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jSfer REPORT 
OP 
THE COMMITTEE 
ON THE 
RELATIONS OF ALCOHOL TO MEDICINE. 
JO PIN BELL, M.D., 
CHAIRMAN. 
EXTRACTED FROM THE 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION. 
PHILADELPHIA: 
COLLINS, PRINTER, 105 JAYNE STREET. 
1869. REPORT.1 
These relations are various, and for the most part unfriendly and 
deceptive. Medicine, as a science and an art, with its attendant 
hygiene, incessantly desires and aims to bring about a removal of 
the disorders of both body and mind; and, at the same time, to 
promote the greatest health and consequent ability in all to dis- 
charge every duty, personal, social, and political, and to enjoy the 
present life under an animating sense of the bounties of creation, 
while looking to a brighter future with devout hope and aspiration. 
With all its imperfections in teaching and practice, to medicine has 
been accorded the merit of increasing the average duration of life, 
and the means of making life desirable and pleasant for the masses, 
by improved public and private hygiene, and a clear explanation 
of the natural laws to which man must conform for the preserva- 
tion of his health and the avoidance of disease. How shall we 
designate the relations of alcohol—a poison, a constant source of 
disease, of strife, and of turmoil, of personal misery, and social 
disorders—to medicine, as now presented in its expressive and 
readily recognized lineaments? There are, however, advocates of 
alcohol, with some poetry and songs on their side, who, remembering 
only the short gleam of sunshine during a few minutes of elevated 
feelings and social hilarity, claim for alcohol benign relations to 
medicine, as giving it aid and support, and holding out promises 
of renewing a health and strength which it never originally 
imparted, exciting joyous feelings, gladdening the hearts of the wan 
and weary, quickening the intellect, and, in fine, beautifying and 
elevating humanity. But the real and unbroken record, beginning 
with the drunkenness of the patriarch Noah, and taking note of 
1 The other members of the committee are Drs. Dunbar and McSherry, of Balti- 
more, whose assistance the chairman was not so fortunate as to procure on this 
occasion.—J. B. 4 
REPORT OF THE COMMITTEE ON THE 
that of the just Lot, and coming down to the last instance of falling 
from grace of a Christian minister, tells of the faithlessness of 
alcoholic support. In a like unbroken series, from Alexander in a 
tit of drunken passion killing his dearest friend Clytus, on to the 
murder in our own day of his children by a father, crazed with 
alcoholic drink, we learn how the nearest and dearest ties of kindred 
and friendship are ruthlessly broken under the dominion of this 
wide-spread poison. Youth, health, and beauty have been made 
hideous; genius and high moral worth perverted and degraded by 
the same malign influence. The State, at a moment of its greatest 
need, has been deprived of its best men—its rulers, counsellors, and 
defenders, who had become the slaves and worshippers of alcohol. 
Its productive industry is curtailed by the sickness, infirmities, 
dissolute courses, and premature deaths to which so many of the 
laboring and manufacturing classes have been reduced by drinking 
alcohol in the form of fermented and distilled liquors. But the 
evil does not stop here: the State, through its citizens, is taxed for 
the relief and support of the poor, a large number of whom have 
become destitute and helpless by the habitual use of alcoholic 
drinks; and the State is. farther taxed in the cost of bringing to 
trial and punishing criminals, and the erection of prisons and 
penitentaries for their safe keeping and confinement. A majority of 
these criminals have been made so by their previous addiction to 
alcohol in some form or another. To alcoholic account must, also, 
be placed, in large proportion, the necessity of constructing and 
maintaining State hospitals for the insane, as well as the numerous 
institutions of a similar character sustained by individual benevo- 
lence. Farther proofs of the extent and depth of the evils of alco- 
holic indulgences‘are painfully exhibited in the increasing calls for 
asylums for inebriates of both sexes, who come from all grades of 
society, and who can furnish from among themselves examples of 
every degree of previous intelligence and refinement. One of the 
first presents and soon one of the first articles of barter offered by 
civilization to barbarism is alcohol, in the form of ardent spirits— 
“ fire-water,” as the poor degraded Indians appropriately call it, for 
it has been to their tribes and race an inward fire, increasing their 
thirst for blood and impelling them to the wildest acts of cruelty 
and torture of their unfortunate captives. 
The relations of alcohol to medicine should be studied under a 
fourfold point of view, as presented under the several heads of 
HYGIENE, ETIOLOGY, THERAPEUTICS, and MEDICAL JURISPRUDENCE. RELATIONS OF ALCOHOL TO MEDICINE. 
5 
At the very beginning of our inquiries it may be asked, if alcohol is 
a poison, why should it be spoken of in connection with hygiene ? 
It is not a food; it forms no part of the protein compounds out of 
which the tissues are organized, nor of fat and oils which serve 
other purposes in the living body. As far as regards anhydrous 
or absolute alcohol, spirit of wine, there can be no doubt of its 
being a violent poison, nor of its destructive effects in this way, 
even when diluted with water, as in distilled spirits, if taken in 
a large quantity at once. A single draught of spirits—brandy, 
rum, or whiskey—in quantity varying from three ounces to a quart, 
has been followed by speedy death, sometimes at the very instant, 
and at other times after an interval of a few hours. The shock of 
a large dose of alcohol on the nervous system acts like a blow on 
the head, or a kick in the stomach. Prussic acid is not more deadly. 
In the second degree of acute alcoholism, coma and lethargy super- 
vene, and death takes place after a period varying from twelve to 
eighteen hours. But need we ask for more conclusive evidence of 
the toxic operation of alcohol on the human frame than that daily 
furnished by the last stage of drunkenness, in the bewilderment of 
the mind and senses, loss of muscular power, and final insensibility 
and stupefaction, resembling apoplexy itself? We shall have some- 
thing more to say on this point under the head of etiology. If it is 
alleged that alcohol, like other poisons, may, when diluted, be used 
with benefit in many cases, the reply is that in no case is any other 
poison, however serviceable, when used medicinally for a limited 
period, had recourse to as daily food, to nourish the system. Not 
only is no acknowledged poison ever employed with this intention, 
but no medicine, even the mildest vegetable bitter, can be continued 
for a length of time without damage to health in some form or 
another—more usually by deranging the digestive and nervous 
systems, for the relief of which it was first taken. It can be shown 
both by physiology and by the still stronger evidence of large and 
long experience in all ages and countries, that alcohol, although its 
habitual use may be tolerated for a length of time, is always detri- 
mental to a person in ordinary health, and still more if he be a 
sufferer from chronic disease and debility. 
Is Alcohol a Ga lo r if a dent?—A plea for the habitual use of alco- 
hol has been set forth on the ground of the chemico-physiological 
hjrpothesis of Liebig, which would make this liquid, not a food, 
but as giving indirect aid, by furnishing elements for respiration 
and the evolution of animal heat. Alcohol, according to this view, 6 
REPORT OF T11E COMMITTEE ON THE 
is a carbo-hydrate on the same line with starch, sugar, fat, and oils. 
It is known to be rapidly absorbed and to enter into the circula- 
tion, whence it in part escapes with the excretions, and in part is 
burnt in the lungs; its carbon uniting with the oxygen of the 
inhaled air to form carbonic acid and its hydrogen similarly com- 
bined to form water. During the process of oxidation, heat is 
supposed to be given out. This hypothesis rests on the postulate 
that a part, and it must be the larger part, of the alcohol taken into 
the stomach is not, after its absorption, discharged 
through the various eliminating organs, but that it remains in the 
blood for the purposes of combustion. To what extent this pos- 
tulate is available we have no means of judging, nor have we any 
demonstration of the soundness of the hypothesis itself. If there 
is to be a continued evolution of caloric, maintained by continued 
oxidation in the manner just stated, there must be a constant supply 
of alcohol, which would be followed by dangerous consequences 
to the brain and other organs, all of which, it will be shown, suffer 
from such supply. But granting that all the conditions are com- 
plied with, the promised results are not obtained. The greater the 
quantity of alcohol ingested and absorbed the greater ought to be 
the quantity of its carbon furnished for combustion and the larger 
the amount of carbonic acid excreted. Now, so far from this 
being the result, it has been ascertained by Prout, Yierdort, Perm, 
Boecker, and others, that there is less carbonic acid both relatively 
and actually given out from the lungs after even a moderate use 
of spirituous drink. Dr. Edward Smith shows, as the result of his 
carefully conducted experiments (Transactions Royal Society, 1859), 
that alcohol and substances containing much alcohol disturb the 
respiration rather than influence it in any direction. The respira- 
tory process, therefore, instead of being quickened into greater 
activity, and made more productive of animal heat, is retarded; 
and there is, at the same time, a confinement and accumulation in 
the venous blood of waste or used-up materials seeking for oxida- 
tion and elimination, to relieve the system of what would be 
oppressive and disturbing if not poisonous. If animal heat were 
generated so rapidly and largely by the fuel furnished in alcohol 
we ought to look to its free use for enabling the living body to 
resist cold, whereas the very opposite is the true result, as will be 
shown in a subsequent part of this Report. It may be stated, in 
advance, that the temperature is always lowered by the free use of 
alcohol in the form of ardent spirits. Drs. Boecker and Hammond RELATIONS OF ALCOHOL TO MEDICINE. 
7 
found this to be the case in their own persons even from moderate 
doses of spirits. 
Is Alcohol an Accessory Food ?—Another plea in favor of alcohol 
is, that it acts indirectly as food, not by contributing anything itself 
to build up or to repair the tissues, but by its diminishing the 
metamorphosis to which they are constantly subjected, and the 
consequent waste, it removes the immediate call and necessity for 
the renewal of food, prevents the cravings of hunger, and lessens 
the debility from fasting. This plea, the second, for the use of 
alcoholics, it must be seen, is quite incompatible with the first 
plea, that their use favors the generation of animal heat. The 
conditions for the latter are, increased respiratory force, increased 
oxidation of carbon and hydrogen, not only of these elements 
as furnished by alcohol, but also by the fat and broken tis- 
sues in the blood, and correspondingly increased metamorphosis 
from the degradation of the detached textural remains. On the 
contrary, the diminution of waste or wear of the tissues implies, 
of necessity, diminished transformation or metamorphosis, less 
oxygen, the prime agent in all these changes, and its diminished 
combination with carbon, and of course less completeness of respi- 
ration and less evolution of animal heat. A choice must be made 
of the two hypotheses; and if the last be the one taken, we must 
admit that it gives color to the plea in favor of the indirect action 
of alcohol as a nutriment; but if it be received, we must utterly 
repudiate the claim set up for alcohol being a supporter of animal 
heat. Many difficulties, however, stand in the way of our sub- 
scribing to a’belief in alcohol being even an indirect food. It 
gives no strength and repairs no waste; and if it seems to act as 
food, it is by preventing certain changes in the constitution of the 
blood which are essential to health, and by substituting its own 
combustion in the lungs for that of the disintegrated and waste 
substances in the venous blood. There is less appetite under these 
circumstances and less consumption of ordinary food, but on what 
conditions is this saving brought about? The reply must be. a 
loss of the balance between supply and waste, a temporary de- 
rangement of the functions of digestion and innervation, a living 
on material that has been thrown off from the tissues as worn and 
unserviceable and the retention and accumulation of which increase 
the proportion and deteriorate the quality of the venous blood, 
causing remora, plethora, congestion of the great organs, and espe- 
cially of those in which the veins abound, viz., the brain, liver, and 8 
KEPOliT OF THE COMMITTEE OX THE 
lungs. We would.ask, in the words of Professor Miller, of Edin- 
burgh : “ Whether shall we take alcohol, eat less, and be imperfectly 
nourished; or take no alcohol; eat more, and be nourished well ? 
Whether shall we thrive better on a small quantity of new nutri- 
tive material, with a great deal of what is old and mouldy; or on 
a constant and fresh supply of new material, in sufficient abundance 
to dispense with the old, which, being then in all respects useless, 
is extruded from the system?”1 The diminished metamorphosis 
of tissue under the use of alcohol is evident not only in the lessened 
elimination of carbon, as carbonic acid, but also in that of nitrogen, 
as urea. This indicates that less mechanical force is produced in 
the body and less work is got from the human machine. Large 
quantities of alcohol, therefore, tend to cause an accumulation in 
the system of imperfectly oxidized bodies, such as uric and oxalic 
acids. The action of the lungs and kidneys is lessened—less car- 
bonic acid, less urea, and less water are eliminated. It is very 
evident from all that has been said, and the assertion cannot be 
too often repeated, that alcohol has no claim whatever to be re- 
garded as food in reference to nutrition or the repairing of tissue, 
nor can we admit its claim to be considered as an ordinary agent 
for maintaining temperature by intra-combustion as tenable. 
Whether it is entitled even to a place among condiments will be 
better ascertained after we shall have inquired into its alleged 
value as an aid to digestion. 
The firm hold which, for some years past, the animal chemistry 
of Liebig has taken of the minds of so many persons, both in and 
out of the profession, who found in it a show of science to sup- 
port their alcoholic creed, must serve as an apology for arguing 
afresh against a theory the weakness and fallacies of which have 
of late been exposed by the experiments of Dr. Edward Smith, 
already cited, and of Fr'icke and Wislicenus. Dr. Anstie, who in- 
sists on alcohol being a food, which disappears in the body and is de- 
composed there, but in a manner yet unknown, is, however, obliged 
to admit that our search for the oxides of alcohol must be entirely 
recommenced. We should go a step further and say with Leh- 
mann, “that we are still entirely deficient in the very first prin- 
ciples necessary for a scientific treatment of the theory of the me; 
tamorphosis of matter in the animal organism.” As remarked by 
the same writer, “ we should be unable to give a scientific explana- 
tion of the mechanico-chemical processes in the living organism 
1 Alcohol: Its Place and Power, pp. 71-2. Philadelphia : Lindsay & Biakiston, RELATIONS OF ALCOHOL TO MEDICINE. 
9 
until we had acquainted ourselves with the yet unknown law of 
molecular forces.” The very foundation of the metamorphic specu- 
lations in which alcohol is made to take so large a share, is not stable. 
They rest on the presumed fact of its being only partially eliminated 
from the organism and of the greater portion of all that is ingested 
being turned tp account in generating animal heat and in forming 
fat. Numerous experimenters, Percy, Bouchardat, Sandras, Lalle- 
mand, Perrin, Duroy, and Hammond, show that alcohol is present 
in the blood and tissues of both man and animals after its ingestion 
in the stomach. Dr. H. never failed in experiments performed by 
himself on dogs to which he had administered strong alcohol to 
recognize the presence of this substance in the blood, the brain, the 
stomach, the expired air and the urine of these animals; but when 
using liquid, containing from eight to fifteen per cent, of alcohol, 
such as the German, French, and Spanish wines, he was never able 
to find it in the solids, though detecting it in the products of res- 
piration by a solution of the bichromate of potassa in sulphuric 
acid.1 In the experiments of Dr. Percy, an injection of about two 
ounces and a half of strong alcohol into the stomach of a dog was 
followed by the almost immediate death of the animal; and in 
submitting the brain immediately after to distillation, a notable 
quantity of the alcohol was procured. 
Alcohol, says Bence Jones,2 produces on each substance, in each 
texture, its chemical action, still continually undergoing oxidation, 
so that, in a few hours, one part has entirely escaped, and another 
part has been entirely oxidized in the blood and textures. Strong- 
er weak, it combines with oxygen ; more or less increased oxidation, 
increased circulation, increased secretion, increased effusion of 
liquor sanguinis and altered nutrition result. But one great and 
pervading error in all these chemical explanations of functional 
action is, in overlooking the part performed by the nerves, on and 
through which the larger number of vital phenomena following 
the use of alcohol, are produced. Not only is this fact evinced in 
the disturbed and deranged functions of animal life—the brain and 
senses, and the ready servitors of the former, the muscles—but 
also those of organic life, digestion, respiration, and nutrition, etc., 
all the movements and changes in which are modified by the vary- 
ing degree of innervation to which they are constantly subjected. 
' A Treatise on Hygiene, p. 553. 
2 Lectures on some of the Applications of Chemistry and Mechanics to Pathology 
and Therapeutics, p. 204. • 10 
REPORT OF THE COMMITTEE ON THE 
If we would have a measure of the power and dangerous effects of 
alcohol on the human organism, it will be found in the disorders 
of the nervous and muscular system, far more than in the altered 
relations of the chemical elements to one another. 
Alcohol as a Stomachic, Condiment, or Food.—Of all the sanitary 
feats for which alcohol has obtained credit, the .greatest stress 
has been laid on its alleged cordial and invigorating action on the 
stomach. Its advocates assure us that it will give appetite, pro- 
mote digestion, relieve if not cure dyspepsia and its concomitant 
blues, and vapors, and horrors, stand in the place of food, when 
this is not obtainable, and obviate the oppression which follows 
excessive repletion. Who shall explain the contradiction of its 
being imagined to be capable, according to the wants of the case, of 
filling a vacuum, or reducing a plenum, of being equally good for 
the starveling who cannot get wherewithal to eat, and for the 
glutton who eats too much? The unsoundness of this creed can be 
demonstrated by general observation and experience, to which 
chemistry and physiology lend their aid. Water, heat, and acid 
are mainly instrumental in the first process of reducing the ingre- 
dients of the food taken into the stomach to a semi-fluid homoge- 
neous mass, the chief component parts of which are albumen and 
casein; and the process of this first or stomachic digestion is com- 
pleted by the addition and incorporation of pepsin, the active organic 
solvent in the gastric juice. Alcohol has no share in this stomachic 
digestion; but, on the contrary, it interferes with and retards the 
reduction of food, and in place of dissolving, it coagulates and 
hardens the protein compounds, and after first increasing, dimi- 
nishes and obstructs the secretions of the solvents from the 
mucous glands of the stomach. Schwann, Blondlot, and Muller 
have shown that alcohol destroys the digestive property of pepsin, 
and Todd and Bowman in their Physiology are equally decided in 
the same belief as expressed in the following language: “ The use 
of alcoholic stimulants also retards digestion, by coagulating the 
pepsin and thereby interfering with its action. Were it not that 
wine and spirits are rapidly absorbed, the introduction of them into 
the stomach in any quantity would be a complete bar to the solu. 
tion of the food, as the pepsin would be precipitated from the solu- 
tion as quickly as it was secreted by the stomach.” The common 
use of alcohol by anatomists and naturalists to preserve animal 
organs and tissues unchanged, ought to be sufficient proof that this 
liquid must be opposed to the reduction of animal matter, either RELATIONS OF ALCOHOL TO MEDICINE. 
11 
into a homogeneous pulp, such as is required for its conversion into 
chyme, or into a homogeneous fluid, as we see in chyle. What can 
be said now of the popular fallacy of a glass of wine after soup or 
after fish at a dinner party, or a glass of spirits and water, if not 
two or three glasses, especially if dyspepsia be complained of? At 
one time the advice almost universally given by physicians to 
dyspeptics was, for them to make their dinners of beefsteak and 
brandy or whiskey and water. Every now and then, some of those 
who followed this dietetic course would tell of the relief obtained; 
but no list has been preserved of the many who were made 
hopelessly intemperate b}r this systematic drinking of alcohol, in 
progressively increasing quantity; for the invalid would find it 
necessary to increase, from time to time, the amount of his liquor, 
in order to procure the same agreeable feelings that ensued after 
the first prescription. Similar evils have, we know, resulted from 
the frequent use of alcoholic tinctures of various bitters; and on this 
account a very natural prejudice is beginning to be felt against this 
class of remedies. It is alleged, with good reason, that in the al- 
kaloids of the various bitter, tonic, and narcotic vegetable substances, 
as well as in the form of powder, extracts, and aqueous solution, we 
can procure all their active properties without recourse to an alco- 
holic menstruum. Doctor Benjamin Rush, in his admirable tract1 
on the subject, after speaking of the danger of valetudinarians who 
labor under disorders of the stomach and bowels, flying to spirits 
for relief, says: “So apprehensive am I of the dangers of con- 
tracting a love for spirituous liquors by accustoming the stomach to 
their stimulus, that I think the fewer medicines we exhibit in 
spirituous vehicles the better.” The immediate effects of alcohol 
as experienced in exhilaration of mind, and removal of painful 
feelings from oppression of the stomach may impose for a time on 
the dyspeptic, but he will not be long in discovering that no abiding 
benefit, in improved power of digestion, can be expected from its 
use. It may be, that the muscular coat of the stomach, obedient to 
the excitement of the sensitive mucous membrane, contracts with 
more force and propels into the duodenum the offending or diffi- 
cultly managed food. But if this food has not been fully converted 
into good chyme by solution in the gastric juice, and is hurried 
onward into the intestines, it becomes an irritant to this portion of 
the alimentary canal, and continues to be so in its whole course, 
* Enquiries into the Effects of Spirituous Liquors upon the Human Body, and 
their Influence upon the Happiness of Society. 12 
REPORT OF THE COMMITTEE ON THE 
and fails at the same time to furnish its due proportion of properly 
elaborated fluid for chyle and blood. If we are in quest of a safe 
auxiliary to pepsin, one that prepares the food for complete reduc- 
tion by the latter, it will be found in dilute acetic acid, but never 
in alcohol. If we want a safe and active condiment, one always at 
hand and of universal use by all mammals, we find it in common 
salt, or the chloride of sodium, which plays so important a part, 
from the first solution of food in the stomach on to its assimilation 
into blood, and .the formation and metamorphosis of tissues. Un- 
like the alien alcohol, which, when taken into the stomach, is 
rapidly absorbed and hurried along with the circulation, to be eli- 
minated in great part as speedily as possible, or when retained pro- 
duces very equivocal if not mischievous results, this salt of soda is 
everywhere at home in the organism. It is one of the saline con- 
stituents of the blood, the chyle and the bile, and has a share in 
the processes of nutrition and secretion, especially in that from the 
kidneys. A comparative trial of the dietetic value of the two sub- 
stances might be made in the following way. Let one human being 
take a drachm of common salt daily, through life, as a condiment 
with his food,, and another for the same period an ounce of alcohol 
diluted with water in the shape of distilled spirits, and note the result. 
It is not difficult to foretell on whose side the advantage would lie. 
The question of the claim of alcohol to be regarded as in any 
sense a food, naturally comes up again when digestion is the theme 
before us. Interfering seriously with this process, we could not 
but regard alcohol as adverse to nutrition, and so its habitual use 
is found to be. While the main proposition is beyond dispute, 
there are, it is alleged, exceptional circumstances in which this 
liquid keeps up the powers of life, not by augmenting the receipts, 
but by diminishing the expense—it supports but does not nourish. 
Dr. Hammond, distinguished for his physiological and psycho- 
logical researches and his contributions to hygiene, has made 
experiments on himself to show that alcohol should be regarded as 
an accessory food, which he puts on the same line, in this respect, 
as pepper, cayenne, mustard, and vinegar, and tea and coffee. The 
experiments of Dr. Hammond1 “had reference to the influence of 
alcohol—1, when the food was just sufficient for the wants of the 
organism ; 2, when it was not sufficient; and 3, when it was more 
than sufficient. Four drachms of alcohol were taken at each meal 
1 Physiological Memoirs—A Treatise on Hygiene. RELATIONS OF ALCOHOL TO MEDICINE. 
13 
diluted with an equal quantity of water.” Each of the three series 
of experiments was continued for a period of five days, and in 
each period 60 drachms of alcohol were taken. After the first 
series, when the food was of such a character in quality and quan- 
tity as to maintain the weight of the body at its normal standard, 
Dr. II. found that he had gained .45, or a little less than half a 
pound. In the same period the amount of carbonic acid and 
aqueous vapor exhaled from the lungs had undergone diminution, 
as had likewise the quantity of urine and its solid constituents. 
During these experiments his general health was somewhat dis- 
turbed. His pulse was increased to an average of ninety per 
minute, and was fuller and stronger than usual, and there was an 
indisposition to exertion of any kind. There were also headache 
and increased heat of the skin. The second series of experiments 
was made when the body was losing weight to the extent of .28 of 
a pound daily. Under the use of the alcohol this decrease was 
arrested, and there was again a small indeed but appreciable in- 
crease equal to .03 of a pound, or rather more than half an ounce 
daily. The quantity of food previously too scant, now fully satis- 
fied the appetite, and all the functions of the body were performed 
with regularity, while during the five days of diet that preceded 
the use of alcohol there was unusual exhaustion after exertion. 
"In the third series of experiments, in which more food was in- 
gested than was necessary, the ill effects of the alcohol were well 
marked. Headache was constantly present, the sleep was dis- 
turbed, the pulse was increased in frequency and force, and there 
was a general feeling of malaise.” Dr. Hammond adds : “ I am sure 
that had the experiments been continued, I should have been made 
seriously ill.” But “ notwithstanding all these abnormal phenom- 
ena, the body continued to increase in weight above the ratio 
which existed before the alcohol was ingested, and the excretions 
were diminished in quantity.” 
Alcohol Injurious in Health.—While giving full credit to the 
experimenter for the zeal which prompted and the intelligence 
which guided him in making these trials, we cannot but regard 
them as too limited in duration and as wanting in number and 
variety of persons to allow of our receiving them as conclusive in 
settling a mooted point. As far as they go, they prove most strongly 
the injurious effects of alcohol when drank by persons in health, 
either when they take their customary allowance of food, or when 
they go beyond it. These two classes of persons will probably" 14 
REPORT OF THE COMMITTEE ON THE 
give us the larger number of all those who use alcoholics in some 
form or another; they are kept in a state of unnatural excitement 
and continual predisposition to disease, and are never in the full 
possession of their mental and muscular power. Were the young, 
when they begin to use alcoholic drinks, to analyze their feelings 
and sanitary condition, they would acknowledge that they experi- 
enced some at least of the discomforts and functional disturbances 
described by Dr. Hammond, as resulting from his first and third 
series of experiments. Left to their own instinctive appetites and 
feelings, most of these young persons would at once desist from the 
further use of drinks which make them dull and feverish, but for 
the evil example and the still more pernicious advice, under a 
show of philosoph}'-, of those with whom they associate. After a 
while they get habituated to the poison; but after a somewhat 
longer while, the poison takes possession of them; they afe its 
slaves, and a certain number—how fearful the proportion—are put 
on the roll of regular topers and confirmed drunkards, broken 
down in health, in mind, and character, and often victims to delir- 
ium tremens and confirmed insanity. Drunkenness is not, as many 
seem to think, an extemporized thing; but, on the contrary, it is 
reached by slow progress—a gradual metamorphosis of the outer 
man and of his character corresponding with a metamorphosis of 
tissues taking place in the interior of his body. The beginning of 
the disease and vice, for continued drunkenness, prolonged alcohol- 
ism is a compound of both, is in the season of youth, of health, of 
confidingness, when evil is least anticipated, and measures of pre- 
vention are not even discussed. And yet this is the very time for 
prevention, and for putting young persons on their guard against 
the danger before them. The means of protection for their whole 
lifetime are simple, easy of fulfilment, involve no mortification of 
the flesh, or ascetic observances of any kind; they check no gener- 
ous emotion, no lofty aspirations; they interpose no impediments 
to the development of the greatest intellectual and bodily vigor, 
nor abate in the least, business activity and acuteness. These means 
are simply abstinence from alcoholic or intoxicating drinks, the 
immediate effects of the use of which are shown in derangement of 
health and uneasy restless feelings, and the secondary and remote 
but still certain effects in diseases of various kinds, and more espe- 
cially of those in which the brain and nervous system at large are 
most affected. This is not a question of mere physiological 
curiosity or of speculative hygiene, the solution of which is to RELATIONS OF ALCOHOL TO MEDICINE. 
15 
show to what extent an appetite for a poison, diluted and disguised 
as it may be, but still a poison, can be indulged in without imme- 
diate ill consequences, and whether the alleged enjoyment of the 
many is to be prevented for the safety of the few. The real ques- 
tion is one of much wider and deeper significance; it is eminently 
practical, and calls for the decided opinion and action of every 
member of a community, of every liver in the land. There are per- 
sons with a happy temperament and under favoring circumstances, 
such as advanced age, who have no fears of their falling into habits 
of intemperance, but how few there are who can look round on 
their family circle, or, if safe there, on the circle of their relatives 
and friends, without being pained and mortified at seeing one of 
the number a drunkard, or who is suffering from a shattered con- 
stitution and incurable disease owing to the habitual use of alco- 
holic liquors, a burden to himself and a sore grievance to others. 
What profession or calling, what religious or philosophic teaching, 
can give security against such a degradation of the individual who 
persistently exposes himself to danger. Would then all the mem- 
bers of a family, or of a family connection, have deemed it any 
hardship determinately to abstain from the use of all intoxicating 
drinks, if by so doing they might have induced the youth—a son, 
a brother—whom they loved and cherished, to abstain also, and 
thus prevent the long train of heart-rending scenes resulting from 
his intemperance. Would they not gladly, rejoicingly abstain from 
such drinks, if in the midst of his career of drunkenness they could 
get him to imitate their example? If it be the part of wisdom to 
look beyond the hour, and to furnish guidance for the future from 
experience acquired in the past, her lessons ought certainly to pre- 
vail under the circumstances we are now describing. Medical men, 
more than all others, have the knowledge and the opportunities for 
giving effect to these lessons; they, more than the rest of mankind 
are cognizant of the evils, both physical and moral, that follow the 
habitual use of alcohol; and, as guardians of health, they are im- 
peratively bound to exert themselves to the utmost not only in 
mitigating but in preventing these evils. If medicine be allowed 
to dwell in a self-complacent if not exultant spirit on the improved 
public health, and prolonged average duration of life of the masses 
in all civilized countries, it is because of a more and more diffused 
application of hygiene in pointing out the means for the prevefttion 
and against the recurrence of diseases both sporadic or occasional 
and epidemic. Medicine, true to her mission, cannot—must not—• 16 
REPORT OF THE COMMITTEE ON THE 
hold back from preventing the diseases, not to speak of the con- 
current moral blight and destruction ensuing on the continued use 
of intoxicating drinks. 
Continuing our comments on Dr. Hammond’s experiments, it 
would seem that the mere diminution of the excretions and a slight 
increase of weight, following the use of alcohol, do not of them- 
selves evince health, for they coexisted in the first and third series 
of experiments, with considerable functional disturbances, viz., 
headache, disturbed sleep, increased frequency and force of pulse, 
increased heat of the skin, and indisposition to exertion of any 
kind, and—though not mentioned—we must believe, loss of appe- 
tite, all of which would have ended in serious illness, had the ex- 
periments been continued. Great eaters might profit by a know- 
ledge of these experiments, and learn that the free use of alcoholic 
drinks, so far from diminishing the effects of repletion, and helping 
them to digest their food, only increases their oppression, causes 
feverish thirst, which they often try to assuage by more drinks of 
the same kind, and a general disorder of the body, culminating in 
serious disease. If they are told that this is the result of intempe- 
rance, they would probably be quite surprised, and perhaps somewhat 
nettled at the imputation, which they would repel by asserting that 
they were never drunk in their lives. What a marvellous dimi- 
nution there would be in the number of diseases and deaths, and 
of individual and social distresses and miseries, if drunkards were 
the only sufferers from the use of alcohol. Dr. Chambers, who’is 
not opposed to its occasional use, declares most emphatically, 
that the action of frequent small divided drams is to produce the 
greatest amount of harm of which the alcohol is capable, combined 
with the least amount of good. A few pages before be had said, 
as the result of observations of cases coming under his notice, “On 
the whole, we may conclude that the effect of continued small doses 
of alcohol is to diminish vital metamorphosis, to make it irregular, 
and to induce in healthy people the necessity for crises of evacua- 
tion. Its first action is upon the stomach, enabling more food to 
be digested, and increasing vitality; but if advantage is not taken 
of this first action, its secondary effect is a diminution of vital 
functions in general, and of digestion among the number.”1 Small 
encouragement to the dyspeptic for his having recourse to alcoholic 
drinks. Present relief and increased digestion, to be followed in 
an indefinitely short period by vomiting or purging, or cholera, 
1 Lectures, chiefly Clinical, p. 568. RELATIONS OF ALCOHOL TO MEDICINE. 
17 
and aggravation of his disease. The same writer tells us that he 
has “ never known a forenoon tippler, even though he never got 
drunk in his life, without a condition of stomach which most infal- 
libly shortened his days.” In the selection of lives for insurance, 
Dr. Chambers thinks it much more to the purpose to ask the pro- 
poser the pointed question: “Do you take spirits in the forenoon? 
Is that a habit ?” than to make the usual aimless inquiry whether 
the proposer is “sober and temperate.” Nobody is anything else, 
of course, on these occasions, and the answer is a mere declaration 
of opinion. Doctor Christison states that three-fourths of all the 
cases of Bright’s disease which he saw were produced by the habi- 
tual, long-continued abuse of drink. Very great occasional excess 
did not act so strongly as long-continued smaller excesses. 
The second series of experiments of Dr. Hammond are excep- 
tional, and cannot be allowed to represent what would be the sani- 
tary condition of laborers, workmen, and all those who take active 
exercise, if placed under the alcoholic regimen. These persons 
might bear up under it for a few days, as they would, for the same 
time, aided by the excitement of hope or promise of reward, but 
no longer. Their systems would require better blood material than 
retained excreta from broken-down tissues, to make up for a defi- 
ciency of real food to sustain them under the additional exhausting 
metamorphosis from muscular contraction, and the waste from 
largely increased cutaneous and pulmonary exhalation and secre- 
tion, which would find no adequate offset in the diminished waste 
caused by alcohol. In treating of the origin of muscular force in 
animals, Lyon Playfair draws the conclusion that the normal food 
and fuel of muscles consist of albuminous bodies, which must 
constantly be supplied to produce sustained effort, and prevent cor- 
poreal deterioration. Dr. Chambers, who talks of alcohol as ac- 
cessory food, is obliged to admit that we are unable to trace any 
direct increase of force to alcohol, even in the smaller doses, and 
for the minutest period of time. 
Wines.—More favor has been asked for wine than distilled spi- 
rits in treating of the effects of alcoholic liquors on the animal 
economy, and not a few writers on dietetics are disposed to make 
a compromise by giving up the products of the still to merited 
reprobation, and yet holding on to the fermented juice of the grape. 
