BY F. W. HUNT, M. D., NEW YORK.

Under this head I propose to review and bring into small compass some of the most important conclusions of modern science on the Medical Properties of Alcoholic Stimulants. My attention will be chiefly directed to those practical questions on which some discrepencies of opinion still exist among medical men.

PHYSIOLOGICAL EFFECTS OF WINE. — The beneficial effects are: 1st, Exhilaration; 2nd, Nutrition; 3rd, Arrest of destructive metamorphosis of structure. The injurious effects are: 4th, Inebriation; 5th, Degeneration of tissue; 6th, Derangement of digestion.

BENEFICIAL EFFECTS, — I. Exhilaration. This may be produced by various articles that do not intoxicate: as, essential oils, peppermint, onions, valerian, assafetida, tea, coffee; the eating of substantial food, slight exercise, quickening the circulation of the blood. But fluids that contain alcohol are the articles most commonly employed in this country for purposes of exhilaration, though their effects are not proportioned to the quantity of alcohol they contain. When pure wine is taken in an exhilarating dose, it increases the amount of vital power that can be rendered available in a given period. When alcohol in any form is given in an intoxicating dose, it positively diminishes the available vital powers. From an extensive series of chemical experiments Dr. Bocker obtained the following general results:

1. “The special action of alcoholic drinks is to arrest destructive assimilation — to stop the over-active processes of life in their effects upon the organism: so that, for a certain period, during the stay of alcohol in the system. less urea, less phosphates, less water are excreted by the kidneys, less carbonic acid by the lungs, and less digestion goes on in the alimentary canal, showing that the muscles, bones, nerves, &c, are not getting rid of their effete tissue, but retaining it and making use of it as far as possible.”

2. “But at the same time they give rise in the body to a defensive reaction, which is prominent first, immediately after taking the dose, then gives place to the special action, and on this ceasing, is again manifested to greater extent.”

3. “So that if a suitable quantity be taken, and both action and reaction are allowed to exhaust themselves before the dose be repeated, more manifestations of life, represented by more excretion, and more consequent renewal of the body takes place in a given time with the alcoholic drink than without. There has been a positive gain in vitality, but if such a large quantity is taken at once that the reaction is overpowered, or if it is arrested by a continuous repetition of the dose, the manifestation of life is kept down; the body is not renewed, because its effete particles are not removed and the amount of vitality must certainly be reckoned at a loss.”

The essential use of wine has been stated by a prominent Homoeopathist to consist in exhilaration. It has power “to deepen case and pleasure on high tides, and at harvest homes when endurance is not required;” “to enable us to surmount seasons of physical and moral depression, and to keep up the life-mark to a constant level, influenced as little as possible by the circumstances of the hour.” It is acknowledged to be possible, in certain conditions of depressed health, to introduce just that quantity of alcohol into the stomach that shall produce the effect of simple exhilaration, and so manage the quantity and the repetitions that the stimulant shall constitute a medicinal diet, adding strength to both the physical and mental powers;“ “to show to age by occasions that its youth lies still within it, and may be found like a spring in a dry land with the thyrsus for a divining rod;” “to make us kinder than our reason and more admissive than our candor, and to enable us to begin larger sympathies and associations from a state in which the feelings are warm and plastic;” “to save the resources of mental excitement by a succedaneous excitement of another kind;” “to balance the animation of the soul by the animation of the body, so that life may be pleasant as well as profitable.” It is even said by learned and wise men, that wine has power “to reveal men's powers to themselves and to their fellows.” (Wilkinson.)

The doctrine may be true without being safe, and its votaries, though armed with reason for all they do, tread a perilous pathway over hair-breath bridges and along the verge of giddy precipices.

How may the beneficial effects of alcohol be obtained without the accompaniment of injurious consequences?

