PHYSIOLOGICAL ACTION OF ALCOHOL. BY HENRY MUNROE, M.D., F.L.S., LECTURER ON MEDICAL JURISPRUDENCE AND HISTOLOGY AT THE HULL AND BAMS RIDING SCHOOL OF MEDICINE, ETC. Pig. 1.—Blood corpuscles; some with darkened centres, owing to the focal point at which they are seen; others in rolls, indicative of slight inflammation. Fig. 2.—Blood corpuscles altered from their natural shape by the action of sherry wine or diluted alcohol (250 diameters). TT is now more than thirty years since the composition of alcohol, A and its effects upon the human body, attracted the attention of the physiologist and the chemist. Since that time many important works have been written upon the subject, and numberless experiments have been made by scientific men whose names rank high, in the annals of * chemistry and physiology, not only in our own country, but also in France, Sweden, Germany, and America. It is not my intention to {rive you a resume of iall that has been written on this topic, for that would occupy too much of your time; nay, even to give you a history of alcohol would necessitate the delivery of many lectures. But I wish to draw your attention to the last verdict of science on this important inquiry, including a notice of some of the recent experiments performed by men eminent in my own profession. 2 THE PHYSIOLOGICAL ACTION OF ALCOHOL. I do not desire my remarks to partake of the character of a teetotal lecture, but rather of a scientific inquiry into the mode of action of alco- hol when introduced into the tissues of the body. Nevertheless, I would not have it understood that I, in any way, disparage the moral efforts made by total abstainers who, years ago, amid good report and evil report, stood in the front of the battle to war against the mul- titude of evils occasioned by strong drink;—all praise be due to them for their noble and self-denying exertions ! I consider that man who has a longing desire for strong drinks, arising from his having indulged in their daily use, and can, by an effort of his will, restrain his appetite from such indulgence, " is greater than he who taketh a city." Had it not been for the successful labors of these moral giants in the great cause of Temperance, presenting to the world in their own personal expe- riences many new and astounding physiological facts, men of science would, probably, never have had their attention drawn to the topic. The alcohol question having lately been discussed in our medical journals, I shall endeavor to condense into one lecture some of the most important points developed. This is the more needful, since, ow- ing to the wide-spread literature of Temperance in the present day, one portion of the public is beginning to read and judge for itself, while the other naturally turns to the medical profession for information on the subject. I need scarcely add, that in the House of Commons, in the Mansion, on the Bench as at the Bar, and even within the walls of our Universities, Colleges, and Medical Schools, men are found devoting their time and talents to do battle against the giant Strong-drink, as the cause of so much pauperism, crime, misery, insanity, and social degradation.* The most important question to be answered is—What is Alcohol ? or, specially, Is it food, or poison, or medicine, or a luxury? Under the term Alcoholic, I include all iutoxicatiug drinks, because it is on account of the alcohol chiefly, if not wholly, that such drinks are used. The principal intoxicating beverages of this country are brandy, whis- ky, rum, gin, wines, ale, porter, perry, and cider, which are more or less intoxicating according to their amount of alcohol. It may not be uninteresting to know the percentage of alcohol contained in liquors which it is so fashionable for adult persons of all ages to indulge in. According to Professor Brande---- Pale Ale contains.... 5 to 9 per cent. I Gin..................51 -GO per cent. Ale .....................<&% " Brandy...............53-39 " Cider....................7 " Rum.................53-68 " Port "Wine..............23 " | Whisky..............5390 " * The author begs to acknowledge the assistance he has derived from the va'/nahlo writings of the following scientific authorities : Dr. F. R. Lees, F.S.A., Edinburgh; Dr. T. K. Chambers; Dr. Brinton, F.R.S.; Dr. E. Smith, F.R.S.; Dr. Carpenter, F.R.S.; Dr. Markham ; Dr. Figg; H. Madge, Esq., M.R.C.S.; T. D. Fletcher, Esq., M.R.C.S.; R. Dunn, Esq., F.R.C.S. TnE PHYSIOLOGICAL ACTION OF ALCOHOL. 3 These liquors are all more or less diluted by the publican, and often colored, drugged, and adulterated to suit the taste of purchasers or in- crease the profit of the dealer. Alcohol, in chemical language, is a hydrated oxide of ethyle. Its composition is C4 II. 02 (or C, II6 O + HO). It is nowhere to be found in any product of nature, was never itself created by God, but is essentially an artificial thing, prepared by man through the de. structive process of fermentation. It will be my aim to show that per- fect health can only be obtained by total abstinence from all intoxicat- ing drinks, since alcohol deranges the natural functions and produces a morbid condition of the tissues. Is Alcoiiol A Poison ? Every writer on toxicology has classified alcohol as a narcotic or a narcotico-acrid poison. For proof, I refer you to the works of Professor Orfila, Dr. Pereira, Professor Christison, Dr. Taylor, and other eminent authorities. Alcohol is a powerful nar- cotic poison; and if a large dose be taken, no antidote is known to its effects. But you may inquire— What is a Poison ? The most comprehensive definition which has been suggested is this: " A poison is a substance which, when taken internally, is capable of destroying life without acting mechanically on the system."