n Surgeon General's Office r qyfw c%* 0-K, *am 9 ft? p v No..-?^^/" PRESENTED BY / //3> ON THE USE AND ABUSE ALCOHOLIC LIQUORS, IN HEALTH AND DISEASE. / BY WILLIAM B. CARPENTER, M.D., F.R.S., F.G.S., EXAMINER IN PHYSIOLOGY IN THE UNIVERSITY OF LONDON, PROFESSOR OF MEDICAL JURISPRUDENCE IN UNIVERSITY COLLEGE, AND AUTHOR OF "PRINCIPLES OF HUMAN PHYSIOLOGY," ETC. ETC. XbW* PHILADELPHIA: LEA AND BLANCHARD, 1850. PHILADELPHIA: T. K. AND P. G. COLLINS, PRINTERS. TO HIS ROYAL HIGHNESS PRINCE ALBERT, IS (BY PERMISSION) MOST RESPECTFULLY; DEDICATED; AS AN EXPRESSION OF THE AUTHOR'S ADMIRATION OF HIS ROYAL HIGHNESS's ENDEAVORS TO ELEVATE THE SOCIAL CONDITION OF HIS ADOPTED COUNTRY; AND WITH THE FIRM BELIEF THAT THE PATRONAGE NOW SO GRACIOUSLY CONCEDED, WILL AID IN CALLING THE ATTENTION OF THE PTT.L1C TO THE SUBJECT OF THE PRESENT INQUIRY, IN A DEGREE COMMENSURATE WITH ITS IMPORTANCE. ADVERTISEMENT ISSUED BY DIRECTION OF THE DONOR OF THE PRIZE. A PRIZE OF ONE HUNDRED GUINEAS WILL BE GIYEN FOR THE BEST ESSAY ON THE USE OF ALCOHOLIC LIQUORS IN HEALTH AND DISEASE. The Essay must contain answers to the following ques- tions:— 1st.—"What are the effects, corporeal and mental, of Alcoholic Liquors on the healthy human system ? 2d.—Does physiology or experience teach us that Alcoholic Li- quors should form part of the ordinary sustenance of Man, 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 sanc- tioned by the principles of science, or the results of practical observation ? 3J.—Are there any special modifications of the bodily or men- tal condition of Man, short of actual disease, in which the occasional or habitual use of Alcoholic Liquors may be neces- sary or beneficial? 4th.—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? The Essay must be delivered to the undersigned address on or before the 30th day of September, 1849. vi ADVERTISEMENT. 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. Guy, M. B., Cantab., Pro- fessor of Forensic Medicine, King's College, London, have kindly consented to act as Adjudicators. Signed on behalf of the Donor, Charles Gilpin, Thomas Beggs. 5, Bishopsgate Street Without, London, April, 1848. ADJUDICATION. From the fifteen MS. 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 bearing the motto—Quot homines tot sententiae, to record our opinion of its great merits. We further deem it right to speak in terms of commen- dation of the Essay having five mottoes, the first of which is—How use doth breed a habit in a man. John Forbes, M. D. (Signed) G. L. Roupell, M. D. William A. Guy, M. B. London, December Glh, 18-19. PREFACE. The circumstances under which the following Essay is given to the Public are sufficiently explained by the pre- ceding Advertisement and Adjudication; but the Author takes this opportunity of offering a short statement of the objects which he had specially in view in its composition. The questions set forth in the Advertisement having been evidently drawn up with great care, and having been ob- viously 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 answering 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 im- possible to maintain such a continuity in his argument as Avould be desirable for its effectiveness ; and he would there- fore request his readers,, in limine, to keep the following issues in view, as those to which he is desirous of leading them. In the first place. That, from a scientific examination of the modus operandi of Alcohol upon the Human body,, when taken in a poisonous dose, or to snch an extent as to pro- duce Intoxication, we may fairly draw inferences with regard to the specific effects which it is likely to produce, viii preface. 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 Medi- cal Profession, and universally admitted by medical writers, being precisely such as the study of its effects in poisonous and immediately fatal 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 be attended, in a large proportion of cases, with consequences prejudicial to the human system,—the morbid actions thus engendered being likely rather to be chronic, than acute, in their character. Thirdly. That as such morbid actions are actually found to be among the most common disorders of persons advanced in life, who have been in the habit of taking a " moderate" allowance of alcoholic 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 borne out by the proved results of the " moderate" use of Alcoholic liquors, in producing a marked liability to the acute forms of similar diseases in hot climates, where their action is accelerated by other 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, insufficient repose, and other like violations of the Laws of Health, when habitually practiced through a long period of time. Fifthly. That the capacity of the healthy Human system to sustain as much bodily or mental labor as it can be legitimately called upon to perform, and its power of resist- ing the extremes of Heat and Cold, as well as other de- preface. ix pressing agencies, are not augmented by the use of Alco- holic liquors ; but that, on the other hand, their use, under such circumstances, tends positively to the impairment of that capacity. Sixthly. That, where there is a deficiency of power, on the part of the system, to carry on its normal actions with the energy and regularity which constitute health, such power can rarely be imparted by the habitual use of Alcoholic liquors; its deficiency being generally consequent upon some habitual departure from the laws of health, for which the use of Alcoholic liquors cannot compensate; and the em- ployment of such liquors, although with the temporary effect of palliating the disorder, having not merely a re- motely injurious effect per se, but also tending to mask the action of other morbific causes, by rendering the system more tolerant of them. Seventhly. That, consequently, it is the duty of the Medi- cal Practitioner to discourage as much as possible the habit- ual use of Alcoholic liquors, in however " moderate" a quan- tity, by all persons in ordinary health; 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, in- stead 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 bo employed in the discriminating selection of those cases, as would be taken by the conscientious practitioner in regard to the adminis- tration of any other powerful remedy which is poisonous in large doses. 2 X PREFACE. The foregoing appear to the Author to be the conclusions legitimately deducible from the facts and arguments which he has brought forwards; it will be for his Professional readers to decide how far the case which he has made out is 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 foregone conclusion, and had, consequently, 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 Physiologist 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 formed to carry into practical effect 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 can- didly heard by those to whom this Essay is more especially addressed. - He cannot allow it to go forth, however, without express- ing his conviction that, whilst there are adequate 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 terrible 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 press upon every member of the com- PREFACE. xi munity. 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 Abuse of Alcoholic liquors; and that, if this could be done away with, the removal of all the other causes would be immeasurably promoted. Every one who wishes well to his kind, there- fore, 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 United States, to societies which advocated the principle of Tem- perance, and which enlisted in their support a large number of intelligent and influential men; but it has been found that little or no good has been effected by them, among the classes on whom it was most desirable that their 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, if 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 pro- portion 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 shown that, in the present dearth of effectual education among the masses, and with the existing temptations to Xll PREFACE. Intemperance arising out of the force of example, the almost compulsory drinking-usages of numerous trades, and the encouragement which in various ways is given to the abuse of Alcoholic liquors, nothing short of Total Abstinence can prevent the continuance, in the rising generation, of the terrible evils which we have at present to deplore. And lastly, experience has also proved that this reformation can- not 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 practice total abstinence myself," is found to be worth a thousand exhorta- tions; 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 follow- ing—" 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 Bombay 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 false, and a mischievous fallacy. And the limitations are these : If it be found by experience, 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 ex- PREFACE. Xiii ceeds 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 experience 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 arising from the right use of it, then the argument becomes a mis- chievous 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 estab- lished our principle, in opposition to the philosophic adage; taking the duty of the citizen and the patriot, even on the lowest ground. But Christian self-denial and Christian love and charity go far 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 bro- ther's soul. ' If meat make my brother to offend, I will eat no meat while the world standeth, lest I make my bro- ther 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 mentioned 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 2* xiv PREFACE. 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 prin- ciple 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 Clerical and Medical Profes- sions combined so to influence the opinion and practice of the educated classes as to promote the spread of this prin- ciple among the " masses" to a degree which no other agency can effect. And he ventures to hope that, whether or not he carries his readers with him to the full extent of his own conclusions, he will at any 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 indiffer- ence what view is to be taken of it; and that, as " univer- sal 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 bet- ter 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 ; up- wards of two thousand of whom, in all grades and degrees —from the court physicians and leading metropolitan sur- geons, who are conversant with the wants of the upper ranks of society, to the humble country practitioner, who is fami- liar with the requirements of the artisan in his workshop, and the laborer in the field—have signed the following certificate:— PREFACE. XV " We, the undersigned, are of opinion— " 1. That a very large proportion of human misery, in- cluding poverty, disease, and crime, is induced by the use of Alcoholic or fermented liquors as beverages. " 2. That the most perfect health is compatible with Total 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." No medical man, therefore, can any longer plead the singularity of the Total Abstinence creed as an excuse for his non-recognition of it; and although a certain amount of moral courage may be needed for the advocacy and the practice of it, yet this is an attribute in which the Author cannot for a moment believe his brethren to be deficient. Judging from his own experience,.indeed, he may say that he has found much less difficulty in the course he has taken than- he anticipated when he determined on it; and that he has met with a cordial recognition of its propriety, not merely on the part of those who participated in hjs opinions but did not feel called upon to act up to them in their in- dividual 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. London, March, 1850. 12j typovipois Tiiyco, xfivait vixzls 3 tyr^u. TABLE OF CONTENTS. CHAPTER I. What are the Effects, Corporeal and Mental, of Alcoholic Liquors on the Healthy Human System? .... Sect. I.—Influence of Alcohol upon the Physical, Chemi- cal, and Vital Properties of the Animal Tis- sues and Fluids .... Corrugation of Tissues Coagulation of Albumen . Impairment of solidifiability of Fibrine Irritating action on living Tissues . Temporary exaltation of Nervous Power Change in red Corpuscles . Sect. II.—Immediate Consequences of the Excessive Use of Alcoholic Liquors on the General System Phenomena of Alcoholic Intoxication Symptoms and Post-mortem appearances of Alcoholic poisoning Pathology of Alcoholic Intoxication Sect. III. —Remote Consequences of the excessive Use of Alcoholic Liquors Diseases of the Nervous System Delirium Ebriosum Delirium Tremens . Insanity .... Oinomania Mental Debility in the Offspring Inflammatory Diseases of the Brain Apoplexy Paralysis and Epilepsy . Diseases of the Alimentary Canal 25 xviii CONTENTS. Sect. Irritation and Inflammation of the Mu cous 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 . 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 57 61 62 63 64 64 65 67 68 69 71 72 73 74 75 78 78 79 83 CHAPTER II. Does Physiology or Experience teach us that Alcoholic Liquors should form part of the ordinary sustenance of man, 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 the results of practical observation ? Sect. I.—Endurance of Bodily Exertion Sect. II.—Endurance of Mental Exertion Sect. III.—Endurance of Cold Sect. IV.—Endurance of Heat Sect. V.—Resistance to Morbific Agencies 89 89 102 107 122 133 CONTENTS. XIX Sect. VI.—Consequence of the Habitual" Moderate" Use of Alcoholic Liquors . Effect upon the Stomach Effect upon the Nervous System Effect upon the Circulation Effect upon Nutrition 139 145 148 150 153 CHAPTER III. Are there any special modifications of the bodily or men- tal condition of man, short of actual disease, in which the occasional or habitual use of Alcoholic Liquors may be necessary or beneficial 1 Sect. I.—Demand for Extraordinary Exertion Sect. II.—Deficiency of other Adequate Sustenance Sect. III.—Deficiency of Constitutional Vigor Pregnancy . . . . Lactation ..... ■ Childhood..... Old Age..... 157 157 162 166 172 174 177 178 CHAPTER IV. Is the Employment of Alcoholic Liquors necessary in the Practice of Medicine ? if so, in what diseases, or in what form and stages of disease, is the use of them necessary or beneficial ?.........185 Sect. I.—Recovery from Shock ..... 185 Sect. II.—Treatment of Acute Diseases . . . 186 Resistance to the depressing influence of Mor- bific Agents......186 Recovery from states of Prostration . . 189 Support under Exhausting Drains . . 190 Forms of Alcoholic Liquors most desirable . 192 Sect. III.—Treatment of Chronic Diseases . . . 193 Appendix A.......197 B.......200 C.......202 am 1c- i <: so CHAPTER I. WHAT ARE THE EFFECTS, CORPOREAL AND MENTAL, OF ALCOHOLIC LIQUORS ON THE HEALTHY SYSTEM? 1. In replying to this question, it wili be desirable to pro* ceed 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 investigations. 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 know- ledge of which we shall derive important 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 that of cor* rugation ; which change is entirely due to the difference in the capillary attraction of the tissue for alcohol and for wa- ter respectively. If animal membranes, a mass of flesh, or coagulated fibrine 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, mix- tures of the two ; and as the animal texture absorbs much less of an alcoholic 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 sub- stance, " Thus," says Professor Liebig, " 9-17 grammes of bladder, fresh, that is, saturated Avith water, (in, which are contained 6-95 grammes of water and 2*22 of dry substance,) when placed in forty cubic centimetres of alcohol, weigh at 3 26 EFFECTS OF ALCOHOL the end of twenty-four hours 4-73 grammes, and have con- sequently lost 4-44 grammes. For one volume of alcohol, therefore, retained by the bladder, rather more than three volumes of water have been expelled from it."* 3. This corrugating effect of alcohol will be usually in- creased 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; but some such physical change must always take place in the walls of the stomach, whenever alcoholic fluids are introduced into it; and in the soft tissues of the body at large, wherever alco- hol has found its way into the current of the circulation. And that such is actually the case, is proved by the expe- riments of Dr. Percy, f who found that when animals are poisoned by alcohol introduced into the stomach, the coats of that organ become so thoroughly imbued with it, through- out their whole thickness, that no washing or maceration can remove it. He found, also, that 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.—(§ 17.) 4. The physical change just described must have an im- portant influence upon the chemical relations of the tissues ; since it is impossible that Alcohol can be substituted, 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 im- portant of the chemical changes which alcohol has the power of effecting, is the coagulation of soluble Albumen : and al- though it will rarely, if ever, be introduced into the mass of the blood, or into the serous fluids of the tissues, by any ordi- nary alcoholic potations, in a sufficiently concentrated state to effect this, yet we should anticipate that its presence, even in a very dilute form, must affect the chemical relations of albu- men, and can scarcely do otherwise than retard that pecu- liar transformation by which it is converted into the more vitalized substance, Fibrine. That such is actually the case * On the Motion of the Animal Juices, p. 11. t Experimental Inquiry concerning the Presence of Alcohol in the Ventri- cles of the Brain, p. 29. ON THE HEALTHY SYSTEM. 27 will be rendered probable by the considerations to be pre- sently adduced. 5. No considerable changes of a physical or chemical na- ture can take place in any of the animal tissues, without 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 solidifiability of the fibrine, which is its special vital endowment,* is impaired by the introduc- tion 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 r 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 anything 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 re- sults from excessive habitual indulgence in alcoholic pota- tions, and of which the imperfect elaboration of the fibrine is one of the special characteristics. (§ 63.)—But, secondly, we find that when alcoholic liquids are applied to living tis- sues, especially to the vascular surface of the skin or mu- cous membrane, they induce redness, heat, and pain, indi- cating an increased determination of blood to the part. These symptoms vary in intensity, according to the state of concentration of the liquid, and the length of time during which it remains in contact with the surface ; and they may pass on from this condition of irritation to one of actual in- flammation. 6. Our best knowledge, however, of the influence of Alco- hol upon the vital actions of the animal tissues, is derived from microscopic observations upon the circulation of blood in the web of the frog's foot. If alcohol be applied to this membrane in a very dilute state, its first effect is to quicken the movement of blood through the vessels, which are at the same time rather contracted than dilated. But this state of things gradually gives place to the opposite; for * The coagulation of albumen and the fibrillation of fibrine are two entirely different processes; the former being a simply physical aggregation, the latter tending to produce an organized tissue, and being therefore of a vital nature. 28 EFFECTS OF ALCOHOL after a time, which varies with the degree of the dilution of the alcohol, the circulation becomes retarded, and the ves- sels 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 imme- diately brought about, and a considerable dilatation of the vessels takes place. The retardation may be such as to amount in some 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, how- ever, there is generally a border, in which the blood flows with increased rapidity. Now this perverted state may gradually give place to the normal condition, if the stimu- lus be only applied for a short time; the circulation being restored where it was deficient, and the vessels gradually contracting to their proper size. But if the contact of con- centrated alcohol be prolonged, it becomes obvious that the tissue has been killed; for the circulation is never re-esta- blished in it, and it is at last separated by gangrene. We rarely witness, in cold-blooded animals, those consequences of the application of irritants whieh properly constitute the in- flammqtory process; but this process is liable to be excited in man, and in warm-blooded animals, by the contact of alcoholic fluids with living tissues, if the contact be suffi- ciently prolonged, and the alcohol sufficiently concentrated. 7. Now the inference to be drawn from the preceding details is these;—that Alcohol, when applied to the living tissues in a sufficiently dilute form, exalts for a time their vital activity; but that this exaltation is temporary only, and is followed by a corresponding depression. And fur- ther, that when the alcohol is in a state of sufficient con- centration to act more potentially, its exhausting or de- pressing 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 observation of the effects of alcohol upon the system at large ; and we are justified, therefore, 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 ON THE HEALTHY SYSTEM. 29 that alcohol in small doses is tonic ; but of this there is no adequate proof. The property of tonic remedies is to increase the vital contractility of the animal solids in gene- ral, but more especially that of the walls of the blood-ves- sels. Now although some slight effect of this kind is at first manifested, after the application of very dilute alcohol to a living membrane, yet it is very transitory, and is succeeded by a much longer period of diminution of the tonic con- tractility of the walls of the blood-vessels. And we shall hereafter see that the supposed tonic properties of alcohol in small doses (especially in the form of wine or malt liquor), are really but a manifestation of its stimulant effects. 8. Various other experiments confirm this view of the effects of Alcohol on the animal tissues; and those of Hum- boldt are particularly valuable, as regards its special capa- bility of producing a temporary excitement of nervous power. " When the crural nerve," he says, " of a full grown and lively frog was immersed in alcohol, 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 stimu- lating fluid. If the nerve was left in it for some time, its excitability was completely exhausted. Its application exhausted instantaneously the excitability of young ani- mals—birds, worms, and insects. If the tail of an earth- worm 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."* 9. There are some peculiar effects of Alcohol upon the blood, 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 dark- ens its color, so as to give it more or less of the venous aspect.—(§ 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 be- comes mingled with the liquor sanguinis. Now, although the peculiar functions of the red corpuscles have not yet * Annals of Medicine, 1799, p. 265. 3* 30 EFFECTS OF ALCOHOL been precisely determined by physiologists, there is no doubt whatever that they are among the most important constitu- ents of the blood; and there is strong reason to believe that they are subservient 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 consi- derable 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 influ- enced 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 ani- mal fabric, we shall inquire into its effects upon the living system as a whole. II. IMMEDIATE CONSEQUENCES OF THE EXCESSIVE USE OF AL- COHOLIC LIQUORS ON IHE 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 stimula- tion, and then narcotism: of these, however, Alcohol is the type; and the term is commonly applied to alcoholic intoxi- cation 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 intro- duction of any poisonous agent into the blood; thus we meet with the terms "arsenical intoxication," "iodine in- toxication," and even "purulent intoxication." In fact, it is there considered an equivalent (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 ingestion of alcoholic liquors, is not without its significance; for, if the classical term "intoxication" be habitually employed as the equivalent of the Saxon "drunk- enness," we are justified in turning that classical term into English again, and in asserting that the condition of drunk- ON THE HEALTHY SYSTEM. 31 enness, 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 ex- amination we shall now proceed; first, detailing the symp- toms of the slighter forms of intoxication; then, 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 first effects of the ingestion of Alcoholic liquors, in sufficient amount to produce their characteristic influence, are, in most persons, an increase in the force and rapidity of the heart's contractions; producing a full, fre- quent, 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 sys- tem are especially 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, exhilara- tion of the spirits, animation 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 quarrel- some; the weak and silly are boisterous with laughter and mirth, and profuse in offers of service; and the sad and hypochondriacal readily burst into tears, and dwell on mournful topics. It sometimes happens, however, that men habitually melancholy become highly mirthful, when they have drunk enough to excite them; but this seems rather to be the case when the melancholy results from external depressing influences, than when it is constitutional; and hence it is that too many persons in circumstances of dis- tress 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 condition, it gradually subsides, and is followed by a state of the opposite character; the appetite, the digestive power, and the organic functions in 32 EFFECTS OF ALCOHOL general, being lowered in activity, the skin dry, the secre- tions diminished, the spirits depressed, and the power of mental exertion for a time impaired. For this condition, sleep, and abstinence (not merely from a renewal of the stimulus, but from more food than the stomach really de- mands), 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 distinguishing cha- racter of the sane mind of man, is considerably 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 control over the mental operations must be regarded, then, as an incipient stage of Insanity. 13. If the first dose of Alcohol be such as to produce more potent effects, or if (as in ordinary intoxication) it be renewed after the first effects have already been manifested, the second stage is induced, in which not merely the intel- lectual but the sensorial apparatus is disturbed. The volun- tary control over the direction of the thoughts is completely lost, and the excitement has more the character of delirium; the ideas becoming confused, the reasoning powers disor- dered, and hallucinations sometimes presenting themselves. At the same time, vertigo, double vision, tinnitus aurium, and various other sensory illusions occur; the muscular movements become tremulous and unsteady, the voice thick, the eyes vacant, and the face commonly pale. Vomiting frequently occurs in this state; and when it does, the con- secutive 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 which he awakes to feel the consequences of his transgres- sion^ These consequences differ in some degree with the previous habits. Those unaccustomed to such excesses usually suffer from headache and feverishness, with a dry and furred tongue, complete anorexia, with a particular ON THE HEALTHY SYSTEM. 33 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 fur- ther dose of his stimulant; and when he has obtained it, he is able to take food, and to proceed with his ordinary avo- cations. 14. In the third and most profound stage of intoxication, there is extreme diminution or entire suspension of cerebral and sensorial power; a state of coma1'supervening upon that last described. This state may vary in intensity, how- ever, between one of deep ordinary sleep, from which the individual can be so far aroused as to give manifestations of sensibility, and a torpor as profound as that of apoplexy; and, when the latter manifests itself, it is an indication of danger, especially when the respiratory movements are impeded. According to the observations of Dr. Ogston,* the face is sometimes pale, sometimes flushed; the eyes vacant and suffused, sometimes glazed; the pupils dilated, and contracting 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 quick and ex- cited, 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 fre- quent than usual, and are imperfectly performed, exhibiting, in the severest cases, the convulsive character of those of persons suffering from asphyxia. Strabismus, general te- tanic 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 the imperfect aeration of the blood; the face becoming livid and tumid, the eyes prominent, and the lips blue. In some instances, the complete prostration of the cerebral and sensorial powers comes on suddenly, without any pre- vious stage of excitement; and in these cases, it is noticed that the pupil is usually contracted. » Edinburgh Medical and Surgical Journal, vol. xl. 34 EFFECTS OF ALCOHOL 15. The unfavorable indications, in case of poisoning by large doses of Alcohol, are profoundness of insensibility, insufficiency of respiratory movement, with consequent failure of circulation and imperfect aeration of blood, the pupils either much dilated or contracted, coldness of the extremities, and the occurrence of strabismus or tetanic spasms. When these symptoms do not appear, the ill effects pass off, in a great measure, within four-and-twenty hours; but it is usually much longer before the various functions regain their healthy tone. 16. In fatal caSes,* the appearances 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 and the whole venous system of the brain are turgid with dark blood; and serous effusion is usually found within the ventricles, or beneath the arachnoid; this, however, being variable in its amount. The substance of the brain is unusually white and firm, as if it had lain in alcohol for an hour or two. The liver, spleen, and kidneys are loaded with venous blood; and the air-passages of the lungs contain more or less of frothy mucus. The stomach usually exhibits but little departure from its normal condition, except 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 mucous coat is usually found thicker, softer, and more vascular than usual; this change sometimes'ex- tending 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 irri- tant 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 subjects, by whom alcohol is very rarely taken in such a form. Of the condition of the liver and kidneys found in habitual * See Dr. Ogston, he. cit.; and Dr. Peters, in New York Journal of Medi- cine, vol. iii. No. 9. ON THE HEALTHY SYSTEM. 35 drunkards, an account will be given hereafter. The blood, in most cases of alcoholic poisoning, according to the ob- servations of Dr. Ogston upon drunkards, and the experi- ments of Dr. Percy upon animals, is either fluid or imper- fectly coagulated. Pathology 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 observations just referred to; and it is very important for our ftraii% inquiries, that the results of these should be rightly understood. That alcoholic liquors, when introduced into the stomach, should undergo rapid absorption into the sanguiferous system, is precisely what might 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 afterwards; 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 fact that, in one of Dr. Percy's experiments, in which the animal fell lifeless to the ground immediately that the injection of the alcohol 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 im- pregnated with alcohol.* 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 brain; thus confirming Dr. Ogston's asser- tion (which had been called in question by Dr. Christison * Op. cit, p. 61. 36 EFFECTS OF ALCOHOL and others) as to its presence in the fluid effused in the ventricles of the brain. 18. In some of the experiments on Alcoholic poisoning, however, made by Dr. Ohristison and others, it would appear as if the total loss of insensibility and voluntary power so instantaneously followed the introduction of the poison into the stomach—especially when it was introduced in a con- centrated form—as not to admit the idea that absorption could have taken place to a sufficient extent for the produc- tion of the effect iy the direct action of the poison on the nervous centres?'^^Ih, such instances, the fatal result would seem rather due to the violent impression made upon the gastric nerves, especially those of the sympathetic system ; whereby the heart's action is suspended, and death takes place by syncope rather than by asphyxia. This is the case with many other poisons, when administered in large quan- tity and in concentrated form, especially with such as exert a chemical action upon the animal tissues; the effect which they produce (through the nervous system) upon the heart, closely resembling that of blows upon the epigastrium, or extensive burns of the cutaneous surface. Now as the con- centration of the alcohol will, on the one hand, favor its physical and chemical action upon the tissues, whilst on the other it will be unfavorable to absorption, which takes place much more readily when it is diluted with water, we are enabled readily to account for this difference in its modus operandi. 19. The general stimulant action, which is for a time exerted by alcohol introduced in small quantities, and di- luted by admixture with the general mass of the blood, is easily explained upon the basis of the observations first de- tailed (§ 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. cit. p. 103.)—This fact is one of fundamental importance, as showing us how directly and immediately the whole nutrition and vital activity of the Nervous System must be affected by the presence of Alcohol in the blood; the alcohol being ON THE HEALTHY SYSTEM. 37 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 properties. It is important also to observe that this affinity is obviously 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 out (as it were) the nervous matter, and will fasten itself upon it—just as we see that other poisons, whose tesults become more obvious to olfr senses, (although the poisons themselves may exist in such minute amount as not to be detectible by the most refined analysis,) will localize themselves in particular organs, or even in particular spots of the same organ.* 20. The selective power of Alcohol appears to lead it in the first instance to attack the Cerebrum, the intellectual powers being affected before any disorder of sensation or motion manifests itself; and to this it seems to be limited in what has been here described as the first stage of intoxica- tion. But wkh the more complete perversion of the intel- lectual powers, which characterizes the second stage, we have also a disturbed function of the Sensory Granglia, upon which the cerebral hemispheres are superposed; this disturbance being indicated by the disorders of sensation, and also by the want of that control over the muscular movements which require 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 Oblongata and 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 admixture of alcohol with the blood has a tend- ency to give a venous character even to that of the arte- ries ; and when this tendency is augmented by imperfect respiration, the blood will become more and more venous, until its influence upon the medulla oblongata is so directly poisonous, that its functions are completely suspended, the respiratory movements are brought to a stand, and death * See, for illustrations of this doctrine, now generally admitted by physiolo- gists, Dr. W. Budd's paper on Symmetrical Diseases, in Med.-Chir. Trans., vol. xxv • and Mr. Paget's Lectures on Nutrition, in Medical Gazette, 1847. '' 4 38 EFFECTS OF ALCOHOL takes place by Asphyxia, precisely as in narcotic poisoning by other substances. 21. This tendency, however, is more or less completely antagonized by the efforts which the system makes (so to speak) to get rid of the poison; which efforts, if successful, will carry it off in the course of a few hours, leaving nothing behind it but the disordered condition which it has pro- duced. We have seen that an increased secretion takes place by the kidneys and skin; and the former of these is certainly a means of eliminating the alcohol, which has been detected in the urme by Dr. Percy, {pp. cit., p. 104,)—con- trary 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 produces a special determination to some particular gland, that determination is the means of eliminating it from the blood; as is seen in the diuretic action of the neu- tral salts. And it would not seem improbable, therefore, that the skin also should be concerned in the exhalation of the alcohol;* more especially since an alcoholic odor may often be observed, not merely in the breath, Mit proceeding from the person generally. Dr. Percy has also shown that alcohol may be detected in the bile of animals poisoned by it. The alcoholic odor of the breath is a sufficient indi- cation that alcoholic vapor is exhaled from the lungs in the act of respiration ; but the quantity of, this is probably small in comparison with that which is carried off in another way, namely, by the combustive process, which takes place in the blood at the expense of the oxygen it contains, and which converts the alcohol into carbonic acid and water; both of which are set free by exhalation from the lungs. The readiness with which alcohol is thus- oxidized, in fact, ; is probably one cause of its influence in giving a venous | aspect to arterial blood; since it will withdraw the oxygen from other substances, which are waiting to be eliminated 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 * Dr. Macnish states (Anatomy of Drunkenness, p. 175), that he has met with two instances, the one in a Claret, the other in a Port drinker in which the cutaneous perspiration after a debauch had the hue of the Ikmor they had drunk. ON THE HEALTHY SYSTEM. 39 carried out of the system; so that recovery may be cer- tainly expected, if life can be sufficiently prolonged by warmth to the surface, by artificial respiration, by the ad- ministration 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 presented by different individuals; but it has not been thought necessary to do so, the great general facts presented by its ordinary operation being those of prime importance in our further investigations. We have now to inquire into the various forms of disease, the pro- duction of which may be assigned, with more or less proba- bility, to the prolonged or repeated action of alcohol on the human system. III. REMOTE CONSEQUENCES OF THE EXCESSIVE USE OF ALCOHOLIC LIQUORS. Diseases of the Nervous System. 