In the present stage of our inquiry, we need only observe that, 
although wines differ in strength and consequent activity of ac- 18 
REPORT OF THE COMMITTEE ON THE 
tion, yet they are all of them alcoholics, and as such, when ingested, 
produce the effect already described, of interrupting stomachic 
digestion by precipitating and coagulating pepsin. Their primary 
action on the brain and heart, by stimulating these organs, is 
analogous to that of distilled spirits; their secondary and remote 
effects are different, but whether to their hygienic credit, is a ques- 
tion that may admit of great doubt. It will suffice to say, with 
Pereira, who is no ascetic or enemy to vinous drinks, that “it can- 
not be denied that the most perfect health is compatible with total 
abstinence from wine; and that the habitual employment of it, espe- 
cially by the indolent and sedentary, is calculated, in many instances, 
to prove injurious. To a person in perfect health, and who has 
been unaccustomed to it, no possible benefit can accrue from using 
it. The preternatural excitement which in these cases it would 
occasion, must be followed by a corresponding degree of depres- 
sion. Even though no sensible injury may result therefrom, no 
benefit can be expected to result.” And in another place this wri- 
ter says: “To persons in health the dietetical employment of wine 
is either useless or pernicious.” All that we have said, in the way 
of advice and warning to the young and the healthy respecting the 
danger they incur in the use of alcoholic drinks in general, is ap- 
plicable to their use of wine. If, as a matter of taste, or of gen- 
tility, or may be from conscientious scruples, a young man rejects 
brandy, or whiskey, or rum, let him not believe, for a moment, that 
he incurs no danger to his health at the time, and is not beginning 
a habit which may enslave him, when he takes a glass of Madeira, 
sherry,- or port. He compounds with temptation by drinking 
twenty-three or twenty-five per cent, of alcohol, in place of forty- 
eight or fifty per cent., a glass of heavier-bodied wine being equal 
in strength, if not in intoxicating property, to half a glass of 
brandy. He will, however, probably prefer champagne, the favo- 
rite beverage of the day among intoxicating liquors; and then 
he takes but twelve per cent, of alcohol. If he drinks four glasses 
of this wine he will be alcoholized to the same extent he would be 
by a glass of brandy or whiskey, with the additional chances of 
having more headache and disinclination for breakfast next morn- 
ing after the champagne than after the brandy, or its equivalents, 
whiskey or rum. We are told of the alcohol in wine being modi- 
fied, not only in taste, but also in its inebriating operation, by the 
different substances—sugar, gum, extractive matter, salts of potassa, 
and in the red wines, tannin, and in the champagne, carbonic acid RELATIONS OF ALCOHOL TO MEDICINE. 
19 
—with which it is mixed. The practical fact, however, is that 
other things being equal, as regards sanitary habits and social posi- 
tion, the spirits drinker will be apt to outlive the wine-bibber, sup- 
posing that each of the two carries his intemperance to the point 
of getting frequently drunk. Pitt, and Fox, and Sheridan, names 
so distinguished in the political and parliamentary history of Eng- 
land, all shortened their days by their free drinking of wine, 
although the stigma of drunkenness was fixed on the last alone, 
who towards the close of his life became a brandy toper. Let not, 
then, the ingenuous youth of our country lose their buoyant feel- 
ings, gayety, and susceptibility to true enjoyment in the muddling 
effects of wine, or of alcoholic drinks in any form. Would, that ad- 
vice on this topic were required only for young men ; but the other 
sex is also in imminent danger. It is, unhappily, no fancy sketch 
to see young girls just beginning to mix in general society, who are 
too ready to quaff champagne with their male partners in the dance, 
or at the supper-table, unconscious of the consequences in their 
changed features and expression, flippant speech, and loss of 
that air of retiring modesty which constitutes so much of their 
charm. They are not aware, at the time, that they are beginning to 
lay up a store of nervousness, fitfulness, and feelings of languor 
and lassitude which may soon furnish an excuse, and, perhaps, in the 
opinion of a thoughtless physician, a cause for recourse to stronger 
wines in the day. More ready still is the now almost inevitable ste- 
reotype prescription of milk-punch—that is to say, the best food 
and strengthener and blood material, half prepared to become 
chyle, mixed with a liquid that is no food, destroys pepsin, and other- 
wise spoils digestion, and poisons the blood, if it is not soon ex- 
pelled from it by the eliminating organs. Others of the female sex, 
not tempted by wines, find at their social meetings sweet cordials 
—liquors of which they are persuaded to drink, and thus lay the 
foundation for habits of intemperance which crop out when they 
become wives and mothers—sadly to the distress and embarrass- 
ment of their physicians, who may now with some feelings of com- 
punction ask themselves how far their own previous prescriptions 
or their entire indifference to the subject of intoxicating drinks had 
contributed to produce this melancholy state of things. 
Intemperance from Wine.—Many well-intentioned persons, who 
deplore the evils of intemperance caused by distilled spirits, think 
that a remedy would be found in the substitution of fermented 
liquors, and, in this belief, advocate the cultivation of the vine on 20 
REPORT OF THE COMMITTEE ON THE 
a large scale, so that the people everywhere may be able to procure 
wine for common use. Foreign countries are cited to show the 
temperance of the inhabitants where wine is largely made and con- 
sumed ; and of these France is spoken of with the most emphasis. 
A careful inquiry into the subject has not by any means justified 
such a favorable view. Your reporter, who spent a year in Paris, 
had an opportunity, while attending in the hospitals of that city, to 
learn something of the habits of the lower and poorer classes of 
the population, who do not come under the notice of travellers. 
Statistical returns show that the people, not only of Paris, but of 
other great towns of France, furnish a large quota of victims to 
alcohol, and the evils of intemperance are deplored by not a few of 
the medical men and publicists of that country. The subject 
subsequently engaged his attention, and he would refer to a small 
volume1 of his for documentary and other proofs that wine gountries, 
taking France as their representative, have little cause for self- 
congratulation and boast on the score of exemption from drunken- 
ness. As said in the work referred to, “What is the experience .of 
those persons who mix with the people in their fetes; who look into 
their cabarets, or small wine and brandy shops; who watch the 
crowds returning into Paris of a Sunday evening from outside the 
barriers, where they get wine cheaper than in the city; who visit 
their hospitals, to note.the causes of disease and of surgical injuries, 
and to make a record of their insane, and the causes of this disease; 
who read the newspapers, and learn in them the origin of quarrels 
and duels between soldiers at a cabaret, and of disobedience of men 
to their officers?” Villerme, high authority on all statistical and 
benevolent questions, said, years ago, that drunkenness is the great- 
est curse of the laboring classes in France. Wine, especially the 
common country wine, does not stimulate them enough; it only 
serves to give them an appetite for something stronger, which they 
find in their own brandy. The successive stages of intemperance 
are so well described by Villerme, that one might suppose he had 
drawn the picture from what transpires so commonly in our own 
country, and in the United Kingdom of Great Britain and Ireland. 
The workmen or operatives drink spirituous liquors, he tells us, 
at first, without pleasure, and merely through imitation ; 'soon to 
indifference succeeds an agreeable sensation; then an insensible 
desire is felt, and a passion continually augmenting. “It is thus 
gradually, and by a rapid descent, a man passes from habits of 
1 On Regimen and Longevity. RELATIONS OF ALCOHOL TO MEDICINE. 
21 
sobriety to habits of intemperance; from the moderate use of 
intoxicating drinks to their abuse. Henceforth everything becomes 
an occasion for visiting the tavern [cabaret): he goes there when 
times are prosperous, because he gets high wages and has money; 
when he is for a while without work, because he has nothing to do; 
when he is happy, in order to enjoy himself; when he has domestic 
troubles, in order to forget them. In fine, it is at the tavern that 
he contracts his debts, and pays them when he can; that he makes 
his bargains; that he contracts his friendships, etc., and that even 
he gives his daughter in marriage.” 
After describing the waste, idleness, turbulence, debasement, 
diseases, shortening of life, vices and crimes which drunkenness 
brings in its train, Villerme adds: “We may affirm that drunken- 
ness is truly the chief cause of the quarrels, a great number of 
crimes, and nearly all the disorders and irregularities which the 
operatives commit, or in which they take a part.”1 Chevalier, in his 
treatise on “The Prevention of Diseases among Printers,” states as 
the chief means for meeting this end, dissuasion from the excessive 
use of intoxicating drinks, and from frequenting petty taverns 
and pot houses. After these statements of their own writers, the 
French people will not, probably, feel themselves scandalized by 
the following extract from the work of Sir Henry Bulwer,2 who, by 
the way, generally describes France in as favorable a light as 
possible. He is speaking of the workmen and operatives of Paris. 
“Hatters, drunkards; tailors, vicious and dissatisfied; nappers and 
cotton spinners, so wretched that no fault should be found with 
them; cabinet-makers, fond of drinking, but of quiet tempers; 
printers and analogous trades, drunkards; house painters, drunkards, 
very careless; marble cutters, drinkers and hot-headed; workmen 
in harbors, exceedingly addicted to drinking; curriers, drunkards 
in the highest degree.” The operatives of both sexes in Lille, St. 
Quentin, etc., exhibit an amount of disease and demoralization 
from alcoholic drinking equal to that in the large manufacturing 
towns of Great Britain, but, happily, without a parallel in those of 
the United States. We have mentioned insanity as one of the 
diseases in France which ranks intoxicating drinks among its 
causes. Of 256 persons received in the hospital for the insane at 
Charenton, near Paris, who were deranged from physical causes in 
1 Annales d’Hygtene, t. xxii. 
2 Monarchy of the Middle Classes, 1834-3S. Vol. i. p. 219. Intemperance and 
its attendant evils have been on the increase in France since Sir Henry wrote. 22 
REPORT OF THE COMMITTEE ON THE 
three years, 64, or one-fourth of the whole, had become so in conse- 
quence of excess in the drinking of wine {abus du vin); of these 
twelve were females. At Caen, the proportion of patients from 
drunkenness in the insane asylum was one in every eight and one- 
half. The returns of the cause are strong drinks {liqueurs fortes). 
M. Fleury, in his course of lectures on Hygiene in the Paris 
School of Medicine, speaks in very decided but not flattering terms 
of alcoholic drinks. They exert, he assures us, “an action of very 
brief duration, and if the working classes would substitute for the 
abuse of these drinks the use of good food, and especially of meat, 
they would gain in strength and health, and would be protected 
from all the diseases which follow in the train of drunkenness. 
Alcoholic drinks are anything but tonics and corroborants with 
the use of which hygiene cannot dispense; they are at most stimu- 
lating agents the use of which ought to be prescribed and regulated 
by therapeutics. Alcoholic drinks are for humanity and society 
an inexhaustible source of physical, intellectual, and moral evils. 
To prohibit completely fermented and distilled liquors, to restrict 
the use of fermented liquors within the narrowest limits, seems to 
us to be the right and the duty of paternal and really civilizing 
governments.”1 
These are not the opinions which the people of America and 
Great Britain, with their imperfect knowledge of the dietetic value 
of wine, would expect to be held and still less to be uttered by a 
learned professor in the School of Medicine of the great city of 
Paris, the capital of France, the great wine producing country of 
Europe. Professor Fleury must have been deeply and painfully 
impressed with the evils of intemperance, caused by the general 
use of alcoholic liquors by his countrymen, when he gave utterance 
to opinions so decidedly adverse to their use, and at the same time 
to the immediate interest of a large and influential body of his 
countrymen, the producers and sellers of the boasted wines of 
Champagne, Burgundy, Bordeaux, etc., and of the distillers of 
brandy at Cognac and other places. M. Fleury’s patriotism does 
not mislead him for a moment into a belief that France can stand 
apart and look with a compassionate feeling on other countries the 
people of which are given to intemperance as if she enjoyed com- 
parative exemption. “ Drunkenness is,” he tells us, “widely spread 
in France, England, Germany, Russia, Sweden, and the United 
States. In France wine is the chief agent; in Germany and in 
1 Cours d’Hygiene, tom. i. p. 200. RELATIONS OF ALCOHOL TO MEDICINE. 
23 
England beer and ardent spirits; in Russia, Sweden, and the 
United States principally that from grain. The lecturer gives 
nearly the same picture of the cabaret, but in darker colors, as 
that presented thirty years before by Villerme, which we have 
copied. The deeply interesting nature of the question, and a de- 
sire to still further awaken the dreamers of wine-land to a clear 
perception of the realities of the whole subject, induce us to repeat 
the language of M. Fleury: “ Drunkenness at home in the midst 
of his family is very rare; it is at the cabaret that the workman 
parts, in exchange for wine or brandy, with the money which 
ought to go to provide food for his wife and children; it is at the 
cabaret he contracts habits of violence and debauchery; it is at 
the cabaret that he gives himself up to all the suggestions of hate 
and envy; it is at the cabaret that he indulges in his dreams of 
communism, and revolts against inevitable social inequalities, and 
puts himself in insurrection against hierarchy and authority.” 
The cultivation of the vine, so far as it relates to the manufacture 
of its fruit into wine and brandy, gives no activity to social pro- 
gress or improvement, affords no genial incentive to the powers of 
man, does not quicken any germ of civilization into a display of 
superior industry, literature, or science; but, on the contrary, the 
people thus engaged are behind their countrymen, who live under 
the same government and institutions with themselves, in all that 
makes useful citizens and contributes to the sum of human worth 
and intelligence. Of the two divisions of France into North and 
South, the proportion of superficies of soil is as 18 of the first to 
34 of the second, of population 13 to 17, and of agricultural 
laborers 7 to 11. The south contains the chief wine districts; it 
has a more genial climate and more fertile soil than the north, and 
yet, notwithstanding these differences, all to the advantage of the 
former division, Baron Dupin, in his work on Productive Forces, 
shows that the people of northern France derive a larger mean 
income per individual from the soil and from manufacturing in- 
dustry and pay more taxes than their countrymen to the south. 
Their agricultural products are to those of the latter as 5 to 6, 
although the proportion of laborers, as just stated, is 7 to 11 ; and 
of surface for cultivation not much more than one half, or 18 to 
34. At the time these calculations were made, the south with a 
greater population sent one scholar to a primary school for two 
sent by the north. The condition, physically and mentally, of the 
small laboring proprietors and laborers and jobbers is every, way 24 
REPORT OF THE COMMITTEE OX THE 
poor. They consume but little of the wine they manufacture ; 
their chief drink is piquelte wine, a liquor made of the wastage of 
the wine barrels, the remnants of grapes, etc., which are subjected 
to a kind of fermentation bordering on the acetous. The inhabit- 
ants of the wine regions in France are accustomed from their 
infancy to drink piquette, and it is the ordinary beverage of the 
poor. The people are generally sober, but thriftless and wanting 
in the knowledge and practice of household economy. Their 
amusements are “dancing, public houses, and gambling.” Grain 
claims a vast superiority over vineyard agriculture, in reference 
both to the amount of food furnished to man and the profitable 
exchange with other countries where soils are less fertile. Mr. 
Tomes, who was for some time American Consular Agent at Rheims, 
in the midst of the “ Champagne Country,”1 describes the laborers 
in the vineyard, and during the season of vintage, in anything but 
inviting colors, or such as would make us hopeful of greater tem- 
perance among a people by the substitution of wines for ardent 
spirits. He tells us that drunkenness, supposed to be of unfrequent 
occurrence in France, is common enough in Champagne. 
Still more emphatic is the language of a late traveller, Dr. Hol- 
land, in Switzerland, as relates to the cultivation of the vine for the 
purpose of making wine. This gentleman thinks that there can 
be no question that the people would be better, healthier, happier, 
and much more prosperous if there was not a vineyard in the can- 
ton of Lausanne, from which he was then writing. It is, he con- 
tinues, the opinion of the best men in Switzerland, those who have 
the highest good of the people at heart, that the increased growth 
of the grape has been steadily and correspondingly attended by an 
increase of drunkenness. They lament the planting of a new vine- 
yard as we, at home, the opening of a grog shop. It must not be 
forgotten that there is a close connection between the wine-press 
and the still, not only in their furnishing the same element, alcohol, 
but in the former supplying wine for distillation into brandy, and 
the product of the still being sent back to give strength and body 
to the wine reserved for home use, and especially for exportation. 
More than a seventh part of the wine made in France is manufac- 
tured, by distillation, into brandy. Welearn from estimates made by 
Mr. McCulloch that for every three pipes of Catalonian wines sent 
to Cuba, South America, and the North of Europe, there goes with 
1 This is the title of his work, giving the result of his observatiofis in that 
country. RELATIONS 0$ ALCOHOL TO MEDICINE. 
25 
them more than a pipe of brandy. Nearly all the wines made are 
doubly alcoholized, first by the process of fermentation, and next 
by the addition of brandy or other distilled liquor, before they are 
sent to market. The assurance and the skill with which foreign 
wines are adulterated are not now exhibited for the first time. 
Bedding, in his work on wines, tells us that claret is not a simple 
wine, or the produce of one kind of grape, or even one vintage, but 
is a mixture of Bordeaux and Bene Carlos, sometimes Languedoc 
and Bordeaux, at others Hermitage or Alicant with Bordeaux, and 
uniformly a portion of brandy is added to it in the proportion of 
six per cent. Its actual proportion of alcohol after this addition is 
about fourteen per cent. The information furnished by the same 
writer on the so much lauded Port wine is instructive. For more 
than a century the Portuguese have ceased to send pure wine to 
England. In its preparation for the English market “they did not 
spare brandy nor elderberries, nor burnt grain, nor anything that 
would answer to color the wine when it was not thought deep 
enough. They created at length such a wine as the world never 
before saw, especially when improved by subsequent adulterations in 
London, where the imitations of Port wine have been so facile, in 
consequence of the absence in most of that imported of the prime 
qualities of good wine, that a vast quantity more is sold than Oporto, 
with its Company, has ever been able to export.”1 And again: 
“ Five-eighths of the wine brought to England is so coarse and such 
a medley of ill-flavored heterogeneous vine produce, bad Portuguese 
brandy, and other matters, that any ingenious person may increase 
one pipe to three by the addition of inexcusable articles without 
any fear of injury to the stomach of the consumer, or to the appear- 
ance of the wine happening.” Physicians, everywhere, ought to 
know the real nature of the stuff which they prescribe under the 
supposition of its being a pure wine fresh from the London docks, 
and primarily from Oporto. But how much is sold of a vile com- 
pound called Port wine, of home manufacture, without its contain- 
ing a drop of wine of any description, we are left to conjecture. 
The quantity is, however, considerable. Madeira wines receive an 
addition of brandy when wracked from the vessels in which they 
had been fermented, and another portion is thrown in previously 
1 The entire export of Port wine is twenty thousand pipes, and yet sixty thou- 
sand, as given in evidence before a committee of the House of Commons, are an- 
nually consumed in Great Britain and Ireland. Dr. C. A. Lee believes that the 
annual importation of what is called Port wine, into the United States, far exceeds 
the whole annual produce of the Alto Douro. 26 
REPORT OF THE COMMITTEE ON THE 
to their exportation. When Madeira was a fashionable wine, every 
sort of deception was practised with respect to it; and after Sherry 
took its place the latter was soon adulterated on a large scale. It 
must have been quite amusing for those in the secret to see the 
amateurs of sherry sip and prolong the pleasures of gustation be- 
fore swallowing their favorite wine which had been subjected in 
England to such additions as are described by Redding: “Sherry 
of the brown kind and low price, when imported, is mingled with 
Cape wines and cheap brandy, the washings of brandy casks, 
sugar-candy, bitter almonds, and similar preparations, while the 
color, if too great for pale sherry, is taken out by the addition of 
a small quantity of lamb’s blood, and then passed off for the best 
sherry by one class of wine sellers and advertisers. The softness 
of good sherry is easily imitated.” Champagne is everywhere 
manufactured to meet the existing demand in Paris, London, and 
other great cities in Europe, and in those of the United States. 
Not one bottle in a hundred of that which is drank in England or 
in this country comes from Champagne. Balls, races, dancing 
parties, and crowded public dinners are profitable markets for 
adulterated wines. The manufacture of this class of liquors is now 
conducted on a large scale in France itself, and not surreptitiously 
but as a regular branch of trade. Many curious and startling 
details on the subject are given in a late work, by M. Lebeuf, 
on the Culture and Treatment of the Vine in its Relations to the 
making of Wines, and the Proportions of the genuine and the arti- 
ficial liquors, or those made by the addition of alcohol and spiritu- 
ous essences to the original juice of the grape. The favor with 
which the wines of Burgundy, Bordeaux, Macon, Chablis, Cham- 
pagne, etc., have been received, has tempted the cupidity of the 
wine merchants, and induced them, says M. Lebeuf, to make with 
avidity various imitations. These manufacturers undertake to 
manufacture all kinds of wine to order, and they often make good 
imitations. Did room permit, we could introduce some amusing 
anecdotes in proof of success, even years ago, in this way. These 
spurious products find a rapid sale, and some people become so 
much accustomed to them as often to prefer them to the real 
article. A similar preference for adulterated porter, in which 
other bitters were introduced to replace the hop, was asserted 
several years ago by a London brewer, in an examination before a 
Committee of the House of Commons. It is somewhat curious 
that the recipes given in M. Lebeuf’s work have not a drop of the RELATIONS OF ALCOHOL TO MEDICINE. 
27 
real wines they are intended to imitate. There are three plans for 
making new wine old : First, letting it become old by age; secondly, 
ageing it by a stove or hot-house; and thirdly, ageing it chemi- 
cally. M. Lebeuf describes one of the chemical concoctions for 
giving age to new or manufactured wine. Many of the liquors 
called French clarets or other alleged products of the vintage in 
different parts of France are mere chemical compounds; and no 
more dependence can be placed on their purity than on that of the 
heavier and more spirituous wines of Spain and Portugal. When 
would-be connoisseurs inhale with apparent delight the delicate 
“bouquet”or perfume of European wines, purchased by retail, they 
are not aware, that in all but the very finest vintages this bouquet 
is the triumph of the chemist rather than a product of the grape. 
At the great French Exposition in Paris, in 1867, there were 
specimens of artificial essences of sherry, port, gin, rum, cognac, 
arrack, Madeira, Masella, etc., which would enable fraudulent pub- 
licans and grocers to manufacture those poor compounds, called 
wines, with which the ignorant and unsuspecting purchasers are 
slowly poisoned. On a review of the whole subject, it will be seen 
that French experience affords small ground for our believing that 
protection against the evils of intemperance will be found in an 
extensive cultivation of the vine, and a correspondingly large pro- 
duction of wine. The line once passed from drinking water, as 
the sole beverage, to alcohol, however it may be weakened by large 
dilution, a desire is soon created for further stimulation by stronger 
drinks, until, step by step, men, and women, too, are led on from 
the use of the weak table wine to the highly alcoholized, bewil- 
dering, and stupefying absinthe. This is not the case with all; 
but who, in advance, can designate the exempt. 
Opportunities are now being afforded, and will annually increase, 
for the people of the United States ascertaining from their own expe- 
rience, the effects, considered hygienically and therapeutically, of the 
drinking of wine. California, a State in which everything exists, 
and is done on a large scale, has already thirty millions of vines in 
bearing, the fruit of which yielded, in 1868, more than fifteen mil- 
lions of gallons of wine, and one million of gallons of brandy. The 
Overland Monthly very wisely urges the growers to make a strictly 
pure wine, and assures them that if this condition be complied with, 
the demand for the wine will exceed greatly the production. In 
other western States great attention is being paid to the cultivation 
of the grape-vine. There are said to be three thousand acres de- 28 
REPORT OF THE COMMITTEE ON THE 
voted to this object within a radius of fifty miles from Keokuk, 
Iowa. The product of wine from the cultivated grape is quite 
considerable in Ohio, North Carolina, etc. 
Nearly 5,000,000 acres of land in France are given to the culti- 
vation of the vine, which affords occupation, in one way or another, 
to upwards of 5,000,000 of persons. The vintage in 1868 amount- 
ed to 1,620,000,000 gallons, and the annual average value is esti- 
mated at $100,000,000. Some French writers have rated it in former 
years as two hundred millions. One department alone, Ilerault, 
produced in 1864 three times more wine than Portugal. 
After this exposition of the “ wine question” made on the evidence 
and experience of judicious and independent observers, what shall 
be said of such a flippant way of disposing of a grave question as is 
attempted in the following language : “ And in the day when every 
farmer can, from half an acre of land, easily and cheaply planted 
and tilled, even by the unskilful, harvest what will fill his ten or 
twelve barrels with honest juice, for the habitual daily drink of 
himself and family—our two heavy afflictions and sins, excessive 
water drinking and excessive whiskey drinking—will vanish from 
the land, and a beneficent change in our national temperament 
begin to be wrought.”1 The great cordial of life, according to this 
writer, is red wine, which he recommends to be taken daily in the 
quantity of a quart for every adult, and of a pint for each child. 
The age of the latter is not specified. Is the drinking to be begun 
when the little being is yet at the breast, imbibing its mother’s 
milk? And this is the prescription which we are assured “will 
prevent and cure dyspepsia.” Far different from this is the opinion 
held by French medical writers, who are familiar with the effects 
of the drinking of wine dietetically and medicinally considered. 
Fodere,2 for example, says: “ If my opinion were asked on the 
necessity of using wine in a state of health, and as a hygienic agent, 
I would frankly reply with Plato”—Galen might have been also 
cited—“ and after what I have seen of the evils caused by it, that it 
would be much better not to accustom children to its use, and that 
we have no call for this factitious stimulus until the approach of 
old age.” This writer, who is the author of a standard work on 
Legal Medicine and Public Hygiene, refers to his experience in the 
treatment of children of all ages at the Medical College of Stras- 
bourg, and adds that boys in good health especially have no need 
1 Three Seasons in European Vineyards, etc., p. 20. By Wm. J. Flagg. 
2 Diet, des Sciences Med., art. Vin. RELATIONS OF ALCOHOL TO MEDICINE. 
29 
of wine during the period of their growth, and that this liquor, of 
which too indulgent parents are afraid to deprive them, so far from 
being beneficial, disposes them, on the contrary, to serious and fatal 
diseases, among which he specifies haemoptysis, pulmonary con- 
sumption, and mania. Potnme, author of an excellent work on 
hysterical and hypochondriacal diseases,1 those which are so often 
supposed to require the exhilarating operation of wine and analo- 
gous liquors, cautions invalids against their use, and declares em- 
phatically, that both nature and common sense clearly point out 
water as the only fitting drink. 
Whatever misgivings may be felt by the advocates of tempe- 
rance, as regards the general use of the fermented juice of the grape, 
and however reasonable their dread of its being made to undergo 
a farther and deleterious change by distillation, there can be no 
question of the sanitary benefits ensuing from the extensive culti- 
vation of this fruit for its legitimate ends, viz., to gratify the palate, 
quench thirst, and be a real “accessory food.” While thus to a 
certain extent nutritive, it is also medicinal. We may not look for 
a complete arrest of pulmonary consumption by the “ cure de raisins 
or a diet consisting chiefly of bread and grapes; but we cannot re- 
ject the testimony in its favor in chronic bronchitis associated with 
irritable dyspepsia, and, also, in hypochondriasis, dysentery, and 
certain diseases of the skin and renal organs. Grapes might well 
enter into the dietary of persons of all ages, from childhood to the 
most advanced period of life, and would prove to be alike grate- 
ful to those in the enjoyment of health, and to those wracked by 
pain and fever. Vineyards may be spread over the country and 
their natural unsophisticated fruit product be made an article of 
lucrative commerce, not only by its consumption on the spot where 
it is grown and in the season of vintage, but, also at a distance, 
both in its recent state, and when dried so as to become raisins. 
With the increased means of preserving fruit fresh on a large scale 
and of transportation to any part of the United States, the inhabit- 
ants of regions remote from the favored lands of the vine will be 
able to procure grapes in even greater abundance than they now 
do apples, oranges, lemons, and figs, not to speak of the more tender 
pineapple and banana. California and other vine districts will 
supply us on the Atlantic side with fresh grapes in quantities a 
thousand-fold greater, and of more varied flavor than we now receive 
1 Maladies Vaporeuses des Deux Sexes. 30 
REPORT OF THE COMMITTEE OX THE 
from the Mediterranean. The practice of gathering grapes just 
before they attain maturity and of divesting them of any adherent 
moisture, and then of packing them away in some light and dry 
substance, was known to the ancients. Grapes were called by the 
Eomans uvse ollares when they were put away in jars hermetically 
sealed with pitch, or in well-closed vessels with dry straw. Cali- 
fornia, the vegetable productions of which are on such a grand 
scale, will, no doubt, soon grow grapes of a size to rival those of 
the bunch found in the valley of Eschol, that required two men to 
carry it, or those of Damascus of the present day, which have 
been found to weigh twenty-four pounds to the bunch. 
The juice of the ripe grape consists of sugar, gum, albumen, fatty 
matters, pectic acid, pectates of lime, potash and soda, acid, bitartrate 
and tartrate of lime, and alumen. Also sulphate of potash, chlorides 
of potassium and soda, phosphate of lime, oxides of iron, silex, and 
essential oils. Sugar, gum, and gluten are in quantity available for 
nutrition in the juice of the grape; but by the process of fermenta- 
tion into alcohol they are changed, and show themselves in much 
smaller proportion. Your reporter draws from his work, already 
quoted, the following particulars on the use of the unfermented 
juice of the grape, which, together with “ the sap of the palm-tree, 
are, as we learn from Captain Charles Stuart, common and delight- 
ful beverages in India, Persia, Palestine, and adjacent countries. 
Must, or the expressed and unfermented juice of the grape, was 
used by the Egyptians at an early date (Gen. xl. 11). Another mode 
of using the juice of the grape for the purpose of drink was to 
evaporate the more watery portion, by which the remainder was 
thickened and could be kept for a length of time without farther 
decay. When wanted for use, it was made with the addition of 
water, not only a refreshing, but a somewhat nutritive drink, as its 
mucilage or extractive matter and sugar were still retained. Dr. 
Russell, in his history of Aleppo, thus speaks of the practice in 
modern times, in that part of the world: ‘ The inspissated juice of 
the grape (sapa vini) called here dibbs, is brought to the city in skins 
and sold in the public markets: it has much the appearance of coarse 
honey, is of a sweet taste, and in great use among the people of all 
sorts.’ This extract, as it may be called, of the juice of the grape, 
mixed with water and allowed to remain in this state for a time, 
would undergo a slight acetous fermentation, rendering the drink 
analogous to the light ascescent wines used by the people of southern RELATIONS OF ALCOHOL TO MEDICINE. 
31 
Europe, or to the piquette already described.”1 In all ages, writes 
Fodere iu the French Dictionary of Medicine, previously quoted, the 
rich have drunk wine and the poor piquette, but the latter class, 
sober from necessity, have, also, always enjoyed better health than 
the rich. Piquette (posia or bra) has been called secondary wine. 
This was the drink issued as part of their daily allowance to the 
farm laborers and slaves, by the ancient Roman landholder. In 
parts of Asia Minor, the Turks make a thick confection of grape 
juice, raisine, which they use largely as a condiment in place of 
sugar or honey. 
There is yet another state in which grapes are largely used, 
viz., when partially deprived of their watery part by drying, but 
still retaining their sugar, mucilage, and an acid. The fruit thus 
prepared is known as raisins; in some places it is dried in the sun, 
in others immersed in lye. In all cases, it is desirable that the 
grapes should be perfectly ripe before they are gathered, and in 
order to secure this result, the leaves and branches which partially 
cover the bunches of the fruit are drawn to one side so as to expose 
it fully to the sun. The damaged berries are carefully removed. 
In eating raisins, care should be taken not to swallow the skin and 
seeds, both of which are indigestible. 
People often speak of wine and the juice of the grape as equiva- 
lent terms, and hence regard the former as a natural product, obvi- 
ously intended for man’s use and enjoyment. Wine is no such 
thing; it is the product of carefully elaborated and artificial pro- 
cesses, necessary to encourage fermentation and to keep this latter 
within certain limits, passing which the liquor would lose its alcohol 
and become vinegar. The juice of the grape left to itself soon runs 
into the acetous fermentation, and this change gives us the really 
natural product, the true resulting liquor, but not wine. Alco- 
hol is always a stranger, and with few exceptions an enemy in 
the human organism; acetic acid, on the contrary, is found in the 
gastric juice, and aids’ digestion. Vinegar was part of the ration of 
the Roman legionaries, the conquering soldiers of the republic; 
with it they quenched their thirst after long marches, and mitigated 
by mixture the effects of bad water. One can hardly procure a 
more refreshing and cooling drink during the dog days than vine- 
gar and water, to which molasses is added. To workmen exposed 
to the sun, it offers every advantage over any of the alcoholic liquors. 
Next to salt, vinegar should be regarded as a universal condiment. 
1 Regimen and Longevity, pp. 231, 232. 32 
REPORT OF THE COMMITTEE ON THE 
Diluted with water it is most refreshing and curative in most forms 
of fever, and might be turned to good account in many chronic 
affections. 
Malt Liquors.—If wine be regarded as the natural drink of 
the French people, malt liquors bear the same relation to the Eng- 
lish. The proportion in quantity of the former to the latter is 
about as three to two, and in the amount of alcohol, of which they 
are the bearers, as 9 to 5. The drinkers of malt liquors by the 
laboring classes of Great Britain pursue nearly a parallel course 
with the wine drinkers of the same class in France. They begin 
with small beer, and they end with gin. The use of these liquors 
by the English people for so many centuries might be adduced 
in their favor, for we may suppose that the revelry and dissi- 
pation in Harold’s camp on the night preceding the fatal battle 
of Hastings, were kept up by large potations of the national beve- 
rage. “ Considered dietetically, beer possesses,” according to Pe- 
reira,1 "a threefold property; it quenches thirst; it stimulates, 
cheers, and, taken in sufficient quantity, it intoxicates; and, lastly, 
it nourishes or strengthens.” “ From these combined qualities, beer 
proves a refreshing and salubrious drink (always presuming that 
it is used in moderation), and an agreeable and valuable stimulus 
and support to those who have to undergo much bodily fatigue.” 