1. By using it in such combinations with sugar, extractive, vegetable essential oils, and ethers, described as the aroma or Bouquet, as constitute the fine wines. It is supposed that the better kinds of wines possess these elements in some peculiarly happy combinations, and that each may possess especial merits and be applicable to peculiar conditions. In cases of mental depression, hypochondriasis, nervous exhaustion, over anxiety, hysterical fainting, vomiting from gastric debility, Bordeaux, Champagne, Rhine, or Moselle wines have been particularly recommended.

2. By using it in a state of effervescence. Sparkling Champagne produces higher and less injurious exhilarations than most other wines. It is supposed that in the act of the elimination of carbonic acid, some exhilarating ethers, little understood, are developed, and that they may quicken the nervous energies and improve the digestive powers. Liebig found protoxide of nitrogen or “laughing gas” in some specimens of Champagne.

3. By its mixture with the other constituents of wine the exhilarating properties of the alcohol are increased, while its poisoning powers are lessened, The ether in wines is said to be a remedy for drunkenness; twenty or thirty drops will restore to temporary sobriety. ( M. Batilliat on the Wines of France, Brit. and For. Med. Chir. Review, 1858.)

II. Nutrition Wine affords but little nutritive matter in itself, but it renders the absorbent apparatus of the digestive tube more ready to take up the nutriment furnished by other substances. Oleaginous substances, in particular, are more easily assimilated with its help, but articles containing albumen are rendered less digestible by the presence of alcohol.

In the administering of wine to promote nutrition, consider,

1. That the alcohol alone should regulate the quantity given, as all other ingredients contained in the selected wine may be considered as innocent and less important.

2. That alcohol may aid development of adipose, but not of muscular tissue.

3. Wines containing but little material for refermentation, for rendering fatty matters rancid, or but little acid in proportion to their alcohol, should be selected.

4. They should be taken with oleaginous food, or immediately after it

III. Arrest of Destructive Metamorphosis of the Tissues. — This is the most important of the beneficial effects of alcohol. Pure wine or brandy is believed to be capable of checking “the progress of interstitial death in low fevers till the period of the zymotic poison's virulence is passed, and it has been evacuated or become inert.” By the judicious use of alcoholic drinks we can check the exhaustion of the body through excessive secretion, as in cases of chronic catarrh, ulcers, abscesses, amputations, &c.; and may diminish the rate of progress of that ”wear and tear “ process by which the overworked mind wears out the body in metropolitan life, and thus breaks down so many struggling, toiling, thinking men.

But, “in wielding this two edged sword,” the greatest judgment is required lest we carry the effect too far. “The destruction of effete tissues is a part of life, and necessarily precedes constructive renewal; if then we check it too far, interstitial life is diminished and the system is overloaded with matter incapable of vitality.” In order to obtain the benefits of the stimulant without the danger of producing bad effect: first, let it always be given in a diluted form, even when its most decided action is desired. Second, give it combined with other nutritious and easily assimilated substances. The sugar contained in good wine is shown by Dr. Bocker's experiments to have a special effect in limiting the destruction of tissues containing phosphates, as the bones and nerves. The ethers may possess a similar power. The acids and extractive matter of wines lessen the injurious effects which the alcohol alone, though diluted, exerts on the mucous membrane; hence, wine is far better than brandy, even when the latter is largely diluted. Third, after a stimulant has been persisted in for some hours, an interval should be allowed during which its effect may subside, “and the system recover for a time its metamorphosis, so that the effete tissues may be duly eliminated and expelled.” (Brit. and For. Med. Chir. Review .) Even the purest wines should always be given in a diluted state. Troy was taken by heroes who drank their wine forty times diluted with water. Such practitioners would be regarded as “high dilutionists” among modern Homoeopathists.