* It may be said that no one drinks pure alcohol. Quite true: you might as well try to drink a glass full of sulphuric acid. It would instantly burn the mouth and tongue, and destroy the tissues. So, you will understand, when we speak of the action of alcohol, we mean alcohol as it is taken, largely diluted with water or mixed with other ingredients. According to the amount of alcohol contained in the liquor, in the same proportion will be its degree of action on the body—other conditions remaining the same. A small quantity of pure alcohol injected into the veins of an animal would cause immediate death, showing alcohol to be a dangerous and deadly poison. Cases are on record of persons who, drinking off at a draught from a quarter of a pint to a quart of ardent spirit, have died immediately afterward. The poison having been absorbed from the stomach, mixed with the blood, carried to the heart, and propelled to the brain, the nervous cen- tres become at once paralyzed, and the heart ceases to beat. Some of my audience may be led to exclaim—" Wiiat ! Alcohol a P0130N ? Is a man who has been out at a convivial party, and, on returning home, performs certain wonderful gyrations with his legs, poisoned ? Is a gentleman who has partaken of a few glasses of wine after an excellent dinner, and sung the praises of the ' Good Rhine winei and its deep, deep draught,' in a state of incipient poisoning? Can a.cohcl in its various forms, when moderately taken, be anything * This will include physiological injury of a kind tending to that result. A certain quantity can kill,—a lesser will injure. 4: THE PHYSIOLOGICAL ACTION OF ALCOHOL. but a blessing to man; affording him such comfort when he is unhappy, or worn out with the cares of business ? Does it not strengthen him when he is weak; cheer him when he is cast down; encourage him when his spirits fail; wrarm him when he is cold; and sustain him under all his trials and sufferings when broken-hearted with worldly troubles? Is not alcohol the 'rosy god' to whom all do honor at almost every epoch of man's existence ? When man is born into the world a little chubby, ruddy, struggling young squeaker, is not hia health drunk by the doctor, nurse, and half-wondering, heart-palpita- ting papa; lest, if this particular part of the ceremony be omitted, the nurse should hint that the young infant's hair would never grow ? When he is christened, do not the godfathers and godmothers drink the health of the young innocent, and pledge themselves to ev- erything ? When he is married, is not the greatest honor done to the bride and groom by drinking to their health and happiness ? When he is buried, is not the same drinking ceremony gone through, only with silent tongues and longer faces; and are not even the very coach- men treated with a little drop, just to drink to the happiness of the deceased ? Can any one in his senses make me believe that the univer- sal custom of drinking alcoholic liquors is a universal evil, when every- body takes them, at every place and on every occasion ? Is everybody in the world, more or less, shortening his existence by taking into his system one of the most delightful and bewitching of drinks ? It is all nonsense to call alcohol a poison. I won't believe it—so here's your health!" Yet modern science, with a voice of deep, sepulchral tone, still per- sists : " It is a poison ;" and many a breaking heart, on leaving this world, has sobbed out its last farewell, re-echoing these words ! As, to follow me in some of my observations, it will be necessary that my audience should be somewhat acquainted with the structure and functions of the body, especially with the process of digestion and absorption, I will endeavor to be as explicit as possible. Every kind of substance employed by man as food consists of sugar, Btarch, oil, and glutinous matters, mingled together in various propor- tions ; these are designed for the support of the animal frame. The glutinous principles of food—fibrine, albumen, and caseine—are employ- ed to build up the structure; while the oil, starch, and sugar are chiefly used to generate heat in the body. The first step of the digestive process is the breaking up of the food in the mouth by means of the jaws and teeth. On this being done, the saliva, a viscid liquid, is poured into the mouth from the salivary glands, and as it mixes with the food, it performs a very important part in the operation of digestion, rendering the starch of the food sol- uble, and gradually changing it into a sort of sugar, after which the other principles become more miscible with it. Nearly a pint of saliva THE PHYSIOLOGICAL ACTION OF ALCOHOL. 5 is furnished every twenty-four hours for the use of an adult. When the food has been masticated and mixed with the saliva, it is then pass ed into the stomach, where it is acted upon by a juice secreted by the filaments of that organ, and poured into the stomach in large quantities whenever food comes in contact with its mucous coats. It consists of a dilute acid known to the chemists as hydrochloric acid, composed of hydrogen and chlorine, united together in certain definite propor- tions. The gastric juice contains also a peculiar organic-ferment or de- composing substance, containing nitrogen—something of the nature of yeast—termed pepsine, which is easily soluble in the acid just named. That gastric juice acts as a simple chemical solvent, is proved by the fact that, after death, it has been known to dissolve the stomach itself. In order that the