The friends of lager beer, which is beginning to be drunk so 
largely in many parts of the United States, will doubtless hold the 
same language with the English writer just quoted. Franklin, 
however, showed long ago, when he was a journeyman printer in 
London, that he got more nourishment and strength from his 
penny loaf and pint of water than his associates from their free 
draughts of beer. Similar experience has been obtained from 
large numbers of working men in England, who have been induced 
to abstain entirely from beer and all intoxicating liquors. Absti- 
nence of this nature is the more called for on* account of the whole- 
sale adulterations of beer, and especially porter, in that country. 
Cocculus Indicus is used to increase its intoxicating quality; and 
some of the popular treatises on brewing give directions for em- 
ploying it. As the use of this poisonous article is prohibited by 
the legislature, and heavy penalties imposed for infraction of the 
law, brewers’ druggists are in the habit of preparing a watery ex- 
tract of the fruit, which is sold as black extract, or hard multura. 
1 On Food and Diet. RELATIONS OF ALCOHOL TO MEDICINE. 
33 
Quassia is used for hops, to communicate a bitter taste; grains of 
Paradise and Cayenne give pungency; coriander, caraway, etc., are 
used to communicate flavor; liquorice, treacle, and honey give con- 
sistence and color. A mixture called beer-heading, composed of 
green vitriol (sulphate of iron) and common salt, is used to give a 
fine frothy or cauliflower head to beer. If to this list we add nux 
vomica, or now its more readily measured alkaloid, strychnia, 
and opium, henbane, foxglove, oil of vitriol, and jalap, we can 
form an opinion of the real nature of the English compounds 
called malt liquors, and of the extent of confidence to be placed in 
them, either for dieteticalor medicinal purposes. It is to be hoped 
that the brewing in this country is of a more honest character, and 
that they who drink American-made beer, ale, and porter will not 
be subjected to more than the effects of the true fermented liquor 
from grain, with the addition of hops, and not be made to suffer 
from any imitation of a popular brew and its additions on the 
other side the water. Little can be said in favor of the much-dwelt- 
on nutritive property of malt liquors, if we receive as correct the 
statement of Liebig, that fourteen hundred and sixty quarts of the 
best Bavarian beer contain only the nutriment furnished by a two 
and a half pound loaf of bread. Beer is a common beverage in 
the northern part of France; in quantity, it is equal to about a 
tenth of the products of the vine in that country. Cider is also 
made and drank in nearly the same proportion in Normandy, and 
the adjoining districts. But of all the countries of Continental 
Europe, Germany is the one in which the manufacture and con- 
sumption of beer are the greatest. The national practices in these 
respects are kept up, to a great extent, by the Germans who have 
settled in the United States, and lager beer has become as famous 
among us as brown stout and Burton ale in England. The propor- 
tion of alcohol in the malt liquors of this latter country is one per 
cent, in smaller beer, and eight per cent, in the best brown stout 
porter. 
Cider, or apple-wine as it has been sometimes called, contains 
from five to ten per cent, of combined alcohol, and it is often made 
stronger by the addition of distilled spirits, in order to preserve it 
from acetous fermentation. It is a pleasant drink, and its use has 
sometimes been contrasted with ardent spirits, as less alcoholic 
and so far safer; but it is often productive of colic and otherwise 
disturbed digestion, and, like all the alcoholics, it will, when 34 
REPORT OF THE COMMITTEE ON THE 
freely used, intoxicate, and induce an appetite for stronger liquors. 
Hence, if a person wishes full protection for himself against the 
risk of intemperance, he will put it on the list of intoxicating 
drinks, from the habitual use of which he should abstain. There 
is nothing either in the health or habits of the inhabitants of the 
cider counties in England and France to make it desirable that its 
manufacture be extended in this country. The perverse ingenuity 
of man has not been content with converting the juice of the apple 
into a drink of doubtful value by fermentation, but has compelled 
it to yield, by distillation, an ardent spirit, and thus add to the 
number of the most pernicious and destructive alcoholics. 
Alcohol Powerless in Resisting Cold.—Having spoken of the va- 
rious combinations of alcohol with water and other substances in 
the different liquors most commonly used as drinks, we shall now 
inquire into the validity of the claims set up for them on the 
ground of their imparting additional strength and power of en- 
durance under exposure to extremes and vicissitudes of tempera- 
ture and weather generally. In anticipation of the conclusion to 
be reached, we shall invert the customary proposition, and affirm 
that the recorded experience of men in all situations and climates, 
and under all kinds of labor and exposure, proves that abstinence 
from intoxicating drinks gives increased ability to go through the 
labors of the farm and the workshop, and to encounter hardships 
by sea and by land beyond what has ever been done in these 
respects under the unnatural excitement of alcohol, followed, as it 
always is, by depression and debility, if not by fever and other 
diseases. First, as regards alcoholic liquors being a preventive 
against cold. On this point there is a singular unanimity of 
opinion among voyagers and travellers both by land and sea, in 
their condemning the use of distilled spirits, or of wine or beer, as 
a preventive against cold. We may mention as holding this view, 
Sir James Ross, Sir John Richardson, Sir John Franklin (first 
voyage), Captain Kennedy, Drs. Kane, Hayes, and McRae, and all 
Arctic explorers. In North America, the Hudson Bay Company 
entirely excluded the use of spirits by all persons in their employ. 
The Russian army, on the march in cold weather, not only uses no 
spirits, but no man who has lately taken any is allowed to march. 
In the Antarctic regions, we have the testimony of Dr. Hooker and 
the practice of many uteetotal” whalers to the same purport. Dr. 
Hayes says that he not only will not use spirits, but he will tajs;e 
no man with him on an Arctic voyage who is accustomed to their RELATIONS OF ALCOHOL TO MEDICINE. 
35 
use. Sir James Ross, the commander of two different expeditions 
in search of a northwest .passage, asserts that of two equal boats’ 
crews in a heavy sea, the water-drinkers will far outdo the others. 
Dr. Kane, in a conversation on the subject, told your reporter 
that spirituous liquors may be of use for a momentary effect, but 
they are decidedly deleterious where continuous exertion and sus- 
tained labor are required. The Rev. W. Scoresby, who was en- 
gaged in so many whaling voyages in the Arctic regions, says 
emphatically that spirits are decidedly injurious in cold climates. 
“The men who have been assisted by such stimulus have been the 
first who were incapable of duty. They became perfectly stupid, 
skulked into different parts of the ship to get out of the way, and 
were generally found asleep.” This gentleman adds: “In the case 
of a storm or sudden difficulty, I should most decidedly prefer 
the water-drinkers to those who were under the influence of any 
stimulant. The latter are unspeakably more liable to accident.” 
In 1619 the crew of a Danish vessel, sixty in number, and fully 
supplied with provisions and ardent spirits, attempted to pass the 
winter in Hudson’s Bay, but there died fifty-eight of them before 
the spring. Very different was the result of a similar wintering 
by an English crew of twenty-two men, who had no spirituous 
liquors; they lost but two of their number by death. In another 
instance, of eight Englishmen, also without spirituous liquors, who 
passed the winter in the same bay, the whole of them survived 
and returned to England. More remarkable still was the case of 
four Russians who were left without ardent spirits or provisions 
in Spitzbergen, and who lived six years in that cold and dreary 
region, and ultimately were restored to their country. Dr. Aiken, 
in a paper published in the first volume of the Transactions of 
the Literary and Philosophical Society of Manchester, says, after his 
examining and comparing a good number of narratives of parties 
who attempted to pass the winter in high northern latitudes, that 
in all the instances of failure, vinous and spirituous liquors had 
been used, and probably in considerable quantities. The Green- 
landers, who are the most civilized, perhaps we ought to say the 
least barbarians, of the people who inhabit the regions around the 
Pole, are remarkable for their sobriety and entire abstinence from 
intoxicating beverages. They contrive, notwithstanding, to keep 
warm, and laugh and grow fat and enjoy themselves at the inter- 
vals when not- engaged in their fatiguing and perilous fishing 
expeditions. Their intemperance consists in the excessive use of 36 
REPORT OF THE COMMITTEE ON THE 
coffee, “ kavit.” It is not probable that a supply of alcoholic drink 
would have enabled one of this people, named Caleb, an assistant 
to the missionary of Lichtensfels, to survive, as he did, an exposure 
of two days and a night in the open air, while the thermometer 
was at zero. At night he drew his kajak, or boat, upon the ice, 
and slept on it in a sitting posture. On his return home, he 
merely complained of thirst, though he had tasted no food during 
the whole time of his absence. The narrator of this incident adds 
that such privations are of common occurrence among these hardy 
natives. The table-talk of the Greenlanders is often kept up for 
several hours after dinner, without the incitement of the bottle; 
the chief theme is a seal-hunt, which, whether we regard the animal 
or the exciting nature and risk of the chase, is to the full as inte- 
resting as a fox-hunt told and talked about by more civilized and 
Christian men in their cups, or perhaps half-seas over. The noble 
reindeer, the friend and servant of the Laplander, keeps up its 
animal heat and muscular strength and activity on very reduced 
respiratory and nutritive elements, viz., grass in summer and moss 
in winter. The amphibious walrus contrives to be fat and strong, 
and to take long sleeps on the ice; and the mighty whale, with all 
the disadvantage of long and frequent immersion in the cold water, 
breathes fully and with good effect, and sustains its ponderous body 
in strength and activity, and its animal heat up to 104° F., on food 
not particularly abounding in fats or carbohydrates, or mixed with 
alcohol in any shape. Equally precise and explicit with maritime 
experience is that derived from the testimony of all those persons 
who have been engaged in travel or hard work on land, in high 
latitudes or in the inclement seasons of more temperate climates, 
and at the same time have been abstinent from intoxicating drinks 
of any description. What can now be said of the intrusion of 
chemistry on hygiene in a question affecting the health and morals 
of all peoples by its teaching that alcohol was a generator of heat 
in the organism, and so far helped to protect from the operation of 
cold ? It would have been difficult, if not impossible, to offer a 
more plausible and at the same time a more pernicious persuasive 
for the inhabitants of cold and temperate latitudes to indulge in 
the large use of intoxicating drinks, with all its attendant perils, 
than this chemical speculation of Liebig and his school, which 
universal experience proves to be utterly without foundation. The 
subjoined cautionary remarks of the eminent philosophical chemist 
Lehmann cannot be too strongly impressed on our minds, when our RELATIONS OF ALCOHOL TO MEDICINE. 
37 
faith is asked to rest on the deductions of the laboratory in place 
of observations on man himself: “In our application of chemistry 
to physiology, we must be especially mindful of the fact that most 
of the fundamental propositions which at the present time have 
attained to a general recognition in chemistry by no means possess 
such a degree of scientific, or rather of logical, exactness as to place 
them beyond all dispute. We must not forget that chemistry, 
like medicine and theology, possesses a dogmatism of its own.” 
How much better would it have been for the health and lives of 
the people if, instead of their being led away by the ingenious 
speculations of the chemist, they had attended to and acted on the 
opinion of the experienced and philanthropic Rush, when he said: 
“There cannot be a greater error than to suppose that spirituous 
liquors lessen the effects of cold upon the body. On the contrary, 
I maintain that they always render the body more liable to be 
affected and injured by cold. The temporary warmth they pro- 
duce is always succeeded by chilliness.”1 Not drunkards only, 
but free drinkers of alcoholic liquors, incur the greatest danger 
of frostbites, and of the loss of life itself, on exposure for any 
length of time to great cold. Whereas, they who abstain from 
such liquors can, as we have seen, bear up under the extremest 
diminution of temperature. Their protecting beverage will be tea 
or coffee, which Dr. Smith has shown to be true excito-respiratory 
agents. Mr. Atkinson, an English painter, who travelled from 
Russia proper through Siberia, amusing himself the while by 
sketching and hunting, declares that in tea he found the best 
cordial and dietetic protection against cold and fatigue, whereas 
spirituous drinks entirely failed to answer these purposes. 
Alcohol Poiuerless against Heat.—Alcohol, which was to protect 
against cold, was also to perform a wonder-working part in miti- 
gating the effects of heat. Blow cold, blow hot, it was believed 
to be a ready and reliable friend. Facts innumerable now show 
that its promise is false in both cases, and that it lures those who 
confide in it to their destruction. The best authorities on tropical 
diseases—Drs. Robert Jackson, Henry Marshall, Ronald Martin, 
Parkes, and many others—speak strongly against the use of spirits. 
Not only is heat less well borne, but insolation is predisposed to 
under the influence of this cause. Dr. Jackson, who was at one 
time at the head of the medical staff in the West Indies, expresses 
1 Inquiries into the Effects of Spirituous Liquors upon the Human Body, and 
their Influence upon the Happiness of Society. 38 
REPORT OF THE COMMITTEE ON THE 
his firm conviction that an English soldier may be rendered capable 
of going through the severest military duty in the hottest islands 
of the West Indies, and that temperance will be one of the best 
means of enabling him to perform his duty with safety and effect. 
Dr. Jackson, when giving incidents of his own personal experience, 
specifies more particularly a journey he took on foot in the island 
of Jamaica, of four days’ duration, in the first of which, setting 
out at twelve o’clock, he walked eighteen miles before dark, and 
on the three following ones a hundred miles. This was done at a 
time and in a climate in which the consequence of walking any 
distance on foot was believed to be dangerous, and to cause sick- 
ness if not death. In this journey the traveller attributes his 
escape to temperance and spare diet. “ I breakfasted,” he says, 
“on tea, about ten in the morning, and made a meal of bread and 
salad after I had taken up my lodging for the night. If I had 
occasion to drink during the day, water or lemonade w;as my bev- 
erage.” Dr. Marshall, inspector of hospitals, in commenting on 
the narrative and opinions of Dr. Jackson, observes, “I have my- 
self marched on foot with troops on actual service, in a tropical 
climate, where the mean temperature was considerably higher than 
that of Jamaica, without any other beverage than water, and occa- 
sionally a cup of coffee. So far from being calculated to assist 
the human body in enduring fatigue, I have always found that the 
strongest liquors were the most enervating, and this in whatever 
quantity they were consumed; for the daily use of spirits is an 
evil which retains its pernicious character through all its grada- 
tions ; indulged in at all, it can produce nothing better than a di- 
luted or mitigated kind of mischief.” Testimony equally strong 
on this head is borne by Dr. Mosely, also an English army phy- 
sician, in his volume on the Diseases of Tropical Climates. “ I 
aver,” he says, “ from my own observation and custom, as well as 
the custom and observations of other people, 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 with- 
out inconvenience, and are never subject to dangerous or trouble- 
some diseases.” Of the like purport is the emphatic language of 
Dr. Bell, a respectable writer on the Climate and Diseases of the 
West Indies. “ Rum, whether used habitually, moderately, or in 
excessive quantities, in the West Indies, always diminishes the 
strength of the body, and renders men more susceptible of disease, 
and unfit for any service in which vigor or activity is required.” RELATIONS OF ALCOHOL TO MEDICINE. 
39 
If we turn to the recorded experience of medical men who have 
served in the East Indies, and who have written on the hygiene 
and diseases of those countries, and especially of India, we shall 
find it to be equally adverse to the use of alcohol. Dr. Parkes1 
says expressly: “ The common notion that some form of alcoholic 
beverage is necessary in tropical climates is, I firmly believe, a 
mischievous delusion.” The records of the 84th regiment, he tells 
us, show that from 1842 to 1850 it numbered many “ teetotalers,” 
at one time more than 400 in its ranks, and that both on common 
tropical service and on marches in India, the teetotalers were more 
healthy, more vigorous, and far better soldiers than those who did 
not abstain. General Havelock and his “ saints,” as his religious 
and temperate men were mockingly called, were always selected 
by the commander-in-chief, when an expedition requiring great 
promptness, decision, and boldness was to be carried out. The 
experience of almost every hunter in India is to the same effect. 
As regards service and exercise in the tropics, we have the testi- 
mony of Ronald Martin that warm tea is the best beverage, and 
this will be corroborated by every one who has made long marches 
or hunting excursions in India. Sir John Hall, Inspector-General 
of the British Army, gives as his own experience, that neither 
spirits nor wine, nor malt liquor is necessary for health. The 
healthiest army he ever served with, that in the Kaffir war, at the 
Cape of Good Hope, had not a single drop of any of them. In 
Algeria the French soldiers find coffee to be their best cordial and 
preservative. Alcohol, says M. Perier, is our worst enemy, th,e 
real and most cruel wound of Algeria. We believe that the medi- 
cal and surgical records of the late war will show that in our own 
country, as it has been shown in tropical regions, that the proba- 
bilities of exemption from disease, and the power of enduring the 
greatest and longest strain on the muscular system, and the entire 
locomotive apparatus, are in the direct proportion to which absti- 
nence from all intoxicating liquors is carried out.2 
Transitions of temperature and the rapid passage from one extreme 
to another are peculiarly trying to the constitution, and prove a 
frequent cause of disease. But these trials are better borne by the 
temperate, that is to say, the abstainers from intoxicating drinks 
than by the intemperate, or the persons who habitually indulge in 
1 Manual of Practical Hygiene. 
2 See Dr. Flint’s volume for U. S. Commission. 40 
REPORT OF THE COMMITTEE ON THE 
the use of these drinks. General Cass used to say that he never 
used ardent spirits, and in the variety of atmospherical exposures 
to which he had been subjected, he had every reason to be pleased 
with his abstinence. General Howard, with still rougher expe- 
rience, will bear similar testimony of himself. Professor Edgar, 
of Belfast, relates the case of a man who had been for thirty years 
in the British army, and in twenty-seven general engagements, had 
suffered from every vicissitude of weather, and had, not unfre- 
quently, found his companions dead with cold by his side. He 
attributes the preservation of his life and of that of five others, who 
left England at the same time with himself, to his having abstained 
from strong drink. A gentleman who heard the narrative of this 
case at a public meeting rose and said : “ I feel myself called upon 
to corroborate the statements which have been made, by detailing 
the results of my own experience. I served thirteen years in the 
hottest climates. I have since been exposed to the severest, winters 
of Canada, and to the rapid changes of American climate ; I have 
nine times crossed the Atlantic ; and I attribute my sound health, 
now at fifty years of age, to my having abstained entirely from 
all intoxicating liquors.” Sailors can now encounter extremes and 
transitions of temperature, from a tropical to an arctic climate, or 
the reverse, and often associated humidity, and yet preserve their 
health and alacrity to perform their duty, without a drop of 
spirituous liquor aboard their vessels. Their commanders know 
this, and if abstainers themselves, they will select their men 
accordingly; and insurance offices, fully alive to the fact that 
there is diminished risk of the loss of a vessel at sea with a tem- 
perate crew and a temperate captain, will ask a lower premium 
than they would under other circumstances. The following in- 
cident will serve to enforce the soundness of these views. Some 
years since a vessel going from Virginia to New York was over- 
taken by a storm, which raged with great violence, and continued 
for a long time. All the sailors on board who drank ardent spirits 
gave up and ceased to labor, under the combined influence of 
fatigue and despair. There was, however, one man on board who 
drank no ardent spirit, and although he with the rest had been 
exposed to the bufferings of the storm, he took the helm, and stood 
at it for six hours after the others had ceased to make any exer- 
tion, and the whole crew were saved. Had it not been for this 
water drinker it is most probable that both vessel and crew would 
have been lost long before the storm abated. It has been too truly 41 
KELATIONS OF ALCOHOL TO MEDICINE. 
said by a distinguished navigator: “ The great day of account will 
bear terrible witness, when the sea shall give up the dead that are 
in it, of the vast and unsuspected extent of the sacrifice of life 
among seamen from shipwrecks and other catastrophes occasioned 
by drunkenness.” 
In former times, so soon as a vessel was aground and threatened 
with wreck, or in mid-ocean came in danger of foundering, the 
crew, in place of redoubling their efforts, under the orders of their 
officers, to save the vessel, would make their way to the liquor 
room, and breaking open the vessels containing it, drink them- 
selves into a state of helpless and hopeless drunkenness. At the 
present time there is less risk of shipwreck, not only on account 
of a better knowledge of navigation, but also of greater temper- 
ance among sailors and their officers; and even when this catas- 
trophe does occur, there is greatly increased probability of the 
lives of all on board being saved, owing to the captain retaining 
his coolness and judgment, and the men being sober and ready to 
obey orders, the seductive poison being no longer at hand. With 
a bottle of strong alcoholic drink at his elbow, and a belief that 
he may use it with benefit, no man is sure of his conduct in any 
critical emergency of his life. He takes a glass in advance, to 
give him, as he imagines, additional strength and readiness; he 
takes a second one to make sure of the hoped-for effect, and a third, 
that there may be no mistake; but at the trial moment he dis- 
covers, when too late, that his strength and resolution, and deaf- 
ness of mental vision are gone. 
Your reporter would state a case in point, coming within his own 
observation, although it dates more than fifty years back—May, 1818. 
The vessel on which he was aboard, as physician, was approaching 
the coast of China after a voyage of nearly six. months from Leg- 
horn. The captain, an excellent sailor, and equal to all the emer- 
gencies of sea life, was pacing the deck, on the lookout for a pilot; 
and as the air was close and sultry and he thirsty and anxious, he 
called to the steward to bring him his customary drink, a glass of 
grog—rum and water. But soon the call was renewed for another 
glass, and again for a third, and a fourth time were heard the 
words, “ Steward, bring me a glass of grog.” Both the doctor and 
his friend the supercargo became uneasy at this state of things; 
and the former went up to the captain and in a kindly tone asked 
him if he was aware how often he had called for grog. The reply 
came that he was not, and he immediately thanked the doctor for 42 
REPORT OF THE COMMITTEE ON THE 
reminding him of the fact. This captain, like most nautical men 
in those days, was in the daily habit of drinking ardent spirits, 
but never to the extent of inebriety. He took his grog with his 
biscuit and cheese, as a matter of course, every day at noon, after 
having made his observations, “ taking the sun,” in order to ascer- 
tain the latitude; and he used to repeat the draught at intervals 
through the day. On the occasion now described he only meant 
to indulge in a glass or two extra, moved thereto by thirst and 
anxiety to get safely into Canton, where he had never been before. 
He had brought his vessel from Philadelphia to the Mediter- 
ranean and thence over the Atlantic and Indian Oceans and 
China Sea, without the loss of a spar or a sail, and he counted on 
terminating his long voyage successfully in a few hours more, with 
reputation to himself and profit to his owners. And yet, if a 
friendly voice had not reached his ear at the critical moment, he 
would have continued his calls for grog until he had become a 
helplessly drunken and a disgraced man. After his return home 
he had charge of a vessel in another voyage, and then he remained 
on shore, becoming more and more a slave to strong drinks, until 
he finally sank under an attack of delirium tremens. On relating 
the above case to a friend, he told of a similar one to which he 
was himself a witness. On a dark and stormy night the vessel in 
which he was a passenger was close to the coast of Cuba, and was 
in imminent danger of being driven on shore, which would have 
been followed by the loss of life of all the persons on board. The 
captain, dead to every sense of duty, set in drinking until he was 
taken completely drunk to his berth, and the vessel was, of neces- 
sity, left to the charge of a young and inexperienced mate, who 
providentially brought her off in safety. On how many occasions 
in common life ought not the warning voice of the physician against 
the habitual use of alcoholics be heard. His interposition may 
not be necessary for the safety of a vessel and her crew, but it will 
be for the happiness and well-doing of a family when the head of 
it is imperilling them all by his free use of the deleterious and 
maddening draught. 
In the exposures to extreme heat, as in foundries, glass-blowing 
establishments, and the like, the men engaged in them are less 
exhausted by heat and sweating if they drink water than if they 
use alcoholic liquors; and it has been found that those persons 
who are exposed to wet and vapor, as hatters, dyers, etc., in their 
daily work escape most of the diseases which had been regarded RELATIONS OF ALCOHOL TO MEDICINE. 
43 
as the unavoidable consequences of these occupations, but which 
experience now shows are mostly brought on by the use of ardent 
spirits, or the excessive potations of malt liquors. Whatever is 
wanting to increase the infirmities caused by long confinement in 
crowded manufactories and work-rooms is found in the use of dis- 
tilled and fermented liquors by the operatives in these places. On 
the other hand, these persons can be placed on as good a sanitary 
footing as any other class in the community by their getting the 
benefit of an improved hygiene, which would consist in abstinence 
from alcoholic liquors, ventilation of the rooms in which they work, 
and a limited number of hours at their task. Farm labor of every 
kind, in all seasons, is now carried on to a considerable extent and 
more satisfactorily by abstinence from intoxicating drinks on the 
part of all—from the owner of the farm to the stripling who is just 
beginning to work in the field. The harvest is gathered in more 
readily and cheerily by all those engaged in it where coffee or 
chocolate takes the place of whiskey or other equivalent alcoholics. 
There are fewer cases of cholera morbus, colic, or dysentery among 
the temperate at this season than among the habitual, not to speak 
of the excessive drinkers. 
Alcohol no Importer of Bodily Strength or of Mental Vigor.—Of the 
many fallacies of opinion on the action of alcohol, there is no one so 
widely spread and generally accredited, and, at the same time, so en- 
tirely groundless, as that which assumes its power of increasing the 
strength of the body either for occasional display or enduring 
effort. We would say, with Dr. Parkes, that if we look upon the 
body as an agent of work from which we desire to obtain as much 
mechanical and mental force as is compatible with health, we can 
consider the effect of alcohol per se as simply a means of diminish- 
ing this development of force. This truth has been abundantly 
demonstrated in our preceding statements of the superior ability 
to encounter bodily strain in every variety of climate and situation 
in which men are required to exert their muscular force. In the 
training of the Roman athletes, as well as of the modern 
we find strict temperance to be an indispensable condition. To 
the former all sensual enjoyments were prohibited, whether in 
devotion to Bacchus or to Yenus. “Abstinuit venere et vino” was, 
according to Horace, the course pursued by a youth who was de- 
sirous of reaching the goal first in the race. Modern trainers are 
somewhat divided in opinion as to the advantage of allowing a 
small quantity of wine or of malt liquors; the best trainers do not 44 
REPORT OF THE COMMITTEE ON THE 
give any intoxicating drink. But all are agreed in never permit- 
ting the use of ardent spirits on any consideration whatever, even 
when diluted with water. This is the declared experience of a late 
successful pedestrian, Weston. Horses in training for the turf and 
the chase attain their greatest speed and bottom without any alco- 
holic drenching. Milton, himself an example of the inspirations 
of genius unclouded by alcohol, has left those oft quoted lines in 
reference to Samson, in which he exclaims:— 
“ 0 madness ! to think use of strongest wines 
And strongest drinks our chief support of health, 
When God, with these forbidden, made choice to rear 
His mighty champion, strong above compare, , 
Whose drink was only from the liquid brook.”—Samson Agonistes. 
To make the lesson complete in this case, let us bear in mind 
the strong injunction of the angel of the Lord, when he appeared 
unto the wife of Manoah, and promised that she who was now child- 
less, should bear a son, a chosen champion, to deliver Israel out of 
the hands of the Philistines. “Now, therefore, beware, I pray thee, 
drink not wine nor strong drink.” And at a subsequent visit, when 
Manoah besought the heavenly messenger to tell him “how to order 
the child,” he received for answer: “Of all that I have said to the 
woman let her beware. She may not eat of anything that cometh 
out of the vine, nor drink wine nor strong drink.” This reiterated 
injunction of the angel has not been taken to heart by expectant 
mothers and their medical advisers in succeeding times; and the more 
the pity, for although women are not expected, now-a-days, to be the 
mothers of Samsons, they are all of them desirous of giving birth 
to healthy children. But, too frequently they allow their wishes 
in this respect to be counteracted by certain longings of another 
kind, and they crave a stimulus “to keep them up,” when occasion- 
ally depressed and languid; and, too often, physicians are ready to 
humor them by prescribing a glass of ale or porter, or of wine; or, 
most convenient of all, the now inevitable milk-punch. To what 
extent the child in utero must suffer from these alcoholic indul- 
gences of the mother, we may have some idea by our knowing the 
disastrous consequences to the child at the breast from her drink- 
ing malt liquors, with the expectation, forsooth, that they will in- 
crease her flow of milk. Convulsions and death of the child have 
followed this false practice.1 On an important part of the hygiene 
1 Combe, Andrew, on the Management of Infancy- Edited by Dr. Bell. RELATIONS OF ALCOHOL TO MEDICINE. 
45 
of pregnancy, we would recommend to pregnant women and their 
medical advisers a careful reading of the thirteenth chapter of 
" Judges.” 
The vulgar error, as we believe it may now be called, that spirit 
rations to soldiers are necessary to sustain them under long 
marches and debilitating influences incident to a campaign, would 
never have been indulged in if ministers of state and leaders of 
armies had drawn a little on their historical readings. These persons 
might have learned that the Roman legionaries, conquerors of the 
world, knew of no other drink, in the earlier days of the republic, 
than water, with, at times, the addition of a little vinegar. The 
history of Mohammedan conquests shows that the followers of the 
"prophet” became masters of the best parts of Asia and Africa 
and Spain, and at one time threatened to overrun all Europe, with- 
out recourse to the stimulus of wine or other alcoholic drinks, all 
of which are strictly prohibited in the Koran. We have, in a 
preceding passage of this report, said something of the capabilities 
of water drinking soldiers at the present day to show their martial 
prowess and bodily strength. In common life, porters, carmen, 
and others, who are obliged to lift and carry heavy weights, have 
in many instances made the agreeable discovery that they have 
more strength for their work, and feel less exhaustion after it when 
they became water drinkers than when they*used alcohol. "I 
have backed as many as sixty tons a day with perfect ease,” said a 
London coal whipper, "since I took the pledge. But, before, I 
could scarcely have been able to crawl home, certain to have lost 
the next day’s work.” Alcohol stimulates, it may be, for a short 
time the nervous system, and through the latter, the muscular, and 
hence it may serve as a goad to incite to a great temporary exhi- 
bition of muscular strength; but this is soon fallowed by exhaus- 
tion proportionate to the previous excitement, and there ensues 
inability to keep up to the ordinary standard of work. With the 
water drinker "there is no lassitude, headache, feverishness, foul 
tongue, or aching limbs next day, even after the hardest labor. 
All is fresh, and supple, and free; there is no reaction.” Alcohol 
cannot nourish or give strength; it cannot give working power; it 
can only hurry the expenditure of what we already have; and, 
besides, it hampers and opposes in getting that store renewed. The 
attempt at bodily recruitment of a laboring man by his taking a 
glass of brandy or whiskey is often the beginning of a habit that 
leads to drunkenness. 46 
REPORT OF TIIE COMMITTEE OX THE 
If the brain be the organ of the mind, or rather a congeries of 
organs, the' functions of which are displayed in the operations of 
the mental faculties, we may readily see that there can be no tho- 
rough work done by the mind unless its instrument or instruments 
be in a good condition. The brain is the first in the order of time, 
and the chiefest, in comparison with other organs, to receive the 
impressions made by alcohol after its reception into the stomach ; 
and in the increased fulness and congestion of the cerebral vessels 
and the temporary poisoning of their blood occurs the material 
cause of the symptoms of inebriety. For the mind to work freely, 
fully and reliably, and with consistent measure, and to be able 
to dive into and explore the mysteries of science and philosophy, 
or to soar on the wings of poetry and song into the blue empyrean, 
a healthy brain is necessary—a brain not alcoholized, not exposed 
to alternate excitement and depression, or stimulation and narcosis. 
Of such a brain, with a capacity for immense labor, was that of 
Newton, a vegetarian and water drinker, eschewing all alcoholics; 
of such, also, were the brains of his great successor, La Place, and of 
Locke, of Milton, Cowper, Wordsworth, etc. Through murky vapors 
raised by alcohol there may still jbe found, at intervals, corrusca- 
tions of genius, snatches of wisdom and critical acumen, but there 
will be w'anting the steady light to illumine the landscape, and to 
enable the mind tc? see every object in its true place and proportion. 
We have, now and then, examples of the brain—in the same person 
—working during an interval of some length between its healthy 
and its morbid state—as in the case of Byron, who wrote the two 
first cantos of “ Childe Harold” when a water drinker, and “ Don 
Juan” when a gin drinker and a chewer of tobacco. Mistaken 
notions of the real character of alcohol have led many students and 
writers to attempt to spur on their jaded intellects to additional 
exertion in the still hours of night by their taking alcoholic stimu- 
lants, in place of seeking rest and the true means of renovation in 
sleep. Lord Brougham, a man of wonderfully diversified faculties 
and power of work, suffered greatly in the latter period of his life 
from this cause. He was fortunate enough to acquire fame, emi- 
nence, and honor for his vast labors in the cause of education, law, 
and social reform before he became a drunkard. Most men, who 
attempt the perilous experiment, fall into habits of intemperance 
before they can accomplish the work that was to give them fame. 
Nature will not be cheated out of her dues; or, more properly 
speaking, the natural laws of God, as binding in their way as his RELATIONS OF ALCOHOL TO MEDICINE. 
47 
revealed ones, cannot be broken without the defaulter being pun- 
ished by loss of health and weakening of both mind and body. 
Alcohol is the lowest and worst means of helping us to evade these 
laws. Under a show of protection, it robs us of that which no 
money can replace. 
A number of ailments which plague both the idle and luxurious 
man and the sedentary student, and for the relief of which alcohol 
is often heedlessly and unwarrantably prescribed, are due, in many 
cases, to the habitual use of this liquor by the complaining parties. 
Some of these persons are induced to increase the quantity or change 
to a stronger drink, and thus innocently become, after a time, vic- 
tims to inebriety. But, on the other hand, dyspepsia, depression of 
spirits, disturbed sleep, nervousness, weakness, irritability, headache, 
capricious appetite, in its being sometimes good, often wanting, 
rheumatic and neuralgic pains have all been, severally, either quite 
removed or greatly mitigated by abstinence from alcoholic drinks; 
and at the same time there was a marked improvement in the 
general health and strength, and greater ability to exercise both 
mind and body in the discharge of various duties required. Of the 
numerous attestations in proof from professional gentlemen and 
scholars, we present the following. The first is from the Rev. 