We have now seen that alcohol, when judiciously employed, is capable of performing important uses in the treatment of disease. For all the objects faintly presented above, fermented liquors have been in use from the earliest ages, and distilled alcohol has been constantly rising in estimation and influence among men since the days of the Arabian Alchemists. It has long ago been employed in, perhaps, every disease known to our race, and its best and worst powers are perhaps as generally and as fully understood as those of any other article employed by science or the arts. And yet, with all the experience and all the knowledge with which the popular mind is imbued, alcohol, which is almost a household word in every dwelling on the globe, and applicable to the most important medical uses, is the article of all others least likely to be employed for good. The injurious effects of stimulants are too numerous and extensive to be satisfactorily treated of here; the more important only must be noticed.

INJURIOUS EFFECTS. — IV. Inebriation is a fourth effect of alcoholic stimulants.

Alcohol is a powerful diffusible stimulant. It increases the action of the heart and arteries, occasioning increased activity of the mind, a rapid flow of ideas and images which are usually of a pleasant description; and, by exciting the nervous and vascular system, it produces a general exhilaration. When a larger quantity of the stimulant is taken, the effect is the physical and psychical disease known as inebriation, intoxication, or drunkenness. Its pathology and treatment, when established as a chronic disease, are becoming highly important, but must be passed over at present.

V. Degeneration of Tissue. — When alcohol is used for the purpose of exhilaration, this effect is always succeeded by a state of depression, varying in intensity in proportion to the previous amount of excitement When the stimulant has been given at or near the termination of an acute disease and a temporary effect only is needed, we may safely repeat the stimulant sufficiently often to prevent the vital powers sinking too low. Under the action of wine or brandy the process of “destructive metamorphosis of the tissues” is temporarily arrested; the dead and effete materials remain as a useless burden in the system mixed up with the healthy fluids, and are finally converted into oil or fat, the least vitalized of all the fluids. In acute cases this repetition of the dose, for the purpose of keeping up uniform action, may be always safe, since we know that it will not long be needed, and that as the disease recedes, it may be suspended entirely.

But in chronic cases a new danger is encountered. That stage of depression which follows temporary exhilaration, may indeed be averted for a time; but, if the dose of the stimulant be repeated before the arrest of metamorphosis has ceased and the reaction of the system begun, a second arrest indeed takes place as before, but the postponed reaction is augmented in force each time it is delayed; and when it occurs at last, it is so painfully depressing that it becomes more and more difficult to resist the instinct to put it off, and in the end it is really dangerous to do so suddenly. During the time that the patient is endeavouring to keep up his physical energies by a moderate stimulation, and while the old blood discs of dead effete material are retained and circulating in the blood vessels, there is a real degeneration of tissue going on in the heart, liver, kidneys, or other organs of the regular though moderate spirit-drinker; even when there is an increase of fat, if there be not also increased muscular power, the apparent improvement is fallacious.

Upon this acknowledged power of alcohol to arrest the metamorphosis of living into dead effete matter, are based all the efforts ever made to treat successfully chronic diseases by the use of stimulants. The reason that they have so rarely succeeded is found in the fact, that alcohol itself produces degeneration of the tissues when this arrest of metamorphosis has been too long and continuously kept up. That transient elevation and consequent depression which alcohol produces, and which can be managed in cases of debility following acute diseases, to keep up artificial strength till that which is more permanent can supply its place, is only]a “broken staff” when trusted by sufferers from organic chronic disease. Extreme and reckless measures may possibly succeed in peculiar constitutions, but they can not be generally relied upon. The experiment of treating phthisis pulmonalis and other asthenic diseases with wine or brandy alone has often been tried, and has sometimes succeeded, but that it cannot be generally a safe or successful practice, will appear from considerations already advanced. Perpetual stimulation can not long be borne without causing disastrous consequences. When alcoholic stimulants in any form are prescribed for a chronic disease, which will probably endure for a few weeks or months, let it always be remembered that habitual drunkenness is not the only rock in the whirlpool to which we have introduced our patient. As soon as we have taught him that alcoholic action will alleviate certain morbid phenomena, he will begin to find it necessary to recur to it again and again for the benefit of the transient relief it affords. The patient knows no harm in alcohol except drunkenness, and so long as he avoids that vice, thinks he can not keep up too steadily the agreeable support that alcohol gives. Following strictly his physician's advice, he feels that he must be safe. “Alas! much safer for him would be the occasional debauch of a man he despises as a profligate, than his own continuous steady course toward death.” ( Brit. Rev., No. 42, p. 243.) Complete drunkenness brings about its own temporary cure, and is usually allowed to be followed by a reaction afterward; but the tippler feels safe because he does not get drunk, whereas, the most alarming symptom in his case is, that he cannot get drunk. Day by day there is a little less life in his system until at last his degenerated body is fit for burial.