food passed down into the stomach should be thor- oughly acted upon, the gastric juice selects, principally, the albuminous portions, reducing them to a substance technically called albuminose; this, with the starchy and oily portions, becomes a common pultaceous mass, called chyme. The starch, sugar, and fat are not so much acted upon in the stomach as they are in the intestines, where they meet with the pancreatic juice and the bile, and are there thoroughly digest- ed. Albumen, the plastic element that builds up the tissues, requires twenty times its quantity of the gastric juice to dissolve it. Man con- sumes three to four ounces of albumen daily, so that his stomach will have to provide from sixty to eighty ounces (three or four pints) of this solvent. It is an error to suppose that, after a good dinner, a glass of spirits or beer assists digestion; or that any liquor containing alcohol—even bitter beer—can in any way assist digestion. Mix some bread and meat with gastric juice ; place them in a phial, and keep that phial in a sand-bath at the slow heat of 98 degrees, occasionally shaking briskly the contents to imitate the motion of the stomach; you will find, after six or eight hours, the whole contents blended into one pultaceous mass. If to another phial of food and gastric juice, treated in the same way, I add a glass of pale ale or a quantity of alcohol, at the end of seven or eight hours, or even some days, the food is scarcely acted upon at all. This is a fact; and if you are led to ask—Why ? I an- swer, because alcohol has the peculiar power of chemically affecting or decomposing the gastric juice by precipitating one of its principal constituents, viz., pepsine, rendering its solvent properties much lesa efficacious. Hence alcohol can not be considered either as food or as a solvent for food. Not as the latter certainly, for it refuses to act with the gastric juice. " It is a remarkable fact," says Dr. Dnndas Thompson," that alcohol, when added to the digestive fluid, produces a white precipitate, so that the fluid is no longer capable of digesting animal or vegetable mat- ter." " The use of alcoholic stimulants," say Drs. Todd and Bowman, 6 THE PHYSIOLOGICAL ACTION OF ALCOHOL. " retards digestion by coagulating the pepsine, an essential element of the gastric juice, and thereby interfering with its action. Were it not' that wine and spirits are rapidly absorbed, the introduction of these into the stomach, in any quantity, would be a complete bar to the di- gestion of food, as the pepsine would be precipitated from the solution as quickly as it was formed by the stomach." Spirit, in any quantity, as a dietary adjunct, is pernicious on account of its antiseptic qualities, which resist the digestion of food by the absorption of water from its particles, in direct antagonism to chemical operation. Dr. Figg says: " If a pound of raw beef, cut square, be immersed for twelve hours in a pint of proof spirit, it will be found, when weighed again, to have lost four ounces three drachms ; if the surface be examined with a mi- croscope, it will be found covered with a profusion of acicular tufts of a coffee-brown color, and the whole structure considerably condensed. This loss of substance and condensation of tissue are attributable to the removal of water, and the brown deposit to the caustic influence of the alcohol on the albuminous element of the beef." If, after din- ner, two or three glasses of spirits were drunk, the gastric juice would be neutralized, and the albuminous portions of the meat charred and solidified, so that the pylorus would turn back the undigested mass, thereby protracting its stay in the stomach beyond the natural time; or should any of the half-digested food force its way into the intestines, it would act as an irritant of their delicate tissues, and probably, to get rid of it, would set up a brisk diarrhoea. Dr. Figg, in speaking of some of the operatives living in the vicinity of the Canongate of Edinburgh, says: "The workpeople of various large establishments dined at mid-day on Saturday, and, receiving their wages immediately after, at once adjourned to the various public- houses, where they indulged in a state of intoxication, which, fed by occasional libations, continued frequently till noon on the following clay, when, exhaustion of funds prohibiting fresh supplies, the collapse of intoxication succeeded. In this crisis, requested to prescribe for the nausea and its concomitant symptoms, a mustard emetic brought up the substance of the dinner of the previous day, with little or no change save that produced by mastication. To each of two mastiffs six months old, five ounces of cold roast mutton, cut into squares, were given, the meat being passed into the oesophagus without contact with the teeth. An elastic catheter was then passed into the stomach of one of them, and one ounce and a quarter of proof 3pirit injected. After some hours had elapsed, both animals were killed. In the case where the meat had been administered by itself, it had disappeared. In the ether, the pieces were as angular as when swallowed." Side by side with these stern realities, let me contrast the experi- ments of Dr. Beaumont on St. Martin, the great criterion in all physi- ological disputation on the digestive system : " Experiment 43.—Eight THE PHYSIOLOGICAL ACTION OF ALCOHOL. 7 A.M.