisted upon doing so before 
 going out in the moniir<^." * ;\.gain, " A British regi- 
 ment quartered on the Niagara frontier of Upper Canada, 
 in the year 1813, was prevented by some accident from 
 receiving the usual supply of spirits ; and, in a very 
 short time, more than two-thirds of the men were on the 
 sick-list from ague and dysentery ; while the very next 
 year, on the same ground, and in almost every respect 
 under the same circumstances, except that the men had 
 their usual allowance of spirits, the sickness was ex- 
 tremely trifling. Every person acquainted with the 
 circumstances believed that the diminution of the sick, 
 during the latter period, was attributable to the men 
 having received the quantity of spirits to which they had 
 been habituated." f 
 
 145. Now, it is obvious that neither of these facts 
 proves that exposure to the morbific agencies in question 
 renders an allowance of spirits necessary, or even bene- 
 ficial, for those who have not been accustomed to make 
 use of it under ordinary circumstances. On the con- 
 trary, the second instance is a valuable testimony to the 
 disadvantage of habitual dependence upon alc^I^clic sti- 
 mulants ; inasmuch as it is evident, that, when they were 
 withheld from the troops, the constitution of the men 
 was rendered peculiarly susceptible to the causes of dis- 
 ease indigenous $ to their locality. All that it proves is, 
 that an unduly depressed state of the system is favorable 
 to attacks of ague and dysentery (of wliich every medical 
 practitioner is aware) ; and that, in persons who have 
 
 * Glasgow Medical Journal, No. xv. 
 
 t Op. cit. 
 
 X Indigenous, belonging to the place. 
 
IN SUSTAINING TUE VITAL POWERS. 
 
 157 
 
 habituated themselves to the use of spirits, such depres- 
 sion is hal)le to supervene when the allowance is with- 
 held, and may be for a time kept off by its restoration. 
 And even the first exaniplc cannot be said to prove more 
 than this ; for it simply gives us the experience of indi- 
 viduals who took an early dose of spirits, as conippr* '^' 
 with that of the individuals who abstained from 'big 
 liabit; without telling us that tlie latter ado])ted ;i! 
 of those substitutes which prudential experience W(m,. , 
 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 losalities where zymotic * poisons are 
 indigenous, no condition of the healthy system is so 
 obnoxious to their influence as that which is natural to 
 it on first rising in the morninor, when the stomach 
 is empty, the pulse comparatively feeble, and the heat- 
 producing power nearly at its minimum. The nutritive 
 actions which have been talvin!^; ])l:ieo daring!; i-Mv.se have 
 
 ox Ox. 
 
 prepared the nervous and muscular apparatus 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 expe- 
 rience of most persons that nervous and muscular exertion 
 is loss efficiently sustained,! and external cold less fully 
 
 u 
 
 * Zymotic, produced by fermentation. 
 
 t 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 per- 
 
 14 
 
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 IMAGE EVALUATION 
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 Corporation 
 
 23 WEST MAIN STREET 
 
 WEBSTER, N.Y. 14580 
 
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.> A^* 
 
 
158 
 
 SUPPOSED USES OF ALCOHOL 
 
 resisted, at this period than at any other ; and the re- 
 commendation 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 alcoholic 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 employed, would be as 
 efficacious at the time, and would have a more perma- 
 nently beneficial effect. 
 
 147. A man, previously in the enjoyment of vigorous 
 health, and not accustomed to depend upon alcoholic 
 stimulants, will derive all the protection he can require 
 from taking his first solid meal before he exposes himself 
 to the cold, damp, or pestilential miasmata whose influ- 
 ence 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 bo 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 
 accordant with the normal economy of the bodily system. 
 On the other hand, although the use of spirits, by pro- 
 ducing a temporary excitement of the circulation, will 
 probably render the system less obnoxious to morbific 
 agencies than if it be exposed to them before ita dormant 
 energies have been in any way aroused, yet we can 
 
 formed by him after breakfast with scarcely an approach to fatigue. 
 — Author. 
 
IN SUSTAINING TUE VITAL POWERS. 
 
 lo9 
 
 the re- 
 : to keep 
 ied upon 
 e follow, 
 leans of 
 morbific 
 eason to 
 lid be as 
 
 perma- 
 
 vigorous 
 
 dcoholic 
 
 I require 
 
 himself 
 
 30 influ- 
 
 hot tea. 
 
 warmth 
 
 that 
 
 liquors. 
 
 iployed, 
 
 culation 
 
 oness of 
 
 g power 
 
 strictly 
 
 system. 
 
 by pro- 
 
 on, will 
 
 morbific 
 
 lormant 
 
 we can 
 
 > fatigue. 
 
 scarcely anticipate that they can be as favorable to the 
 sustenance of its energy (a previously healthy and vigor- 
 ous condition being supposed) as persistence in the regu- 
 lar habits to wliich it has been accustomed. For it has 
 been already shown, that the continued endurance of cold 
 is not favored by the use of alcoholic hquors, but on the 
 contrary is impaired by it ; and where cold, therefore, 
 acts concurrently with zymotic poisons, and favors 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 resisting power of the system which 
 are most eflScient in maintaining its standard warmth. 
 
 148. So far as we are acquainted with the bearings of 
 experience on this question, they are decidedly favorable 
 to the view here advocated ; namely, that, where a healthy 
 state of the system has been previously maintained with- 
 out 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 recourse 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 for- 
 tification of " the inner man." For we do not see that 
 the circumstances of tropical or those of cold or temperate 
 chmates differ as regards the susceptibility 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 dimin- 
 ishes, instead of increasing, the hability of the body to 
 
 
 U 
 
160 
 
 SUPPOSED USES OF ALCOUOL 
 
 the influence of pestilential miasms in warm climates, 
 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 cei-tainly 
 to the full as efficacious as " the daily morning dram, 
 which soldiers on the march in India almost invariably 
 take ; " and there is no adequate reason why the coflFee 
 should not have an equal value in colder countries, when 
 employed with the larger allowance 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 equability of health, and especially 
 to avoid that depressed condition which sooner or later 
 supervenes upon states of undue excitement, it is obvious 
 that, when all the nutritive functions are regularly and 
 vigorously discharged, it is unwise to interfere with their 
 performance by the use of alcoholic hquors, which, if 
 sufficient to produce either general stimulat* or excite- 
 ment of any one function, must involve as i. nsequence 
 a corresponding diminution of the normal activity at some 
 subsequent period. It is quite true that tliis may not 
 manifest itself at once ; so that for weeks, months, and 
 years, the vigor of the system may seem to be efficiently 
 maintained, and morbific agencies to be perfectly kept at 
 bay, by the habitual use of a small quantity of alcoWic 
 
IN SUSTAINING THE VITAL POWERS. 
 
 IGl 
 
 stimulus ; to which the beneficial result will then be pro- 
 bably attributed. But the trial is not completed in weeks, 
 months, or years ; it must last for the w^hole of life ; and if 
 it be true, as we shall presently endeavor to show, that the 
 continued employment, however moderate, of small quan- 
 tities of alcoholic liquors favors, 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 poi- 
 sons 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 fevei*s 
 prevail, are frequently attacked by them when their vital 
 powers begin to dechne with advancing years ; and, if 
 that dechne be hastened by the previous over-excitement 
 of alcohohc liquors, the influence of these morbific causes 
 will be earlier and more powerfully e> erted. 
 
 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 fiicts universally admitted 
 
 regard to the peculiar susceptibility of habitually 
 
 m 
 
 intemperate persons, and especially of those whose con- 
 stitutions have been broken down by the combined 
 influence of intemperance and advancing years, to 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 
 
 I 
 
 If 
 
 
162 
 
 SUPPOSED rSES OF ALCOHOL 
 
 dependence on that cause is in danger of being over- 
 looked. 
 
 151. We have abundant evidence, then, not merely 
 in the experience of individuals, but in that of large 
 bodies of men, that the most vigorous health may be 
 maintained, under circumstances usually regarded as 
 most trying to the power of bodily and mental endu- 
 rance, without the assistance of alcoholic stimulants. 
 Such evidence is afforded by the numerous ships that 
 are travelling every part of the wide ocean, whose crews, 
 pledged to the total-abstinence principle, maintain a 
 degree of health and vigor which cannot bo surpassed ; 
 by the many workshops of every kind, in which the 
 severest labof is endured with a constancy at least equal 
 to that of the drinkers of alcoholic beverages ; by troops 
 executing toilsome marches in the sultry heat of the 
 torrid zone, and through the pestilential 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 ; 
 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 luivc given the 
 principle of total abstinence a fair trial, and have lx)me 
 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, how- 
 ever moderate, of fermented liquors. For, if the appetite 
 prompt to the use of an adequate amount of nourishment 
 to repair the waste of the system ; if the stomach perform 
 its action with due energy, and supply to the absorbent 
 
IN SUSTAINING THE VITAL POWERS. 
 
 163 
 
 vessels the material for fresh blood in a state of clue 
 preparation; if the circulation be carried on with that 
 equable regularity which is most favorable to the actions 
 to which it is subservient ; 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 
 exhale the carbonic acid which is evolved by their exer- 
 cise, 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, eli- 
 minate from the blood the other products of the waste of 
 the system, and thus keep it in the state of purity most 
 favorable to the discharge of its multitudinous functions ; 
 in a word, if all the actions concerned in the maintenance 
 of the fabric be already discharged with that vigor and 
 uniformity which constitutes health, — why should we 
 attempt to alter them by means of agents, which, if they 
 produce any efiect whatever on the system, can only 
 operate by producing a departure from that perfect bal- 
 ance 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 in 
 more detail. 
 
 VI. CONSEQUENCES OF THE HABITUAL "MODERATE ■ 
 USE OF ALCOHOLIC LIQUORS. 
 
 152. Effect vpon the General System and Excretory 
 Organs, — If the natural appetite be already good 
 enough to give a rehsh to the food which the system 
 requires, can the artificial production of an increased 
 
164 
 
 SUPPOSED USES OF ALCOHOL 
 
 appetite be necessary or desirable ? And, if the stomach 
 be abeady capable of digesting and preparing as much 
 nutriment as is required to keep up the solids of the blood 
 to their proper amount, can any but prejudicial conse- 
 quences result from forcing it to dispose of more 7 Two 
 classes of evils may be expected to proceed from such a 
 system : in the first place, the habitual introduction of 
 more alimentary material into the circulating current 
 than the nutritive functions can appropriate, must pre- 
 dispose to disorder of the system in general ; and, 
 secondly, by constant reliance upon an artificial stimu- 
 lus, the natural powers of the stomach itself must be in 
 danger of becoming gi-adually impaired. 
 
 153. The efiect upon the system at large of an habi- 
 tual introduction of more alimentary material than the 
 nutritive functions can appropriate seems to vary with 
 the temperament. In some individuals, they are converted 
 into blood, so that the normal amount of that liquid 
 undergoes an augmentation ; thereby inducing a state of 
 plethora,* which is favorable to local congestions and 
 inflammatory diseases of various organs, and which espe- 
 cially predisposes to hemorrhage, — this being an efibrt 
 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 func- 
 tional activity, which cannot but render them peculiarly 
 * Plethora, repletion, too great fulness. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 165 
 
 susceptible of derangement. The excretory action of the 
 lungs, however, is chiefly regulated (as already shown, 
 Ȥ> 127) by the temperature ; so that, when it is dimin- 
 ished by external warmth, more remains to be accom- 
 plished 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 sanguineous temperament, disorders both of 
 the liver and kidney are very apt to arise ; those being 
 most liable to the former who have not the power of 
 generating fatty tissue at the expense of the surplus 
 of non-azotized food ; and those being most liable to the 
 latter, in whom the too free use of alcoholic liquors occa- 
 sions an undue determination of blood to the kidneys. On 
 the other hand, habitual excess of food in warm climates 
 usually manifests itself first in disorders of the liver ; 
 since the diminished excretion of carbon by the lungs 
 causes the blood to proceed to the liver more highly 
 charged with that element, whilst at the same time the 
 consumption of that part of the biliary secretion which 
 should be 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 assistance of the kidneys in disposing of the 
 superfluity of azotized ahment ; a considerable amount of 
 urea * being daily excreted through the former channel, f 
 
 * Urea, the substance of urine. 
 
 t See the experiments of Dr. Landerer, of Athens, in Brit, and 
 For. Med.-Chir. Review, vol. i. p. 341. 
 
 1i 
 
 li 
 
166 
 
 SUPPOSED USES OF ALCOHOL 
 
 This result of what is accounted the " moderate " use of 
 alcohohc liquors in warm climates, for the purpose of in- 
 creasing the appetite and stimulating the digestive powers 
 of the stomach, is much dwelt upon by writers ou tropical 
 diseases ; who represent it as, in the long-run, not less 
 hurtful than that excess which produces effects more 
 immediately and obviously pernicious. In this point of 
 view, it ranks with high-seasoned dishes, and those other 
 seducing provocatives to the diminished appetite and 
 lessened digestive powers of the residents in such cli- 
 mates, wliich, by occasioning the habitual ingestion of 
 more food than the system requires, are among the most 
 fertile sources of tropical 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 op- 
 portunities, 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 sys- 
 tem, even though it may be for a time sufficiently com- 
 pensated 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 inflammatory diseases 
 
 * Ejocreting orgam, those which separate the refuse matter. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 167 
 
 of the abdominnl viscera which so much more speedily 
 follow upon habitual excess in warm climates. For the 
 excreting organs cannot be always kept in 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 docs, 
 into an inflammatory condition, it is almost cerluin to be 
 remotely followed by a state of depressed activity, in 
 which the nutrition of the organ becomes impaired, so 
 that it is left, during the remainder of life, in a state 
 by no means equal 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 habitual 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 ex- 
 perience. The consequences are so remote, that wc may 
 not appear to be justified in attributing them to the 
 causes we have assigned. But let it be remembered, that 
 we have multitudes of other cases, in which the long- 
 continujed agency of morbific causes of comparatively low 
 intensity has been proved to be in the end not less potent 
 than the administration of a poison in a dose large enough 
 to produce its obviously and immediately injurious effects. 
 Thus a man who would be rapidly suffocated by immer- 
 sion in an atmosphere of carbonic acid may hve for 
 weeks, months, or years, in an atmosphere shghtly con- 
 taminated by it, without experiencing any evil effects 
 which he can distinctly connect with its influence ; and, 
 
168 
 
 SUPPOSED USES OF ALCOHOL 
 
 yet who will now deny that the constant action of this 
 minute dose of aerial poison is insidiously undei*mining 
 his vital powers, and preparing him to become the easy 
 prey of the destroying pestilence? So, again, we see 
 that a brief exposure to the pestilential atmosphere of the 
 swamps of the Guinea coast is often sufficient to induce 
 an attack of the most rapidly fatal forms of tropical fever ; 
 but the dweller among the marshy lands of temperate 
 climates, inhaling the paludal * poison in its less concen- 
 trated form, becomes after a time afflicted Avith inter- 
 mittent fever; and no one has any hesitation in here 
 recognizing the connection of cause and effect. On the 
 other hand, the resident in a town where the insufficiency 
 of the drainage causes the surface-moisture to be imper- 
 fectly carried off, and to be not merely charged with the 
 malaria of vegetable decomposition, but with the mias- 
 matic emanations of animal putrescence, may long be 
 free from serious disorder, if the cause do not operate 
 in sufficient intensity ; yet he becomes liable in a greatly 
 increased degree to the operation of .olmost every mor- 
 bific agent, and especially of the various forms of fever- 
 poison ; and no one who has paid even a slight degree of 
 attention to the results of the sanitary inquiries which 
 have now been carried on for many years past hesitates 
 in admitting the relation of cause and effect between 
 insufficiency of drainage and the higher rate of mortality 
 in undraincd localities, although not only days and weeks, 
 but months and years, may be required for the operation 
 of the cause upon the animal system. 
 
 157. Should we not, then, be running counter to all 
 
 * Paludal, mai'shy. 
 
/ i 
 
 IN SUSTAINING THE VITAL POWERS. 
 
 1G9 
 
 analogy, if wo do not hold ourselves ready to admit, 
 that such an habitual excess in diet as is favored by the 
 moderate use of alcohoho stimulants, and a consefi[uent 
 habitual over-exertion of the excretory organs, must bo 
 likely to have remotely injurious results 7 — and are we 
 not justified in assuming a relation of cause and effect to 
 exist, when we find such results occurring precisely as 
 we should predict 1 If the medical man has no hesitation 
 in regarding those severer derangements of the excretory 
 organs which are so common amongst those who commit 
 habitual excesses in eating and drinking as the conse- 
 quence of those excesses, why should he refrain from 
 attributing the milder but more protracted disorders of 
 the same organs to the less violent but more enduring 
 operation of the same cause? "The little I take does 
 me no harm "is the common defence of those who are 
 indisposed to abandon an agreeable habit, and who cannot 
 plead a positive benefit derived from it ; but, before such 
 a statement can be justified, the individual who makes it 
 ought to be endowed with the gift of prophecy, and to be 
 able to have present to his mind the whole future history 
 of his bodily fabric, and to show that, by reducing the 
 amount of his excess to a measure which produces no 
 immediately injurious results, he has not merely post- 
 poned its evil consequences to a remote period, but has 
 kept himself free from them altogether. The onus pro- 
 bandi* lies with those who assume the absence of a 
 connection which is indicated by every fact with which 
 we are acquainted. 
 158. Although we have hitherto been considering the 
 
 • Onus probandi, burden of proof. 
 