These effects of alcohol are not generally caused by wines as they are seldom used to this extent; but when brandy or any other form of alcohol is prescribed by official authority, it is sure to be faithfully taken at short intervals. The temporary elevation and resulting depression are more decidedly felt; the “want” of renewed stimulus returns with increased intensity after each indulgence.

VI. Derangement of the Digestive Power. — A sixth effect of alcohol, which furnishes another reason why it can not generally be given in large doses or long continued in the treatment of disease, is the derangement of the digestive power that it always ultimately causes, whether intoxication be produced by it or not. In estimating the injury done the stomach by its use, we must not wait for the sensation of pain to reveal the fact, that the mucous coat of the stomach is passing into a state of inflammation.

In the nervous system, says Dr. Johnson, “we distinguish two great classes of nerves; those that take their origin from the brain, and those that arise from the spinal marrow, besides those that constitute the ganglionic system of nerves. The nerves that originate in the brain transmit sensations to the sensorium, and nervous influence to the voluntary muscles; while the nerves which proceed from the spinal marrow regulate the functions of various vital organs, as the stomach, liver, heart, &c.”

“Of the nerves of the first division, we notice that each has its particular sensibility in health, but when they are inflamed or diseased they become exquisitely sensible to impressions which in health they would not have felt. Common food, swallowed, ceases to be felt as soon as it reaches the stomach, but a tea-spoonful of capsicum produces a burning heat in the same surface by inflaming its nerves.

“Here arises one of the most useful precepts in the art of preserving health. Whenever we call forth conscious sensation in the stomach, whether of a pleasurable or painful kind, we offer a violence to that organ; the injury may be slight but it is none the less real. When food of the right quality, and in the right quantity is taken into the healthy stomach, no sensation is felt, but when a full meal is taken, which includes some stimulating article, a sensible impression is made on the nerves of the stomach; when this sensation is a pleasurable one, when a general exhilaration is produced, the pulse is quickened, the face flushed, the mind more active, and the flow of ideas more free. But this exhilaration is transient and partial. In proportion as the ganglionic system of nerves is excited, the voluntary nerves and muscles are disqualified for action. These nerves of the ganglionic system convey the vital power from the nervous centres to those organs which continue their action independent of the will, as the nerves of the heart In a. state of health, pleasurable sensations are diffused over the body, as well as to the mind by the presence of food in the stomach, without any conscious sensations being produced by it.” (On morbid sensibility of the stomach, etc.)

The practical bearing of these facts is highly important particularly in all the forms of chronic diseases in which there is a failure of function in some of the vital organs, and a call for the aid of stimulants in keeping up their action.