23. From the.peculiar tendency which the Alcohol in the blood has to disorder the functions of the Nervous System, it might be expected that the habitual ingestion of alcoholic liquors in excess would bring about a more permanent de- rangement of this apparatus, and more particularly of its Encephalic portion—which seems to be singled out by al- cohol, almost to the exclusion of the spinal cord, just as the spinal cord is affected by strychnine, almost to the exclusion of the encephalon. This Ave 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 frequent among the habitually intemperate than among the habitually sober, as to justify us in regarding the excessive use of alcoholic liquors as among the most 40 EFFECTS OF ALCOHOL 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 in the use of alcoholic drinks tends 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 frequently result from the repetition of the cause which produces the single paroxysm. There are, in fact, some individuals in whom a fit of posi- tive madness, persisting for some little time after the imme- diate effects of the stimulus have subsided, is brought On by every excess in drinking. The head becomes extremely hot, the face flushed, the pulse very frequent, full, and hard, the temper is excessively violent, the individual sometimes at- tacking every one who comes in his way, and being always prone to ferocity against any one who opposes him; and all sense of danger being lost, he is not deterred from violence by the fear of personal injury, but rushes madly upon what may prove his destruction. This condition, the delirium ebriosum of Darwin, is obviously an exaggeration of one of the ordinary forms of excitement in common intoxication; and it usually subsides in a day or two, if the individual be simply restrained from doing mischief to himself or others. It is sometimes accompanied, however, with tremors, even in the midst of violent excitement; and this form constitutes the transition to the disorder next to be noticed. The fre- quent repetition of this paroxysm, of which, as of ordinary drunkenness, the stimulating action of alcohol on the nerv- ous centres must be regarded as the immediate cause, is almost certain, like the recurrence of regular maniacal paroxysms, to end in some settled form of Insanity. 25. Delirium Tremens.—The habitual drunkard, who has exhausted his nervous power by continual over-excite- ment, is liable to another form of disordered action of his brain, which is commonly known from one of its most marked symptoms—the peculiar tremor of the limbs—as delirium tremens. This state is in many respects the opposite of the preceding. There is little or no heat of the head or flush- ing of the face, the skin is cool and humid, and even chilly; the pulse, though frequent, is small and weak; and the ON THE HEALTHY SYSTEM. 41 temper, though very irritable, is not violent—the prominent disposition, indeed, being anxiety and apprehension of in- jury or danger. There is an almost entire want of sleep ; and even if repose be obtained, it is very imperfect, being interrupted by frightful dreams. On the other hand, the waking state is frequently so disturbed by illusions of a disagreeable or frightful nature, that it differs but little 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 ceiling, and on the floors; foul things crept along the bed- clothes, and glaring 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 perspiration would -start to my brow, and my limbs would shiver until the bed rattled again. Strange lights would dance before my eyes, and then suddenly the very blackness of darkness would appal 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 j)itchy dark. I lost the sense of feeling, too, for I endeavored to grasp my arm in one hand, but conscious- ness was gone. I put my hand to my side, my head, but felt nothing, and still I knew my limbs and frame were there. And then the scene would change. I was falling— falling swiftly as an arrow far down into some terrible abyss; and so like reality was it, that as I fell I could see the rocky sides of the horrible shaft, where mocking, gib- ing, mowing, fiend-like forms were perched; and I could feel the air rushing pasf, me, making my hair stream out by the force of the unwholesome blast. Then the paroxysm sometimes ceased for a few moments, and I would sink back on my pallet drenched with perspiration, utterly exhausted, * Autobiography of J. B. Gough, p. 70. 4* 42 EFFECTS OF ALCOHOL and feeling a dreadful certainty of the renewal of my tor- ments." 26. With this disturbed condition of the brain, a more or less disordered state of the digestive apparatus is commonly associated. The tongue is furred, the stomach unable to bear food without vomiting or a sense of oppression; the bowels are usually constipated, or, if they be relaxed, the stools are dark and offensive, and the urine is scanty. Sometimes the disease proceeds to a fatal termination, which is generally preceded by contracted pupil, occasionally stra- bismus, incessant low delirium, increase in the muscular tre- mor almost amounting to subsultus tendinum, and other indications of nervous exhaustion; the pulse becomes thready, and at the same time more rapid, so that it some- times can scarcely be counted; cold sweats break out upon the skin, and the chilliness of the surface increases, proceed- ing from the extremities to the trunk. 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 super- vention of profound sleep give to the exhausted energies of the nervous system the means of restoration. Some- times, however, the recovery is never complete, but the pa- tient^ remains in a state of Melancholia, with more or less of deficiency of intellectual power; and this more especially happens after repeated attacks of the disease. 27. Between the 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 this important difference—that, while the former is but an exalted manifestation of the primary excitement ordinarily produced by alcohol, the .latter, super- vening at the end of a prolonged debauch, is the conse- quence of exhaustion produced by continued excitement. Delirium Tremens more frequently 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 ON THE HEALTHY SYSTEM. 43 the potent stimulus can excite to anything like regular ac- tion. 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 perver- sion of its functional power and of its nutritive operations. In fatal cases, no morbid appearances are found that in the least indicate turgescence of the vessels or inflammatory excitement, unless the delirium have partaken of the cha- racters of that which directly arises out of intoxication. And it is manifest, therefore, that the disordered condition must be in the nervous pulp itself, and that" it must be of a kind to keep up morbid and irritative activity, at the same time that the tissue is incapable of exercising those repara- tive functions which are carried on in the healthy condition during the state of repose. 28. Although, in the vast majority of cases, Delirium Tre- mens is the immediate or the consecutive result of the excess- ive use of Alcoholic liquors, jet it may occur independently of them ; but its other causes are such as resemble the ex- citement of alcohol, in producing exhaustion or depression of the nervous power—such, for instance, as excessive deple- tion, 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 established by habitual intemperance ; and this has been especially re- marked of the delirium traumaticum. - 29. It is important to remark that a slighter form of this disorder, marked by tremors of the hands and feet, defi- ciency of nervous power, and occasional illusions, will some- times appear as a consequence of habitual tippling, even with- out intoxication having been once produced. And a still slighter manifestation of the want of control over the mus- cular apparatus—the trembling of the hands in the execu- tion of a voluntary movement—is familiar to every one as extremely frequent among the habitually intemperate. We thus see that the disease is at least as much dependent upon the disordered state of nutrition, consequent upon the habi- tual presence of alcohol in the blood, as it is upon that posi- tive exhaustion of nervous power consequent upon the vio- lence of the excitement, which is the more immediate effect of the stimulus. 44 EFFECTS OF ALCOHOL 30. Insanity.—Such being the case, we have no difficulty in understanding how the habitual use of Alcoholic liquors in excess becomes one of the most frequent causes of Insanity, properly so called, i. e. of settled Mental Derangement. Upon that point, all writers on the subject are agreed, however much they may differ 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 accord- ing to the mode in which it has been made. Thus, in Pau- per Lunatic Asylums, the proportion of those who have bo- come insane from Intemperance is usually much larger than it is in Asylums for the reception of Lunatics from the higher classes, among whom intemperance is less frequent, while causes of a purely moral and intellectual nature ope- rate upon them 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 propor- tion becomes much larger than it will be if (as happens in many cases), some other cause have been in operation con- currently, and the disorder be set down as its result, no no- tice whatever being taken of the habit of intemperance. This omission must be particularly allowed for, when the relative proportion of intemperance to other causes is being estimated in regard to the middle and higher classes; on account of the strong desire which usually exists among the friends of the patient to conceal the nature of his previous habits, and to lay his disorder entirely to the account of the cause from which it has seemed immediately to proceed. 31. There can be no doubt that those who have weakened and disordered the nutrition of the brain by habitual In- temperance, are far more liable than others to be strongly affected 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 predis- posing cause, at least as much towards its production as what is commonly termed the exciting cause has done. In fact, of predisposing causes generally, it may be remarked that their action upon the system is that of slowly and im- perceptibly modifying its nutritive operations, so as gradu- ally to alter the chemical, physical, and thereby the vital ON THE nEALTHY SYSTEM. 45 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 operation is often singled out as the cause, from which the result may seem most directly to proceed, yet it frequently happens that it has really had a far smaller share in the production of the disorder than those remoter causes whose operation has been more enduring and really more effectual.* 32. In the Statistical Tables, published by. the Metropo- litan Commissioners of Lunacy, in 1844, comprehending the returns from 98 Asylums in England and Wales, we find that, out of 12,007 cases whose supposed causes were re- turned, 1799, 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 sensuality, in which excess- ive use of alcoholic liquors must have shared. Moreover, in every case in which Hereditary Predisposition was trace- able, 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 disorder, in all the cases in which it is traceable, than it would be to regard intemperance in that light, in every case in which the patient had previously indulged in alcoholic excesses. Of the 2526 cases, then, in which the disorder is attributed to hereditary predisposition, a con- siderable proportion might with equal justice be set down to the account of intemperance. And there can be no doubt that the same practice had a great share in the production of the disease in the 3187 cases set down to bodily disorder, and in the 2969 for which moral causes are assigned. 33. If we turn from this general statement to the expe- rience of individual asylums, we frequently find the propor- tion much higher; and curious variations are sometimes observable between the returns for successive years. Thus, in the Glasgow Lunatic Asylum, according to the report of Dr. Hutcheson, the following were the proportions which intemperance bore to other causes during seven years:— * See Mr. J. S. Mill's Elements of Logic, vol. i. p. 398. 46 EFFECTS OF ALCOHOL Year. Total number of patients. Cases where the disease was heredita-ry, &c. Cases where ' Cases where the cause was intemperance unknown. 1 was the cause. Proportion per cent, of intemperance to other causes. 1840 1841 1842 1843 1844 1845 184G 149 157 199 327 390 364 414 3 20 54 116 77 47 . 49 34 44 20 38 41 38 02 20 30 46 31 53 90 • 1'(J5 134 191 23-1 9 4* 18 2 24 7 25-3 Total 1900 306 277 375 19 7 Of the great increase which presents itself in the number of cases attributable to intemperance during the last two years of this return, Dr. Hutcheson thus speaks in his re- port 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 contested elections, public dinners, races, &c. It is also a fact well known to those who have minutely studied the * This marked diminution in- the per centage of cases attributable to In- temperance is chiefly due to the admission into the Glasgow Asylum, during the year 1843, of a number of lunatics who had previously been confined at Arran, for the most part, during several years. Of the origin of their Insanity very little was known: and they were chiefly assigned to the head of "He- reditary and Constitutional Predisposition," thereby diminishing the per cent- age 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 circumstance is attributed by Dr. Hutcheson to the im- proved condition of trade, which caused an adequate demand for labor. On this point he makes the following remarks, in his report for 1842, p. 30: "It may be said, that when wages are low, and occupation difficult to be obtained, men will have less money to spend, and consequently will drink less. A 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 generally 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 pleasure. To this he will sacrifice everything; .and habits of intemperance are frequently acquired in seasons of distress, which the individual, in more favorable circumstances, finds it impossible to lay aside." ON THE HEALTHY SYSTEM. 47 subject, that over-exertion of the brain leads to a desire for stimulants, which, however, are easily enough abandoned when the brain is allowed to rest." For the reason already given, it is probable that the average proportion of 19*7 per cent, does not by any means represent the entire num- ber of cases in which intemperance was the principal cause of the disease; and that we should be within the truth in assigning to it at least a quarter of the whole number of cases. . 34. In the report of the Aberdeen Lunatic Asylum for 1847, we find intemperance specified as the cause in 17 cases out_of 93 admitted; but of these 93, there were 8 cases in which hereditary predisposition, and 11 in which predisposition from previous attacks, was assigned as the cause; and there can be no doubt that of these 19 cases a considerable proportion might be set down, in part, to the account of intemperance. In the report of the Dundee Lunatic Asylum, we find that 8 out of 52 cases admitted are set down to intemperance; 7 were hereditary; and in 4 the cause was unknown. In other asylums, the proportion of cases returned as due to Intemperance is much greater than in those already referred to. Thus, in the Commis- sioner'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. Oinomania.—-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 given by Dr. Hutcheson in the report of the Glasgow Lunatic Asylum 48 EFFECTS OF ALCOHOL for 1842 (pp. 39-44); deeming its value sufficient to justify him in presenting it without abridgment. The designation Oinomania, he would remark, has been substituted by Dr. H. for the less appropriate term Dipsomania, used by other authors. "This form of mania," he observes, "is quite dif- ferent from drunkenness, which, however, may lead to it; the diagnostic mark of the disease being the irresistible propensity to swallow stimulants in enormous doses, when- ever and wherever they can be procured. There are indi- viduals who, at the festive board, invariably become excited, if not intoxicated, but who are otherwise habitually sober, and in the course of the year drink much less than others who never appear to be under the influence of stimulants. Others indulge in their potations in a regular manner, and daily consume a larger quantity of liquor than is consistent with good health or sobriety. All these, however, possess self-control, and can, at any time, refrain from stimulants; but those affected with the disease cannot do so, however convinced they may be of the impropriety of yielding to their propensity, or however desirous they may be to subdue it. I repeat that the disease does not consist in the mere act or habit of becoming intoxicated; but in the irresistible impulse which drives the unhappy being to do that which he knows to be pernicious and wrong, and which, in the intervals of his paroxysms, he views with loathing and dis- gust. He derives no pleasure from taste, for he gulps down the liquor, of whatever kind it may be; or from society, for he generally avoids society; but he only derives a tempo- rary satisfaction from the gratification 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 three 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 state, 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 from the fourth cause mentioned, it is not so easily removed, and is very apt to assume the chronic form. " The Periodic or paroxysmal form is much more frequent ON THE HEALTHY SYSTEM. 49 than the acute. This is often observed in individuals who have suffered from injuries of the head, females during pregnancy, at the catamenial periods, on the approach of the critical period 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 partakes of stimulants. In these, total abstinence is the only remedy. Like the form about to be mentioned, it is frequently hereditary, being derived from a parent predis- posed 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 stimu- lants, and frequently loathes them for the same period. But by degrees he becomes uneasy, listless, and depressed, feels incapable of application, and restless, and at last begins to drink till he is intoxicated. He awakes from a restless sleep, seeks again a repetition of the intoxicating dose, and continues the same course for a week or longer. Then a stage of apathy and depression follows, during which he feels a loathing for stimulants, is the prey of remorse, and regrets bitterly his yielding to his malady. This is followed by fresh vigor, diligent application to business, and a deter- mined 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 disease be checked, he falls a victim to the physical effects of intemperance, becomes maniacal, or imbecile, or affected with the form of the dis- ease next to be mentioned. " Of all the forms of Oinomania the most common is the chronic. The causes of this are injuries of the head, dis- eases of the heart, hereditary predisposition, and intemper- ance. This is by far the most incurable form of the malady. The patient is incessantly under the most overwhelming desire for stimulants. He will disregard every impediment, sacrifice comfort and reputation, 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 tremulous, incapable of any exertion either of mind or body, his first feeling is a desire for stimulants, 5 50 EFFECTS OF ALCOHOL with every fresh dose of which he recovers a certain degree of vigor both of body and mind, till he feels comparatively comfortable. A few hours pass without the craving being so strong; but it soon returns, and the patient drinks till intoxication is produced. Then succeed the restless sleep, the suffering, the comparative tranquillity, the excitement, and the state of insensibility; and, unless absolutely se- cluded from all means of gratifying the propensity, the patient continues the same course till he dies, or becomes imbecile. This is that fearful state portrayed by Charles Lamb, in which reason revisits the mind only during the transient period of incipient intoxication. "It must be remarked that, in all these forms of the disease, the patient is perfectly incapable of self-control; that he is impelled by an irresistible impulse to gratify his propensity; that, while the paroxysm is on him, he is regard- less of his health, his life, and all that can make life dear to him ; that he is prone to dissipate his property, and easily becomes the prey of the designing; and that in many cases he exhibits a propensity to commit homicide or suicide. He is thus dangerous to himself and others, and however responsible he may have been for bringing the disease on himself, his responsibility ceases as soon as he comes under the influence of the malady. The disease, however, may not be brought on by the act of the individual; and then it is clear at once that neither directly nor indirectly can he be deemed responsible. But suppose that it were the result of his previous conduct, I repeat that, however culpable he may have been for that, he is not a responsible being while afflicted with the malady; for I can see no distinction be- tween this form of the disease and any other which has been induced by the habits or acts of the individual. " The only chance of cure or alleviation is from attention to the health, and abstinence from intoxicating liquors. Neither can be secured so long as the patient is at large; and no amendment can be depended on, unless he has un- dergone a long course of discipline and probation. Con- sidering, then, that the individual is irresponsible and dan- gerous 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 rela- tives, but necessary for the security of the public, that he ON THE HEALTHY SYSTEM. 51 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 forfll 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 probation. It is otherwise with those who have not that self-control, or who fancy that they are unjustly interfered with when checked in their career. They require a much longer probation, which should be increased at each return of their malady. "Of the chronic form, I have seen only one case com- pletely cured, and that after a seclusion of two years' dura- tion. In general it is not cured; and no sooner is the pa- tient liberated than he manifests all the symptoms of his disease. Paradoxical though the statement may appear to be, such individuals are sane only when confined in an Asylum." The Superintendent of the Dundee Asylum, in remarking upon the frequent causation of Insanity by Intemperance, makes a very similar statement of the results of his obser- vations ; and regrets that there are not in this country such Asylums as are understood to exist in the United States, for the reception of those incorrigible drunkards in whom the power of self-control has been altogether destroyed by their repeated yielding to the craving for Alcoholic stimu- lants. . 36. Mental Debility in the Offspring.—-It is scarcely necessary to accumulate further proof in support of the as- sertion that, of all the single causes of Insanity, habitual Intemperance is the most potent, and that it aggravates the 52 EFFECTS OF ALCOHOL operation of other causes. We have now to show that it has a special tendency to produce Idiocy, Insanity, or Mental De- bility, in the offspring. Looking to the decided tendency to hereditary predisposition in the ordinary forms of In- sanity* looking also to the fact that any perverted or im- perfect 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); we should expect to find that the off- spring of habitual drunkards would share with those of luna- tics in the predisposition 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 extensive opportunities of observation; and the fact has come down"to us sanctioned by the experience of anti- quity. Thus Plutarch says, " One drunkard begets another;" and Aristotle remarks that " drunken women bring forth children like unto themselves." Dr. W. A. F. Browne, the resident Physician of the Crichton Lunatic Asylum at Dum- fries, 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 unfore- seen exigency, or of the ordinary calls of duty. At present, I have two patients who appear to inherit a tendency to un- healthy action of the brain, from mothers addicted to drink- ing ; and another, an idiot, whose father was a drunkard."* The author has learned from Dr. Hutcheson that the results of his observations are precisely in accordance with the fore- going.—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 legislature of Massachu- setts. " The habits of the parents of 300 of the Idiots were learned; and 145, or nearly one-half, are reported as 'known to be habitual drunkards.' Such parents, it is af- firmed, give a weak and lax constitution to their children ; who are, consequently, 'deficient in bodily and vital energy,' and predisposed by their very organization to have cravings for alcoholic stimulants; many of these children are feeble, * Moral Statistics of Glasgow, by William Logan, 1S49, p. 20. ON THE HEALTHY SYSTEM. 53 and live irregularly. Haying 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 tendency to idiocy in their constitution; and this they leave to their children after them. The parents of case No. 62 were drunkards, and had seven idiotic children."* 37. There is a prevalent impression that idiocy is 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 offspring was com- pletely 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 viti- ates or impairs the sources of health for several generations. That the effects of drunkenness are highly inimical to a permanent healthy state of the brain is often proved at a great distance of time from the course of intemperance, and long after the adoption of regular habits. 38. Inflammatory Diseases of the Brain.—All medical writers agree in regarding Intemperance as one of the con- ditions which tend to produce Inflammatory diseases of the Encephalon, now distinguished as Cerebritis and Meningitis ; and this is precisely what might be anticipated, when it is considered how great must be the derangement of the circu- lating and nutritive operations, occasioned by the presence of alcohol in the blood. An attack of acute Encephalitis not unfrequently supervenes upon a debauch, which is then regarded as its exciting cause.f But it may occur quite in- dependently of any special act of access, in consequence of the predisposition arising from the perversion of the normal functions, by the habitual use of alcoholic liquors in quan- tities that may never produce actual intoxication. Perhaps, indeed, this is the more common occurrence. We have seen * American Journal of Medical Sciences, April, 1849, p. 437. t See, for example, a fatal case related by Dr. Percy, op. cit., p. 54, 5* 54 EFFECTS OF ALCOHOL that the state of excitement first produced in most persons by the ingestion of alcohol, would pass into Meningitis (or rather inflammation of the convolutions) if it were not to subside with the elimination of the alcohol from the blood. On the other hand, the state of torpor of the mental func- tions, which alcohol produces from the first in some individu- als, and which comes on in all if the intoxication be carried far enough, is indicative of that congestion of the substance of the brain which, if confirmed, and accompanied by a cer- tain disturbance of the nutritive operations, would become Cerebritis. There can be no hesitation, therefore, in admit- ting the relation of cause and effect, in cases in which it is so obviously established by the sequence of the phenomena. 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, character- istic of the advanced stage of intoxication, may be consi- dered to be identical with that of congestive apoplexy, 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 circula- tion, such as is occasioned by imperfect discharge of the functions of the brain; and this obstruction being also fa- vored by that partial stagnation of blood in the lungs, which takes place whenever the respiratory movements are inter- fered with. This apoplectic tendency seems to render the intoxicated man peculiarly liable to suffer from causes which would not otherwise produce rupture of the vessels; thus, there are numerous instances on record, in which blows re- ceived in pugilistic encounters, or other comparatively slight injuries, have occasioned fatal hemorrhage within the cra- nium ; the sufferer having been previously dosed with spirits * 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 deple- tion that is proper in a case of true congestive apoplexy. ON THE HEALTHY SYSTEM. 55 in such quantity as of itself to produce a state of conges- tion bordering on apoplexy. And it occasionally happens, though this is comparatively rare, that cerebral hemorrhage occurs without any external violence, after an excessive in- dulgence in spirituous potations. 41. But the influence of Alcoholic Liquors in the causa- tion of Apoplexy is usually of a much 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 in- temperance in eating as well as in drinking; the latter, how- ever, being the chief cause, inasmuch as, without the habit- ual assistance of alcoholic liquors, continual excess in eat- ing would generally soon correct itself. Hence, we find that such cases are rather apt to occur among those who take considerable quantities of wine or malt-liquor with full meals of solid food, than among the drinkers of spirits, who are seldom great eaters. It is not difficult to see the reason of this. For, on the one hand, the habit of excess in eat- ing and drinking has a tendency to produce that condition of Plethora which is most peculiarly prone to favor hemor- rhagic effusions; whilst, on the other, the ingestion of a large quantity of solid food, by causing pressure on the ves- sels of the abdominal viscera, and by impeding the descent of the diaphragm, tends to force an unusual quantity of blood into the encephalic vessels, as well as to obstruct its return from them. Such an habitual derangement of the circulation may well be supposed to occasion a progressive weakening of the vessels of the brain; and in this manner it happens that, after a persistence for months or years in this course, Apoplexy may supervene, and be its legitimate con- sequence, without the attack being traceable to any extraor- dinary 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 of Apoplexy, it is impossible to give a stronger proof than the rigidity of the rule of absti- nence which is laid down for those in whom a disposition to * There is evidence that habitually excessive use of Alcoholic liquors has a tendency to produce hemorrhages elsewhere, probably by diminishing the plasticity of the blood, and by impairing the nutrition of the walls of the blood- vessels.—(See §§ 52 and 68.) 56 EFFECTS OF ALCOHOL it has already manifested itself. Now if it be necessary to lay down such rules to prevent the recurrence of the disease, is it not most obvious that we are justified in attributing to an habitual violation of them its first occurrence ? And if habitual excess be so obviously a predisposing cause, can we reasonably deny that the long-continued even " mode- rate" use of stimulants is likely to exert a slow, but in the end a decided, influence ? It is surely in vain here to reply that, as food is wholesome in moderation, but is hurtful in excess, so may alcohol be also ; for alcohol (as will be more fully shown hereafter) can never properly act as food, save when other alimentary matters are deficient; and even in the smallest and most diluted doses, alcohol exerts an in- fluence on the vital properties of the tissues with which it is brought into contact, that is never manifested by proper alimentary matters. 43. Paralysis and Epilepsy.—As the conditions upon which the cerebral forms of Paralysis depend are so nearly the same with those which induce Apoplexy, we cannot doubt that the continual intemperate use of Alcoholic liquors must predispose to this disease, especially when it accom- panies 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 paralytic attacks. The writer has had oppor- tunities of noticing this in the case of two gentlemen ad- vanced in life, each of whom suffered from repeated attacks of paralysis, which almost invariably supervened upon a viola- tion of the habitual rule of abstinence from fermented liquors, and of extreme moderation in diet.—Precisely the same, too, may be said of Epilepsy, which disease is now gene- rally attributed to a disordered state of nutrition 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 predisposing causes, especially when the disease occurs in persons ad- vanced in life; whilst in those who are already predisposed from these or other causes, the excessive use of fermented ON THE HEALTHY SYSTEM. 57 liquors is frequently the immediate or exciting cause of the paroxysm. 44. Besides these positive diseases, a premature exhaus- tion of Nervous power, manifested in the decline of mental vigor, and of nervo-muscular energy, is ranked by com- mon consent among the consequences of habitual excess in the use of Alcoholic liquors; and reasons will be given hereafter for the belief that it is occasionally the direct, but more frequently the indirect, consequence of the habit- ual 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 liquors has—in addition to its direct ac- tion upon the functions of circulation and nutrition—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 manifestation of whose action, however, is only postponed, and becomes more severe in the end, in proportion to the duration of the agency. This indirect operation of alcoholic 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 considered, 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, by the direct irritating action of the fluid upon the mucous lining of the Alimentary Canal; and second, by the general deteriora- tion of the nutritive processes, resulting in various ways from the entrance of Alcohol into the Blood. 47. Irritation and Inflammation of the Mucous Mem- brane of the Stomach.—That irritation would be produced in the very vascular mucous membrane of the Stomach, by the direct contact of Alcoholic liquors, and that this would vary in its intensity with the amount, concentration, and 58 EFFECTS OF ALCOHOL duration of the application of the irritant, is precisely what we should anticipate, from what has been already shown by observation to be the result of the application of alcohol to a living membrane. A small quantity of alcoholic liquor, diluted by the fluids already in the stomach, appears to produce only the first effect, namely, a quickening of the circulation, and a temporary exaltation of the functional activity of the organ, as shown in the increase of appetite and of digestive power. But when a larger quantity is in- troduced, and especially when successive doses are taken so as to keep up the irritation, or when the alcohol is in a state of high concentration, and the stomach contains but little other fluid, all the effects of an irritant are produced, vary- ing from moderate congestion with diminished functional activity, to intense congestion passing into inflammation, and even to a -gangrenous state. The more severe effects, however, are not often seen; in consequence, it may be surmised, of the rapidity with which the alcohol has been absorbed (§ 18), and the brevity of the duration of its con- tact with the membrane, shielded as this is with its coat of mucus. Hence, a repetition of the dose seems more likely to produce a state of high irritation, or of inflammation, than any single dose, unless this have been too great to be quickly absorbed. 48. The morbid appearances found in the Stomachs of men or animals killed by narcotic poisoning, and attributa- ble at first sight to the direct influence of the irritant, can seldom be fairly regarded in that light; since they are for the most part such as are producible by the Asphyxia which has been the immediate cause of death. When we find general injection of the mucous membrane, local patches of extreme congestion, numerous minute extravasations, or hemorrhagic patches of large extent, these are more likely to have been the result of the stagnation of the pulmonary circulation, acting backwards 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 animals poisoned by Alcohol, it frequently happens that scarcely any positively morbid appearances are discernible in the stomach; and the departures from the healthy character ON THE HEALTHY SYSTEM. 59 which are noticed in the stomach of the human subject after death from alcoholic poisoning, are most frequently such as indicate an altered state of its nutrition, consequent upon habitual irritation. Of these departures, a thickened state of the mucous membrane seems to be the most constant; the membrane being sometimes softened (as stated by Dr. Ogston); sometimes unusually firm, corrugated, and pale (as observed by Dr. Peters). These last appearances seem to have been most common, when a quantity of undiluted Spi- rits had been taken shortly before death, and to have re- sulted from that physical action exerted by them upon the membrane, to which reference has already been made (§§ 2, 3). It sometimes happens, however, that, after the narcotic 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 termina- tion (as now and then occurs), the usual appearances indi- cative 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 membrane during life, is derived from the well-known observations ot Dr. Beaumont in the case of Alexis St. Martin. This man appears to have been habitually temperate and healthy; but to have occasionally indulged in excess both in eating and drinking, the results of which could be seen by direct observation through the fistulous opening in the parietes of his stomach. "Thus," says Dr. Beaumont, under the date July 28th, 1833, " Stomach not healthy, some erythema, and aphthous patches on the mucous surface. St. Martin has been drinking ardent spirits pretty freely, for eight or ten days past, complains of no pain, nor shows symptoms of general indisposition—says he feels well, and has a good appetite. August 1st. Inner membrane of the Stomach morbid; considerable erythema, and some aphthous patches on the exposed surface; secretions vitiated. August 3d. Inner membrane of Stomach unusually morbid; the erythe- matous appearance more extensive, and spots more livid than usual, from the surface of which exuded small drops 60 EFFECTS OF ALCOHOL of grumous blood; the aphthous patches larger and more numerous; the mucous covering thicker than common, and the secretions much more vitiated. The gastric fluids ex- tracted this morning were mixed with a large proportion of thick, ropy mucus, and considerable muco-purulent matter, slightly tinged with blood, resembling the discharge from the bowels in some cases of chronic dysentery." Now, it is very important to remark that all this disorder was proved by direct observation to be actually existing in the Mucous coat of the stomach, without any such manifesta- tion of it by general or local symptoms as would by them- selves have been thought indicative of its presence. " For," continues Dr. Beaumont, " St. Martin complains of no symptoms indicating any general derangement of the sys- tem, except an uneasy sensation, and a tenderness at the pit of the stomach, and some vertigo, with dimness and yel- lowness of vision on stooping down and rising again; has a thin, yellowish-brown coat on his tongue, and his counte- nance 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 re- covered its healthy appearance; the patient having in the mean time entirely abstained from all alcoholic liquors, and having been confined to low diet. Dr. Beaumont further states that " diseased appearances, similar to those men- tioned above, have frequently presented themselves in the course of my experiments and observations. They have generally, but not always, succeeded to some appreciable cause. Improper indulgence in eating and drinking has been the most common precursor of these diseased condi- tions of the stomach. The free use of ardent Spirits, Wine, Beer, or any intoxicating liquor, when continued for some days, has invariably produced these morbid changes." 