 15 
 
170 
 
 SUPPOSED USES OF ALCOHOL 
 
 effects of the "moderate" use of alcoholic stimulants 
 upon the excretory organs, as consisting simply in aug- 
 menting the amount of labor they are called upon to 
 perform, by favoring the reception of too large an amount 
 of alimentary matter into the system, yet there is another 
 point of view iinder which it will be convenient here to 
 examine its results ; namely, the direct influence of the 
 alcoholic stimulus upon the organs themselves. This in- 
 fluence may for a time be corrective of the other, and may 
 thus aid in concealing and retarding its evil consequences. 
 For we have seen (§ 57) that the introduction of a small 
 quantity of alcohol into the circulation has a direct action > 
 upon the kidney, increasing the determination of blood to 
 that organ, and tending to augment its secretion ; and it 
 is highly probable that it has a similar effect upon the 
 liver, more especially as the blood which has received 
 the alcohol by the absorbent action of the gastric veins * 
 passes through that organ before proceeding to any other 
 part of the system. In this manner, the call for increased 
 action of these two depurating! organs being met by 
 augmented functional activity on their part, a system of 
 compensation is maintained, whereby the effects of excess 
 are neutralized for a time, — but only for a time ; for, 
 as surely as any organ is habitually exerted in an ex- 
 cessive degree, so surely must its vital powers be prema- 
 turely exhausted, the remoteness of the period at which 
 the flagging of its power begins to manifest itself being 
 inversely to the degree of habitual over-excitement. 
 Hence we have additional reason for imputing a con- 
 siderable proportion of those chronic disorders of the 
 
 * Gastric veins, veins of the stomach, 
 t Depurating, separating refuse matter. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 171 
 
 ' i 
 
 excretory organs, to wliich reference has been more 
 especially made, to the habitual employment of alcoholic 
 liquors in what is ordinarily considered to be a " moder- 
 ate " amount, and regarded as perfectly consistent with 
 health, if not rec^uircd to maintain it. 
 
 159. It would be absurd, however, to affirm that such 
 diseases always proceed from this cause ; since those who 
 practise total abstinence from alcoholic hquors arc by no 
 means proof against other errors in dietetics ; and, in so 
 far as they habitually take in more food than their sys- 
 tem needs, they will be liable to suffer from disorder 
 of the organs whose duty it is to eliminate the waste. 
 But they will be much sooner warned of the excess they 
 ha\re committed, if the stomach refuses to digest the 
 superfluity, instead of being forced by artificial stimula- 
 tion to an undue exertion of its power ; and an attack of 
 indigestion, by early giving a salutary check to the prac- 
 tice, 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 "moderation," and who at the same time 
 practise habitual though slight excess in the amount of 
 sohd food which they consume, the delusive behef that 
 in neither case are they doing themselves any harm. 
 
 160. Effect upon the Stomach. — Such, then, are the 
 consequences to the system at largo, which theory and 
 experience join to indicate, as resulting from such an 
 habitual use of alcoholic liquors as stimulates the appe- 
 tite 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 pro- 
 duces upon the stomach itself. We have already described 
 
172 
 
 SUPPOSED USES OP ALCOHOL 
 
 the admitted results of what is commonly regarded as 
 *' excess; " and we shall therefore at present limit our- 
 selves 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 habit 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 be 
 impaired. The case is very similar to that of sleep. A 
 person in health, and not subjected to any unfavorable 
 influences, is naturally disposed to pass as much time in 
 repose as his system needs for its renovation ; but, if he 
 were long to accustom himself to the use of 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 beverages with their meals are seldom able to 
 discontinue them without a temporary loss of appetite 
 and of digestive power, unless, indeed, their place be 
 supplied by the more wholesome excitement of fresh air 
 and exercise. 
 
 161. With many persons, the evil, so far as the 
 stomach is concerned, may seem to be confined to 
 the induction of this state of reliance on artificial aid. 
 Year after year passes away, without any indication that 
 its powers have been overtasked, or that any unhealthy 
 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 Ihat, 
 
IN SUSTAINING THE VITAL POWERS. 
 
 173 
 
 whilst a potent dose of a poison speedily manifests its 
 action by the violence of its effects, the repeated intro- 
 duction of minute doses is not really inoperative, although 
 the effects are not speedily apparent. If the stomach be 
 not an exception to the general law of the action of sti- 
 mulants upon the animal body, we should expect that, by 
 the habitual over-excitement of its function, in however 
 trifling a degree, its vital energy will undergo a prema- 
 ture depression ; and that the result of the moderate use 
 of alcohohc stimulants will manifest itself, sooner or later, 
 in diminution of the digestive power. The earhest indi- 
 cation 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 sufficient to whet the appe- 
 tite, 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 bene- 
 fit 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 increased 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" 
 allowance being indulged in for a long course of years, 
 we should anticipate that injurious consequences, though 
 perhaps long postponed, must ultimately show themselves; 
 and that such is the case is unfortunately 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 
 
 16* 
 
174 
 
 SUPPOSED USES OF ALCOHOL 
 
 and middle life. And although the common idea, that 
 alcoholic liquors, when taken in small quantities, have a 
 ionic * property, may render it difficult for some to coin- 
 cide in the conclusion that the real effect of the habitual 
 use of even this small quantity must be of the opposite 
 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 recognition of the consequences which 
 might be theoretically expected to proceed from its long- 
 continued action. 
 
 162. It is not here maintained, however, that the 
 habitual employment 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 individuals throughout a long life, without the mani- 
 festation of any injurious results; whilst, on the other 
 hand, it cannot but be admitted that the disorder in ques- 
 tion may be induced in other ways. But the existence 
 of exceptional cases by no means invalidates the argu- 
 ment based upon general experience, any more than our 
 occasionally meeting with individuals who have daily con- 
 sumed a bottle of spirits, and have yet enjoyed a hearty 
 old age, warrants us in rejecting the evidence which indi- 
 cates that such a consumption wottWr have, in by far the 
 larger proportion of mankind, a decided tendency to 
 shorten life. Nor does it follow, that, because the loss 
 
 * Tonic, strengthening. 
 
IN SUSTAINING THE VITAL POWERS. 
 
 175 
 
 of digestive power may be justly attributed to other 
 causes when this one has been wanting, it has been inope- 
 rative 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 
 alcohohc liquors on the ground that it keeps them "up 
 to their work," the expenditure of nervous power, conse- 
 quent upon that undue exertion of the cerebral functions 
 which has been aided 1>;'^ the continual over-stimulation, 
 has a large share in the result. 
 
 163. Effect upon the Nervous System. — Every 
 medical man is 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 vigor, 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 con- 
 dition. It is not to be denied that such a state mav arise 
 quite independently of the agency, direct or indirect, of ha- 
 bitual stimulation; one instance, in particular, is strongly 
 present to the writer's recollection, in which it supervened 
 on a long course of excessive mental exertion, in an indi- 
 vidual who was most moderate in every thing but the 
 labor of his brain, and who rarely or never sought for 
 artificial support from alcoholic stimulants. But 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 system may be maintained for a longer time 
 by many persons, with the assistance of alcoholic stimu- 
 lants, than without them ; and thus the delusion -is kept 
 
 I 
 
 mm 
 
176 
 
 SUPPOSED USES OF ALCOHOL 
 
 up, that the strength is not reallj overtasked : when the 
 fact is, on the contrary, that the prolongation of the term 
 of over-exertion, by the repeated application of the sti- 
 mulus, is really expending more and more of the powers 
 of the nervous system, and preparing for a more com- 
 plete prostration at a later period. 
 
 164. The temporary advantage, then, which is thus 
 gained is very dearly purchased. The man who ha- 
 bitually abstains, not merely from alcoholic liquors, but 
 from other artificial provocatives (misnamed supports) 
 to the endurance of mental activity, is early warned by 
 the failure of his intellectual energy and cheerful tone 
 of spirits, that he is overtasking his brain ; whilst his 
 stomach tells 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 vigor. But the case is very different when the 
 effort 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 com- 
 plete ; and, as the stomach has been longer over-excited 
 and overtasked, its tone is the more seriously injured, 
 not merely by the depression consequent upon its own 
 overwork, 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 
 
IN SUSTAINING THE VITAL POWERS. 
 
 177 
 
 activity of supply ; and although, in like manner, the 
 habitual use of alcoholic stimulants may cause the sto- 
 mach to be less susceptible of the loss of the accustomed 
 energy, — yet, when the crisis does 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 impeded 
 by the deficiency of nervous energy, when this has been 
 lowered 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 the malady ; 
 and tedious and difficult is the process of restoration, as 
 every medical man well knows. We shall hereafter have 
 occasion {§§ 227, 228) to consider the best methods of 
 medical and hygienic * treatment for this condition, and 
 shall show that the measures which experience now 
 proves to be the most efficacious means of restoring the 
 vigor of the system are precisely such as the physio- 
 logist 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 ner- 
 vous system ; and we have found that we may, with the 
 highest probability, if not with absolute certainty, attri- 
 bute many of the chronic disorders which affect these 
 organs in advancing life — especially that loss of func- 
 
 Ilygienic, health-producing. 
 
178 
 
 SUPPOSED rSES OF ALCOHOL 
 
 tional 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 
 the stimulating influence of alcoholic beverages. In so 
 far, therefore, as the use of these beverages causes or 
 favors such excessive action, it must in the end be hurt- 
 ful, rather than beneficial, to the general health, — not- 
 withstanding that its temporary efiect 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 liquoi-s, taken habitually in 
 small quantities, upon the functions of circulation and 
 nutrition. 
 
 166. Effect upon the Circulation. — It may be diffi- 
 cult 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 circula- 
 tion; 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 "moderate;" and we have 
 now to inquire, whether it can recur habitually, through 
 a long series of years, without producing injurious re- 
 sults. There cannot be a doubt, that, in a healthy 
 person, the rate of the 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 
 
IN SUSTAINING THE VITAL POWERS. 
 
 179 
 
 of the erect posture, and still more in active exercise ; 
 but it may be accelerated also by exalted activity of the 
 nervous system, which sets up an unusual demand for 
 blood in the brain ; and its increase of rate, during the 
 digestive process, appears to be connected with the large 
 supply of blood then transmitted to the chylopoietic 
 viscera,* and required for the due performance of their 
 several offices. Now, whenever the circulation under- 
 goes any considerable acceleration, there is a tendency to 
 a recurrence of local congestions, arising from the want 
 of power, on the part of the vessels of some particular 
 organ, to allow their current to pass at the same rate 
 with the rest. Of this we have a familiar example in 
 that accumulation of blood in the pulmonary arteries 
 which is liable to take place in most persoiis during 
 violent muscular exertion, producing the feeling of being 
 " out of breath," and which is particularly marked in 
 those in whom there exists some disordered condition of 
 the lungs that obstructs the passage of blood through 
 their capillaries. 
 
 167. There are few persons, however, in whom there 
 is not some tendency to an irregularity of the circula- 
 tion, which manifests itself in a torpor in some parts, 
 and an undue activity in others. One of the most com- 
 mon forms of this, especially among individuals who 
 work their brains more than their muscles, is a torpor 
 of the current in the extremities, and an undue activity 
 in the cephalic circulation ; so that the head is habitually 
 heated, whilst the hands and feet are cold. Now, where 
 such is the case, we find that even the normal accelera- 
 
 * Chylopoietic viscera, organs which form chyle. 
 
180 
 
 SUPPOSED USES OF ALCOHOL 
 
 tion produced by the ingestion of food aggravates this 
 disordered condition; so that the face becomes more 
 flushed, and the head more hot, after meals, than at any 
 other time.* Precisely the same result is observable in 
 such persons, after the use of even a small quantity of 
 alcohoUc stimulant ; and the habitual production of it can- 
 not but be injurious, as tending to establish that inequality 
 which it should be our endeavor to counteract. 
 
 168. Similar inequalities exist in di£ferent individuals, 
 in regard to other organs. Thus it very frequently 
 happens, that the liver is the part in wliich a disposition 
 to torpidity of circulation exists ; and congestion of its 
 portal system of vessels must stagnate the whole of the 
 circulation through the chylopoietio viscera, from which 
 the blood of that system is derived. Any such disposi- 
 tion to local congestion must operate with increased force 
 in producing general irregularity of the circulation, when 
 the rate of movement is unduly accelerated ; just as the 
 outlets to a theatre, which suffice to discharge the entire 
 audience in a few minutes, when the pressure towards 
 them is uniform and regular, are speedily blocked up, 
 and produce a stagnation of the entire current ; whilst, 
 under the influence of an alarm of fire, every one is 
 rushing toward them with undue haste. And, as we 
 have seen that hepatic and abdominal congestions are 
 among the ordinary results of excess in the use of alco- 
 holic liquors ('J 155), it cannot be doubted that even 
 
 * The acceleration produced by muscular exercise 'will, of 
 course, be unattended by this result ; the cause of the acceleration 
 being such as to divert the current from the brain to the limbs, 
 and to make it pass through them with energy and rapidity. — 
 
 AUTHOB. 
 
IN SUSTAINING THE VITAL I'OWEIIS. 
 
 181 
 
 their moderate employment must aggravate any tendency 
 to such derangement of the circulation, when it already 
 exists. No such derangement can be habitual, and bo 
 thus continually liable to aggravation, without laying a 
 foundation for other more serious disorders. So, again, 
 as we have seen that habitual excess in alcoholic liquors 
 has a tendency to produce determination of blood towards 
 the kidneys, and thereby to favor the development of 
 many serious diseases in those organs (*§»•§> 54 — 58), we 
 can scarcely refuse to admit, that, where the least ten- 
 dency to disordered action already exists in them, it must 
 be aggravated by the habitual recurrence of such a slight 
 increase in the afflux of blood to them as would of itself 
 attract no attention. 
 
 169. If it be said, that, in thus reasoning upon proba- 
 bihties, we are going further than experience warrants 
 us in doing, we must again take leave to refer to the 
 argument from analogy on which we have already dwelt 
 (^ 156), as a justification of our somewhat theoretical 
 propositions. The whole tendency of modem pathologi- 
 cal research has been to show, that the human frame, if 
 endowed with an ordinary amount of inherent vigor, is 
 no otherwise incident to disease than as it is in various 
 ways subjected to the agency of causes which produce a 
 departure from the normal play of its functions ; and 
 that, although old age and decay are inevitable, diseases 
 are not, being preventible in the precise proportion in 
 which we are able to discover and eradicate their causes. 
 And when we can clearly trace a relation of cause and 
 eflFect between obvious and flagrant violations of the rules 
 of health and the occurrence of certain forms of acute 
 
 disease, we seem justified in assuming, that minor but 
 16 
 
182 
 
 SUPPOSED USES OF ALCOHOL 
 
 habitual violations of the same kind must be allowed to 
 participate, at any rate, in the production of chronic 
 diseases of the same order. The very nature of chronic 
 dibcaso implies a prolonged action of the causes in which 
 it arises ; for no such determinate alteration of the nor- 
 mal functions as it involves can be at all accounted 
 for by any temporary causes of perversion ; these either 
 inducing a transitory disorder, or, if acting with suflS- 
 cient intensity, exciting an attack of acute disease. In 
 chronic diseases, we find that the organ has, so to speak, 
 groivn to its perverted action ; so that no curative 
 measure is permanently beneficial which does not first 
 act by withdrawing the cause of the original departure 
 from the healthy state, and by placing the organ in the 
 best condition for its recovery. We are fully justified, 
 therefore, by all that we know of the causes of disease, 
 in asserting that the habitual use of alcoholic hquors by 
 healthy individuals, even in small quantities, is likely, 
 when sufficiently protracted, to favor the development 
 of such chronic disorders as originally depend upon an 
 irregularity in the movement of the circulating current, 
 or are liable to be augmented by it. 
 
 170. Effect upon Nutrition. — There appears, more- 
 over, to be an adequate amount of evidence, that the 
 practice in question has an unfavorable influence upon 
 the nutritive operations, by which the alimentary ma- 
 terials first converted into blood are applied to the 
 rfcgeneration of the living tissues. This influence is 
 not so clearly manifested in the ordinary course of these 
 operations — which indeed is not demonstrably affected 
 by it — as in the extraordinary demand which is made 
 upon the regenerative powers for the repair of injuries 
 
IN SUSTAINING THE VITAL POWEKS. 
 
 183 
 
 occasioned by accident or disease. It in well known to 
 surgeons, that the most desirable of all nio<u -t by which 
 the reparation of wounds can Ik) effected is tlio simple 
 adhesive process known as "union by the first inten- 
 tion;" and that where, in consequence of loss of sub- 
 stance, union by the first intention cannot Ix) effectetl, 
 the most favorable method is that which is termed the 
 " scabbing process ; " in which a hard crust being formed 
 upon the surface, so as to protect it from the iri'itating 
 action of the atmosphere, a continued growth or re- 
 formation of tissue takes place beneath, without any 
 interruption from inflammatory action, until complete 
 filling-up has been effected, and a new cutaneous surface 
 is formed beneath the scab. But it too frecjucntly hap- 
 pens that the reparative processes cannot be induced 
 to take place after either of these fashions, but that 
 inflammatory action is set up in the wound, and matter 
 forms between its lips or beneath the scab, rendering 
 its detachment necessary, and thus re-converting the 
 wound into an open sore. The healing of this sore must 
 be accomplished by the much less healthy process of 
 suppurating granulation ; during the progress of which, 
 a large amount of nutritive material runs to waste as 
 purulent discharge, whilst a great degree of constitu- 
 tional irritation is often set up ; and the best termination 
 of which is the formation of a cicatrix, that subsequently 
 undergoes an unsightly and often inconvenient contrac- 
 tion, from which the new tissue formed under a scab is 
 free. 
 
 171. Now, the occurrence of the first of these modifi- 
 cations of the healing process is an obvious indication of 
 such a healthful condition of the nutritive operations as 
 
184 
 
 SUPPOSED USES OF ALCOHOL 
 
 can repair the effects of an injury in the most complete 
 manner, with the least possible waste of nutritive mate- 
 rial, and with the most entire absence of constitutional 
 disturbance ; whilst, on the other hand, the impossibihty 
 of procuring it, even under the most favorable circum- 
 stances of rest, fresh air, and wholesome ahment, indi- 
 cates that the nutritive functions are not in their normal 
 condition. Amongst the lower animals we seldom find 
 injuries repaired in any less favorable mode, unless the 
 part be placed in circumstances adverse to this healthy 
 action. But among "civilized" communities of men, 
 the case is very different; for the occurrence of the 
 scabbing process, in the case of any but trivial wounds, 
 is the exception, not the rule ; being, in fact, so rare 
 that many surgeons never think of attempting to bring 
 it about. Now, that there is nothing essentially different 
 in the constitution of man which places him in this 
 respect at a disadvantage as compared with the lower 
 animals, appears from the fact, that all who have visited 
 "savage" nations, in whom more constant exposure to 
 air is practised, and who enjoy immunity from many 
 causes of disease which exist in civihzed communities, 
 have been struck with the facility with which wounds 
 heal among them, and with their remarkable freedom 
 from that constitutional disturbance which, amongst our- 
 selves, almost invariably follows severe injuries. Thus, 
 Hawkesworth, in his voyage to New Zealand, makes 
 particular mention of the "facility with which wounds 
 healed that had left scars behind them, and that we saw in 
 a recent state ; when we saAv the man who had been shot 
 with the musket-ball through the fleshy part of the arm, 
 his wound seemed to be so well digested, and in so. fair a 
 
 
IN SUSTAINING THE VITAL POWERS. 
 