It has recently again been proposed to treat tubercular consumption with stimulants alone, on the ground that alcohol possesses the power of arresting the progress of degeneration of tissues. We have already seen that it possesses this power, but for reasons, some of which have already appeared, its beneficial influence is chiefly confined to cases of brief duration. We here find another reason for the final disappointment of those who for a time think themselves stronger and more comfortable under the use of large potations of brandy. They cannot be long kept up without deranging the digestive powers, though some constitutions will bear up longer than others. The mucous membrane of the stomach becomes morbidly sensitive, irritable and partially inflamed; the gastric juice is then secreted in a perverted state; it possesses imperfect solvent powers; it becomes at the same time highly irritating, and the peristaltic movements of the stomach are deranged also. Food then taken into the stomach, instead of being digested, undergoes the acetous or lactic fermentation. When different kinds of wines are tried in these cases, the effect varies in degree, but they all contain free acid in some quantity; and, unfortunately, they are quite frequently adulterated. Most of the wines sold contain large quantities of undecomposed fermenting matter, which is speedily excited to action by the warmth of the stomach; they run rapidly into a state of acidity in which irritating gases are formed. “There may be often found a much larger quantity of acid than the taste indicates, concealed by molasses or perhaps sugar of lead. Instead of tartaric there may be malic acid, the consequences of which to the digestion are well-known to the eaters of rhubarb tarts, and the drinkers of hard cider.” (Batilliat, p. 142.) “There may be alum, copper, iron, nickel, and even arsenic accidentally added to inferior wine, and nobody knows what else for purposes of fraud. (Brit. and For. Med. Chir. Rev., 1858, p. 246.)

When brandy or other distilled spirits are habitually used for a certain period, the derangement of digestion is still more serious than that caused by the worst of wines.

The effect of alcohol on the mucous coat of the stomach, says Dr. Budd, “depends greatly on the degree of its dilution. Cirrhosis or 'gin-drinker's liver' is generally caused by drinking distilled spirits, which injure the stomach more than fermented liquors do, even when the former are diluted to the same degree of strength.” In all cases in which the mucous surface of the stomach is already inflamed, or when the passage of the blood is obstructed in the liver, (in which case there is always a congested state of the blood-vessels of the stomach predisposing to inflammation or hemorrhage,) the influence of alcohol in every shape is pernicious and destructive. In hot climates a very small quantity of fermented liquor of any kind often effects incalculable mischief. (On Diseases of the Stomach, London, 1856, p. 71.)

In the case of St. Martin, a Canadian, who, in consequence of a gun-shot wound had a permanent fistulous opening through the abdominal parietes into the stomach, the rare opportunity was afforded of seeing much that went on in the stomach during digestion. At one time Dr. Beaumont observed that the interior of the stomach exhibited erythematous and aphthous patches on the mucous surface, caused by the drinking of ardent spirits during the preceding eight or ten days; but there was no pain, and the patient had a good appetite. This state continued several days; the secretions were vitiated, and the small quantity of gastric juice extracted by a syringe from the stomach was vitiated and impure in appearance. At another time the small quantity of this fluid extracted in the morning before eating, was mixed with an unusual proportion of vitiated mucus, saliva, and bile, tinged lightly with blood, which appeared to exude from the surface of the erythematous and irritable patches of aphthous inflammation. On succeeding days the same morbid appearances were observed. The aphthous patches grew larger and more numerous, the mucous covering became thicker, the gastric secretions more vitiated and purulent, resembling the discharges from the bowels in protracted cases of chronic dysentery. With all this evidence of local disease of the stomach there was little derangement of its functions, and no pain except an uneasy sensation in the epigastrium. There was some vertigo, some dimness and yellowness of vision, a thin yellowish coating on the tongue, the countenance sallow, pulse uniform and regular, appetite good, sleep as good as usual.

During all this time, though the appetite was good, it was not that of health. Digestion when the stomach is in this state is very imperfect, and under a full diet and indulgence in stimulants there can be no recovery of the lost strength. After being confined for a few days to a restricted diet, avoiding stimulants entirely, an improvement was visible. On the sixth day of observation, at eight o'clock in the morning, before eating, the stomach was observed to be “empty; its coats clean and healthy as usual; secretions less vitiated; extracted two ounces of gastric juice of more natural and healthy appearance, with the usual gastric acid flavor; he complains of no uneasy sensations, or the slightest symptoms of indisposition; says, he feels perfectly well and has a voracious appetite” (Beaumont on Digestion.)