—St. Martin breakfasted on three hard-boiled eggs, pancakes, and coffee. At a quarter-past ten, no part of the breakfast remained in the stomach. At eleven, ate two roasted eggs and three ripe apples ; at a quarter-past twelve, no vestige. At two p.m., same day, roasted pig and vegetables ; at-half-past four, all gone." It may be argued on the other side, that so small a quantity as a glass or two of beer or wine daily could produce little or no injury, and that the cases related only show the effects of alcohol when taken in large doses; in fact, that alcoholic beverages, when taken in modera- tion, assist digestion rather than otherwise. I have often heard it as- serted by patients that they could not eat their dinner at all until they had had a glass of beer; but after having imbibed a certain quantity of this " nourishing " element, they could then take their dinner with much pleasure and benefit. Doubtless, if no person took more alcoholic liquor than a glass of beer, such a procedure would be ruinous to all teetotal societies, as well as to a good many brewers; for, according to the calculation of Mr. Gladstone, every adult male in England consumes not far short of six hundred quarts per year. But the term moderation, with regard to alcoholic drinks, defies all definition. What may seem a moderate dose for one person, may nearly poison another. A patient of mine, some years ago, asked me if he might have " a sup of ale to steady his stomach and revive him a little." I replied, he might have " a little." He drank a gallon of ale next day; and then said, " From lately being so abstemious, it got into my head a bit!" However, let us see how far a glass of beer is beneficial. It is sup- posed to stimulate the stomach to an increased secretion of the gastric juice, and thereby assist digestion. If this were so, two glasses of beer should cause the stomach to secrete double the quantity. But this is not so. Nature secretes this powerful fluid to effect the solution of sol- id*, not liquids. Dr. Beaumont completely demonstrated this fact in one of his valuable experiments, where the fluid which exuded from the coats of St. Martin's stomach on the contact of alcohol, was mere- ly an enlarged supply of its natural mucus (with the evident end of sheathing its delicate structure from the destructive action of the poi- son). To expect the stomach to secrete gastric juice at all times, on the contact of alcohol, is an expectation not in accordance with the laws of nature. The only influence of alcohol on the stomach is that of a simple irritant. The Russian practice of passing round a small liqueur- glass of undiluted spirits to each guest just before going to dinner, sim- ply inflames or irritates the mucous membrane of the stomach, induc- ing the person to eat more than is beneficial, and robbing him of the power to digest the food when he has swallowed it. He suffers from two evils—too much food, and less ability to digest it: nay, from two othtrs besides—dyspepsia and a doctor's bill! Such a powerful irri- 8 THE PHYSIOLOGICAL ACTION OF ALCOHOL. tant to the mucous membrane of the stomach does alcoholic liquor in any shape become, that I have had many patients who have been obliged te desist from its use altogether. I have known a single glass of brandy or whisky occasion in some persons the most obstinate nausea and vomiting for days after, leaving the stomach quite unable to bear the least quantity of solid food, and with difficulty the bland- est of drinks. Alcohol, taken in small quantities or largely diluted as in the form of beer, causes the stomach gradually to lose its tone, and makes it de- pendent upon artificial stimulus. Atony, or want of tone of the stomach, gradually supervenes, and incurable disorder of health results. If you habitually give an organ assistance, it will at last come to trust to that assistance, and refuse to wrork without such aid being rendered. So, if a person stimulates his stomach habitually with a glass of beer at his dinner, that stomach will very soon become languid, and object to work without its beer. Persons so accustomed to the artificial stimu- lus cry out," I earCt eat my dinner without my beer!" because the stomach says, " I wonH go without." A little wholesome abstinence and starvation would soon bring it round. Dr. Hammond practically demonstrates by his experiments, that al- cohol taken with ordinary diet has the same injurious effects as tJie ex- cessive use of food; in other words, that its use is qualitative abuse, as gluttony is quantitative intemperance. If it be as admitted, even by our opponents, that alcohol thickens the circulating stream, retards ex- cretion, arrests hunger, and so makes the present supply of food last longer, some of its present and ultimate results must be evil. The oc- casional use as described may apparently have some advantage, but the continual use must be allowed to be an unmitigated mischief. The testimony of two millions of total abstainers in England shows that health is improved by the disuse of such poisonous liquids. When alcohol is taken into the stomach as a portion of the ordinaiy drink, it readily passes into the blood by a simple act of endosrnodic ab- sorption, through the coats of the blood-vessels, rather than by the special absorbent process in the intestines. Received into the blood, it is carried with the stream to the heart and lungs, and then (such part as is not eliminated by the breath) back to the heart, to be pumped by that organ to all parts of the body. Alcohol thus passes on with the arterial blood, carrying into every capillary its own peculiar influence. The blood consists of a fluid termed liquor sanguinis, and the cor- puscles or blood discs, the latter floating in the fluid element. It is well known to microscopic observers of the blood, how speedily ele- ments of diet, medicinal substances, and poisons are found in the liquor sanguinis, and how the corpuscles of the blood become affected by these various agents. By experimenting on the blood with sherry wine or diluted alcohol, the blood disc becomes altered in shape and THE PHYSIOLOGICAL ACTION OF ALCOHOL. 