50. From the precise concurrence of these Observations with what Theory would lead us to expect, in regard to the action of Alcoholic liquors on the Mucous membrane of the stomach, it is obvious that we have no right to suppose that the peculiar condition of St. Martin gave him any peculiar liability to suffer in the manner above described. On the contrary, such disorders of the circulation, nutrition, and secretion, might be anticipated to occur in every case; and it is only because they are not immediately indicated by ON THE HEALTHY SYSTEM. 61 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 be- lieve that some such condition must be the result of every excess in the use of alcoholic liquors, however little it may be indicated by the local or general symptoms. 51. Inflammatory Gastric Dyspepsia.—It might be anti- cipated, then, that habitual excess would convert this state of occasional and transient disorder, which only requires rest and abstinence for its cure, into one of a more persistent and obstinate character; which, by unfitting the stomach for the discharge of its normal functions, would seriously impair the general nutritive operations. Such has been shown by experience to be the case; a special form of dys- peptic disorder, termed Inflammatory (Jastric Dyspepsia, being well known to practical men as common among those who have freely indulged in alcoholic potations. Of this disorder, the following are the symptoms, as enumerated by Dr. Todd :* "Painful digestion, sense of heat, tenderness, or pain at the epigastrium, increased upon taking food, or on pressure; thirst; tongue more or less of a bright red color, sometimes brownish red, sometimes dry, glossy, and adhesive; 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." The various stages and degrees of the disease are characterized by various modifications of these symptoms, many of them the con- sequences 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 intro- duction of alcohol into the blood; . Thus, we find a special * Cyclopaedia of Practical Medicine, Art. Indigestion. 6 62 EFFECTS OF ALCOHOL 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 exertion, passing on, in the more . 'confirmed states, to complete Hypochondriasis. Although excess in eating may aid in the production of this wretched condition, yet, 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 potations; " it is the dyspepsia of the Dram Drinker and Opium Eater, and be- longs altogether more to the Drunkard than to the Glutton." In the treatment of this disease, the complete disuse of stimulants is found to be of the greatest importance; not- withstanding that, in the more chronic forms of it, a tempo- rary alleviation is sometimes obtained from small quantities of alcoholic liquors.* 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 stomach, and it may extend itself along the whole course of the Alimentary Canal, to parts with which the Alcoholic liquors themselves have not come in contact; so as to be attributable rather to the general imperfection of the nutritive operations than to the local effects of the stimulant. Thus, we find that habitually intemperate persons are subject to soreness, red- ness, and ulceration of the membrane of the nose, and of that of the lower part of the intestinal canal; and hemor- rhages from various parts of this membrane, as well as from the mouth itself, are of no unfrequent occurrence—the escape of blood being obviously dependent in part on its own insufficient plasticity, and in part upon the softened condition of the walls of the vessels. It is important to bear this in mind, as increasing the probability of the same cause being concerned in the production of a similar soften- ing elsewhere ; as, for example, in the vessels of the Brain. —(See § 41.) * See the observations of Sir Philip Crampton on this subject, in Dublin Hospital Reports, vol. i p. 349. ON THE HEALTHY SYSTEM. 63 53. Where, in place of excessive, indulgence, what is commonly considered a moderate use has been made of Alco- holic liquors, we cannot, with the same confidence, attribute to it any decided departure from the healthy condition of the stomach; and it is certain that the mucous membrane becomes in time so habituated to its presence, that its con- tact no longer produces the same effects as it does on a membrane unaccustomed to it. But we shall hereafter (§§ 160-162) find reason to believe that such habitual use is not without its consequences, although these may be very remote; the continual.over-excitement of the vital activity of the gastric mucous membrane being probably.one of the causes of that premature loss of functional power which is observable in a great number of those who have accustomed themselves to the use of alcoholic liquors. This cause, how- ever, will seldom act alone; being usually combined with excess 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; and it stimulates this gland for a time to increased activity, one effect of which is to eliminate a portion of the alcobol from the blood—this sub- stance, according to Dr. Percy's observations, being detect- ible in the bile of animals poisoned by alcohol. Hence the Liver, like the stomach, is subject to habitual over-stimula- tion from the direct contact of alcohol with its substance. But we have seen that the presence of alcohol in the blood prevents it from acquiring its proper arterial character by passage through the lungs; and we shall hereafter find that it causes the undue retention in it of hydro-carbonaceous matters, which ought to be removed by the respiratory pro- cess. Hence, an undue amount of labor is thrown upon the Liver—one of the functions of this Gland being, to sepa- rate from the blood such hydro-carbonaceous matters as are 64 EFFECTS OF ALCOHOL not carried off by the respiratory organs; and this con- tinual overwork must predispose it to various disorders. 55. Acute and Chronic Inflammation of the Liver.—In tropical climates, acute inflammatory diseases of the Liver are among the most common of these disorders; and they are distinctly traceable, in a large proportion of cases, to that excess, both in eating and drinking, to which Europeans are unfortunately but too prone, being rare among the Na- tives, and almost equally rare among the Europeans who adopt the native manner of living. In this country, such acute diseases are comparatively rare; but there are certain remote consequences which are no less clearly traceable to chronic inflammation and degeneration, resulting from the excessive use of fermented liquors, especially when these are taken in the form of distilled spirits. The following is the account of the state of the Liver given by Dr. Peters {he. cit.), as presented in the seventy cases which he had an opportunity of examining: "In 'moderate drinkers,' the liver was generally 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, and its edges their normal sharpness. In those who had been more addicted to the use of spirits, the liver was still larger, its edges were more ob- tuse, and the patches of fat on its surface 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 off with ease." It is evi- dent that in all these cases the Liver was the subject of va- rious degrees of fatty degeneration, which takes place, on the one hand, as the result of deficient functional activity of the Gland, whilst, on the other, it is indicative of an excess of fatty matter in the system. 5Q. The peculiar conditions of the Liver known as "granular liver," and " hob-nailed liver," -or "gin liver," were comparatively rare in Dr. Peters' experience, being observed only in four or five cases; but they seem to, be much more common in this country; and its greater preva- lence may possibly be due to a difference in the character ON THE HEALTHY SYSTEM. 65 of the spirit usually employed by drinkers among the lower classes, Gin being here the most common, Rum and Brandy in the United States. These conditions appear to be de- pendent upon atrophy of the proper hepatic substance, with hypertrophy of the connecting areolar tissue; the former being apparently the result of the exhaustion of the func- tional power of the liver by over-excitement; and the latter to continual attacks of chronic inflammation, which produce the false membranes, adhesions, puckerings, &c, that give rise to the second of the designations just cited. Between the state of contraction (in which the Liver is frequently not more than half its usual size), and the state of enlargement just described, there is not that opposition which might at first sight appear; for in both is there diminished functional and nutritive activity of the proper substance of the gland; and the state of enlargement, which is simply dependent upon the accumulation of fatty matter, not unfrequently gives place to one of contraction. In fact, it would not seem improbable that each state may have a relation to the general disposition to the development of fat, in the indi- vidual ; for whilst in many habitual drunkards there is a great tendency to the production of fat, and to its deposi- tion in various parts of the body (§ 61), there is an equal tendency in others to a leanness which no fattening process will overcome.—Certain it is, however, that the habitual use of Alcoholic liquors has a tendency first to excite and then to diminish the functional activity of the Liver; and thus predisposes in the first instance to inflammatory diseases of the organ, whilst its more remote operation is to induce atrophy or degeneration. This will be especially the case in tropical climates; where several causes concur (as will be shown hereafter) to augment the injurious influence of Alco- hol upon the Liver, and consequently to increase the amount and severity of the diseases of that organ induced by its habitual use.—Of course, every disturbance of the function of the Liver must be an additional source of disorder in the digestive operations, in which the action of this gland has so important a share. Diseases of the Kidneys. 57. We have seen that a special determination of blood to the Kidneys takes place as one of the results of the recep- 6* 66 EFFECTS OF ALCOHOL tion of Alcoholic liquors into the blood; and these organs are thereby excited to augmented action, one of the pur- poses of which would seem to be the removal of the alcohol from the current of the circulation. As the blood of the Kid- neys is derived from the arterial system, in which the alco- hol 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 tend- ency 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 case), 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 inflamma- tion, 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 as Bright's Disease, or Granular Degeneration 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 unorgan- izable matters—a state, in faet, 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, with- out deserving this appellation, were in the constant habit of using ardent spirits several times in the course of the day; and the experience of English Hospital practice is (so far as the writer has been able to ascertain) precisely similar. The disease is very rarely met with in the private practice of those whose patients are of a class not given to excessive spi- rituous potations. Here, too, it would seem as if the nse of malt spirit (Gin or Whisky) gives a greater predisposition to the disease than that of Rum or Brandy; the former hav- ing a more diuretic effect .than the latter, that is, producing a greater temporary activity in the kidneys, and.having a greater tendency to bring about a state of chronic irritation. ON THE HEALTHY SYSTEM. 67 58. But we are not to suppose that, if this severe form of renal disease be not developed, the Kidneys escape alto- gether free. We should expect that the consequences of long-continued and habitual excitement would manifest them- selves in subsequent impairment of functional power, even if no obvious structural disease be engendered; and there can be little doubt that such is the case, since we find that persons advanced in life, who have habitually indulged freely, even if not excessively, in Alcoholic liquors, are extreme- ly apt to suffer from Gout, Rheumatism, and other disor- ders, which mainly depend upon the insufficient elimination of such morbid matters from the blood as ought to be car- ried forth through this channel (§ 6Q). Excesses in diet, which, at an early period of life, are counteracted by the activity of the excretory apparatus, are no longer thus pre- vented from giving rise to an accumulation of morbific pro- ducts in the blood, when the Kidneys begin to fail in the performance of their duty; and although we may not be able, with positive certainty, to attribute this failure to free indulgence in alcoholic liquors, yet it cannot be reasonably questioned that such habits must tend to produce it, since we find that over-excitement of any organ is regularly followed, sooner or later, by depression of its functional power, and have seen that the continual stimulation of the Kidney by alcohol has a special tendency to produce perverted nutri- tion, and thus to render it entirely unfit for the performance of its duties. Diseases of the Skin. 59. The determination of blood to the Skin, which has been noticed as one of the results of the ingestion of Alco- holic liquors, has a tendency, when frequently-repeated, to produce various disorders in its nutrition, chiefly those re- sulting from congestion or inflammation of its several.tissues. Such disorders show themselves especially in the skin of the face; and this for two reasons : because, in the first place, the face partakes in the general determination of blood to- wards the head, so that it becomes more flushed than any other part of the surface; and also because the exposure of this part of the cutaneous surface disposes it to be more af- fected than that of the body and limbs by external cold, which will always tend, by lowering the vital activity of any 68 EFFECTS OF ALCOHOL tissue, to increase the evils resulting from too copious a de- termination of blood towards it. Hence we find the skin of the face especially disposed to exhibit those Carbuncles, Boils, &c, which may be considered, in a large proportion of cases, as the direct result of habitual intemperance ; it is also the part in which the Erysipelatous attacks, so com- mon among the intemperate, most frequently commence, when they are not immediately excited by some injury else- where ; and it is on the face, too, that we most frequently meet with various forms of Acne, of which the Acne rosacea is, in a very large proportion of cases, directly attributable to intemperate habits. We have already noticed other dis- eases of the Skin (§ 51), which seem to be rather consequent upon the disorder of the digestive apparatus induced by the habitual free use of Alcoholic liquors, than due to the direct agency of the alcohol upon its tissue. There is a disease, how- ever, noticed by Dr. Darwin under the name of Psora Ebrio- rum, which may be attributed with great probability to a chronic though slight perversion of the nutritive operations of the skin, in consequence of the presence of alcohol in the blood. Of this disease, Dr. Darwin says: "Elderly people who have been much addicted 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 disease.* Most other cutaneous disorders, which are less directly- traceable to intemperate habits, are greatly aggravated by them ; so that strict abstinence from fer- mented liquors is an almost invariable rule in the treatment of them, unless the use of these in small quantities should be thought requisite to improve the state of the digestive function. General Disorders of Nutrition. 60. Having thus considered the principal forms of disease which the intemperate employment of Alcoholic liquors has a tendency to induce in the several parts of the Excretory apparatus, to which they seem to give a special determina- f Anatomy of Drunkenness, p. 178. ON THE HEALTHY SYSTEM. 69 tion, we have now to consider those General Disorders of Nutrition which are traceable to the same cause, and which manifest themselves either as substantive diseases, as modi- fying the course of other diseases, or as giving a special liability 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 func- tional 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 solid 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 intemperate, that they are in the habitually abstinent. Notwithstanding some appearances to the contrary, there is abundant evi- dence that such is the case. Although a high degree of bodily vigor seems to be exhibited by certain classes of men, who consume large quantities of fermented liquors, yet this is extremely deceptive, as the facts to be presently stated will clearly indicate; and the general result is evidently on the other side. 61. Tendency to the Deposition of Fat.—The immediate effects of Alcoholic liquors upon the general appearance of the body, especially as regards the deposition of fat, vary with their nature, and with the circumstances under which they are habitually used. Thus it is generally to be noticed that those who indulge largely in malt liquors become fat, and often exceedingly corpulent; the large consumers of wine commonly share the same tendency; but the spirit- drinker is more commonly lean and even emaciated. This difference may partly depend upon the constitution of the liquors; thus ale, beer, &c, contain a considerable amount of saccharine matter, which is either consumed in respira- tion, leaving the fatty matters of the blood to be deposited as fat, or is itself converted into fat; in wine, again, there is more or less of solid matter, which furnishes materials for combustion; whilst in distilled spirits, there is scarcely 70 EFFECTS OF ALCOHOL anything save the alcohol. But it also depends in part upon the amount of solid food habitually taken with the drink ; thus, the beer-drinker, if he be leading a life of great mus- cular 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 nei- ther 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 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 omentum 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 exhibits any considerable depo- sit of fat, except for some special purpose (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 accumulation 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 promoted, it is obvious that the muscular vigor and general " hardiness" of the system are much im- paired, the animal becoming liable to many disorders from which it was previously exempt, and requiring much more careful treatment to keep it in good condition. When, in- deed, 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 functional inactivity, f * Dr. Peters, he. cit. , t The following interesting case is recorded by Dr. Kobertson (Treatise on Diet, 4th Edition, vol. i. p. 272). The subject of it was a very young man, who died thus early from the intemperate use of spirits. For several months ON THE HEALTHY SYSTEM. 71 63. Diminished Power of Sustaining Injuries by Disease or Accident.—The classes of men among whom there is an appearance of remarkable bodily vigor, notwithstanding habitual excess in the use of Alcoholic 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 remarkable examples; 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 clown 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 Avell known to those who have observed the practice of the London Hospitals, that when such men suffer from inflammatory attacks, or from local injuries, these are peculiarly disposed to run on to a fatal termination; in consequence, it is evident, 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 pro- cesses an asthenic instead of a sthenic character; there is no limitation by plastic 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 stimu- lants 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 before his death, he had been-unable to eat more than a very small quantity of food, and his powers were almost exclusively maintained by frequent dram drinking. The immediate cause of death was cerebral " ramollisse- ment;" but although the body was much attenuated, the muscular fibre of tiie system much wasted, and the subcutaneous fat of the extremities had alqpost 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. * See Appendix A. 72 EFFECTS OF ALCOHOL affected with inflammation rapidly become infiltrated Avith pus, or pass into a gangrenous state. Hence 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 the highest possible health, by active exercise, abundance of nutritious food, occasional mild purgation, and either entire abstinence from fermented liquors, or by the very sparing use of them. Men thus " trained" recover with remarkable rapidity from the severe bruises which they are liable to receive. 64. Although there are now few men who habitually take wine to a corresponding extent, or who maintain by active exercise in the open air anything like the same muscular vigor, yet such examples are occasionally met with among the fox hunting country squires, 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, not- withstanding their appearance of vigor, they are bad sub- jects for medical or surgical treatment, owing to the imperfect condition of their nutritive functions. Among the spirit- drinkers of our large towns, it is notorious that the nutritive and reparative powers are low; and of this fact we have a remarkable illustration in the frequency, among the intem- perate, of a certian form of phagedenic ulceration, whose origin is sufficiently indicated by the term " Geneva-ulcer," by which it is commonly known at Guy's and other metropo- litan hospitals. This ulcer, usually commencing on the leg, begins as a red, angry, 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 con- fined, however, to gin-drinkers, but is occasionally met with in the bloated, plethoric, red-faced wine-bibber. 65. Liability to Epidemic Diseases.—Another most im- portant indication of the disordered state of Nutrition, consequent upon habitual excess in the use of intoxicating liquors, is the liability of the intemperate to suffer from various other morbific causes, especially those of an Epi- demic or Pestilential nature. On this last point there is, ON THE HEALTHY SYSTEM. 73 the writer believes, no difference of opinion amongst Medical Practitioners in any part of the world ; all being agreed that the habitual drunkard is far more likely to suffer from such agencies than the habitually sober or temperate man. Whether habitual abstinence is still safer than habitual moderation, is a point which cannot be so easily ascertained; some considerations on this subject, however, will be offered hereafter (§§ 141-150). The peculiar liability of the habit- ually intemperate to suffer from the Cholera-poison is well known. The following circumstance, which occurred during the former epidemic- of Cholera, is "very significant on this point; especially showing that the state 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 we're much given to Alcoholic potations (with the idea, probably, of increasing their power of resisting the malady) during their leisure hours; and they were therefore confined to the Hospital, and debarred from obtaining more than a small allowance of alcoholic drink; after which not a single fresh case oc- curred among them. During the present epidemic, the writer has learned from various sources that a considerable proportion Of those in whom the liability to the disease was not evidently produced by the condition of the locality in which they resided, might be considered as deriving a pre- disposition to it from habitual Intemperance—many estab- lishments having lost those men, and those only, who had been accustomed to free indulgence in the use of alcoholic liquors. The general connection between the intemperate habits of a population, and its high rate of mortality from various causes, will be shown hereafter; and a high rate of mortality is always indicative of a large amount of sickness, although the ratio between the two is by no means constant. 66. Gout and Rheumatism.—Among the general dis- orders of nutrition, to Avhich the intemperate use of Alco- holic 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 7 74 EFFECTS OF ALCOHOL a use of alcoholic liquors, as stimulates the stomach to digest more azot;zed aliment than the system can appropriate. This may be regarded as the fundamental cause of the disease, when it occurs in its sthenic form. Of the ulterior stages of it, we yet know too little to enable us to trace with certainty the effect of alcohol upon each of them; but this much is pretty certain—that an impaired condition of the nutritive operations will be favorable to the production of the materies morbi, whatever be its nature;—that this will be further promoted by any impediment to the due oxidation of the constituents of the blood, such as the ad- mixture of Alcohol has been shown to occasion; and that the elimination of this morbid matter will be obstructed by that torpid condition of the Liver and Kidneys, to which these organs are especially liable in those who have habitu- ally over-excited them in earlier life (§ 58). In the pro- duction of Rheumatism, also, we may clearly trace the aggravating influence of habitual excess in the use of alco- holic 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 oxygenation presented by the presence of alcohol in the blood, will cause it to be retained, and to accumulate there, instead of being burned off (which it ought to be, as fast as formed) and escaping from the lungs in the condition of carbonic acid and water.* Here, again, the torpor of 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 matter; and in Rheumatism, as in Gout, the intensity of the inflammation can scarcely but be aug- mented by the diathesis induced by the habitual presence of alcohol in the blood.—All these predictions arc verified by the experience of every practical man. 67. Diseases of the Heart and Arteries.—Closely con- * This idea of the influence of alcohol in conducing to the retention of lactic acid, and thereby favoring the rheumatic diathesis, is confirmed by the success of Dr. G. O. Rees's method of treating Rheumatism by Lemon juice; the rationale of which seems to be, that the citric acid affords a large and ready supply of oxygen, whereby the lactic acid (or materies morbi, whatever it be) is burned off. ON THE HEALTHY SYSTEM. 75 nected with the gouty and rheumatic diatheses are Diseases of the Heart and Arteries; of which, some obviously arise out of these constitutional states, and are thus indirectly favored by the abuse of Alcoholic liquors; whilst others seem to be more directly dependent upon the introduction of alcohol into the blood. The continual but irregular ex- citement of the contractile action of the heart and arteries, which is the result of the habitual use of stimulants, must of itself predispose their tissues to disease; and this pre- disposition will of course be increased by the contact of blood charged with alcohol with their lining membrane, as well as by the general disordered condition of the nutritive operations. Now, attacks of acute Arteritis seem not un- frequently traceable to alcoholic intoxication ; and it cannot therefore, be regarded as improbable, that those more chronic disorders of their walls, which give rise to Aneurism, soft- ening, fatty degeneration, and other structural charges, and which thereby predispose to hemorrhage, should be favored, if not absolutely produced, by the habitual presence of alcohol in the circulating current. Accordingly, we find the intemperate use of alcoholic liquors specified by authors on the Diseases of Arteries, as among the most important of their predisposing causes. 68. Spontaneous Combustion.—Although the phenome- non termed " Spontaneous Combustion" of the Human body is one of such rarity, that it might seem scarcely to deserve to be ranked among the ordinary results of habitual excess in the use of Alcoholic liquors, yet it should not be passed by in any inquiry into the consequences of such ex- cess ; more especially since it may be regarded with much probability, as resulting from the same kind of perverted nutrition, carried to an extreme degree, as that to which we have already traced various other consequences. It would be more correct to speak of these cases as instances of unusual combustibility of the body, than of really spon- taneous combustion ; since, in scarcely any of them, perhaps in none, does there seem adequate evidence that the com- bustion originated without the contact of external flame; their real peculiarity consisting in this—that whereas, an ordinary human body requires a large amount of wood, coal, or other inflammable material for its combustion, the body in the subjects of this accident takes fire very readily, and 76 EFFECTS OF ALCOHOL burns as if it were itself highly inflammable. In some in- stances, 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 remarkable 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, perhaps, 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 phos- phorus 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 effect this conversion, it, is to be expected that the phos- phorus would be retained in the fluids, and possibly depo- sited again in the solids; and since we have seen that the continual presence of alcohol in the circulation gives even to arterial blood a venous character, it is not difficult to understand how such a retention of the phosphorus destined for excretion should be favored by habitual intemperance. It is a remarkable confirmation of this view, that the breath of drunkards has been sometimes observed to be luminous, a3 if it contained the vapor of phosphorus or of some of its compounds; and that it has been found by experiments upon dogs, that if phosphorus be mixed with oil and in- jected 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 con- stitutional, in the production of which we can trace the operation of the habitually excessive use of Alcoholic stimu- lants, with tolerable directness. It would be easy to extend * 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. ON THE nEALTHY SYSTEM. 77 this catalogue by the inclusion of other diseases which are manifestly aggravated by intemperate habits; but this, in fact, would require the enumeration of almost every disease to which the human body is subject, more especially if In- flammation participate in it. But the writer thinks it pre- ferable to limit his statements to the cases in which the chain of causation is most continuously and obviously trace- able. It has been his object throughout to show what con- sequences might be expected to arise from habitual "intem- perance;" regard being had to the facts which have been fully ascertained, with respect to the modus operandi of alcohol 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 secreting organs, of the skin, of the heart and arteries, and of the organic fluids and solids in general, might be thus anticipated; and that such anticipations are all completely verified by the results of practical observation. We might now push the investigation further, and inquire what evidence we have in regard to the consequences of the habitually " moderate" use of alcoholic liquors on the human system. It must be freely admitted, however, that we have not the same data for the determination of this question, as 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 "temperate" use of alcoholic liquors, and the shortness of the time during which Total Abstinence has been hitherto practiced by any large number of individuals, render it difficult, if not im- possible, to draw any valid inference, as yet, from compa- rative observation. But the writer would argue, that if we have such a complete accordance between the predictions of Theory and the results of Observation, in regard to the consequences of habitual " excess," as establishes the rela- tion of cause and effect beyond dispute; we have a strong case in favor of such a relation, when, the cause being in less active operation, 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 7* 78 EFFECTS OF ALCOHOL 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 ALCOHOLIC 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 Alco- holic liquors to shorten life ; either by themselves giving rise to the diseases above enumerated, or by increasing the susceptibility 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 accus- tomed to the excessive use of alcoholic liquors, contrary to his statement in his proposal for insurance, the Policy is declared void. And it is, doubtless, owing in part to the superior sobriety of the great bulk of Insurers over that of the average of the population, that a lower rate of mor- tality presents itself amongst them, than that which might be expected according to the calculations founded on the entire mortality of the country—to the great profit of the Office. Thus at the 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 Offiees, it is about 11 per 1000; and in those insured in Friendly Societies, it is about 10 per 1000. Now the average mortality for all ages between 15 and 70 years, is about 20 per 1000; where- as in the Temperance Provident Institution, after an expe- rience of eight years, and with several lives above 70 years of age, the average mortality has been only 6 per 1000, up to the present season, in which it has undergone a slight increase from the Cholera epidemic. It is worthy of re- mark, however, that although many of the insurers in this Office are of the poorer class, whose condition and employ- ments expose them much more than the middling classes generally to the endemic causes of Cholera, no more than 8 have died of this disease, ou't'of the total of about 3500 insurers. As a means of further comparison, the following table may be subjoined, in which the mortality of the in- surers in the Temperance Provident Institution, for the first N s ON THE HEALTHY SYSTEM. 79 five years, is compared with that of the insurers in other Offices during the corresponding period of their existence. LIFE POLICIES. DEATHS. "'V •- "\\ % A issued 944 and had 14; being equal to 15 per thousand. M V) B " . 1901 " 27 " 14 " <\£^ V\Wi c " 838 "11 " 13 4J \^v D " 2470 " 65 « 26 « ^ J^ Tpiu 15% „ 12 „ 7£ " £ V During the sixth year of its existence, only two deaths V occurred out of the whole number of insurers in the Tem- J\^ > >vperance Provident Institution, by which its annual average ^Vof mortality was reduced still lower. ^ v \ ^ 70. Such comparisons, however, must not be regarded as s ^ ^ - demonstrating that the usual rate of mortality among ' 4.2 " moderate" or "temperate" men is reduced to half its \*^ ^ j amount by " total abstinence;" since other causes have "\ doubtless concurred to keep down the mortality in the Tem- ,N perance Provident Institution—such as a more healthful N,s ~: ? condition of the class which has furnished most of the in-v* X ' surers—or a more favorable distribution of ages. But it \ .; A . will be seen to be impossible that either of these separately, ^ ~ ■v _■ or both conjointly, should have occasioned the whole of the ^ "j i. difference above pointed out; the annual average, 6 per A ^ AlO00, being no higher than that of the age of 15, which is - ^ more favorable than that of any other period of life. And T^we appear fully justified, therefore, in attributing a part of the result to the abstinent system practiced by the Insurers v. s^in the Temperance Provident Office. v j v 71. The influence of excess in the use of Alcoholic liquors < ^ *"in directly producing sickness and mortality, or in predis- ^* ^i ~, posing to it, is most remarkable in tropical climates, and espe- *^ / ^y Jcially in such as are otherwise unhealthy. £ It would seem, y\^ * ^indeed, that the more unhealthy the station, the more freely i -^ V Jdo the residents at it indulge in the use of alcoholic stimu- ? * ^ slants;(either from the mistaken idea that they enable them to v* v" ^withstand the effects of the climate, or from the desire that „,' „ their life, if short, shall be a merry one. J Some years since, ^ the writer, being himself in the , Island of St. Vincent in 1 V the West Indies, met with a gentleman resident in Tobago, \ who informed him that the average annual mortality amongst '-{,>!• the Europeans of that island was about one in three. Upon lv and which is already retarded by the diminution in the activity of respiration. We shall presently find that experience is * We are of course 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 thirst, is of quite a different character. 128 SUPPOSED USES OF ALCOHOL 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 alco- holic liquors than with their habitual use. 135. The stimulative effects, from which Alcoholic liquors derive their reputation as supporters of bodily vigor, during habitual exposure to a heated atmosphere, are exerted in two ways; in the first place, by giving temporary assistance to the digestive process; and secondly, by increasing, for a time, the nervous and muscular power. It is commonly supposed that the diminution of appetite which is expe- rienced by most persons who change their residence from a temperate country to a hot one is the result of the ener- vating influence of the climate; whereas the fact is evident to those who take into account the proportionally smaller amount of carbonic acid exhaled as the external tempera- ture 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 pur- pose 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 de- rived from the abuse of fermented liquors, 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 stimu- lants as an artificial provocative to the appetite, whereby the blood becomes charged with more alimentary 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 peculiarly 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 diminution in the appetite is ex- perienced by most persons during the heat of summer; and if the warning be not lost, the amount of food ingested is proportioned to the demand. But those who from habit con- tinue to take in their usual supply, are extremely liable to be warned of the impropriety of such a course by hepatic de- IN SUSTAINING THE VITAL POWERS. 