Sydney Smith, one of the founders of the Edinburgh Review, and 
a frequent contributor to its pages, the racy Englishman and laugh- 
ing philosopher, who writes thus to his daughter, Lady Holland: 
“ Many thanks for your kind anxiety respecting my health. I not 
only was never better, but never half so well; indeed I find I have 
been very ill all my life without knowing it. Let me state some of 
the good arising from abstaining from all fermented liquors: First, 
sweet sleep; having never known what sweet sleep was, I sleep 
like a baby or a plough-boy. If I wake, no needless terrors, no 
black visions of life, but pleasing hopes and pleasing recollections 
—Holland House past and to come! If I dream, it is not of lions 
and tigers, but of Easter dues and tithes. Secondly, I take longer 
walks, and make greater exertions without fatigue. My under- 
standing is improved, and I comprehend political economy. I see 
better without wine and spectacles than when I used both. Only 
one evil comes from it: I am in such extravagant spirits that I 
must lose blood or look out for some one who will bore or depress 
me. Pray leave oft' wine—the stomach is quite at rest, no heart- 
burn, no pain, no distension.” The second relator of his own case 
is the Rev. Samuel Miller, D. D., of Princeton. For sixteen years 48 
REPORT OF THE COMMITTEE ON TH>E 
lie had followed the advice of his physicians, to take a glass or two 
glasses of sound wine daily. “During all this time,” he writes, “my 
health wfs delicate. More than six years ago, when approaching 
my sixtieth year, I broke off at once. The experiment had not 
proceeded more than a month before I became satisfied that my 
abstinence was very strikingly beneficial. My appetite was now 
more uniform, my digestion much improved, my strength in- 
creased, my sleep more comfortable, and all my mental exercises 
were more clear, pleasant, and successful.” Of the same nature is 
the personal experience of the late eminent Professor Silliman, of 
Yale College. After several years of failing health, notwithstand- 
ing the use of the most approved stimulants and the most nutritious 
and varied diet, he was induced to abandon the use of wine and 
every alcoholic stimulus, and to substitute a plain diet composed 
chiefly of vegetables and milk, with very little flesh meat. The 
result was, at the end of a year an ability to resume all his ardu- 
ous duties with constant exertion of both body and mind. Dr. 
Cheyne, Physician-General to the Army in Ireland, an eminent 
practitioner in Dublin, and a strenuous advocate of temperance and 
temperance societies, gives the following case in his second letter, 
written more than thirty years ago, on the effects of wine and 
spirits. “Nearly three months ago, a gentleman far advanced in 
years, came to Dublin to obtain relief from a painful affection of 
the biliary ducts, under which he had been suffering for nearly a 
year. He considered himself to be temperate in wine, of which, I 
believe, he seldom exceeded a pint after dinner. Before he left 
the country he was ordered to take not more than three or four 
glasses of wine in the course of the day. This gentleman came 
under my care, and shortly after had an attack of the palsy, one 
side of his body becoming nearly insensible and powerless. I took 
the opportunity of withdrawing from him every description of fer- 
mented liquor, limiting him to aqueous drinks. Under this regi- 
men, to which, being a man of strong resolution, he cheerfully 
submitted, in four or five weeks, he nearly recovered the use of his 
paralyzed limbs, and, what was not to be expected at his advanced 
age, he recovered flesh.” 
Immediate Abstinence from Alcohol Safe.—Another cruel and 
pernicious fallacy in relation to the disuse of alcohol is, that this 
ought to be gradual, and that there is danger from a sudden cessation 
in drinking intoxicating liquors, especially in cases of confirmed 
drunkenness. Acting on this fear, the advice often given to the RELATIONS OF ALCOHOL TO MEDICINE. 
49 
unfortunate victim of intemperance is, that he should leave off 
gradually, by diminishing the quantity of liquor from day to day; 
but, unfortunately, the reform is so slow, and so interfered with by 
fresh temptations, as often never to be completed, and there is con- 
tinual risk of the inebriate, with his system still poisoned by alcohol, 
and his strongly acquired vicious appetite, falling back on his old 
usages, if not running into some wild excess. The anticipated 
danger from an immediate withdrawal of every kind of intoxicating 
liquor is utterly groundless, as we know now by a large array of 
facts bearing directly on the question. The most besotted drunk- 
ards, on being sent to prison and deprived at once of their alcoholic 
drinks, for the most part distilled spirits, have not suffered in their 
health in consequence; but, on the contrary, their health and 
appearance have been much improved. For a few days they are 
uneasy and indifferent to persons and things around them, and 
their appetite is poor; but, after this, they eat heartily and gain in 
the manner just mentioned. How much easier must it be in ordi- 
nary life for the sufferer, who is in his own house, and can pursue 
a suitable regimen, and take air and moderate exercise, to make, 
at once, the desired change in his drinking habits. Most of the 
paupers sent to our county almshouses have been reduced to indi- 
gence by intemperance. Many are admitted with worn-out consti- 
tutions, bloated bodies, swollen limbs, and other disgusting effects 
of drunkenness—there appears to be but one step between them 
and the grave ; but yet, although deprived from the moment of 
their admission of all intoxicating drinks, they soon rally and their 
bodies seem to be quite renovated under this new and improved 
regimen. Webb, the noted pedestrian, who was remarkable for 
vigor of body and mind, used water alone for his drink. He was 
recommending, one day, his regimen to a friend, and urged him 
with great earnestness to quit a course of living, by which his 
health and his intellect would be equally destroyed. The gentle- 
man appeared convinced, and told him that he would conform to 
his counsel, but thought he could not change his course of life at 
once, and he would leave strong liquors by degrees. "By degrees!” 
said Webb, with indignation; "if you should fall in the fire, would 
you tell your servant to pull you out by degrees?” 
Social Pleasures marred by Alcohol.—The social principle is said 
to be more genial and expansive under the exhilarating operation 
of alcohol; but under this incentive the line of true exhilaration is 
soon reached and easily passed, and the excitement is apt to abate 50 
REPORT OF THE COMMITTEE ON THE 
with the first feelings and pledges of good fellowship and mutual 
regard, and soon be lost in a confused perception of what is really 
going on. Self-control is weakened, and mistrusts and jealousies, 
which had been long dormant, are revived, and show themselves 
in a tone of petulance at first, and then of anger, increasing with 
every round of the bottle, until men who, at the beginning of the sym- 
posium had grasped each other’s hand with cordiality and smiles, 
find themselves, at its end, indulging in bitter interjections of dislike 
and hatred, and ready to engage in bodily strife, to the extent of the 
shedding of blood and the taking of life itself. No such doubtful and 
treacherous help as alcohol is required to increase the activity of 
the social principle; it expands under other and safer and more 
abiding influences, and if exhilarating beverages are required, they 
will be found in tea and coffee. On this point your reporter can 
speak from personal experience. He was associated with seven of 
his medical brethren in a club which used to meet, once a week, 
at the house of one of its members in succession. It was agreed, 
in advance, that there should be no other beverage, after water, 
than tea and coffee; and no other solid than a few slices of bread 
and butter and light cakes. The meetings were continued for 
more than thirty years, and the members of the club, and the few 
friends invited to join them, could all bear the same testimony to 
the pleasant, genial spirit, the ready joke and repartee and laugh, 
intermingled sometimes with occasional remarks on the topics of 
the day, which abounded on those occasions. There was sure to 
be the cordial bidding good night, and on the following morning 
exemption from headaches, and all unpleasant feelings and remin- 
iscences. 
Holidays intended, and wisely too, for recreation and pleasure, 
and for allowing opportunities for relaxation from work, and for 
social enjoyment, are too often commemorative of scenes of disor- 
der and turmoil, under the mischievous belief that alcoholic liquors 
must be drunk at such times with more than usual freedom, as a 
means of increasing the pleasures of the day. Physicians are ap- 
prised, on the following morning, by an addition to their sick list, 
of the nature of the rejoicings of many deluded persons, for which 
they are thus doing penance. Magistrates are called upon to re- 
buke and punish infractors of the peace, “ marrers of the general 
joy;” men who would have conducted themselves as quiet and 
well-behaved citizens, but for their having poisoned their brains by 
alcoholic drinking. RELATIONS OP ALCOHOL TO MEDICINE. 
51 
It is to be feared that in many parts of tjiis country the same 
language might be held as that used by the Rev. Augustus Wm. 
Hare, Rector of Alton Barnes, England, in one of a series of prac- 
tical sermons addressed to a plain country congregation: “I verily 
believe,” said this good man, “that there is more drunkenness, more 
rioting, more wickedness of all kinds going on at these three holy 
seasons of Christmas, Easter, and Whitsuntide, than on any other 
three weeks of the year.” Our great national holiday of the fourth 
of July is probably the most abused, we might say, desecrated of 
all. Now, with a knowledge of these facts, ought those persons to 
be considered as ascetics and opposed to the people and especially 
to the youth of our country enjoying themselves on all anniver- 
saries and festive occasions, if they were to recommend entire 
abstinence from all intoxicating drink by the parties participating 
in these rejoicings? Would not the sleep after a day thus spent 
be more sound and refreshing, and the waking in the morning 
more cheerful, and bring with it more alacrity to resume regular 
labor or business, than if alcohol had been freely used ? 
ETIOLOGY. 
Alcohol as a Cause of Disease.—With a knowledge of the long list 
of diseases caused or aggravated beyond recovery by the use of 
alcohol as a drink, it must seem a mockery to call it a food or a 
substitute for food. Excuses are made for alcohol by our being 
told that any article of ordinary food may, if eaten in excess, be a 
cause of sickness, and that it is not more logical to condemn alcohol 
for its deleterious effects when taken in excess than it would be to 
forbid the use of mutton-chop or beef-steak, because men have 
gorged themselves with these meats and died in consequence. But 
there is no analogy in the two cases, is a highly nutritive 
food; it furnishes large material for making blood ; and is in no 
sense a poison. Alcohol is not a nutritive food, it contributes 
nothing towards the formation of blood, and is in its nature always 
a poison. If a person commits an excess in eating meat, and suf- 
fers in consequence, he will be more cautious for the future, and 
eat less, but still know all the while that he is increasing his tis- 
sues and gaining material to keep up his health and strength. A 
drinker of alcohol is seldom admonished by his excesses, but con- 
tinues on in increasing quantity, or even if he lessens this he is 52 
REPORT OF THE COMMITTEE OX THE 
still alcoholized, still#primed for an explosion of disease. Gluttony 
is a vice, but its being indulged in by one man furnishes no excuse 
or apology for another man becoming a drunkard. Relief is some- 
times sought by the glutton in alcohol to relieve his overloaded 
stomach or to quicken a palled appetite, but the result is disas- 
trous. “A glutton,” says Darwin, “may be crammed up to the throat, 
and fed like a stalled ox, but he will not be diseased, unless he 
adds spirits or fermented liquor to his food. This is well known 
in the distilleries, where the swine, which are fattened by the spiritu- 
ous sediments of barrels, acquire diseased livers.” The tendency of 
the general use of animal flesh is to keep up the health and 
augment the bodily strength of the individual, and to increase 
population. The tendency of the general use of alcohol is to impair 
health and bodily vigor, and to diminish population. 
Whatever causes tend to impoverish and demoralize a people, 
contribute, at the same time in so doing, towards diminishing the 
public health and increasing disease. On this account, statis- 
tical returns, which would seem, at first sight, only to interest 
governments and political economists, have real importance in the 
eyes of medical men. What a startling announcement is that 
made in our daily papers, viz., that the sales of retail liquor-dealers 
in the United States during one year amounted, according to the 
report of Commissioner Wells, to $1,483,491,865! Of this sum, New 
York is credited with $246,617,520; Pennsylvania, $152,608,495; 
Ohio, $151,734,875; and Illinois,. $119,033,945. When to this 
enormous amount of nearly fifteen hundred millions of dollars is 
added the value of the time wasted in the consumption of ardent 
spirits, and of the property destroyed by intoxicated persons, we 
can readily credit the assertion that the savings, from the disuse of 
alcoholic drinks, would extinguish the public debt in one year- 
Another estimate, at reduced figures, is that the people of the 
United States expend erfough annually for liquor to more than 
half pay the debt._ -Even if we assume this last estimate to be 
correct, what a fearful interference is caused by alcohol with 
national economy and progress! But, on the ground of humanity* 
the most important items have been left out, viz., the diseases 
caused by drinking alcohol, and the loss of time on the part of 
those laid up from this cause. It is estimated that in Great Britain 
the annual consumption of intoxicating liquors is 1,025,000,000 
gallons, upon which there is a tax of $120,000,000 a year to the 
country. During the five years ending September, 1867, there were RELATIONS OF ALCOHOL TO MEDICINE. 
53 
nearly 1,000,000 cases of assaults and drunken and disorderly con- 
duct summarily disposed of before the magistrates in England. 
The annual average of these cases was 193,640. Again, the total 
value of intoxicating liquors consumed by the- people of Great 
Britain in 1865 was $443,098,380. This sum exceeds by many 
millions the gross expenditures of the United Kingdom in 1865. 
A recent calculation shows that on a Saturday evening in London 
there is one intoxicated person for every eight persons who are 
sober. In Scotland, the people who pay taxes for the support of 
the poor have had a reminder of the increase of intemperance 
in that country in the fact that within thirty years the cost of 
pauperism has increased from $950,000 to $4,250,000. The pro- 
lific cause is intemperance. We might multiply statements of this 
nature, such as all civilized countries, more particularly those of 
Northern and Middle Europe, and the United States—every city, 
town, and county in the latter—would furnish. The same melan- 
choly story is told in all of them—poverty, insanity, and crime to 
the individuals; enormous expenditure, nearly all of it preventable, 
by the government. 
Alcohol Shortens Life.—The first charge under the present head 
which we bring against alcohol is that its use shortens life. It 
appears from the tables of Mr. Neison, Actuary of the' Medical 
Invalid and General Life Insurance Company of London, that, on 
an average of the different periods of life from 15 to 90, there are 
32 deaths of the intemperate to every 10 of other persons. Thus, 
between the ages of 15 and 20, of the intemperate 18 and of others 
10 persons die; between 20 and 30, of intemperate 51, of others 10; 
between 30 and 40, of intemperate 42, and 10 of others; between 
40 and 50, of intemperate 41 to 10 of temperate; between 50 and 
60, of intemperate 29 to 10 of others; between 60 and 70, of 
intemperate 19 to 10; between 70 and 80, of intemperate 20 to 10. 
These estimates do not include moderate drinkers, but those only 
who were "decidedly addicted to drinking habits.” The total also 
of other deaths is taken from the whole population ; so that, in 
fact, the disparity is greater than it appears. If we look at the 
rates of mortality from the points of view of equation of life, we 
find that at the age of 20 the general population had an equal 
chance of living 44 years, while the intemperate have the chance 
of living but 15J years. In other words, they have but 35 per 
cent, of the chances of living. We learn from another source 
that the annual mortality in the Temperance Provident Society of 54 
REPORT OF THE COMMITTEE ON THE 
London, during seven years, averaged only 4 in 1000. In agri- 
cultural laborers in the prime of life, the more highly favored of 
the working classes, it is 8 per 1000. Among healthy persons 
generally it is 10 per 1000. Among clerks, at the same age, it 
is no less than 22 per 1000. “The Teetotal Society” in Preston, 
England, presented some years ago, as we learn from the report of 
the Rev. Mr. Clay, not merely the smallest proportion of sick, but 
it also suffered the shortest average duration of sickness. We 
meet every now and then, however, with instances of longevity 
among notorious drunkards, whose constitutions seem to be proof 
against alcohol-poisoning, as some of the peasants of Stvria are 
against the regular use of large doses of arsenic. These old drunk- 
ards have been aptly called “the devil’s decoys,” as encouraging 
younger persons with less tenacity of life to imitate them; but 
they are exceptional, and do not help the average which is against 
the intemperate as a class. Dr. Cheyne affirms that, “should ten 
young men at twenty-one years of age use but one glass [of ardent 
spirits] of two ounces a day, and never increase the quantity, nine 
out of ten would shorten life more than ten years.” 
Organic Lesions caused by Alcohol. — The same causes which 
shorten life by weakening the springs of action predispose the 
intemperate to the attacks of disease, especially of an epidemic or 
malignant character, whether it be influenza, cholera, yellow fever, 
or smallpox. This predisposition shows itself also in a readiness 
to contract almost any other disease, especially where there exists 
an hereditary tendency to their occurrence, as in gout, epilepsy, 
insanity, and consumption. The special brain disease of drunkards, 
delirium tremens, is often brought on by a debauch or very slight 
increase of alcoholic drinking, and also by some special irritation 
of the nervous system, as by a fractured limb, etc. The cumulative 
effects of prolonged imbibition of alcohol have been clearly proved 
by the experiments of Dr. Ogston. 
Alcohol acts on the stomach by causing a chronic catarrhal con- 
dition, increase of connective tissue between the glands, degenera- 
tion of their contents, and more or less atrophy or disappearance 
of the parts. Taking another view, when spirituous liquors are 
introduced into the stomach, they tend to coagulate, in the first 
instance, all albuminous articles of food or fluids with which they 
are brought in contact; as an irritant, they stimulate the glandular 
secretions from the mucous membrane, and ultimately cause per- 
manent congestion of the vessels and spurious melancholic deposits. RELATIONS OF ALCOHOL TO MEDICINE. 
55 
The coagulation of food by alcohol is very different from that 
produced by gastric fluids, and tends to render it more difficult 
of solution by the gastric juice or by pepsin. Chronic vomiting 
acknowledges alcohol as one of its causes. On its first entering 
into the circulation after absorption by the stomach, alcohol finds 
its way through the vessels of the portal system and permeates all 
the tissues of the liver. But the nervous centres are the greatest 
sufferers; the morbid changes within the skull amounting to 92 
per cent, of those examined, as we learn from Dr. Ogston, who made 
an autopsy of 117 drunkards. The prolonged action of alcoholic 
poison on the brain produces induration of the cerebral and cere- 
bellar substances in by far the larger number of cases, coincident 
with an increased amount of subarachnoid serum, while the stea- 
tomatous degeneration of the small arteries leads to atrophy of the 
convolutions and oedema of the brain. Dr. Aitken1 tells of the 
case of a person who for many years had been in the habit of 
drinking daily a large quantity of brandy. He died of typhoid 
asthenia, with characteristic degeneration of nearly every important 
organ of the body and of the bloodvessels. The fluid collected 
from the cavities of the brain, consisting of the serum and some 
blood, contained 2.6 per cent, by volume and 2.1 per cent, of alco- 
hol. Dr. Samuel Lewis, of Philadelphia, when house-surgeon in the 
hospital at Edinburgh, made a careful autopsy of a man who hac| 
been a vagrant, and habitually indulged in strong drinks. Dr. L., 
following the process laid down by Ogston, detected alcohol in the 
brain. Dr. R. D. Mussey, in his brief report to the Association, 
on the “Effects of Alcoholic Liquor in Health and Disease” (Vol. 
III. of Transactions), quotes Dr. J. C. Hanson, who bled a man that 
had been drinking for three or four days, and who detected in the 
blood thus drawn alcohol in the form of a halitus which burned 
for thirty seconds with a blue flame, on the application of a lighted 
taper. Ogston found alcohol in the brain of sufficient strength to 
burn-upon a light being applied. 
The changes in the respiratory organs succeed in frequency 
those of the nervous centres, being in the proportion of 63.24 per 
cent. As already stated, alcohol ingested in any quantity, however 
small, lessens the amount of carbonic acid in the air of respiration ; 
habitually taken in larger quantities, it alters the molecular con- 
stitution of the lungs, as chronic bronchitis and lobar emphysema 
1 Science and Practice of Medicine, Medical ExAminer, vol. i. 56 
REPORT OF TIIE COMMITTEE ON THE 
are certainly more common in those who take much alcohol. Dr. 
Craigie says that all the spirit-drinkers whom he has ever seen 
have been either subject to chronic cough or have labored under 
chronic bronchial disorder with asthma. Alcohol acts on the liver 
by producing enlargement of the organ and an albuminoid and 
fatty deposit, or it causes at once increase of connective tissue, with 
cirrhosis, or the waxy liver of French, the hob-nailed liver of 
English writers, by both of whom it has been carefully described, 
and attributed to the same cause. Finally, there is contraction of 
Glisson’s capsule, and atrophy of the portal canals and cells, by 
the pressure of shrinking exudation. The fatty liver is often met 
with in persons who lead an indolent life and are at the same time 
gross feeders, “ eating largely of fatty substances, and drinking 
freely of spirits, but more especially of porter and other heavy 
malt liquors.” If, says Dr. Bence Jones, the different organs and 
textures of the body were arranged in a series according to the 
different amount of fat-producing or fat-depositing action that takes 
place in each, the liver would occupy the highest place and the 
lungs the lowest. It must be remembered, however, that the waxy, 
sometimes confounded with the fatty liver, is common in phthisis, 
and is seen in cases of great constitutional disturbance and ex- 
haustion connected with cancerous ulceration and abundant sup- 
puration. The liver in a state of fatty degeneration would seem 
to grow at the expense of the fat of the body, as is the case in the 
geese which are largely fed, deprived of exercise, kept in a dark 
place, and so treated that the only growing organ is their large 
liver, which goes to make the celebrated pates de foie gras. Chemi- 
cal theory might suggest, d priori, that alcohol in the hepatic vessels 
would be decomposed and its carbon be eliminated in the bile, of 
which this element forms so large a part; but experiment and 
observation teach the very reverse, and that, so far from there 
being an increased quantity of bile, and consequently of carbon, 
discharged from the liver of alcoholic drinkers, this secretion is 
diminished. The morbid changes in the liver amounted to 56.4 
per cent. The heart, under the free and habitual use of alcohol, 
becomes altered in its molecular constitution, and there is not only 
a tendency to the deposit of fat on its external surface, but it 
undergoes a real fatty degeneration in its substance by the deposit 
of fat in the interstices of its muscular fibres, and displacement and 
diminution of these latter. This organ also undergoes hypertrophy, 
dilatation, pericardial adhesion or thickening, and valvular disease. RELATIONS OF ALCOHOL TO MEDICINE. 
57 
Its percentage, including the aorta and pulmonary artery, was 
47.86. The kidneys, under alcoholic influence, fail to eliminate 
the usual quantity of urea and of water; the amount of phosphates 
is diminished, and of the sulphates increased. They are altered by 
hypertrophy, congestion, and fatty degeneration in the proportion 
of 41 per cent. Setting aside tea and coffee, our stimulants are, 
writes Dr. Bence Jones, essentially alcoholic, and it is the long- 
continued strong chemical action of alcohol on oxygen and on the 
different textures of the temperature of ninety-eight degrees that 
gives rise so frequently to that increased motion and increased 
thickening, followed by contraction and suboxidation, which con- 
stitutes cirrhosis of the liver and kidney. "The increased oxida- 
tion, the increased flow of blood, the altered nutrition, are identical 
in kind with the first actions of inflammation; and when the series 
of actions are repeated over and over again for years, the result is 
the same as might have been produced in a shorter time by an 
ordinary inflammation, when no alcohol whatever had been taken.” 
No doubt the alcohol acts on the vessels and ducts of the kidney, 
but not so powerfully as on the interstitial texture, the change in 
which, thus produced, gives "interstitial nephritis.” The insidious 
progress of disease from alcohol, and the apparent impunity with 
Avhich in some cases it is taken into the system, are indicated in 
the preceding extract, and ought to give warning, not so much 
against the coming danger, as against any exposure to it at all. 
The writer just quoted says: "With regard to treatment, medicine 
avails little for stopping the effect of alcohol poison, or for removing 
the thickening of the interstitial structure. No appreciable altera- 
tion of structure occurs until the alcohol has acted for months; but 
as each day produces its infinitesimal effect, some good may be 
done by recognizing the disease early, and by stopping, as far as 
possible, the further action of the poison. Usually the second 
nature cannot be changed, and the treatment consists then only in 
alleviating symptoms and in warding off' complications as they 
arise.” Dr. Jones describes interstitial nephritis in connection with 
or as a complication of Bright’s disease. A correct diagnosis and 
knowledge of cause are the more important, as, of all the symptoms, 
general debility is the one which most frequently presents itself, 
and for the relief of which there would be a strong temptation to 
have recourse to alcoholic drinks, either distilled or fermented. 
Christison has been already quoted in this report, as stating that 
three-fourths of all the cases of Bright’s disease which he saw were 58 
REPORT OF THE COMMITTEE ON THE 
produced by the habitual abuse of alcoholic drinks. Dropsy is a 
common attendant on organic lesions of the heart, liver, or kidneys, 
and is for the most part to be regarded as symptomatic of disease 
of one or other of these organs. Albuminuria affords a ready 
example of this connection in the case of the kidneys. Ascites, 
as resulting from fatty degeneration of the liver, is thus explained 
by Dr. Chambers: “The constant presence of alcohol in the blood 
obstructs the necessary renewal of the fibrous capsule of the liver; 
contraction of the degenerated tissue ensues, the portal blood cannot 
pass through the viscus, to get rid of its effete particles or to bear 
the nutriment to the general circulation; the natural halitus of the 
peritoneal sac cannot be reabsorbed, and therefore accumulates, to 
form an ascitic (or, as the Greek word means, an ‘ensacked’) col- 
lection of serum. With this fluid is mixed, also, the albuminous 
serum and fibrous serum which exudes from the obstructed capil- 
laries, and often these capillaries rupture, and blood-corpuscles are 
found in the dropsical fluid.” 
In the bloodvessels, alcohol causes general turgescence, and espe- 
cially of the skin, and ready tendency to congestion. The amount 
of fat is increased in the blood, or it is more visible, under alcoholic 
drinking. Fat increases in the blood in most acute diseases when 
the biliary secretion is retarded, and when a scanty amount of food 
is taken. These are the very conditions which obtain in alcoholism. 
Oil is found in the blood and urine, and a milky appearance is 
imparted to the serum of the blood of drunkards. The white and 
fatty blood of Frank originates in the use of alcoholic drinks. An 
analysis of the blood of two patients with delirium tremens, made 
by Mr. W. J. Cox {Sanit. Rev), showed that this fluid was in both 
instances attenuated and deficient in plastic material; and contained 
a great excess, or from six to eight times more than common, of fatty 
matters. Lecanu found in one case of a sot the still higher pro- 
portion of one hundred and seventeen parts in a thousand. The 
blood, in addition to the fatty matter which it holds, is also sur- 
charged with unchanged and unused or unmetamorphosed material, 
and contains about thirty per cent, more of carbon than in the 
normal state. How poorly is this nutrimental fluid enabled, under 
these circumstances, to supply the tissues; or if anything is sent, 
it is fatty or oily matter with which the organs become infiltrated. 
Impaired health must soon follow by the retention of carbon and 
urea, oxalic acid, etc.; a retention, be it remembered, of sub- 
stances which ought to be eliminated. So long as alcohol remains RELATIONS OF ALCOHOL TO MEDICINE. 
59 
in the blood as alcohol, a certain toxic or poisonous effect continues 
to be produced upon the nervous system through which this cor- 
rupt blood circulates; and if a constant supply of the alcohol is 
kept up, the phenomena of alcoholism, chronic or persistent, and 
acute paroxysms generally, in the form of delirium tremens, super- 
vene, which is at once the most common and the most prominent 
evidence of alcoholism. In other instances, the degeneration of 
several vital organs may become so excessive that death follows by 
asthenia, or by typhoid phenomena ending in coma. Congestion 
in the mucous membranes of the lungs and stomach is evidence of 
retarded motion of the blood. Hsemorrhoidal swellings are always 
aggravated by the use of alcoholic fluids.1 Among the morbid 
effects of alcohol on the liver should have been mentioned the 
formation of sugar, or rather of glucose, the material out of which 
sugar is generated in this organ. This process may go on to the 
extent of producing diabetes mellitus. 
Dr. Rush, in his tract so often quoted by us (Inquiries, etc), enu- 
merates the following diseases as the result of the drinking of spi- 
rituous liquors, viz: 1. A sickness of the stomach and vomiting 
in the morning; 2. A universal dropsy; 3. Obstructions of the 
liver; 4. Madness; 5. Palsy; and 6. Apoplexy. Alcohol is an 
occasional cause of chronic vomiting. One woman had acquired 
the habit of dram drinking only the preceding year, while staying 
with some friends in Scotland at their shooling, where a nip of whis- 
key was the regular preparation for breakfast. The words of lament 
of Dr. Chambers which follow, have unhappily an equally strong 
application to many of our medical friends in the U. States: “But 
dram drinking is by no means confined to uneducated persons; 
those whose ‘talk is of bullocks,’ or to idle women. I am ashamed 
to say that I have been consulted about its consequences by several 
members of our profession who ought to know better and set a 
better example. Quis custodet ipsos custodies.'1'1 To these should 
be added, as the effects of alcoholics in general, albuminuria, rheu- 
matism, gout, epilepsy, and certain skin diseases. Intemperance is 
the most usual predisposing cause of albuminuria or Bright’s dis- 
ease, as exposure to cold or to cold and moisture, is the most com- 
monly exciting one. Dr. Bright remarks: “ Where intemperance 
has laid the foundation, the mischief will generally be so deeply 
rooted before the discovery is made, that even could we remove 
1 Aitken, op. c.it. 60 
REPORT OF THE COMMITTEE ON THE 
the exciting cause, little could be hoped from remedies; but at the 
same time, a more impressive warning against the intemperate use 
of ardent spirits cannot be derived from any other form of disease 
with which we are acquainted; since, most assuredly, by no other 
remedy do so many individuals fall victims to the vice.” The 
words of warning do not carry with them the needed force here, as 
they are directed against what the writer calls “the intemperate 
use of ardent spirits,” instead of saying the use or habitual use; for 
one may very pertinently ask, what is the line between the tem- 
perate and intemperate use? Every drunkard begins with the 
temperate use of alcohol, and in doing so puts himself on the road 
to intemperance, with all its consequences. A man may, as we 
have previously shown, destroy his health, and become the victim 
of incurable disease, by continued small drinking of alcoholic 
liquors, without his ever having been drunk or subjected himseif 
to the imputation of intemperance. What plea of necessity, what 
promise of pleasure are there, to make a man encounter such 
alarming dangers and positive sufferings? He begins to drink 
alcohol moderately, temperately, as he believes, and without mean- 
ing it drinks, for a longer or shorter time, immoderately and intem- 
perately, and he gets an incurable disease of the liver or kidney, and 
dropsy and all kinds of complicated disorders, which end in death. 
Was this sacrifice of self made for the sake of advancement in the 
world, the acquisition of wealth and honors, the benefit of his 
family, his friends, or his country? Would he, in fine, be less 
of a free agent under a pledge of total abstinence, than under the 
dominion of an invincible habit? 
Diseases caused by Fermented Liquors.—Under the head of “Hygi- 
ene,” some observations were made on wine drinking as a cause of dis- 
ease. Distinctions have been attempted to be drawn between different 
kinds of liquors, in regard to their effects on the human organism, 
and it is quite common to find writers and consumers who, for 
instance, are ready enough to give up to reprobation the use of 
ardent spirits, while, at the same time, they insist most strongly on 
the blamelessness and often salutary effects of fermented liquors— 
wine, beer, and cider. We have touched on this point when speak- 
ing of the different kinds of intoxicating drinks under the head of 
hygiene. Examined in its relation to disease, the distinction will 
not hold. Alcohol may be variously disguised, but in all its forms 
and combinations it is still alcohol, with its constant property of 
producing intoxication and other disorders of body and mind. If RELATIONS OF ALCOHOL TO MEDICINE. 
61 
the diseases from excess in wine drinking be less violent and acute 
than those from ardent spirits, they are in greater number and 
more complicated from the first than from the latter cause. The 
drinker of ardent spirit, if he survive the first shock given to his 
constitution, may sometimes, though rarely, attain old age, and in 
the tolerable enjoyment of his faculties. The tippler in wine sub- 
jects himself to such a complication of diseases that he sinks earlier 
under them. If he survive for any long term of years, his life can 
only be called a long disease—showing itself atdifferent times as gout, 
rheumatism, cerebral disorders, gravel, and painful eruptions and 
boils on the skin. The lovers of the bottle, says Beddoes, flatter 
themselves that care in selecting wines will exempt them from 
evils which they cannot dissemble from themselves wine produces. 
But the distinction, he is afraid, rests upon a difference little in 
point as to health. “It is the result of common observation,” he 
continues to remark, “confirmed by unvarying medical experience, 
that among country gentlemen, citizens, the frequenters of the com- 
mon and combination room, the associates of the mess, the farmer, 
the merchant’s clerks, and the artisans that crowd the smokeshops 
in places like Birmingham, a large proportion injure their digestive 
organs, whatever may be the purity or adulteration of liquors, pro- 
vided they be of the same strength, and taken with nearly equal 
freedom.” The following case is full of instruction, as showing the 
promptness with which remote parts will sometimes respond to 
disturbance in the stomach, produced by a fermented liquor. It is 
related by Mr. Crampton, Surgeon-General of Ireland, and pub- 
lished in the Dublin Hospital Reports: A gentleman of a fair com- 
plexion and rather delicate frame, who labored under a severe pain 
of a periodic nature, which depended upon an inflammation of the 
periosteum of the right tibia, noticed a circumstance with respect 
to the influence of fermented liquors in this affection, which, says 
Mr. Crampton, appears to be of considerable importance, as illus- 
trative of the effects of even very small quantities of alcohol in 
diseases of an inflammatory nature. The patient observed, at first, 
that the pain invariably recurred within an hour after dinner, at 
whatever hour he might have taken that meal, and whether the 
food had been animal or vegetable. Suspecting that this might be 
connected with the nature of the liquid, rather than the solid mat- 
ter which he took into his stomach, he left off fermented liquors. 