 185 
 
 way of being perfectly healed, that, if I had not known 
 no application had been mjide to it, I should certainly 
 have inquired with a very interesting curiosity after the 
 vulnerary herbs and surgical art of the country." Of 
 these people, he states that at that period water Avas 
 their solo and universal liquor. 
 
 172. Now, it would be absurd to maintain, that the 
 habitual moderate use of fermented hquors is the sole 
 reason of the rarity of this healthful operation of the 
 reparative process amongst ourselves ; since a multitude 
 of other departures from the laws of health are con- 
 tinually practised by almost every member of a civilized 
 community. But, if we look to the unquestionable fact, 
 that habitual excess in the use of fermented liquors pro- 
 duces a condition altogether opposed to the healthful 
 performance of these processes, so that the slightest 
 scratch or abrasion may give rise to a rapidly fatal attack 
 of inflammation (Ȥ> (53), it can scarcely be denied, that, 
 where a minor departure from the normal condition 
 shows itself, and the same cause has been in action in 
 less intensity, that departure may be reasonably consid- 
 ered, in part at least, as its eftect. And this conclusion 
 is remarkably confirmed by the surgical cxijcrience of 
 the late campaigns in India, on occasions on which there 
 had been, from accidental causes, an interruption in the 
 usual supply of spirits. Thus, ^Er. llavelock^ in his 
 " Narrative," in reference to the wounded, after the vic- 
 tories in India, observes : " The medical officers of this 
 army have distinctly attributed to their previous ab- 
 stinence from strong drink the rapid recovery of the 
 wounded at Ghuznee." And Mr. Atkinson, in his work 
 on Affghanistan, is more explicit, stating that ''all the 
 16» 
 
 
180 
 
 SUPPOSED USES OF ALCOHOL. ETC. 
 
 \i 
 
 n 
 
 ti 
 
 swortl-cuts, which were very numerous, and many of 
 them very deep, united in the most satisfactory manner ; 
 which we decidedly attributed to the men having been 
 without rum for the previous six weeks. In consequence, 
 there was no inflammatory action to produce fever, and 
 interrupt the adhesion of the parts." 
 
 173. From the foregoing considerations, then, we 
 seem entitled to draw the general conclusion, that, in 
 the " average man," the habitual use of alcoholic liquors, 
 in moderate or even in small quantities, is not merely 
 unnecessary for the maintenance of bodily and mental 
 vigor, but is even unfavorable to the permanent enjoy- 
 ment of health, even though it may for a time appear to 
 contribute to it. For, as it is justly remarked by Dr. 
 Robertson, " that man only is in good health who recovers 
 rapidly from the simple accidents incidental to his occu- 
 pation, and from the simple disorders incidental to his 
 humanity and to the climate he lives in, and who can 
 bear the treatment that those accidents or those disorders 
 demand ; " and, if such be not the case, we may feel 
 confident, that, however great the temporary power of 
 exertion may be, such power is destined to give way at 
 a period much earlier than that of its normal duration. 
 And if it be true, as we have endeavored to show, that 
 the effect of the habit is not merely to induce certain 
 predispositions to disease by its own agency, but also to 
 favor almost any of those which may already exist in a 
 latent form, we have an additional right to aflSrm, that 
 even the most moderate habitual use of alcoholic liquors 
 becomes to the "average man" positively injurious, if 
 protracted for a sufiicient length of time to allow of the 
 development of its effects. 
 
187 
 
 CHAPTER III. 
 
 ARE THERE ANY SPECIAL MODIFICATIONS OF IHE 
 BODILY OR MENTAL CONDITION OF MAN, SHORT 
 OF ACTUAL DISEASE, IN WHICH THE OCCASIONAL 
 OR HABITUAL USE OF ALCOHOLIC LIQUORS MAY 
 BE NECESSARY OR BENEFICIAL? 
 
 174. There appear to be three classes of cases in 
 which recourse may be had with temporary advantage 
 to the use of alcoholic liquors : those, in the first place, 
 in which there is a demand for some extraordinary exer- 
 tion of the animal powers, and in which the occurrence 
 of subsequent depression may not be an adequate objec- 
 tion to the employment of a stimulus that enables the 
 system to meet it ; those, in the second place, in which 
 there is a deficiency of the proper sustenance, and in 
 which alcohol serves as a heat-producing article of food ; 
 and those, in the third place, in which there is a want 
 of sufiicient vigor on the part of the system itself to 
 digest and assimilate the aliment which it really needs 
 for its support. 
 
 I. DEMAND FOR EXTRAORDINARY EXERTION. 
 
 175. Of the first class, the following appropriate 
 example may be extracted from the letter of Dr. J. D. 
 Hooker, alreailv cited : "I know of only (mo occasion," 
 
 wtmmmmmmfmk 
 
188 
 
 USE OF ALCOHOL 
 
 
 i 
 
 I 
 
 he says, " on which the use of spirits appeared indispen- 
 sable ; and that was when a httle more exertion at the 
 crowning of a mighty and long-continued effort was 
 demanded. Thus the ship, when saihng in the paek- 
 ice, is sometimes beset, or falls to leeward into the 
 lee-ice. This takes two or three minutes — but, if there 
 is much wind, it takes many hours — to get her out. 
 Not being in command, the sails are of no use ; and the 
 ice prevents her from moving in any way but with it to 
 leeward. Under these circumstances, the only way 
 to get her out is by fastening ropes from the ship to the 
 larger masses of ice, and Avarping her out by main force 
 against the wind. Now, I have seen every officer and 
 man in the ship straining at the capstan for hours together, 
 through snow and sleet, with the perspiration running 
 down our faces and bodies like water. Towards the end 
 of such a struggle, at the mighty crowning effort, I have 
 seen a little grog work wonders. I could not have 
 drunk hot coffee without stopping to cool ; nor, if I had, 
 do I think it would have supplied the temporary amount 
 of strength which was called for on the spot under cir- 
 cumstances hke this. These, however, are extreme cases, 
 which do not affect the sailor in his ordinary condition, 
 and which any ship might be well prepared for." 
 
 176. It must be within the experience of most persons, 
 that a very small quantity of alcoholic stimulus has been 
 of similar efficacy in sustaining the nervo-muscular energy 
 under some temporary effort, wliich circumstances called 
 for, and to which the system, exhausted by previous 
 fatigue, would not otherwise have been equal. And the 
 writer can speak from his own knowledge of its corre- 
 sponding effect in quickening and freshening the mental 
 
IN EXCEPTIONAL CASES. 
 
 189 
 
 pspen- 
 It the 
 was 
 pack- 
 the 
 there 
 T out. 
 dthe 
 it to 
 way 
 to the 
 force 
 and 
 ether, 
 
 power, during a brief period, through which it could not 
 otherwise have been sustained. Of course, in every such 
 case, a corresponding depression is subsequently felt; 
 but this depression is rather traceable to the fatigue of 
 over-exertion than to the re-action consequent upon over- 
 excitement. For, in the cases alluded to, the eflfect of the 
 alcoholic liquor is not to quicken the circulation, or to 
 exalt any of the functions above their normal activity, 
 but merely to keep them up to par ; and its use for such 
 a purpose is therefore free from many of the objections 
 which have been urged against its habitual employ- 
 ment. 
 
 177. But it must not hence be supposed, that recourse 
 to alcoholic liquors can habitually be had with impunity 
 for purposes of this kind. Every kind of ' ' forcing ' ' must 
 be in the end injurious to the vital powers, and more espe- 
 cially to those of the nervous system; and the more 
 frequently and violently it is practised, the more speedily 
 may we expect that functional derangement will manifest 
 itself Extreme overtasking of its poAvers is often so 
 immediately followed by apoplexy, paralysis, epilepsy, 
 mental derangement, or fatuity, that no one has any 
 hesitation in regarding these as the natural results of 
 the previous immoderate exertion ; and we appear equally 
 justified in attributing similar results to similar causes, 
 however remote the results may be, where causes less 
 potent have been in continual or frequently repeated 
 operation. For every such irregularity tends to derange 
 the nutrition of the system; and, if a renewal of the 
 irregularity should take place before the effects of 
 the preceding derangement have been recovered from, 
 they are, of course, aggravated ; and thus a cumulative 
 
 11 
 
 •MMMMana 
 
190 
 
 USE OF ALCOHOL 
 
 result is produced, and a permanently disordered state 
 of nutrition established, which manifests itself at last in 
 some serious and settled form of cerebral disease. 
 
 178. The case resembles that of the racer, excited to 
 put forth his utmost speed, or the jaded roadster goaded 
 to a temporary improvement of his pace by the applica- 
 tion of the spur. The spur gives no strength ; but, like 
 the dram to the sailor toiling at the capstan, or the glass 
 of wine to the public speaker wearied with his previous 
 exertions, it calls forth the most vigorous exercise of 
 the remaining strength. The racer may fall dead on the 
 spot ; the roadster may sink from exhaustion ; but 
 the spur has only been the indirect means of bringing 
 about this catastrophe, the real cause of it being the 
 undue exertion which it has called forth. And in like 
 manner, when recourse has been had to alcoholic liquors 
 for the maintenance of the power to meet some extraor- 
 dinary demand upon the bodily or mental energy, and 
 the amount used has been merely such as to meet that 
 demand, we ought to attribute the subsequent exhaus- 
 tion rather to the violence of the effort which has been 
 put forth, than to the stimulus, trifling in itself, by which 
 the system was rendered capable of making it. The 
 occasional dram or glass of wine would of itself have 
 produced but little mischief in comparison ; and its con- 
 sequences might have been manifested in some other 
 way . But the frequent over-exertion of the vital powers, 
 especially those of the nervous system, must ultimately 
 tell upon the fabric, under whatever kind of excitement 
 it is called forth. 
 
 179. However desirable, then, it may be to avoid the 
 necessity for such immoderate exertion, it can scarcely 
 
IN EXCEPTIONAL CASES. 
 
 191 
 
 ite 
 in 
 
 ' 
 
 be denied, that occasions will arise in the experience of 
 some persons, in which the temporary assistance derived 
 from alcohohc liquors could scarcely be replaced by any 
 other. When the choice lies between the easy and 
 satisfactory performance of the prescribed duty, and the 
 discharge of it as a task which must be got through at 
 all hazards by the most determined bracing up of the 
 powers for its execution, there can scarcely be a doubt, 
 in the opinion of the writer, that, if the former can be 
 procured by the use of such a small dose of alcohol as 
 shall merely raise the vital powers for a time to their 
 usual energy, it will be followed by less of subsequent 
 exhaustion than the latter. But again, he would repeat, 
 — and he cannot do so too often, or too earnestly, — 
 that the habitual recourse to such a practice is fraught 
 with the greatest prospective danger ; since it encourages 
 the delusive idea, that the exertion which is thus for a 
 time sustained is really doing no injury to the system ; 
 besides which, it is next to impossible that the frequent 
 use of alcoholic liquora, however moderate, can be per- 
 severed in, for any length of time, without favoring 
 the production of that disordered state of nutrition of the 
 brain which the irregular activity of the nervo'S system 
 has of itself so marked a tendency to generate. It should 
 rather be the aim of those who have accustomed them- 
 selves to such assistance to avoid the necessity (so far as 
 may be possible) for such extra-exertion, and to prepare 
 themselves to meet it, when it is indispensable, by care- 
 ful and constant attention to all the rules of health. 
 The most beneficial results from such a use of stimulants 
 are to be experienced by those who are habitually absti- 
 nent ; since the quantity of alcohohc liquor which they 
 
 MMWi 
 
192 
 
 USE OF ALCOHOL 
 
 require for the purpose is extremely small ; and whatever 
 injurious effects it may produce will be more likely to be 
 dissipated, when a considerable interval elapses before it 
 is again resorted to. When alcohohc liquor is employed 
 as an ordinary beverage, the quantity required to give 
 the desired aid, on the occasions in question, is such 
 as must of itself exert a prejudicial influence on the 
 system. 
 
 180. Nearly allied to the preceding cases, are those in 
 which the use of alcoholic liquors may be found beneficial 
 in assisting to fortify the system against a temporary 
 exposure to cold or damp, separately, or in combination. 
 We have already examined into the reputed efficacy of 
 alcoholic liquors in favoring the resistance to cold, and 
 have found reason to adopt the conclusion that this re- 
 putation is altogether fallacious as regards the power of 
 continued endurance. There can scarcely be a question, 
 however, that although, considered simply as a heat- 
 producing material, alcohol is inferior in some important 
 particulars to such oleaginous matters as can be readily 
 introduced into the current of blood, it has for a time 
 the power of keeping off the chilling influence of severe 
 external cold, in virtue of the augmented rapidity of the 
 circulation which it induces, and particularly of the de- 
 termination of blood which it favors towards the vessels 
 of the skin. And this effect seems to be exerted Avith 
 still greater benefit when cold and damp are acting 
 together; their depressing influence being kept at bay 
 for a time by the moderate use of alcoholic stimulants, 
 so that no injurious result is subsequently felt from an 
 exposure which might otherwise have been followed by a 
 severe "cold," an attack of rheumatism, or some* other 
 
IN EXCEPTIONAL CAPES. 
 
 193 
 
 it 
 )d 
 ve 
 
 3h 
 
 le 
 
 malady, as determined by tlic idiosyncrasy * of the indi- 
 vidual. 
 
 181. It is not here argued, however, that alcoholic 
 liquors afford the best means of resisting such influences. 
 On the contrary, it is within the experience of most per- 
 sons, that muscular exertion, where it can be employed, 
 is a far better means of keeping up that vigor of the 
 circulation which shall resist the influence of the external 
 chill, than the use of any stimulants whatever in a state 
 of bodily inactivity. But, where circumstances prevent 
 a resort to the former, and the choice lies among the 
 best internal means 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 influ- 
 ence is powerful and likely to be of short duration, it 
 may be betler resisted 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 un- 
 desirable ; for the system is never so obnoxious to the 
 depressing influence of cold and damp as when it is 
 already in a buite of depression resulting from previous 
 over-stimulation ; and the use of coffee, cocoa, and other 
 hot beverages, with solid food, which shall aid in per- 
 manently sustaining the heat of the system, is then 
 unquestionably to be preferred. Here, again, we would 
 remark, that the habitu[il abstainer has decidedly the 
 advantage, since a very small amount of the stimulus 
 is sufficient, as in the former case, to produce the desired 
 result ; and that, if recoui-se be too frequently had to it, 
 the remote consequences of alcoholic excitement may be 
 expected to manifest themselves. 
 
 17 
 
 * Idiosyncrasy, peculiarity of constitution. 
 
194 
 
 USE OF ALCOHOL 
 
 II. DEFICIENCY OF OTHER ADEQUATE SUSTENANCE. 
 
 182. The second class of cases in which the use of a 
 small amount of alcoholic liquors seems 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 ani- 
 mal tissues would otherwise be attacked. Under such 
 circumstances, too, the temporary elevation of the ha- 
 bitually depressed state of the animal power seems rather 
 beneficial than injurious. Of this we have a remark- 
 able 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 teaspoonful 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 teaspoonful of rum each, to 
 enable them to bear with their distressing situation." 
 And again: " Our situation was miserable ; always wet, 
 and sufiering 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 teaspoonful 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, facK, 
 litating the endurance of such an exposure, it can scarcely 
 be questioned, that, in circumstances such as those of 
 Captain Bligh's crew, the administration of the few drops 
 of spirit was of the most important service, both Us sup- 
 
IN EXCEPTIONAL CASES. 
 
 lOo 
 
 ^E. 
 
 plying com])U3tible muterial, and as enabling the poweix 
 of their system, already seriously depressed, from being 
 fatally reduced by the privations to which the party was 
 subjectefl. 
 
 183. The beneficial influence of a small quantity of 
 alcoholic stimulus, in contributing to the endurance 
 of bodily labor under circumstances peculiarly trying, 
 and under the disadvantage of a deficient allowance of 
 animal food, hiis been demonstrated on an extensive scale 
 by the hygienic* experience of the large prison at 
 Nismes, called the "Maison Centrale," of which an ac- 
 count has been recently published by the chief physician, 
 M. Boileau Castelnau, Avho has been connected with the 
 prison for the last twenty-five years.f Of this account an 
 abridgment will be here given, as the facts are considered 
 by the writer as of very great importance, in disprov- 
 ing, by the experience of a large number of individuals, 
 the position of those who assert that under no circum- 
 stances can the habitual use of alcoholic liquors be 
 otherwise than injurious. This prison usually contains 
 a population of 1,200 convicts, most of them adults, the 
 minimum age being eleven. Its wards have been habitu- 
 ally over-crowded and ill-ventilated, and insufficiently 
 heated in winter ; and the food of the prisoners has been 
 coarse and innutritions, whilst more labor has been ex- 
 tracted from them than their strength has been adequate 
 to perform. The prisoners, moreover, have been sub- 
 jected to the tyranny of brutal keepers, frequently loaded 
 with irons, and occasionally severely whipped. Under 
 these circumstances, it is not surprising that the rate of 
 
 * Hygienic, health-producing. 
 
 t See the Annalcs d'llygienc Publique, Jan. 1819. 
 