129 rangement; and the bilious 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 altogether abstained from fruit), seems to find a rational explanation in the accumulation of excrementitious matter, which must be the consequence of habitual excess in diet—especially when the stomach is sti- mulated by alcoholic liquors 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 influ- ence of Alcoholic liquors upon the nervous system, whereby it is enabled to put forth increased power so long as this in- fluence lasts, is exerted in any other mode, when the body is habitually exposed to a high temperature, than that in which it operates under ordinary circumstances. That the excite- ment must be followed by subsequent depression, is as true in India as in England; and that this excitement, if habitu- ally had recourse to, will be followed in hot climates by consequences 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 ac- tivity 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 sti- mulants, or at most the very sparing use of them, is favor- able to the endurance of extreme heat, especially when great bodily exertion is required. And we shall first cite the evi- dence of the late Mr. Gardner,* a well-educated surgeon, who spent several years of most active exertion in the ex- ploration of the Botany of Brazil, into which country he penetrated further than any scientific European had pre- viously done. During three years' travelling in that climate, he tells us,f under constant fatigue and exposure to vicissi- » The author has been informed by an intimate friend of this gentleman, that his lamented death, which took place from a coup de soleil, whilst holding the appointment of Superintendent of the Botanic Garden at Ceylon, was en- tirely due to the injudicious and almost fool-hardy exposure to which his con- fidence in his vigor led him to subject himself. j" Travels in Brazil, p. 402. 130 SUPPOSED USES OF ALCOHOL tudes of weather and irregularity of living, his only beverage, besides water, was tea, of which he had laid in a large stock previously to his departure from Pernambuco. He was told when he arrived at Brazil, that he would find it necessary to mix either wine or brandy with the water which he drank ; but a very short experience convinced him, not only that they are unnecessary, but that they are decidedly hurtful to those whose occupations lead them much into the sun. "Whoever drinks stimulating liquors," he says, "and travels day after day in the sun, will certainly suffer from headache; and in countries where miasmata prevail, he will be far more likely to be attacked by the diseases which are there en- demic." 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 established himself.—So, again, Mr. Waterton, the well-known traveller, speaks of himself as confident that the preservation of his vigor, dur- ing 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 exertion ; 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 alcoholic than our ginger-beer. The following testimony, given by Doctor Mosely in his work on Tropical Diseases, may be added to the foregoing: "I have ever found," he says, "from my own knowledge and custom, as well as from the custom and observation of others, that those who drink nothing but water, or make it their principal drink, are but little affected by the climate, 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 peculiarities of individual constitution, it will be preferable to have recourse to cases in which large bodies of men are included. IN SUSTAINING THE VITAL POWERS. 131 140. The following statement, which the writer has re- ceived from an officer in the regiment to which it refers, proves that our English soldiers in India not only do not suffer from, but are absolutely benefitted 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 hundred 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 soldiers on the march in India almost invariably take. Half way on the day's march, the regiment halted, and an- other 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 commanding officer employed the most judicious precautions to prevent the men from obtaining arrack in the villages on the route; and his exertions were effectively seconded by the zealous co-operation of the other officers, and by the admi- rable 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 this water system were shortly these: Although the road is proverbial for cholera and dysentery, and passes through several unhealthy and marshy districts, the men were free from sickness to an ex- tent absolutely unprecedented in our marches in India; they had no cholera and no fever; and only two men were -lost by dysentery, both of whom were old chronic cases taken out of hospital 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 132 SUPPOSED USES OF ALCOHOL 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 was far below their usual allowance. Those who entirely abstained were certainly in no respect inferior, either in power of sustaining exertion or in freedom from sickness, to those who occasionally took small quantities of spirits; on the contrary, they rather seemed to have the advantage. That this remarkable result was not due to any peculiar healthfulness of the season, or other modifying cir- cumstance, 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 men out of a strength of 400; and that it had so many sick that, when it met the 84th on its march, it was obliged to borrow the spare " dhoolies" (or palanquins for the sick) belonging to the latter.* 141. The foregoing account fully accords with that given by Sir James (then Mr.) McGrigor, of the march in Egypt of a division of the British army sent from Hindustan to aid the main army in opposing the French under Bonaparte. After the Great Desert had been crossed, in July, 1801, no spirits were issued to the troops in Upper Egypt, owing to a difficulty in procuring carriage for them. At this time, there was much fatigue-duty to be performed ; which, for want of followers, was done by the soldiers themselves; the other duties were severe upon them; they were frequently exer- cised, 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; but at no time was the Indian army more healthy.\ . 142. The intimate acquaintance of Sir Charles Napier with the habits and wants of the Indian soldier can be doubted by no one; and the following is his testimony in favor of the abstinence system (delivered in his own charac- * The marked contrast between the rate of mortality in the 63d and 84th Regiments, during their respective residences at Secunderabad during two consecutive years, has been already noticed (§§81, 82) ; but ft maybe as well here to remind the reader that the former lost 73 men in nine months, which was at the rate of 7S.8 per 1000 of average strength for the entire year; whilst the latter lost but 39 men in the whole twelve months, being at the rate of 34.2 of average strength. ■f Medical Sketches of the Expedition from India to Egypt, p. S6. IN SUSTAINING THE VITAL POWERS. 133 teristic 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 de- stroyed. 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 drink- ing. 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 with a view of sus- taining the power of exertion in tropical climates, is dearly purchased by the increased liability to disease, which not only theoretically, but according to all competent evidence, actually results from their habitual use. And thus Theory and Practice are again completely agreed, in affording a de- cisive contradiction to the usually received idea that Alco- holic liquors assist the body in the endurance of Heat. V. RESISTANCE TO MORBIFIC AGENCIES. 144. It is a common idea, and one apparently supported by adequate evidence, that such a use of fermented liquors as aids in keeping the body in "high condition," renders it less susceptible of the influence of pestilential miasmata, of cold and damp, or of other morbific agencies ; and this be- lief is entertained by many, who deprecate the habitual use of fermented liquors under other circumstances. Thus, says Dr. Macnish, " I am persuaded that while, in the 12 134 SUPPOSED USES OF ALCOHOL tropics, stimulating liquors are highly prejudicial, and often occasion while they never prevent" disease, they are fre- quently of great service in accomplishing the latter object in damp foggy countries, especially when fatigue, poor diet, agues, dysenteries, and other diseases of debility are 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 abstinent."* These assertions he endeavors to jus- tify by the two following statements : "At Walcheren, it was remarked 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 ; and the natives generally insisted upon doing so before going out in the morning."| Again, " A British regiment 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 extremely 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."| 145. Now ft is obvious that neither of these facts proves that exposure to the morbific agencies in question renders an allowance of spirits necessary, or even beneficial, for those who have not been accustomed to make use of it under ordinary circumstances. On the contrary, the second instance is a valuable testimony to the disadvantage of habitual dependence upon alcoholic stimulants ; inasmuch as it is evident that, when they were withheld from the troops, the constitution of the men was rendered peculiarly suscep- tible to the causes of disease 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 which every medical practitioner is aware), and that, in per- * Anatomy of Drunkenness, pp. 277, 279. ■J" Glasgow Medical Journal, No. xv. J Op. cit. IN SUSTAINING THE VITAL POWERS. 135 sons who have habituated themselves to the use of spirits, such depression is liable to supervene when the allowance is withheld, and may be for a time kept off by its restora- tion. And even the first example cannot be said to prove more than this ; for it simply gives us the experience of in- dividuals who took an early dose of spirits, as compared with that of the individuals who abstained from this habit; without telling us that the latter adopted any of those sub- stitutes which prudential experience would dictate. 146. The writer is strongly impressed with the belief that the result, in this and in many similar cases, is to be attributed to the neglect of such precautions. It is well known that, in localities where zymotic poisons are indi- genous, no condition of the healthy system is so obnoxious to their influence as that which is natural to it on first rising in the morning, when the stomach is empty, the pulse com- paratively feeble, and the heat-producing power nearly at its minimum. The nutritive actions which have been taking place during repose have prepared the nervous and mus- cular 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 experience of most persons that nervous and muscular exertion is less efficiently sustained,* and exter- nal cold less fully resisted, at this period, than at any other ; and tile recommendation of experience to " take something to keep the cold out of the stomach" is here fully justified upon physiological principles. But it does not hence follow that alcoholic stimulants constitute the best means of pro- tecting 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 permanently beneficial effect. 147. A man, previously in the enjoyment of vigorous health, and not accustomed to depend upon alcoholic stimu- » The writer can speak feelingly on this subject; being himself unable to walk a couple of miles upon the empty stomach of early morning, without extreme languor almost amounting to syncope; although four or five times that amount would usually be performed by him after breakfast with scarcely an approach to fatigue. 136 SUPPOSED USES OF ALCOHOL lants, 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 influence is to be resisted; and the moderate use of hot tea, coffee, or cocoa will help to diffuse a genial warmth through his body which is more enduring than that which results from the ingestion of spirituous liquors. In this way, the stomach will be wholesomely employed, new material will be supplied to the blood, the circulation will be quickened without being excited, the firmness of the pulse will be increased, and the heat-producing power will be augmented; and all this in a manner strictly accordant with the normal economy of the bodily system.—On the other hand, although the use of spirits, by producing a temporary excitement of the circu- lation, will probably render the system less obnoxious to morbific agencies than if it be exposed to them before its dormant energies have been in any way aroused, yet we can scarcely anticipate that they can be as favorable to the sustenance of its energy (a previously healthy and vigorous condition being supposed), as persistence in the regular habits to which it has been accustomed. For it has been already shown that the continued endurance of cold is not favored by the use of alcoholic liquors, but on the contrary is impaired by it; and where cold, therefore, acts concur- rently 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 efficient 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 without the assistance of alcoholic liquors, the operation of morbific agents will be more efficiently warded off by a continuance of the abstinent plan than by recourse to stimulants; pro- vided that the same precaution be exercised by the disciple of abstinence as by the spirit-drinker, in not exposing himself to the morning air without a fortification of " the inner man." For we do not see that the circumstances of tropical or those of cold or temperate climates differ as regards the susceptibility of the system to zymotic poisons, IN SUSTAINING THE VITAL POWERS. 137 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 absti- nence from spirits diminishes, instead of increasing, the liability of the body to 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 (§§ 1,38, 139), in addi- tion 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 dysen- tery," without a -single fresh attack of these complaints (§ 140). Here the ".pint of hot coffee and biscuit" were certainly 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 coffee 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 super- venes 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 liquors, which, if sufficient to pro- duce either general stimulation, or excitement of any one function, must involve as its consequence a corresponding diminution of the normal activity at some subsequent period. It is quite true that this 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 alcoholic stimulus; to which the beneficial result will then be probably attributed. But the trial is not com- pleted in weeks, months, or years; it must last for the whole of life; and if it be true, as we shall presently en- deavor to show, that the continued emplovment, however 12* 138 SUPPOSED USES OF ALCOHOL moderate, of small quantities 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 influ- ence of zymotic poisons and other morbific agencies. It is well known that persons of regular habits and good ordinary health, who have long resided in countries where intermittent fevers prevail, are frequently attacked by them when their vital powers begin to decline with advancing years; and if that decline be hastened by the previous over-excitement of alcoholic liquors, the influence of these morbific causes will be earlier and more powerfully exerted. 150. These theoretical deductions are not merely sanc- tioned by such results of experience as can be brought to bear directly upon them; for they are in complete harmony with the facts universally admitted, in regard to the pecu- liar susceptibility of habitually intemperate persons, and especially of those whose constitutions have been broken down by the combined influence of intemperance and ad- vancing years, to attacks of fever, cholera, and other pesti- lential 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 rea- sonable to attribute to the same cause, acting with dimin- ished intensity, but over a longer period of time, a result of a similar nature; even though this may be so long post- poned, that its dependence on that cause is in danger of being overlooked. 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 maybe maintained, under circumstances usually regarded as most trying to the power of bodily and mental endurance, without the assistance of Alcoholic stimulants. Such evidence is afforded by the numerous ships that are travelling every part of the wide ocean, whose crews, pledged to the total abstinence princi- ple, maintain a degree of health and vigor which cannot be surpassed; by the many workshops of every kind, in which the severest labor 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 IN SUSTAINING THE VITAL POWERS. 139 torrid zone, and through the pestilential atmosphere of tro- pical marshes, who find the " cup of cold water" more re- freshing 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 have given the principle of Total Abstinence a fair trial, and have borne their willing testimony to its beneficial results. And where such is the case, there can scarcely be a question that this system is preferable to the habitual use, however moderate, of fer- mented 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 en- ergy, and supply to the absorbent vessels the material for fresh blood in a state of due preparation ; if the circulation be carried on with that equable regularity wdiich 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 exercise, and introduce the oxygen- which.is needed for a renewal of the effort; and if the liver, kidneys, and skin, by the constant discharge of their respective offices, eliminate from the blood the other 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 constitute health, why should we attempt to alter them by means of agents, which, if they produce any effect whatever on the system, can only operate by pro- ducing a departure from that perfect'balance of. the several parts of the- nutritive functions which it is so desirable to maintain, and so difficult to restore when perverted ? Let us examine these questions in more detail. VI. CONSEQUENCES OF THE HABITUAL "MODERATE" USE OF ALCOHOLIC LIQUORS. 152. Effect upon the General System and Excretory Organs.—If the natural appetite be already good enough 140 SUPPOSED USES OF ALCOHOL to give a relish to the food which the system requires, can the artificial production of an increased appetite be neces- sary or desirable ? And if the stomach be already 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 consequences result from forcing it to dispose of more ? Two classes of evils may be expected to proceed from such a system ; in the first place, the habit- ual introduction of more alimentary material into the cir- culating current than the nutritive functions can appro- priate, must predispose 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 gradually impaired. 153. The effect upon the system-at large of an habitual introduction of more alimentary material than the nutritive functions can appropriate seems to vary with the tempera- ment. In some individuals, they are converted into blood, so that the normal amount of that liquid undergoes an aug- mentation ; thereby inducing a state of plethora, which is favorable to local congestions and inflammatory diseases of various organs, and which especially predisposes to hemorrhage—this being an effort of nature, to relieve the undue turgescence. But in other constitutions, the super- fluous aliment wTould 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 superflu- ous non-assimilated matter; and hence they are brought into a state of undue functional activity, which cannot but render them peculiarly susceptible of derangement. The exeretory action of the lungs, however, is chiefly regulated (as already shown, § 127) by the temperature; so that, when it is diminished by external warmth, more remains to be accomplished by the other depurating organs ; and hence any excess in diet is more likely to have a prejudicial effect 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, disorder? both of the IN SUSTAINING THE VITAL POWERS. 141 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 occasions an undue de- termination 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 dispos- ing of the superfluity of azotized aliment; a considerable amount of urea being daily excreted through the former channel.* This result of what is accounted the " moderate" use of alcoholic liquors in warm climates, for the purpose of increasing the appetite and stimulating the digestive powers of the stomach, is much dwelt upon by writers on 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 digest- ive powers of the residents in such climates, which, by occa- sioning the habitual ingestion of more food than the system requires, are among the most fertile sources of tropical dis- ease. 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 opportuni- ties, therefore, in the study of tropical diseases, of perceiv- ing 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 * See the experiments of Dr. Landerer of Athens, in Brit, and For. Med.- Chir. Review, vol. i. p. 541. 142 SUPPOSED USES OF ALCOHOL upon the general system ; even though it may be for a time sufficiently compensated by increased^activity of the excret- ing organs. And the disorders of -the Liver and Kidneys which are so frequent among those who have been accus- tomed 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 of the abdominal viscera which so much more speedily follow upon habitual excess in warm climates. For the excreting organs cannot be always kept in a con- dition of excessive activity; like other parts of the system, they suffer sooner or later from too great an exaltation of their function ; and if this should not pass, as it often does, into an inflammatory condition, it is almost certain to be remotely followed by a state of depressed activity, in which the nutrition of the organ becomes impaired, so that it is left, 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 experience. The con- sequences are so remote, that we may not appear to be jus- tified 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-continued 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 imme- diately injurious effects. Thus, a man who would be rapidly suffocated by immersion in an atmosphere of carbonic acid may live for weeks, months, or years in an atmosphere slightly contaminated by it, without experiencing any evil effects which he can distinctly connect with its influence; and yet who will now deny that the constant action of this minute dose of aerial poison is insidiously undermining 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 IN SUSTAINING THE VITAL POWERS. 143 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 concentrated form, becomes after a time afflicted with intermittent 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 imperfectly carried off, and to be not merely charged with the malaria of vegetable decomposition, but with the miasmatic 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 almost every morbific 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 drain- age and the higher Tate of mortality in undrained localities, although not only days and weeks, but months and years, may he required for the operation of the cause upon the ani- mal system. 157. Should we not then be running counter to all ana- logy, if we do not hold ourselves ready to admit that such an habitual excess in diet as is favored by the moderate use of Alcoholic stimulants, and a consequent habitual over- exertion of the excretory organs, must be likely to have re- motely injurious results ?—and are we not justified in assum- ing a relation of cause and effect to exist, when we find such results occurring precisely as we should predict? If the medical man has no hesitation in regarding those severer derangements of the excretory organs which are so com- mon amongst those who commit habitual excesses in eating and drinking as the consequence of those excesses, why should he refrain from attributing the milder but more pro- tracted 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 144 SUPPOSED USES OF ALCOHOL 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 postponed its evil con- sequences to a remote period, but has kept himself free from them altogether. The onus probandi 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 effects of the " moderate" use of Alcoholic stimulants upon the excretory organs, as consisting simply in augmenting 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 under which it will be convenient here to examine its results; namely, the direct influence of the alcoholic stimulus upon the organs themselves. This influence 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, in- creasing 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 man- ner, 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 excessive degree, so surely must its vital powers be pre- maturely 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 considerable pro- portion of those chronic disorders of the excretory organs, to which reference has been more especially made, to the habitual employment of alcoholic liquors in what is ordi- narily considered to be a " moderate" amount, and regarded IN SUSTAINING THE VITAL POWERS. 145 as perfectly consistent with health, if not required to main- tain it. 159. It would be absurd, however, to affirm that such dis- eases always proceed from this cause; since those who prac- tice Total Abstinence from alcoholic liquors are by no means proof against other errors in dietetics; and in so far as they habitually take in more food than their system 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 have committed, if the stomach refuses to digest the superfluity, instead of being forced by artificial stimulation to an undue exertion of its power; and an attack of indigestion, by early giving a salutary check to the practice, may ward off its remoter consequences. It is the freedom from such checks, up to a certain time of life, which encourages in those who habitually use fermented liquors in "moderation," and who at the same time practice habitual though slight excess in the amount of solid food which they consume, the delusive belief that in neither case are they doing themselves any harm. 160. Effect upon the Stomach.—Such, then, are the con- sequences to the system at large, which Theory and Expe- rience join to indicate, as resulting from such an habitual use of Alcoholic liquors as stimulates the appetite to desire, and the stomach to digest, a larger amount of food than is necessary to supply the wants of the body; and we have next to inquire into the effeets it produces upon the Stomach itself. We have already described the admitted results of what is commonly regarded as " excess;" and we shall there- fore at present limit ourselves to the inquiry, whether the "moderate" use of alcoholic liquors is likely to be productive of any injurious consequences, as regards this important organ. All our knowledge of the action of stimulants would lead to the conclusion, that, when once the habit of employ- ing 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 in- fluences, 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 13 146 SUPPOSED USES OF ALCOHOL himself completely unable to sleep without it. And expe- rience 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 ex- citement 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 over- tasked, 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- that, whilst a potent dose of a poison speedily manifests its action by the violence of its effects, the repeated introduction of minute doses is not really inoperative, al- though the effects are not speedily apparent. If the stomach be not an exception to the general law of the action of 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 premature depres- sion; and that the result of the moderate use of alcoholic stimulants will manifest itself, sooner or later, in diminution of the digestive power. The earliest indication of this, in most instances, is the demand for the augmentation of the stimulus to produce the same result; the amount which was at first sufficient to whet the appetite and increase the digest- ive power, being no longer found adequate. If the demand be yielded to, and the quantity of the stimulus be augmented, the original benefit seems for a time to be derived from it; but, after the stomach has become tolerant of the liquor, that which at first excited it to 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 IN SUSTAINING THE VITAL POWERS. 147 by that "loss of tone" of the stomach which is so common an attendant of advancing years, for the too great activity to which the organ has been previously forced, during the long period of early and middle life. And although the common idea, that alcoholic liquors, when taken in small quantities, have a tonic property, may render it difficult for some to coincide in the conclusion that the real effect of the habitual use of even this small quantity must be of the oppo- site 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 pre- vent 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 habit- ual 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 manifestation of any in- jurious results; whilst, on the other hand, it cannot but be admitted that the disorder in question may be induced in other ways. But the existence of exceptional cases by no means invalidates the argument based upon general expe- rience, any more than our occasionally meeting with indi- viduals who have daily consumed a bottle of spirits, and have yet enjoyed a hearty old age, warrants us in rejecting the evidence which indicates that such a consumption would have, in by far the larger proportion of mankind, a decided tendency to shorten life. Nor does it follow that, because the loss of digestive power may be justly attributed to other causes when this one has been wanting, it has been inopera- tive 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 alcoholic liquors on the ground that it keeps them "up to their work," the expenditure of nervous power, consequent upon that un- due exertion of the cerebral functions which has been aided by the continual over-stimulation, has a large share in the result. 148 SUPPOSED USES OF ALCOHOL 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 exer- tion, depression of spirits, want of appetite, enfeebled diges- tion, and the whole train of disordered actions which is consequent upon this condition. It is not to be denied that such a state may arise, quite independently of the agency, direct or indirect, of habitual 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 individual 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 stimulants, than without them; and thus the delusion is kept up, that the strength is not really overtasked: when the fact is, on the contrary, that the prolongation of the term of over- exertion, by the repeated application of the stimulus, is really expending more and more of the powers of the nervous system, and preparing for a more complete prostration at a later period. 164.. The temporary advantage, then, which is thus gained, is very dearly purchased. The man who habitually abstains, not merely from alcoholic liquors, but from other artificial provocatives (misnamed supports) to the endurance of men- tal activity, is early warned by the failure of his intellectual energy and cheerful tone of spirits, that he is overtask- ing 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; IN SUSTAINING THE VITAL POWERS. 149 for, as the excessive expenditure of nervous power has been greater, so is the exhaustion more complete; and as the sto- mach has been longer over-excited and overtasked, its tone is the more seriously injured, not merely by the depression consequent upon its own over-work, but by the impairment of the nervous power which is required for its due activity. Thus, then, although the consequences of habitual over-exer- tion of the brain may be less speedily felt, when the stomach is kept up by alcoholic stimulants to a state of extraordinary activity of supply—and although, in like manner, the habit- ual use of alcoholic stimulants may cause the stomach 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 appa- ratus 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 Jength of time then required for the cure is proportional to the duration of the causes Avhich 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 physiologist 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 digest- ive apparatus, the excretory organs, and the nervous system; and we have found that we may, with the highest probability, if not with absolute certainty, attribute many of the chronic disorders which affect these organs in advancing life—espe- cially that loss of functional power which is frequently the earliest stage of such disorders, and which, if appropriately treated in the first instance, might not proceed further—to the excessive action to which they have been subjected, under the stimulating influence of alcoholic beverages. In so far, therefore, as the use of these beverages causes or favors 13* 150 SUPPOSED USES OF ALCOHOL such excessive action, it must in the end be hurtful, rather than beneficial, to the general health—notwithstanding that its temporary effect may appear to be wholesome and exhila- rating—or at any rate, if negative for good, to be also nega- tive for evil. But we have further to consider whether this inference is borne out by the effects of alcoholic liquors, taken habitually in small quantities, upon the functions of circu- lation and nutrition. 166. Effect upon the Circulation.—It maybe difficult to prove that the ingestion of a small quantity of Alcoholic liquor, taken in conjunction with food, has any decidedly stimulating influence upon the general circulation; since a certain acceleration of the pulse, and an increase in its fulness, normally occur during digestion; and the augmen- tation produced by the alcohol may be so trifling as to be scarcely detectible. Such augmentation, however, is cer- tainly 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 results. There cannot be a doubt that, in a healthy person, the rate of the circulation is propor- tioned 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 mainte- nance of the erect posture, and still more in active exercise; but it may be accelerated also by exalted activity of the nervdus system, which sets up an unusual demand for blood in the brain; and its increase of weight, 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 undergoes any considerable acceleration, there is a tendency to a recurrence of local con- gestions, 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 pul- monary arteries which is liable to take place in most persons 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 IN SUSTAINING THE VITAL POWERS. 151 lungs that obstructs the passage of blood through their capil- laries. 167. There are few persons, however, in whom there is not some tendency to an irregularity of the circulation, which manifests itself in a torpor in some parts, and an undue activity in others. One of the most common 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 circula- tion; 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 acceleration 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 ob- servable in such persons, after the use of even a small quan- tity of alcoholic stimulant; and the habitual production of it cannot but be injurious, as tending to establish that inequality which it should be our endeavor to counteract. 168. Similar inequalities exist in different individuals, in regard to other organs: thus, it very frequently happens that the Liver is the part in which a disposition to torpidity of circulation exists; and congestion of its portal system of vessels must stagnate the whole of the circulation through the chylopoietic viscera, from which the blood of that system is derived. Any such disposition to local congestion must operate with increased force in producing general irregularity of" the circulation, when the rate of movement is unduly ac- celerated; 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 alcoholic liquors (§ 155), it cannot be doubted that even their moderate employment must aggravate any tendency to such derange- * The acceleration produced by muscular exercise will, of course, be unat- tended by this result j 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. « 152 SUPPOSED USES OF ALCOHOL ment of the circulation, when it already exists. No such derangement can be habitual, and be 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 deter- mination 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 tendency 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- bilities, 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 modern pathological research has been to show that the human frame, if endowed with an ordinary amount of inherent vigor, is no otherwise incident to dis- ease 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 effect 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 habitual violations of the same kind must be allowed to par- ticipate, at any rate, in the production of chronic diseases of the same order. The very nature of chronic disease im- plies a prolonged action of the causes in which it- arises ; for no such determinate alteration of the normal 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 sufficient intensity, exciting an attack of acute disease. In chronic diseases, we find that the organ has, so to speak, grown 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 SUSTAINING THE VITAL POWERS. 153 in the best condition for its recovery.—We are fully justi- fied, therefore, by all that we know of the causes of disease, in asserting that the habitual use of Alcoholic liquors 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, moreover, to be an adequate amount of evidence that the practice in question has an unfavorable influence upon the Nutritive operations by which the alimentary materials first converted into blood are applied to the regeneration of the living tis- sues. 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 de- mand which is made upon the regenerative powers.for the repair of injuries occasioned by accident or disease. It is well known to Surgeons that the most desirable of all modes by which the reparation of wounds can be effected is the simple adhesive process known as " union by the first intention;" and that where, in consequence of loss of sub- stance, union by the first intention cannot be effected, the most favorable method is that which is termed the " scab- bing process;" in which a hard crust being formed upon the surface, so as to protect it from the irritating action of the atmosphere, a continued growth or re-formation of tissue takes place beneath, without any interruption from inflam- matory action, until complete filling-up has been effected, and a new cutaneous surface is formed beneath the scab. But it too frequently happens that the reparative processes cannot be induced to take place after either of these fash- ions, but that inflammatory action is set up in the wround, and matter forms between its lips, or beneath the scab, ren- dering 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 suppu- rating granulation; during the progress of which a large amount of nutritive material runs to waste as purulent dis- charge, whilst a great degree of constitutional irritation is often set up ; and the best termination of which is the for- mation of a cicatrix, that subsequently undergoes an un- 154 SUPPOSED USES OF ALCOHOL sightly and often inconvenient contraction, from which the new tissue formed under a scab is free. 171. Now the occurrence of the first of these modifica- tions of the healing process is an obvious indication of such a healthful condition of the nutritive operations as can re- pair the effects of an injury in the most complete manner, with the least possible waste of nutritive material, and with the most entire absence of constitutional disturbance. Whilst, on the other hand, the impossibility of procuring it, even under the most favorable circumstances of rest, fresh air, and wholesome aliment, indicates 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" com- munities of men, the case is very different; for the occur- rence 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 practiced, and who enjoy immunity from many causes of disease which exist in civilized communities, have been struck with the facility with wdiich wounds heal among them, and with their remark- able freedom from that constitutional disturbance which, amongst ourselves, 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 saw 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 way of being perfectly healed, that, if I had not known no ap- plication had been made to it, I should certainly have in- quired with a very interested curiosity after the vulnerary herbs and surgical art of the eountry." Of these people, he states that at that period water was their sole and uni- versal liquor. 