On the first day after he made the change, the pain did not return 
till he had been an hour in bed; and this led him to institute a 62 
RETORT OF THE COMMITTEE ON THE 
number of experiments upon the influenee of the different kinds 
of fermented liquors in different quantities. The result was that 
the pain could, with certainty, be excited within an hour by drink- 
ing a glass of any kind of fermented liquor, however weak ; and a 
single drachm, by measure, of port wine, diluted with four ounces 
of water, acted with equal energy as a glass of undiluted wine. 
Sir Anthony Carlisle tells of a gentleman of a gouty habit who, 
before he had done drinking his claret at dinner, felt twinges of 
pain in the great toe of one of his feet. Dr. Cheyne remarks, as a 
commentary on Mr. Crampton’s case, that "in a numerous class of 
protracted disorders, hence called chronic, in which some viscus 
continues long in a state of inflammation, before it is disorganized, 
a very small portion of alcohol will often feed the inflammation, 
and hence, in such diseases, the most important part of regimen, as 
will be acknowledged by every physician of experience, consists 
in an entire disuse of distilled or fermented liquors.” 
It is a common if not a professional opinion that the gout is as 
frequently owing to gluttony in eating as to intemperance in drink- 
ing fermented or spirituous liquors. To this Dr. Darwin replies, 
that he has seen no person afflicted with gout who has not drunk 
freely of fermented liquor, as wine and water, or small beer. Dr. 
Wood, in the like sentiment, makes the remark that the abuse of 
vines and malt liquors is more apt to cause gout than that of 
ardent spirits.1 In a person with the gouty diathesis, one may fear 
that any use of those liquors is an abuse, inasmuch as he will be 
in danger of an attack by taking the smallest quantity of them. 
And then again, whoever should put himself on a prophylactic 
regimen, to prevent the recurrence of gout, could scarcely include 
in this fermented liquors, any more than condiments and rich sauces. 
Dr. Garod, in his valuable work on Gout and Rheumatic Gout, tells 
us very explicitly: "There is no truth better established than that 
the use of fermented liquors is the most powerful of all the pre- 
disposing causes of gout; nay, so potent that it may be a question 
whether the malady would ever have been known to mankind, had 
such beverages not been indulged in. Distilled spirits, taken ex- 
clusively, appear to exert little or no power in inducing gout, 
whereas with wines, strong ales, and porter, the reverse holds good.” 
The author takes care, however, not to be misunderstood on this 
point, for he says, it must not for a minute be supposed that spirits 
1 Therapeutics and Pharmacology, vol. i. p. 645. RELATIONS OF ALCOHOL TO MEDICINE. 
63 
are less pernicious to the system than wine. On the contrary, the 
occurrence of granular kidney and dropsy is exceedingly com- 
mon among populations where large amounts of distilled spirits 
are imbibed. Yan Swieten says that gout was little known in 
Holland until wine was introduced as a substitute for beer. Linnaeus 
was inclined to regard wine as almost the sole producer of gout, 
seeing that the Laplanders partook plentifully of malt liquors with- 
out so much as dreaming of such a disease. But this exemption 
from gout when drinking malt liquors is enjoyed by those only who 
use the weaker kinds. The effects of large draughts, daily, of 
strong porter are well shown by Dr. William Budd, in his account 
of the great indulgences in this way of a body of men employed 
to raise ballast from the bottom of the Thames, and who are under 
much exposure to inclemency of weather; their occupation re- 
quires great bodily exertion, occasioning profuse sweating and 
much exhaustion. Their allowance of liquor is very large; each, 
man drinks from two to three gallons of porter daily, and gene- 
rally a considerable quantity besides. Although not a numerous 
body, many of these ballasters are yearly admitted to the Seaman’s 
Hospital Ship, affected with gout. The fact is otherwise interest- 
ing, as it seems to show that no amount of bodily exertion is ade- 
quate to counteract the influence of such large doses of porter. 
Dr. Garod’s own experience of the relative power of alcoholic 
liquors in inducing gout is, that port, sherry, and other stronger 
varieties are the most potent in their operation. The lighter wines, 
as claret, hock, moselle, and even champagne, although capable of 
acting as the exciting cause of an attack in gouty subjects, have, 
when taken in moderation, but comparatively little inducing power, 
and probably in this respect rank with the weaker kinds of malt 
liquors. The exemption, in a good measure, of the wine drinking 
population of France and Rhenish Germany is due not only to 
their using weaker vinous liquors, but, also, to their simple living 
in other respects, and the relatively small amount of animal food 
which they consume. The same explanation will apply to the 
agricultural population of England in their use of the weaker 
kinds of malt liquors. In some of the large cities of France and 
Germany, gout is common; there the finer qualities of wine are 
taken, together with larger quantities of animal food. Stout and 
porter were found by Dr. Garod to rank next to wine in predis- 
posing to gout, as is seen in the cases of the men connected with 
the great London breweries, and who not unfrequently drink an 64 
EE PORT OF THE COMMITTEE ON THE 
almost fabulous quantity of malt liquors. In Bavaria and Berlin, 
where a large amount of beer is taken, gout also prevails. Cider 
and similar beverages will also act to some extent in predisposing 
to attacks of gout. Certain wines, such as champagne, even to 
the amount of only a single glass, are among the most common 
exciting causes of gout. Beer and cider sometimes act in the same 
way. Gouty pains in the limbs have been felt before leaving the 
dinner table, from partaking of champagne wine. 
In the last century, when wine was proportionately more used, 
and at the same time more pure in England than it is at the present 
day, all the diseases attributed to strong drinks were freely re- 
ferred to this liquor as a cause, and surnames were given to those 
who drank much of a particular kind, as we find in Sir John 
Floyer’s work on the Cold Bath, in which he speaks of the (diseased) 
livers of most Clareteers. The witty author of Hudibras, in the 
century preceding, in his satire on drunkenness, speaks throughout 
of wine as the aliment to this vice. He concludes in the following 
quaint but expressive lines :— 
“ So Noah, when he anchored safe on 
The mountain’s top, his lofty haven, 
Aud all the passengers he bore, 
Were on the new world set ashore, 
He made it next his chief design 
To plant and propagate a vine, 
Which since has overwhelm’d and drown’d 
Far greater numbers on dry ground 
Of wretched mankind, one by one, 
Than all the Flood before had done.” 
Nowhere can be found more emphatic warning against indulg- 
ence in wine than in the “ Proverbs” of Solomon, the wisest of 
men. Who, he asks (chapter xxiii. 29, 30), hath woe, sorrow, 
contentions, babbling, wounds without cause, redness of the eyes ? 
“They that tarry long at the wine; they that go to seek mixed 
wine.” How admirably does he describe in a few words (in verses 
32, 33, 34, and 35) the virulent poisoning, the imaginary company, 
the foolish utterances, bewilderment, insensibility, and stupor of 
drunkenness. The wise Preacher, himself a king, enjoins total 
abstinence on kings and princes. “It is not for kings, 0 Lemuel, it 
is not for kings to drink wine, nor for princes strong drink.”— 
Chap. xxxi. 4. 
In some of the returns of the causes of the disease in French 
asylums for the insane, we read, as already stated, “abuse of wine,” RELATION'S OF ALCOHOL TO MEDICINE. 
65 
and in others, “ abuse of strong liquors.” Both men and women 
were the sufferers. When Juvenal lashed with all the severity of 
satire the drunkards and.gluttons of his day, he knew of no other 
intoxicating drink than the fermented juice of the grape, wines 
variously combined and spiced, as when he speaks of 
“ Hot, heavy lees, to fire the wretched guests, 
And turn them all to Corybants or beasts.” 
It was this liquor which gave rise to the scene that he describes 
when he says :— 
“ At first with sneers and sarcasms you engage, 
Then deal round mutual wounds with mutual rage.” 
McNish1 speaks in very decided language of the deleterious 
effects of malt liquors. Those addicted to their use increase 
enormously in bulk. They become loaded with fat; their chin 
gets double or triple, the eye is prominent, and the whole face 
bloated and stupid. Their circulation is clogged; their pulse 
feels like a cord and is full and laboring, but not quick. During 
sleep the breathing is stertorous. Everything indicates an excess 
of blood, and when a pound or two is taken away, immense 
relief is obtained. The blood in such cases is more dark and 
sizy than in others. In seven cases out of ten, malt liquor 
drunkards die of apoplexy or palsy. If they escape this hazard, 
swelled liver or dropsy carries them off. The abdomen -seldom 
loses its prominence, but the lower extremities get ultimately 
emaciated. Profuse bleedings frequently ensue from the nose, and 
save life by depleting the bloodvessels of the brain. This picture 
is deeply shaded, but it was drawn from the life by a careful and 
experienced observer. The drunkenness in question, continues 
this writer, is peculiarly of British growth. They who would 
make bare endurance an evidence of benefit received, may read 
without fear, if not with entire approval, of the enormous quan- 
tities of malt liquor drank daily by men engaged in their work 
without immediate prostration, sickness, and death. “ Many of the 
coal heavers on the Thames think nothing of drinking daily two 
gallons of porter, especially in the summer season, when they 
labor under profuse perspirations. A friend has informed me that 
he knew an instance of one of them having consumed eighteen 
pints in one day, and he states that there are many such instances.” 
1 Anatomy of Drunkenness. 66 
REPORT OF THE COMMITTEE ON THE 
In respect to the chronic effects of beer, Dr. Chambers believes 
that a long continued-course of excess in beer, even moderate ex- 
cess, is more productive of degeneration, than excess in wine or 
spirits. It is with malt liquors in England as it is with wine in 
France, the habit of drinking them leads often to the use of dis- 
tilled spirits—gin and brandy. The free use of intoxicating drinks, 
whether they be fermented or distilled, in our own country, is the 
more to be deprecated, as our climate will less admit of the inhabit- 
ants using stimulants; the air itself which they breathe, and the 
atmosphere in which they live being more exciting than that on 
the other side of the Atlantic. Climatologists may not be able to 
give a full explanation of the cause, but the fact is not the less 
undoubted: we see already the more mercurial character of our 
people than that of their European ancestors. We have heard in- 
telligent gentlemen from Great Britain volunteer the observation, 
that they could not take, in the United States, their wine or other 
liquors with the same freedom that they were accustomed to at 
home. No one has given the respective characters of the malt and 
ardent spirit drunkard with greater truth than Hogarth, in his 
pictures “ Beer Alley,” and “ Gin Lane.” The denizens of the 
first are represented as plump, rubicund, and bloated; they of the 
second as pale, tottering, and emaciated, and dashed over with the 
aspect of blank despair. 
Cider is, we have seen, both a predisposing and exciting cause 
of gout. It also, in districts in which it is largely used, gives rise 
to colica pictonum, or vegetable colic, and under circumstances in 
which no lead was present to be brought in contact with the cider. 
Dyspepsia and other derangements of the alimentary canal are 
sometimes referable to the use of this liquor. Professor Silliman, 
of whose experience in the use of alcohol drinks we have spoken, 
attributed bleeding at the nose, under which he had at different 
times suffered, to his drinking cider. lie mentions two other cases 
of the disease referable to the same cause. 
All Distilled Spirits Bad.—Drinkers of distilled liquors are not 
content to regard them as a group from which they can take, in- 
differently, any one that happens to be at hand and is ulost easily 
procured. They will, on the contrary, be heard discussing the 
respective merits, on the score of health even as well as of taste, of 
brandy, rum, gin, whiskey, as if the question were really an open 
one, on the solution of which vital interests depended. Thus, by 
one set, we are told that brandy, the real cognac, is distinguished RELATION'S OF ALCOHOL TO MEDICINE 
67 
by its cordial and stomachic properties ; by another, that good old 
Jamaica rum with its volatile oil is wholesome and pleasant, and 
suggestive withal of jack-tar and jollity. A third party will ex- 
patiate on the virtues of gin, old Holland, with its fine flavor of 
juniper, sweet flag, etc., which makes it so good a diuretic—good in 
often causing inflammation of the kidney and bladder in cases of 
imperfect or suspended discharge of urine for which it was taken. 
But the patriotic American hoists the flag over a line of hogsheads 
of old Monongahela, the watchword a few years ago, old Bourbon 
at the present time, as the liquor on which to get merry with one’s 
friends, and uproariously drunk on our great national festival of the 
fourth of July. There was a time, we do not know how it is now, 
when old Virginia used to exclaim “Psha” to both rum and whiskey- 
and point to her fine old peach brandy, oily with age; and then 
looking towards the Blue Ridge with a significant gesture, intimate 
that her young folks who lived on the other side of the mountain, 
and had got mixed up with Pennsylvania Germans and Scotch Irish, 
were burning their vitals with new apple brandy, in place of keep- 
ing to their primitive cider. But we can imagine the consternation 
among the spiritualists who had met in friendly council when they 
heard suddenly a loud voice from Germany, denouncing one of 
their prime favorites, and of such respectable parentage, too, as 
coming from the grape. Dr. Roesch, of Urach, who is by no means 
an advocate of total abstinence, denounces brandy for its pernicious 
effects both physical and moral. He says, “Whoever shall succeed 
in banishing brandy from use will confer an advantage equal to the 
discovery of vaccination.” We agree with him, but to denounce 
brandy while approving of the use of the other distilled liquors is 
very much like the conduct of a swearer who has a vocabulary of 
oaths which he ejaculates without stint, but who denounces the ut- 
terance of a particularly strong one, which he considers infamous 
and a sad breach of good manners and politeness. It undoubtedly 
is so, but what of the rest of the vocabulary? Brandy deserves 
lavish censure; but if we thrust it to one side with ignominy, shall 
we, smilingly, invite to our table or festive board the rest of the 
noisy family—rum, gin, whiskey, arrack, absinthe, or their pro- 
fessing peace relatives, wine, beer, and cider, at the risk of being 
ourselves turned out of house and home, and contracting diseases 
of a virulent character ? 
Rheumatism caused by Alcohol.—Having shown the fallacy of 
the belief that fermented liquors should be placed in favorable con- 68 
REPORT OF THE COMMITTEE ON THE 
trast with distilled spirits, when treating of alcohol as a prolific 
cause of disease in so many different forms, we continue our notice 
of some of the more conspicuous of these morbid changes. In 
speaking of cold or of cold and moisture as the common exciting 
cause of rheumatism, due stress is not laid on the predisposition 
which makes this cause effective. Careful observation will show 
that a great predisposing cause not noticed by many of our syste- 
matic writers on the practice of medicine is the free use of alcoholic 
drinks and most commonly of distilled spirits. The laboring 
classes are frequent sufferers from rheumatism, on account, we are 
told, of their greater exposure to cold and moisture in their various 
employments, and, also, of their being often imperfectly clad, but 
it should be added that these persons are, at the same'time, in 
large numbers, drinkers of distilled spirits. So long as they in- 
dulge in this habit so long will they be liable to a recurrence of 
the disease, which, after a time, may assume a more chronic form. 
The product of the still would seem to perform nearly the same 
part in the production or at least ready recurrence of rheumatism 
that wine does in gout. But in the former as in the latter disease, 
other alcoholic drinks take a share in bringing on a state of pre- 
disposition as well as inviting to an attack. We are glad to be 
able to adduce recent testimony in favor of our opinion, long since 
founded in clinical experiences, of the share that alcohol often has 
in the production of rheumatism. Mr. Higginbottom, of Nottingham, 
writing to the British Medical Journal at the beginning of last year, 
lays down the following conclusions1 on what he calls alcoholic 
rheumatism. 
1. Alcohol rheumatism is the result of a distinct cause. 2. It is 
produced by drinking fermented alcoholic beverages. 3. It is slow 
in effecting a marked visible change in the system. 4. It does 
not actually appear before middle life. 5. Its effects are produced 
by the accumulation of the fermented alcoholic fluids taken into 
the system. 6. It causes stupidity, stiffness in the body, hobbling 
gait and ultimate lameness. 7. It causes changes of structure, pro- 
ducing chronic alcoholism. 8. The remedy is abstinence from the 
use of all fermented alcoholic drinks, and taking vigorous exercise 
in the open air. Valuable as these conclusions of Mr. Higginbottom 
are, they do not cover the entire ground, nor include the acute 
1 We borrow on this occasion from the “ Half Yearly Compeud of Medical Sci- 
ence,” by Drs. Butler and Brinton. Part II., July, 18o8. RELATIONS OF ALCOHOL TO MEDICINE. 
69 
rheumatism which shows itself more frequently in early manhood 
and in the prime of life, and which is due in large measure to the 
free use of distilled spirits as its predisposing cause. As bearing 
on this subject, in the way of cause, prevention, and cure, we give 
the case of an inhabitant of Birmingham, who many years since 
wrote as follows : “Three years ago I was very poorly, I had the 
rheumatism in my back and legs, and if I drank even half a pint 
of my own home-brewed ale I was sure to have a headache in the 
morning. Once I left off'drinking strong drinks, I got well of all 
my pains and aches. I am now in my sixty-ninth year, and never 
did I enjoy better health; my appetite is good, my sleep refreshes 
me, and I scarcely ever feel tired. All my life I have been a very 
moderate drinker.” Another teetotaler, after referring to habits of 
intemperance which he acquired when a clerk in the city of Dur- 
ham, England, says, that during this time he was attacked periodi- 
cally with rheumatic affections of the most violent kind, bowel 
complaints, etc., but after he abstained from all intoxicating drinks he 
never experienced one moment’s uneasiness, or, with the exception 
of cold, had a day’s illness. We cite another case nearer home, and 
it is far from being a solitary one. A respectable and very intel- 
ligent farmer near Newtown, Pa., found himself afflicted with rheu- 
matic complaints and sinking under the infirmities of age. Sus- 
pecting that his habits might have something to do with his infir- 
mities, he abandoned the use of ardent spirits and simplified his 
diet. His rheumatic and other complaints soon left him entirely, 
and he felt that he had renewed his tenure of life by more than 
five years. In a harvest time, when he was then more than sixty 
years of age, he went into the field and cradled with his two full 
grown robust sons and a hired man, and he held his way with them 
all, doing as much as any of them. He drank but.twice in the 
day, and then only water. His sons and the hired man drank re- 
peatedly of spirits. At the date of this account, the old gentleman, 
then sixty-three years old, was uncommonly well and active, and 
his mind clear and energetic; his sight was so much improved by 
his change of habits that he could read newspapers and other small 
print without glasses. This case and that of the Birmingham man, 
and others of the like stamp that abound in the annals of temperance, 
make the best reply to the fears so often expressed and acted on, 
of the danger of a person in advanced life entirely and at once 
abandoning the use of his customary stimulants. 70 
REPORT OF THE COMMITTEE OX THE 
Symptoms of Alcoholic Poisoning.—We gave a brief sketch of 
the lesions of the several organs caused bv the habitual use, or, as 
most commonly phrased, the abuse of alcoholic liquors, without 
our attempting a description of the functional disorders, which 
would have led us into details not called for on the present occa- 
sion. A few words, however, on the symptoms of alcoholic poi- 
soning in the confirmed drinker, will be in place, as connected with 
imperfect nutrition, and a break-down of the system. These are 
irregular appetite and digestion, irritablfe state of the alimentary 
canal, heartburn, squeamish ness, vomiting, palpitation of the heart, 
constipation, deficient secretion of bile. With retarded circulation, 
but the action of the heart temporarily increased, there is congestion 
of the capillary vessels of the lungs, and a short tickling cough. 
The morbid results of prolonged alcoholization are of a double 
nature; partly chemical, and partly physiological or real. The 
general nutrition of the body suffers, and a bad state of health is 
at last induced, of a particular kind, which is sometimes described 
as the drunkard's cachexia, or “dyscrasia." That there should be 
marked symptoms of great disorder of the nervous system in 
drunkards is what must ensue as a consequence of the frequency 
of the lesions of the nervous centres and their meninges, as previ- 
ously stated. Hence, the diminished innervation in the morning, 
and exhaustion after the excitement of the evening previous; tre- 
mors of the hands, feeble and uncertain gait, which are in degree 
removed by taking breakfast, and in a more prompt but deleterious 
way by a morning dram, sometimes of the raw liquor, oftener dis- 
guised in the form of bitters, mint sling, etc., putting the blood early 
in a ferment, and the nervous system in an irritable condition, and 
increasing the morbid appetite, which finds further gratification in 
an alcoholic drink at midday, if not sooner. The fickleness, and 
moroseness, and muscular weakness of the morning have now 
yielded to a show of cheerfulness, and greater freedom of move- 
ment. The dinner hour comes, and food of a substantial nature is 
partaken of, and material is furnished for adding to the blood, and 
enabling the system to bear up under the alcoholic poisoning which 
is renewed at this time by free potations of liquor, varying in 
strength and quality, according to the circumstances of the tippler, 
or the wealth and dietetic tendencies of his host or companions. 
He is now “high up,” boisterously merry, or captious and quarrel- 
some, according to his temperament; but he is almost as annoying 
when he attempts to be agreeable, with his maudlin talk, extravu- RELATIONS OF ALCOHOL TO MEDICINE. 
71 
gaht promises—never meant to be fulfilled—and affected sentimen- 
tality, as when he is purposely offensive by rude speech and threats 
of violence. Night comes and finds him somewhat calmed, but 
still restless and excitable, and eager to renew at supper the alco- 
holic indulgences of dinner, with the addition of song, jest, and 
ribaldry, until, overcome by liquor, he is taken helplessly to his 
bed, or if he be a visitor, is helped by some of his companions, not 
quite so far gone as himself, or by a sober servant, to his own 
home. Such is the daily course of a genteel drunkard, one who 
in all other matters may be found to affect great regard for the pro- 
prieties of life. There are others, again, who would not for any 
consideration expose themselves to public observation of their in- 
firmity, and who deprecate excess in drinking. They are content 
to take their bitters in the morning, to strengthen their stomach, and 
help it, as they suppose, to digest their breakfast; they take a glass 
of wine or of brandy and water at noon to help them along in get- 
ting through their work, whatever it may be; and they must have 
a glass or two at dinner as an aid to digestion, and to prevent heart- 
burn, or to correct acidity, and what not. If they meet with friends 
in the afternoon they do not object to a glass and a cigar, and when 
night comes they treat themselves just before going to bed to an- 
other glass, perhaps a little stiffer with brandy or whiskey than in 
the day, in order to make them sleep sound, and prevent cramps 
or deaden some rheumatic or other pain. In fine, they lie down 
quite boozy, and passably stupid, and awake in the morning ready 
to repeat the same course of moderate drinking and a show of 
sobriety to the outer world. But in time they are overtaken by 
infirmities of different kinds, for the poisoned organism cannot wear 
the mask of hypocrisy, and it gets disease of the liver, or becomes 
dropsical, or falls into palsy, to the great wonderment of the man’s 
friends and acquaintances, who always considered him to be steady 
and sober, and who have often heard him say that he was never 
drunk in his life. It must, of course, be a vile slander to say that 
this man was broken down and destroyed by intemperance? Was 
he not even one of the prayerful ? 
Chronic Alcoholism.—The state of prolonged or chronic poison- 
ing from the habitual and inordinate use of alcohol has been desig- 
nated by Huss chronic alcoholism, which is not to be measured by 
the lesions of any particular organ or apparatus, although its chief 
seat is in the nervous system. It is thus defined by the Swedish 
writer: “ The name chronic alcoholism applies to the collective 72 
REPORT OF THE COMMITTEE OX THE 
symptoms of a disordered condition of the mental, motor, and 
sensory functions of the nervous system ; these symptoms assuming 
a chronic form, and without their being immediately connected with 
any of those (organic) modifications of the central or peripheric 
portions of the nervous system, which may be detected during life, 
or discovered after death by ocular inspection; such symptoms, 
moreover, affecting individuals who have persisted for a consider- 
able length of time in the abuse of alcoholic liquors .” The symp- 
toms of the disease depend, says Marcet,1 in a functional disturb- 
ance of the properties of the nervous system, which may last for 
weeks, months, or years, even after the habit of excessive drinking 
has been given up. There is often something peculiar in the look 
and gait of individuals prone to drink to excess, or even of habit- 
ual tipplers—a trembling of the limbs, often of the whole body, or 
a want of steadiness and co-ordination in the movements not very 
unlike incipient chorea. In the daytime the patient is seized with 
trembling, especially when in the sitting posture; some hardly 
tremble at all when walking. The trembling may be very slight 
indeed, or ‘confined to a particular part of the body, being fre- 
quently visible in the tongue, or only occurring at intervals. 
Marcet, whose descriptions we are now following, mentions want 
of sleep as one of the prominent symptoms of chronic alcoholism, 
the patient perpetually turning himself in bed, and, as soon as he 
shuts his eyes, extraordinary visions, mostly of a painful kind, 
appear before him. Complaint is generally made, also, of giddi- 
ness and headache, and a ringing noise in the ears. Hallucinations, 
so characteristic of delirium tremens, are very often noticed in 
chronic alcoholism, although usually to a much more subdued 
extent. They mostly affect the organs of sight and of hearing. 
Great weakness, especially in the knees and hips, is a prevalent 
character of the disease in question; and it may be considered as 
threatening paralysis. Difficulty of breathing perceived in the 
throat, as a sensation of choking, is a frequent symptom*'of chronic 
alcoholism, entirely independent of any affection of the lungs. It 
would seem that the habit of swallowing air, so frequently met 
with in those who drink to excess, is in some way or other con- 
nected with the difficulty of breathing; which latter, in fact, in- 
stead of being relieved, as it apparently is at the time, is increased 
by this ingurgitation. 
' Chronic Alcoholic Intoxication. RELATIONS OF ALCOHOL TO MEDICINE. 
73 
Of the causes predisposing to chronic alcoholism Marcet enume- 
rates the quantity and quality of the alcoholic beverage and the 
time during which it has been taken; also, the age, sex, tempera- 
ment, habits, and profession. He quotes McNish to say that “claret 
is the most wholesome wine that is known.” It has been observed 
that wines of the same quality (bearing the same generic name), 
and grown in adjoining districts, do not act with equal power upon 
the brain. Most of the patients coming under Dr. Marcet’s notice, 
and who suffered from chronic alcoholism, drank to a considerable 
extent both malt liquors and spirits. He specifies, however, some 
cases in which the disease was brought on by drinking beer alone. 
One man, aged 28 years, had always been of sober habits, and was 
only drunk once in his life, when no more than twelve years of 
age. His daily allowance of beer has been one pint, and he has 
taken no spirits. “Three years ago he became a teetotaller, because 
he found that even so little as one pint of beer daily did not agree 
with his health. He has suffered from the usual symptoms of 
chronic alcoholism for the last three years.” A temperance advo- 
cate who would be heard asserting that a pint <5f beer daily, drank 
bjr a man in the prime of life, might, after a time, subject him to 
the break-down and suffering from chronic alcoholism, could not 
be expected to escape the complimentary epithets of ascetic, fanatic, 
ignoramus, etc. He would be told, with an air of triumph, and as 
at once refuting all heresy on this point, of the quantity of beer 
consumed by the English people, and of its being to them often 
food and drink. In reference to the time the habit of drinking 
alcohol has been indulged, Dr. Marcet points out the interesting 
fact of the disease occurring or of the symptoms becoming fre- 
quently aggravated long after the drinking to excess has been 
given up, and even in many cases after a complete abstinence for 
some time from alcoholic stimulants. A melancholy proof, this, 
of the long and persistent action of the poison, and a lesson of 
warning against first indulgences. On the score of age, as affected 
by alcohol, we learn from McNish that a child suckled by a 
drunken nurse is hardly ever healthy; it is especially subject to 
derangements of the digestive organs, and to convulsive affections. 
Dr. North has observed this latter disease to be instantly arrested 
by transferring the child to a sober woman. At forty years of age, 
or thereabouts, they who have habitually indulged in alcoholic 
liquors begin to suffer. One individual becomes a prey to gout, 74 
REPORT OF THE COMMITTEE ON THE 
another to rheumatism, another to bronchitis, and another to dis- 
orders of digestion. “Now, these very diseases are known to pre- 
dispose greatly to chronic alcoholism, and it is therefore not to be 
wondered at that this disorder should make its appearance at the 
above-mentioned period.” The youngest patient coming under 
treatment by Dr. Marcet for chronic alcoholism was eighteen years 
of age, and the oldest seventy-five. Women seem to be much less 
subject to suffer from the long abuse of alcoholic liquors than men. 
The habits of an individual are among the most important of the 
causes predisposing to chronic alcoholism. As a general rule, we 
can say, with Dr. Marcet, that habits of indolence and idleness, 
independently of their acting as a strong inducement to drink, 
favor slow poisoning by alcohol. In its milder state, the disease 
has been repeatedly checked in a remarkable degree by having 
recourse to exercise of both mind and body. Among the predis- 
posing causes of chronic alcoholism, Dr. Marcet lays great and 
deserved stress on smoking tobacco, as one of them ; and he cites 
cases in illustration of the fact. Alcohol and tobacco aggravate, 
respectively, each the pernicious effects of the other. The author 
concludes his observations on this point by “advising young men, 
whatever may be their position in life, not to take to smoking, as 
such habit is certainly not conducive to healthand we may 
add, with a knowledge of the narcotic and poisonous nature of the 
weed, that its use in this, or indeed in any other period of life, 
cannot be merely harmless. As relates to the professions or em- 
ployments which most predispose to chronic alcoholism, Dr. Mar- 
cet, contrary to the once generally received and still by many 
accredited dictum, expresses his conviction that “such professions 
as exhaust the body, from their requiring great muscular exercise, 
especially under circumstances which excite excessive perspiration, 
favor the early development of chronic alcoholism; and occasion- ' 
ally, in these instances, a very small proportion of alcoholic beverage 
will be hurtful. Thus individuals obliged to remain long before a 
blazing fire, as furnacemen and engineers on board steamboats or 
in factories, are very liable to suffer from spirituous stimulants.” 
Professions affording very little or no exercise of the mind and 
body predispose also to suffer early, and consequently when young, 
from the habit of drinking. Although a proportionately larger 
number of cases of the disease is found in the laboring and indus- 
trial classes, yet there still exists “a comparatively vast number of RELATIONS OF ALCOHOL TO MEDICINE. 
75 
individuals in comfortable as well as wealthy circumstances whose 
nervous system becomes affected from the effects of the long- 
continued habit of drinking wine or spirits.” The tendency of 
alcoholic drinks to produce “ chronic alcoholic intoxication” is 
increased by drinking early in the morning, before breakfast, and 
consequently on an empty stomach, and living on a spare solid 
diet. This fact, one of general observation, must show the fallacy 
of the belief in alcohol being an auxiliary food, for at this very 
time it is gradually poisoning the system into a state of chronic 
alcoholism. It also must serve to show the error in administering 
morning drams either of pure liquor or in the form of* bitters, 
early in the morning, as a preventive of fever. While the waste 
of the body may be diminished by the use of alcoholic drinks, the 
nervous system is not the less poisoned and the stomach inflamed 
in consequence. 
Dr. Marcet enumerates what be conceives to be the immediate 
causes of an attack of chronic alcobolism. In these we find an 
exceptional excess and a severe fit of drunkenness, coexisting dis- 
ease, sucb as inflammation of the lungs, rheumatism, or gout, the 
occurrence of any one of which will bring on an attack of chronic 
alcoholism in a person who is addicted to the use of intoxicating 
liquors. This chronic poisoning is often accompanied by a second- 
ary disorder in the form of bronchitis, or, more frequently still, 
affections of the stomach. Cerebral concussion has suddenly de- 
veloped chronic alcoholism. It may be mentioned that the symp- 
toms of the two are very much alike. 
Affections of the nervous system resembling chronic alcoholism 
are pointed out by Dr. Marcet. They are produced by long-con- 
tinued and excessive intellectual exertions, and by sudden and 
violent emotions; and he has treated them successfully by the 
same means as those of alcoholic origin. 
Although it does not come within the scope of this report to 
enter into details of treatment of the diseases caused by alcohol, yet 
reference may be made, on the present occasion, to a remedy, oxide 
of zinc, which Dr. Marcet regards as exceedingly efficacious in 
chronic alcoholic intoxication. Among its other effects, this sub- 
stance produces, in a remarkable degree, sleep. It is a tonic as well 
as a sedative and narcotic. The author has found it to be very ser- 
viceable in cases of mental exhaustion; he has, also, prescribed it 
with advantage in epilepsy, chorea, mild hysteria, paralysis, and 
lead palsy. Gastric disorders, which so frequently accompany 76 
REPORT OF THE COMMITTEE ON THE 
chronic alcoholism, are sometimes rapidly subdued by oxide of 
zinc. The addition, at night, of opium will be found useful where 
there is great pain of the stomach and much vomiting. In some 
of these cases the carbonate of ammonia may for a few days be 
substituted for the oxide of zinc. The usual effects of this medi- 
cine in simple cases of chronic alcoholism are improvement of 
sleep, increase of appetite, return of muscular power, and disap- 
pearance of mental depression. The usual dose of the oxide of 
zinc prescribed by Dr. Marcet was two grains twice a day, often 
increased to four and six grains at the same times. Bromide of 
potassium, and, still more recently, bromide of ammonium, have 
been advantageously prescribed in delirium tremens and in chronic 
alcoholism to quiet tremors and nervous disorders, and to procure 
sleep. 
Among the disorders caused by alcohol we find enumerated, of 
late, colica pictonum. Some interesting facts in proof are given 
by Dr. Amos Sawyer, in the St. Louis Medical Reporter for April, 
1868. He shows from the experience of a number of painters that 
the sufferers from lead colic are they who drink intoxicating 
liquors, and that all those who abstain from them are exempt from 
its attacks. We have seen that cider is recognized in some dis- 
tricts to be a cause of colica pictonum, or, as called here, vegetable 
colic. 
Delirium tremens is said to be the most exact of all the alcoholo- 
meters. In a period of three years, in the Frederic Hospital at 
Copenhagen, there were 456 persons laboring under this disease, in 
a total of 9000 patients, or nearly 1 in 20. There is a stage of 
alcoholism preceding that of complete drunkenness, which has 
been called ebrious ferocity, manifesting itself in coarseness and 
brutality of deportment, and disregard of the feelings of others, 
particularly of the savage’s own family. A man in this condition 
is ready to use violence, and to take the life of those who differ 
from or are opposed to him in any way. This variety shows itself 
most in individuals of great bodily7" strength in the uneducated class. 