196 
 
 USE OF ALCOHOL 
 
 mortality in the prison has been always high, varying 
 from one in 23 88 to one in 7*85, whilst the average rate 
 of mortality amongst the inhal^itanta of the town of 
 Nismcs, of the same ago and sex, amounted to one in 
 49'9. The rate of mortality in the prison underwent 
 considerable variations in different 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 mor- 
 tahty for 1829 was one in 940, whilst for 1830 it was 
 one in 8 50 ; clearly proving the fatal influence of a low 
 temperature upon systems debihtated by insufficient food, 
 impure air, and work disproportioned to their strength. 
 With the exception of the year 1833, in which the mor- 
 tality was again great, the rate was much less for several 
 subsequent years, varying between one in 11*35, and one 
 in 1562 ; but in 1839 it suddenly rose from one in 12-32 
 to one in 7*85. The cause of this terrible augmentation 
 (from 102 deaths to 162) seems to have lain in a mini- 
 sterial ordinance issued on the 10th of May, 1839, 
 limiting the alimentary articles allowed to be sold at the 
 canteen to potatoes, cheese, and butter. Previously to 
 th at time, the convicts had had it in their power to lay 
 ou t a portion of their earnings, wliich was at their own 
 d isposal, 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 whom 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 
 mus t be aware, that, in the south of France, wine is con- 
 idered an absolute necessary of life. It is drunk 'by the 
 s 
 
IX EXCEPTION AT, CASES. 
 
 197 
 
 poorest of the people, and ap|)cais essential to enahlo 
 them to digest their coarse, unstitnulating fixxl. Within 
 the town of Nismes, it costs about a penny the litre 
 (1| pint) ; and without the wall, where it is free from 
 duty, the laborer may drink it at a penny the hour. Po- 
 tatoes, butter, and cheese could not replace its stimulus ; 
 and besides, the south of France containing no pastures, 
 the butter was bad and dear, and the cheese also dear. 
 Hence, the pittance at the disposal of the prisoners wa.s 
 more than ever insufficient 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 to1)acco 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 1,216 pri- 
 soners, or one in 9*07. Attention being now attracted to 
 the condition of the prisoners, an attempt was made 
 to ameliorate it ; the old keepers being removed, and their 
 places being supplied by the " Freres des ecoles chre- 
 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 fifty-six out of 
 1,290 prisoners, or one in 23-88. The " Freres," how- 
 ever, being disgusted at the continual obstructions which 
 their measures received, gave up their charge ; the old 
 system of hard work and cruel punishments was again 
 
 * Freres, &c. an order of friars. 
 
 17* 
 
198 
 
 USE OF ALCOHOL 
 
 introduced ; aiid the pittance at the disposal of the pri- 
 soners was diminished to a mere fraction. The effect of 
 this change speedily showed itself in the increased mor- 
 tality, the avei-age of deaths progi-essively increasing, in 
 the years 1845, 1846, and 1847, to one in 19-63, one 
 in 16 -52, and one in 1357. One of the first acts, how- 
 ever, of the revolutionary government of February, 1848, 
 was to put a stop to the system of convict-labor, as 
 it was then carried on, and the result of this change was 
 speedily apparent in the diminished mortality ; for, whilst 
 the number of deaths during the seven months ending 
 October 31, 1847, had been forty-four, only sixteen 
 deaths took place during the corresponding months 
 of 1848. 
 
 186. Now, the principal lesson taught by this fearful 
 history is the dependence of the vital powers upon food, 
 and the fatal effects of the exaction of severe labor from 
 men insufficiently supplied with aliment, especially when 
 they are subjected to the additionally injurious influences 
 of a low temperature, foul air, and ill treatment. But 
 it seems obvious, from the large increase in the r.ate of 
 mortality which ensued upon the prohibition of icine^ no 
 extraordinary depression of temperature having existed 
 to account for it, that its deprivation exerted a positively 
 injurious effect. If an adequate measure of nutritious 
 food had been supplied in its stead, the change would 
 doubtless have been for the better ; but the support given 
 by the wine, which was probably too weak and poor to 
 have any decided stimulating effect in moderate quantities, 
 had become so necessary to the debilitated systems of 
 these men, that its withdrawal was fatal to many among 
 them. 
 
IN EXCEPTIONAL CASES. 
 
 199 
 
 187. From these two cases, then, and from others 
 which miglit be cited to the same effect, we seem justified 
 in concluding that the use of alcoholic liquors in small 
 quantity may assist in sustaining the powers of the sys- 
 tem, 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 docs decidedly more good than harm, and should 
 therefore bo 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 
 Avithout the use of alcohohc 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 OF CONSTITUTIONAL VIGOR. 
 
 188. Wo 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 vigor on 
 the part of the system itself to digest and assimilate the 
 aliment which it really needs. Such cases present them- 
 selves in all ranks of life. In the higher, they too fre- 
 quently 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 
 hereditary weakness of digestive power. In the middle 
 classes, it is usually traceable to the " wear and tear " of 
 
200 
 
 USE OF ALCOHOL 
 
 professional or commercial avocations ; to undue cerebral 
 labor, carried on, as this frequently is, in ill-ventilated 
 apartments ; and to the anxieties incident to the consci- 
 entious discharge of the duties of a profession, or to the 
 fluctuations of business. Among the lower classes, on 
 the other hand, it is traceable rather to the condition of 
 their dweUings, workshops, and persons ; to the want 
 of ventilation of the buildings in which they dwell or 
 labor, 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 reduc- 
 tion of demand for aliment to its lowest point ; for where 
 neither the muscular nor the nervous systems are ade- 
 quately exercised, and 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 combustive action can be needed to keep up the heat of 
 the body to its proper standard. But the digestive 
 powers are very liable, when their natural use is too 
 little called for, to sink beloiv the level at which the 
 demands of the system should keep them ; and thus an 
 almost total want of appetite, and extreme debility of the 
 stomach, are the result, which of course tends to aug- 
 ment the habits of self-indulgence, and to foster the 
 whole system of " coddling." In such cases, an appa- 
 rent benefit is derived from the habitual employment of 
 a glass or two of wine, or a tumbler of bitter ale : but 
 tliis merely facilitates the persistence in a wrong course ; 
 and every judicious practitioner would now assent to the 
 truthfulness of the advice, given by Abernethy in a case 
 of this kind, to " live on a shilling a day, and earn it." 
 
IN EXCEPTIONAL CASES. 
 
 201 
 
 •al 
 ed 
 
 It is utterly impossible that alcoholic licjuors can coun- 
 teract the influence of heated rooms and late hours ; that 
 they can stand in the place of healthful exercise of mind 
 and body ; or that they can neutrahze 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 appetite which ought to be 
 naturally felt, and to urge the unwilling stomach to di- 
 gest that food which the body really requires. But this 
 they can only eflfect by their stimulating properties; 
 and, as the usual dose almost invariably ceases after a 
 time to exert its original influence, it requires a gradual 
 increase, until the evil effects of its habitual use in such 
 a state of the system are unmistakably manifested. 
 
 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 favorable to the recovery of its 
 vigor, 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 labor in behalf of others for the weariness of ennui, 
 or continual thought of one's self, 
 
 191. Nevertheless, it may happen, that, after all these 
 means have had a fair trial, and considerable improve- 
 ment may have been produced, the stomach may not bo 
 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 
 
 ..,Ji 
 
202 
 
 USB OF ALCOHOL 
 
 consequence of their own unhealthful habits), or in whom 
 they have been fixed (so to speak) by an erroneous sys- 
 tem of bodily and mental training, and especially by the 
 habitual use of stimulants during childhood and youth. 
 In such cases, the writer believes that the habitual use 
 of a small quantity of alcoholic stimulant, especially 
 when combined with a bitter tonic, may be of more 
 service than any other form of medicine ; and, if care be 
 taken not to employ it to such an extent as to produce 
 an artificial appetite, or to force the stomach to digest 
 more than the system really needs, it does not appear 
 likely to have the same permanently injurious effects as 
 it exerts in most other cases. It will generally be found 
 to be an indication of its beneficial use, that the dose 
 does not require increase ; the small quantity originally 
 taken continuing to exert its good effects ; and this 
 benefit will be more hkely to be persistent, if the use 
 of the alcoholic stimulant be intermitted whenever the 
 digestive powers seem adequate to the support of the sys- 
 tem without it. 
 
 192. The want of appetite and feebleness of digestive 
 power, so common among individuals in the middle 
 classes, who go through an undue amount of cerebral 
 labor, frequently under circumstances which are of them- 
 selves prejudicial to health, has been already adverted to 
 under another head (§§ 163, 164) ; and it has been 
 shown, that the use of alcoholic liquors cannot in gen- 
 eral be regarded as likely to be permanently beneficial 
 in such a condition, although temporary benefit may 
 doubtless be derived from it. It is impossible that alco- 
 hol can supply the place of mental repose to the man 
 whose intellect is overtasked, and whose anxieties ' are 
 
IN EXCEPTIONAL CASES. 
 
 203 
 
 unduly excited for himself or for others ; or that it can 
 be an efficient substitute for muscular exercise to the 
 man of sedentary habits, or for fresh air to him who is 
 habitually exercising his brain in a close, ill-ventilated 
 apartment. All that it can do is, as in the former 
 case, to restore the appetite which ought to be felt, and 
 to force the digestive powers to the discharge of the duty 
 which they are indisposed to perform of their own accord. 
 And here, too, we find that, when stimulants are habit- 
 ually employed for such a purpose, they gradually lose 
 their power ; and the wearied stomach, like the jaded 
 roadster, at last breaks down, under the combined influ- 
 ence of the withdrawal of nervous agency consequent 
 upon cerebral exhaustion, and of the depression of its 
 own energies consequent upon the habitual over-excite- 
 ment to which it has itself been subjected. 
 
 193. Here, then, it is obvious that the use of alcohol- 
 ic stimulants can only serve as a palliative, and that 
 the true remedy can only be found in such a change 
 of habits as shall bring back the system as nearly as 
 possible to the natural state. The intellectual labor 
 must be moderated ; the mind must be prevented from 
 dwelling on its own sources of anxiety by the healthful 
 influences of social and domestic intercourse, of variety 
 of occupation, and of objects that shall interest without 
 exciting it; and the body must be placed, by regular 
 exercise, fresh air, and adequate repose, in the most 
 favorable condition for the endurance of mental labor. 
 Such measures, steadily pursued, with an occasional 
 complete intermission from the ordinary occupations, and 
 an entire change of scene with the accompaniment of 
 fresh objects of interest (for ennui is to be especially 
 
 i i 
 
 1 I 
 
204 
 
 USE OF ALCOHOL 
 
 Ill 
 
 avoided), more especially when a bracing air and aug- 
 mented muscular exercise tend still further to the bodily 
 invigoration, will usually be found sufficient, when em- 
 ployed in time, for sustaining the appetite and digestive 
 powers under that amount of mental lalwr to which the 
 system is really equal ; and recourse should be had to all 
 such natural means of procuring and sustaining the vigor 
 of health, before the artificial and delusive aid of alcoholic 
 stimulants is invoked. It is, indeed, among the most 
 injurious 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 
 lx>lsters 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 moans 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 alcoholic 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 sustjiin 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 heredi- 
 tary 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 in- 
 crease the dose ; and the practice is continued with appa- 
 rent benefit through the whole of life. A characteristic 
 
IN EXCEPTIONAL CASES. 
 
 205 
 
 
 example of the results of experience in this respect is 
 afforded by the case of the late Dr. Joseph Clarke, 
 of Dublin, who lived to the age of seventy-six years, 
 and who discharged the duties of a laborious profes- 
 sion, with scarcely any intermission, to the end of his 
 life.* 
 
 195. The craving which is felt for alcoholic liquor 
 among the classes whose labor is rather physical than 
 mental, and the benefit which in many cases appears to 
 be derived from it, proceed from a different cause. No- 
 thing can be conceived in itself more likely to whet the 
 appetite, and invigorate the digestive powers, than regu- 
 lar but not excessive muscular toil, with that moderate 
 occupation of mind which the execution of the labor 
 involves; but, in order that this may exert its proper 
 effect, it must be carried on under circumstances other- 
 wise favorable to 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 involves, and the 
 labor cannot be borne without the assistance of stimu- 
 lants. 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 the system 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 cir- 
 
 ! 
 
 ' 41 
 
 ♦ See the Sketch of Dr. Clarke's Life and Writings, by his 
 nephew, Dr. Collins, p. 81. 
 18 
 
206 
 
 USE OF ALCOHOL 
 
 oumstances, 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 func- 
 tions of tlie body; 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 efiect ; 
 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 conditicm of 
 the journeymen tailors employed in the large London 
 workshops, as disclosed by the inquiries whose results 
 are published in the first " Sanitary Beport" (1842). 
 The heat and closeness of the 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 hands from the country fainted 
 away. In order to get the strength up for the day's 
 work, and to Create an appetite for breakfast, 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 subsequent ten hours. Now, the utter inability 
 of the alcoholic stimulus to afibrd more than a tempo- 
 rary power of endurance under such a state of things, 
 and the cumulative eflfect 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 from consiunption ; 
 
IN EXCEPTIONAL CASES. 
 
 207 
 
 their average age not being above thirty-two, and a man 
 of fifty being considered a& superannuated. "* 
 
 197. Nothing can be more absurd, then, than to 
 maintain that any real benefit is derived from alcoholic 
 liquors in such cases, or 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 
 miasmata; nor, again, can it make up for the want of 
 personal cleanliness. These agencies can only be reme- 
 died by their proper antagonistic measures, — hot and 
 foul air by proper ventilation ; noxious emanations from 
 the soil by efficient sewerage ; filthiness of the skin and 
 garments by the use of baths and wash-houses ; and, if 
 they be allowed to continue, they must exert their influ- 
 ence on the bodily system, all the alcohol in the world 
 notwithstanding. When, on the other hand, they are 
 removed, — the artisan's labor being prosecuted in pure 
 air, and his home and garments being kept clean and 
 fresh, so that his skin and lungs are allowed their due 
 exercise, — it will be seldom, if ever, that any thing else 
 will be 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 
 
 ♦ 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 gradually ceased to manifest itself. 
 
208 
 
 USE OF ALCOHOL 
 
 I 
 
 i 
 
 4- 
 
 G^- 
 
 beneficial, is in the end rather pernicious than otherwise ; 
 and this not so much, in the cases now under considera- 
 tion, by their own specific effects on the system, as by 
 causing the individual io feel less need of the very change 
 which is needed for the restoration of the body to its 
 wonted vigor. The insensibility to the efiects of various 
 morbific causes, which the habitual use of these stimu- 
 lants 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 feel- 
 ing the immediate 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 efiectually made. Any systema- 
 tic departure from the laws of health — all experience 
 teaches — must 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 efiects tends to render the process of cure as pro- 
 tracted 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 endu- 
 rable, it sooner prompts the sufierer to seek a remedy. 
 
 198. Pregnancy. — Among the modifications of the 
 bodily condition, short of actual disease, in which 
 the occasional and even the habitual use of fr.i uiwffifd 
 ')jap9m seems desirable in some instances, are the states 
 of pregnancy and lactation. The state of pregnancy 
 frequently occasions a peculiar irritability of the stomach 
 
 \ 
 
IN EXCEPTIONAL CASES. 
 
 209 
 
 (fr jr|n i " iil lj' ' f t w jn i nlj ii i i ni ;i a rh ni mrtrr ), which indis- 
 poses it to retain the nutriment really required by the 
 system, or which prevents 14 from' properly digesting and 
 preparing It w^en retkinM: This irritabihty is occasion- 
 ally so aggravated as to become the bubject of medical 
 treatment; and the most powerful sedative "^ medicines 
 are sometimes required to subdue it sufficiently for the 
 retention of even small quantities of food.^ Sometimes 
 even these are ineffectual ; and more rehef is obtainable 
 from small quantities of wine, frequently repeated, 
 than from any thing elseJJ T^ ^Hg°j ^^ Philidnlphia, 
 mentions a case in which nothing could be borne but 
 ■vibaiBpagiie. J.n milder cases of the same kind, it often 
 happens that a small quantity of fermented liquor, taken 
 with the principal meai, seems 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 
 habitually, 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, ae^the source of irritation is temporary, 
 there"is less danger than in other circumstances, lest the 
 demand should be rendered permanent by the habituation, 
 of the stomach to the stimulus. 
 
 199. But the evils attending its habitual use, even 
 under such circumstances, can only be reduce ^. to their 
 minimum by very careful attention to all the other con- 
 ditions favorable to health during the pregnant state, — 
 especially fresh air, moderate exercise, early hours, ade- 
 
 li 
 
 * Sedative, composing, sleep-producing. 
 
 18* 
 
210 
 
 USE OF ALCOHOL 
 
 'i* 
 
 quate repose, and the avoidance of all sources of excite- 
 ment ; and also by the strict hmitation of the quantity 
 of the alcoholic liquor to that which is suflScient 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 there- 
 by 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 diflScult of rehn- 
 quishment ; and where there is reason to believe that the 
 individual does not possess self-command sufiBcient to 
 break through the habit at the proper time, it might 
 be advisable to endeavor to substitute a medicine for a 
 beverage^ giving to the alcoholic compound such a form 
 as may render it not peculiarly palatable or inviting. 
 
 200. Lactatio7i. — The benefit derivable from the use 
 of alcoholic liquors to support the system during lacta- 
 tion * is more doubtful. Certainly it may be aflSrmed, 
 that, in every case in which the appetite is good and the 
 general system healthy, the habitual use of these stimu- 
 lants is no more called for than at any other time ; and 
 that they are likely to produce the same injurious efiects as 
 when unnecessarily given under ordinary circumstances. 
 The regular administration of alcohol, with the professed 
 
 * Lactation^ the condition of nursing, or giving milk. 
 
I 
 
 IN EXCEPTIONAL CASES. 
 
 211 
 
 I 
 
 object of supporting tho system under the demand occa- 
 sioned by Ihc flow of milk, is "a mockery, a delusion, 
 and a snare." For alcohol affords no single clement of 
 the secretion, and is much more likely to impair than 
 to improve the quality of the milk. G'he only mode in 
 which it can contribute, even indirectly, to increase the 
 amount of solid aliment which tho secretion may contain, 
 is by affording a supply of combustivo 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 ingeation, and the 
 stomach is equal to the dige&iion, of an adequate amount 
 of solid food, no such benefit can be looked for ; and, al- 
 though 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 i:he child ; having a special tendency to occasion 
 derangements of the digestive organs, Jvnd 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 mamma '."y secretion would lead 
 us to expect, that alcohol, if introduced into the circula- 
 tion more rjipidly than it can be consumed, would pass 
 into the railk, and would consequently produce the same 
 effects upon the child as if directly given to it, besides 
 deranging by its presence the act of secretion itself, in 
 
 ♦ Dr. North says (Practical Observations on the Convulsions of 
 Infants), that he has seen these almost instantly removed by the 
 transference of the child to a temperate woman. — Author. 
 