172. Now, it would be absurd to maintain that the habit- IN SUSTAINING THE VITAL POWERS, 155 ual moderate use of fermented liquors is the sole reason of the rarity of this healthful operation of the reparative pro- cess amongst ourselves; since a multitude of other depart- ures from the laws of. health are continually practiced 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 produces 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 (§ 63), it can scarcely be denied that, where a minor departure from the normal condition shows itself, and the same cause has been in ac- tion in less intensity, that departure may bereasonably con- sidered, in part at least, as its effect. And this conclusion is remarkably confirmed by the surgical experience 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, Mr. Havelock, in his "Narrative," in reference to the wounded, after the victories in India, observes : " The Medical Officers of this army have dis- tinctly attributed to their previous abstinence from strong drink the rapid recovery of the wounded at Ghuznee." And Mr. Atkinson, in his work on Affghanistan, is more explicit, stating that " alj the sword cuts, which were very numerous, and many of them very deep, united in the most satisfac- tory 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 " ave- rage 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 un- favorable to the permanent enjoyment 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 occupation, 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 156 SUPPOSED USES OF ALCOHOL, ETC. 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 affirm that even the most moderate habitual use of alcoholic liquors becomes to the " average man" positively injurious, if protracted for a sufficient length of time to allow of the development of its effects. USE OF ALCOHOL IN EXCEPTIONAL CASES. 157 CHAPTER III. 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 ALCo' HOLIC 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 exertion of the animal powers, and in which the occurrence of subsequent depression may not be an adequate objection to the employ- ment 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 sufficient 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 exam- ple may be extracted from the letter of Dr. J. D. Hooker, already cited: "I know of only one occasion," he says, "on which the use of spirits appeared indispensable ; and that was when a little more exertion at the crowning of a mighty and long-continued effort was demanded. Thus, the ship, when sailing in the pack-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 158 USE OF ALCOHOL way to get her out is by fastening ropes from the ship to the larger masses of ice, and warping 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 cof- fee 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 circumstances like 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, which 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 corresponding effect, in quickening and freshening the mental power, during a brief period through which it could not otherwise have been sustained. Of course, in every such case, a correspond- ing depression is subsequently felt; but this depression is rather traceable to the fatigue of over-exertion than to the reaction consequent upon over-excitement. For, in the cases alluded to, the effect 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 em- ployment. 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 especially to those of the nervous system; and the more frequently and violently it is practiced, the more speedily may we ex- pect that functional derangement will manifest itself. Ex- treme overtasking of its powers is often so immediately fol- lowed by apoplexy, paralysis, epilepsy, mental derangement, IN EXCEPTIONAL CASES. 159 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 re- peated operation. For every such irregularity tends to de- range the nutrition of the system ; and, if a renewal of the irregularity should take place before the effects of the pre- ceding derangement have been recovered from, they are of course aggravated; and thus a cumulative 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 application 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 road- ster 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 extraordinary 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 exhaustion 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 pro- duced but little mischief in comparison; and its consequences 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 be denied that occasions will arise in the experience of some persons, in which the temporary assistance derived from 160 USE OF ALCOHOL Alcoholic 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 bea 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 earn- estly—that the habitual recourse to such a practice is fraught with the greatest prospective danger; since it en- courages 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 liquors, however moderate, can be persevered 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 nervous system has of itself so marked a tendency to generate. It should rather be the aim of those who have accustomed themselves 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 careful and constant atten- tion 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 abstinent; since the quantity of alcoholic liquor which- they require for the purpose is ex- tremely 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 alco- holic 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 ex- posure 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 IN EXCEPTIONAL CASES. 161 reason to adopt the conclusion that this reputation is alto- gether fallacious as regards the power of continued en- durance. 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 determination of blood which it favors towards the vessels of the skin. And this effect seems to be exerted with 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 malady, as determined by the 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 persons 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 influence is powerful and likely to be of short duration, it may be better 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 undesirable; for the system is never so obnoxious to the depressing influence of cold and damp as when it is already in a state of depression resulting from previous over-stimulation; and the use of coffee, cocoa, and other hot beverages, with solid food, which shall aid in perma- nently sustaining the heat of the system, is then unques- tionably to be preferred. Here, again, we would remark that the habitual abstainer has decidedly the advantage, 14* 162 USE OF ALCOHOL since a very small amount of the stimulus is sufficient, as in the former case, to produce the desired result; and that, if recourse be too frequently had to it, the remote conse- quences of alcoholic excitement may be expected to manifest themselves. II. DEFICIENCY OF OTHER ADEQUATE SUSTENANCE. 182. The second class of cases in which the use of a small amount of alcoholic liquors 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 animal tissues would otherwise be attacked. Under such circumstances, too, the temporary elevation of the habitually depressed state of the animal power seems rather beneficial than injurious. Of this we have a remarkable example in the well-known case of the Mutiny of the Bounty, from Captain Bligh's Narrative, of which the following passages are extracted: "At daybreak I served to every person a 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 suffering extreme cold in the night, without the least shelter from the weather. The little rum we had was of the greatest service; when our nights were particularly distressing, I generally served a 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, coffee, or cocoa, with plenty of nourishing food, over alcoholic liquors, in facilitating the endurance of such an exposure, it can scarcely be questioned that, in circumstances such as those of Captain Bligh's crew, the administration of the few drops of spirit was of the most important service, both as supplying combustible material, and as enabling the powers of their system, already seriously depressed, from being fatally reduced by the privations to which the party was subjected. 183. The beneficial influence of a small quantity of Alco- holic stimulus, in contributing to the endurance of bodily IN EXCEPTIONAL CASES. 163 labor under circumstances peculiarly trying, and under the disadvantage of a deficient allowance of animal food, has been demonstrated on an extensive scale by the hygienic experience of the large prison at Nismes, called the "Maison Centrale," of which an account has been recently published by the chief physician, M. Boileau Castelnau, who has been connected with the prison for the last twenty-five years.* Of this account an abridgment will be here given, as the facts are considered by the writer as of very great import- ance, in disproving, by the experience of a large number of individuals, the position of those who assert that under no circumstances can the habitual use of alcoholic liquors be otherwise than injurious. This prison usually contains a population of 1200 convicts, most of them adults, the mini- mum age being eleven. Its wards have been habitually over-crowded and ill-ventilated, and insufficiently heated in winter; and the food of the prisoners has been coarse and innutritious, whilst more labor has been exacted from them than their strength has been adequate to perform. The prisoners, moreover, have been subjected to the tyranny of brutal keepers, frequently loaded with irons, and occasionally severely whipped. Under these circumstances, it is not sur- prising that the rate of mortality in the prison has been always high, varying from 1 in 23-88 to 1 in 7'85, whilst the average rate of mortality amongst the inhabitants of the town of Nismes, of the same age and sex, amounted to 1 in 49*9. The rate of mortality in the prison underwent con- siderable variations in different years; and for these varia- tions some definite cause could generally be assigned. Thus the winters of 1828-9, and of 1829-30 were unusually severe and prolonged; and the rate of mortality for 1829 was 1 in 9*40, whilst for 1830 it was 1 in 8*50; clearly proving the fatal influence of a low temperature upon systems de- bilitated by insufficient food, impure air, and work dispro- portioned to their strength. With the exception of the year 1833, in which the mortality was again great, the rate was much less for several subsequent years, varying between 1 in 11-35, and 1 in 15-62 ; but in 1839 it suddenly rose from 1 in 12-32 to 1 in 7*85. The cause of this terrible augmen- tation (from 102 deaths to 162) seems to have lain in a min- * See the Annales d'Hygiene Publique, Jan. 1849; 164 USE OF ALCOHOL isterial 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 that time, the convicts had had it in their power to lay out a portion of their earnings, which was at their own disposal, in the pur- chase 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 must be aware that, in the south of France, wine is considered an absolute necessary of life. It is drunk by the poorest of the people, and appears essential to enable them to digest their coarse unstimulating food. Within the town of Nismes, it costs about a penny the litre (If pint); and without the wall, where it is free from duty, the laborer may drink it at a penny the hour. Potatoes, butter, and cheese could not re- place its stimulus; and besides, the south of France con- taining no pastures, the butter was bad and dear; and the cheese also dear. Hence, the pittance at the disposal of the prisoners was more than ever insufficient to supply the de- ficiency of nutriment." 185. The rate of mortality was somewhat diminished in the following year, the diet being increased, and the prison- ers receiving small supplies of wine and tobacco at exorbi- tant rates, principally through the connivance of the offi- cials ; still, hoAvever, it remained very high, the number of deaths in 1840 being 135 out of 1216 prisoners, or 1 in 9-07. Attention being now attracted to the 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 chretiennes," who substituted moral persuasion for physical force; and the diet being im- proved both in quantity and quality. In consequence of these measures, the mortality again began to diminish, and reached its lowest point in 1844, when the number of deaths was only 56 out of 1290 prisoners, or 1 in 23-88. The "Freres," however, being disgusted at the continual ob- structions which their measures received, gave up their charge; the old system of hard work and cruel punishments was again introduced; and the pittance at the disposal of the IN EXCEPTIONAL CASES. 165 prisoners was diminished to a mere fraction. The effect of this change speedily showed itself in the increased mortal- ity, the average of deaths progressively increasing, in the years 1845, 1846, and 1847, to 1 in 19-63, 1 in 16-52, and 1 in 13-57. One of the first acts, however, of the revolu- tionary 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 44, only 16 deaths took place during the corresponding months of 1848. & 186. Now the principal lesson taught by this fearful his- tory 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 lowtemperature, foul air, and ill treatment. But it seems obvious, from the large increase in the rate of mortality which ensued upon the prohibition of wine, no extraordi- nary 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 sup- plied 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. 187. From these two cases, then, and from others which might-be cited to the same effect, we seem justified in con- cluding that the use of Alcoholic liquors in small quantity may assist in sustaining the powers of the system, when these have undergone an extreme depression from the com- bined influence of exposure or exertion, and of want of food; so that under such circumstances the alcohol does decidedly more good than harm, and should therefore be employed when accessible. And this we may freely admit, without having in the least degree to qualify the doctrine previously advanced, that continual exposure and protracted exertion may be better sustained without the use of alcoholic liquors 166 USE OF ALCOHOL 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. We have now to inquireinto the third class of cases, in which a temporarily beneficial result appears to be "de- rived 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 themselves in all ranks of life. In the higher, they too frequently result from heated rooms and late hours, from the want of regular exercise of mind and body, and from habits of self-indulgence and " coddling," which foster, especially in females, what may have been an hereditary weakness of digestive power. In the middle classes, it is usually traceable to the " wear and tear" of 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 conscien- tious discharge of the duties of a profession, or to the fluc- tuations of business. Among the lower classes, on the other hand, it is traceable rather to the condition of their dwell- ings, 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 reduction of demand for aliment to its loAvest point; for where neither the muscular nor the nervous systems are adequately exer- cised, and where the body is habitually kept in a tempera- ture not far below its OAvn, there can be very little "waste" to be repaired, and a very small amount of combustive ac- tion 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 below the level at which the demands of the system should keep them; and thus an almost total want of appetite, and ex- treme debility of the stomach, are the result, which of course tends to augment the habits of self-indulgence, and to fos- IN EXCEPTIONAL CASES. 167 ter the whole system of " coddling." In such cases, an ap- parent benefit is derived from the habitual employment of a glass or two of wine or a tumbler of bitter ale; but this merely facilitates the persistence in a wrong course; and every judicious practitioner would now assent to the truth- fulness of the advice given by Abernethy in a case of this kind, to " live on a shilling a day and earn it." It is utterly impossible that alcoholic liquors can counteract the influence of heated rooms and late hours; that they can stand in the place of healthful exercise of mind and body; ot that they can neutralize the evil results which are sure to proceed from the habitual direction of the attention to self. All that they can beneficially do is to create for a time that appetite which ought to be naturally felt, and to urge the unwilling stomach to digest that food which the body really requires. But this they can only effect by their stimulating properties; and as the usual dose almost invariably ceases after a time to exert its original 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 hoursfor 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 improvement may have been produced, the stomach may not be equal to its work; and this is liable to be the case more particularly with those to whom weak digestive powers have been trans- mitted from their parents (generally in consequence of their own unhealthful habits), or in whom they have been fixed (so to speak) by an erroneous system of bodily and mental training, and especially by the habitual use of stimulants during childhood and youth. In such cases, the writer be- lieves that the habitual use of a small quantity of alcoholic 168 USE OF ALCOHOL 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 pro- duce 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 in- dication 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 likely to be persistent, if the use of the alcoholic stimulant be in- termitted whenever the digestive powers seem adequate to the support of the system 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, fre- quently under circumstances which are of themselves pre- judicial 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 general, 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 Alcohol can supply the place of mental repose to the man whose intellect is overtasked, and whose anxieties are 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 per- form of their own accord. And here, too, we find that, when stimulants are habitually 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 influence of the withdrawal of nervous agency consequent upon cerebral exhaustion, and of the depression of its own energies consequent upon the habitual over-excitement to which it has itself been subjected. 193. Here, then, it is obvious that the use of Alcoholic stimulants can only serve as a palliative, and that the true remedy can only be found in such a change of habits as shall IN EXCEPTIONAL CASES. 169 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 ob- jects of interest (for ennui is to be especially avoided), more especially when a bracing air and augmented muscular exer- cise tend still further to the bodily invigoration, will usually be found sufficient, when employed in time, for sustaining the appetite and digestive powers under that amount of mental labor to which the system is really equal; and re- course 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 bolsters up his failing credit with accommodation-bills, to carry onwards, from page to page of the book of life, a heavy balance which must be accounted for at some subse- quent period. 194. Still, the writer is by no means disposed to deny that, after all other practicable means have been taken for the invigoration of the system, the habitual use of a small or moderate quantity of Alcoholic liquors may be found beneficial in some individuals of the class referred to; en- abling them to digest that food which the system really needs,- and thus contributing to sustain their powers under an amount of exertion to which they would not otherwise be equal. And this will be especially the case (as with the class first treated of), where, from hereditary predisposition, or the habits of early life, there is a fixed constitutional debi- lity of the digestive powers. In such instances, the stimu- lating effects of the alcohol do not manifest themselves; it is not found requisite to increase the dose; and the practice is continued with apparent benefit through the whole of life. 15 170 USE OF ALCOHOL A characteristic 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 76 years, and who dis- charged the duties of a laborious profession, with scarcely any intermission, to the end of his life.* 195. The craving which is felt for Alcoholic liquors among the classes whose labor is rather physical than mental, and the benefit which in many cases appears to be derived from it, proceeds from a different cause. Nothing can be con- ceived in itself more likely to whet the appetite and invigo- rate the digestive powers than regular 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 otherwise favorable to health, and more espe- cially 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 stimulants. And' if the atmosphere of the dwelling be charged with the nox- ious emanations resulting from animal or vegetable putrefac- tion, 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 circumstances, recourse is had, with apparent benefit, to the use of alcoholic liquors; for they spur on the stomach to its work, and cause it, for a time at least, to furnish what is needed for the maintenance of the various functions of the body; 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 con- dition, that the stimulus which was at first found sufficient very speedily ceases to produce its usual effect; and that the feeling of necessity for it increases, the more it is used. Of this, we have an example—which, though an extreme case, teaches the lesson with the force that extreme cases * See the Sketch of Dr. Clarke's Life and Writings, by his Nephew, Dr. Collins, p. 81. IN EXCEPTIONAL CASES. 171 alone can do—in the condition of the journeymen Tailors employed in the large London workshops, as disclosed by the inquiries whose results are published in the first " Sani- tary Report" (1842). The heat and closeness of the work- shops 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 afford more than a temporary power of endurance under such a state of things, and the cumulative effect of the noxious atmosphere on the one hand, and of the habitual use of spirits on the other, are fearfully shown in the excessive mortality among this class of men, espe- cially from consumption; their average age not being above thirty-two, and a man of fifty being considered as superan- nuated.* 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 remedied 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 influence on the bodily system, all the alcohol in the world notAvithstanding. When, on the other hand, they are re- moved—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 anything else will be required * The writer has been informed that these workshops have been greatly improved of late years, especially in regard to ventilation ; and that the crav- ing for spirits, on the part of those employed in them, has gradually ceased to manifest itself. 172 USE OF ALCOHOL to sharpen his appetite, and invigorate his digestive powers, for the consumption of as much food as his system may re- quire. 198. On the whole, then, we may conclude that in by far the greater number of cases falling under one or other of the above categories, the influence of the habitual use of Alcoholic liquors, while it may seem temporarily beneficial, is in the end rather pernicious than otherwise ; and this not so much (in the cases now under consideration) by their own specific effects on the system, as by causing the individual to feel less need of the very change which is needed for the resto- ration of the body to its wonted vigor. The insensibility to the effects of various morbific causes, which the habitual use of these stimulants induces, and the toleration of them which it thus permits, may be regarded, indeed, as one of its most injurious results. Those who are prevented from feeling the 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 con- cealed for a time, he only waits until his onslaught may be more effectually made. Any systematic departure from the laAvs of health—all experience teaches—must exert its in- fluence on the system, sooner or later; the sooner it does so, the more readily may the mischief usually be corrected; whilst the postponement of its effects tends to render the process of cure as protracted as the operation of the causes has been. It is one of the greatest benefits of the absti- nent system, then, that by making the evils of such a de- parture less endurable, it sooner prompts the sufferer 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 fermented liquors seems de- sirable in some instances,are the states of pregnancy and lactation. The state of pregnancy frequently occasions a peculiar irritability of the stomach (apparently of a purely nervous character), which indisposes it to retain the nutri- ment really required by the system, or which prevents it from properly digesting and preparing it when retained. This irritability is occasionally so aggravated as to become IN EXCEPTIONAL CASES. 173 the subject of medical treatment; and the most powerful sedative medicines are sometimes required to subdue it suf- ficiently for the retention of even small quantities of food. Sometimes even these are ineffectual; and more relief is obtainable from small quantities of wine, frequently repeat- ed, than from anything else. Dr. Meigs (of Philadelphia) mentions a case in which nothing could be borne but cham- pagne. In milder cases of thesame kind, it often happens that a small quantity of fermented liquor, taken with the principal meal, 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 cer- tainly seems a less evil to employ this, even habitually, dur- ing the period of pregnancy, than to allow the system both of mother and foetus to be suffering for want of the aliment which this condition so peculiarly requires. And as the source of irritation is temporary, there is less danger than in other circumstances, lest the demand should be rendered permanent by the habituation of the stomach to the sti- mulus. 199. But the evils attending its habitual use, even under such circumstances, can only be reduced to their minimum by very careful attention to all the other conditions favor- able to health during the pregnant state—especially fresh air, moderate exercise, early hours, adequate repose, and the avoidance of all sources of excitement; and also by the strict limitation of the quantity of the alcoholic liquor to that which is sufficient to produce the desired result. The writer has known cases in which, under such watchful regulation, great benefit appeared to be derived from the very moderate use of alcoholic liquors (especially of those in which the bitter and sedative properties of the hop are combined) without any corresponding disadvantage; the stomach being thereby enabled, so long as the pregnant state lasted, to receive and digest the food which the system really needed; and the requirement not being felt after its termination. But it must not be forgotten that the habit of indulgence in fermented liquors, once established/is often felt by females, as well as by men, to be very difficult of relinquishment; and where there is reason to believe that the individual does not possess self-command sufficient to break through the habit at the proper time, it might be advisable to endeavor 15* 174 USE OF ALCOHOL to substitute a medicine for a beverage, giving to the alco- holic compound such a form as may render it not peculiarly palatable or inviting. 200. Lactation.—The benefit derivable from the use of Alcoholic liquors to support the system during lactation, is more doubtful. Certainly it may be affirmed that in every- case in which the appetite is good, and the general system healthy, the habitual use of these stimulants is no more called for than at any other time; and that they are likely to produce the same injurious effects as when unnecessarily given under ordinary circumstances. The regular adminis- tration of alcohol, with the professed object of supporting the system under the demand occasioned by the flow of milk, is " a mockery, a delusion, and a snare." For alcohol affords no single element of the secretion; and is much more likely to impair than to improve the quality of the milk. The only mode in which it can contribute, even indirectly, to increase the amount of solid aliment which the secretion may contain, is by affording a supply of combustive mate- rial, the consumption of which may leave more oleaginous and saccharine matter to pass into the milk. But where the appetite already prompts to the mgestion, and the stomach is equal to the digestion, 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 the child; having a special tendency to occasion derangements of the digestive organs, and convulsive complaints.* This, indeed, might be fully expected; since all that we know of the mode in which substances taken into the blood affect the mam- mary secretion, would lead us to expect that alcohol, if in- troduced into the circulation more rapidly than it can be consumed, would pass into the milk, and would consequently produce the same effects upon the child as if directly given * 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. IN EXCEPTIONAL CASES. 175 to it—besides deranging by its presence,, the act of secre- tion itself, in virtue of its tendency to produce coagulation of albuminous matters. And the fact that multitudes of women of good constitutions, whose general habits are con- ducive to health, go through the period of lactation without any feeling of debility, simply finding their appetite in- creased during its continuance, is a sufficient proof that this condition is not one which in itself occasions a demand for alcoholic liquors. 201. But there are cases in which, notwithstanding all that can be done to promote the general health, the stomach does not seem capable of retaining and digesting the re- quisite amount of nutriment, except under the artificial as- sistance afforded by Alcoholic liquors; and in which it appears more desirable, for the welfare alike of mother and child, that such assistance should be afforded than that lac- tation 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 fer- mented 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 con- dition of both mother and child ; and this small allowance did not require to be increased during the continuance of the lactation, and was relinquished without difficulty soon after the weaning of the infant. In such cases, the alco- holic 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 smallness of the quan- tity of alcohol introduced at any one time prevents it from either itself passing into the milk, or exerting any inju- rious influence on the secreting process. But it may be questioned whether the practice is in the end desirable ; or wdiether it is not, like the same practice under other circum- stances 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 sus- tain it. Such certainly appeared to be the case in the in- stance just referred to; for the system remained in a very depressed state for some time after the conclusion of the 176 USE OF ALCOHOL first lactation; and on subsequent occasions it has been found absolutely necessary to discontinue nursing at a very early period of the infant'sdife, owing to the inadequacy of the milk for its nutrition, and the obvious inability of the mother to bear the drain. Hence it may be affirmed, with 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 inability to furnish what was required, without the stimulus of alcoholic liquors, was Nature's warning, which ought not to have been disregarded. 202. Considering, then, that lactation (unlike pregnancy) may be put an end to at any period, should it prove injurious to the mother, the writer is disposed to give his full assent to the dictum of Dr. Macnish: that, "if a woman cannot afford the necessary supply without these indulgences, she should gi\re over the infant to some one who can, and drop nursing altogether."—"The only cases," continues Dr. M., "in which a moderate portion of malt liquor is justifiable, are when the milk is deficient, and the nurse averse or unable to put another in her place. Here, of two evils, we choose the least, and rather give the infant milk of an inferior quality than endanger its health by weaning it prematurely, or stinting it of its accustomed nourishment."* . Noav 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 imper- fect supply of poor milk from the mother ;t and that, if the mother be so foolish as to persevere in nursing her infant, when Nature has warned her of her incapacity for doing so, it is the duty of the medical man to set before her, as strongly as possible, the risk—the almost absolute certainty—of future prejudice to herself. The eAils which proceed from lactation, protracted beyond the ability of the system to sustain it, may be to a certain degree kept in check by the use of alco- holic stimulants; but the writer is convinced, from observa- tion of the above and similar cases, that its manifestation is * Anatomy of Drunkenness, p. 301. \ The author has found, in hisown experience, that good Cow's milk, some- what diluted with water, and sweetened with a small quantity of sugar (?o as to be brought nearly to the composition of Human milk), has answered extremely well even for very young infants. IN EXCEPTIONAL CASES. 177 only postponed. * Under no circumstances, therefore, can he consider that the habitual or even occasional use of alcoholic liquors, during lactation, is necessary or beneficial. 203. Childhood.—It has been maintained by some, that there are certain states of the constitution in childhood in which benefit is derived from the habitual use of small quan- tities 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, ex- tending through the whole of life. For, if the habit be begun thus early, it will seldom be found possible to discontinue it; the stomach is rendered dependent upon artificial support; and the improvement which this appears 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 com- pletely artificial support yielded by alcoholic liquors. 204. There cannot be any reasonable doubt that the habit- ual use of Alcoholic liquors by children in average health is in every way injurious.* In no period of life are the * In illustration of the injurious effects of the habitual use of 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 evacuations destitute of their usual quantity of bile. In the other child, no change whatever was produced.' He then reversed the 178 USE OF ALCOHOL 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 disposition to take just that amount of exercise of the nervo-muscular apparatus which is beneficial to the system, Avithout exceeding it. The motives which stimulate the adult to over-exertion in his battle with the Avorld, 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 fatigue, and is indisposed to persevere after this warning of the failure of his poAvers. 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 preserva- tion and improvement of health be judiciously and perse- veringly employed, it is believed by the writer that more good, will in the end be done than will be accomplished by the assistance of alcoholic liquors. And in support of this belief, he can appeal to the large numbers of families uoav growing up, in this country and in America, in the enjoy- ment of vigorous health, among whom no alcoholic liquor is ever consumed; and he can point to numerous cases within his personal knowledge, in which the apparent debility of constitution having been such as in the opinion of some to call for the assistance of fermented liquors, the advice was resisted, and those other means adopted Avhich 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 undesirableness of the habitual use of Alcoholic liquors during the vigor of early and mid- dle life, that they are requisite or useful for the support of old age. Now upon this point, also, the writer believes that much misconception is prevalent, arising out of a dis- regard to the dictates of Nature on the subject. During 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 straightway into disorder as in the first experiment. IN EXCEPTIONAL CASES. 179 the most active period of life, the "waste" of the body is considerable ; and the demand for food, and the power of digesting it, are both adequate (in the healthy state) to supply that Avaste. But with the advance of years, the power of activity diminishes ; the body (so to speak) lives much more sIoavIv, as is proved by the lessened exhalation of carbonic acid and the diminished excretion of urea,; and the waste being thus lessened, the demand for food, and the poAver of digesting it, are proportionably diminished. Now this abatement of the appetite and digestive power (like that which is felt by those Avho go from cold or tem- perate climates to reside in tropical regions) is a natural warning that a smaller amount of food should be taken in; and if it be so received, and no more nutriment be habitu- ally ingested than -the appetite legitimately prompts, the digestive powers will be found as adequate as in a state of greater activity to provide for the wants of the system. But this abatement is very commonly regarded as an indi- cation of the failure of the powers of the stomach ; and re- course is had to alcoholic liquors, with the view of re-excit- ing these. Now, although from such a practice, when very moderately resorted to, less prospective evil may be antici- pated, as regards merely the effects of the continual inges- tion of alcohol upon the stomach, than it js liable to occa- sion when commenced earlier in life ; yet it is very much to be deprecated on another account—namely, that it forces admission into the system (so to speak) for a larger amount of alimentary matter than it can appropriate; and as all the or- gans which are set apart for the elimination of the superfluity (the kidneys, the liver, the skin, and the glandulse of the in- testinal canal), are less easily stimulated to increased activity in the decline of life than at an earlier period, it follows that habitual excess in diet, even though to no great amount, is yet more likely to be followed by the disorders which it tends to produce. And hence it is, more especially, that we find the lithic acid diathesis so prone to manifest itself in ad- vanced life, and requiring such careful dietetic management for its correction. 