The accuracy of Dr. Beaumont's observations have been attested by Professor Sewall, of Washington, D.C., and they have been more recently confirmed by other experiments. (See Amer. Jour. Med. Sci. 1857.) All observation shows that large quantities of alcohol may be taken repeatedly without exciting the pain and sensible systems of inflammation in other delicate surfaces, but that inflammation is nevertheless excited by the harsh action of the stimulant, that digestion is deranged and health undermined, before the cause of the insidious danger is suspected. It has also been shown that the inflammation excited by a too free indulgence in stimulants soon subsides under the influence of low diet and cooling drinks. “Such,” says Dr. Budd, “is the power of reparation possessed by the lining membrane of the stomach, without which it would be unfit for the functions of digestion. When, in consequence of the continuance of appetite, the usual diet continues to be taken, the surface of the stomach is long in recovering its healthy state; in many cases it continues fretted and sore, under an amount of food that in a healthy condition would produce no irritation.”

When brandy is prescribed as a medicine it is quite common to begin with doses small enough to avoid a rapid development of those drug symptoms, which are often found at last far worse than the original disease. After repeated exhilarations, alternated with depressions, not permitted to last long the confidence of the patient is gained and brandy becomes established in reputation as the real “staff of life.” Now, whatever be the progress of the original disease, the remedy will soon assume a conspicuous position. The chronic disease which alcohol generally creates is slowly developed, and in many cases it is not possible to refer to any serious lesion of the nervous system appreciable during life or discoverable after death. There are some men who can drink habitually six or eight glasses of brandy daily, for several years without greatly deranging their health; but these are extraordinary men, and we need not look for them among phthisical patients. It is much more common to see a gradual change come over the habitual spirit-drinker, until he finds himself in the height of a paroxysm of delirium tremens, from which he never fully recovers. “In some cases,” says Dr. Huss, of Sweden, “he begins to find his digestive powers impaired, he becomes dyspeptic and can only eat solid food by taking a drink of brandy with each mouthful; some when trying to keep sober take only vinegar or spices.” In other cases there may not be intoxication at any time. In many, the symptoms begin gradually with “loss of appetite, indigestion, nausea, vomiting, occasional diarrhea; emaciation and cachexia, pustular eruptions, eructations and offensive breath; serious functional disease of the liver, kidneys, heart, and coats of the vessels which finally lead to chronic disease of those organs: and these symptoms are followed by fatal serious effusions or general dropsy, hemorrhages, extravasations or apoplexies. Intercurrently with these states are sometimes seen fits of intoxication, delirium tremens, sexual debility, suicidal melancholy, and life terminates with epileptiform convulsions, general paralysis or idiocy.” M. Morel says, “one class of men arrive, at length, by a series of well-marked lesions, physical and intellectual, at general paralysis.“Another class,” although profoundedly affected, as regards the innervation, remain stationary at a point leading a miserable existence, characterized physically by a special condition of cachexia and marasmus, morally by a manifestation of the worst tendencies and of the lowest bruttishness.” (On the Physical, Intellectual, and Moral Degeneration of the Human Race, p 113.)

In these melancholy cases we see well displayed the capacity of this potent remedy in causing degeneration of all the tissues, including the brain and nerves; even when it is not carried so far, similar symptoms are conspicuous, “the hands tremble especially in the morning, at a later period the tremors continue through the day, being increased by slight exertion, and only relieved by alcoholic stimulants. There, is dimness of sight as if a veil were suddenly passed before the eyes; the tongue is tremulous, and speech is indistinct; the patient is troubled with frightful dreams, sensations of insects creeping over the skin; tremors and shuffling gait in walking; diminished muscular power in the lower limbs, finally in every part; diminished sensibility of the skin; vertigo, staggering; hallucinations so startling and exciting as to banish sleep altogether. He imagines that he sees persons or objects or hears voices; the pupils become dilated and less sensible to light than in health.” (Huss on Alcoholismus, etc.)