212 
 
 USB OF ALCOHOL 
 
 i? ii' 
 
 virtue of its tendency to pr'oduce coagulation of albu- 
 minous 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 con- 
 dition is not one which in itself occasions a demand for 
 alcoholic liquors. 
 
 201. But there are cases in which, notwithstanding 
 all that can be done to promote the general health, the 
 stomach does not seem capable of retaining and digesting 
 the requisite amount of nutriment, except under the 
 artificial assistance afibrded by alcoholic liquors ; and in 
 which it appears more desirable, for the welfare alike 
 of mother and child, that such assistance should be 
 affijrded, than that lactation should be carried on without 
 it. In one case of 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 continuance of 
 the lactation, and was relinfjuished without difficulty 
 soon after the weaning of the infant. In such cases, the 
 alcoholic liquor seems to have no other operation than 
 that of enabling the stomach to digest the amount of 
 solid aliment required by the system ; whilst the small- 
 ness of the quantity of alcohol introduced at any one 
 
IN EXCEPTIONAL CASES. 
 
 213 
 
 i] 
 
 time prevents it from either itself passing into the milk, 
 or exerting any injurious influence on the secreting pra- 
 cess. But it may be questioned whether the practice is 
 in the end desirable ; or whether it is not, like the same 
 practice under other circumstances already adverted to, 
 really detrimental, by causing lactation to be persevered 
 in, without apparent injury at the time, by females 
 whose bodily vigor 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 tim3 after the conclusion of the first lacta- 
 tion; and on subsequent occasions it has been found 
 absolutely necessary to discontinue nursing at a very 
 early period of the infant's hfe, owing to the inadequacy 
 of the milk for its nutrition, and the obvious inabihty of 
 the mother to bear the drain. Hence it may be affirmed, 
 with tolerable 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 inabihty to furnish what was 
 required, without the stimulus of alcoholic liquors, was 
 nature's warning, wliich ought not to have been disre- 
 garded. 
 
 202. Considering, then, that lactation (unlike preg- 
 nancy) may bo 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, 
 
214 
 
 USE OF ALCOHOL 
 
 and the nurse averse or unable to put another in her 
 place. Here, of two evils, we choose the least, and 
 rather give the infant milk of an inferior quahty than 
 endanger its health by weaning it prematurely, or stint- 
 ing it of its accustomed nourishment." * Now, upon 
 this, the writer would remark, that a judicious system of 
 feeding, gradually introduced from a very early period 
 in the life of a child, will generally be preferable to an 
 imperfect supply of poor milk from the mother ; f and 
 that, if the mother be so foolish as to persevere in nurs- 
 ing 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, pro- 
 tracted 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 mani- 
 festation is only postponed. Under no circumstances, 
 therefore, can he consider that the habitual or even occa- 
 sional use of alcoholic liquors during lactation is necessary 
 or beneficial. 
 
 203. Childhood. — It has been maintained by some, 
 that there are certain states of the constitution in child- 
 hood in which benefit is derived from the habitual use of 
 
 
 * Anatomy of Drunkenness, p. 301. 
 
 t The author has found, in his own experience, that good cow's 
 milk, somewhat diluted with water, and sweetened with a small 
 quantity of sugar (so as to be brought nearly to the composition 
 of human milk), has answered extremely well even for very young 
 infants. 
 
IN EXCEPTIONAL CASES. 
 
 215 
 
 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 digestive 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 hfe. For, if the habit 
 be begun thus early, it will seldom be found possible to 
 discontinue it ; t =« stomach is rendered dependent upon 
 artificial suppo^ , a d the improvement which this ap- 
 pears to produce will probably render the parent less 
 anxious to avail himself 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 
 naturally 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-bathing, and other 
 adjumenta,* — 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 injurious.! In no period of life 
 
 * Armenia, assisting remedies. 
 
 t In illustration of the injurious effects of the habitual use of 
 
216 
 
 USE OF ALCOHOL 
 
 are the nutritive functions more energetically carried on, 
 if the child be only placed in circumstances favorable to 
 health ; and at no period of life is there such a disposi- 
 tion to take just that amount of exercise of the nervo- 
 muscular 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 his mental exertions beyond the stage at which 
 they may be best intermitted; and, whilst naturally 
 prone to muscular exercise, he readily complains of fa- 
 tigue, and is indisposed to persevere after this 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 articles of which they are 
 fond ; and if this be duly restrained, and every natural 
 means for the preservation and improvement of health 
 
 fermented liquors upon healthy children, Dr. Macnish (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 difference 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-colored, and the eva- 
 cuations destitute of their usual quantity of bile. In the other 
 child, no change whatever 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 got straight- 
 way into disorder, as in the first experiment. — Authob. ' 
 
IN EXCEPTIONAL CASES. 
 
 217 
 
 l)e judiciously and perseveringly employed, it is believed 
 by the writer that more good will in the end bo done 
 than will be accomplished by the assistance of alcoholic 
 liquors. And, in support of this belief, he 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 con- 
 sumed ; and he can point to numerous cases within his 
 personal knovvledge, 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 wliich have 
 been already adverted to, with the effect of rearing to 
 vigor and endurance children that originally appeared 
 very unlikely to possess either. 
 
 205. Old Age. — It has been maintained, again, by 
 some of those who fully admit the undcsirablencss of the 
 habitual use of alcoholic liquors during the vigor of early 
 and middle hfe, that they are requisite or useful for 
 the support of old age. Now, upon this point, also, 
 the writer believes that much misconception is prevalent, 
 arising out of a disregard to the dictates of nature on 
 the subject. During the most active period of life, the 
 "waste" of the body is considerable; and the demand 
 for food, and the power of thgesting it. nrc 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 lessened exhalation of carbonic .acid and the 
 diminished excretion of ur'^a ; and, the waste l)cing thus 
 lessened, the demand for food, and the power of digest- 
 in<' it, ore proportionably diminished. Now, this abatc- 
 
 19 
 
218 
 
 USE OF ALCOHOL 
 
 I:- 
 
 ^ 
 
 ment of the appetite and digestive power (like that -which 
 is felt by those who go from cold or temperate 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 gi-eater 
 activity to provide for the wants of the system. But this 
 abatement is very commonly regarded Jis an indication of 
 the failure of the powers of the stomach ; and recourse 
 is had to alcoholic hquors, with the view of re-exciting 
 these. Now, although from such a practice, when very 
 moderately resorted to, less prospective evil may be anti- 
 cipated, as regards merely the eflfects 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 syskm (so to speak) for 
 a larger amount of alimentary matter than it can appro- 
 priate ; and as all the organs which are set apart for the 
 ehmination 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 dechne 
 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 disorders Avhich 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. 
 
 • Lithic acid diathesis, stute of tlio system which tcnds^ to form 
 stone. 
 
IN EXCEPTIONAL CASES. 
 
 219 
 
 206. 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 bene- 
 ficial to persons advanced in life and not suffering under 
 any positive ailment, but experienc'^^g absolute deficiency 
 of digestive power heyoTim ai '^h is in conformit / 
 with the general dechne of activity. In such cases, the 
 benefit to be expected from their employment is, that 
 the stomach should be assisted in the digestion of the food 
 which the system really requires ; and, in so far as their 
 use is carried beyond that point, it is hurtful in every 
 way. Such cases may be expected to be rare among 
 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 labor, 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 their nervous systems, and thus deprived 
 the stomach of the nervous power which it requires ; or 
 who have impaired their vigor by breathing a foul atmo- 
 sphere, by irregularity and insufiiciency in regard 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 pro- 
 longation of life and the restoration of vigor be the 
 paramount objects of consideration, recourse should at 
 first be had to all those measures of general hygiene 
 
220 
 
 USE OP ALCOHOL 
 
 /■ 
 
 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 to dis- 
 pense with them in old age ; yet experience has demon- 
 strated, even here, that, where the evil results of their 
 continued use have begun to manifest themselves, 
 decided and permanent benefit has followed their aban- 
 donment; and, where it was believed by the individual 
 that he could not possibly dispense with their use, the 
 stomach has recovered its healthy tone (.specially under 
 the copious external and internal use of cold water, 
 and the influence of an invigorating 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 assurances of medical 
 practitioners in the New England States ; since the entire 
 disuse of fermented liquora has been now practised as a 
 habit, for some years, by a large proportion of the popu- 
 lation of those States, including those who are most 
 subject to those influences (the " wear and tear" of social 
 hfe) which are usually regarded as most powerfully con- 
 
 * For two remarkable cases of this kind, see Appendix C. 
 
IN EXCEPTIONAL CASES. 
 
 221 
 
 spiring to render the assistance of stimulants desirable. 
 The following statements on this subject have l)cen 
 recently put forth by the Massachusetts Temperance 
 Society, under the sanction of their distinguished presi- 
 dent, 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 number of persons on this side of 
 the Atlantic have wholly abandoned the use of wine, 
 cider, and malt liquors; and many of those who con- 
 tinue to employ them have great!}/ diminished the quan- 
 tity. Wine is no longer thought necessary in the 
 convalescent stage of fever. Cider, formerly one of 
 the household provisions of almost every family in the 
 North, is rarely seen; and the very trees which pro- 
 duced it are either cut down for fuel, or converted to the 
 production of fruits for food. The stronger beers are 
 quite disused, except among emigi-ants ; and even the 
 milder are employed only in some very light and unstimu- 
 lating 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 employ- 
 ment, 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 see per- 
 sons who in former times used wine freely, and who have 
 now given it up, present an appearance of mental 
 and bodily vigor they had not exhibited before! The 
 
 ♦ Preface to the reprint of an Essay on the Physiological Effects 
 of Alcoholic Drinks, from Dr. Forbes's Review, Boston, N.E. 1848, 
 19* 
 
222 
 
 USE OF ALCOHOL 
 
 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 by 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 abandoned it, who wish 
 well to their fellow-men, and are willing to show that 
 they are capable of making the sacrifices they advise, 
 should submit to a privation which they have sufficient 
 reason to beheve will be most salutary to tuemselves and 
 others ! " 
 
 210. The extent of change of habit, in this respect, 
 among the middle and higher classes of society in Bos- 
 ton, and other great towns of New England, may be 
 judged of from the fact that many of those pubUc festi- 
 vities at which the assistance of alcoholic liquors is con- 
 sidered indispensable in this country are there conducted 
 without any such artificial excitement. " Of late years" 
 (we quote the same authority), " we have had the grati- 
 fication of witnessing so many exceptions to the former 
 praxjtice, that it appears very probable the rule will 
 be reversed, and the exceptions change to the opposite 
 side. The great festivals on the anniversary of National 
 Independence are in many places celebrated without other 
 stimulus than that of patriotic feeling. The annual 
 ceremonies of our literary institutions, too often stained 
 by lavish draughts of the juice of the grape, are now 
 purified hy 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 most distinguished, have 
 
IN EXCEPTIONAL CASES. 
 
 228 
 
 unshackled themselves from the chains of ancient habit. 
 Under the influence of a maatT-spirit (President Everett) 
 the great annual festival of Commencement at Cambridge 
 University has been accomplished without the aid of 
 wine ; and the oldest of our literary fraternities, the Phi 
 Beta Kappa Society, has enjoyed the excitement of a 
 social meeting without the consequent depression fi-om 
 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 great associ- 
 ation of mechanics of the metropolis hold a brilliant 
 triennial feast, from which every kind of alcoholic, fer- 
 mented, vinous, and other stimulating liquid is wholly 
 excluded."* 
 
 i" 
 
 211. On the whole, then, the writer thinks that phy- 
 siology and experience alike sanction the conclusion, that, 
 although there are states of the stomach in which the 
 diminished appetite and digestive poAver prevent the recep- 
 tion of an adequate supply of aliment into the system, 
 and in which the assistance of alcoholic liquors is tempo- 
 rarily beneficial, that assistance is rather a palliative 
 
 may 
 have 
 
 * " In order to give a mora exact idea of the importance of the 
 celebrations alluded to above, we have thought it well 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 300 
 
 Festival of Phi Beta Kappa 150 
 
 Festival of the Clergy 200 
 
 Festival of the Massachusetts Medical Society .... 300 
 Festival of the Massachusetts Mechanics' Association . . 600 " 
 
224 
 
 USE OF ALCOHOL 
 
 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 unfavorable influences from 
 which its depression of power may have proceeded, it 
 renders the individual less disposed to seek, in a change 
 of habit, the remedies which will be really effectual. 
 " Thus," as an American physician has remarked to the 
 writer, " where you (the English practitioner) recom- 
 mend to a man losing his digestive power, from the fatigue 
 and confinement of a city life, to take wine, porter, or 
 bitter alp, with his dinner, we order him out of town, 
 to get fresh air, and the refreshment of idleness 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 ori- 
 ginal constitution, in which the want of digestive power 
 is more completely and permanently supplied by the 
 habitual use of a small quantity of alcoholic hquors than 
 it can be by any other means within the power of the 
 individual. It may be impossible to predicate, in any 
 individual instance, whether this shall be the case or not ; 
 but the results of observation appear sufficient to prove, 
 that it would be erroneous to assert dogmatically that it 
 never can be. Still, the evils resulting from the unne- 
 cessary employment of stimulants are so great that 
 recourse should never be had to them, until every other 
 more natural method of sustaining the vital powers has 
 been tried without success. They should never be em- 
 
IN EXCEPTIONAL CASES. 
 
 225 
 
 ployed to repliice any hygienic rofiuiremcnt, such as fresh 
 air, mental repose, muscular exercise, &o. ; and they 
 should be disused whenever it may appear that the 
 necessity for them no longer exists. 
 
226 
 
 CHAPTER IV. 
 
 < } 
 
 IS THE EMPLOYMENT OF ALCOHOLIC LIQUORS NE- 
 CESSARY IN THE PRACTICE OF MEDICINE? IF 
 SO, IN WHAT DISEASES, OR IN WHAT FORMS 
 AND STAGES OF DISEASE, IS THE USE OF THEM 
 
 NECESSARY OR BENEFICIAL? 
 
 U 
 
 u 
 
 213. Those who maintain that alcoholic liquors are 
 not requisite for the ordinary sustenance of man, or even 
 that they are likely to be rather prejudicial than other- 
 wise when habitually taken in small quantities, — that, in 
 fact, alcohol is to almost every one a true poison, slower 
 or more rapid in its operation, according to the rate at 
 which it is taken, — may still maintain, with perfect 
 consistency, that (like many other poisons) it may be a 
 most valuable remedy, when administered, with caution 
 and discrimination, in various forms of disease. In re- 
 plying to the above question, we shall first look at the 
 inferences which we may draw from the physiological 
 action of alcohol in regard to the conditions of the system 
 in which it is most likely to be useful. 
 
 I i 
 
 I. RECOVERY FROM SHOCK. 
 
 V\ 
 
 213. We have seen that alcohol, when introduced into 
 the circulation, acts as a stimulant in augmenting the 
 force and rapidity of the heart's contractions, and that it 
 
USE OF ALCOHOL, ETC. 
 
 227 
 
 w 
 
 also increases the excitability of the nervous system ; we 
 have found, moreover, that it supplies the means of 
 keeping up the animal heat, which may be advantage- 
 ously employed when other means are deficient. Hence 
 we should say, that alcoholic liquors may be advantage- 
 ously employed to assist in rousing the system from the 
 effects of agencies of various kinds, which threaten for a 
 time to produce a fatal depression of the vital powers ; 
 such, for exar pie, as severe injuries that produce a 
 violent shock, under the primary effect of which the sys- 
 tem appears likely to sink. But great caution must 
 be used in their administration, and they should not be 
 given unless there appears to be a positive necessity for 
 doing so (J. e. unless the patient appears Ukely to sink 
 without them) ; for it is as certain that re-actionary 
 excitement will follow a primary depression as it is that 
 depression will be consequent upon primary excitement ; 
 and, if stimulants have been unnecessarily employed, 
 the difficulty of controlhng the re-action will be increased. 
 This caution is more aspecially necessary where the Orain 
 is the part to which the injury has occurred ; since the 
 special determination of alcohol to this organ will increase 
 the violence of the re-action in a most dangerous man- 
 ner. 
 
 214. There is no class of cases, perhaps, in which 
 the good effects of stimulants in maintaining the heart's 
 action, and in keeping up the nervous excitability, are 
 more manifest than in those severe and extensive burns 
 of the trunk of the body to which the children of the 
 lower classes are peculiarly liable, from their clothes 
 taking fire tlirough carelessness or negligence. The 
 shock given by this injury to the deUcate and im- 
 
228 
 
 USE OF ALCOHOL 
 
 Y 
 
 pressibie system of the child is often rapidly fatal ; the 
 heart's action being extremely depressed, the nervous 
 power reduced, and the body gradually cooling, until its 
 temperature falls to a degree incompatible with the main- 
 tenance of life. The writer has witnessed many such 
 cases, in which hfe oociiicd to be kept in the body by the 
 frequent administration of a spoonful of cordial, but in 
 which death supervened upon a short intermission of the 
 stimulus ; the nurses in hospitals being generally pos- 
 sessed with the belief that the little patients viust die, 
 and being too frequently careless in the employment of 
 the only means by which hfe can be sustained. 
 
 II. TREATMENT OF ACUTE DISEASES. 
 
 215. Resistance to the Depressing Influence of Mor- 
 bific * Agents. — In the class of cases to which reference 
 has just been made, the shock is temporary ; and, if the 
 patient can be kept ahve until the system has recovered 
 from its immediate consequences, a great point is gained. 
 There is another class of cases in which the depression 
 is produced by a morbific agency, and in which it is of 
 equal importance to keep up the vital powers for a tune ; 
 since, if they can be sustained for a few hours or days, 
 the patient has a fair cl ance for recovery. Of such we 
 have examples in many forms of fever ; especially in 
 those which 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 
 
 Morbific, that which produces disease. 
 
IN THE TREATMENT OF DISEASE. 
 