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 beneficial to persons advanced in life and not suffering under any posi- 180 USE OF ALCOHOL tive ailment, but experiencing absolute deficiency of digest- ive power beyond that which is in conformity with the general decline of activity ; in such cases, the benefit to be expected from their employment is that the stomach should be 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 ob- served the., laws of health, and who have not prematurely exhausted the powers of their digestive apparatus by habit- ual 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 opera- tion ; or who have overtasked their nervous systems, and thus deprived the stomach of the nervous poAver Avhich it requires ; or who have impaired their vigor by breathing a foul atmosphere, by irregularity and insufficiency 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, Avhich no treat- ment, medical or hygienic, can ever completely repair. 207. But here, as in all other instances, if the prolonga- tion 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, which prudential experience would recommend; and the assistance of Alco- holic 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 dispense with them in old age; yet experience has demonstrated, even here, that, where the evil results of their continued use have begun to. manifest themselves, decided and permanent benefit has followed their abandon- ment ; and Avhere it was believed by the individual that he could not possibly dispense with their use, the stomach has recovered its healthy tone (especially under the copious ex- ternal and internal use of cold water, and the influence of an invigorating atmosphere), so as to be able to discharge IN EXCEPTIONAL CASES. 181 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 com- paratively limited number of instances, the author has thought it safest to rely on the assurances of medical prac- titioners in the New England States; since the entire dis- use of fermented liquors has been now practiced as a habit, for some years, by a large proportion of the population of those States, including those who are most subject to those influences (the "wear and tear" of social life) which are usually regarded as most powerfully conspiring to render the- assistance of stimulants desirable.—The following state- ments on this subject have been recently put forth by the Massachusetts Temperance Society, under the sanction of their distinguished President, Dr. Warren:—f 209. " In regard to the habitual use of wine, it is pro- bable that the change of opinion is greater here than in Europe. A Arast number of persons on this side of the At- lantic have Avholly abandoned the use of wine, cider, and malt liquors; and many of those who continue to employ them have greatly diminished the quantity. Wine is no longer thought necessary in the convalescent stage of fever. Cider, formerly one of the household provisions,of almost every family in the North, is rarely seen; and the very trees which produced it are either cut down for fuel, or con- verted to the production of fruits for food. The stronger beers are quite disused, except among emigrants; and even the milder are employed only in some very light and un- stimulating form to allay thirst, principally in the hot sea- son." " 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 posi- tive improvement in strength, activity, and agreeable sen- sations. How common is it amongst us to see persons who * For two remarkable cases of this kind, see Appendix C. f Preface to the Reprint of an Essay on the Physiological effects of Alco- holic Drinks, from Dr. Forbes's Review, Boston, N. E., 1848. 16 182 USE OF ALCOHOL 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 influence of such a change of habit in the wealthier classes has been great be- yond calculation, in leading the mass of society to abandon the use of spirits, and to repeat an experiment already made by those Avhom 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 shoAV that they are capable of making the sacrifice they advise, should submit to a privation which they have sufficient reason to believe will be most salutary to themselves and others." 210. The extent of change of habit, in this respect, among the middle and higher classes of society in Boston, and other great towns of New England, may be judged of from the fact that many of those public, festivities at which the assistance of alcoholic liquors is considered indispensable in this country, are there conducted without any such artificial excitement. " Of late years" (we quote the same author- ity), " we have had the gratification of witnessing so many exceptions to the former practice, that it appears very pro- bable that 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 feel- ing. The annual ceremonies of our literary institutions, too often stained by lavish draughts of the juice of the grape, are now purified by the effusions of chastened wit, and elevated by the flights of an unclouded imagination. Most of the Universities, and particularly the oldest, and we may perhaps venture to say the most distinguished, have unshackled themselves from the chains of ancient habit. Under the influence of a master-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 meet- ing Avithout the consequent depression from artificial stimu- lus. Wine is no longer admitted at the yearly convocation of the Clergy, or the assemblage of the Medical profession of IN EXCEPTIONAL CASES. 183 this state. The great association of mechanics of the me- tropolis hold a brilliant triennial feast, from which every kind of alcoholic, fermented, vinous, and other stimulating liquid is wholly excluded."* 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 dimi- nished appetite and digestive powTer prevent the reception of an adequate supply of aliment into the system, and in which the assistance of alcoholic liquors is temporarily bene- ficial, that assistance is rather a palliative than a cure of the condition which calls for it; and, if perseveringly had recourse to, is likely to induce a train of evils of its own; whilst, at the same time, by the apparent support which it gives, and by rendering the system more tolerant of the 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 practi- tioner) recommend to a man losing his digestive power, from the fatigue and confinement of a city life, to take wine, porter, or bitter ale, with his dinner, we 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 belieA^es that there are ex- ceptional cases, arising chiefly from peculiarity of original constitution, in which the want of digestive power is more completely and permanently supplied by the habitual use of a small quantity of Alcoholic liquors than it can be by any other means within the power of the individual. It may be * In order to give a more 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 - 600 184 USE OF ALCOHOL IN EXCEPTIONAL CASES. 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 unnecessary 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 employed to replace any hygienic requirement, such as fresh air, mental repose, muscular exercise, &c.; and they should be disused Whenever it may appear that the necessity for them no longer exists. USE OF ALCOHOL IN THE TREATMENT OF DISEASE. 185 CHAPTER IV. 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? 213. Those wdio maintain that Alcoholic liquors are not requisite for the ordinary sustenance of Man, or even that they are likely to be rather prejudicial than othenvise Avhen 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 Avhen ad- ministered, with caution and discrimination, in various forms of disease. In replying to the above question, we shall first look at the inferences which we may draw from the physio- logical action of Alcohol, in regard to the conditions of the system in which it is most likely to be useful. I. RECOVERY FROM SHOCK. 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 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 advantageously employed when other means are deficient. Hence we should say that alcoholic liquors may be advantageously employed to assist in rousing the system from the effects of agencies of various kinds, which threaten, for a time, to produce a fatal depres- sion of the vital powers; such, for example, as severe inju- ries that produce a violent shock, under the primary effect 186 USE OF ALCOHOL of which the system 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 {i. e. unless the patient appears,likely to sink without them); for it is as certain that reactionary excite- ment Will follow a primary depression as it is that depres- sion will be consequent upon primary excitement; and if stimulants have been unnecessarily employed, the difficulty of controlling the reaction will be increased. This caution is more especially necessary where the brain is the part to which the injury has occurred; since the special determina- tion of alcohol to this organ will increase the violence of the re-action in a most dangerous manner. 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 mani- fest 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 fife through care- lessness or negligence. The shock given by this injury to the delicate and impressible system of the child is often rapidly fatal; the heart's action being extremely depressed, the nervous power reduced, and the body gradually cool- ing, until its temperature falls to a degree incompatible with the maintenance of life. The writer has witnessed many such cases, in which life seemed 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 possessed with the belief that the little patients must die, and being too frequently careless in the employment of the only means by which life can be sustained. II. TREATMENT OF ACUTE DISEASES. 215. Resistance to the depressing influence of Morbific Agents.—In the class of cases to which reference has just been made, the shock is temporary; and if the patient can be kept alive until the system has recovered from its imme- diate consequences, a great point is gained. There is an- other class of cases in which the depression is produced by a morbific agency, and in which it is of equal importance to IN THE TREATMENT OF DISEASE. 187 keep up the vital powers for a time ; since, if they can be sustained for a few hours or days, the patient has a fair chance 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 epi- demics of fever are 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 writ- er witnessed in Edinburgh in the years 1836-7, afforded him an opportunity of seeing the decided efficacy of Alco- holic stimulants in one form at least of this fever; the opposite methods of treatment, followed by two physicians whose practice he watched, being attended with such differ- ent results that, as the cases were of the same class, and the other conditions identical, there wras 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 administration of wine and spirit was commenced, as soon as the weakness of the pulse, and the coldness of the extremities, 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 wdiom a more potent stimulus was therefore needed to make an im- pression), a bottle of sherry with tAvelve ounces of whisky was the daily allowance for a week or more—the patient ultimately recovering. Now the result of this wine-treat- ment 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 failure of calorifying power, and no local lesion being detectible on post-mortem examination. 216. It is by 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 188 USE OF ALCOHOL of typhus and typhoid fevers, become progressively feebler and more rapid; and it has been noticed by Drs. Stokes and Graves, as the best indication for the use of Avine, that the impulse is greatly diminished, and that the first sound becomes very feeble or is entirely extinguished. Now the effect 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 subsultus tendinum; and if the wine acts beneficially, it ren- ders 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 Avine be acting injuriously, the skin and tongue become drier, and the respiratory movements more hurried. Concurrently with the failure of the heart's ac- tion, there seems often to be a deficiency of heat-produc- ing material; all that was previously contained in the body having been burned off during the "earlier period of the fever; and little or none having been taken in from Avith- out. Day by day, the fatty matter of the body is used up by the respiratory process; and thus, as in cases of simple starvation, the patient must die of cold, unless some means be provided for the sustenance of the heat. In such a con- dition of the system, no farinaceous or oleaginous matters could be digested or absorbed in sufficient quantity; whereas alcohol is taken into the current of the circulation by sim- ple endosmose, without any preparation Avhatever, and can be immediately applied to the production of heat. 217. Noav in the cases in which the Alcohol is thus useful, there is an entire absence of stimulating effects. This is probably due in part to the fact that the Alcohol is burned off nearly as fast as it is introduced (the general rule in such cases being to. give a small quantity at a time, but to repeat this frequently); but it would also appear to result in part from this—that the stimulating poAver of the Alcohol is ex- pended in neutralizing (so to speak) the depressing influence of the fever-poison already in the system, and that it simply tends, therefore, to restore both the heart and the brain to their condition of normal activity. Where the habits of the patient have been previously intemperate, the ordinary doses of alcoholic stimulants have no perceptible effect; and it is IN THE TREATMENT OF DISEASE. 189 necessary to go on increasing them, until some marked influ- ence 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 remedy which the Physician has at his command; for it is equally so in the typhoid states of other diseases, especially Ery- sipelas and the Exanthemata; and it is in the typhoid form of erysipelas, which so often presents itself in men of the bad habit of body resulting from habitual intemperance (§ 63), that the largest quantities of alcoholic 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 Prostration.—During the stage of convalescence from fevers and acute inflammatory diseases, in which the vital powers have been greatly de- pressed, 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 from that low irri- tative state which is the consequence 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 gene- ral vigor is more speedily restored. Every practical man must have perceived that the state of debility in which the patient is left after the termination of an acute disease is extremely different from the state of exhaustion consequent upon a long-continued course of over-excitement. The former partakes of the nature of shock; the vital powers are not so much exhausted as depressed; and recovery is best promoted by arousing the system, so far as possible, to the due per- formance 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 the rapidity of the heart's action at the same time that its strength increases, and by calming 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 190 USE OF ALCOHOL nutrition; especially where either the disease, or the treat- ment 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 or other forms of disease dependent upon the imperfect performance of the nutritive processes. 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 state of chronic inflammation is often kept up by the low and imperfect state of the general nutritive operations, and hence (as Prof. Alison was Avont to teach and to practice with great success), however contradictory it may at first appear, we may frequently combine a general tonic or some- what stimulant regimen with local depletion or counter-irri- tation. 220. When Alcoholic stimulants are employed for these purposes, the greatest care and watchfulness should 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 has frequently commenced with the therapeutic use of them; 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 pos- sible period—substituting, if he should think it necessary, a small quantity of alcohol in some medicinal form—in order that the patient may have as little motive as possible for continuing its use, after the time for their really beneficial action has passed. 221. Support under Exhausting Drains. — There is another class of cases, in which the stimulating action of Alcoholic liquors may be occasionally had recourse to with advantage; those, namely, in which there is great drain upon the nutritive material, owing to some disordered action AYhich at the same time lowers the vital poAvers of the sys- tem—such, especially, as an extensive suppurating surface. IN THE TREATMENT OF DISEASE. 191 Now here the general rule, that the appetite and the digest- ive poAver 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 digest- i\'e 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 powers of the system. We should therefore an- ticipate a beneficial result from such an employment of alcoholic stimulants as would for a time augment the digest- ive power of the stomach, and would thus enable it to ap- propriate and prepare the amount of nutritive matter which the system really needs, whilst at the same time its general powers are sustained under the depressing influence of the disease. Experience shoAvs that such is the case ; and that, under such circumstances, alcoholic liquors may be bene- ficially employed, not so much to stimulate the heart, or the nervous system, nor to take the place of solid 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 unfavorable course which febrile and inflammatory diseases are disposed to run in the habitually intemperate; this being chiefly de- pendent upon the imperfect elaboration of plastic material, Avhich predisposes to suppurative action, or to gangrenous or phagedenic ulceration, and impedes the attempt at rege- neration Avhich constitutes a most important part of the sthenic form of inflammation. A similar disposition to the asthenic form of inflammatory disease, and its severe con- sequences is seen among the habitually ill-fed, ill-lodged, ill-clothed inhabitants of the densest and Avorst-draincd parts of our great towns, many of Avhom are also intemper- ate ; and in many of these cases, it Avould seem requisite to support the system by Alcoholic liquors, even 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 requisite treatment. Whatever augments the plasticity of the fibrine, up to a certain point, is likely to be bene- ficial; and as the great object in such cases is. to give the requisite 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 192 USE OF ALCOHOL and porter are frequently the physician's and surgeon's main stay under such circumstances. They must, however, be very guardedly employed; and the test of their bene- ficial influence will be found in the absence of stimulating effects, and in the improvement of the character of the in- flammatory process ; which will be made known, where there is purulent discharge, by the conversion of a thin, sanious, fetid pus into that which is expressively designated by the term "laudable," and by the stoppage of an extending gangrene or phagedsena. 223. The foregoing are the principal forms of acute dis- ease, in which recourse may be advantageously had to Alco- holic liquors ; but the Avriter Avould remark that, whilst gene- ral principles may be thus laid down, their application to each individual case must be left to the discrimination and tact of the practitioner, since no two cases are alike in all their conditions; and it will frequently happen that even the most experienced physician and surgeon will find it ne- cessary to be rather guided by the result of trials cautiously made, than by any rules whatsoever. In cases of fever,, it may be especially noticed that the instinct of the patient, shown by his desire for Avine, or his disposition to reject it, will generally prove a most valuable guide, even Avhen his intelligence is prostrated. 224. Forms of Alcoholic Liquors most desirable.—The different forms of alcoholic liquors must not be used indis- criminately in these varying conditions, for their operation upon the system differs considerably, and there are certain conditions of the body to which each is especially appro- priate. , 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 form of alcoholic 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 fre- quently requisite to administer spirits to patients who have been in the habit of free or excessive indulgence in alcoholic liquors, under circumstances in which 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 stimu- lation, it is not usually desirable to administer distilled spirit, and wine will be found the preferable form; this is IN THE TREATMENT OF DISEASE. . 193 especially the case in the advanced stage of fever, and in convalescence 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 employed; as 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 calmative 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 poisonous agents being very different from that Avhich results from the ex- haustion of its poAvers through chronic diseases, although debility is a characteristic of both. The writer's idea of the difference betAveen the two states, and of the relations of eaeh to alcoholic stimulants, may perhaps be best ex- plained 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 helping hand in getting on his legs again. But if the same man expend his powers in a prolonged pugilistic encounter, although he may not have received any one severe injury, he becomes at last so ex- hausted that no helping hand can avail him anything, and he sinks beneath the slightest force put forth by his oppo- nent—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 stimulants in chronic diseases, so far, at least, as regards their stimulant operation upon the heart and nervous system; and what benefit they are capable of conferring wM be obtained by their improvement of the digestive poAver, and of the processes of primary assimila- tion. But it is very doubtful whether the temporary im- provement which can sometimes be thus obtained is not really fallacious—like that which we see in the burning of a lamp, just after the raising of the wick, when there is a 17 194 USE OF ALCOHOL deficiency of oil; since it is procured, not by the re-anima- tion of power which exists in the body, but has previously lain dormant, but by the more rapid consumption of the small stock of power left. And the question of their bene- fit 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 efficacy. But we have seen reason, within a- recent period, to deny or doubt the efficacy of many systems of treatment of chronic dis- eases which long-continued experience 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 especially important, in judging of the action of all remedies which must be persevered in for some time in order to produce any decided result, to take their remote consequences 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 of 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 only beneficial effect 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-con- tinued excess in diet, and habitual indulgence in a mode- rate allowance of fermented liquors, especially when accom- panied by exhaustion of the nervous power by over-exertion or anxiety of mind. It is quite absurd to effect that any change or variety of direct stimulation can reinvigorate the digestive apparatus under such circumstances. We may keep our patient in town at his usual occupations, practice all kinds of experiments upon his stomach, recommend fat bacon or lean chops, prescribe blue pill and senna-draught, IN THE TREATMENT OF DISEASE. 195 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 be- take himself to some agreeable spot, where there is sufficient to interest, but nothing to excite; to inhale the fresh and invigorating breezes of a mountainous country, in place of the close and deteriorated atmosphere of a toAvn ; to pro- mote the copious action of his skin by exercise, sweating, and free ablution; to wash out his inside and increase the tonic power of his stomach Avith occasional (but not excess- ive) 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 perma- nent restoration to health. 228. There is perhaps no class of cases in which the benefits of the Hydropathic treatment are so strikingly dis- played, especially when it is carried on in a spot where all other aids concur to make it most effectual; and reasoning from analogy, the writer is strongly inclined to believe that it would be of similar efficacy in re-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" com- parative experience, they are decidedly in favor of the Hydropathic treatment, moderately and judiciously applied, especially in cases of chronic Gout and Rheumatism ; but he would not be dogmatic enough to assert that there are not individual instances in which (as in the class formerly adverted to, § 194) the long-continued or even the habitual use of alcoholic liquors will promote recovery from chronic diseases by their influence on the digestive and assimilative apparatus. He does not see the possibility, however, of laying down any general rules by which such cases can be distinguished; and it will be only from the results of an extended exrjterience of, the comparative advantages and disadvantages of different modes of treatment, and of the immediate and remote consequences of the employment of alcoholic stimulants, as compared with those of the absti- nent system, that any really valuable inferences can be drawn. Until these shall have been obtained, he believes 196 USE OF ALCOHOL IN THE TREATMENT OF DISEASE. that abstinence will in most cases be the safer plan ; except where the prostration of the vital poAvers has proceeded to such an extent as to require temporary stimulation for the performance of any of the nutritive and regenerative operations. 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 asthe solvent for the various articles of food which are taken into the Stomach. It is Water alone which forms all the fluid portion of the blood, and thus serves to convey the nutritive material through the minutest capillary pores into the substance of the solid tissues. It is Water which, when mingled in various proportions with the solid components of the various textures, gives to them the consistence 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 ad- mixture of any other fluid—especially of one which, like Alcohol, possesses so marked a physical, chemical, and vital influence upon the other components of the Animal body— can be othenvise than injurious in the great majority of cases; and Avhere 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. 71. Some very remarkable details regarding the condition of the Ballasters and Coal-whippers employed on the Thames, have lately been ascertained by the inquiries of the " Commissioner" employed by the Morning Chronicle] and have been made public in the columns of that newspaper. The drinking habits of these men have been in part engendered by the system under which they have worked; which has involved, as the necessary condition of their employment, the expenditure of a large part of their earnings at the public house. This system was done away with, a few years since, as regards the Coal-whippers; but it still remains in force with respect to the Ballasters. Several of the former class are now Total Abstainers; while others who adopted the Abstinence system for a time have returned to their former habits. The in- quiries 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 showing 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 teetotaler 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 hun- dred and eighty tons in one day. I drank no fermented liquors the whole of the time. I had only ginger-beer and milk, and that cost me 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 three quarts of fluid altogether. I found that amount of drink necessary. I per- spired very violently—my shirt was wet through, and my flannels wringing wet with the perspiration over the work. The rule among us is that we do twenty-eight tons on deck, and twenty-eight tons filling in the ship's hold. We go on in that way throughout the day, spelling at every twenty-eight tons. The perspiration in the summer streams down our foreheads so rapidly, that it will often 17* 198 APPENDIX. 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. You can scrape the coal-dust off the tongue with the teeth; and, do what you will, it is impossible to get the least 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 tee- totaler, 1 was one of the strongest men in the business. I was able to carry seven hundred weight on my back for fifty yards, and I could lift nine half-hundreds with my right arm. After finishing my day's work, I was like a child with weakness." To the foregoing account, the following may be added from another witness by way of finish to the picture:— "Then there's the coals on your back to be carried up a nasty ladder, or some such contrivance, perhaps twenty feet—and a sack full of coals weighs two cwts. 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 slip- pery or wet weather, or you'll topple over, and there's the hospital or work-house for you. Last week we carried along planks sixty feet, at least. There's nothing extra allowed for distance, but there ought to be. I've sweat to that degree in summer that I've been tempted to jump into the Thames just to cool myself. The sweat's run into my boots, and I've felt it running down me for hours as I 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, even if it should be proAred that assistance is derived in its 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 stimulation, more work being got out of the frame than, it is natu- rally capable of discharging, its powers would be exhausted at an earlier period than that to which they would be preserved under a system of less excessive labor, performed without artificial support. And that such is the case is abundantly proved by the fact that APPENDIX. 199 such of these men as survive the attacks of acute disease, or are not the 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 Absti- nence 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 four 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 25 th 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 rto stop at the public house generally till I was drunk, and unfit to work in the morning. I will vouch for it, I used to take about three pots a day after I had done work. My reckoning used to come to about Is. Sd. per day, or, including Sundays, about 10s. Qd. 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 phy- sical, 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 statements just quoted, that both agree in the assertion that the principal part of the liquor consumed is taken in the evening, after the day's toil is over, as they "could not stand it" whilst at work. Thus it appears that the amount which can be effectively employed as a stimulus to nervo-muscular exertion is really small; and it is further evident that there is an entire absence of proof that anything is in the end gained by their use;— a conclusion which is in perfect harmony with the statements made 200 APPENDIX. in the Essay (§§ 85-102), as to the incapacity of Alcoholic liquors for maintaining the physical powers of the human system. That some of those who have tried the Total Abstinence 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 adequate 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 individuals similarly employed (given in the next Appendix), that where this course has been followed, the labor has been performed with more ease, and that the power of endurance has been increased. APPENDIX B, p. 95. The recent inquiries of the "Commissioner" of the Morning Chronicle not only reveal the circumstances under Ajhich a vast amount of excessiA7e drinking takes place among men engaged in laborious employments, but also confirm all that is stated in the text as to the possibility of performing the severest labor without such assistance, provided due support be obtained from solid food. The following 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 done more work since I have been a teetotaler in my eight 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 successful con- tradiction, that I do my work with more ease to myself, aud with more satisfaction to my employer, since I have given over intoxi- cating drinks. I scarcely know what thirst is. Before I took the pledge, I was always dry; and the. mere shadow of the pot-boy was quite sufficient to convince me that I wanted something. I certainly 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. APPENDIX. 201 But before I became a teetotaler, after 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 quantity of coals week after week without losing a day. I've got a family of six children under twelve years of age. My wife 's a teetotaler, and has suckled four children upon the principle of total abstinence. Teetotalism has made my home quite happy, and what I get goes twice as far. Where I work now, four of ua 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 ourselves, 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 intoxicating drink. Coal-backing from the ship's hold is the hardest work that it is possible for a man to do. Going up a ladder sixteen feet high, with 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 him 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. 202 APPENDIX. APPENDIX C, p. 181. On the Effect of Water-Drinking in the Cure of Gout. By John Bostock, M. D., F. R. S.— Communicated to the Medico- Chirur- gical Society. "The case to which I propose to direct the attention of the Society is that of a gentleman seventy years of age, who had been, from a very early period of his life, subject to very frequent attacks of gout, the predisposition to which complaint is inherited from his parents. Connected with this, he has been a constant sufferer from stomach-affections of various kinds; acidity, flatulence, heart-burn, irregularity of the bowels, and, in short, from every one of the affec- tions which are enumerated in Cullen'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 neATer in what could be considered an excess- ive quantity. In this way he had passed about forty years, seldom actually confined by indisposition, but almost always subject to a succession of ailments, which rendered it necessary to have recourse to medicines of various kinds, and, more especially, to alkalies, which were taken in large quantity, and, as the symptoms appeared to in- dicate, to purgatives or to sedatives, and to a. variety of tonics and stimulants. During this period, the renal secretion was seldom in what could-be considered a perfectly healthy state; it was some- times loaded with deposits, and of high specific gravity; sometimes of low specific gravity, limpid and aqueous; sometimes very copious, at other times scanty; while its chemical constitution was most variable both as to the nature and the proportion of its saline con- tents. " About four years ago, in consequence of the accession of cer- tain 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 appro- priate remedies, the threatened disease was averted. And besides APPENDIX. 203 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 dyspeptic 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 con- nected with it which I conceive to be particularly deserving of attention; that, although of an average specific gravity, and con- taining 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 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 functions of the kidney are more actively and effectively performed."