Ebrious moroseness, another variety of a state preceding drunken- 
ness, is met with more in the rich and those not occupied and who 
have some culture and refinement. They are discontented, morose, 
and querulous, especially with members of their own family and 
friends; they are prone to babble to no purpose, are speculative and 
ready to engage in games of chance. On failure and disappoint- 
ment they become taciturn and commit suicide. Ebrious ha Huei- RELATION'S OF ALCOHOL TO MEDICINE. 
77 
notions of the senses are also met with in chronic alcoholism,, dis- 
tinct from delirium. Dipsomania, mania crapulosa vel ebriosa, or 
oinomania, manifests itself in an irresistible craving for alcoholic 
drinks, which overpowers all the higher feelings, and the oinomaniac 
is urged on to a course opposed alike by his reason and his con- 
science ; but then resistance is vain. The disease appears in three 
forms: the acute, the periodical, and the chronic. The last is the 
most common form—that in which the patient is under the most 
overpowering desire for stimulants. Such unfortunate individuals, 
as truly said by Bucknill and Tuke,1 are sane only when confined 
in an asylum. Insanity, always a severe infliction, must be re- 
garded with additional grief by the sane friends of the sufferer 
when it is brought on by indulgence in alcoholic drinks, or, as it 
is commonly worded by intemperance; and the case becomes the 
more distressing when we find numbers of the female sex among 
its victims. The returns for a period of twenty-eight years 
show, in the PennsylvaniafUospital for the Insane, 389 cases of 
insanity from intemperance during this period, of whom 357 were 
males and 32 females; being, collectively, in the proportion of 
nearly 14 (13.9) per cent, of the 5315 patients insane from all 
causes. In four asylums for the insane in England the average 
was 13 per cent. But worse than insanity from alcohol are the 
dire consequences to the offspring of intemperance on the part of 
one or both parents. A drunken mother, for example, will give 
birth to children in succession who are emaciated, and as it were 
dried up, and who die soon after being born. At length one at a 
later period survives for some years, but with “ the looses of an old 
withered baby, its skin loose and wrinkled, for it has no flesh; and 
is no bigger than one a month old, and no more able to walk or 
stand than at that age.” Instances of this nature occur more fre- 
quently, as might be expected, in the case of drunken fathers, for 
they, of the two parents, furnish a larger proportion of cases of in- 
temperance. It is a lamentable thing that the other sex should ex- 
hibit such a list as they do. Doctor Howe states that out of three 
hundred idiots in Massachusetts, a hundred and forty-five were the 
offspring of intemperate parents. Short of these extreme and 
startling examples of punishment of the children for the sins of 
their fathers, we meet with inherited predisposition to insanity and 
to other diseases, caused or acquiring greater force by intemper- 
1 Psychological Medicine. 78 
REPORT OF THE COMMITTEE ON THE 
ance on the part of the parent. Among these morbid predisposi- 
tions is the inherited love of liquor, or an appetite that prompts its 
possessor to early and excessive drinking if he once tastes of an 
alcoholic fluid. Sometimes the inherited feebleness and imbecility 
are not manifested until the age of puberty, when the individual 
shows himself to be incapable of further improvement, and sinks 
into a state of idiocy. Examples of hereditary degeneration, both 
physical and mental, are given by Dr. Morel in two sections on 
chronic alcoholism and the effects of alcoholic intoxication, of his 
instructive work.1 This author describes the case of a young man 
who, at the age of nineteen years, was taken to the insane asylum 
at Mareville, for mental derangement caused by excess in alcoholic 
drinking. As the inheritor of a good fortune, he received every 
attention and care in his early life, but they produced no effect on 
a perverse and obstinate nature, whose instincts were of the most 
cruel kind. When but three yearsnld, he was the terror of all 
the children in the neighborhood, whom he subjected to incredible 
tortures in the absence of older persons who would have restrained 
him. His chief pleasures of boyhood were in destroying and tor- 
turing animals. This young man had for his father a person who 
moved in educated society, and filled important offices, but who was 
for a long time intemperate, concealing, however, the fact from the 
public eye. He had five children, only one of whom survived in- 
fancy, and he was the unfortunate being now described. Edward, 
as he was called by Dr. Morel, evinced in his tender years a great 
fondness for drawing and reading, and after a time was placed at 
college; but his teachers soon perceived that all their efforts were 
in vain, and that this boy, both in body and mind, was afflicted with 
an arrest of growth; his head was microcephalous and his intellect 
limited. On his return home, he went rapidly through successive 
stages of degeneration by continual debauchery, until, fortunately, he 
was placed under restraint in an asylum. This young man labored 
under the double curse—1st, of inherited predisposition, and 2dly, of 
the example given to him by his father’s excesses. Morel relates the 
case of another young man with similarly inherited predisposition 
and running a similar career of extravagance and misconduct, but 
pushed to greater extremes even than in the former one. Charles dis- 
played from his earliest years the most cruel instincts. Early placed 
1 Traite des Desgenerescences Physiques, Intellectuelles, et Morales de l’Espece 
Humaiue. Paris, 185,7. With atlas. RELATION'S OF ALCOHOL TO MEDICINE. 
79 
at school, he was sent hack in succession from one after another to 
his parents. It was thought that he might be subjected to some 
control by his being made to lead a military life, and he entered 
the army. Here he distressed his family by the most shameful 
excesses; he sold his military effects to procure brandy, and at last 
deserted; and he was only saved from capital punishment by the 
statements of physicians that he was insane and labored under an 
unconquerable propensity for strong drink. From that time he led 
a miserable existence in different asylums for the insane; leaving 
each of them with promises of reform which were invariably 
broken. It would be difficult, the author writes, to form a correct 
idea of the degradation and complete degeneration of this brutified 
being, who will end his days either in a state of general palsy, or 
in marasmus with an entire abolition of sentiment and intelligence. 
The records of our own institutions and domestic histories would 
doubtless furnish many cases of an analogous nature to those here 
described. Morel exhibits a picture of progressive degeneration of 
alcoholic origin, and its continuance in a family until it ended in the 
extinction of'the latter, at the fourth generation. In the first gene- 
ration, there was immorality, excess in alcoholics, moral debasement. 
In the second, hereditary drunkenness, maniacal attacks, general 
paralysis. In the third generation, sobriety, hypochondriac ten- 
dencies, lupomania, systematic belief in persecutions, homicidal 
tendencies. In the fourth, limited intelligence, a first attack of 
mania at sixteen years of age, stupidity, transition to idiocy com- 
plete and incurable. While pointing out, as warning, the heredi- 
tary predisposition to indulge in the use of alcoholic liquors and in 
other excesses, we are not to suppose that this is the general course 
of things. Happily, children who have seen the brutification of 
their fathers have, generally, a dread of alcohol in any form of com- 
bination, and where their surroundings are favorable and no devilish 
incitements offered, they would, of themselves, entirely abstain from 
the use of the pernicious liquor. They ought to learn, that under 
any circumstances they are in danger, if, by evil example or encour- 
agement in the guise of plausible theories, they allow themselves 
to use intoxicating liquor in even the smallest quantity. Their 
inheritance, even without their following paternal or, worse still, 
maternal example, subjects them to many troubles and infirmities, 
sometimes shown in eccentricities of conduct, nervous disorders, 
or irritation of some particular organ. These may serve as a 
goad to the brain and impel the sufferer to the use of intoxicating 80 
REPORT OF THE COMMITTEE ON THE 
drinks. Of 200 persons laboring under chronic alcoholism, and 
who were the subjects of Morel’s observations, he found 55 whose 
fatal passion for alcoholics was owing to a diseased state; general 
paralysis occurring in temperate persons caused this morbid appe- 
tite. In six hypochondriac men and four hysterical women the 
most marked desire for alcohol served by its indulgence to compli- 
cate the primary neurosis, and produced such complex disturbances 
in the organism as to make it difficult to judge of the responsibility 
of the parties for their acts. 
Alcohol an Inciter to Vice.—How often physicians hear the same 
story when consulted by a patient who has recently contracted 
syphilis. The sufferer had drank somewhat freely; and in a night 
stroll with his companions was induced to visit a house of ill-fame, 
and have connection with one of its inmates; he comes away with 
the inoculated poison of chancre or of gonorrhoea, and has ample 
time subsequently to meditate on the criminal act itself, and on the 
devilish promptings of alcohol that incited him to its commission. 
Could the secret history of illegitimacy be written, there would be 
cause for astonishment at the large number of cases that owe their 
origin to alcohol, which, while weakening the chaste resolve of her 
who had partaken of it in the shape of sparkling wine or sweet 
cordial, gives, at the same time, additional impulse to the delirious 
passion of the moment. Still stronger and more frequent is the 
alcoholic excitement of the other and chief party to the wrong, in 
the commission of which he forgets all the obligations of honor, 
duty, and trust. We hear much of the “greatest social evil” of 
the day, for the abatement of which the most praiseworthy efforts 
are made by philanthropists and zealous social reformers of both 
sexes. By none of these parties can its enormity and extensive 
demoralizing effects be better known than by members of the medi- 
cal profession, who are so often made cognizant of the first lapse 
from virtue of the unfortunate females by whom they are consulted 
as to the means of concealing its consequences, and entreated to save 
them from shame by causing abortion. These poor distressed crea- 
tures, for such they are, whatever may be their station in life, are not 
aware of the enormity of their proposal, nor of the danger to their 
lives and the ruin of health by an adoption of the means of relief b v 
an operation. But what shall be said of a physician who is so base 
and alike wanting in sound physiology and ethics as to be the ope- 
rator in bringing on abortion, whether it be under the circumstances 
here supposed, or to gratify the wicked freak of a married woman RELATIONS OF ALCOHOL TO MEDICINE. 
81 
who does not wish any longer to be a mother! This danger escaped, 
the physician engages in his legitimate task of helping the young 
mother through her confinement. She is then, not seldom, lost sight 
of, to make her appearance in another place in the flaunting garb 
and with the painted cheeks and froward speech of a harlot, who is 
henceforth doomed to suffer from privations, and disease, and con- 
tumely, and scorn. This is not the fate, we must rejoice to know, 
of all, not even of a majority of the females who become mothers 
out of wedlock. Throughout all this affecting drama, physicians 
well know that from the opening scene to the last one alcohol has 
been a provocative and aggravation to the misdeeds and sufferings 
of the unfortunate woman. Alcohol first played its sinister part 
in helping to make her yield to the temptation of the moment, 
and again, when she has recourse to it to make her insensible to 
the qualms of conscience and the fears of the consequence of her 
first deviation from the path of virtue. She flies to alcohol to 
drown remorse and her feelings of degradation, and, at times, to 
obtund the gnawing of hunger, and, as she is told, to keep her 
warm under her scanty clothing. She is now a miserable drunken 
outcast, and hence the greatest impediment to the prostitute being 
brought back to penitence and the abandonment of her evil ways 
is alcohol, taken as it is to the extent of producing frequent ine- 
briation and of destroying all remains of moral sense and womanly 
feeling. 
We cannot better terminate our account of the large share 
alcohol has in relation to etiology, or as a cause of disease in so 
many forms and varieties, than by giving the chief results of a 
series of observations, made by Dr. Marcet, on this subject.1 The 
writer bases his conclusions on 695 out-door hospital patients, 
whose cases he has arranged in a series of groups, as relates to 
their employments, fifteen in number, and to their diseases, nine in 
number. The first series included no less than one hundred and 
twenty-seven different employments. These were so grouped that 
in-door employments were separated from those carried on in the 
open air. He gives a fundamental table, showing the proportion 
of “ sobers and drinkers” in connection with diseases and employ- 
ments, from which he deduced the “ influence of alcohol as a gene- 
ral predisposing cause of disease.” The result of his observations 
show that, of the whole number of patients (695), two out of every 
1 British and Foreign Medico-Chirurgical Review, vol. xxix. 1868. 82 
REPORT OF THE COMMITTEE ON THE 
three were predisposed to disease from the habitual use of alcohol; 
by some merely to exhilarate, by others to cause drunkenness. 
The greatest proportion of alcoholism was found among shopkeepers 
owing to their in-door life, want of exercise, and of fresh air, by 
which they are prevented from throwing off alcohol by respiration 
as freely as porters who are heavier drinkers. Febrile disorders 
most abound in drinkers compared to sobers, irrespective of their 
employments. Both to prevent primary attack and recurrence of 
fever and ague, strict sobriety is demanded—a conclusion at 
variance with the popular but erroneous belief. “This influence 
of alcohol as a predisposing cause of febrile diseases probably 
results from the abuse of alcohol interfering with the healthy pro- 
cess of nutrition and lessening the general standard of health—a 
morbid poison exerting thereby more readily its baleful action.” 
It must be evident, from what Dr. Marcet had said just before, of 
the prophylaxis against fever consisting in strict sobriety, and 
the so much greater predisposition of drinkers to be attacked 
by fever, that the use at all of alcohol by persons thus exposed is 
an abuse of this article. In regard to the group of diseases of the 
lungs, the writer’s tables confirm the received opinion that drinkers 
are much more disposed to these, in comparison with other diseases, 
than sobers. In no other disease or group of diseases throughout 
the whole table is the proportion, and, consequently, the predispo- 
sition so great as in laryngitis. In speaking of diseases of the 
stomach and intestines, it is said that gastritis is much more liable 
to be brought on by drink than disorders of the intestines. Alco- 
holic excesses are regarded as a predisposing cause of cutaneous 
affections. The cases of gout and rheumatism number 151 in the 
695, and it was found that the predisposition to them from alcohol 
was a little less than the corresponding predisposition to all other 
diseases taken collectively. 
The inferences from these observations and estimates made by 
Dr. Marcet are of great practical moment, inasmuch as, while 
themselves supplying data, they prompt to a careful study of the 
prevention of diseases—a problem, the solution of which interests 
a far greater number of persons than attempts, necessarily of an 
uncertain and imperfect nature, to cure. The success of the first 
would render the second unnecessary, and not only save many 
lives in every community, but also the feelings, the time, and the 
productive industry of the sick and of their families, and their 
friends and attendants. Of the 695 cases of disease rated and clas- RELATION’S OF ALCOHOL TO MEDICINE. 
83 
sified by Dr. Marcet, two-thirds of the entire number, or 463, were 
caused by indulgence in alcohol, and were preventable on the simple 
condition of abstaining from that liquor in some form, of combina- 
tion or another. If these persons, in place of being “drinkers,” had 
been teetotalers, what tax would they have paid for their exemption 
from disease? None whatever. But, on the contrary, they would 
have enriched themselves by improved health, a better frame of mind 
for personal and social enjoyment, and more ability to gain the means 
of livelihood for themselves and their families. The loss of life by 
preventable diseases is begun in infancy and continued to old age. 
In the first period it is brought about by a defective supply of the 
mother’s milk and its vitiated quality, and by other errors in diet 
and regimen generally. In the second, it is largely induced by the 
free and continued use of alcohol. The child is not, however, ex- 
empt from the poisonous effect of this article; for the little being, 
although not drinking it, receives it from the milk of a drunken 
mother, as it does some kindred poison from the milk of the cow 
fed on distillery slops. Governments wisely enact laws with pen- 
alties-for their infraction, to prevent the introduction and spread- 
ing of contagious diseases—smallpox, etc., and will not allow of the 
sale of damaged or unwholesome food; but we look in vain for 
similarly preventive measures against the production and diffusion 
of alcohol, the great poisoner and corrupter of the blood, the pro- 
ducer and fermenter of diseases in their worst and most malignant 
forms, the disturber of the peace of families and communities, the 
inciter to rebellion against country and God. Governments will 
not see “the following fact, which has received overwhelming proof, 
that the least habitual excess beyond a very moderate indulgence in 
fermented beverages lowers the vital properties of the blood, destroys 
the normal tone of the nervous centres, and, as a constant sequela, 
most powerfully predisposes the frame to the absorption of epidemic 
virus of whatever kind. Pure aerated blood affords the best safe- 
guard against the attacks of any epidemic. But the more perfect 
system of house ventilation, cleanliness, etc., will fail to secure this, 
if by the constant imbibition of alcohol in excess the functions of the 
lungs and skin are interfered with, their health-relations destroyed, 
and their waste products retained within the current.”1 When this 
intelligent writer speaks of “ the constant imbibition of alcohol in 
1 Mr. W. J. Coxe, Epidemics and their Every Day Causes. Sau. Rev., vol. iv. 
p. 260. 84 
REPORT OF THE COMMITTEE OX THE 
excess,” we ought to understand its constant imbibition as always 
an excess, and assuredly so if a “step beyond the very moderate 
indulgence in fermented beverages” have the deleterious effects 
described. In many of Dr. Marcet’s patients, alcohol taken to the 
extent merely of causing exhilaration, was an excess, and a cause 
of disease. Derangement of function will follow the very first 
drink of ardent spirits, as in the two cases related by Mr. Coxe, 
in which, on comparing the- amount of carbonic acid evolved 
from the lungs one hour before, with that given out one hour after 
a dose of whiskey to the parties experimented on, he found in the 
first a reduction of 250, and in the second of 280 cubic inches of 
carbonic acid. 
THERAPEUTICS. 
Two great obstacles interfere with our obtaining correct know- 
ledge of the therapeutical value «of alcohol. The first of these is 
imperfect pathology, which prevents our ascertaining the real 
character of the morbid phenomena that we are called upon to 
remove; and the second is in the preconceived notions or belief of 
the action and effects of alcohol in health. The still popular and 
too often professional belief is, that debility and stimulants stand 
towards each other in the relations of disease and remedy; and 
alcohol, as a genial stimulus, and even quasi tonic, is made the 
representative of the entire class, and its use is directed in the 
debility and prostration arising from fever and inflammation; 
mainly on the faith of its alleged restorative and strengthening 
power in the temporary feebleness, and languor, and exhaustion 
from fatigue, sometimes occurring in ordinary health. Alcohol, 
under this creed, was given in disease to stimulate and rouse the 
system from a state of prostration, and to excite the flagging organs 
to greater functional activity. But in later days, under the theory 
of metamorphoses of tissues, and of their destructive activity in 
acute diseases—febrile, inflammatory, etc.—alcohol is prescribed 
still as a stimulus, but a stimulus which is endowed with a new 
property of abating this activity of metamorphosis, by acting as a 
sedative. Strange and contradictory effects are thus expected and 
believed to arise from alcohol as a medicine. At one time it is to 
stimulate the weak to become strong, to rouse the torpid organs 
into full functional activity, and to awaken from stupor and coma 
in the advanced stage of fevers; it is also to enable us for a time KELATIONS OF ALCOHOL TO MEDICINE. 
85 
to do without food and sleep. At other times alcohol is to calm 
nervous irritation, to procure rest and sleep for the feverish and 
delirious patient, and to quiet the ravings of insanity. On all these 
several occasions it is still called a stimulus, and the impartial in- 
quirer finds himself under the necessity either of denying at least 
its alleged good effects, or of insisting on the action of the remedy 
being designated by a word or words expressive of its. compound 
properties. When alcohol relieves gastric pain, colic, and neural- 
gia, it acts as an anaesthetic or sedative; when it brings on heavi- 
ness and sleep, and in greater degree stupor and temporary coma— 
a condition too often seen in a drunken man—it is manifestly nar- 
cotic. The stimulant property which is so commonly assumed for 
it is less seldom displayed, or rather we should say that it is soon 
lost in and succeeded by its property of narcosis. But it would 
appear from the experiments of Dr. Edward Smith1 that the first 
effects of alcohol, in the shape of brandy taken by a temperate man, 
are not those of increased excitement, but, on the contrary, display 
themselves in lessened consciousness, lessened sensibility to light, to 
sound, and to touch, and relaxation of the muscles connected with the 
reproductive system. There is in fact diminished vitality, a striking 
evidence of which is seen in the lessened ability to generate heat. 
Dr. Chambers, in noticing these experiments, sees in them proof of 
the primary as well as secondary action of alcohol—showing a dimi- 
nution of vitality in the nervous system. If we would do justice 
to the subject, we must take up alcohol, with a knowledge, of course, 
that we have in hand an active poison, and inquire into its opera- 
tion and effects, curative and toxical, as we do into those of opium, 
henbane, belladonna, aconite, nux vomica, prussic acid, arsenic, 
arid corrosive sublimate. So far there is no consistent theory to 
guide us; materials are not wanting, but they lack connection and 
arrangement; and until we are better instructed in these respects, 
we must feel ourselves justified in simply saying that a patient with 
fever, to whom alcohol had been administered, was alcoholized, and 
that certain symptoms indicative of relief, or the reverse, followed. 
It is common enough for us to speak of a patient having been mer- 
curialized, without our thinking it necessary to attempt to explain 
the modus operctndi of the mercury that had been taken, rtnd the 
farthest to be expected of us in this wa}7- would be to call the medi- 
cine an alterative. So should we talk and write about alcohol; let 
1 Op. cit. 86 
REPORT OF THE COMMITTEE ON THE 
its effects in a case of fever be carefully noted from the beginning 
to the end, without our being biased by previous theory, or making 
our record in a speculative nomenclature. It will not be enough 
to say, “My patient got well under the stimulation of hot toddy, 
milk-punch, wine, etc.,” or “My patient died, notwithstanding his free 
use of stimulants, in a state of stupor and coma. I did all I could 
to keep him from sinking.” Nor will it be satisfactory to be told 
that a patient in fever took pints, if not quarts, of spirits and of 
wine, unless we learn, at the same time, the precise dose and the 
interval elapsing before the next one, and the symptoms from hour 
to hour following the ingestion of the alcoholic drink. We have 
clinical details sometimes quite minute of the history of a case of 
fever, or of pneumonia, etc., but we have no detail, indeed no men- 
tion, of febrile separated from alcoholic symptoms, and we seldom 
hear of the degree of intelligence of the nurse or other attendant, 
who is left with discretionary power to ply the patient during the 
night with the prescribed alcoholic, ignorant or unobservant of its 
effects all this time. Alcohol as a substance circulating in the 
blood, and soon finding its way to the brain and liver, is, during 
the entire period of its administration, constantly and powerfully 
acting on the organism for good or for evil. Its effects on the 
nervous system and heart are our chief guides in directing a con- 
tinuance of or regulating the dose; but other organs, although 
slower to be impressed by it, are more retentive of its action, 
and a single spoonful of brandy, which will in part escape 
through the eliminating organs, may remain for hours in the 
blood, and a still longer period in the tissues of the different 
organs in which it was deposited. As an aid to an investigation of 
the subject, and to greater precision in noting the varied effects of 
alcohol, we would refer to the valuable work of Dr. Anstie on 
Stimulants and Narcotics. Although we differ from him most 
pointedly when he insists on alcohol being a food, we must admit 
the wisdom of his cautionary advice to prevent its common use 
its prescription in disease being made a reason or pretext for its 
being taken in health. Numerous experiments—mostly on ani- 
mals—give additional force to his opinions. While specifying 
with great care the stimulant as separate from the narcotic effects 
of alcohol, the author attributes to stimulation a range of action 
and therapeutical effects, which in common are thought to be pro- 
duced and explicable by the operation of sedatives and narcotics. 
Stimulauts, as such, are to his mind almost always quieting and RELATIONS OF ALCOHOL TO MEDICINE. 
87 
soothing in disease; narcotics are of doubtful utility, and for the 
most part, as far as represented by alcohol, are injurious. His 
mode of viewing these vexed questions may be in a measure un- 
derstood from his remarks on “Narcotic Inebriation,” or drunken- 
ness. “ This remarkable condition has been frequently very 
incorrectly described. Its first stages have been represented as the 
result of the preliminary ‘stimulant’ influence which is exerted on 
the brain by a particular class of narcotics. It has been said that 
alcohol, the ethers, chloroform, Indian hemp, camphor, and some 
others, when given in large doses, are at first intensely stimulating, 
but that a secondary depression quickly arises, which disturbs all 
The intellectual powers. It is, however, highly improper to give 
the name ‘ stimulation’ to that effect which is produced by a dose of 
any narcotic which places the taker in such an unnatural mental con- 
dition. In order to make this more clearly perceptible, I shall now 
analyze, with some minuteness, the phenomena of the inebriation 
produced by alcohol, by chloroform, and by hashish respectively. 
“ When an excessive or narcotic dose of alcohol is taken into 
the stomach, the symptoms will vary according to the rapidity with 
which the blood becomes saturated with the poisonous agent. A 
certain interval will elapse during which only so small a quantity 
shall have been absorbed through the stomach walls as may stimu- 
late the nervous matter when carried by the circulation to the brain ; 
and this interval will be long or short according as more or fewer 
obstacles to absorption have existed, such as dilution of the alco- 
hol, or mechanical obstructions (e. g., food in the stomach). But 
from the moment that a certain degree of saturation of the blood 
is overpast, and the so-called ‘ phenomena of excitement’ com- 
mence, stimulation is entirely at an end, as we may plainly perceive 
from the fact that the nervous system, in all its parts, is becoming 
paralyzed. The first warning of alcoholic inebriation is flushing 
of the face, an occurrence which indicates that the cervical sympa- 
thetic is becoming paralyzed; this is a symptom not peculiar to 
the action of alcohol; but when caused by that narcotic is always 
a sign that paralysis of the hemispheres is commencing. It is 
about this period, or soon afterwards, that the drinker finds himself 
in unnaturally high spirits; that his animal passions are most pro- 
minent; that feelings of vanity carry him away into garrulity of 
talk, and that whatever sentimentalism there may be in his nature 
is apt to come out, often ludicrously enough. As more and more 
alcohol begins to circulate through the nervous system, and espe- 88 
REPORT OF THE COMMITTEE ON THE 
cially through the brain, fresh mental peculiarities are developed, 
but always in a certain orderly sequence, although this fact easily 
escapes observation.- The clue to a right appreciation of the suc- 
cessive phenomena is this: that the feelings ordinarily suppressed 
by voluntary effort, or observed by the impressions of actual life, 
are displayed, by the removal of the customary veils, in the order 
of their concealment. Reason and prudence, and the moral sense 
which form the varnish, mostly a thin one, superimposed upon the 
sensuous nature, vanish simultaneously with the faculty of esti- 
mating ideas of time and space, and with the power of active co- 
ordination of the muscular movements. It is now that the truth 
of the proverb begins to be most completely realized, ‘ in vino 
veritas,' for the very most hidden things of the mind come out.” 
Stimulation resolves itself, according to Dr. Anstie, into a group 
of physiological effects, of which we give the simplest expression 
in saying that they one and all tend to restore the healthy standard 
of some vital process or processes. And again, he says : True 
stimulation is the supply of some missing influence requisite to the 
maintaining of that balance of the powers and materials of exist- 
ence which we call life. The type of the stimulant class is there- 
fore found in foods, with the power of adding to formed tissue, or 
to the unformed elements of the body—water, salts, or metals de- 
posited or held in solution, etc.—and by evolving heat, which again 
may be converted into electricity. What the writer here says of 
stimulation neither explains nor defines, and the same language 
would be equally applicable or inapplicable to a remedial mode of 
action produced by tonics, alteratives, etc. 
Narcotics, says Dr. Anstie, are distinguished by one central 
feature which marks their influence upon the organism, viz., the 
production of consecutive paralysis of the various portions of the 
nervous system. These effects do not appear to be caused, in the 
slightest degree, by doses which are of less than a certain amount. 
Most if not all narcotics, when given in smaller doses than those 
required to produce the lesser degrees of narcosis, act as stimulants. 
The stimulant action is not produced in the slightest degree by 
narcotic doses. The symptoms of alcohol narcosis are very similar 
to those produced by chloroform and ether. There is the same 
gradually advancing sensor and motor palsy, commencing with the 
lower portion of the body, and blended and confused with the 
effects on consciousness produced by palsy of the brain. Narcosis 
proper may be described as a physiological process in which the RELATIONS OF ALCOHOL TO MEDICINE. 
89 
nervous system is deprived, by the agency of a poisoned blood- 
supply, of its vital characteristics, with greater or less rapidity, and 
which directly tends to produce general death of the organism by 
means of such deprivation. 
In repeating these views of Dr. Anstie on stimulation and nar- 
cosis, we contribute something to a better understanding of the 
therapeutical value of. alcohol, and the ends to which wre should 
look when administering it. But it is not easy to carry in the 
mind a clear perception of the precise dose of alcohol, and the 
time and circumstances under which these two conditions of the 
system occur or are produced. On one cardinal point he is not as 
clear as could be desired : it is that of mistaking action for power, 
and of regarding that which is in fact only borrowed, as an actual 
increase of capital. As justly said by Dr. Paris, we cannot infuse 
into the body any specific elixir from the vials of the laboratory; 
“we cannot directly increase the vis vitae; but by removing the 
obstacles which oppose the effects of nature, we can enable her 
to do so.” The restoration can only be done by means of the 
vital stimuli, food, air, water, and heat.1 The most that other 
stimuli can do is to excite a reaction injurious, as Muller very pro- 
perly remarks, in proportion to the change effected by them in the 
organic composition. “An endless injury has been done to medi- 
cine, and many lives have been lost through the error of confound- 
ing all agents which excite reaction in the system with those which 
are absolutely essential to life, and which renovate while they 
stimulate the organs; the false notion having been thereby in- 
duced that, because stimuli feed as it were the flame of life, stimu- 
lating agents generally are necessary to life.” The theory is 
changed, but the Brunonian practice is renewed in all its former 
power, we were going to say virulence, by the free administration 
of alcoholics in most of the acute, and many of the chronic dis- 
eases which come under medical treatment. Let us hope that fifty 
years hence there may not be occasion for the remark made by a 
medical writer in the early part of the present century—that the 
Brunonian doctrine, and the practice growing out of it had de- 
stroyed more lives than all the wars of the French Revolution. 
The writer probably meant to include in this censure the results 
of the dietetic habits which were strengthened and greatly increased 
by Brown’s teaching. Dr. Rush repeats what has been often said 
that spirituous liquors destroy more lives than the sword. 
1 Pharmacologia. 90 
REPORT OF THE COMMITTEE ON THE 
Alcohol occupies a foremost place, with many practitioners, in 
the treatment of fever at the present time. We need not dwell on 
the details of the alcoholic practice carried to its extremes by Dr. 
Todd; but shall speak first of its somewhat modified features 
based on experiments and a show of plausible pathology by Dr. 
Anstie, who warns us, however, against an undue persistence in the 
use of the remedy in general. Thus, for instance, after speaking 
of the great relief in neuralgia afforded by the use of a moderate 
dose of alcohol, he adds the remark that if the article is to be ad- 
ministered at all for this purpose, it should be given with as much 
precision as to dose as we should use in giving an acknowledged 
poison. Admirable caution, and applicable to every form of dis- 
ease or infirmity in which alcohol is prescribed! In another place 
the writer, when telling us of the powerful effect which alcohol 
often exerts in averting threatened epileptiform attacks, confesses 
that he hesitates to order its employment by any epileptic, unless 
he be a person of great intelligence and firmness of mind, on ac- 
count of the almost inevitable tendency which patients have to 
overdo any remedy which they fancy will avert some terrible 
danger—a measure which in the case of alcohol might have the 
disastrous effect of leading to habits of drinking. 
The classical illustration of the favorable soporific influence of 
alcohol, to use the language of Dr. Anstie, is to be found in its use 
in low fevers, such as typhus and typhoid. In cases of these dis- 
eases, a certain rapidity of pulse shows that the patient cannot ob- 
tain natural sleep, but will pass into a state either of coma or 
delirium, and that under such circumstances it too often happens 
that meat, broth, etc., cannot be retained by the stomach. “ Not- 
withstanding all that has been said by persons who have never 
fairly tried the plan, there is nothing which meets the exigencies 
of this condition with an efficiency which at all approaches that of 
alcohol in repeated non-narcotic doses.” A case is given of a 
woman, aged 36 years, suffering from typhus fever, who was seized 
on the tenth day of the disease with rather violent delirium, the 
skin was hot and rather dry, pulse 146. Six ounces of brandy per 
diem had been allowed so far; the quantity was now doubled. 
During the next twenty-four hours the pulse came down to 120, the 
delirium ceased, and the tongue became less dry than it had pre- 
viously been. A test of the injurious or narcotic effects of alcohol, 
where the dose has been beyond the wants of the case, is found, 
writes Dr. Anstie (Lancet, 1868, p. 121), by distillation of an ave- RELATIONS OF ALCOHOL TO MEDICINE. 
91 
rage sample of the twenty-four hours’ urine. If renal elimination 
to the extent of one grain per diem be proved, it may be confi- 
dently asserted that a more or less poisonous effect has been pro- 
duced, more especially if the sphygmograph gives the evidences of 
lowered arterial action. 
The supporting treatment, in which, among the medicinal agents, 
alcohol has been assigned a high rank, is that advocated by Dr. 
John Hughes Bennett in continued fever, which includes typhoid 
and typhus. His practice partakes, however, of the eclectic (not 
the shallow teaching so called) as well as of the alcoholic. At the 
beginning, or the stage of excitement, this writer directs saline anti- 
monials, slight laxatives if occasion requires them, and he orders 
the head to be shaved and cold applied. Fluid nutrients, such as 
milk and beef-tea, are given from the first, and wine and other 
stimulants as soon as the pulse becomes weak after having been 
rapid and strong, but still retaining its frequency. The quantity of 
wine usually given is from three to six ounces a day; but in some 
cases marked by tmusual depression, or when the individual has 
been previously accustomed to alcoholic drinks, a larger quantity, 
or, in its stead, from one to four ounces of spirits may be required. 
Caution is given#not to continue the use of stimulants longer than 
is necessary. The same general rules are laid down for the treat- 
ment of eruptive fevers that are recommended in that of continued 
fever. 