 229 
 
 precisely alike ; and the treatment which is of service in 
 one may be found injurious in the other, notwithstanding 
 that the general type may be the same. A severe 
 epidemic of typhoid fever, which the writer witnessed 
 in Edinburgh in the years 1836-7, aflforded him an 
 opportunity of seeing the decided efficacy of alcoholie 
 stimulants in one form at least of this fever ; the oppo- 
 site methods of treatment, followed by two physicians 
 whose practice he watched, being attended with such 
 different results, that, as the cases were of the same 
 class, and the other conditions identical, there was no 
 other way of accounting for the difference. By neither 
 physician were any active measures taken during the 
 early stages of the fever, for none seemed called for : 
 but, in one set of cases, the same expectant practice was 
 continued to the end ; whilst, in the other, the adminis- 
 tration of wine and spirit was commenced, as soon as the 
 weakness of the pulse, and the coldness of the extremi- 
 ties, indicated the incipient failure of the circulating and 
 calorifying * powers. The quantity was increased as the 
 necessities of the patient seemed to require ; and, in one 
 case (that of a woman whose habits had been previously 
 intemperate, and on whom a more potent stimulus was 
 therefore needed to make an impression), a bottle of 
 sherry with twelve ounces of whiskey was the daily 
 allowance for a week or more, — the patient ultimately 
 recovering. Now, the result of this wine- treatment was, 
 that the mortality was not above a third of that of the 
 simple expectant treatment; the patients dying under 
 the latter from actual exhaustion and &ilure of oalori- 
 
 Calorifying, producing heat. 
 
 20 
 
280 
 
 USB OF ALCOHOL 
 
 'l\ 
 
 ^ying power, and no local lesion* being detectible on 
 post-mortem examination. 
 
 216. It is bj no means difficult to give a satisfactory 
 rationale ^ of this beneficial action. The immediate 
 cause of death in such cases appears to be a failure of 
 the power of the heart, the contractions of which, in the 
 advanced stage of typhus and typhoid fevers, become 
 progressively feebler and more rapid ; and it has been 
 noticed by Drs. Stokes and Graves, as the best indica- 
 tion for the use of wine, that the impulse is greatly 
 diminished, and that the first sound becomes very feeble, 
 or is entirely extinguished. Now, the efiect 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 restless delirium, with an approach to 
 Bubsultus tendinum ; % and, if the wine acts beneficially, 
 it renders the patient more tranquil, and disposes him to 
 sleep. Under the influence of wine, too, in suitable 
 cases, the skin and tongue become moister, and the 
 breathing more deep and slow ; but, if the wine be acting 
 injuriously, the skin and tongue become drier, and the 
 respiratory movements more hurried. Concurrently with 
 the failure of the heart's action, there seems often to be 
 a deficiency of heat-producing material ; all that was pre- 
 viously contained in the body having been burned off 
 during the earlier period of the fever, and little or none 
 having been taken in from without. Day by day, the 
 fiitty matter of the body is used up by the respiratory 
 
 • Lesion, injury. 
 
 t Rationale, explanation. 
 
 X SubauItuB tentUnumf twitching of the tendons, spasms. 
 
 ill 
 
m THE TREATMENT OF DISEASE. 
 
 231 
 
 process ; and thus, as in cases of simple starvation, the 
 patient must die of coldf unless some means be provided 
 for the sustenance of the heat. In such a condition of 
 the system, no farinaceous or oleaginous matters could 
 be digested or absorbed in sujBficient quantity ; whereas 
 alcohol is taken into the current of the circulation 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 stimulaling' ef- 
 fects. This is probably due in part to the fact, that the 
 alcohol is burned off nearly aa fast as it is introduced 
 (the general rule in such cases being to give a small 
 quantity at a time, but to repeat this frequently); but 
 it would ako appear to result in part from this, — that 
 the stimulating' power of the alcohol is expended in neu- 
 tralizing (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 previously intemperate, the 
 ordinary doses of alcoholic stimulants have no percepti- 
 ble 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 most important re- 
 medy which the physician has at his command ; for it is 
 equally so in the typhoid states of other diseases, especially 
 
 Endosmose, suction. 
 
^82 
 
 USB OF ALCOHOL 
 
 erysipelaa and the exj'nthemata ; * and it ia in the typhoid 
 form of erysipelas, which so often presents itself in men 
 of the bad habit of body resulting from habitual intem- 
 perance (*§> 63), that the largest quantities of alcohoUc 
 stimulants may be given, without any other perceptible 
 effect than that most beneficial one, — the support of the 
 system whilst the disease runs its course. 
 
 219. Recovery from States of Prostr alien. — During 
 the stage of convalescence from fevers and acute inflam- 
 matory diseases, in which the vital powers have been 
 greatly depressed, it will frequently happen that the use 
 of alcoholic liquors will be decidedly beneficial ; and this 
 apparently in two ways, — by raising the nervous system 
 jfrom that low irritative state which is the conseq -jnce of 
 depressed vital power, and by increasing the digestive 
 power of the stomach and the general nutritive activity 
 of the system, so that the reparative processes take place 
 more rapidly, and the general vigor is more speedily 
 restored. Every practical man must have perceived, that 
 the state of debihty in which the patient is left after the 
 termination of an acute disease is extremely different 
 from the state of exhaustion consec^uent upon a long- 
 continued course of over-excitement. The former par- 
 takes of the nature of shock ; the vital powers are not so 
 much exhausted as depressed ; and recovery is best pro- 
 moted by arousing the system, so far as possible, to the 
 due performance of its functions. If alcoholic stimulants 
 are really beneficial under such circumstances, they make 
 their utility apparent in the same way as in the advanced 
 stage of typhoid fever ; that is, by reducing tho rapidity 
 
 * Exanthemata, eruptiTO fevers. 
 
IN THE TREATMENT OF DISEASE. 
 
 233 
 
 of the heart's action at the same time that its strength 
 increases, and by cakning the mind instead of exciting it. 
 Dr. A. Combe mentions the case of a delicate lady, who, 
 during recovery from fever, took to the extent of a bottle 
 of Madeira in twenty-four hours, with these obviously 
 beneficial results. It is well known that much depends, 
 in this condition, on procuring as speedy a renewal as 
 possible of the normal actions of nutrition ; es))ecially 
 where either the disease, or the treatment it has required, 
 has caused them to be greatly lowered, or almost entirely 
 suspended ; for there is great danger lest the convalescent 
 should pass into a cachectic condition, "^ and a foundation 
 be laid for tubercular f or other forms of disease depend- 
 ent upon the imperfect performance of the nutritive pro- 
 cesses. Hence, if, when these operations are just being 
 renewed, a little increased energy can be artificially 
 imparted to them, we have a better hope of escape from 
 these evil consequences. As a general rule, no alcoholic 
 stimulants should be employed, until after the complete 
 subsidence of the inflammatory processes : but this rule is 
 not invariable ; for a stnte of chronic inflammation is often 
 kept up by the low and imperfect state of the general 
 nutritive operations, and hence (as Professor Alison was 
 wont to teach and to practise with great success), however 
 contradictory it may at fii-st appear, we may frequently 
 combine a general tonic or somewhat stimulant regimen 
 with local depletion or counter-irritation. % 
 
 220. When alcoholic stimulants are employed for 
 these purposes, the greatest care and watchfulness 
 
 * Cachectic condition, state of permanent and general disease, 
 t Tubercular, consumptive, scrofulous. 
 % Counter-irritation, blistering or irritating the skin. 
 20* 
 
234 
 
 USB OF ALCOHOL 
 
 
 Bhould be used in their administration, both to avoid 
 doing positive mischief by an over-dose, and also to 
 avoid bringing the system into a habit of dependence 
 upon them, and thereby predisposing it to the various 
 remoter evils formerly described. There is no doubt 
 that a course of over-indulgence in alcoholic liquors haa 
 frequently commenced with the therapeutic* use of thein; 
 and it is extremely desirable, therefore, that the medical 
 practitioner should enforce the diminution of the dose, 
 and the final discontinuance of the remedy, at the earliest 
 possible period, — substituting, if he should think it 
 necessary, a small quantity of alcohol in some medici- 
 nal form, — in order that the patient may have as little 
 motive as possible for continuing its use, after the time 
 for its really beneficial action has passed. 
 
 221. Support under Exhausting' Drains. — There 
 is another class of cases, in which the stimulating action 
 of alcoholic hquors may be occasionally had recourse to 
 with advantage ; those, namely, in which there is great 
 drain upon the nutritive material, owing to some dis- 
 ordered action which at the same time lowers the vital 
 powers of the system, — such, especially, as an extensive 
 suppurating f surface. Now, here the general rule, that 
 the appetite and the digestive power are proportionate 
 to the demand for nutriment in the body, does not hold 
 good ; since the depressing influence of the disease lowers 
 the functional activity of the digestive apparatus to such 
 a degree that it cannot supply what is needed ; and thus 
 there is a progressive diminution of the nutritive solids 
 of the blood, which still further depresses the vital 
 
 * Therapeutic, medicinal. . ' 
 
 t Suppwratmgt discharging matter as from « sore. 
 
IN THE TREATMENT OF DISEASE. 
 
 285 
 
 powers of the system. We should therefore anticipate a 
 beneficial result from such an employment of alcoholio 
 Btimulants as would for a time augment the digestive 
 power of the stomach, and would thus enable it to appro- 
 priate and prepare the amount of nutritive matter which 
 the system really needs, whilst at the same time its gene- 
 ral powers are sustained under the depressing influence 
 of the disease. Experience shows that such is the case ; 
 and that, under such circumstances, alcoholic liquors may 
 be beneficially employed, not so much to stimulate the 
 heart, or the nervous system, nor to take the place of 
 "^olid food ; but, by stimulating the stomach, to augment 
 the quantity of solid material which it can advantageously 
 receive. 
 
 222. Allusion has already been made to the unfavor- 
 able course which febrile and inflammatory diseases are 
 disposed to run in the habitually intemperate ; this being 
 chiefly dependent upon the imperfect elaboration * of 
 plastic t material, which predisposes to suppurative ac- 
 ti<Mi, or to gangrenous % or phagedenic || ulceration, and 
 impedes the attempt at regeneration,<§i which constitutes a 
 most important part of the sthenic IT form of inflammation. 
 A similar disposition to the asthenic ** form of inflam- 
 matory disease and its severe consequences is seen among 
 the habitually ill-fed, ill-lodged, ill-clothed inhabitants 
 of the densest and worst-drained parts of our great towns, 
 
 * Elaboration, manufacture, 
 t Plastic, adhesive. 
 
 X Gangrenous, tending to mortification. 
 II Phagedenic, corroding, eating in. 
 § Regeneration, formation of new ftubstancc. 
 ^ Sthenic, vigorous, active. 
 •♦ Asthenic, feeble* 
 
286 
 
 USB OF ALCOHOL 
 
 many of whom are also intemperate; and, in many of 
 these cases, it would seem requisite to support the system 
 by alcoholic liquors, oven during the acute stage of an 
 inflammatory attack, in order to enable it to resist the 
 depressing influence of the disease, and to bear the requi- 
 site treatment. Whatever augments the plasticity of the 
 fibrne, up to a certain point, is likely to be beneficial ; 
 and, as the great object in such cases is to give the requi- 
 site support without stimulus, the use of malt-liquors will 
 be indicated. Here, too, we find that experience is in 
 full accordance with the teachings of theory, and that 
 ale and porter are frequently the physician's and sur- 
 geon's main stay under such circumstances. They must, 
 however, be very guardedly employed ; and the test of 
 their beneficial influence will be found in the absence 
 of stimulating effects, and in the improvement of the 
 character of the inflammatory process; which will be 
 made known, where there is purulent * discharge, by the 
 conversion of a thin, sanious,f fetid % pus into that which 
 is expressively designated by the term " laudable," || and 
 by the stoppage of an extending gangrene or phagedaena. 
 223. The foregoing are the principal forms of acute 
 disease, in which recourse may be advantageously had to 
 alcoholic liquors ; but the writer would remark, that, 
 whilst general principles may be thus laid down, their 
 application to each individual case must be left to the dis- 
 crimination and tact of the practitioner, since no two cases 
 are alike in all their conditions ; and it will frequently 
 
 • Purulent, mattery. 
 
 t Sanious, attended with watery blood. 
 
 X Fetid, foul, corrupt. 
 
 II Lai*dabk, healthy. 
 
IN THE TREATMENT OV DISEASE. 
 
 237 
 
 happen that even the most experienced physician and 
 surgeon will find it necessary to be rather guided by the 
 result of trials cautiously made than by any rules what- 
 ever. In cases of fever, it may bo especially noticed, 
 that the instinct of the patient, shown by his desire for 
 wine, or his disposition to reject it, will generally prove 
 a most valuable guide, even when his intelligence is 
 prostrated. 
 
 224. Forms of Alcoholic Liquors most desirable. — 
 The diflfercnt forms of alcoholic liquors must not be used 
 indiscriminately in these varying conditions; for their ope- 
 ration upon the system diflfers considerably, and there are 
 certain conditions of the body to which each is especially 
 appropriate. Thus, distilled spirit is the most rapid and 
 powerful in its action upon the heart and nervous system ; 
 and hence it is the most potent fonn of alcohohc liquor 
 in those states of alarming depression from which we 
 desire to arouse the patient as rapidly as possible. We 
 find, too, that it is frequently requisite to administer 
 spirits to patients who have been in the habit of free or 
 excessive indulgence in alcoholic liquors, under circum- 
 stances in wliich wine would otherwise be preferable, 
 e. g. in fever ; the milder stimulus, in such cases, not 
 producing the effect we desire. Where, however, we 
 desire to give more continued support, with less of sti- 
 mulation, it is not usually desirable to administer distilled 
 spirit, and wine will be found the preferable form : this 
 is especially the case in the advanced stage of fever, 
 and in convaliescence from acute diseases. On the other 
 hand, where we desire to give still greater support with 
 as little stimulation as possible, as in the class of cases 
 last referred to, malt-liquor may be more advantageously 
 
288 
 
 U8B OF ALCOUOL 
 
 employed ; aa the alcohol, probably from its peculiar state 
 of admixture, is less disposed to exert its remote effects, 
 and the nutritive matter with which it is combined is in 
 itself beneficial ; whilst the bitter and somewhat calma- 
 tive properties of the hop aid in producing the desired 
 effect upon the stomach. 
 
 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 caution ; the condition of the system 
 under the depressing' influence of " shock " or of poison- 
 ous agents being very different from that which results 
 from the exhaustion of its powers through chronic dis- 
 eases, 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 simple illustration. When 
 a vigorous man is prostrated by a violent blow, he speedily 
 rallies from it, and is all the better for the aid of a help- 
 ing hand in getting on his legs again. But if the same 
 man expend his powers in a prolonged pugilistic encoun- 
 ter, although he may not have received any one severe 
 injury, he becomes 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 his restoration. 
 In general, then, it is believed by the writer that little 
 permanent good can be expected from the use of alcoholic 
 Btimulants in chronic diseases, so far, at least, aa regards 
 * Chronic, of long duration. 
 
IN THE TREATMENT OF DISEASE. 
 
 289 
 
 their stimulant operation upon the heart and nervous 
 system ; and >vhat benefit they are capable of conferring 
 will be obtained by their improvement of the digestive 
 power, and of the processes of primary assimilation.* But 
 it is very doubtful whether the temporary improvement 
 which can sometimes be thus obtained is not really fal- 
 lacious, — like that which we see in the burning of a 
 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 exists in the body, but has 
 previously lain dormant, but by the more rapid con- 
 sumption of the small stock of power left. And the 
 question of their benefit or injury will often depend upon 
 whether, by this more rapid consumption, new vigor can 
 be infused into the system by the introduction of new 
 material. 
 
 226. The use of alcoholic 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 efficacy of many systems of 
 treatment of chronic diseases which long-continued ex- 
 perience appeared to have sanctioned, and to believe that 
 the vis medicatrix\ of the system is often itself the 
 great restorer, when time is given for its operation, and 
 other circumstances concur to favor it. And it is espe- 
 cially important, in judging of the action of all remedies 
 which must be persevered in for some time in order to 
 
 * Auimilaiion, converaion of food into living substance, 
 t V%» medicatrix, inherent healing power. 
 
240 
 
 USE OF ALCOHOL 
 
 produce any decided result, to take their remote conse- 
 quences fully into account, and to consider how far these 
 are, or are not, favorable to our object. Now, the writer 
 has endeavored to show, that the remote consequences of 
 the continued use oi alcoholic liquors, even in small 
 quantity, are all of them so unfavorable to health, that, 
 if the immediate invigoration of the digestive power and 
 of the assimilative processes, which seems to be their 
 (mly beneficial eflfect under such circumstances, can be 
 obtained in some other way, it will be most desirable to 
 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 of direct stimulation 
 can re-invigorate the digestive apparatus under such 
 circumstances. We may keep our patient in town at 
 his usual occupations, practise all kinds of experiments 
 upon his stomach, recommend fat bacon or lean chops, 
 prescribe blue pill and senna-draught, or quinine and 
 calumbo, and ring the changes upon all the wines, 
 spirits, and malt-liquors which the cellar can 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 
 suflficient to interest, but nothing to excite ; to inhale the 
 fresh and invigorating breezes of a mountaanous coun- 
 try, in place of the close and deteriorated atmosphere of 
 
IN THB TREATMENT OF DISEASE. 
 
 241 
 
 a town ; to promote the copious action of his skin by 
 exercise, sweating, and free ablution ; to wash out his 
 inside, ff.nd increase the tonic power of his stomach with 
 occasional (but not excessive) 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 best possible chance of permanent restoration to 
 health. 
 