—Medi- cal 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 Tem- perance 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 intoxi- cating drink. Beer, and occasionally gin and water, had been com- monly used; but, for a few years before practicing 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 relinquished all at once in the eighty- ninth year of her age. For a time, it was feared her health would suffer, but it was soon manifest that those fears were groundless; her appetite improved with the change of diet, and occasional inter- ruptions by a disordered stomach were much less frequent; she would at times observe that she could eat, drink, and sleep as well as at almost any period of her life; nor did her spirits appear to suffer eA-en temporarily. For nearly fifteen years, she had been tried with a sore in one of her legs, which was troublesome, and at times appeared to be dangerous; after practicing 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 medi- cal attendant recommended wine, to which she had recourse for about six months, when the wound in her leg again opened, and 204 APPENDIX. became troublesome; the wine was consequently discontinued, 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 enjoyment of excellent health and spirits, and the full possession of nearly all her faculties, although ninety-three years old." ,EA AND BLANCHARTHS PUBLICATIONS. MEDICAL BOOKS. TO THE MEDICAL PROFESSION. The following list embraces works on Medical and other Sciences issued by the subscribers. They are to be met with at all the principal bookstores throughout the Union, and will be found as low in price as is consistent with the correctness of their printing, beauty of execution, illustration, and durability of binding. No prices are here mentioned, there being no fixed standard, as it is evident that books cannot be retailed h*. the same rate in New Orleans or Chicago as in Philadelphia. Any information, however, relative to size, cost, &c, can be had on application, free of postage, to the subscribers, or to any of the medical booksellers throughout the country. LEA & BL AN CHARD, Philadelphia. DICTIONARIES, JOURNALS, &o. AMERICAN JOURNAL OP THE ME- DICAL SCIENCES, quarterly, at $5 a year. AN ANALYTICAL COMPEND of the various branches of Practical Medicine, Surgery, Anatomy, Midwifery, Diseases of Women and Children, Materia Medica and Therapeutics, Physiology, Chemis- try and Pharmacy, by John Neill, M. D., and F. Gurney Smith, M. D., with nu- merous illustrations (nearly ready). CYCLOPAEDIA OF PRACTICAL MEDI- C1NE, by Forbes, Tweedie, fee, edited by Dunglison, in 4 super royal volumes, 3154 double columned pages, strongly bound. DUNGLISON'S MEDICAL DICTION ARY, Gth ed., 1 vol. imp. 8vo., 804 large pages, double columns. HOBLYN'S DICTIONARY OF MEDI- CAL TERMS, by Hays, 1 vol. large 12nio., 40ii pages, double columns. MEDICAL NEWS AND LIBRARY, monthly, at $1 a year. ANATOMY, VATOMICAL ATLAS, by Smith and Horner, large imp. 8vo., 650 figures. HORNER'S SPECIAL ANATOMY AND HISTOLOGY, 7th edition, 2 vols. 8vo., many cuts, 1130 pages. HORNER'S UNITED STATES' DIS- SECTOR, 1vol. large royal 12mo., many cuts, 444 pages. •- aUAIN'S ELEMENTS OF ANATOMY, by Sharpey, many cuts (preparing). WILSON'S HUMAN ANATOMY, by Goddard, 3d edition, 1 vol. 8vo., 235 wood- cuts, C20 pages. WILSON'S DISSECTOR, or Practical and Surgical Anatomy, with cuts,- 1 vol. 12mo., 444 pages. PHYSIOLOGY. CARPENTER'S PRINCIPLES OF HU- MAN PHYSIOLOGY, edited byClymer, 1 vol. 8vo., over 300 illustrations, 3d edition, with many additions. CARPENTER'S ELEMENTS, OR MAN- UAL OF PHYSIOLOGY, 1 vol. 8vo., 56G pages, many cuts. CARPENTER'S COMPARATIVE ANA- TOMY AND PHYSIOLOGY, revised by the author, with beautiful engravings (preparing). CONNECTION BETWEEN PHVSt OLOGY AND INTELLECTUAL SCIENCE, 1 vol. 18mo., paper, &3 cts. LEA AND BLANCHARD'S PUBLICATIONS. MEDICAL BOOKS CYCLOPAEDIA OF ANATOMY AND PHYSIOLOGY, based on the large work of Todd, in two vols, large 8vo„ numer- ous cuts (preparing). DUNGLISON'S HUMAN PHYSIOLOGY, 6th edition, 2 vols. 8vo., 1350 pages, and 370 wood-cuts. HARRISON ON THE NERVES, 1 vol. 8vo., 292 pages. MULLER'S PHYSIOLOGY, by Bell, 1 vol. 8vo., 886 pages. ROGET'S OUTLINES OF PHYSI- OLOGY, 8vo., 516 pages. SOLLY ON THE HUMAN BRAIN, ITS STRUCTURE, PHYSIOLOGY, AND DISEASES (preparing). TODD AND BOWMAN'S PHYSIOLO- GICAL ANATOMY AND PHYSI- OLOGY OF MAN, with numerous wood- cuts (publishing in the Medical News), to be complete in one volume. PATHOLOGY. ABERCROMBIE ON THE STOMACH, new edition, 1 vol. 8vo., 320 pages. ABERCROMBIE ON THE BRAIN, new edition, 1 vol. 8vo., 324 pages. ALISON'S OUTLINES OF PATHO- LOGY, &c, 1 vol. 8vo., 420 pages. ANDRAL ON THE BLOOD, translated by Meigs and Stille, 1 vol. small 8vo., 120 pages. BERZELIUS ON THE KIDNEYS AND URINE, 8vo., 180 pages. BENNET ON THE UTERUS, 1 vol. 12mo., 146 pages. BUDD ON THE LIVER, 1 vol. 8vo.,392 pages, plates and wood-cuts. BILLING'S PRINCIPLES, 1 vol. 8vo., 304 BIRD ON URINARY DEPOSITS, 8vo., 228 pages, cuts. HASSE'S PATHOLOGICAL ANATO- MY, 8vo., 379 pages. HOPE ON THE HEART, by Pennock, a new edition, with plates, 1 vol. 8vo., 572 pages. HUGHES ON THE LUNGS AND HEART, 1 vol. 12mo.,270 pages, with a plate. PHILIP ON PROTRACTED INDIGES- TION, 8vo 240 pages. PHILIP'' N SCROFULA, 1 vol. 8vo., 350 r es, plates. PROI^r ON THE STOMACH AND RE- NAL DISEASES, 1 vol. 8vo., 466 pages, coloured plates. RICORD ON VENEREAL, new edition, 1 vol. 8vo., 256 pages. VOG EL'S PATHOLOGICAL ANATOMY OP THE HUMAN BODY, 1 vol. 8vo., 536 pages, coloured plates. WALSHE ON THE LUNGS, 1 vol. 12mo., 310 pages. WILSON ON THE SKIN, 1 vol. 8vo., 370 pages ; a new edition. Same Work, with coloured plates. WILLIAMS' PATHOLOGY, OR PRIN- CIPLES OF MEDICINE, 1 vol. 8vo., 384 pages. WILLIAMS ON THE RESPIRATORY ORGANS, by Clymer, 1 vol. 8vo., 500 pages. PRACTICE OF MEDICINE. ASH WELL ON THE DISEASES OP FEMALES, by Goddard, Tvol. 8vo., 520 pages. BARTLETT ON THE HISTORY, DIAG- NOSIS AND TREATMENT OF TY- PHOID, TYPHUS, BILIOUS REMIT- TENT, CONGESTIVE AND YELLOW FEVER, a new and extended edition of his former work (nearly ready). BENEDICT'S COMPENDIUM OF CHAPMAN'S LECTURES, 1 vol. 8vo., 258 pages. CHAPMAN ON THORACIC AND AB- DOMINAL VISCERA, &c, 1 vol. 8vo„ 384 pages. CHAPMAN ON FEVERS, GOUT, DROPSY, &c. &c, 1 vol. 8vo., 450 pages. COLOMBAT DE L'ISERE ON FE- MALES, translated and edited by Meigs, 1 vol. 8vo., 720 pages, cuts. COATES' POPULAR MEDICINE, a new edition, brought up to the day, many cuts (preparing). CONDIE ON THE DISEASES OF CHIL- DREN, 2d edition, 1 vol. 8vo., 658 pages. CHURCHILL ON THE DISEASES OF FEMALES, by Huston, 4th edition, 1 vol. 8vo., 604 pages. CHURCHILL ON THE MANAGEMENT AND MORE IMPORTANT DISEASES OF INFANCY- AND CHILDHOuO (preparing). CLYMER AND OTHERS ON FEVERS, a complete work, in 1 vol. 8vo., 600 pages. DEWEES ON CHILDREN, 9th edition, 1 vol. 8vo., 548 pages. DEWEES ON FEMALES, 8th edition, 1 vol. 8vo., 532 pages, with plates. DUNGLISON'S PRACTICE OF MEDI- CINE, 2d edition, 2 volumes 8vo., lj;;-2 ESttUIROL ON INSANITY, by Hunt, 8vo., 496 pages. MEIGS ON FEMALES, in a series of Letters to his CIa?s, with cuts (a new work, nearly ready). THOMSON ON THE SICK ROOM, &c, 1 vol. large 12mo., 360 pages, cuts. WATSON'S PRINCIPLES AND PRAC- TICE OF PHYSIC, 3d improved edition, by Condie, 1 very large vol. 8vo., over 1000 pages strongly bound. LEA AND BLANCHARD'S PUBLICATIONS. MEDIC SURGERY. I BRODIE ON URINARY ORGANS, 1 vol. ! 8vo., 214 pages, BRODIE ON THE JOINTS, 1 vol. 8vo. \ 216 pages. ! BRODIE'S LECTURES ON SURGERY, I 1 vol. 8vo., 350 pages. ! BRODIE'S SELECT SURGICAL WORKS i I vol. 8vo., 780 pages. I CF1ELIUS' SYSTEM OP SURGERY, by i South and Norris, in 3 large 8vo. vols., ! over 2000 pages, well bound. ; COOPER ON DISLOCATIONS AND ; FRACTURES, 1 vol. 8vo., 500 pp.,many ; cuts. ; COOPER ON HERNIA, 1 vol. imp. 8vo., j 428 pages, plates. ; COOPER ON THE TESTIS AND THY- ; MUS GLAND, 1 vol. imp. 8vo., many ; plates. ; COOPER ON THE ANATOMY AND DISEASES OF THE BREAST, SUR- GICAL PAPERS, &c. &c, 1 vol. impe- j rial 8vo., plates. DRUITT'S PRINCIPLES AND PRAC- I TICE OF MODERN SURGERY, 3d ed., 1 1 vol. 8vo,, 534 pages, many cuts. DURLACHER ON CORNS, BUNIONS, ! &c, 12mo., 134 pages. DISEASES AND SURGERY OP THE! EAR, a new and complete work (pre-j paring). j FERGUSSON'SPRACTICAL SURGERY ] vol. 8vo., 2d edition, 640 pages, many 5 cuts. „ GUTHRIE ON THE BLADDER, 8vo., 150 pages. HARRIS ON THE MAXILLARY SI-; NUS, 8vo., 166 pages. ; JONES' (WHARTON) OPHTHALMIC \ MEDICINE AND SURGERY, by Hays, . 1 vol. royal 12mo., 529 pages, many cuts,! and plates, plain or coloured. LISTON'S LECTURES ON SURGERY, \ by Mutter, 1 vol. 8vo., 566 pages, many j cuts. LAWRENCE ON THE EYE, by Hays,: new edition, much improved, 863 pages, many cuts and plates. LAWRENCE ON RUPTURES, 1 vol. 8vo., 480 pages. MALGAIGNE'S OPERATIVE SUR- GERY, with illustrations (preparing). MILLER'S PRINCIPLES OF SURGERY, 1 vol. 8vo., 526 pages. MILLER'S PRACTICE OF SURGERY, 1 vol. Svo., 496 pages. BOOKS. MAURY'S DENTAL SURGERY, 1 vol. 8vo., 286 pages, many plates and cuts. ROBERTSON ON THE TEETH, 1 vol. 8vo., 230 pages, plates. SARGENT'S MINOR SURGERY, 1 vol. 12mo., with cuts (preparing). MATERIA MEDICA AND THERA- PEUTICS. DUNGLISON'S MATERIA MEDICA ANDTHERAPEUTICS, a new edition, with cuts, 2 vols. 8vo., 986 pages. DUNGLISON ON NEW REMEDIES, 5th ed., 1 vol. 8vo., 653 pages. ELLIS* MEDICAL FORMULARY, 8th edition, much improved, 1 vol. 8vo., 272 pages. GRIFFITH'S MEDICAL BOTANY, a new and complete work, 1 large vol. 8vo., with over 350 illustrations, 704 pages. GRIFFITH'S UNIVERSAL FORMU- LARY AND PHARMACY, a new and complete work, 1 vol. large 8vo. (at press). PEREIRA'S MATERIA MEDICA AND THERAPEUTICS, by Carson, 2d ed., 2 vols. 8vo., 1580 very large pages, nearly 300 wood-cuts. ROYLE'S MATERIA MEDICA AND THERAPEUTICS, by Carson, 1 vol, 8vo., 689 pages, many cuts. STILLE'S ELEMENTS OF GENERAL THERAPEUTICS, a Jiew work (pre- paring). UNIVERSAL DISPENSATORY, with many wood-cuts, 1 vol. large 8vo. (pre- paring). OBSTETRICS. CHURCHILL'S THEORY AND PRAC- TICE OF MIDWIFERY, by Huston, 2d ed., 1 vol. 8vo., 520 pages, many cut3. DEWEES' SYSTEM OF MIDWIFERY, 11th edition, 1 vol. 8vo., 660 pages, with plates. RIGBY'S SYSTEM OP MIDWIFERY, 1 vol. 8vo., 492 pages. RAMSBOTHAM ON PARTURITION, with many plates, 1 large vol. imperial 8vo., new and improved edition, 520 pages. LEA AND BLANCHARD'S PUBLICATIONS. MEDICAL BOOKS. CHEMISTRY AND HYGIENE. BRIGHAM ON MENTAL EXCITE- MENT, &c, 1 vol. 12mo., 204 pages. DUNGLISON ON HUMAN HEALTH, 2d edition, 8vo., 464 pages. FOWNE'S ELEMENTARY CHEMIS- TRY FOR STUDENTS, by Bridges, 2d edition, 1 vol. royal 12mo., 460 large pages, many cuts. GRAHAM'S ELEMENTS OF CHEMIS- TRY, 1 large vol. 8vo. (new and im- proved edition at press), many cuts. MAN'S POWER OVER HIMSELF TO PREVENT OR CONTROL INSANITY, 18mo., paper, price 25 cents. PRACTICAL ORGANIC CHEMISTRY, 18mo., paper, 25 cts. SIMON'S CHEMISTRY OF MAN, 8vo., 730 pages, plates. MEDICAL JURISPRUDENCE, EDUCA- TION, Sua. . BARTLETT'S PHILOSOPHY OF MEDI- CINE, 1 vol. 8vo., 312 pages. DUNGLISON'S MEDICAL STUDENT, 2d edition, 12mo., 312 pages. TAYLOR'S MEDICAL JURISPRU- DENCE, by Griffith, 1 vol. 8vo., 540 pages. TAYLOR'S MANUAL OF TOXICO- LOGY, edited by Griffith (at press). TRAILL'S MEDICAL JURISPRU- DENCE, 1 vol. 8vo., 234 pages. NATURAL SCIENCE, Bus. ARNOTT'S ELEMENTS OF PHYSICS. new edition, 1 vol. 8vo., 484 pages, many cuts. ANSTED'S ANCIENT WORLD—POPU- LAR GEOLOGY, with numerous illus- trations (nearly ready). BIRD'S NATURAL PHILOSOPHY, from a new London edition, 1 vol. royal 12mo., many cuts (at press). BREWSTER'S TREATISE ON OPTICS, 1 vol. 12mo., 423 pages, many cuts. BABBAGE'S " FRAGMENT," 1 vol. 8vo., 250 pages. BUCKLAND'S GEOLOGY AND MINE- RALOGY, 2 vols. 8vo., with numerous plates and mans. BRIDGEWATER TREATISES, with many plates, cuts, maps, &c, 7 vols. 8vo., 3287 pages. CARPENTER'S ANIMAL PHYSIOLO- GY, with 300 wood-cuts (preparing). CARPENTER'S POPULAR VEGETA- BLE PHYSIOLOGY, 1 vol. royal 12mo., many cuts. DANA ON CORALS, 1 vol. royal 4to., with an atlas of plates, being vols. 8 and 9 of U. States Exploring Expedition (at press). DE LA BECHE'S NEW WORK ON GEOLOGY, with wood-cuts (preparing). GRIFFITHS' CHEMISTRY OF THE FOUR SEASONS, 1 vol. royal 12mo., 451 pages, many cuts. ; HALE'S ETHNOGRAPHY AND PHI- LOLOGY OF THE U. S. EXPLORING EXPEDITION, in 1 large imp. 4to. vol. : HERSCHELL'S TREATISE ON ASTRO- NOMY, 1 vol. I2mo., 417 pages, numer- ous plates and cuts. INTRODUCTION TO VEGETABLE PHYSIOLOGY, founded on the works of De Candolle, Lindley, &c, 18mo. KIRBY ON ANIMALS, plates, 1 vol. 8vo., 520 pages. KIRBY AND SPENCE'S ENTOMO- LOGY, 1 vol. 8vo., 61(0 large pages; plates, plain or coloured. METCALF ON CALORIC, 1 vol. large 8vo. (preparing). MULLER'S PRINCIPLES OF PHYSICS AND METEOROLOGY, with five hun- dred and fifty wood-cuts, and two co- loured plates (nearly ready). ! PHILOSOPHY IN SPORT MADE SCI- ' ENCE IN EARNEST,lvol. royal 18mo., 430 pages, many cuts. ROGET'S ANIMAL AND VEGETABLE PHYSIOLOGY, with 400 cuts, 2 vols. 8vo., 872 pages. [TRIMMER'S GEOLOGY AND MINE- RALOGY, 1 vol. 8vo., 528 pages, many cuts. VETERINARY MEDICINE. CLATER AND SKINNER'S FARRIER 1 vol. 12mo., 220 pages. YOUATT'S GREAT WORK ON THE HORSE, by Skinner, 1 vol. 8vo., 448 pages, many cuts. YOUATT AND CLATER'S CATTLE DOCTOR, 1 vol. 12mo., 282 pages, cuts. YOUATT ON THE DOG, by Lewis, 1 vol. demy 8vo., 403 pages, beautiful plates. YOUATT ON THE PIG, 1 vol. 12mo oages, beautiful plates. CATALOGUE OF LEA AND BLANCHARD'S PUBLICATIONS. THE AMERICAN ENCYCLOPAEDIA. BROUGHT UP TO 1847. THE ENCYCLOPEDIA AMERICANA! A POPULAR DICTIONARY OF ARTS, SCIENCES, LITERATURE, HISTORY, POLITICS AND BIOGRAPHY. IN FOURTEEN LARGE OCTAVO VOLUMES OF OVER SIX HUNDRED DOUBLE COLUMNED PAGES EACH. For sale very low, in various styles of binding. During the long period which this work has been before the public, it has attained a very high character as an ENCYCLOPAEDIA FOR DAILY REFERENCE, Containing, in a comparatively moderate space, a vast quantity of informa- tion which is scarcely to be met with elsewhere, and of the exact kind which is wanted in the daily exigencies of conversation and reading. It has also a recommendation shared by no other work of the kind now before the public, in being an American book. The numerous American Biogra- phies, Accounts ofAmerican Inventions and Discoveries, References to our Political Institutions, and the general adaptation of the whole to our own peculiar habits and modes of thought, peculiarly suit it to readers in this country. From these causes, it is also especially fitted for all DISTRICT SCHOOL AND OTHER PUBLIC LIBRARIES, in some of which it has been tried with great satisfaction. It fulfils, to a greater extent than perhaps any similar work, the requirements for these institutions, presenting, in a small compass and price, the materials of a library, and furnishing a book for every-dav use and reference, indispensable to those removed from the large public collections. Some years having elapsed since the original thirteen volumes of the ENCYCLOPAEDIA AMERICANA were published, to bring it up to the present day, with the history of that period, at the request ofnumerous subscribers, the publishers have just issued a SUPPLEMENTARY VOLUME (THE FOURTEENTH), BRINGING THE WORK UP TO THE YEAR 1847 EDITED BY HENRY VETHAKE, LL.D. Vice-Provost and Professor of Mathematics in the University of Pennsylvania, Author of "A Treatise on Political Economy." In one large octavo volume of over 650 double columned pages. LEA AND BLANCHARD'S PUBLICATIONS. ENCYCLOPAEDIA AMERICANA. The numerous subscribers who have been waiting the completion of this volume can now perfect their sets, and all who want A REGISTER OF THE EVENTS OF THE LAST FIFTEEN YEARS, FOR THE WHOLE WORLD, can obtain this volume separately: price Two Dollars uncut in cloth, or Two Dollars and Fifty Cents in leather, to match the styles in which the publishers have been selling sets. Subscribers in the large cities can be supplied on application at any of the principal bookstores ; and persons residing in the country can have their sets matched by sending a volume in charge of friends visiting the city. Complete sets furnished at very low prices in various bindings. " The publishers of the -Encyclopedia Americana conferred an obligation on the public when, fourteen years ago, they issued the thirteen volumes from their press. They contained a wonder- ful amount of information, upon almost every subject which would be likely to occupy public attention, or be the theme of conversation in the private circle. Whatever one would wish to inquire about, it seemed only necessary to dip into the Encyclopaedia Americana, and there the outline, at least, would be found, and reference made to those works which treat at large upon the subject. It was not strange, therefore, that the work was popular. But in fourteen years, great events occur. The last fourteen years have been full of them, and great discoveries have been made in sciences and the arts; and great men have, by death, commended their names and deeds to the fidelity of the biographer, so that the Encyclopaedia that approached perfection in 1832, might fall considerably behind in 1846. To bring up the work, and keep it at the present point, has been a task assumed by Professor Vethake, of the Pennsylvania University, a gentleman entirely competent to such an undertaking; and with a disposition to do a good work, he has supplied a supplementary volume to the main work, corresponding in size and arrangements therewith, and becoming, indeed, a fourteenth volume. The author has been exceedingly industrious, and very fortunate in discovering and selecting materials, using all that Germany has presented, and resort- ing to every species of information of events connected with the plan of the work, since the pub- lication of the thirteen volumes. He has continued articles that were commenced in that work, and added new articles upon science, biography, history, and geography, so as to make the present volume a necessary appendage in completing facts to the other. The publishers deserve the thanks of the readers of the volume, for the handsome type, and clear white paper they have used m the publication."— United States Gazette. " This volume is worth owning by itself, as a most convenient and reliable compend of recent His- tory, Biography, Statistics, &c, &c. The entire work forms the cheapest and probably now the most desirable Encyclopaedia published for popular use."—Neu> York Tribune. " The Conversations Lexicon (Encyclopaedia Americana) has become a household book in all the intelligent families in America, and is undoubtedly the best depository of biographical, historical, geographical and political information of that kind which discriminating readers require."—SUli- man's Journal. "This volume of the Encyclopaedia is a Westminster Abbey of American reputation. What names are on the roll since 1833!"—N. Y. Literary World. " The work to which this volume forms a supplement, is one of the most important contributions that has ever been made to the literature of our country. Besides condensing into a compara- tively narrow compass, the substance of larger works of the same kind which had preceded it, it contains a vast amount of information that is not elsewhere to be found, and is distinguished, not less for its admirable arrangement, than for the variety of subjects of which it treats. The present volume, which is edited by one of the most distinguished scholars of our country, is worthy to follow in the train of those which have preceded it. It is a remarkably felicitous condensation or the more recent improvements in science and the arts, besides forming a very important aildi- * on to the department of Biography, the general progress of society, &c, <5u? " -Albany Argits LEA AND BLANCHARD'S PUBLICATIONS. CAMPBELL'S LOUD CHANCELLORS. JUST PUBLISHED. LIVES OF THE LORD CHANCELLORS AND KEEPERS OF THE GREAT SEAL OF ENGLAND, FROM THE EARLIEST TIMES TO THE REIGN OF KING GEORGE IV., BY JOHN LORD CAMPBELL, AM., F.R.S.E. First Series, forming three neat volumes in demy octavo, extra cloth. Bringing the work to the time of Lord Jeffries. THE SECOND SERIES WILL SHORTLY FOLLOW IN FOUR VOLUMES TO MATCH. " It is sufficient for us to thank Lord Campbell for the honest industry with which he has thus far prosecuted his large task, the general candor and liberality with which he has analyzed the lives and characters of a long succession of influential magistrates and ministers, and the manly style of his narrative. We need hardly say that we shall expect with great interest the continuation oTthis performance. But the present series of itself is more than sufficient to give Lord Campbell a high station among the English authors of his age."—Quarterly Review. " The volumes teem with exciting incidents, abound in portraits, sketches and anecdotes, and are at once interesting and instructive. The work is not only historical and biographical, but it is anecdotal and philosophical. Many of the chapters embody thrilling incidents, while as a whole, the publication may be regarded as of a high intellectual order."—Inquirer. "A work in three handsome octavo volumes, which we shall regard as both an ornament and an honor to our library. A History of the Lord Chancellors of England from the institution of the office, is necessarily a History of the Constitution, the Court, and the Jurisprudence of the King- dom, and these volumes teem with a world of collateral matter of the liveUest character for the general reader, as well as with much of the deepest interest for the professional or philosophical mind."—Saturday Courier. " The brilliant success of this work in England is by no means greater than its merits. It is certainly the most brilliant contribution to English history made within our recollection ; it has the charm and freedom of Biography combined with the elaborate and careful comprehensiveness iif History."—iV. Y. Tribune. MURRAY'S ENCYCLOPEDIA OF GEOGRAPHY. THE EN CYCLOP/E DIA OF GEOGRAPHY, COMrWSINO *V COMPLETE DESCRIPTION OF THE EARTH, PHYSICAL, STATISTICAL, CIVIL AND POLITICAL. EXHIBITING ITS RELATION TO THE HEAVENLY BODIES. ITS PHYSICAL STRUCTURE, THE NATURAL HISTORY OF EACH COUNTRY, AND THE INDUSTRY, COMMERCE, POLITICAL INSTITUTIONS, AND CIVIL AND SOCIAL STATE OF ALL NATIONS. BY HUGH MURRAY, F.R.S.E., &c. Assisted in Botany, by Professor HOOKER-Zoology, &c, by W. W. SWAINSON-Astronorny, Sc. by Professor WALLACE—Geology, fas., by Professor'JAMLSON. REVISED,WITH ADDITIONS, BY THOMAS G. BRADFORD. THE WHOLE BROUGHT UP, BY A SUPPLEMENT, TO 1843. In three large octavo volumes. VARIOUS STYLES. OF BINDING. This great work, furnished at u remarkably cheap rate, contains about Nineteen Hundred large imperial Pages, and is illustrated by Etghty- Two small Maps, and a colored Map of the United States, after Tan ner's, together with about Eleven Hundred Wood Cuts executed in the best style, LEA AND BLANCHARD'S PUBLICATIONS. STRICKLAND'S QUEENS OF ENGLAND. A NEW AND ELEGANT EDITION OF LIVES OF THE QUEENS OF ENGLAND, FROM THE NORMAN CONQUEST; WITH ANECDOTES OF THEIR COURTS, NOW FIRST PUBLISHED FROM OFFICIAI RECORDS AND OTHER AUTHENTIC DOCUMENTS, PRIVATE AS WELL AS PUBLIC, NEW EDITION, WITH ADDITIONS AND CORRECTIONS. BY AGNES STRICKLAND. Forming a handsome series in crown octavo, beautifully printed with large type on fine paper, done up in rich extra crimson cloth, and sold at a cheaper rate than former editions. Volume One, of nearly seven hundred large pages, containing Volumes One, Two, and Three, of the duodecimo edition, and Volume Two, of more than six hundred pages, containing Volumes Four and Five of the 12mo., have just been issued. The remainder will follow rapidly, two volumes in one, and the whole will form an elegant set of one of the most popular his- tories of the day. The publishers have gone to much expense in pre- paring this from the revised and improved London edition, to meet the fre ■ quent inquiries for the " Lives of the Queens of England," in better style, larger type, and finer paper than has heretofore been accessible to readers in this country. Any volume of this edition sold separately. A few copies still on hand of the Duodecimo Edition. Ten volumes are now ready. Vol. I.—Contains Matilda of Flanders, Matilda of Scotland, Adelicia of Louvaine, Matilda of Boulogne, and Eleanor of Aquitaine. Price 50 cents, in fancy paper. Vol. II.—Berengaria of Navarre, Isabella of Angouleme, Eleanor of Provence, Eleanor of Castile, Marguerite of France, Isabella of France, Philippa of Hainault, and Anne of Bohemia. Price 50 cents. Vol. III.—Isabella of Valois, Joanna of Navarre, Katha- rine of Valois, Margaret of Anjou, Elizabeth Woodville, and Ann of War- wick. Price 50 cents. Vol. IV.—Elizabeth of York, Katharine of Arragon, Anne Boleyn, Jane Seymour, Anne of Cleves, and Katharine Howard. Price G5 cents. Vol. V.—Katharine Parr and Queen Mary. Price 65 cents. Vol. VI.—Queen Elizabeth. Price 65 cents. Vol. VII.—Queen Elizabeth (continued), and Anne of Denmark. Price 65 cents. Vol. VIII.—Henrietta Maria and Catharine of Braganza. Price 65 cents. Vol. IX.—Mary of Modena. Price 75 cents. Vol. X.— Mary of Modena (continued), and Mary II. Price 75 cents. Any volume sold separately, or the whole to match in neat green cloth. JUST PUBLISHED VOLU1SE TEN: CONTAINING MARY OF MODENA, AND MARY II. Price 75 cents in fancy paper.—Also, in extra green cloth. "These volumes have the fascination of a romance united to the integrity of history."—Times. "A most valuable and entertaining work."—Chronicle. "This interesting and well-written work, in which the severe truth of history takes almost the wudness of romance, will constitute a valuable addition to our biographical literature."—Morning Herald. " A valuable contribution to historical knowledge, to young persons especially. It contains a mass of every kin J of historical matter of interest, which industry and research could collect. We have derived much entertainment and instruction from the work."—Athenaeum. " The execution of this work is equal to the conception. Great pains have been taken to make it both interesting and valuable."—Literary Gazette. " A charming work—full of interest, at once serious and pleasing."—Monsieur Guizat. ' A most charming biographical memoir. We conclude by expressing our unoualified opinion, that we know of no more valuable contribution to modern history than this ninth volume of M.» Strickland's Lives of the Queens."—Morning Herald. r.EA AND BLANCHARD'S PUBLICATIONS. BIOGRAPHY AND POETICAL REMAINS OF.THE LATE MARGARET MILLER DAVIDSON. BY WASHINGTON IRVING. A NEW EDITION, REVISED. POETICAL REMAINS OF THE LATE LUCRETIA ISARIA DAVIDSON". COLLECTED AND ARRANGED BY HER MOTHER, WITH A BIOGRAPHY BY MISS SEDGWICK. A NEW EDITION, REVISED. SELECTIONS FROM THE WRITINGS OF MRS. MARGARET M. DAVIDSON, THE MOTHER OF LUCRETIA AND MARGARET. WITH A PREFACE BY MISS SEDGWICK. i'he above three works are done up to match in a neat duodecimo form, fancy paper, price fifty cent s each; or in extra cloth. THE LANGUAGE OF FLOWERS, WITH ILLUSTRATIVE POETRY; TO WHICH ARE NOW ADDED THE CALENDAR OF FLOWERS, AND THE DIAL OF FLOWERS. SEVENTH AMERICAN, FROM TIIE NINTH LONDON EDITION. Revised by the Editor of the " Forget-Me-Not." In one very neat 18mo. volume, extra crimson cloth, gilt. With six colored Plates. CAMPBELL'S POETICAL WORKS, THE ONLY COMPLETE AMERICAN EDITION, WITH A MEMOIR OF THE AUTHOR BY IRVING, AND AN ESSAY ON HIS GENIUS BY JEFFREY. In one beautiful crown octavo volume, extra cloth, or calf gilt: with a Portrait and 12 Plates. KEBLE'S CHRISTIAN YEAR, EDITED BY THE RIGHT REV. BISHOP DOANE. Miniature Edition, in 32mo., extra cloth, with Illuminated Title. RELIG10 MEDICI, AND ITS SEQUEL, CHRISTIAN MORALS, BY SIR THOMAS BROWNE, KT., WITH RESEMBLANT PASSAGES FROM COWPER'S TASK. In one neat I2mo. volume. ^ HEMANS'S COMPLETE POETICAL WORKS, IN SEVEN VOLUMES, ROYAL 12MO., PAPER OR CLOTH. ROGERS'S POEMS, ILLUSTRATED, IN ONE IMPERIAL OCTAVO VOLUME, EXTRA CLOTH OR WHITB CALF. LEA AND BLANCHARD'S PUBLICATIONS. DICKENS'S WORKS. VARIOUS EDITIONS AND PRICES. CHEAPEST EDITION IN NINE PARTS PAPER, AS FOLLOWS: THE PICKWICK PAPERS, 1 large vol. 8vo., paper, price 50 cents. OLIVER TWIST, 1 vol. 8vo., paper, price 25 cents. SKETCHES OF EVERY-DAY-LIFE, 1vol. 8vo., paper, price 37 J cents. NICHOLAS NICKLEBY, 1 large vol. 8vo., paper, price 50 cents. THE OLD CURIOSITY SHOP, 1 vol. 8vo., paper, with many Cuts, price 50 cents. BARNABY RUDGE, 1 vol. 8vo., with many Cuts, price 50 cents. MARTIN CHUZZLEW1T, 1 vol. 8vo., with plates, price 50 cents. CHRISTMAS STORIES.—The Carol, The Chimes, The Cricket on the Hearth, and The Battle of Life—together with Pictures from Italy, 1 vol. 8vo., price 37£ cents. DOMBEY AND SON, Part I., to be completed in Two Parts, price 25 cents each. Forming a neat and uniform Edition of these popular works. Any work sold separately. ALSO, A UNIFORM AND CHEAP EDITION OF DICKENS'S NOVELS AND TALES, IN THREE LARGE VOLUMES. THE NOVELS AND TALES OF CHARLES DICKENS, (BOZ,) In Three large and beautiful Octavo Volumes, done up in Extra Cloth, CONTAINING ABOUT TWENTY-TWO HUNDRED AND FIFTY LARGE DOUBLE COLUMNED PAGES. PRICE FOR THE WHOLE, ONLY THREE DOLLARS AND SEVENTY-FIVE CENTS. The frequent inquiries for a uniform, compact and good edition of Boz's works, have induced the publishers to prepare one, which they now offer at a price so low that it should command a very extended sale. It is printed on fine white paper, with good type, and forms three large volumes, averaging about seven hundred and fifty pages each, done up in various styles of extra cloth, making a beautiful and portable edition.—Some of the works are illustrated with Wood Engravings. This Edition comprehends the first seven parts, and will be completed with the issue of the Fourth Volume, on the completion of "Dombey and Son," now in progress of publication, con- taining that work, the " Christmas Stories," and " Pictures from Italy." Purchasers may thus rely on being able to perfect their sets. ALSO, AN EDITION PROFUSELY ILLUSTRATED WITH ONE HUNDRED AND THIRTY-FOUR PLATES, AND ONE HUNDRED AND FORTY WOOD-CUTS. In Imperial octavo, extra cloth, on fine white paper. 53* The above are the only Complete and Uniform Editions of Dickens's Works now before the public. NOW PUBLISHING, DOSTBEY AND SON. FINE EDITION. In twenty numbers, price 8 cents each, with two illustrations by Hablot K. Browne in each number. This is the only edition which presents the plates accbmpanying the text to which they refer. LEA AND BLANCHARD'S PUBLICATIONS. SELECT WORKS OF FIELDING AND SMOLLETT, Printed in a neat and uniform style, to match the cheap edition of Dickens's Works. SELECT WORKS OF TOBIAS SMOLLETT, WITH A MEMOIR OF HIS LIFE AND WRITINGS, BY SIR WALTER SCOTT. THIS EDITION CONTAINS! THE ADVENTURES OF RODERICK RANDOM. Price twenty-five cents. THE ADVENTURES OF PEREGRINE PICKLE. Price fifty cents. THE EXPEDITION OF HUMPHREY CLINKER. Price twenty-five cents. THE ADVENTURES OF FERDINAND COUNT FATHOM. Price twenty-five cents. THE ADVENTURES OF SIR LAUNCELOT GREAVES, THE HISTORY AND ADVENTURES OF AN ATOM, AND SELECT POEMS. Price twenty-five cents. Or, the whole done up in one very large octavo volume, extra cloth. s e l e cTWiluroTIn^ WITH A MEMOIR OF HIS LIFE AND WRITINGS, BY SIR WALTER SCOTT, AND AN ESSAY ON HIS LIFE AND GENIUS, BY ARTHUR MURPHY, ESQ. THIS EDITION CONTAINS l TOM JONES OR THE HISTORY OF A FOUNDLING. Price fifty cents. THE ADVENTURES OF JOSEPH ANDREWS, AND HIS FRIEND MR. ABRAHAM ADAMS, Price fifty cents. AMELIA. Price twenty-five cents. THE LIFE OF JONATHAN WILD THE GREAT. Price twenty-five cents. Or, the whole in one large octavo volume, extra cloth. coo?iFr¥om?T^ A UNIFORM EDITION, IN TWENTY-THREE LARGE DUODECIMO VOLUMES, WELL BOUND IN SHEEP GILT, Forming a beautiful series, each volume comprehending a novel. ALSO, A CHEAP EDITION, IN FORTY-SIX VOLUMES, DUODECIMO,! DONE UP IN NEAT PAPER COVERS. Price only twenty-five cents a volume, each work in two volumes. Any novel sold separate. comprising: I5S XvJ!^°4™£thf■ prairie-the red rover-wing AND WING-WYAN- DOTTEfoR THE HUTTED KNOLL^ND THE TRAVELING BACHELOR. ALSO, NED^ERirORTA LIFE BEFORE THE MAST, In one 12mo. volume. Price twenty-five eentg. ALSO, COOPER'S SEA TALES, In six neat volumes, royal 12mo., extra eloth. COOPER'S LEATHER STOCKING TALES, In five neat volumes, royal 12mo., extra cloth. LEA AND BLANCHARD'S PUBLICATIONS. BOY'S TREASURY OF SPORTS. THE BOY'S TREASURY OF SPORTS, PASTIMES AND RECREATIONS. WITH FOUR HUNDRED ILLUSTRATIONS, BY SAMUEL WILLIAMS. IS NOW READY. In one very neat volume, bound in extra crimson cloth; handsomely printed and illustrated with engravings in the first style of art, and containing about six hundred and fifty articles. A present for all seasons. PREFACE. This illustrated Manual of" Sports, Pastimes, and Recreations," has been prepared with especial regard to the Health, Exercise, and Rational Enjoyment of the young readers to whom it is ad- dressed. Every variety of commendable Recreation will be found in the following pages. First, you have the little Toys of the Nursery; the Tops and Marbles of the Play-ground; and the Balls of the Play-room, or the smooth Lawn. '1 hen, you have a number of Pastimes that serve to gladden the fireside ; to light up many faces right joyfully, and make the parlour re-echo with mirth. Next, come the Exercising Sports of the Field, the Green, and the Play-ground; followed by the noble and truly English game of Cricket. Gymnastics are next admitted; then, the delightful recreation of Swimming ; and the healthful sport of Skating. Archery, once the pride of England, is then detailed ; and very properly followed by Instructions in the graceful accomplishment of Fencing, and the manly and enlivening exercise of Riding. Angling, the pastime of childhood, boyhood, manhood, and old age, is next described ; and by attention to the instructions here laid down, the lad with a stick and a string may soon become an expert Angler. Keeping Animals is a favourite pursuit of boyhood. Accordingly, we have described how to rear the Babbit, the Squirrel, the Dormouse, the Guinea Pig, the Pigeon, and the Silkworm. A long chapter is adapted tovthe rearing of Song Birds ; the several varieties of which, and their respective cages, are next described. And here we may hint, that kindness to Animals invariably denotes an excellent disposition; for, to pet a little creature one hour, and to treat it harshly the next, marks a capricious if not a cruel temper. Humanity is a jewel, which every boy should be proud to wear in his breast. We now approach the more sedate amusements—as .Draughts and Chess; two of the noblest exercises of the ingenuity of the human mind. Dominoes and Bagatelle follow. With a know- ledge of these four games, who would pass a dull hour in the dreariest day of winter; or who would sit idly by the fire ? Amusements in Arithmetic, harmless Legerdemain, or sleight-of-hand, and Tricks with Cards, will delight many a family circle, when the business of the day is over, and the book is laid aside. Although the present volume is a book of amusements, Science has not been excluded from its pages. And why should it be 1 when Science is as entertaining as a fairy tale. The changes we read of in little nursery-books are not more amusing than the changes in Chemistry, Optics, Eleo tricity, Magnetism, &c. By understanding these, you may almost become a little Magician. Toy Balloons and Paper Fireworks, (or Fireworks urithout Fire,) come next. Then follow In- structions for Modelling in Card-Board; so that you may hudd for yourself a palace or a carriage, and, in short, make for yourself a little paper world. Puzzles and Paradoxes, Enigmas and Kiddles, and Talking with the Fingers, next make up plenty of exercise for ''Guess," and " Guess again." And as you have the " Keys" in your own hand, yon may keep your friends in suspense, and make yourself as mysterious as the Sphynx. A chapter of Miscellanies—useful and amusing secrets—winds up the volume. The " Treasury" contains upwards of four hundred Engravings ; so that it is not only a collection of "secrets worth knowing," but it is a book of pictures, as full of prints as a Christmas pudding is of plums. It maybe as well to mention that the " Treasury" holds many new games that have never before been printed in a book of this kind. The old games have been described afresh. Thus it is, altogether, a new book. And now we take leave, wishing you many hours, and days, and weeks of enjoyment over these pages; and we hope that you may be as happy as this book is brimful of amusement. LEA AND BLANCHARD'S PUBLICATIONS. SMALL BOOKS ON GREAT SUBJECTS. A SERIES OF WORKS WHICH DESERVE THE ATTENTION OF THE PUBLIC, FROM THE VARIETY AND IMPORTANCE OF THETR SUBJECTS, AND THE CONCISENESS AND STRENGTH WITH WHICH THEY ARE WRITTEN. They form a neat 18mo. series, in paper, or strongly done up in three neat volumes, extra cloth. THERE ARE ALREADY PUBLISHED, No. 1.—PHILOSOPHICAL THEORIES AND PHILOSOPHICAL EXPERIENCE. 2.—ON THE CONNEXION BETWEEN PHYSIOLOGY AND INTELLECTUAL SCIENCE. 3.—ON MAN'S POWER OVER HIMSELF. TO PREVENT OR CONTROL INSANITY. 4.—AN INTRODUCTION TO PRACTICAL ORGANIC CHEMISTRY, WITH REFER- ENCES TO THE WORKS OF DAVY, BRANDE, LIEBIG, &c. 5.—A BRIEF VIEW OF GREEK PHILOSOPHY UP TO THE AGE OF PERICLES. 6.—GREEK PHILOSOPHY FROM THE AGE OF SOCRATES TO THE COMING OF CHRIST. 7.-CHRISTIAN DOCTRINE AND PRACTICE IN THE SECOND CENTURY. 8—AN EXPOSITION OF VULGAR AND COMMON ERRORS, ADAPTED TO THE YEAR OF GRACE MDCCCXLV. 9.—AN INTRODUCTION TO VEGETABLE PHYSIOLOGY, WITH REFERENCES TO THE WORKS OF DE CANDOLLE, LINDLEY, The publishers are happy in presenting to the admirers of Don Quixote an edition of that work in some degree worthy of its reputation and popularity. The want of such a one has long been felt in this country and in presenting this, they have only to express their hope that it may meet the numerous demands and-inquiries. The translation is that by Jarvis, which is acknowledged supe- rior in both force and fidelity to all others. It has in some few instances been slightly altered to adapt it better to modern readers, or occasionally to suit it to the inimitable designs of Tony Johannot. These latter are admitted to be the only successfnl pictorial exponents of the wit and humor ol Cervantes and a choice selection of them have been engraved in the best manner. A copious memoir of the author and his works has been added by the editor. The volumes are printed in arge clear type, on fine paper, and handsomely bound, and the whole is confidently offered as wortnv tne approbation of all readers of this imperishable romance. LEA AND BLANCHARD'S PUBLICATIONS. PICCIOLA. ILLUSTRATED EDITION. PICCIOLA, THE PRISONER OF FENESTRELLA; OR, CAPTIVITY CAPTIVE. BY X. B. SAINTINE. A. NEW EDITION, WITH ILLUSTRATIONS. In one elegant duodecimo volume, large type, and fine paper; price in fancy covers 50 cents, or in beautiful extra crimson cloth. " Perhaps the most beautiful and touching work of fiction ever written, with the exception of Undine."— Atlas. " The same publishers have shown their patriotism, common sense, and good taste by putting forth their fourth edition of this work, with a set of very beautiful engraved embellishments. There never was a book which better deserved the compliment. It is one of greatly superior merit to Paul and Virginia, and we believe it is destined to surpass that popular work of St. Pierre in popu- larity. It is better suited to the advanced ideas of the present age, and possesses peculiar moral charms in which Paul and Virginia is deficient. St. Pierre's work derived its popularity from its bold attack on feudal prejudices; Saintine's strikes deeper, and assails the secret infidelity which is the bane of modern society, in its stronghold. A thousand editions of Picciola will not be too many for its merit."—Lady's Book. "This is a little gem of its kind—a beautiful conceit, beautifully unfolded and applied. The style and plot of this truly charming story require no criticism; we will only express the wish that those who rely on works of fiction for their intellectual food, may always find those as pure in language sud beautiful in moral as Picciola."—New York Review. " The present edition is got up in beautiful style, with illustrations, and reflects credit upon the publishers. We recommend to those of our readers who were not fortunate enough to meet with Picciola some years ago, when it was first translated, and for a season all the rage, to lose no time in procuring it now—«nd to those who read it then, but do not possess a copy, to embrace the op- portunity of supplying themselves from the present very excellent edition."—Saturday Evening Post. " A new edition of this exquisite story has recently been issued by Messrs. Lea & Blanchard, embellished and illustrated in the most elegant manner. We understand that the work was com- pletely out of print, and a new edition will then be welcomed. It contains a dehghtful letter from the author, giving a painful insight into the personal history of the characters who figure in the story."—Evening Bulletin. " The most charming work we have read for many a day."—Richmond Enquirer. RORY O'MORE-A NATIONAL ROMANCE, BY SAMUEL LOVER. A new and cheap edition, with Illustrations by the Author. Price only 25 cents. Also, a beautiful edition in royal 12mo., price 50 cents, to match the following. "A truly Irish, national, and characteristic story."—London Literary Gazette. " Mr. Lover has here produced his best work of fiction, which will survive when half the Irish sketches with which the literary world teems are forgotten. The interest we take in the varied adventures of Rory is never once suffered to abate. We welcome him with high delight and part from him with regret."—London Sun. LOVER'S IRISH STORIES. LEGENDS AND STORIES OF IRELAND, BY SAMUEL LOVER. In one very neat 12mo. volume, fine paper, extra cloth or fancy paper, With Illustrations by the Author. LOVER'S SONGS AND BALLADS, INCLUDING THOSE OF THE "IRISH EVENINGS." In one neat 12mo. volume, price 25 cents. MAHSTON, OR THE MEMOIRS OF A STATESMAN AND SOLDIER, BY THE REV. GEORGE CROLY, Author of " Salathiel," " Angel of the World," &c. In one octavo volume, paper, price fifty cents. "A work of high character and absorbing interest."— Neu Orleans Bet. LEA AND BLANCHARD'S PUBLICATIONS. ROSCOE'S LIVES OF THE KINGS OF ENGLAND. TO MATCH MISS STRICKLAND'S "QUEENS." VOLUME ONE, CONTAINING THE LIFE OF WILLIAM THE CONQUEROR. In neat royal duodecimo, extra cloth, or fancy paper. "The historical reader will find this a work of peculiar interest. It displays throughout the most pains-taking research, and a style of narrative which has aU the lucidity and stremjth ol Gibbon It is a work with which, shedding such a light as we are justified in saying it will do upon English history, every library ought to be provided."