Dr. Wood assures us1 that in low febrile diseases alcoholic liquors 
are a most valuable resource, and, indeed, indispensable. They are 
not, he thinks, so well adapted to the prostration or collapse which 
sometimes occurs in the cold stage at the commencement of the 
fever as to the debility coming on in its course. In this latter con- 
dition, which so often supervenes in febrile diseases, and not unfre- 
quently constitutes their greatest danger, they are adapted beyond 
all other medicines by the universality as well as the energy of 
their stimulant property. Unless the prostration is sudden and 
alarming, the mildest form of these stimulants should be first 
employed, and recourse be had to the strongest only as increasing 
debility may seem to require them. Thus, it is usually advisable 
to begin with wine-whey, then, if necessary, to advance to pure 
wine, and ultimately to ardent spirits. Dr. Wood expresses, we 
believe, the opinion of most practitioners, when he tells us that 
alcoholic liquids may often be advantageously used in scarlatina, 
1 Therapeutics and Pharmacology, vol. i. p. 658. 92 
REPORT OF THE COMMITTEE ON THE 
diphtheria, smallpox, and erysipelatous fever, and occasionally in 
bilious remittent and yellow fevers, when they present typhoid 
symptoms. Even the existence of inflammation, under these cir- 
cumstances, does not positively contraindicate their use. Active 
alcoholic stimulation is often necessary in typhoid or typhous 
pneumonia. We should have stated that in these specifications of 
diseases laid down by Dr. Wood it is in typhus, enteric, or typhoid 
and petechial fevers that the alcoholic remedies generally prove 
most serviceable. He believes the same treatment, in this par- 
ticular, is applicable, to the advanced stage of inflammation when 
copious suppuration takes place, also to various constitutional 
affections attended with suppurative or ulcerative conditions. Dr. 
Gerhard, giving in a measure the results of twenty-three years’ 
experience of hospital practice, says1 that in the treatment of 
typhoid fever he sometimes gives alcoholic stimulants in large 
doses, and in many instances considers them totally unnecessary— 
a discrimination which we could wish to see displayed by some of 
the wholesale prescribers of alcohol in every stage of a fever. Dr. 
G. considers it necessary to give the patient some stimulants in 
typhus fever. Some patients, he tells us, will require large doses, 
others will do well on small portions. Dr. J. F. Meigs, in a valu- 
able paper on the “Morphological Changes in th^Blood in Malarial 
Fever,” gives cases of different forms of severe and malignant 
remittent fever in which he prescribed with benefit, in the Penn- 
sylvania Hospital, alcoholic stimulants, chiefly in combination, as 
in the form of milk-punch. 
As an offset to the stimulating practice of Dr. Anstie, we must 
refer to the moderate and non-stimulant course pursued by Dr. 
Weeks, of Guy’s Hospital, in certain cases of fever. In a clinical 
lecture delivered by him2 he reminds his youthful auditors of 
what they had themselves witnessed, viz., that fevers will do well 
without alcoholic stimulants. “Of course,” he said, “stimulants are 
often needed, but young persons with typhus and typhoid fevers 
do better, I believe, without them.” The lecturer adds: “That 
they make good recoveries on a simple milk diet is a fact which 
my hospital cases prove, and which no arguments can gainsay; 
and, on the other hand, I have seen a marked improvement take 
place in some cases where a stimulus has been left off.” The same 
thing occurs in bronchitis and in regard to heart disease—rather a 
1 Pennsylvania Hospital Reports, 1868. 
2 111 Lancet, 1867. 93 
RELATIONS OF ALCOHOL TO MEDICINE. 
vague term. Dr. Weeks is convinced that the amount of mischief 
•done by stimulants is immense. A constant stimulation by alcohol 
of a diseased and weak heart adds greatly to the trouble. 
Worthy of commendation are the views on the treatment of 
typhus fever inculcated by Dr. Chambers {Led. VI.). As to the 
use of alcohol in fevers, he is guided almost entirely by the condi- 
tion of the nervous system. If there is very complete prostration 
and delirium of a low muttering character, it is required. A 
tremulous state of the muscles, marked especially by a quivering 
of the hands and fingers, is a good test of the necessity for it, and 
so is a sharp, weak, unequal action of the heart. All these indi- 
cate that the nervous system is feeling very sensitively the destruc- 
tive metamorphosis going on, and has its power lowered by its 
sensitiveness. “ Then is the opportunity for the powerful anaesthetic 
alcohol which in severe cases you see me order without scruple, 
but which I do not rank as part of the necessary methodus medendi 
of fever, and have not yet ordered it for the boy we have been pre- 
scribing for. Above all, I would caution you against employing 
it as a substitute for the treatment which I have been describing. 
Wine may be useful as an adjunct, but never must it take the 
place of the true restoratives.” One cannot but admire the wise 
caution and well-timed rebuke, in these remarks, against making 
the occasional and admittedly serviceable use of alcohol in fever, a 
foundation for a system of large, continued, and exclusively alco- 
holic treatment of this disease. Dr. Chambers regards the alcoholic 
as an exceptional mode of treatment, just as he does the local ab- 
straction of blood, of which, in treating this fever, he gives examples. 
The case of a girl, with typhus fever, is given, who complained much 
of pain in the right iliac fossa, which was treated by leeches and 
mercury, with immediate relief. Justice cannot be done to the sub- 
ject, nor to the lecturer in regard to his views of the proper places 
of alcohol in continued fever, unless we follow him in the successive 
division of the means which he recommends to combat the disease. 
The once popular practice of giving an emetic at the beginning of 
fever is renewed by Dr. Chambers, with results which he regards 
as very satisfactory. He inclines to an opinion of the etiology of 
typhus which was taught half a century ago by Dr. Chapman, of 
the University of Pennsylvania, viz., that the most usual path of 
ingress of the febrile poison is the digestive canal. The English 
lecturer tells us of several instances of the success of the emetic 
treatment which removes an essential part of the disease. Wine 94 
REPORT OF THE COMMITTEE ON THE 
and emetics were given in both classes of continued fevers; the 
wine, as usual, in accordance with the patient’s age and the condi- 
tion of the nervous system, and emetics whenever the history we 
could elicit made us conjecture that the fever was in its first week. 
Following the emetic will be sponging the whole person of the 
patient three or four times a day with tepid water, to which the 
nurses more generally add some distilled vinegar to make it more 
agreeable. Cold affusion is sometimes resorted to with benefit; 
but it should be withheld where pneumonia is present, or where 
the patient has recently had an attack of acute rheumatism. The 
most important indication in the treatment of the low forms of 
fever, is to give a large supply of nitrogenous material which had 
been wasted and carried away by destructive metamorphosis. 
“The suitablest food,” says Dr. Chambers, “is that which is natu- 
rally supplied to the weakest stomach. The feeble digestive 
organs of babies can assimilate milk, and milk forms the most 
appropriate nourishment for the debilitated viscera of the fever 
patient. By giving two or three ounces every hour, you may get 
down a quart and a half per diem. But in ordinary instances every 
two hours is often enough, and that period is adopted for the boy 
before us. If there is sufficient acid left in the stomach to coagu- 
late the casein into clots, and cheesy lumps are rejected by vomit- 
ing, as happens sometimes in milder cases, you may guard against 
this by adding liquor calcis or soda water to the milk, or you may 
replace it by beef-tea.” Lumping of the cheese into solid masses, 
not acidification, is to be avoided. “Sour buttermilk is by no 
means to be despised as a food.” It is quite a relief to those who 
look for the natural means of restoration in exhausted states of the 
system, to find a true nutrient recommended, as in the case of milk, 
without the equivocal but among a large number of practitioners 
the almost inevitable addition of alcohol. Better by far to give 
the two separately, and not be prevented from continuing the milk 
because the alcoholic fluid—whiskey or brandy—disturbs and dis- 
agrees. The former will be administered without interruption at 
short intervals; the latter, if at all, at longer periods. The milk 
is urgently wanted to fill up the bloodvessels; the alcohol is at 
times serviceable to soothe the nervous system, but it makes no 
blood, nor helps to make any. Eggs are universally admitted to 
be a highly nutritious food; “if taken raw and diluted with milk 
or water, they are .quickly absorbed. But should they be delayed 
and putrefy, the products of their decomposition are particularly RELATION'S OF ALCOHOL TO MEDICINE. 
95 
injurious; the sulphuretted hydrogen and ammonia are poisons to 
the intestines. I should recommend you,” continues Dr. Chambers, 
“to avoid eggs till convalescence has restored the gastric powers. 
The same objection does not lie against milk, the lactic acid arising 
from whose decomposition assists in the solution of the casein.” 
The means which Dr. Chambers recommends to combat typhus 
fever are—1st, an emetic; 2d, repeated sponging the entire sur- 
face of the body with warm water; 3d, the free use of nitroge- 
nous material for nutriment, to supply the large waste by the 
fever; and 4th, remedies drawn from the pharmacopoeia. Of 
these, the first in the order of therapeutic value, as accredited 
by Dr. Chambers, is hydrochloric acid diluted, in a dose of 
twenty minims with water and syrup every two hours, as in the 
following prescription: R.—Acidi hydrochlorici syrupi 3j, 
aquae sj, alterna qucique hora sumat. The acid, on somewhat 
theoretical grounds, is prescribed in low fevers in which there is 
supposed to be a super-alkaline condition of the fluids, according 
to Dr. Richardson, or a sub-acid, as suggested by Dr. Chambers. 
This gentleman asks: “ What blood when analyzed comes nearest 
in its altered proportions to the blood in low fevers? Is it not 
that of scurvy and purpura ? There is the same excess of black- 
ened (melanosed) blood disks, the same deficiency of neutral salts 
and organizable (coagulable) lymph. Everybody treats these 
chronic affections with acids, and why not also an acute affection 
which corresponds with them on one point at any rate? As to 
the particular acid employed, muriatic certainly deserves to be tried 
before others—first, because it is such a large constituent of the 
body that it might almost be called a food instead of a medicine; 
and secondly, because it is such a powerful arrester of the decom- 
position of animal matters.” Dr. Chambers presents the therapeu- 
tical statistics of two classes of patients with typhus fever. The first, 
numbering 109, were treated on what may be called “general prin- 
ciples,” leaving a mortality of 23 ; the second, in number 121, were 
treated by continuous nutriment and hydrochloric acid, with a loss 
by death of only 4. Both series were spread over a considerable 
number of years, so that they include sporadic cases as well as the 
produce of epidemics. “ They were all treated by the same physi- 
cian in the same wards of a general hospital (where the cases are 
usually more severe than in special fever hospitals), and they 
nearly all came from the same group of districts, of which our 
hospital is the centre.” The treatment in the second series, addi- 96 
REPORT OF THE COMMITTEE ON THE 
tional to the use of the hydrochloric acid, consisted in sponging 
the body two or three times daily with tepid water when the skin 
was hot and dry, and, in a few instances, in leeches or cupping 
applied to the exterior of inflamed localities in the abdomen or 
chest. The difference in the result of the two methods of treatment 
in the two series of cases is very striking; the deaths in the former 
were 19J per cent., or nearly 1 in 5, and in the latter 2J per cent., 
or only 1 in 40. The continuous liquid nutriment, given every 
two hours in the last series of cases, consisted of strong beef-tea 
and milk, of which, together, about six pints were administered in 
the twenty-four hours. Dr. Henderson, writing from Shanghai 
(China), states that the employment of the hydrochloric acid there 
diminished the mortality of continued fever from 20 per cent, to 7 
per cent., certainly a very marked decrease, and in a totally differ- 
ent climate from that of England. It is after giving the above 
methodus medendi in fever, that Dr. Chambers introduces alcohol 
to notice as a secondary and exceptional though at times an efficient 
remedy, in the terms which have been previously cited. 
Counter testimony to the alleged febrifuge virtue of alcohol is 
offered by Pucinotti, an Italian writer, who attributes the severity 
of the fevers, with which the country around Rome is afflicted, to 
the use of spirits and other stimulants used by some as preventives. 
He relates the case of an old man who had come from Romagna 
every second year to labor, during the harvest, in the Campagna 
of Rome, and who never had the fever. His beverage in the morn- 
ing and through the day was cold water with a little lemon-juice. 
This practice his father had adopted before him, and with the same 
happy result; but His two sons, who would use spirit (brandy), and 
even mixed with it at one time gunpowder, and at another cayenne 
pepper, both fell victims to the fever. 
The alcoholic treatment of delirium tremens still has its advo- 
cates, and, if received, would constitute an exception to all medical 
experience in other diseases, viz., that the marked and extreme 
effects of a poison should be removed by large and repeated doses 
of the same poison; that alcohol should be both bane and antidote, 
a cause and a cure of delirium tremens, giving rise to fatty degene- 
ration of the blood and removing it at the same time. The medical 
skeptic might ask whether the patient with this disease gets well 
on account of or in despite of the alcohol used. At any rate, if 
we admit that the disease is cured by any drug, as in Dr. Joseph 
Klapp’s successful cases after the administration of an emetic, those RELATION’S OF ALCOHOL TO MEDICINE. 
97 
"with the like results after the use of opium by many practitioners, 
and the numerous cases treated by Dr. Dunglison at the Phila- 
delphia Hospital (Blockley) on the expectant and eclectic plan, but 
without a drop of alcohol, and with entire success, and the equally 
successful but contrasted practice of free alcoholic stimulation in 
160 cases in the above hospital, it is very evident that the disease 
will disappear under opposite and neutral modes of treatment. 
Dr. Bennett thinks that nutritive stimulants will for the most part 
suffice, as far as relates to internal means. One thing is clear, that, 
if it can possibly be avoided, the doctor ought not to leave his 
patient, after an attack of delirium tremens, a drunkard as much as 
he found him one, and as liable as ever to continue to be a drunk- 
ard. When the poor creature is told that although alcohol made 
him ill, alcohol also made him well, he will exclaim, Hurrah for 
alcohol, and a fig for water-drinkers and total abstinence! Dr. 
Handfield Jones, in his Clinical Observations on Functional Nervous 
Disorders, makes some instructive statements on the pathology and 
treatment of delirium tremens. He cites the views entertained by 
different writers, that the disease presents itself under two states, 
which are sometimes so many stages, viz., one of inflammation and 
high irritation of the brain and its meninges, and the other of ex- 
hausted nervous energy or collapse. A similar division is made of 
traumatic delirium. There should also be a separation of cases 
where the symptoms ensue immediately after casual alcoholic excess 
from those in which this is not the case. Dr. Peddre tells of his 
‘having treated eighty cases of delirium tremens successfully by tar- 
tar emetic, in doses of a quarter to half a grain in simple solution, 
every two hours, or at shorter intervals, according to the degree of 
excitement and irritability. The action of the antimony seems to 
be chiefly sedative, or, to use the language of the Italian school, 
eolftra-stimulant. Dr. Ware points out the natural termination of 
the disease by sleep in sixty to seventy hours, dating from the time 
when the state of entire watchfulness and delirium commences. 
The mere expectant treatment, he tells us, gave but one death in 
twenty-nine cases; while out of fifteen cases treated with opium, 
in small or large doses, six died, two of them being complicated. 
In the Edinburgh Infirmary, where for many years the disease 
seems to have been treated with laudanum and whisky in a very 
careless manner, the mortality is stated to have been 35 per cent., 
and in St. George’s Hospital 14.6 per cent.; in the infantry regi- 
ments 17.6 per cent., and in the cavalry 13.8 per cent. On the 98 
REPORT OF THE COMMITTEE OX THE 
other hand, Dr. Gairdner’s experience at Edinburgh is of one death 
among thirty cases “treated in an extremely simple and natural 
manner:” Laycock has treated sixty-eight cases of delirium tremens 
without opium or stimulants, and has had only two deaths. This 
writer assigns six days as that of the self-limitation of the disease. 
A safer sedative than opium is the extract of hyoscyamus in doses 
of ten to fifteen grains, or of a drachm of the tincture, repeated at 
intervals. Tincture of digitalis, in a dose of half an ounce, has 
often a very soothing effect. Eight ounces have been given in a 
period of a few hours. In the English hospitals we find that Dr. 
Fincham of the Westminster, Dr. Maclean of the Netley, Dr. Flem- 
ing of the Queen’s, Birmingham, cut off* at once all alcoholic stimu- 
lants and rely on pure air, quiet, seclusion, and nourishing and 
palatable food, supplied at short intervals. The treatment pursued 
by Dr. Goodfellow of the Middlesex, and Dr. Harvey of the Aber- 
deen Royal Infirmary, is mainly expectant and dietetic, abundance 
of nourishing food being allowed.1 
In the phlegmasise generally the stimulating is replacing the 
depleting and reducing treatment—a bound from one extreme 
to the other. Dr. Anstie reports a case of double pneumonia in 
a man aged twenty-four years, who for ten days lived on nothing 
but brandy and a little water. In the first part of this time he 
took twelve ounces of the liquor daily, and ultimately twice 
this quantity. In a month from the day of the doctor’s first 
visit the man was well enough to resume his work. Dr. Bennett 
adopted with great success in this disease what he terms his treat-’ 
ment by restoration, directed to further the natural progress of the 
disease and to support the vital strength. During the period of 
febrile excitement he contented himself with giving salines in small 
doses, with a view of diminishing the viscosity of the blood. At 
the beginning of the treatment he ordered as much beef-tea* as 
could be taken; and as soon as the pulse became soft, nutrients 
and from four to eight ounces of wdne daily. As the period of 
crisis approached, he gave a diuretic consisting of half a drachm 
of nitric ether, and sometimes ten minims of colchicum wine three 
times daily, to favor excretion of urates. But when crisis occurred 
by sweat or stool, he took care not to check it in any way. Of 129 
cases of acute pneumonia treated by Dr. Bennett in the wards of 
the Edinburgh Infirmary, during a period of six and a half years’ 
1 British Medical Journal, July, 1869. RELATIONS OP ALCOHOL TO MEDICINE. 
99 
service, the deaths numbered only 4, or 1 in 32f cases; and of all 
the cases of uncomplicated pneumonia, 105 in number, not one 
died—a most extraordinary result, when it is remembered that in 
other places, under different modes of treatment, the mortality was 
from 1 in 4 to 1 in 9J cases. It is to be feared that there is great 
lack of precision of statement, and too rapid, if not vague, gene- 
ralization, in speaking of the treatment of pneumonia, and, indeed, 
of inflammations in general. One of the worst epidemics, and one 
attended by disastrous results, is that affecting the minds of physi- 
cians, so that the fears and prejudices, the isolated and exceptional 
experience of a few, are communicated to the profession at large, 
and received by it as a body of well-established and coherent facts. 
In some cases of pneumonia, bloodletting has been found unsuc- 
cessful; in others, injurious. A specification of the true character 
of these cases, not only of the extent of the organic lesions of the 
lungs, but the associated circumstances of age and habits of the 
patients, complications with other diseases—typhoid and typhus 
fevers, measles, scarlatina, phthisis—is necessary to enable us to 
form a judgment of the effects of treatment. These effects in one 
case constitute no absolute guide, and scarcely a strong probability 
in another case; and hence to tell, without suitable specification, 
that we depleted freely or stimulated largelj* in pneumonia, conveys 
no definite information. Of one thing we may be very sure, that 
the out-and-out course of treatment, whichever it may be, is wrong, 
if not mischievous. It is misleading, also, to make the predomi- 
nant feature represent the entire treatment, which is, or ought to 
be, different in the different stages of the disease. The time has 
probably passed forever when physicians will follow the practice 
of the last of the Gregorys in the Edinburgh University, who used 
to say in his lectures that, provided he was called early in pneu- 
monia, he would be contented to dispense with all other aids than 
those of the lancet and water-gruel. The time will also pass when 
alcoholic stimulants will be regarded as the sole or even the best 
remedies in pneumonia. Dr. Gregory had, no doubt, cases in his mind 
to justify his language of faith in the lancet; and Dr. Anstie gives us 
cases in equal justification of his free recourse to the brandy-bottle in 
prescribing for his pneumonic patients. The results of the extreme, 
if not exclusively, stimulating treatment in this disease are not 
calculated to win confidence and secure general imitation. There 
are still judicious practitioners who bleed in pneumonia, to the 
great relief of their patients, and who do not deem it inconsistent 100 
REPORT OF THE COMMITTEE ON THE 
practice to stimulate at the same time, and in this way bring about 
a cure. They do not pledge themselves to bleed; they certainly 
do not stimulate in every case, to the exclusion of a modified 
treatment. Sound conservative medicine is, we believe, fairly 
represented on this point in the lecture (XX.) of Dr. Chambers on 
“Pneumonia.” It begins by relating three cases of the disease. 
1. Frank, uncomplicated double pneumonia in a temperate man 
with excessive dyspnoea. Cured with venesection, jacket-poultice, 
continuous feeding, and wine. 2. Pneumonia of upper and lower 
lobes of one lung, very slight in the other lung, in a broken-down 
old man. Cured with cupping, jacket-poultice, continuous feeding, 
and wine. 3. Congestive pneumonia of lower lobe in typh-fever. 
Cured with half-jacket poultice, cupping beneath scapula, continu- 
ous feeding, wine, and bark. Dr. Chambers describes the symptoms 
of the first case. Age of the patient, 21 years; lips and tongue 
livid ; pulse very quick and small, but the heart beat strongly, in 
spite of its great rapidity. The expectoration was copious and 
glairy, of a deep tawny color, and with a few small striae of blood 
in it. The state of the lungs, ascertained by auscultation and per- 
cussion, is given. “It was obvious that active inflammation raged 
throughout nearly the whole (if not quite the whole) of the right 
lung, and in the lower lobe of the left, and that it was most ad- 
vanced in the back part of the right side. At most, a third of the 
pulmonary tissue was in working condition, so no wonder that 
exaggerated puerile breathing was heard in that third, and the 
ribs were heaved in an extraordinary manner when heaved at all.” 
This man was brought to the hospital six days after his seizure, his 
case marked by severe rigors, followed by a dull pain in the side, 
and cough. The treatment after his reception is thus described: 
“The patient was bled to three-quarters of a pint from the arm, 
took eight ounces of port wine during the twenty-four hours and 
beef-tea every two hours, and had his chest completely enveloped 
in a thick, hot linseed-meal poultice. lie was ordered, also, three 
effervescent draughts of citrate of ammonia daily.” Relief began 
immediately after the venesection. The treatment was completed 
by the administration, from the eighth day, of decoction of bark. 
The second case was that of a man sixty-three years of age, sus- 
pected of “petty tippling.” Ilis pulse was large, short, and empty. 
Ilis tongue was thickly furred and clammy, his hands tremulous, 
and his manner excited. There was also occasional delirium. On 
the fourth day of the disease he was sent to the hospital, where he RELATIONS OF ALCOHOL TO MEDICINE. 
101 
received the following treatment: “He was cupped that day to 
six ounces on the cardiac region, and on the morrow to the same 
amount beneath the right clavicle. The chest was completely 
enveloped in a jacket of linseed poultice. He was ordered eight 
ounces of port wine every two hours, and three effervescing 
draughts daily of carbonate of ammonia and tartaric acid. After 
a fortnight’s stay in the hospital, he began to take bark and am- 
monia. The third case was that of a youth aged seventeen years, 
who, on the third day from his seizure, presented the most unfa- 
vorable appearances—complete prostration and constant delirium; 
tongue clammy and tremulous, protruded with great difficulty from 
the dry lips; the pulse 120 and small; the skin hot and dry; the 
eyes were bloodshot, and on the front of the body were from 
thirty to forty fever-spots of various hues, some slightly raised and 
inclining to rose-color, som^livid, some completely purpuric, and 
not changed by pressure. He was treated,” says Dr. Chambers, 
“in my usual way, with hydrochloric acid and tepid sponging, and 
was going on as usual very well till May 8, the tenth day of the 
disease, when some fine crepitation and dulness on percussion were 
found in the lower lobe of the right lung, accompanied by slight 
cough, but without expectoration. On the 4th he was cupped 
beneath the right scapula to four ounces, a poultice was applied 
over that part, and he was directed to be kept turned on the left 
side.” On the 7th the percussion was normal, and the breath- 
sounds, for the most part, healthy. The convalescence was rapid 
under bark and wine. 
In farther remarks on bloodletting in pneumonia, Dr. C. states 
that the best guide for its necessity is dyspnoea, and we are told to 
be careful to supply material in the place of that which we take 
away by this operation. “ Let the patients be fed with beef-tea 
or milk every two hours, just as if we had typh-fever. This is 
to be done in all severe cases, irrespective of other treatment.” 
Alcohol, we are told on the same authority, especially in the form 
of port wine, is very useful in treating pneumonia. “ Even to hearty 
temperate persons, when we are going to bleed, it is desirable to 
give a little wine, as was done in Case I. A glass of hot negus 
before the operation makes it safer.” Whenever the nervous sys- 
tem is becoming prostrate we may give a little wine from time to 
time. Old persons, especially of the wealthier classes, who have 
indulged freely, in alcoholic liquors, may begin wine immediately. 
“Children, on the other hand, get well quicker without it.” In the 102 
REPORT OF THE COMMITTEE ON THE 
administration of alcohol under any form, a rule directly opposite to 
that which governs the giving of nutritious food should be observed. 
The frequent repetition of small doses is specially and repeatedly 
objected to by Dr. Chambers. He always prefers two or three doses 
a day, enough at once to produce a decided effect. In the case 
of a young girl aged sixteen, taken with typh-fever and super- 
vening pneumonia, the only additions to the usual treatment of the 
former disease were six leeches beneath the shoulder blade, a 
jacket-poultice, and ten grains of compound kino powder, three 
times a day during the first day, to check diarrhoea. The combina- 
tion of alcohol and opium, with local detraction of blood, and nutri- 
ents, was successful in the case of a laborer, twenty-eight years, seized 
with pneumonia. Six leeches to the side one day, and sixteen 
more on the next, with a jacket-poultice, was followed by the use 
of ten minims of lauda*num every fqur hours, six ounces of port 
wine daily, and a teacup of beef-tea hourly. Dr. Chambers thinks 
the opiate treatment of pneumonia is especially suited to cases 
where there is evidence of deficient power in the nervous system—• 
great prostration, or tremor of the hand and tongue. He gives it, 
also, where the tongue has a smooth, whitey-brown, paper-colored 
coat, and where there is diarrhoea, or even tendency to diarrhoea, 
such as two fluid motions daily, for, in pneumonia, “of all unfortu- 
nate complications there is none so bad as looseness of bowels; 
those patients always do best who are constipated either naturally 
or artificially.” As farther illustrating the good effects of local 
bloodletting with the use of laudanum, is another case related by 
the same author, of a young girl who had just reached the age of 
puberty. “On admission, the breathing was very labored, and she 
raised the alse nasi in inspiration. The respirations were forty- 
four in the minute, and the pulse one hundred and forty-four. There 
was bronchial breathing and whistling rales all over the chest. 
The whole of the right lower lobe was dull on percussion. No 
stitch in the side, or pain on* pressure. She was cupped to siv 
between the shoulders, eight leeches were applied beneath the 
shoulder blades, and the chest was enveloped in a jacket-poultice. 
I also ordered her ten minims of laudanum every three hours, and 
teacup diet.” In a case of pneumonia occurring in a muscular 
laborer, aged thirty-two years, who had been a hard drinker, and 
had had several attacks of delirium tremens, and on his admission 
exhibited a pulse of one hundred and forty, and respirations sixty 
in the minute, cupping to the extent of sviij was practised beneath RELATIONS OF ALCOHOL TO MEDICINE. 
103 
the shoulder blades, a jacket-poultice was applied, and twenty 
minims of laudanum every four hours, and a teacup diet every 
two hours. In reference to the convalescence in this case, the 
lecturer points out the fact of the gradual progress of textural 
change in the lungs in pneumonia, and the gradual recession in its 
disappearance. 
It has been seen that an almost uniform part of the treatment of 
pneumonia by Dr. Chambers consists in his directing the use of a 
warm thick linseed poultice, to be applied around the chest as a 
kind of jacket. He says, this is “another direct restorative, about 
the use of which also any when and any where you need have no 
manner of hesitation. You can always, without any exception of 
age, sex, condition, cause, or complication, follow a treatment to 
which I attribute more power of saving the lives of pneumonic 
patients than to any other, and which you see me apply in all 
cases.” Under the use of the linseed poultice the dyspnoea is' di- 
minished, the breath being easily drawn in spite of the weight of 
the poultice; the hot fevered skin becomes moist and active, and 
soon the ribs begin to move again and air is admitted into the 
hitherto paralyzed lung-tissue. To the infant who cannot afford 
much loss of blood, this remedy is the really safe and invariably 
necessary one. 
“ The poultice is best made of linseed meal, because that keeps 
moist the longest. It should be spread half an inch thick on a 
cloth or flannel as broad as the circumference of the thorax. If any 
portion of the upper lobes be inflamed, it is essential, and if even 
only the lower lobes are inflamed, it is prudent that the poultice 
should be deep enough to cover the whole chest from the collar 
bones to the hypochondria. Lay the patient in it on his back, and 
fold it across the front till it meets. In adults it will usually keep 
its place of its own accord; but in children you should have a tape 
stitched on in front and a tape behind, which you can tie over the 
shoulder in the manner of a shoulder strap; otherwise the little 
prisoners wriggle out of their soft breast-plates. When once you 
have got this jacket poultice in situ, keep it there, and desire the 
nurse, on pain of dismissal, never to take it off till another hot one 
is ready to go on. The poultice in low fever often takes the place 
of sponging by its softening and suffusing with a gentle perspiration 
the whole body.” 
Dr. Chambers, in referring to his refusing the very urgent re- 
quest of a patient laboring under emphysema of the lung, for beer, 104 
REPORT OF THE COMMITTEE OX THE 
adds: “I hope, if probable, to break him of the habit, for nothing 
is so injurious to regenerative tendencies as alcohol, and no form 
of alcohol liquid so bad as beer.” But he corrects himself by 
making “one exception to the bad pre-eminence of alcohol, that is, 
mercury. Avoid mercury in these cases as you would a poison. 
Avoid also purgatives.” 
A case of 'pericarditis occurring in the course of acute rheuma- 
tism—quite a common event—was treated by Dr. Anstie as follows: 
The patient, aged eighteen years, had been in homoeopathic hands 
for four days. He took one grain of morphia every four hours 
throughout the ’persistence of the chest symptoms, and for seven 
days twelve ounces of gin each day, and about an equal quantity 
of water, two drachms of the gin being given every half hour. 
For a while gin and water was the only thing the stomach did not 
absolutely reject at once. “ Recovery in this case was very rapid, 
for the man was able to get about in a month.” Dr. A. generally 
recommends in this disease repeated small doses of alcohol. Dr. 
Bennett treats acute pericarditis according to the general and, as 
seems to us, rational principles which govern him in prescribing 
for other phlegmasise and fevers. During the acute febrile symp- 
toms, salines and quietude. If there be much local pain, leeches 
and local warmth. If there be excited action and dyspnoea, ether 
and morphia, and, as early as possible, nutrients and wine to sup- 
port the vital changes which it is necessary for the exudation to 
go through, so as to favor absorption. Active purgatives should 
be avoided ; and blisters are thought to be of doubtful value. Dr. 
Chambers, in prescribing for pericarditis, makes no mention of 
alcohol. His chief reliance is on leeching early and repeating 
opium and poultices. He speaks highly of enveloping the patient 
in blankets. As a palliative to relieve some of the many un- 
pleasant and often very painful symptoms in chronic pericarditis, 
alcohol is frequently given. Of its curative power nothing can be 
said, especially when occurring, as it so often does, after Bright’s 
disease, a product of alcoholism. Dr. Stokes1 thinks that our great 
reliance must be on the free use of wine or brandy in confirmed 
cases of fatty degeneration of the heart, where the patients have 
always been temperate, and, above all, where the pulse is slow, 
with tendency to faintness or to attacks of pseudo-apoplexy. By 
such a course alone can we hope, in the opinion of the author, to 
1 Diseases of the Heart and Aorta. RELATIONS OF ALCOHOL TO MEDICINE. 
105 
preserve or prolong the patient’s life. “ Cardiac suffering” from 
the use of tobacco and excessive drinking of green tea is relieved 
by similar means. The same remark is made to apply to the treat- 
ment of hypertrophy of the heart, with passive enlargement of the 
organ, or with permanently patent aortic valves. It must be borne 
in mind, however, as we have already stated, that fatty degeneration 
of the heart will probably acknowledge the large use of alcohol 
for its chief cause, although the disease may, as in the c'ases speci- 
fied by Dr. Stokes, occur in a temperate person. Dr. Chambers, 
with his usual discrimination, says in reference to the treatment of 
“disease of the heart” (Lect. XXV.): “ While you bid your patients 
live generously you must take care to disabuse them of the notion 
that the advice includes excess in alcohol. Alcohol is really the 
most ungenerous diet that there is. It impoverishes the blood, and 
there is no surer road to that degeneration of the muscular fibre 
which is so much to be feared. And in heart disease it is more 
especially hurtful, by quickening the beat, causing capillary con- 
gestion and irregular circulation, and thus mechanically inducing 
dilatation of the cavities. Let the alcoholic drink be limited to 
that quantity which increases the appetite. In a great many in- 
stances this quantity may be very shortly written down—0.” 
The convulsions of teething are arrested by the use of alcohol in 
a remarkable manner, according to Dr. Anstie. He has found no 
other plan of treatment so beneficial. “ There is not,” he says, “the 
least necessity for intoxicating the little patients; a minute dose of 
wine or brandy (for young infants a few drops at a time in a little 
water) is amply sufficient for any good purpose that can be effected.” 
Many will ask whether a better purpose would not be effected by a 
substitute for a remedy which is so liable to be abused and made a 
source of such great and abiding mischief. The .mother, let us 
suppose, finds alcohol good in the convulsions of her child from 
teething; she will be very apt to give it to allay the irritation and 
restlessness accompanying this process. An occasional starting in 
sleep will alarm her, and for fear of convulsions she will give her 
child alcohol, and if she has any hysterical twitches herself she 
will believe that alcohol, even without the thoughtless advice of a 
physician, may be of service to her also. In fine, if alcohol finds 
a recognized place in the nursery dispensary, the foundation for a 
love of it on the part of the poor infant is laid, which grows with 
its growth and strengthens with its strength. This is no imaginary 
fear. There are safer and better anaesthetics in infantine convul- 106 
REPORT OF THE COMMITTEE ON THE 
sions than alcohol in any shape. Excellent results are claimed by 
Dr. Anstie for alcohol in some cases of tetanus. This treatment is 
familiar to every physician, and has long enjoyed a certain amount 
of vogue. Alcohol has, also, been given in hydrophobia and 'in 
snake poisoning in large and intoxicating doses with, in some cases, 
satisfactory effects. 