 228. There is perhaps no class of cases in which the 
 benefits of the hydropathic treatment are so 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 in- 
 clined to believe, that it would be of similar efficacy in 
 re-invigorating the system exhausted by other forms of 
 chronic disease, and would in most cases be preferable 
 to any form of alcoholic stimulants for procuring an 
 increase of digestive and assimilative power. So far as 
 the writer is acquainted with the results of comparative 
 experience, they are decidedly in favor of the hydro- 
 pathic treatment, moderately and judiciously applied, 
 especially in cases of chrcmic gout and rheumati3m ; but 
 he would not be dogmatic enough to assert, that there 
 are not individual instances in which (as in the class 
 formerly adverted to, f» 194) the loug-continued or even 
 the habitual use of alcoholic liquors will promote recovery 
 from chronic diseases by their influence on the digestive 
 and assimilative apparatus. He does not see the possi- 
 bility, however, of laying down any general rules by 
 which such canes can be distinguished ; and it will be only 
 from the results of an extended experience of the com- 
 paiative advantages and disadvantages of different modes 
 21 
 
242 
 
 USE OF ALCOHOL 
 
 of treatment, and of the immediate and remote conse- 
 quences 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 abstinence will 
 in most cases be the safer plan ; except where the pros- 
 tration of the vital powers has proceeded to such an 
 extent as to require temporary stimulation for the per- 
 formance of any of the nutritive and regenerative opera- 
 tions. , 
 
 229. It may not be amiss to remark, in conclusion, 
 that it is 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 
 St; -ach. It is water alone which forms all the fluid 
 portion of the blood, and thus serves to convey the nutri- 
 tive material through the minutest capillary * pores into 
 the substance of the solid tissues. It is water which, 
 when mingled in various proportions with the solid com- 
 ponents of the various textures, gives to them the con- 
 sistence which they severally require. And it is water 
 which takes up the products of their decay, and conveys 
 them, by a most complicated and wonderful system of 
 sewerage, altogether out of the system. 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 in- 
 fluence upon the other components of the animal body — 
 
 CapiUaiy, very minute, hair vessels. 
 
IN THE TREATMENT OP DISEASE. 
 
 243 
 
 can be otherwise than injurious in the great majority 
 of cases ; and, where a benefit is derivable from it, this 
 will depend upon the fact that the abnormal condition of 
 the system renders some one or more of the special 
 actions of alcohol remedial instead of noxious, so that 
 the balance becomes on the whole in favor of its use. 
 
APPENDIX A, p. 67. 
 
 Some very remarkable details regarding the condition of 
 the ballasters and coal-whipperft employed on the Thames, 
 have lately been ascertained by the inquiries of the " Com- 
 missioner " 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 engen- 
 dered 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 earn- 
 ings 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 ballasters. 
 Several of the former class are now total abstainers ; while 
 others, who adop'od the abstinence system for a time, 
 have returned to their former habits. The inquiries of 
 Mr. Mayhew, the ** Commissioner," were specially directed 
 to the experience of both these classes ; and we shall first 
 quote the statement of one of the latter, by way of show- 
 ing the extreme severity of the labor undergone by these 
 men, and the circumstances under which the assistance of 
 alcoholic liquors is sought by them : " I was a strict tee- 
 totaler for many years, and I wish I could be so now. 
 All that time I was a coal-whipper, at the heaviest work ; 
 and I have made one of a gang that has done as much as 
 one hundred and eighty tons in one day. I drank no fer- 
 21* 
 
246 
 
 APPENDIX. 
 
 1 1: 
 
 hi 
 
 mented liquors the whole of the time. I had only ginger- 
 beer and milk, and that cost mo Is. 6d. 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 had about 
 two quarts of milk and five bottles of ginger-beer, or about 
 thre'' 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 
 perspi'-ation over the work. The rule among us is, that 
 Vi e do twenty-eight tons on deck, and twenty-eight tons 
 filing in the ship's hold. "We go on in that way through- 
 out the day, spelling at every twenty eight 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 wipe it off. This makes the eyes very sore. 
 At night, when we get home, we cannot bear to sit with a 
 candle. The perspiration is of a very briny nature ; for I 
 •often taste it as it runs down my lips. We are often so 
 heated 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 shoes full of blood. The thirst produced 
 -by our work is very excessive. It is completely as if you 
 had a fever upon you. The dust gets into the throat, and 
 very nearly suffocates you. Yiu taa scrape the coal-dust 
 K)ff the tongue with the teeth i. and, do whrf. you will, it 
 is impossible to get the lea.«r- spittle into the mouth. I 
 have known the coal-dust to be that thick in a ship's hold, 
 that I have 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 teetotcler, I was on( of the 
 strongest men in the business. I was able to carry seven 
 
APPENDIX. 
 
 247 
 
 hundred weight on my back for fifty yards, and I could 
 lift nine half-hundreds with my right arm. After finish- 
 ing my day's work, I was like a child with weakness." 
 
 Tc 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 two cwt. and a 
 
 stone at least ; the sack itself 's 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 wagon, and must look sharp, 'specially in 
 
 slippery or wet weather, or you'll topple over, and there's 
 
 the hospital or workhouse for you. Last week we carried 
 
 along planks bixty 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 had 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 labor is greater 
 than any man should be called on to perform ; and that, 
 oven if it should be proved that assistance is derived in 
 it'j execution from the use of alcoholic liquors, the fact 
 would not be in the least degree in their favor. For we 
 might fairly anticipate, that, under this artificial stimula- 
 tion, more work being got out of the frame than it is 
 naturally capable of discharging, its powers would be ex- 
 hausted at an earlier period than that to which they would 
 be preserved under a system of less excessive labor, per- 
 formed without artificial support. And that such is the 
 
 !>,>.»; 
 
248 
 
 APPBNDIX. 
 
 case is abundantly proved by the fact, that sucb of these 
 men as survive the attacks of acute disease, or are not thd 
 subjects of accident, become prematurely old ; and that, 
 among the whole class, there are few who have passed 
 the age of fifty years. The amount of alcoholic liquor 
 habitually consumed by them may be judged of from the 
 following 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 
 pints of ale per day. I used to drink a good drop of gin 
 too. The 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 the money, they go up to what 
 they term the * lucky-shop ' for it. The coal-porters take 
 this every morning through the week, when they can 
 afford it. After my work, I used to drink more than 
 when I was at it. I used to sit as long as the house 
 would let me have any. Upon an average, I should say, 
 I used to take three or four pints more of an evening ; so 
 that altogether I think I may fairly say I drank my foar 
 pots of ale regularly every day, and about half a pint of 
 dog's-nose. I reckon my drink used to cost me 13s. 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 the 25th of last August, told Mr. M. that before 
 he took the pledge he used to drink a great deal after he 
 had done his work, but while he 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 the day- 
 time," said this man. " Of an evening, I used to stop at 
 the public^honse generally till I was drunk, and Unfit to 
 
 111 
 
APPENDIX. 
 
 249 
 
 work in the morning. I will vouch for it, I used to take 
 about three pots a day after I had done work. My reck- 
 oning used to come to about Is. 8d. 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 did indeed, sir, more 
 to my shame.*' 
 
 It seems a legitimate inference, from the early decay of 
 the physical powers of these men, that no real support is 
 given them by alcoholic liquors, in the performance of their 
 arduous labor ; and it is a remarkable point in the state- 
 ments just quoted, that both agree in the assertion that 
 the principal part of the liquor consumed is taken in the 
 evening, after the day'« toil is over, as they '* could not 
 stand it " whilst at work. Thus it appears that the amount 
 which can be effectively employed as a stimulus to nervo- 
 xnuscular exertion is really small ; and it is further evident 
 that there is an entire absence of proof that any thing is 
 in the end gained by their use ; a conclusion which is in 
 perfect harmony with the statements made in the Essay 
 (§§ S^ — 102), as to the incapacity of alcoholic liquors for 
 maintaining the physical powers of the human system. 
 
 That some of tiiose who have tried the total-absti- 
 nence system have gone back 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 labor 
 they are called on to perform, but also by the want of ade- 
 quate sustenance from solid food. A due allowance of 
 this is unquestionably essential to the maintenance of the 
 strength ; and it appears from the testimony of other indi- 
 viduals similarly employed (given in the next Appendix), 
 thai, where this course has been followed, the labor has 
 been performed with more ease, and that the power of 
 endurance has been increased. 
 
260 
 
 APPENDIX B, p. 102. 
 
 I 
 
 The recent inquiries of the " Commissioner" of the 
 Morning Chronicle not only reveal the circumstances 
 under which a vast amount of excessive drinking takes 
 place among men engaged in laborious employments, but 
 also confirm all that is stated in the text as to the possi- 
 bility of performing the severest labor without such assist- 
 ance, provided due support be obtained from solid food. 
 The follov.'ing is the statement made to Mr. Mayhew by a 
 coal-whipper, who had been a teetotaler of eight years' 
 standing : " It's food only that can give real strength 
 to the frame. I have iune more work since I have been 
 a teetotaler in my eigbc years, than I did in ten or twelve 
 years before. I have felt stronger. I don't say that I do 
 my work better ; but this I will say, without fear of suc- 
 cessful contradiction, that I do my work with more ease to 
 myself, and with more satisfaction to my employer, since 
 I have given over intoxicating drinks. I scaiv.^.!/ know 
 what thiist is. Before I took the pledge, I was always 
 dry ; and the more shadow of the pot-boy was quite 
 sufficient to convince me that I wanted something. I cer- 
 tainly havn't felt weaker since I have left off malt-liquor. 
 I have eaten more and drank less. I live as well now as 
 any of the publicans do ; and who has a better right to 
 do so than the man who works ? I have backed as many 
 as sixty tons in a day since I took the pledge, and have 
 done it without any intoxicating drink with perfect ease to 
 myself, and walked five miles to a temperance .meeting 
 afterwards. But, before I became a teetotaler, after the 
 
APPENDIX. 
 
 251 
 
 of the 
 stances 
 ; takes 
 Its, but 
 i possi- 
 1 assist- 
 id food, 
 ew by a 
 t years' 
 strength 
 ire been 
 twelve 
 lat I do 
 of suc- 
 ease to 
 ', since 
 ■ know 
 always 
 I quite 
 I cer- 
 •liquor. 
 now as 
 ight to 
 s many 
 d have 
 ease to 
 eeting 
 tor the 
 
 same amount of work I should scarcely have been able to 
 crawl home. I should have been certain to have lost the 
 next day's work at least; but now I can back that quan- 
 tity of coals week after week without losing a day. I've 
 got a family of six children under twelve years rC ^e. 
 My wife 's a tectoaler, and has suckled four childr( ipon 
 the principle of total abstinence. Teetotalism ha ide 
 my home quite happy, aiid what I get goes twice 
 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 without 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 our- 
 selves, than the drinkers can. Many teetotalers have 
 backed coals out of the hold, and I have heard them say 
 over and over again that they did their work with more 
 comfort and ease than they did when they drank intoxi- 
 cating 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 238 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." 
 
 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 ; 2d, That he could 
 do it with more ease and comfort to himself ; 3d, That at 
 the end of his day's labor he was not too much fatigued 
 to prevent hira from voluntarily walking five miles to a 
 temperance meeting ; whilst (like the first witness cited 
 in the preceding Appendix, who spoke of himself as " like 
 a child with weakness " when his toil was over) he was 
 previously scarce able to crawl home. 
 

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252 
 
 APPENDIX C, p. 220. 
 
 On the Effect of Water-drinking in the Owe of Gout, 
 Ey John Bostock, M.D., FJR.B. •^Cotnmunleated to 
 the Medico- Chirurgical Society. 
 
 «i 
 
 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 sufferer from stomach- 
 affections of various kinds ; acidity, flatulence, heart- 
 bum, irregularity of the bowels, and, in short, from every 
 one of the affections which are enumerated in CuUen's 
 well-known definition of dyspepsia. His mode of life was 
 regular and moderately active ; and his diet, what might 
 be styled temperate, although not abstemious. He had, 
 indeed, been advised by his 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 excessive quantity. In this way he had 
 passed about forty years, seldom actually confined by 
 indisposition, but almost always subject to a Sttcceseion 
 of ailments, which rendered it necessary to have recourse 
 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 seda- 
 
APPENDIX. 
 
 253 
 
 tives, and to a variety of tonics and stimulants. During 
 this period, the renal secretion was seldom in what could 
 he considered a perfectly healthy state ; it was sometimes 
 loaded with deposits, and of high specific gravity ; some- 
 times of low specific gravity, limpid and aqueous ; 
 sometimes very copious, at other times scanty ; while itf« 
 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, and more especially to abstain 
 entirely from fermented liquor or distilled spirits of any 
 description. By this restriction, and by other appropriate 
 remedies, the threatened disease was averted. And, be- 
 sides this fortunate result, the patient found his general 
 state of health and feelings so much improved by the 
 change of diet, that the abstinence from all kinds of 
 liquors has been strictly adhered to up to the present 
 period. The effect has been, that he has lost all the dys- 
 peptic symptoms to which he had been subject for upwards 
 of forty years ; and, what I am more particularly desirous 
 of pointing out to the society, the renal secretion has been 
 now, for a long period, in a perfectly natural state : it is 
 nearly uniform in its specific gravity, and 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, considerably more 
 of these substances discharged from the system than was 
 22 
 
254 
 
 APPEKDIX. 
 
 formerly the case. It would appear, therefore, that the 
 abstraction of alcohol has produced a more healthy state 
 of the digestive and secreting functions ; so that the func- 
 tions of the kidney are more actively and effectively 
 performed." — Medical Gazette, Feb. 23, 1844. 
 
 To this interesting case, which is understood to be that 
 of Dr. Bostock himself, may be added the following, from 
 the Bristol Temperance Herald : — 
 
 " Rebecca 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 advantage that any one could possess 
 in using a stimulating drink. This practice she relin- 
 quished 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 improved with the change of diet, and occasional 
 interruptions by a disordered stomach were much less fre- 
 quent ; 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 appen* to suffer even temporarily. 
 For nearly fifteen years, she 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. At the expiration of two 
 years, she had a rather violent attack of influenza, which 
 brought her so low that her medical attendant recom- 
 
APPENDIX. 
 
 255 
 
 mended wine, to which she had recourse for about six 
 months, when the wound in her leg again opened^ and 
 became troublesome : the wine was, consequently, discon- 
 tinued, and, after the lapse of a few months, the sore 
 again healed up! Her health also improved yet more 
 decidedly than after her first trial of total abstinence ; and 
 she continued, until within a few days of her decease 
 (which took place in the spring of 1843), in the enjoy- 
 ment of excellent health and spirits, and the full posses- 
 sion of nearly all her faculties, although ninety-three 
 years old." 
 
THB 
 
 USE OF ALCOHOL 
 
 POE THE PREPARATION OF MEDICINES, 
 
 BY THE EDITOB. 
 
 In i^ nmnber of the States in this country, laws have been 
 passed prohibiting the sale of alcohol, except for medicine 
 ^nd the arts. In these States the apothecaries have be- 
 come its only regular venders, and some of them have 
 availed themselves of the opportunity thus afforded to 
 retail it to the tippler. This practice partially defeats the 
 operation of the law, and thus threatens to be a public 
 nuisance. The question has naturally arisen. Whether 
 alcohol is a necessary article of the Materia Medica ; and, 
 if 80, to what extent ? Whether, for example, it is not 
 employed in many cases where other articles might be 
 substituted with propriety, and even with advantage ? 
 
 The principal uses for which alcohol is employed in 
 medicine are, Jtrst^ As a Stimulant ; second^ As a Men- 
 struum ; thirds As an Antiseptic. 
 
 As a stimulant, it is not so necessary as might at first 
 view appear. When it is employed, for example, to 
 revive a person who is much exhausted, the distilled aro- 
 matic herbs, or a mixture of the essential oils, would 
 answer. Peppermint-water, and the other aromatic 
 waters, by increasing the proportion of the essential o\\m, 
 22* 
 
268 
 
 USB OF ALCOHOL 
 
 / 
 
 mty be mado as strong a stimulant as can be swallowed 
 without excoriating the throat. These may often, there- 
 fore, be very properly substituted for brandy. For some 
 other cases, the preparations of ammonia are more proper. 
 Their action is more rapid ; they possess greater stimulant 
 powers ; and the quantity required is therefore less. 
 
 Second, as a menstruum, alcohol is employed for ex- 
 tracting the virtues of medicinal plants, and dissolving 
 medidnul resins. The substance, being infused in alcohol 
 A certain time, imparts its properties, or a portion of them, 
 to the liquid ; which is then administered, sometimes in a 
 pure state, and sometimes diluted with water. Many 
 people are not aware, that, when they take a glass of 
 elixir proprietatis or of tincture of rhubarb, they swallow 
 two ounces of strong rum. Yet delicate females, and 
 even children, are made to take these daily, and thus 
 become habituated to the use of alcoholic stimulants. 
 The danger arising from such practices in some inflamma- 
 tory complaints must bo very great. 
 
 The medicinal resins for which alcohol is used as a sol- 
 vent are aloes, myrrh, guaiacum, dec. The tincture formed 
 by the combination of alcohol and the first two of these is 
 the famous " Elixir Pro." which, in former times, every 
 good mother thought herself obliged to prepare and keep 
 for the benefit of her young family. Many an unconscious 
 mother has brought on symptoms of violent fever by 
 intoxicating her offspring with these insidious articles. 
 Now, for these there are substitutes, which may be 
 employed in the greater number of instances. An infu- 
 •ion of rhubarb in water, with some aromatic, is a better 
 medicine than the alcoholic preparation in three cases out 
 of fourt Aloes may be used as an extract in pills, and 
 may be employed in the simpler state of powder, and even 
 in decoction ; so that there are, in fact, very few, if any, 
 
FOR THE PREPARATION OF MEDICINES. 
 
 259 
 
 cases where the spirituous preparation is required. It is 
 a common opinion, indeed, that tincture of aloes and 
 myrrh, or elixir proprietatis, is an excellent remedy for 
 colic. If it be used in a colic from indigestion, the astrin- 
 gent property of the alcohol may, by contracting the 
 stomach on undigested food, increase the pain ; and 
 the same is true of brandy, gin, and other forms of alco- 
 hol. If, again, it be used for w'nd-colic, or pain from 
 flatulence, drinks actually hot, as hot peppermint- water, 
 or even simple hot water, are preferable. Tincture of 
 cinchona, or " tincture of bark," as it was formerly called, 
 contains less tonic power* than may be found in the pre- 
 parations of quinine ; and the same may be said of most 
 of the bitter tinctures, as calumba and cascarilla. Tinc- 
 ture of red lavender poured upon loaf-sugar has been a 
 favorite cordial with young ladies who wish to fortify 
 their stomachs against any particular emergency, and it is 
 notorious that this indulgence has been a very frequent 
 origin of tippling. If, instead of taking lavender to re- 
 lieve the stomach, they omitted the use of sugar-plums 
 and bon hons, they might experience neither the disposi- 
 tion for, nor the ill consequences arising from, alcoholic 
 articles. Stoughton's elixir, which is the same ac ;l.o 
 tincture of gentian, was regularly introduced into the draw- 
 ing-room during the last generation to give keenness to 
 the appetite for an approaching feast. But at last it was 
 discovered, that, by overstimulating the empty and unpro- 
 tected organ, and producing a sense of satiety before any 
 food was taken, instead of quickening the appetite or 
 aiding the digestion, it blunted the one and enfeebled 
 the other. Our epicures, having sagaciously observed 
 these disagreeable effects, have proposed to tickle and 
 awaken the stomach by the introduction of a large cold 
 oyster or two. The best substitute for both of these will 
 
260 
 
 US£ OF ALCOHOIi 
 
 / 
 
 be found in half a glass of water, fresh as it comes from 
 the spring, and not spoiled by ice. The cases above 
 mentioned will perhaps be thought sufficient to show how 
 easy it often is to find substitutes for alcoholic medicines. 
 