—Sunday Times. MEMOIRS OF THE LOVES OF THE POETS, Biographical Sketches of Women celebrated in Ancient and Modern Poetry. BY MRS. JAMIE SON. In one royal duodecimo volume, price 75 cents. FREDERICK THE GREAT, HIS COURT AND TIMES. PDTTFn WITH AN INTRODUCTION, BY THOMAS CAMP- BELL ESQ .AUTHOR OF THE "PLEASURES OF HOPE." ' Second Series, in two duodecimo volumes, extra cloth. HISTORY OF CONGRESS, c-vvrraTTiTjr' A n ASSTTTCATION OF THE PROCEEDINGS OF THE SENATE AND THE K HOUSEPoF REPRESENTATIVES, FROM 1789 TO 1793. EMBRACING THE FIRST H0USETERM Of'THE ADMINISTRATION OF GENERAL WASHINGTON. In one large octavo volume of over 700 pages, price only $1.50. MOORE'S IRELAND-WOW COMPLETE. THE HISTORY OF IRELAND, FROM THE EARLIEST KINGS OF THAT REALM DOWN TO ITS LATEST CHIEFS. In two octavo volumes, extra cloth. Mr Moore has at length completed his History of Ireland containing the most troubled and inter- HISTORY OF TnTwArfF^ IN 1815, CONTAINING MINUTE DETAILS OF ^BATTLES 0F QUATRE-BRAS, LIGNY. WAVRE BY CAPTAIN W. SIBORNE. In one octavo volume, with Maps and Plans of Battles, &c, viz.: 1. Part of Belgium n« of Quatre-Bras, at 3 oclock P M. %^%L\^f^\[past 8o'clock P. M. 6. Field of Water- ?o\,%Ta%euaT^ the advance of the AU^f^rrues^^_________„___ TEXT BOOK OF ECCLESIASTICAL HISTORY. uv t rTr-iFSELER PROFESSOR OF THEOLOGY IN GOTTINGEN. TRANSLATED SS THIRD GERMAN EDITION, BY F. CUNNINGHAM. In three octavo volumes, containing over 1200 large pages. t}"9^ Thework seems W^ rfanll on the points The notes contain much valuable 'formation, cmciseiyanu «. j rendered tiresome and ex- that really require elucidation, whi e at the same time tM> dook ibi of it pensive by a useless array of m?je learning Jhc^f^nSd^ |Se publication to the attention of is pleasing to the eye. I take grea.pleas:ure j" c°n"^f ^» ^ve ft a fair examination. teachers. It will, I am persuaded, commend itseU to ™™%efvectmlyt your 0bt. Servt^ , . Principal Phila. High School. To Messrs. Lea & Blanchard. _____ June 28,18-17. Gentlemen.— , _ ,„^„„ » „mhrn<*il in the Classical Section of Chambers's Edu- The edition of" Cf^s Commentaries, ^ g hmltz and Zumpt has „- cational Course, and given to «*e world ^Vo hesitation n[saying, that the design expressed in ceived from me a candid examination. I navenp nesirau"» "' ^ |- th t lhe work ,s weil calcu- to notice of the publishers has been ^f/^^Tto be unexceptionable. The annotations latod to become popular and usefulI The £*^eMS £> ^^ f uitate,tl,? research ot embrace in condensed form such yaliiab.»» o i, ^ indolence. Tins is an nn- derstood and.apprewated. • - prgf 0fAncic„t Languages, Central High School, Phila. VOLUME II. P, VIRGILII MARONIS CARMINA, NEARLY READY. LEA AND BLANCHARD'S PUBLICATIONS. SCHOOL BOOKS. BIRD'S NATURAL -PHILOSOPHY. NEARLY READY. ELEMENTS OF NATURAL, PHILOSOPHY, BEING AN EXPERIMENTAL INTRODUCTION TO THE PHYSICAL SCIENCES. ILLUSTRATED WITH OVER THREE HUNDRED WOOD-CUTS. BY GOLDING BIRD, M.D., Assistant Physician to Guy's HospitaL FROM THE THIRD LONDON EDITION. In one neat volume. "By the appearance of Dr. Bird's work, the student has now all that he can desire in one neat, concise, and well-dierested volume. The elements of natural philosophy are explained in very sim- ple language, and illustrated by numerous wood-cuts."—Medical Gazette. ARNOTT'S PHYSICS. ELEMENTS OF PHYSICS; OR, NATURAL PHILOSOPHY, GENERAL AND MEDICAL. WRITTEN FOR UNIVERSAL USE, IN PLAIN, OR NON-TECHNICAL LANGUAGE. BY NIELL ARNOTT, M.D. A NEW EDITION, BY ISAAC HAYS, M. D. Complete in one octavo volume, with nearly two hundred wood-cuts. This standard work has been long and favourably known as one of the best popular exp«s*iona of the interesting science it treats of. It is extensively used in many of the first seminaries. ELEMENTARY CHEMISTRY, THEORETICAL AND PRACTICAL. BY GEORGE POWNES, Ph. D„ Chemical Lecturer in the Middlesex Hospital Medical School, State of New York. Department of Common Schools. J Albany, Oct. lith, 1815. Messrs. Lea <$• Blanchard: Gentlemen:—I have examined the copy of "White's Universal History," which you were so obliging as to send me, and cheerfully and fully concur in the commendations of its value, as a com- prehensive and enlightened survey of the Ancient and Modern World which many of the most com- petent judges have, as I perceive, already bestowed upon it. It appears to me to be admirably adapted to the purposes of our public schools; and I unhesitatingly approve of its introduction into those seminaries of elementary instruction. Very respectfully, your obedient servant, Samuel s. randall, Deputy Superintendent Common Schools. This work is admirably calculated for District and other libraries : an edition for that pnrpose without questions has been prepared, done up in strong cloth. HERSCHELL'S ASTRONOMY. A TREATISE ON A S T E, O EI O M "S", BY SIR JOHN F. W. HERSCIIELL, F. R. S., &c. WITH NUMEROUS PLATES AND WOOD-CUTS. k NEW EDITION, WITH A PREFACE AND A SERIES OF QUESTIONS, BY S. 0. WALKER. In one volume. 12mo. LEA & BLANCHARD'S NEW PUBLICATIONS. NOW READY. JOHNSTON'S PHYSICAL ATLAS. THE PHYSICAL ATLAS OF NATURAL PHENOMENA. FOR THE USE OF COLLEGES, ACADEMIES, AND FAMILIES. BY ALEXANDER KEITH JOHNSTON, F. R. G. S., F. G. S. Geographer at Edinburgh in Ordinary to her Majesty, Honorary Member of the Geographical Society, Berlin. In one large volume, imperial quarto, handsomely bound, With Twenty-six Plates, Engraved and Colored in the best style. Together with 112 pages of Descriptive Letter-press, and a very copious Index. LIST OF PLATES. GEOLOGY. 1. Geological Structure of the Globe. 2. Mountain Chains of Europe and Asia. 3. Mountain Chains of America. 4. Illustration of the Glacier System of the Alps. (Mont Blanc.) 5. Phenomena of Volcanic Action. Palaeontological and Geological Map of the British Islands. (Frontispiece.) HYDROGRAPHY. 1. Physical Chart of the Atlantic Ocean. 2. Physical Chart of the Indian Ocean. 3. Physical Chart of the Pacific Ocean or Great Sea. 4. Tidal Chart of the British Seas. 5. The River Systems of Europe and Asia. 6. The River Systems of America. Tidal Chart of the World. This very conviction of its value would lead us to urge upon Mr. Johnston the ex pediency of some reduced form of his great Atlas, which might render it more access- ible to common readers. * * We know of no work of which ihe methods are so well fitted for the instruction of those who come ignorantly to the subject.—Quarterly Review. To the scholar, to the student, and to the already large, yet daily increasing multi- tude of inquirers who cultivate natural science, the Physical Atlas is a treasure of incalculable value. It brings, before the mind's eye, in one grand panoramic view, and in a form clear, definite, and easily comprehensible, all the facts at present known relative to the great subjects of which it treats, and may be regarded as a lucid epitome of a thousand scattered volumes, more or less intrinsically valuable, of which it contains the heart and substance.—Blackwood^s Magazine. By devoting a single hour to the contemplatiouof our globe in the diorama of a Phy- sical Atlas, the student will witness the grandeur of the tenement in which he dwells, and will not fail to appreciate the beautiful conception of Humboldt, when he speaks of" the life of the earth."—North British Review. The author avails herself with much pleasure, of an opportunity of expressing her admiration of the accuracy, extent, and execution of Mr. Keith Johnston's Physical Atlas, and of the valuable information contained in the letterpress which accompanies it, which has afforded "her the greatest assistance. It was the author's wish, and her publisher's intention, that the present edition should be accompanied by a series of maps to illustrate the more important questions of Physical Geography treated of in it; but Mr. A. Keith Johnston having announced the publication of a new edition of his " Physical Atlas," in a reduced size at a low price—the first two numbers of which have already appeared—the project was relinquished, in the belief that Mr. A. K. Johnston's smaller Atlas will furnish suitable illustrations to this work.—From the New Edition of Mrs Somervillfs Physical Geography. METEOROLOGY. 1. Humboldt's System of Isothermal Lines. 2. Geographical Distribution of the Cur- rents of Air, 3. Hyelographic or Rain Map of the World." 4. Hyetographic or Rain Map of Europe. NATURAL HISTORY. 1. Geographical Distribution of Plants. 2. Geographical Distribution of the Cutti vated Plants used as Food. 3. Geographical Distribution of Quadru- niana, Edentata, Marsupialia, and Pachydermata. 4. Geographical Distribution of Carnivora 5. Geographical Distribution of Rotlentia and Ruminantja. 6. Geographical Distribution of Birds. 7. Geographical Distribution of Reptiles 8: Ethnographic Map of the World. 9. Ethnographic Map of Great Britain and Ireland. LEA & BLANCHARD'S NEW PUBLICATIONS. SOMERVILLE'S PHYSICAL GEOGRAPHY. New Edition, much improved. Now Ready. PHYSICAL "GEOGRAPHY. BY MARY SOMERVILLE, AUTHOR OF " THE CONNECTION OF THE PHYSICAL SCIENCES," ETC. ETC. SECOND AMERICAN EDITION. From, the Second and Revised London Edition. WITH AMERICAN NOTES, GLOSSARY, &C. In one neat royal 12mo. volume, extra cloth, of over 500 pages. The great success of this work, and its introduction into many of the higher school* and academies, have induced the publishers to prepare a new and much improved edition. In addition to the corrections and improvements of the author bestowed on the work in its passage through the press a second time in London, notes have been introduced to adapt it more fully to the physical geography of this country ; and a comprehensive glossary has been added, rendering the volume more particularly suited to educational purposes. The amount of these additions may be understood from the fact, that not only has the size of the page been increased, but the volume itself enlarged by over one hundred and fifty pages. At the same time, the price has not been increased. While reading this work, we could not help thinking how interesting, as well as useful, geography as a branch of education might be made in our schools. In many of them, however, this is not accomplished. It is to be hoped that this defect will be remedied ; and that in all our educational institutions Geography will soon be taught in the proper way. Mrs. Somerville's work may, in this respect, be pointed to as a model.— Taifs Edinburgh Magazine. Although there are few subjects drier and more uninteresting in their details than Geography, when confined to descriptions of the mere form of the earth, the height of its mountains, the length and breadth of its rivers, with the extent of its oceans, the whole features of this study become changed when, instead of regarding the objects which it embraces in their present condition or superficial character, we enter on their past history and examine their nature and relations by the light of modern science. Springs, rivers, inland seas, and lakes follow in their turn the ocean ; and each is treated in the same judicious way. No more is said than is necessary to the under- standing of these subjects in their proper relations; whilst every fact is stated in a lucid and interesting manner.—The Athenaum. An admirable work, full of varied information and wholesome philosophy.— New Orleans Bee. We have thus followed Mrs. Somerville through her intellectual journey over the globe, delighted and improved by her instructions, and anxious that others should de- rive from it the same pleasure and advantage. From the extracts Which we have made, the reader will see that the work is written in a style always simple and per- spicuous, often vigorous and elegant, occasionally rising to a strain of eloquence, commensurate with the lofty ideas which it clothes. In Mrs. Somerville's pages no sentiments are recorded which the Christian or philosopher disowns. In associating life with nature—in taking cognizance of man as tenant of the earth-home which she describes, her aspiralions ever after truth, secular and divine, and everywhere through- out her work we meet with just and noble sentiments, the indication and the offspring of a highly cultivated and well-balanced mind.—North British Review. From the information given, and the strength of thought displayed, on almost every page, the work is equally entitled to an attentive perusal.—S. Literary Messenger. Our praise comes lagging in the rear, and is well-nigh superfluous. But we are anxious to recommend to our youth the enlarged method of studying geography which her present work demonstrates to be as captivating as it is instructive. Nowhere, except in her own previous work, The Connexion of the Physical Sciences, is there to be found so large a store of well-selected information so lucidly set forth. In sur- veying and grouping together whatever has been seen by the eyes of others, or detect- ed by their laborious investigations, she is not surpassed by any one. We have no obscurities other than what the imperfect state of science itself involves her in ; no dissertations which are felt to interrupt or delay. She strings her beads distinct and close together. With quiet perspicacity she seizes at once whatever is most interest- ing and most captivating in hersubject. Therefore it is we are for the book ; and we hold such presents as Mrs. Somerville has bestowed upon the public, to be of incalcu- lable value, disseminating more sound information than all the literary and scientific institutions will accomplish in a whole cycle of their existence.— Vlackwood's Mag. LEA & BLANCHARD'S NEW PUBLICATIONS. LIBRARY OF ILLUSTRATED SCIENTIFIC WORKS. UNDER THIS TITLE LEA & BLANC HARD ARE PUBLISHING A SERIES OF BEAUTIFULLY ILLUSTRATED WORKS, ON VARIOUS BRANCHES OF SCIENCE, By the most distinguished men in their respective departments. Printed in the handsomest style, and embellished in the most efficient manner. Itr No expense has been or will be spared to render this series worthy of the isup- port of the scientific public, and at the same time one of the handsomest specimens of typographical and artistic execution which has appeared in this country. Specimens of the Engravings and style of the volumes may be had on application to the publishers. MULLER'S PHYSJCS-LATELY ISSUED, PRINCIPLES OF PHYSICS AND METEOROLOGY. BY PROFESSOR J. MULLER, M. D. EDITED, WITH ADDITIONS, BY R. EGLESFELD GRIFFITH, M. D. In one large and handsome octavo volume, with 550 wood-cuts, and two colored plates. This is a large, elegant, and most admirable volume—thefirst of a series of scien- Ufic books now passing through the press in London, and which cannot fail to com- mend themselves to die favor of aU who take any interest in the progress of science among the great mass of the people. The author is one of the most distinguished scienUfic men in Germany, and these works have been prepared with the utmost care, and are put forth in a form admirably adapted to secure that wide circulation and universal favor which they deserve.—N. Y. Courier and Inquirer. NOW READY. PRACTICAL-PHABMACY. CO%7onLNGofT^^^^^^ BY FRANCIS MOHR, Ph. D., Assessor Pharmacia of the Royal Prussian College of Medicine, Coblentzj AND THEOPHILUS REDWOOD, Professor of Pharmacy in the Pharmaceutical Society of Great Britain. EDITED, WITH EXTENSIVE ADDITIONS, BY PROFESSOR WILLIAM PROCTER, Of the Philadelphia College of Pharmacy. In one handsomely printed octavo volume, of 570 pages, with over 500 en- gravings on wood. In Preparation, toorhs on Metallurgy, Food, the Steam Engine, Machines, Astronomy, Rural Economy, Kc. LEA & BLANCHARD'S NEW PUBLICATIONS. Library of Illustrated Scientific Works.—Continued. KNAPP'S CHEMICAL TECHNOLOGY. TECHNOLOGY; OR, CHEMISTRY APPLIED TO TEE ARTS AND TO MANUFACTURES. BY DR. F. KNAPP, Professor at the University of Giessen. Edited, with numerous Notes and Additions, by DR. EDMUND RONALDS, and DR. THOMAS RICHARDSON. First American Edition, with Notes and Additions, BY PROFESSOR WALTER R. JOHNSON. In tivo handsome octavo volumes, printed and illustrated in the highest style of art. Volume One, lately published, with two hundred and fourteen large wood engravings. Volume Two, now ready, with two hundred and fifty wood engravings. One of the best works of modern times.—New York Commercial. We think it will prove the most popular, as it is decidedly the best of the series. Written by one who has for many years studied both theoretically and practically the processes which he describes, the descriptions are precise, and conveyed in a sim- ple unpretending style, so that they are easily understood, while they are sufficiently full in detail to include wilhin them everything necessary to the entire comprehen- sion of the operations. The work is also carefully brought down to include the most recent improvements introduced upon the continent of Europe, and thus gives us full descriptions of processes to which reference is frequently made in other works, while many of them are, we believe, now for the first time presented in a complete state to the English reader.—Franklin Institute Journal. WEISBACH'S MECHANICS. PRINCIPLES OF~THE MECHANICS OF MACHINERY AND ENGINEERING. By Professor JULIUS WEISBACH. TRANSLATED AND EDITED BY PROFESSOR GORDON, OF GLASGOW. First American Edition, with Additions, By Prof. WALTER R. JOHNSON. In two Octavo Volumes, beautifully printed. Volume One, with five hundred and fifty illustrations, just issued. Volume Two, with three hundred and thirty illustrations, now ready. This work is one of the most interesting to mathematicians that has been laid be- fore us for some lime; and we may safely term it a scientific gem.— The Builder. The most valuable contribution to practical science that has yet appeared in this country.—Athenaeum. In every way worthy of being recommended to our readers — Franklin Institute Journal. From Charles H. Haswell, Esq., Engineer in Chief, V. S. N. The design of the author in supplying the instructor with a guide for teaching, and the student with an auxiliary for the acquirement of the science of mechanics, has, in my opinion, been attained in a most successful manner. The illustrations, in the fullness of their construction, and in typographical execution, are without a parallel. It will afford me much pleasure to recommend its use by the members of the pro- fession with which I am connected. LEA & BLANCHARD'S NEW PUBLICATIONS. Now Complete.—STRICKLAND'S QUEENS OF ENGLAND. NEW AND IMPROVED EDITION. LIVES OF THE QUEENS OF ENGLAND, PROM THE NORMAN CONQUEST. WITH ANECDOTES OF THEIR COURTS. Now First Published from Official Records, and other Authentic Documents, Pri- vate as well as Public. new edition, with additions and corrections. BY AGNES STRICKLAND. In six volumes crown octavo, extra crimson cloth, or half morocco, printed on fine paper and large type. In this edition, Volume One contains Vols. 1, 2 and 3 of the 12mo. edition ; Volume Two contains Vols. 4 and 5; Volume Three contains Vols. 6 and 7 ; Volume Four contains Vols. 8 and 9 ; Volume Five contains Vols. 10 and 11 ; and Volume Six contains Vol. 12. The whole forming a very handsome se- ries, suitable for presents, prizes, &c. The publishers have great pleasure in presenting to the public this work in a complete form. During the long period in which it has been issuing from the press, it has assumed the character of a standard work ; and, as occupying ground hitherto untouched, as embodying numerous historical facts hitherto unnoticed, and as con- taining vivid sketches of the character and manners of the times, with anecdotes, documents, &c. &c, it presents numerous claims on the attention of both the student of history and desultory reader. Those who have been waiting its completion can now obtain it, forming a handsome set, twelve volumes in six, in various styles of binding. HERVEY'S COURT OF GEORGE II. MEMOIRS OF THE REI&nIf GEORGE THE SECOND, From his Accession to the Death of Queen Caroline. BY JOHN LORD HERVEY. edited, from the original manuscript, at ickworth, By the Right Hon. JOHN WILSON CROKER, LL. D., F. R. S., &c. In two handsome volumes, royal 12mo., extra cloth. PARDOE'S FRANCIS THE FIRST.—Now Ready. THE COURT AND REIGN~0F FRANCIS THE FIRST, KING OF FRANCE. BY MISS PARDOE, AUTHOR OF " LOUIS THE FOURTEENTH," " CITY OF THE SULTAN, &C. &C. In two very neat volumes, royal 12mo., extra cloth. EASTERN L.IFE, PRESENT AND PAST. BY HARRIET MARTINEAU. In one large and handsome volume, crown octavo. HOUSEHOLD EDUCATION. BY HARRIET MARTINEAU. In one handsome vol., royal 12mo. LEA & BLANCHARD'S NEW PUBLICATIONS. MAGNIFICENTaPRESENTATION WORK. IRISH MELODIES. BY THOMAS MOORE, Esq. WITH NOTES AND BIOGRAPHICAL PREFACES. 1LLUSTRATKD WITH BEAUTIFUL STEEL. PLATES, ENGRAVED UNDER THE IMMEDIATE SUPERINTENDENCE OF MR. EDWARD FINDEN In one large imperial quarto volume of 174 pages, handsomely bound in extra •cloth, with gilt edges. Beautifully printed on.superior paper. LIST OF PLATES. Nora Creina, ... - Painted by W. P. Frith, Engr'd by E. Finden. Rich and Rare werethe Gems she Wore, " W.Fisher, " W. H. Mote. Evbleen,......« R. T. Bott, « E. Finden. Love's Young Dream, - " A.Derby, " E. Finden. Lesbia, ..'---- " W. P. Frith, « W.Holl. Kathleen and St. Kevin, - - - " E. Hawkes, " W. Holl. The Hamlet's Pride, - - - - " W. Room, " W.Edwards. Laughing Eyes,....." W. P. Frith, " E. Finden. The Mountain Sprite, - " F. Wood, " E. Finden. The Desmond's Love, - - - - " F. Crowley, " W. Edwards. The care which has been exercised in every portion of this volume, both as to its mechanical and artistical execution, renders it in all respects well worthy of the "Irish Melodies." In illustrations, type, printing, paper, and binding, it is equal to anything that has as yet appeared in this country ; and, as a work whose attraction is not confined to a single season, it should command the attention of the public. Now Ready.—MACKAY'SJTRAVELS IN THE UNITED STATES. THE WESTERIV WORLD; OR, TRAVELS IN THE UNITED STATES. exhibiting them in Their latest development, social, political, and industrial. INCLUDING A CHAPTER. ON CALIFORNIA. BY ALEXANDER MACKAY, Esq. FROM THE SECOND AND ENLARGED LONDON EDITION. In two very neat vols., royal 12mo. READINGS FOR THE YOUNG. FROM THE WORKS OF SIR WALTER SCOTT. WITH NUMEROUS AND BEAUTIFUL PLATES. In two very handsome vols., royal 18mo., crimson cloth POEMS, BY ELLIS, CURRER, AND ACTON BELL, Authors.of "Jane Eyre," &c. In one vol., royal 18mo. DOMBEY AND SON, COMPLETE. In one large octavo vol. of 320double-columned pages, with 16 plates, price 50 cents. ALSO, AN EDITION ON FINE PAPER, WITH 40 PLATES, EXTRA CLOTH. DICKENS'S DAVID COPPERFIELD. PUBLISHING IN NUMBERS, WITH PLATES, PRICE 5 CENTS EACH. Uniform with Lea & Blanchard's complete edition of Dickens's Novels and Tales. MIRABEAU, A Mfte History. In one neat volume, royal 12mo. LEA & BLANCHARD'S NEW PUBLICATIONS. SHAW'S ENGLISH LITERATURE. OUTLINES OF ENGLISH LITERATURE. BY THOMAS B. SHAW, Professor of English Literature in the Imperial Alexander Lyceum of St. Petersburg In one large and handsome royal 12irio. volume. A valuable and very interesting volume, which for various merits will gradually find its way into all libraries.— N. Y. Knickerbocker. Supplies a want long and severely felt.—Southern Literary Gazette. Traces our literary history with remarkable zest, fairness, and intelligence.—A^. Y. Home Journal. An admirable work—graphic and delightful.—Pennsylvanian. The best publication of its size upon English literature that we have ever met with. —NeaVs Saturday Gazette. Eminently readable.— City Item. A judicious epitome—well adapted for a class-book, and at the same time worthy of a place in any library.—Penn. Inquirer. From the Rev. W. G. T. Shedd, Prof essor of Ejnglish Literature in the University of Vt. Burlington, May 18,1849. I t ake great pleasure in saying that it supplies a want that .has long existed of a brief history of English literature, written in the right method and spirit, to serve as an i ntroduction to the critical study of it. I shall recommend the book to my classes. FOSTER'S EUROPEAN LITERATURE.—Now Ready. HANDBOOK OF MODERN EUROPEAN LITERATURE: British, Danish, Dutch, French, German, Hungarian, Italian, Polish and Rus- sian, Portuguese, Spanish, and Swedish. With a fall Biographical and Chronological Index. BY MRS. FOSTER. In one large royal 12mo. volume, extra cloth. (UNIFORM WITH SHAW'S OUTLINES OF ENGLISH LITERATURE.) This compilation will prove of great utility to all young persons who have just com- pleted their academical studies. The volume gives both a general and particular view of the literature of Europe from the revival of letters to the present day. It is compiled with care and judgment, and is, in all respects, one of the most instructive works that could be placed in the hands of young persons.—Morning Herald. ATLAS TO DANA ON CORALS. In one large Imperial folio volume, with Sixty-one Plates, Drawn and Colored after Nature, by the best Artists. Beautifully and strongly bound in half morocco. Of this magnificent work but a very few copies have been offered for sale, and these are nearly exhausted. Those who are derirous of enriching their libraries with so splendid a specimen of American Art and Science will therefore do well to procure copies at once. A FEW COPIES STILL ON HAND OF DANA ON CORALS AND ZOOPHYTES. Being Volume VIII. of the United States Exploring Expedition Publications. WILKES'S CALIFORNIA—A New Work, Just Issued. WESTERN AMERICA, INCLUDING OREGON AND CALIFORNIA. With Maps of those Regions and of the Sacramento Valley. BY CHARLES WILKES, U. S. N., Commander of the United States Exploring Expedition. Octavo. Price 75 cents. LEA & BLANCHARD'S NEW PUBLICATIONS. SIXTH EDITION, REVISED. NOW READY. LYNCH'S DEAD SEA EXPEDITION. NARRATIVE OF THTu. S. EXPEDITION TO THE RIVER JORDAN AND THE DEAD SEA. BY W. F. LYNCH, TJ. S. N., Commander of the Expedition. In one large and beautiful octavo volume, of over five hundred pages. With, a Map of the Jordan, of the Dead Sea, and Twenty- eight Illustrations, executed in the handsomest style. This work has elicited the approbation of the press in a manner almost unequalled. From among numerous similar testimonials, the publishers beg to submit the following: This book, so long and anxiously expected, fully sustains the hopes of the most san- guine and fastidious. It is truly a magnificent work. The type,paper,binding, style, and execution are all of the best and highest character, as are also the maps and en- gravings. It will do more to elevate the character of our national literature than any work that has appeared for years. The intrinsic interest of the subject will give it popularity and immortality at once. It must be read to be appreciated; and it will be read extensively, and valued, both in this and other countries.—Lady's Book, Aug. 1849. Lieut. Lynch's book must be pronounced of great value, not only for the additions which it makes to our knowledge, but as the authentic record of an enterprise in the highest degree honorable to all the parties concerned. In our esteem, the value of the work is greatly enhanced by the engravings. The interest of these lies in their repre- senting subjects mostly new to those who have been wearied with the five-hundredth repetition of the same scenes and objects. The views on the Dead Sea are of special and remarkable interest, and the costume figures are also striking and suggestive.— North British Review, August, 1649. A large and elegant volume, of marked interest and decided value.—N. Y. Courier and Enquirer. A most elegant volume, profusely illustrated with beautiful maps and plates.— Evening Bulletin. One of the most useful and deeply interesting volumes that have recently been issued from the press.—Albany Evening Journal. A lasting memorial of a great national enterprise successfully consummated.—N. Y. Commercial Advertiser. It has rarely been our lot to receive a work of more sterling merit.— City Item. For the Christian student this volume possesses peculiar interest.—Zion's Herald. We have read this work with profound interest and much satisfaction.—Southern Weekly Gazette. A work of rare interest.—N. Y. Churchman. It will unquestionably be regarded as one of the most valuable and interesting works of the season.— Washington Union. Our thanks are due to Lieut. Lynch for the gratification and instruction we have de- rived from his very able volume.—N. Y. Tribune. TALES AND STORIES FROM HISTORY. BY AGNES STRICKLAND, Author of" Lives of the Queens of England," etc. In one handsome royal 18mo. volume, crimson extra cloth, with illustrations. THE SUGAR PLANTER'S MANIJAE. BEING A TREATISE ON THE ART OF OBTAINING SUGAR FROM THE CANE. BY W. J. EVANS, M. D. In one neat volume, small 8vo., 268 pages, with wood-cuts and two plates. THEORY OF EIFE. BY S. T. COLERIDGE. In one small volume, 12mo. LEA & BLANCHARD'S NEW PUBLICATIONS. HERSCHEIi'S OUTLINES OP ASTRONOMT.-^Vflic JJ«««ly. OUTLINES OF~ASTRONOMY. BY SIR JOHN F. W. HERSCHEL, F. E. S., &c. In one neat volume, crown octavo, with six plates and numerous wood-cuts. With this, we take leave of this remarkable work, which we hold to be, beyond a doubt, the greatest and most remarkable of the works in which the laws of astrono- my and the appearance of the heavens are described to those who are not mathema- ticians nor observers, and recalled to those who are. It is the reward of men who can descend from the advancement of knowledge to care for its diffusion, that their works are essential to all, that they become the manuals of the proficient as well as the text-books of the learner.—Athenceum. Probably no book ever written upon any science has been found to embrace with- in so small a compass an entire epitome of everything known within all its various departments, practical, theoretical, and physical.—Examiner. A text-book of astronomy, from one of the highest names in the science.—Silliman's Journal. BAROJV" HUMBOLDT'S JVEW WORK.—JYow Ready. ASPECTS OF MTURE, IN DIFFERENT LANDS AND DIFFERENT CLIMATES. With Scientific Elucidations. BY ALEXANDER VON HUMBOLDT. TRANSLATED BY MRS. SABINE. In one very neat volume, royal 12mo., extra cloth. It is not without diffidence that I present to the public a series of papers which took theirorigin in the presence of natural scenes of grandeur or beauty, on the ocean, in the forests of the Orinoco, in the Steppes of Venezuela, and in the mountain wilder- nesses of Peru and Mexico. Detached fragments were writted down on the spot, and at the moment, and afterwards moulded into a whole. The view of nature on an en- larged scale, the display of the concurrent action of various forces or powers, and the renewal of the enjoyment which the immediate prospect of tropical scenery affords to sensitive minds—are the objects which I have proposed to myself.—Author's Preface. ZOOLOGICAL RECREATIONS.—Just Issued, BY W. J. BRODERTP, Esq., F. R. S. In one neat volume of 376 pages, royal 12mo., extra cloth. BOWMAJV'S PRACTICAL CHEMISTRY.—Just Issued. INTRODUCTION TO PRACTICAL CHEMISTRY. INCLUDING ANALYSIS. By JOHN E. BOWMAN, Demonstrator of Chemistry, King's College. In one handsome volume, royal 12mo., of over 300 pages. WITH NEARLY ONE HUNDRED ENGRAVINGS ON WOOD. STEINMETZ'S HISTORY OF THE JESUITS. HISTORY OF THE JESUITS, FROM THE FOUNDATION OF THEIR SOCIETY TO ITS SUPPRESSION BY POPE CLEMENT XIV.: Their Missions throughout the World ; their Educational System and Literature; with their Revival and Present State. BY ANDREW STEINMETZ, Author of "The Novitiate," and '-The Jesuit in the Family." In two handsome crown 8vo. vols, of about four hundred pages each, extra cloth. LEA & BLANCHARD'S NEW PUBLICATIONS. KENNEDY'S LIFE OP WIRT. CHEAPER EDITION, NOW READY. MEMOIRS OF THE lFe OF WILLIAM WIRT. BY JOHN P. KENNEDY. SECOND EDITION, REVISED. In two large and handsome 12mo. volumes, with a Portrait and fac-simile of a letter from John Adams. The whole of Mr. Wirt's Papers, Correspondence, Diaries, &c, having been placed in the hands of Mr. Kennedy, to be used in this work, it will be found to contain much that is new and interesting relative to the political history of the times, as well as to the private life of Mr. Wirt. One of the most valuable books of the season, and certainly one of the most enter- taining works ever published in this country. Mr. Kennedy is admirably qualified for the preparation of such a work, and has evidently had access to a great variety of useful material. The work is one which should be in the hands of every young man in the country. Its intrinsic interest will secure it a very general popularity.—N. Y. Courier and Enquirer. The genius of the author and the popular character of his subject insure an equally interesting and valuable book, which it would be superfluous in us to commend, in any labored terms, to the attention of our readers. It is an indispensable addition to the libraries of all intelligent Americans. It is got up in the best style, with a like- ness of Mr. Wirt from a portrait by Charles B. King.—Philadelphia North American. The fascinating letters of Mr. Wirt, one of the most brilliant and agreeable men of the day, in themselves furnish a rich fund of instruction and enjoyment.—Richmond Inquirer. This work has been looked for with much interest by the public, and will not disap- point the high expectations justly based upon the well-known talents of the author, and the abundant materials left by the distinguished orator and jurist, to which he has had free access.—Baltimore American. The style is at once vigorous and fascinating, and the interest of the most absorbing character.— Philadelphia Inquirer. Now Ready__INGERSOLL'S NEW WORK. HISTORICAL. SKETCH OF THE SECOJVO WAR BETWEEN THE UNITED STATES OF AMERICA AND GREAT BRITAIN, DECLARED BY ACT OF CONGRESS THE 18th OF JUNE, 1S12, AND CON- CLUDED BY PEACE THE 15th OF FEBRUARY, 1815. BY CHARLES J. INGERSOLL. EMBRACING THE EVENTS OF 1814. In one well-printed 8vo. vol., of 318 pages, double columns, paper covers, price $1 00 FRANCE UNDER LOUIS PHILIPPE. The History of Ten Years, 1810—1840; or, France wider Louis Philippe. BY LOUIS BLANC, Secretary of the Provisional Government of 1S48. TRANSLATED BY WALTER H. KELLY. In two handsome crown 8vo. volumes, extra cloth, or six parts, paper, at fifty cents. HISTORY OF THE FRENCn REVOLUTION OF 1789. BY LOUIS BLANC, Author of" France under Louis Philippe," &c. TRANSLATED FROM THE FRENCH. In one volume, crown octavo. LEA & BLANCHARD'S NEW PUBLICATIONS. SCHMITZ & ZUMPT'S_CLASSICAL SERIES, VOLUME I. C. JUl.II CAESARIS COMMENTARII DE BELLO GALLICO. WITH AN INTRODUCTION, NOTES, AND A GEOGRAPHICAL INDEX IN ENGLISH. ALSO, A MAP OF GAUL, AND ILLUSTRATIVE ENGRAVINGS. In one handsome lSmo. volume, of 232 pages, extra cloth, price 50 cts. VOLUME II. PUBLII VIRGILII MARONIS CARMINA. WITH AN INTRODUCTION AND NOTES. In one handsome 18mo. volume, of 438 pages, extra cloth, price 75 cts. VOLUME III. C. CRISPI SALLUSTII CATALINA ET JUGURTHA. WITH INTRODUCTION, AND NOTES IN ENGLISH. ALSO, A MAP OF NUMIDIA AND OTHER ILLUSTRATIVE ENGRAVINGS. In one handsome 18mo. volume, of 168 pages, extra cloth, price 50 cts. VOLUME IV.—Now Ready. LATIN GRAMMAR. BY LEONHARD SCHMITZ, Ph. D., F. R. S. E., RECTOR OF THE HIGH SCHOOL, EDINBURGH. In one handsome 18mo. volume, of 318 pages, neatly half-bound, price 60 cts. VOLUME V.—Wow Ready. Q. CURTII RUFI DE GESTIS ALEXANDRI MAGNI. LIBRI QUI SUPERSUNT VIII. WITH A MAP, INTRODUCTION, ENGLISH NOTES, &C. In one handsome 18mo. volume, of 326 pages, price 70 cents. VOLUME VI.—Nearly Ready. M. TULLI CICERONIS 0RATI0NES SELECTS. WITH INTRODUCTION, ENGLISH NOTES, &C &C Ill one handsome lSmo. volume. VOLUME VII.—Nearly Ready. INTRODUCTION TO THE LATIN GRAMMAR. BY LEONARD SCHMITZ, Ph. D., F, R. S. E., &c. In one handsome 18mo. volume. The neatness, cheapness, and accuracy of this series, together with its skillful adaptation to the wants both of teachers and students, have secured for it the almost universal approbation of those to whom it has been submitted. From among the very numerous testimonials which the publishers have re- ceived, they beg to submit the following:— LEA & BLANCHARD'S NEW PUBLICATIONS. Schmitx and XumpVs Classical Series.—Continued. From Prof. Roche, Transylvania University, Lexington, Ky., March 31, 1S49. Whatever influence my position may give me shall be most cheerfully employed in bringing into general use in the West these very valuable works. I trust that you will prosecute to a close the proposed series, and that the execution of those that re- main to complete a Latin Curriculum may be as neat and in all respects as unex- ceptionable as that of those already published. From Prof. John Wilson, Prep. Hep. Dickinson College, Carlisle, Dec. 8,1848. I have examined the three volumes with considerable care, and can give them my unqualified approbation. The plan is judicious, and the execution worthy of all praise. The notes comprise all that a student needs, and all that he should have; and their position at the foot of the page is just what it should be. From Prof. E. E. Wiley, Emory and Henry College, Va. Nov. 30,1848. From the cursory examination given them, I must say that I have been highly grati- fied. Such a series as you propose giving to the public is certainly a great desidera- tum. Our classical text-books have heretofore been rendered entirely too expensive, by the costly dresses in which they have appeared, and by the extensive display of notes appended ; many of which, though learned, are of little worth to the student in elucidating the text. It will afford me pleasure to introduce into my department such books of your series as may be in our course. From S. H. Taylor, Esq., And over, Mass., Oct. 30,1S48. The notes seem to me very accurate, and are not so numerous as to do for the stu- dent what he ought to do for himself. I can with safety, therefore, recommend it to my pupils. From Prof. M. M, Campbell, Principal of the Grammar School, Indiana University, Nov. 6,1S4S. I like the plan of your series I feel sure it will succeed, and thus displace some of the learned lumber of our schools. The notes, short, plain, and apposite, are placed where they ought to be, and furnish the learner just about help enough. From Philip Lindsley, D. D., Pres. of the University of Nashville, Nov. 27,1848. The classical series, edited by Drs. Schmitz and Zumpt, has already acquired a high and well-meriied reputation on both sides of the Atlantic. 1 have carefully ex- amined yo.ur editions of Cifesar and Virgil. I think them admirable text-books for schools, and preferable to all others. I shall avail myself of every suitable occasion to recommend them. From B. Sanford, Esq , Bridgewater, Mass., Jan. 17,1849. I have examined, with considerable care, both the Cassar and the Virgil, and am much pleased with the plan and execution of the series ihus far. I am particularly gratified with the propriety and judgment displayed by the editors in the preparation of the notes; avoiding, as I think, the prolixity and profuseness of some of our classi- cal works, and, at the same lime, the barrenness and deficiency of oihers ; giving a body of annotations better suited to aid the teacher ill imparting a knowledge of the language, than is to be found in any edition heretofore in use. From Prof. Sturgess, Hanover College, Indiana, Dec. 30,1848. The mere name of the editors is a sufficient and most ample guarantee of the accu- racy of the text, the judicious choice of various readings, and the conformity of those adopted to fhe latest investigations of MSS., and the results of the most enlightened criticism. The notes I have not examined very carefully, except those of the Virgil. They are admirable, extremely condensed, and conveying a great deal of most valu- able criticism in the briefest possible way. They are particularly valuable for their sesthetinal remarks, and the frequent references to parallel passages in the same au- thor. The preliminary life is excellent, and of great value to the student. The S;il- lust appears to be of the same general character, and the notes to furnish just such help as the diligent student really needs. I think that in bringing out such a course at a cheap rate you are conferring a great boon on the country, and additional honor on your press, already so distinguished for the value of its issues.