9 throws out matter from its interior; minute molecular particles also fringe the circumference. Some of these molecules separate from the blood discs and float about in the fluid; others elongate into tails, which move about with a tremulous motion. When the liquor san- guinis becomes surcharged with alcohol, either by imbibition of small quantities daily, or by a large quantity suddenly, the blood-corpuscles swimming in it not only become affected, but.also the liquor sanguinis itself suffers deterioration. An unwholesome or deficient diet gives rise to blood diseases, such as gout, scurvy, fever, diarrhoea, etc.; for substances taken as food impart their qualities to the fluid of the blood, and also to the corpuscles. The day after a debauch, the parched tongue, nausea, shivering, and feverish symptoms, all testify, not only that the blood has become poisoned or deteriorated, but that it has cir- culated such poison to every organ of the body. Prof. Schultz states, " that alcohol stimulates the blood discs to an increased and unnatural contraction, which hurries them on to the last stage of development— that is, induces their premature decay and death. The coloring mat- ter is dissolved out of them, and the pale discs lose all their vitality; whence less oxygen can be absorbed and less carbon carried out." It is not difficult to recognize the pale anaemic condition of the daily spirit-drinker. The experiments of Dr. Bocker on the blood, with spirits, wine, and beer, the results attested by the microscope, and the researches of Dr. Virchow, the celebrated pathologist, concur in prov- ing that alcohol poisons the blood, and arrests the development, as well as hastens the decay, of the red corpuscles. Dr. Bocker noticed the alterations undergone by the blood of habitual alcohol drinkers as yet in good health, viz., a partial loss of power to become red by exposure to the air, in consequence of the loss of vitality in a portion of the blood discs. This loss of vitality manifests itself by the formation of black specks (oil) in the discs (an observation confirmed by Lallemand), and then by their conversion into round pale globules which, in all cases of disease (i. e., of diminished vitality), are found in excess in the blood. This devitalized condition of the nutritive fluid is probably the first step to the devitalization, of the tissue which it feeds. We have seen that so soon as the alcohol has been absorbed into the nlood, it is carried by the tide to the heart, the inner surface of which organ, disturbed by the presence of the alcohol, pumps away so much tiie faster to get rid of the intruder. The heart is, in fact, a wonderful pump, that gives seventy or eighty strokes per minute, of every hour, day, and night perpetually, and were it to cease beating for a single minute, life would cease. Now it sounds to reason, that if an artificial stimulus be taken into the blood, which urges on the action of the pump to extra work, that extra work must all the sooner wear out the machinery. Let a person take a glass of brandy, and in a few minutes his pulse would rise ten or more beata 10 THE PHYSIOLOGICAL ACTION OF ALCOHOL. per minute. Should a dose of alcoholic drink be taken daily, the heart will very often become hypertrophied, or enlarged throughout. In- deed, it is painful to witness how many persons are actually laboring under disease of the heart, owing chiefly to the use of these liquors. There is no kind of tissue, whether healthy or morbid, that may not undergo fatty degeneration; and there is no organic disease so troublesome to the medical man, or so difficult of cure. It is a well- known fact, that the fibro-albuminous substance called "flesh" under- goes, under certain circumstances, a transformation into fat. In involuntary muscle this degeneration begins with the transverse stria;, and more especially at the circumferance of the fasciculus. As this extends inward, minute molecules of fat occupy the position of the strise, and at length obliterate them, so that the normal structure of tho muscle disappears. When cut into, a greasy stain is left upon tho knife. The heart, in persons affected with fatty degeneration, loses tho firm muscular appearance which characterizes it in health, and pre- sents a pale yellowish buff color, either throughout or in special parts. To show the frequency of this peculiar disease, I quote the statement of Dr. Ogle, that in 143 post-mortems, he found one hundred persons whose hearts were thus affected, as tested in each case by a microscopic examination. Dr. King Chambers justly observes, " that the most active renewal of the body possible is health ; the cessation of renewal is death ; the arrc3t of renewal is disease." Now, since the direct action of alcohol is to arrest the renewal of tissue, how could any well-inform- ed medical man recommend, as a vital tonic, an agent which has the property of arresting the metamorphosis of tissue? Again, says Dr. Chambers, " in death, decomposition goes on to its end; there is no renewal of the organism, and the living form disappears. In disease, decomposition goes on, but there is an arrest of renewal, and the decayed tissues are not thrown off by the newly-formed substance; they become degenerate, not regenerate—a kind of death in life." NowT if, by the aid of the microscope, we examine a very fine section of muscle taken from a person in good health, we