Such are the principal effects of alcohol when its use is long persisted in, and these effects are transmitted to successive generations. M. Morel says, he never witnessed a cure of the disease caused by alcohol in a patient who derived the tendency to alcoholic excesses from hereditary predisposition. In one family he noticed that habitual intemperance in a great-grandfather entailed upon the first generation, — “Immorality, depravity, intemperance, and brutish disposition; In the second, hereditary drunkenness, attacks of mania, general paralysis; In the third, sobriety, hypochondriasis, lypomania, systematic ideas of persecution, homicidal tendencies; In the fourth generation, intelligence was but slightly developed, access of mania at 16 years of age, stupidity running into idiocy, and into a condition involving the extinction of the race.” Similar remarks have been made by Drs. Cox, Adams and Whitehead. (Hereditary Diseases p. 31.)

M. Morel, after showing that the use and effects of alcohol are rapidly extending in the various countries of Europe, as England, Scotland, Ireland, Prussia, and also in the United States, and in Central and South America, thus sums up their degenerative influences on the race: — “They have invariably the same character in all latitudes. New maladies are generated and old ones take on increased fatality; the average duration of human life is lessened; the viability of new-born children is less to be depended on; and the disturbances of the moral and intellectual nature become at length signalized by the highest rates of insanity, of suicide and crime. (On Degenerations of the Human Race, p. 389.)

But it will be objected that the deleterious effects of alcohol are those of its intemperate use only. The symptoms enumerated are those which this article will produce in any case, if freely used and long persisted in. On the propriety of using it in cases of debility following acute diseases, we have already admitted all that experience will confirm, and on this point there is no controversy. It is in chronic cases in which the selected remedy, whatever it be, must be long persisted in, that this remedy, though capable of frequently affording transient benefit is still a perilous one when a large quantity is required, or when its action must be long kept up. If tubercular consumption can be cured, or even retarded in its course by giving wines or other stimulants, of such strength that none of the injurious consequences above enumerated can be caused by them, it is right to use them; but there must be some limit beyond which their employment is hazardous, and who has yet pointed out the line of perfect safety? Is there something in consumptive diseases that grants the debilitated sufferers perfect immunity from the bad consequences of exciting poisons? A large portion of them are much distressed by gastric disorder. For weeks or months before death they suffer from pain and tenderness of the epigastrium, loss of appetite, thirst, frequent vomiting of acid matters. These symptoms often cause more difficulty than pulmonary disease; and after death, M. Louis found the stomach in about one-fifth of the cases who died of this disease, softened or partially destroyed in texture, and he supposed this change to be the result of inflammation. It is probable that he was mistaken in his opinion on this point, and that the solution of the coats of the stomach is effected by the action of the gastric fluid which has retained its digestive power after death; but can it be possible that burning, irritating draughts of alcohol, even largely diluted, can exert any soothing or invigorating influence upon a patient affected with any of the symptoms just enumerated? In all the commonest forms of phthisis in every stage, the liver is in a state of torpor and congestion; the blood which should flow rapidly through it from the stomach is obstructed; the capillaries of the mucous membrane of the latter organ are congested; the appetite, though sufficiently craving, is capricious, morbid. If strong brandy can be taken without sensible and immediate injury, it is because the case is not a bad one. If it be long continued, it must undermine the last pillar of hope. If in large doses it does not intoxicate, it can only be that our patient has reached that wretched condition already alluded to in which “it is impossible to get drunk;” if it does intoxicate, it shows that the patient has entered upon that downward course of physical and moral degradation in which recovery of health is impossible; and, if it could be restored, life itself would be of little value.

Here we leave the subject; not because we have exhausted it, or can hope to have set any disputed question at rest, for the subject is inexhaustible and constitutes a troubled ocean that will never rest. We have condensed the more important of the well-established facts which have a practical bearing on the cure of disease; we have kept within the line of safe experience, and have seen beyond it the dangers of reckless attempts to disregard the lessons furnished by all past observation.