 There is a class of preparations, revealed by science, 
 which promises great advantages as a substitute for the 
 tinctures. In the number of the ** Boston Medical and 
 Surgical Journal" for September 5, 1849, will be found 
 an account of a mode of producing a fermentation, by 
 which is generated a substance containing the properties 
 of medicinal articles in a convenient state for administra- 
 tion and preservation. By adding to an infusion of senna 
 a due proportion of sugar, a fermentation is generated 
 which produces a vinous fluid, so weak as not to possess 
 any important stimulant properties, and yet strong enough 
 to prevent decomposition. This preparation we have tried, 
 and find elegant, convenient, and safe. It cannot be used 
 for the purposes of intoxication, on account of its weak- 
 ness and medicinal effect. Various preparations — as, for 
 example, aloes, opium, gentian, rhubarb, and many others 
 most necessary in medical practice — may be made in the 
 same way. Perhaps it will be thought that they are no 
 better than tinctures ; but, in fact, they have not the 
 strength of tinctures. No extraneous alcohol is intro- 
 duced. We recommend to the enterprising apothecary 
 the preparation of these products of fermentation as pro- 
 mising much advantage to the medical practitioner, and 
 a valuable improvement in economy to the apothecary 
 himself. 
 
 A third use of alcohol is to prevent decomposition. 
 For this purpose it is added to some infusions, decoctions, 
 and syrups. The two former of these should always be 
 prepared recently and without alcohol; and the last, if 
 properly made, do not require it. 
 
 '. r, 
 
FOR THB PREPARATION OF MEDICINES. 
 
 261 
 
 Physicians have been among the most forward, perse- 
 vering, and able advocates of temperance. Without their 
 aid, the temperance reformation could never have pro- 
 ceeded as far as it has. But it appears there is an evil 
 existing under their eyes, and, in a measure, maintained 
 by their prescriptions, which has become formidable to the 
 public morals. If they would take the matter into con- 
 sideration, and satisfy their own minds when alcoholic 
 preparations are really required, their prescriptions would 
 undoubtedly be much more restricted than they now are 
 in the employment of the tinctures. The facts so briefly 
 stated above will probably be sufficient to convince them, 
 that they might, with a very little sacrifice of convenience, 
 employ substitutes more beneficial to the patient, and less 
 objectionable on the ground of temperance ; and they 
 would have the satisfaction of believing, that they have 
 removed from the reach of their patients an article which 
 might, by slow and insidious steps, have ultimately led to 
 their ruin. 
 
 Note. -^ Some of the Pharmaeopceias direct that spirit should 
 be added to infusions to prevent decomposition, when they are to 
 be kept any length of time. This may be accomplished without 
 alcohol, by placing the infusion, while hot, in a closely stopped 
 bottle, and keeping it in a cool place. 
 
262 
 
 MEDICAL CERTIHCATE. 
 
 Thtt 4fMMM(, ifwkieh a copy u given at page xxiii. has already bten mbierUii ty 
 MlMiut flOOO MeUieul PractUwMers, among toAum are the fultvwing i — 
 
 A4»mii, M«%. Maxwell, M.n. ProfeMor, 
 
 A4(llM»n, T. M.o. Senior PliyRiriBn to 
 
 Uuf*t HiMiplliil 
 AM^Htn, Win. m.d. r.ii.i. k,c. London 
 AtkmMn, dou burgeon, Ea«t Linton, 
 
 Ilii4din||l4in)«hlr« 
 AllMtN, W. P. M.D. ProfeiMr of the 
 
 frtMUlcn of Pliyitic and Clinical Me- 
 
 iieim in the Unlvenily of Edin- 
 burgh, ind Phyiicinn to the auoen 
 AlMl«r»on, Ales. Burgeon, Tranent, 
 
 llMidingtonnliIre 
 Amslt, i. MoncrlefT, r.ii.i. Vice-Presi- 
 
 4«Ht of the Riiynl College of Sur- 
 
 |«Mii of England, Ilc. 'x. 
 Arnott, Neil, m.d. r.n.: Physician 
 
 £«('. to the Queen ) Author of " £le- 
 
 in«Ht« of Pliyitlc))," Ijondun 
 Bftlilngton, Dun. Guy, m.d. r.iki. Pby- 
 
 •i«lNfl to Guy's Hospital 
 illy, WllllHtn, M.D. r. R.». Physician to 
 
 th« Mill-lmnk Prison, London 
 BftrtMr, iohn, M.n.o.s. Aldborough, 
 
 iilfliflk 
 PmUIo, Wlllliim. M.D. Edinburgh and 
 
 Londott, Pliyslcian Extraordinary to 
 
 hiu iMto Mnjesty William IV. &c. &c. 
 
 liONdon 
 DtwutHOfit, Thos. Surgeon, Bradford, 
 
 Yorkshire 
 B«ll, L'liM. W. M.D. Physician to the 
 
 Mflnehester Hoynl Inflrmnry 
 Billlflg, A. M.o r.R.s. late Senior Phy- 
 
 Mieintt to the London Hospital 
 Bo«(o«k, John, m.d. r.H.s. 
 Bowiimti, W, r.R.a. Professor of Phy- 
 
 «k*iogy In King's (College, London 
 Bright, ttiehard, m.d. r.a.s. Physician 
 
 £«lr. to the Queen, Consulting Phy- 
 
 •tolUtt to Ouy's Hospital 
 
 Brodie, Sir Ren. C. Bart r.a.s. Ser- 
 geant-Surgeon to the Queen 
 
 Buchanan, M. S. m.d. Professor of 
 Anatomy in the Andersonian Uni- 
 versity, Glasgow 
 
 Budd,0. M.D. r.R.i. Physician to King's 
 College Hospital, London 
 
 Burn, J. M.D. Edinburgh 
 
 Burnett, Sir W. m.u. r.>.t. Phyitetan- 
 General to the Navy, itc. &c 
 
 Burrows, Geo. m d p.r.i. Physician t* 
 St. Uartholumew's Hospital 
 
 Carmichael R. r.R.t. M.a.i.*. Dublin 
 
 Carpenter, W. B. m.d. r.a.s. &e. ttt. 
 London 
 
 Chalmers, Wm. m d. late Physician to 
 the Royal Infirmary of Glaagow, 
 Croydon, Surrey 
 
 Chambers, Wni. F. m.d. f.r.s. Phyal- 
 cian to the Queen and to the Queen 
 Dowager 
 
 Clark, Sir James, Bnrt. m.o. F.R.i. Phy- 
 sician in Ordinary to the Queen and 
 his Royal Highness Prince Albert 
 
 riay, Chas. m.d. Editor of the •' Bri- 
 tish Record of Obstetric Medicine '* 
 
 Clanny,Wm- R. m.d. f.r.i. Edinburgh, 
 Consulting Physiciun to the Sunder- 
 land Inflrmnry 
 
 Cluley, Wm. h.r.c.s. Ashton-under- 
 Lyne, Lancashire 
 
 Collenette, B. m.r.u.8. Guernsey 
 
 Collet, H. J. M.R.c.s. Worthing, Sussex 
 
 Combe, And. m.d. Physician in Ordi- 
 nary to the Queen for Scotland 
 
 Cooke, Wm. m.d. h.r.c.8. tec. London 
 
 Copland, James, m d. f.r §. Author of 
 " Dictionary of Practical Medicine " 
 
 Couper, John, m.d. Professor of Mat»- 
 ria Medica in the University of Glaa- 
 gow 
 
MEDICAL CERTIFIOATB. 
 
 268 
 
 Courtney, A. m.r.o.i. late Surgeon, 
 R.N. RnmKgale 
 
 Cnimptun, Sir Philip, Rort. m.d. r.iut. 
 Burgeon-Uunural lu the FurccH, Ire- 
 land 
 
 Crl«p, Edwards, m.d. m.iuc.*. London 
 
 Crlap, Fred. A. n.ii.ct. Walwortb, 
 Surrey 
 
 Currle, Claud, Surg.-Oeneral, Madraii 
 
 Daviei, J. B. m.d. Senior Physician to 
 Queen's ilogpital, UirininKham 
 
 Duncan, Robt. m.d. m.k.c.i. Tunbridgo 
 Well* 
 
 Ed!!n, T. M.n.c.a. Liverpool 
 
 Eyre, Sir Jaa. m.d. h.r.c.i. I^ndon 
 
 Farre, Arthur, m.o. r.iut. Profu88ur of 
 Midwifery in Kiiig'd College, I<ond. 
 
 Ferguson, Robert, m.d. Physician-Ac- 
 coucheur to the Queen, London 
 
 Fergusson, W. r.a.i. r.n.c.t. Surgeon 
 to King's College Hospital, Ijondon 
 
 Ferrier, J. C. m d. Member of the 
 Council of "The Provincial Medi- 
 cal and Surgical Association," late 
 Physician to the Worthing Dispen- 
 sary, Brixton, Surrey. 
 
 Fife, Sir John, r.a.c*. Surgeon to the 
 Infirmary, Newcastle-upon-Tyne 
 
 Forbes, John, m.d. r.a.s. Physician in 
 Ordinary tu her MnjcHty'it liou!<KhnlJ 
 
 Fothergill, John, m.b.c.s. Darlington, 
 Durham 
 
 Gay, J. r.R.c.t. Surgeon to the Royal 
 Free Hospital, London 
 
 Gavcd, Arthur, M.R.c.i. St. Mabyn, 
 Cornwall 
 
 Grainger, R. D. r.ius. Member of the 
 Council of the Royal College of Sur- 
 geons of England 
 
 Grant, George, m.d. Richmond Hill, 
 Surrey 
 
 Gray, Wm. A. m.d. Edinburgh 
 
 Gregory, Geo. m.d. f.r.c.p. Physician 
 to the Small Pox and Vaccination 
 Hospitals, London 
 
 Grind rod, R. B. ix.d. Author of " Bac- 
 chus " 
 
 Guy, W. Augustus, f.iuc.p. Physician 
 to King's College Hospital, London 
 
 Hnll, Marshall, m.o. r.a.f. he. k,c. Lon- 
 don 
 
 Harvey, Joshua, m.d. Physician to the 
 Retreat for ptTKonn nfltittcd with dis- 
 orders of the Mind, Oublin 
 
 llawkini*, Cn^or H. r.s.ci. Surgeon to 
 St. George's Hospital, I<ondon 
 
 Hawkins, Francis, m.d. r.a.cr. Physi- 
 cian to the MiddleM-x Hospital 
 
 Hawkins, Jnmcs, m.r c u. London 
 
 Henderson, Willlntn, m.i>. Professor of 
 General Pittliology in the University 
 of Edinburgh 
 
 Ilick.'t, U. SuriS'f'n, London 
 
 lligginbottom, John, f.r.c.i. Author of 
 " Alcohol as a Medicine," he Not- 
 tingham 
 
 HilU, Geo. M.n.o.s. Arundel, Sussei 
 
 Hingriton, Andrew, M.a.e.s. Llskeard, 
 Cornwall 
 
 Hinffston, Richard, Surgeon, Cornwall 
 
 Hofmunn, A. VV. ProfcHHur to the Royal 
 College of t'h'Mnistry, London 
 
 Holland, G. C. m.d. Physician Extr. to 
 tlie Sheffield General Infirmary 
 
 Holland, Henry, m.d. p.R.t. Physician 
 Extraordinary to the Queen ; Author 
 of" Medical Notes and Reflections" 
 
 Hue, C. M.D. r.ii.c.p. Senior Physician 
 tu St. nartiiultiiiii w'd IIo:ipital 
 
 Hume, Joiseph, m.d. and M.r. 
 
 Hunter, Robert, M.D. F.a.c.p. Cdin. and 
 Lecturer on Anatomy, Glasgow 
 
 Jeffreys, Julius, f.h.s. f.o.s. he. he 
 London 
 
 Judd, W. H. F.R.C.B. Surgeon in Ordi- 
 nary to II. R. II. Prince Albert 
 
 Key, C. Aston, f.r.s. Senior Surgeon 
 to Guy'ii Hoi^pital 
 
 Kiernnn, Fran. F,R.a. f.r c.s. he. he, 
 London 
 
 Kirk, James R. m o. Glasgow 
 
 Latliam, P. M. m.d. Physician Extraor- 
 dinary to the Queen, late Physician 
 to St. Uartholomcw'ii Hospital 
 
 Lnurie, James A. m.d. Surgeon to the 
 Glasgow Royal Infirmary 
 
 Little, W. J. M.D. Physician to the 
 London Hospital 
 
264 
 
 MEDICAL CBBTIFICATB. 
 
 / 
 
 Lonsdale, H. k.d. r.iuo.r. Edinburgh, 
 Physician to the Cumlwrland Infir- 
 mary, Carliala 
 
 MKSregor, Sir James, Bait if.o. r.B.i. 
 Director-General of the Army Medi- 
 cal Department 
 
 H'Kenzie, Wm. m.d. Surgeon-Octtlist 
 to her M^iJeflty, Glasgow 
 
 Mantel!, G. A. uuo. r.a.i. r.ii.o.t. Lon- 
 don 
 
 Marsh, Sir H. Bart if.D. Physician to 
 the Queen, Dublin 
 
 Moore, G. if.D. Author of " Man and 
 his Motives," &c Tunbridge Wells 
 
 Mudge, H. if.K.c.1. Burgeon to the Hos- 
 pital and Dispensary, Boduiin, Corn- 
 wall 
 
 Munro, Sir Alex. ii.d. late Professor of 
 Anatomy in the University of Edin. 
 
 Newth, Geo. Elisha, m R.c.f. Edin- 
 burgh, Assistant-Accoucheur to St 
 Thomas's Hospital, London 
 
 Oxley, W. 1I.D. Hackney, Middlesex 
 
 Paris, J. A. h.d. f.r.s. President of the 
 Boyal College of Physicians, Lond. 
 
 Percy, John, if.o. f.r.s. Professor of 
 Chemistry, Queen's College, Bir- 
 mingham 
 
 Pereira, Jonathan, ii.d. r.>.s. Assistant- 
 Physician to the Lond. Hospital, &c. 
 
 Peny, Uobt m.d. Physician to the Glas- 
 gow Eoyal Infirmary 
 
 Pettigrew, 1'. J. f.b.i. r.iuc.s. &c. &c. 
 London 
 
 Prout, Wm. if.D. r.B.s. Author of *' Sto- 
 mach and Renal Diseases," &c. 
 
 Reid, John, m.d. Professor of Anatomy 
 in the University of St. Andrews 
 
 Roget, P. M. M.D. r.ius. London 
 
 Roupell, G. L. M.D. F.B.S. Physician to 
 St. Bartholomew's Hospital 
 
 Eoyle, J. F. m.d. f.r.s. Prof, of Materia 
 Medica in King's College, London 
 
 Sladen, Ramsay, Phys.-Gen. Madras 
 
 Sleman, R. m.iuc.s. Tavistock, Devon 
 
 Smith, A. M.D. Deputy-Inspector of 
 Army Hospitals 
 
 Snow, John, m.o. Vice-President of the 
 Westminster Medical Society, Lond. 
 
 Syme, J. m.d. Professor of Clinical 
 Surgery in the University of Edin- 
 burgh, and Surgeon to thejQueea 
 for Scotland 
 
 Tatum, T. F.i.o.t. Surgeon to Bt 
 George's Hospital 
 
 Taylor, Alfred S. F.i.i. Professor of 
 Medical Jurisprudence and Chemb- 
 try in Guy's Hospital 
 
 Taylor, John, m.d. Professor of Natu- 
 ral Philosophy in the Andersonian 
 University, Glasgow 
 
 Thomson, John, m.d. Hamilton, La* 
 narkshire 
 
 Thomson, Robt. Dundas, k.d. Profes* 
 Bor of Chemistry in the University of 
 Glasgow 
 
 Toone, John, H.a.c.s. Salisbury 
 
 Toynbee, Joseph, f.b.s. f.b.o.s. Lond. 
 
 Tweedie, A. m.d. f.r.*. Physician to 
 the Fever and to the Foundling Hos- 
 pital, London 
 
 Ure, And. m.d. F.i.i. London 
 
 Ure, Alexander, f.k.c.s. London 
 
 Watson, James, U. m.o. Tranent, Had- 
 dingtonshire 
 
 Watson, Thomas, h.d. f.i.c.f. Con- 
 sulting Physician to King's College 
 Hospital, London 
 
 Webster, G. h.d. M.ii.o.i. Edinburgh, 
 Dulwicb, Surrey 
 
 Whitfeld, H. m.iuc.s. Ashford, Kent 
 
 Whittle, Edward John, Surgeon, Lam- 
 berhurst, Sussex 
 
 Wilkins, Ignatius, m.i.o.s. Wade> 
 bridge, Cornwall 
 
 Williams, C. J. B. m.d. f.b.s. Pro£ of 
 Medicine in the University of Lond. 
 
 Wilson, Erasmus, F.s.i. f.b.o.s. &e. 
 &.C. London 
 
 Winslow, Forbes, h.d. m.b.o.s. Editor 
 of the "Journal of Psychological 
 Medicine and Mental Pathology," 
 London 
 
 Wood, Andrew, h.d. f.i.o.s. Edin. 
 
 Wright, Samuel, m.d. vuo. Physician 
 to Queen's College, Birmingham 
 
 Young, J. Forbes, m.d. Kennington, 
 Surrey.