find the muscles firm, elastic, and of a bright red color, made up of parallel fibres, with beautiful crossings or stria?; but if we similarly examine the muscle of a man who leads an idle, sedentary life, and indulges in intoxicating drinks, we detect, at once, a pale, flabby, inelastic oily appearance. Alcoholic narcotization appears to produce this peculiar condition of the tissues mere than any other agent with which we are acquainted. " Three quarters of the chronic illnesses which the medical man has to treat," sajrs Dr. Chambers, " are occasioned by this disease." The eminent French analytical chemist, Lecanu, found as much as 117 parts of fat in 1,000 parts of a drunkard's blood, the highest estimate of the quantity in health being 8J- parts, while the ordinary quantity ia not more than two or three parts; so that the blood of the drunkard THE PHYSIOLOGICAL ACTION OF ALCOHOL. 11 contains forty times in excess of the ordinary quantity. No reflecting mind, at all acquainted with Temperance literature, would wonder at the large percentage of this peculiar disease, when it recalls the fact that during the last year, in the United Kingdom, there were con- sumed 28,500,000 gallons of whisky, 6,000,000 gallons of wine, and 660,000,000 gallons of ale and porter !!! As a very suddenly fatal case of this disease occurred not long ago- one of a like character with half a dozen more which I have witnessed during the last few years—I may mention it. The person was of middle age, rather stout, of exceedingly quiet habits, never appearing to be in a hurry about anything, taking only moderate exercise, but never seen walking fast or exerting himself. He had, however, con- tracted the bad habit of taking a small glass of whisky three or four times a day, yet never appearing drunk or in the* least excited. He was the popular picture of good health, and had scarcely ever had a day's illness, but sometimes complained of a fullness at the chest and slight beating of the heart. One day, after having partaken of his dinner, drank a glass of ale, and smoked his pipe as usual, on rising up to go to his business, he suddenly dropped down on the floor, and died immediately. On making the post-mortem examination, the brain seemed healthy, so did the heart, lungs, liver, and other viscera. The man had died, apparently, without the slightest indication of organic disease, or of any lesion to account for so sudden a catastrophe. On making thin sections of the heart, liver, and kidneys, and placing them under the microscope, the mystery of his death was immediately re- vealed, for eveiy organ subjected to microscopic analysis exemplified the slow, structural lesions of fatty degeneration. The fibres of the heart, a powerful muscle, 'had become so enfeebled and degenerated by the internal deposit of oil globules, that it had suddenly, and spas- modically ceased to act. Had the man been a pure water-drinker, such a suddenly fatal result could hardly have happened. It is the misfortune of medical men to have scores of patients in a year laboring under some of the protean forms of fatty degeneration, who would never require the doctor's assistance if they could only forego the daily use of small quantities of alcohol. This agrees with a broad experience. As Dr. Lees observes: " That alcohol should contribute to the fattening process under certain conditions, and produce in drinkers fatty degeneration of the blood, follows as a matter of course, since, on the one hand, we have an agent that retains waste matter by lowering the nu- tritive and excretory functions, and on the other, a direct poisoner of the vesicles of tho vital stream." Dr. T. K. Chambers also remarks : "Alcohol is really the most ungenerous diet there is. It impoverishes the blood, and there is no surer road to that degeneration of muscular fibre so much to be feared; and in heart disease it is more especially hurtful, by quickening the beat, causing cap- illary congestion and irregular circulation, and thus mechanically inducing dilatation 12 THE PHYSIOLOGICAL ACTION OF ALCOHOL. of the cavities. Let the alcoholic drink be limited. * * * For a great many instances, the quantity may be very shortly written down—0." The organs most affected by alcohol when taken into the stomach— the organs in which it is found most to accumulate—are, according to the eminent French physiologists, Professors Lallemand and Pen-in, the liver and the substance of the brain. " If in the blood it is repre- sented by 10; in the brain it is 134; in the liver 148." " But if alco- hol be injected into the veins, it spreads to all the tissues, accumulates most largely in the brain; being in the liver as T75; in cerebral mat- ter, 30." So that these observers come to the old conclusion, that the selective power of alcohol for the brain is nearly twice as great as that for the liver, and nearly three times as that for other tissues; and that death by alcoholic poisoning is due, primarily, to its special action on the nervous centres-. When a person dies suddenly from the effects of a large dose of alcohol, it is from sudden shock to the nervous system. There are numerous such cases. Dr. Lees says : " On 19th September, 1863, two Rochdale men made a bet as to which would drink the most rum. In a quarter of an hour they had drunk fifteen pennyworth each. One fell clown dead a few moments afterward, and the other became insensible." I knew myself the case of an engine-driver to a luggage train who, for a wager, drank off, within ten minutes, a pint of rum. In a few minutes afterward he was in strong convulsions, and then be- came insensible. Medical aid being