In the exhaustion and syncope from hemorrhage recourse is had 
to brandy*and kindred liquors in large doses, and often without 
due discrimination. When the hemorrhage has ceased, or in cases 
of exhaustion termed shock, from external injury or from mental 
cause, the desired reaction is obtained by a moderate quantity of 
strong alcoholic liquor. Dr. Young contests the propriety of giving 
alcohol under such circumstances, on the ground that this substance 
is not a stimulant to the heart, but rather an enfeebling agent and 
one that diminishes animal heat, as shown by the experiments of 
Dr. 1ST. S. Davis, of Chicago, and others previously named. Dr. 
Young from his own extensive experience, as surgeon in the army 
and in private practice, is led to believe that alcoholic liquors 
retard the reaction and increase depression, and he has, in conse- 
quence, long since avoided their administration. He substitutes 
for them hot coffee, hot teas, and hot broth, when obtainable, and 
he has been much better pleased with the effects of these beverages. 
For the long list of disorders of the digestive organs and those of 
the nervous system so often associated with and resulting from 
them, alcohol is freely prescribed, often thoughtlessly by the phy- 
sician, and still more freely drank, for the most part with appetite, 
but in ignorance, by the patient. The most obvious and abiding 
consequences of this extensive and uncalled-for practice are often 
aggravation of the disorders which it was meant to remove, and 
often, O how often, habits of intemperance in its varied and dis- 
tressing varieties, of which so many persons of all ages, ranks, and 
professions, and both sexes have been the victims. Many a drunk- 
ard, says Dr. Wood,1 owed a miserable death to the inconsiderate 
recommendation of a little brandy in dyspepsia. Whence, we 
would ask, comes the advice? where rests the responsibility? 
The evils are the more deplorable as they might easily have been 
prevented, for, it may be safely and truly said, that in all 
and nervous troubles there is not a pain or an ache or an unpleasant 
sensation, or depression of spirits, or wakefulness, that cannot be 
1 Therapeutics and Pharmacology, vol. i. 671-2. DELATIONS OF ALCOHOL TO MEDICINE. 
107 
relieved by other remedies and agents than alcohol, and their 
recurrence prevented by an amended system of dietetics, in which 
alcohol finds no place. A reform in this matter requires on the 
part of physicians when they become advisers^the exercise of 
thought, patience, firmness, knowledge, and sound ethics, which 
look to the consequences of an indulgence beyond the hour of its 
gratification. Medical men will be slow to admit that they are 
wanting in these requisites, for the exercise of which every com- 
munity must look hopefully to them more than to any other class. 
Ingenious paradox must yield to a plain statement of facts. Dr. 
Rush, speaking from his own extensive observation and experience, 
gives his warning when he tells us that “valetudinarians, especially 
those who labor under disorders of the stomach and bowels, are 
very apt to fly to spirits for relief. Let such people be cautious 
how they repeat this dangerous remedy. I have known many 
men and women of excellent character and principles who have 
been betrayed by occasional doses of gin or brandy to ease the 
colic, into a love of spirituous liquors, insomuch that they have 
afterwards fallen sacrifices to their fatal effects. The different pre- 
parations of opium are a thousand times more safe and innocent in 
all spasmodic affections of the stomach and bowels. So apprehen- 
sive am I of the danger of contracting a love for spirituous liquors, 
by accustoming the stomach to their stimulus, that I think the 
fewer medicines we exhibit in spirituous liquors the better.” 
Brandy, says Dr. Chambers in commending the remedies for 
eructation and vomiting, useful in teaspoonful doses in acute cases, 
is obviously not adapted for chronic disease. In our medical 
studies and reading we are too apt to skip the beginning in our 
eagerness to reach the great object before us, viz., the cure of disease. 
We are not fully aware of the fact, that it is of far more importance 
to know how to prevent than how to cure a disease, even.had we the 
power of always curing instead of being so often baffled in our at- 
tempts in this way. Prevention works on a large scale, therapeutics 
act on a limited number of individual cases. A careful study of 
the Materia Alimentaria ought to precede that of Materia Medica, 
and in that case the student would learn what are real alimentary 
principles and what are fictitious ones. He would see that water 
is a tVue primary alimentary and vital principle, indispensable in 
health and a safe ally in disease; it is restorative, exhilarating, 
strengthening, forming the larger part of the blood and other fluids 
and the tissues, entering freely into the organism and escaping as 108 
REPORT OF THE COMMITTEE ON THE 
freely, and not like alcohol which is introduced as an admitted 
stranger and hurried out like a smuggled article as rapidly as 
possible, and leaving behind it a very equivocal reputation if not 
positive proofs disorderly and destructive nature. Dr. Anstie, 
in the work already quoted, relates several cases of persons of both 
sexes who lived for a length of time on alcoholic drink, chiefly 
distilled spirits with a very slight addition of real solid food. One 
old man, eighty-three years of age, it is stated, had taken nothing 
for a number of years but gin to the amount of a bottle a day, with 
water and a small finger length of bread. The chief witness of 
the truth of the story in this case was the old man’s daughter, and 
we may be allowed to doubt its literal accuracy. No notice is 
taken of the quantity of water he was in the practice of drinking 
between his gin potations; and it must be remembered that absolute 
alcohol could not be drank at all without the addition to it of water, 
as we meet it in distilled spirits; it is still'alcoholized water that 
is taken, for in its pure state alcohol could not enter the circulation 
without its causing acute poisoning. It is to be deeply regretted 
that our profession at large is not more thoroughly imbued with 
the truth of the fact, acknowledged by some of the greatest names 
in medicine, that water is the most salutary and sustaining drink 
in health, and among the foremost remedies in disease. The 
“watery regimen,” which includes both the internal and external 
use of water, would furnish a theme for investigation by the 
American Medical Association most prolific of instruction in a 
hygienical as well as therapeutical point of view, and would prove 
the best corrective of alcoholic drinking that could be devised. 
The materials for the purpose are abundant. When a more active 
medicinal agency is required it will be readily found in the varied 
sanitary and curative constituents of the waters of mineral springs, 
combined in nature’s laboratory by nature’s pharmacy, and enabling 
us to meet nearly every indication for the cure of disease in every 
form.1 
1 The writer of the present report, at the approaching termination of a longlife 
of professional, and literary toil, may hope to escape the imputation of obtrusive 
vanity of authorship, if he refer now to some of his contributions to these subjects, 
as, for example, on Baths and the Watery Regimen, on Mineral Springs, etc. The 
British and Foreign Medico-Chirurgical Review, never lavish of its praise, sairf, soon 
after the first appearance of the volume on Baths, etc.: “ The work by Dr. Bell is 
the most complete monograph, we do not hesitate to say, ever issued from the 
press, and should find a place as a work of reference in the library of every prac- 
titioner.” RELATIONS OF ALCOHOL TO MEDICINE. 
109 
Little can be said in favor of alcohol in the treatment of chronic 
diseases. Too much is of necessity forced on our notice of its delete- 
rious agency in the production of many diseases of this class, as we 
have had occasion to indicate in this report, to allow of our putting 
any faith in its curative power under these circumstances. Some 
physicians have been sanguine enough, of late years, to believe 
that an exception favorable to alcohol will be found in its use in 
pulmonary consumption. It could hardly have been.supposed on 
any theoretical or indeed pathological grounds that a degradation 
of tissues and exhaustion from impeded and imperfect nutrition so 
often caused by alcohol, would be any protection against the for- 
mation of tubercle, or a means of restraining its growth in a sub- 
sequent stage. But such would seem in some cases to be the fact, 
looking at the not unfrequent exemption of drunkards from phthisis. 
It is going too far, however, to convert this escape into a general- 
proposition. Every practitioner must have met with consumptive 
drunkards; and it remains to be seen how far drunkards by their 
original constitution and temperament, and descent from non- 
phthisical parents might expect to escape from this disease, even 
while indulging in habits calculated to bring it on.* For the pre- 
sent we believe that the profession must accept the conclusions, 
reached by Dr. John Bell of New York in his elaborate Fiske Brize 
Essay.1 They are— 
1. That alcoholic drinks have a marked influence in preventing 
the deposit of tubercle, is destitute of any solid foundation. 
2. On the contrary, their use appears rather to predispose to- 
tubercular deposition. 
3. When tubercle already exists, alcohol has no obvious effect 
in modifying the usual course run by that substance. 
4. Neither does it mitigate in any considerable degree the mor- 
bid effects of tubercle upon the system in any stage of disease. 
Professor Davis’ observations have led him to a disbelief of the 
prophylactic power of alcohol to ward off phthisis. Apposite to the 
present argument, and in favor of the negative side, is the result 
of observations made by Dr. Marcet, of 695 out-door hospital pa- 
tients to ascertain the extent of the predisposition to diseases from 
alcohol. We made free use of this writer’s paper under our head 
of etiology, and among others of his conclusions which pointed to 
the fact of drinkers being much more predisposed to diseases of the 
1 Published in Am. Journ. Med. Sciences, 1859. 110 
REPORT OF THE COMMITTEE ON THE 
respiratory organs than those who are sober, and that this predis- 
position was still greater in laryngitis. We may now add, in ref- 
erence to particular employments, that drinking shop-keepers are 
much more predisposed to pulmonary affections than sober shop- 
keepers. A similar difference was observed between drinking 
engineers and sober engineers. 
Doctor Chambers holds the opinion (Lect. XXIII.) that alcohol is 
not only useless but injurious to the consumptive, excepting for 
its beneficial action upon the mucous membrane, as when added to 
cod-liver oil to enable this latter to be absorbed more rapidly. 
Alcohol, continues the lecturer, “ arrests and obstructs the vigor of 
vital action; by it growth is checked, as we see in animals artifici- 
ally kept small by dosing with alcohol in youth, without a suffi- 
cient supply of food, and in men who have early in life habitually 
indulged in ardent spirits. Under its use renewal goes on slower, 
as we know by the diminished excretion of urea, water, bile, etc, 
(see Dr. Boecker’s Experiments and Lecture L. in this volume), and we 
can hardly therefore expect it to be advantageous where the con- 
tinual renewal of vital powers is our primary object!” Sometimes 
where the alcohol, acting as an anesthetic, seems to check the dis- 
ease and relieve the symptoms, it “ has acted merely as a mask 
behind which the evil has gone on unawares.” The lightening of 
the symptoms “is merely a misty cloud of anesthesia which stands 
between the patient and his pain, and I doubt if life is prolonged.” 
How universally applicable are these remarks to the delusive ac- 
tion of alcohol in all chronic diseases! 
RECAPITULATION. 
It is very evident from the preceding statements, enforced as they 
are by diversified trials and experiments, that the habitual use of 
alcohol, in its various combinations of distilled and fermented 
liquors, is opposed to individual comfort and health, as well as to 
social order and progress, and is the fruitful source of a long list of 
diseases and crimes. 
The drinking of alcoholic or intoxicating liquors, so far from 
being followed by increased activity of respiration and increase of 
animal heat, has a directly contrary effect, by disturbing the res- 
piration and diminishing the temperature of the human body, and 
rendering it less able to bear the extremes of cold. This fact is 
proved by the unanimous experience of all Arctic explorers and RELATIONS OF ALCOHOL TO MEDICINE. 
111 
navigators, and of those persons who, as soldiers, travellers, and 
workmen, have been exposed to great and continued cold and 
vicissitudes of temperature. 
Fatigue and hardships of every kind, in all the varieties of season 
and climate, are better encountered by the drinkers of water alone 
than by the drinkers of any kind of alcoholic liquor, and especially 
of ardent spirits. 
The fervid heats of summer in our own climate and of the tropi- 
cal regions are best borne and fewer diseases incurred by those 
who follow out the watery regimen, to the exclusion of alcohol in 
any form. 
Alcohol interrupts digestion by precipitating and coagulating 
pepsin. It is in no sense a food or a condiment; it forms no ele- 
ment or constituent of the blood or tissues; it is an alien in the 
healthy living body, and to be eliminated as soon as possible; or, if 
retained, it becomes a source of textural degeneration and disease. 
A search for the oxides of alcohol must be entirely recommenced, 
and we are wanting in the very first principles necessary for a 
scientific theory of the metamorphosis of matter in the animal 
organism. 
Alcohol interferes with the processes of digestion and nutrition, 
and causes febrile disturbances in those who take their ordinary 
allowance of food, and in those also who indulge in excessive re- 
pletion. The young are the greatest sufferers in this way. 
Danger to valetudinarians who make use of alcoholic drinks or 
tinctures, as pointed out by Dr. Rush. 
Acetic acid, not alcohol, an aid to digestion. 
Common salt the universal condiment. 
Danger to youth in acquiring a habit of using intoxicating 
drinks. Protection, for life, by total abstinence. No man safe 
against the consequences of the habitual use of alcohol. 
Fallacy of regarding alcohol as accessory food. Alcohol pro- 
duces the greatest amount of harm when taken in small divided 
drams, and particularly when these are begun early in the day. 
The combination of alcohol in wine has little to recommend it 
over that in distilled spirits. Intemperance prevails to a great 
extent in wine countries. Danger to the youth of both sexes from 
drinking wine. Pictures of drunkenness from wine in France, by 
French writers. Great adulterations of wines of all kinds. Wine 
largely used for being distilled into brandy. Vineyards may still 
be encouraged for their supply of grapes, as an agreeable and 112 
REPORT OF THE COMMITTEE ON THE 
somewhat nutritive fruit. Their large and increasing use. Con- 
version into raisins. Vinegar the natural product of fermentation 
of the grape. Its sanitary uses as a condiment, and, when diluted, 
as a drink. 
Malt liquors convey very little nutriment, are adulterated largely 
in Great Britain, by the addition of many poisonous substances, 
the chief of which is Cocculus Indicus.—Franklin’s experience. 
Cider, an intoxicant, often causes colic and otherwise disturbed 
digestion; is mischievous by its being made to yield ardent spirits 
by distillation. 
Examples of the pernicious effects of alcohol, in those who drink 
it being less able to resist cold, and of the comparative immunity 
of water drinkers under such exposure. 
Alcohol shown to be equally powerless against heat. 
Proofs adduced by eminent medical men in the military service 
in the East and West Indies. 
Better health and discipline, and greater efficiency of sailors who 
abstain from alcohol. Always danger when it is used on board 
ship—case related by the reporter. 
Greater endurance of heat and fatigue by abstainers from alcohol 
who work in foundries, glass-blowing establishments, and the like. 
So it is with agricultural laborers. 
Alcohol imparts no bodily strength or mental vigor; training of 
the athletes and pugilists; injunction by the angel on the mother 
of Samson, that she, when pregnant, should abstain from wine and 
all strong drink ; the practice of the Roman legionaries, and of the 
Mohammedan conquerors. 
The brain, the organ of the mind, cannot perform its functions 
fully and regularly when poisoned by alcohol, even in small quan- 
tity, from day to day ; Newton a water-drinker ; other great names 
on the same list; testimony from personal experience in favor of 
total abstinence from alcohol, by the Rev. Sydney Smith, Dr. Miller, 
Princeton, and Professor Silliman. 
Immediate abstinence from alcohol safe. 
Social pleasures marred by alcohol, and increased by its disuse. 
Holidays, instead of being times of relaxation and enjoyment, are 
too often commemorative of disorder, tumult, and violence, under 
the influence of alcohol. 
Etiology.—Alcohol as a Cause of Disease.—Alcohol is not a 
nutritive food ; it contributes nothing towards the formation of RELATIONS OF ALCOHOL TO MEDICINE. 
113 
blood, and is in its nature always a poison. Gluttony is a vice, but 
it furnishes no excuse for drunkenness. 
Immense consumption of intoxicating liquors in the United 
States, and in Great Britain and Ireland. Loss of life and property, 
diseases, and loss of time and interruption to industrial pursuits in 
consequence. 
Alcohol shortens life; examples. Increased longevity by total 
abstinence. 
Organic lesions caused by alcohol, and its use predisposing to 
attacks of epidemic disease, and, also, of hereditary diseases. 
Alcohol acts on the stomach, alters its tissue, and interrupts its 
function. The brain is among the first of the suffering organs from 
the ingestion of alcohol. This fluid found in its substance, and 
in that of the other nervous centres. Diseases of the respiratory 
organs and of the liver are numerous from the use of alcohol. The 
same is to be said of the heart, which, like the liver, is changed by 
fatty degeneration. Textural changes in the kidneys from the use 
of alcohol—Bright’s disease. 
Dropsy, a common attendant on organic lesions of the heart, 
liver, or kidneys. 
Alcohol in the blood, poisoning the liver and kidneys. It in- 
creases the amount of fat in the blood, which is diminished in plastic 
material in delirium tremens, and contains at this time six to eight 
times more than common of fatty matter. 
Haemorrhoids always aggravated by the use of alcoholic liquors. 
Diseases enumerated by Dr. Bush as the result of drinking spirit- 
uous liquors. 
Albuminuria (Bright’s disease) a most impressive warning 
against the use of ardent spirits. 
The temperate soon becomes the intemperate use of alcoholic 
drinks. 
Diseases caused by wine—numerous and complicated—gout, 
rheumatism, cerebral disorders, gravel, and painful eruptions and 
boils of the skin. Promptly injurious effects in remote parts, pro- 
duced by drinking a fermented liquor. Cases by Mr. Crampton 
and Sir Anthony Carlisle. Entire disuse of distilled and fermented 
liquors. 
Gout, an effect of drinking fermented liquors, and especially 
wine. Great eating alone will not bring it oh. In a person with 
gouty diathesis, the use of these liquors is an abuse. Beer will 
bring on gout, and it ranks next to wine in this respect—cider acts 114 
REPORT OF THE COMMITTEE ON THE 
also as a predisponent to the disease—Butler’s verses on wine—In- 
sanity in France from the large use of wine—Juvenal’s satire. 
Diseases caused by beer—plethora and obesity, fatty degeneration. 
Malt-liquor drunkards in seven eases out of ten die of apoplexy 
or palsy; escaping these, they perish of dropsy or diseased liver. 
Inordinate quantity of malt liquor consumed. 
Alcoholic stimulants excite more readily the people of the 
United States than Europeans. The air itself more exciting, the 
Americans more mercurial and excitable. Observations of travellers 
on this point. Contrasted features of the gin and the beer drunkard, 
as painted by Hogarth. 
Colica pictonum caused by cider. 
All distilled spirits bad. No ground for the selection of one over 
another for drinking. 
Roesch of Urach denounces brandy as pernicious, both physically 
and morally. Wherein are other liquors of the distilled class any 
better ? 
Rheumatism caused by alcohol in distilled spirits and in fer- 
mented liquors—alcoholic rheumatism described by Higginbottom. 
Cases. 
A day of a genteel tippler, who is always alcoholized but never 
drunk. 
Colica pictonum from the use of distilled spirits. Delirium tre- 
mens, the most exact of all the alcoholimeters; ebrious ferocity; 
ebrious moroseness; ebrious hallucinations; dipsomania ; mania cra- 
pulosa vel ebriosa, or oinomania, showing itself often in an irresist- 
ible craving for alcoholic drinks. Chronic alcoholism. 
Proportion of the insane from alcoholic drink to the insane from 
all causes, in the Pennsylvania Hospital and in English asylums. 
Inherited insanity from drunken parents. 
Examples of hereditary degeneration. 
Alcohol an inciter to vice. Illustrations: fallen women. 
Results of observations by Dr. Marcet, showing the predispo- 
sition to a large number of diseases of different kinds caused by 
the habitual use of alcohol; by some to the extent of merely ex- 
hilarating, by others to cause drunkenness.—Inferences to be drawn 
for the prevention of diseases. 
Therapeutics.—Obstacles to a correct knowledge of the thera- 
peutical value of alcohol.—Misplaced association between debility 
and stimulus, and preconceived notions of the action and effects of 
alcohol in health. RELATIONS OF ALCOHOL TO MEDICINE. 
115 
Different hypotheses under which alcohol has been prescribed 
in disease, and especially in fever. 
Alcohol acts as a stimulus, a sedative, and a narcotic, according 
to the dose and the time that elapses after its ingestion, as well as 
the state of the system for which it is administered. 
Dr. Anstie’s views on stimulants and narcotics. 
His wise caution to prevent the prescription of alcohol in disease 
being made a reason or pretext for its being taken in health. 
Neither alcohol nor any medicinal stimulus can give power, or 
increase the vis vitse.—The excitement or reaction resulting from 
its use, if long kept up, exhausts rather than strengthens.—The 
restoration of power can only be brought about by means of the 
vital stimuli—food, air, water, and heat. 
Alcohol still occupies the foremost place in the opinion of many 
practitioners at the present time, in their treatment of fever. 
The practice of giving large doses of alcohol in continued fevers 
—typhus and typhoid—by Anstie.—Ilis test of its injurious or 
narcotic effects, where the dose has been beyond the wants of the 
case. 
Dr. Hughes Bennett’s treatment of fever, eclectic and moderately 
alcoholic. 
Dr. Wood recommends our beginning with the mildest form of 
alcoholic stimulants, such as wine whey, then wine, and have re- 
course to the strongest as increasing debility may seem to require. 
Alcoholic liquors useful in scarlatina, diphtheria, smallpox, and 
erysipelatous fever, when typhoid symptoms prevail, and in the 
advanced stage of inflammation. 
Dr. Gerhard has sometimes used stimulants in large doses in 
typhoid fever, but in many instances he considers them totally un- 
necessary.—In typhus fever some will require large doses; others 
will get well on small portions. 
Dr. J. F. Meigs has prescribed milk punch with benefit in severe 
and malignant remittent fever. 
Dr. Weeks, of Guy’s Hospital, says that fevers will do well 
without alcoholic stimulants. This is more particularly the case 
with young persons. They make good recoveries in the hospital 
on a simple milk diet. 
Immense amount of mischief done by stimulants, in the opinion 
of Dr. Weeks. 
Dr. Chambers uses alcohol under certain well-defined conditions, 
but does not think this article should rank as a part of the neces- 116 
REPORT OF THE COMMITTEE ON THE 
sary methodus medendi of fever.—Wine must never take the place 
of true restoratives.—Dr. Chambers regards the alcoholic as an 
exceptional mode of treatment in typhus fever, just as he does, the 
local abstraction of blood. 
Dr. Chambers’s plan of treating fever—properly eclectic—de- 
pleting while stimulating and nourishio^. 
Alleged febrifuge virtue of alcohol erroneous. 
Delirium tremens—variety of modes of treatment. 
Preference given to that which begins by an entire abstraction of 
alcohol from the patient. 
Alcohol in the phlegmasia.—Large doses in pneumonia given 
by Dr. Anstie.—Dr. Bennett’s very successful treatment by “ resto- 
ration.”—Contrasted modes of practice between that of the past 
and of the present generation in pneumonia. 
Dr. Chambers directs in pneumonia, cupping or leeching, a nutri- 
ent diet, and wine or other alcoholic at long intervals, as twice 
or thrice in the course of the day, and finally a jacket-poultice of 
linseed meal. He thinks no form of alcohol liquid so bad as beer. 
Pericarditis is treated by Dr. Anstie with repeated small doses of 
alcohol. Dr. Bennett treats his patients according to general 
principles, the same as when he prescribes for fevers and other 
phlegmasiae. Dr. Stokes relies on the free use of wine and brandy 
in fatty degeneration of the heart. 
Dr. Chambers’ judicious advice on the treatment of diseases of the 
heart. 
In epileptiform convulsions, and in the convulsions of teething, 
and in neuralgia, Dr. Anstie extols the use of alcohol. Risk from 
the use of this liquor becoming a habit with child and mother. 
Exhaustion from hemorrhage generally believed to call for the 
free use of alcohol. Dr. Young contests the propriety of this prac- 
tice. 
Little can be said in favor of alcohol in chronic diseases. 
Alcohol gives no protection to drunkards or the drinkers of 
intoxicating liquors against pulmonary consumption. Conclusions 
of Dr. John Bell, of New York, on this subject. Similar adverse 
opinion of Dr. Chambers. 
Danger of habits of intemperance being formed by the frequent 
use of alcohol in dyspepsia, and other disorders of the digestive 
system. Dr. Rush’s admonitions on this point. 
More important to know how to prevent than how to cure a 
disease. Value of the watery regimen. Reference to works on 
this subject by the reporter. RELATIONS OF ALCOHOL TO MEDICINE. 
117 
MEDICAL JURISPRUDENCE. 
In its Relations to Alcohol.—Alcohol introduces its customers to 
a great variety of places and company which are far from being 
of the most agreeable kind. It brings some to the station-house 
or lock-up, to spend the remainder of the night; some to the 
almshouse or to the prison, to spend there the remainder of their 
days; others are carried to the hospital; and others, again, to.a 
lunatic asylum. Some it introduces into courts of law, to have it 
determined how far a thoroughly alcoholized man is capable of 
continuing to take charge of his property, or is responsible for acts 
of fraud, or of violence on his fellow-creatures. These are ques- 
tions for medico-legal investigation, into which we cannot be 
expected to engage on the present occasion beyond a mention of 
some leading points. For a regular array of arguments and ap- 
plied cases, we would refer to the standard works on the subject.1 
As regards a drunkard’s tenure of property, reference may be 
made to a case cited by Lord Eldon, where a commission of lunacy 
was supported against a person who, when sober, was a very sen- 
sible man, but, being in a continual state of intoxication, he was 
incapable of managing his property. By the Roman law a noto- 
rious spendthrift was put under guardianship ; and by the law of 
Scotland, a man who from drunkenness, facility of temper, or any 
other cause, is liable to be stripped of his property by the necessi- 
tous or designing, has the power of putting himself under trustees, 
without whose sanction no act of his can be valid. This is techni- 
cally called inhibiting one's self. In the State of New York there 
is a statute which places the property of habitual drunkards under 
the care of the Chancellor, in the same manner as that of lunatics.2 
Any deed or agreement made by a party while drunk is not 
invalidated by the English law. 
Drunkenness is not held to be an excuse for homicide; or, 
stated in other words, “ insanity immediately produced by intoxi- 
cation does not destroy responsibility where the patient, when 
1 Medical Jurisprudence of Insanity, by I. Ray, M. D.; Elements of Medical 
Jurisprudence, by Theodoric Romeyn Beck, M. I)., and John B. Beck, M. I)., re- 
vised by C. R. Gilman, M. D.; Treatise on Medical Jurisprudence, by Francis 
Wharton and Moreton Stille, M. D., medical part revised and corrected by Alfred 
Stille, M. D. ; Medical Jurisprudence, by Alfred Taylor, M. D., with Notes and 
References by Clement B. Penrose. 
2 A similar law was passed in Pennsylvania in 1819, and in New Hampshire in 
1822. 118 
REPORT OF THE COMMITTEE ON THE 
sane and responsible, made bimself voluntarily intoxicated.” 
Drunkenness, so long as it does not prostrate the faculties, cannot 
be distinguished from any other kind of passion. There is still 
less excuse for the former state than the latter, inasmuch as in 
many, if not in all cases of murder committed by a drunkard, the 
guilty man wrought himself up to a state of mind to make him dare 
to do the deed by previous drinking to the extent of producing 
partial if not complete intoxication. The tenor of common and 
civil law to this effect is clear. Sir E. Coke most emphatically 
declares, that, "as for a drunkard, who is voluntarius demon, he 
hath, as been said, no privilege thereby; but what hurt or ill 
soever he doeth, his drunkenness doth aggravate it.” In our own 
day, Judge Parke, a very authoritative crown judge, said to a jury 
in 1833: "I must also tell you, if a man makes himself volunta- 
rily drunk, it is no excuse for any crime he may commit while he 
is so; he takes the consequences of his own voluntary act, or most 
crimes would go unpunished.” The law in our own country is 
that drunkenness is no defence to the fact of guilt; the only 
point about which there has been any fluctuation of opinion being 
the extent to which evidence of drunkenness is receivable to deter- 
mine the exactness of the intent, or the extent of deliberation. A 
person laboring under delirium tremens is declared to be irrespon- 
sible, as in this case drunkenness is the remote cause of what may 
be considered actual insanity. When delirium tremens is set up 
as a defence, the prisoner must show that he was under a delirium 
at the time the act was perpetrated. Judge Story has said : “The 
law looks to the immediate, and not the cause which remotely 
produced it. Many species of insanity arise remotely from what, 
in a moral point of view, is a criminal neglect or fault of the party; 
as from religious melancholy, undue exposure, extravagant pride, 
ambition, etc.; yet such insanity has always been deemed a suffi- 
cient excuse for any crime done under its influence.” The state of 
mind here represented must not for a moment be confounded with 
drunkenness per se. The same enlightened and learned judge just 
quoted tells us that insanity is not a competent excuse for crime, 
if it be committed “ while the party is in a fit of intoxication, and 
while it lasts.” Involuntary drunkenness, as where a person is 
ignorant of the readiness with which it may occur, or the mental 
disorder produced by it, or where he is made drunk by his com- 
panions, will be received as an excuse or in mitigation of criminal 
acts committed in this state. An irresistible propensity to exces- RELATIONS OF ALCOHOL TO MEDICINE. 
119 
sive drinking is to be regarded with some indulgence, and as not 
so much a cause of insanity as one of the first or preluding symp- 
toms of this disease. This propensity shows itself, and seeks for 
its indulgence at intervals, and in the paroxysms of drunkenness 
thus brought on, Esquirol looks on the person at the time as a true 
monomaniac, and not morally responsible. Crimes committed in 
the lucid intervals between these paroxysms, or of attacks of de- 
lirium tremens, do not stand excused on account of the state of 
mind of the prisoner during the actual disease. The following 
case in one of the New York courts bears on this point. Thomas 
Harty, the prisoner, was addicted to drinking spirituous liquors. 
He resided in Albany during the winter of 1832-3, and while 
there had several paroxysms of delirium tremens, which were of 
short duration. In the spring he removed to Troy. On the 31st 
of August he murdered his wife by a blow with an axe. He had 
for three weeks previous to this period exhibited no marks of 
insanity. Some ten days previous to the homicide he had ill- 
treated his wife, and for a few days she refused to live with him; 
but at length returned home. After the deed was done, his actions 
and conversation induced some persons to think he was insane. 
But the most intelligent individuals, who conversed with him, did 
not consider him so. And there was no proof of insanity or de- 
lirium tremens either on the morning on which he killed his wife 
or for several months before. He was executed for murder. 
The light in which the English law regards drunkenness, in rela- 
tion to responsibility for crime, is shown in the legal admissibility 
of confessions made in this state. In a particular case, the prisoner 
confessed, while drunk, that he had committed a robbery and mur- 
der, which had taken place some time before, but of which he had 
not been suspected. He mentioned a spot where the property of 
the murdered person had been concealed by him, and the whole 
of the circumstances of the murder. The property was found as 
he had described, and the case clearly brought home to him, chiefly 
by collateral evidence from his own confession. He was convicted. 
We have yet much to lgarn respecting the psychology of alco- 
holism, of which drunkenness is made the chief feature, but it is 
not always the most characteristic one. There is a condition of the 
qervous system, and a corresponding frame of mind, especially of 
the affective faculties in the habitual drinker, preceding and follow- 
ing a paroxysm, as it may be called, of drunkenness, which, if it 
does not bode mischief as much as this latter, is, notwithstanding, a 120 
RELATIONS OF ALCOHOL TO MEDICINE. 
perilous one both for its possessor and for other persons with whom 
he is brought in contact. Destructiveness and cornbativeness are 
more roused in a fit of drunkenness than at other times ; but the 
darker and more malignant passions of hatred, envy, revenge, 
cool and collected cruelty, and treachery, with an exalted but per- 
verted imagination, are at work under alcoholic promptings and 
poisoning, in a less demonstrative but more determined and per- 
sistent manner. In this poisoned and perverted state of feeling 
the most horrid crimes are committed; their perpetrators not re- 
quiring to be worked up to the pitch of intoxication, but impelled 
by some alleged mysterious influence—“ a voice from heaven,” “a 
spirit whispering to them,” etc. In their intercourse with those 
around them they are moody, sullen, and morose in manner, and 
scant in speech, as if absorbed in meditation. They are, in fact, 
less of free agents than the boisterous drunkard, and require as 
careful watching as the more distinctly recognized insane. 
JOHN BELL, 
Chairman of Committee and Pieporter. 
April 27th, 1868. 
Note.—With the abundant supply of matter and copious refer- 
ences, together with previous handling of the subject committed to 
him and his associates by the Association, the author, although going 
over much of the same ground with Dr. Carpenter, in his excellent 
Prize Essay on the “ Use and Abuse of Alcoholic Liquors in Health 
and Disease,” has not found it necessary to make the use of this 
work which, with more space at his disposal, he would otherwise 
have done. More than thirty-eight years have elapsed since the 
author first gave his own creed of total abstinence from all intoxi- 
cating liquors, and adduced a large bod}- of evidence in its favor in 
the Anniversary Report which he prepared and read for the Managers 
of the Pennsylvania Temperance Society, May 27th, 1831. From 
this document he has drawn freely on the present occasion. He has 
to regret not to have seen Dr. Wilson’s valuable work on the 
“ Pathology of Drunkenness.” The author has been allowed to intro- 
duce some additional facts into the report since it was first presented 
to the Association, at its meeting in New Orleans. Room could not 
be found in the volume of the Transactions for the Recapitulation, 
introduced in the extra copies of the Report. REPORT 
OP 
THE COMMITTEE 
ON THE 
RELATIONS OF ALCOHOL TO MEDICINE. 
BY 
JOHN BELL, M.D., 
CHAIRMAN. 
EXTRACTED PROM THE 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION. 
PHILADELPHIA: 
COLLINS, PRINTER, 105 JAYNE STREET. 
1869.