at hand, a great portion of the rum was brought up from his stomach; but his life, for a week after, was despaired of. Now the brain is divided into (1.) the cerebrum, or brain proper, com- posed of many convolutions of grey matter, with which man perceives, remembers, judges, wills, and dictates movements; (2.) the sensorium, which is a mass of white vesicular nerve-substance, situated near the cerebrum, or upper brain. Its particular office is to register all the im- pressions received from the special organs of sense—the eye, ear, nose, tongue, and skin. Beneath the sensorium, and posteriorly, is the cere- bellum, which regulates and equilibrates locomotion; and inferior to this comes the medulla oblongata, which excites and directs respiration. Thus all creatures having a cerebrum are capable of performing some kind of intellectual operation. Habits of intoxication, or the continued use of alcoholic drinks short of this stage, as shown on a post-mortem examination of the brain, produce a congested condition of its minute capillary vessels, indicat- ing an amount of pressure which materially interferes with healthy function. This congestion, seen, on cutting through the brain, as mi- nute blood spots, often gives rise to epilepsy and apoplexy. The blood, so becoming impaired by the habitual use of intoxicating beverages, is no longer able to sustain the brain in a healthy condition; and beneath the pia mater, a membrane surrounding the couvolutiona THE PHYSIOLOGICAL ACTION OF ALCOHOL. 13 r,f the brain, is nearly always found an effusion of a milky fluid, indica- tive of congestion and stimulation, which accounts in part for the men- tal incapacity and disorder of the drunkard. I will not trouble you with a description of the diseases to which the braii is liable from habits of intoxication, such as inflammation of its tiuml-ranes, arrest of development, idiotcy, delirium tremens, insanity, paralysis, etc.; but draw your attention to the effects of alcohol on the cerebrum or brain proper, the most important part of my subject. Re- calling the fact, that it is in this organ alcohol most largely accumulates, the disturbed mental functions which follow drinking can be easily ex- plained. I would first refer you to the experiments made by Dr. Ed- ward Smith, upon himself and others, with reference to the psychologies action of a small dose of diluted alcohol: " In from three to seven minutes the mind was disturbed. Consciousness, the power of fixing the attention, the perception of light, and, we believe, of sound also, and th6 power of directing and co-ordinating the muscles, were lessened ; while there was a very marked, peculiar, continuous, thrilling, not unpleasant sensation, passing down through the whole system, during thirty minutes. After this period the effect dimin- ished, as shown by increased consciousness and the perception of light, as if a veil had fallen from the eyes ; nevertheless, the last power to be completely regained was conscious- ness. "Spirits made us very hilarious and talkative in ten minutes, and during twenty to twenty-five; so much so, that my friend was altogether a king. But as minutes flew away, so did our joyousness ; and, little by little, we lessened our garrulity and felt less happy, until at length, having gone down by degrees, we remained silent, almost mo- rose, and extremely miserable. Then, indeed, we felt the horrors and the sorrows ol the drunkard's lot, and saw,- with a clearness which can only be perceived by such ex- perience, how certain it is that he must again drain the intoxicating cup. " In addition, -every mental perception was darkened ; and the dreaminess, which io not an unpleasant feature of it, is a condition in which neither thought nor imagina- tion acquires power." It appears from the experience of Mr. Fletcher, who has paid much attention to the cases of drunkards, from the remarks of Mr. Dunn, in his " Medical Psychology," and from observations of my owTn, that there is some analogy between our physical and psychical natures; for as the physical part of us, when its power is at a low ebb, becomes suscepti- ble of morbid influences which, in full vigor, would pass over it with- out effect, so when the psychical (synonymous with the moral) part of the brain has its healthy function disturbed and deranged by the intro- duction of a morbid poison like alcohol, the individual so circumstan- ced sinks low in depravity, and becomes the helpless subject of the forces of evil, which are powerless against a nature free from the morbid in- fluences of alcohol. Different persons are affected in different ways by the same poison. Indulgence in alcoholic drinks may act upon one or more of the cere- bral organs; and, as its necessary consequence, the manifestations of functional disturbance "will follow in such of tho mental powers as these organs subserve. If the indulgence be continued, then, either from de> 14: THE PHYSIOLOGICAL ACTICN OF ALCOHOL. ranged nutrition or organic lesion, manifestations formerly developed only during a fit of intoxication may become permanent, and terminate in insanity or dipsomania. M. Flourens first pointed out the fact that certain morbific agents, when introduced into the current of the circu- lation, tend to act primarily and specially on one nervous centre in pref- erence to that of another, by virtue of some special elective affinity be- tween such morbific agents and certain ganglia. Thus, in the tottering gait of the tipsy man, we see the influence of alcohol upon the func- tions of the cerebellum in the impairment of its power of co-ordinating the muscles.* Certain writers on diseases of the mind make especial allusion to that form of insanity termed dipsomania, in which a person has an un- quenchable thirst for alcoholic drinks,—a tendency as decidedly maniac- al as that of homicidal mania; or the uncontrollable desire to burn, term- ed pyromania ; or to steal, called kleprtomania. The different tendencies of homicidal mania in different individuals are often only nursed into action when the current of the blood has been poisoned with alcohol. I had a case of a person who, whenever his brain was so excited, told me that he experienced a most uncontrolla- ble desire to kill or injure some one; so much so, that he could at times hardly restrain himself from the action, and was obliged to refrain from all stimulants, lest, in an unlucky moment, he might commit himself. Townley, who murdered the young lady of his affections, for which he was sentenced to be imprisoned in a lunatic asylum for life, poisoned his brain with brandy and soda-water before he committed the rash act. The brandy stimulated into action certain portions of the brain, which acquired such a power as to subjugate his will, and hurry him to the per- formance of a frightful deed, opposed alike to his better judgment and his ordinary desires. Wilkes Booth, the cowardly murderer of the late Presiderf of the United States, when he saw his helpless victim in the box at the thea- tre, had not the cruelty to strike the blow; his better feelings overcame him, and trembling with suppressed agony at the thought of becoming an assassin, he rushed into the nearest restaurant, crying out, " Brandy! brandy! brandy!" Then, gulping down the hellish draught, it instant- ly poisoned his blood, fired up his brain, transformed his whole nature into that of a raging fiend; and, in this remorseless condition, he * I remember well the case of a gentleman whose legs would get drunk two hours before his brain became affected. I have often seen him taken home by persons whose heads were giddy with drink, but whose legs were firm, while his brain appeared per- fectly sober, though he had no power of locomotion. He was often far more sober in his conversation than the companions who carried him home; yet, if left alone, he would suddenly fall to the ground, his legs useless and paralyzed. When at the pub- lic-house he was often asked to have "just another glass," he would answer, " I will, if you will see me safe home afterward." THE PHYSIOLOGICAL ACTION OF ALCOHOL. 15 Bhot down that noble-hearted President, the nation's great hope, the people's best friend. Then, what killed the President of the United States ? I answer, " Brandy! brandy 1 brandy 1" f As to pyromania, some years ago I knew a laboring man in a coun- try village who, whenever he had had a few glasses of ale at the pub- lic-house, would chuckle with delight at the thought of firing certain gentlemen's stacks. Yet, when his brain was free from the poison, a quieter, better disposed man could not be. Unfortunately he became addicted to habits of intoxication ; and one night, under alcoholic ex- citement, fired some stacks belonging to his employers, for which he was sentenced for fifteen years to a penal settlement, where his brain would never again be alcoholically excited. Next I will give an example of kleptomania. I knew, many years ago, a very clever, industrious, and talented young man, who told me that whenever he had been drinking, he could hardly withstand the temptation of stealing anything that came in his wTay; but that these feelings never troubled him at other times. One afternoon, after he had been indulging with his fellow-workmen in drink, his will unfortu- nately was overpowered, and he took from the mansion where he was working some articles of worth, for which he was accused, and after- wards sentenced to a term of imprisonment. When set at liberty he had the good fortune to be placed among some kind-hearted persons, vulgarly called teetotallers ; and, from conscientious motives, signed the riiEDGE, now above twenty years ago. From that time to the present moment he has never experienced the over-mastering desire which so often beset him in his drinking clays—to take that which was not his own. Moreover, no pretext on earth could now entice him to taste of any liquor containing alcohol, feeling that, under its influence, he might again fall its victim. He holds an influential position in the town where he resides. I have known some ladies of good position in society who, after a dinner or supper party, and after having taken sundry glasses of wine, could not withstand the temptation of taking home any little article not their own, when the opportunity offered; and who, in their sober moments, have returned them as if taken by mistake. We have many instances recorded in our police reports of gentlemen of position, under + Since the delivery of this lecture, another lamentable illustration has become pub- lic, in the person of Dr. Pritchard of Glasgow, since executed for poisoning his wife and mother-in-law. In his two confessions he states as follows: " 1. Mrs. Pritchard was much better immediately after her mother's death, but subsequently became exhaust- ed from want of sleep. I accounted for this by the shock produced by her mother's death ; and, hardly knowing how to act, at her own request I gave her chloroform. It was about midnight; Mary M'Leod was in the room, and in an evil moment—being, besides, somewhat excited by whisky—I yielded to the temptation to give her sufficient to cause death; which 1 did. 2. I can assign no motive for the conduct which actu* ttdme beyond a species of terrible madness, and the use