supposed morbid conditions, for which alcoholic remedies are prescribed by the enlighted part of the profession. One of these is that popularly prevalent condition of exhaustion or impairment from overwork, mental or physical, or from excessive drains by nursing or unnatural discharges. It is in this large class of half-invalids that the moderate daily use of beer, ale, wine, and occasionally stronger alcoholic drinks is prescribed, on the plea that their power to retard the waste tissues is conservative and equivalent to the addition of new matter by assimilation, the utter fallacy of which we have already indicated with sufficient clearness. The other morbid condition for which these agents are very generally prescribed is that weakness of the heart sometimes met with in low forms of fever and in the advanced stage of other acute diseases. It is claimed that alcohol is capable of strengthening and sustaining the action of the heart under the circumstances just named, and also under the first depressing influence of severe shock. There is nothing in the ascertained physiological action of alcohol on the human system, as developed by a wide range of experimental investigation, to sustain this claim. Indeed, it is difficult to conceive how it is possible that an agent which so plainly and directly diminishes nerve sensibility and voluntary muscular action can at the same time I have used the sphygmograph and act as a cordial or heart-tonic. every other available means for testing experimentally the effects of alcohol upon the action of the heart and blood-vessels generally, but have failed in every instance to get proof of any increased force of cardiac action. The first and very transient effect is generally increased frequency of beat, followed immediately by dilatation of the peripheral vessels from impaired vaso-motor sensibility and the same unsteady or wavy sphygmographic tracing as is given in typhoid fever, and which is usually regarded as evidence of cardiac debility. Sometimes when the doses of alcohol are increased to the extent of decided anæsthesia the heart acts slower and the arteries have more volume from the increased obstruction to the movement of the blood through the capillaries and smaller vessels, and the diminished oxygenation and decarbonization of the blood in the lungs. Turning from the field of experimentation to the sick-room, my search for evidences of the power of alcohol to sustain the force of the heart or in any way to strengthen the patient the has been equally unsuccessful. I was educated and entered practice of medicine at a time when alcoholic drinks were universally regarded as stimulating and heat-producing in their influence on the human system, and commenced their use without prejudice or preconceived notions. But the first ten years of direct clinical or practical upon ALCOHOLIC REMEDIES A CONCESSION TO PREJUDICE. 135 observation satisfied me fully of the incorrectness of those views, and very nearly banished the use of these agents from my list of remedies. And while it is true that during the last thirty years I have not prescribed for internal use the aggregate amount of one quart of any kind of fermented or distilled drinks, either in private or hospital practice, yet I have continued to have abundant opportunities for observing the effects of these agents as given by others with whom I have been in council; and simple truth compels me to say that I have never yet seen a case in which the use of alcoholic drinks either increased the force of the heart's action or strengthened the patient beyond the first thirty minutes after it was swallowed. But I could detail very many cases in which the free administration of alcoholic remedies was quieting the patient's restlessness, enfeebling the capillary and peripheral circulation, and steadily favoring increased passive or hypostatic engorgements of the lungs and other internal viscera, and thereby hastening a fatal result, where both attending physicians and friends thought they were the only agents that were keeping the patient alive. Yet, persuading the abandonment of their use and the substitution of simple nourishment, aided by such nerveexcitants as tea, coffee, carbonate of ammonia, camphor, strychnia, etc., judiciously administered, instead of further prostration or sinking in consequence of such withdrawal, there has generally been a slow but steady improvement in all cases where improvement was possible, and in no case has it been found necessary or advisable to return to the use of the alcoholic articles after they had been abandoned. If I am asked why, under such a statement of facts, the profession continues to prescribe these drinks, I answer, simply from the force of habit and traditional education, coupled with a reluctance to risk the experiment of omitting them while the general popular notions sanction their use. Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of patients and friends something must be done. A little wine or brandy is given, and, as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither wine nor brandy had been used. Of course both doctor and friends will regard the so-called stimulant as the cause of the recovery. So, too, when patients are getting weak, in the advanced stage of fever or some other self-limited disease, an abundance of nourishment is regularly administered, in the greater part of which is mixed some kind of alcoholic drink. The latter will always occupy the chief attention, and if, after a severe run, the fever or disease finally disappears it will be said that the patient was sustained or "kept alive" for over two or three weeks, as the case may be, "solely by the stimulants," when, in fact, if the same nourishment and care had been given without a drop of alcohol he would have convalesced sooner and more perfectly, as I have seen demonstrated a thousand times during the last thirty years. Indeed, if any one will take the trouble to examine and analyze carefully the records of the large general hospitals of both Europe and America, for the last half century, I venture the statement that the ratio of mortality from general fevers and acute diseases will be found to have increased, pari passu, with the increase in the quantity of alcoholic drinks consumed in their treatment. A similar examination of the vital statistics of different nations and communities will show a close relation between the relative mortality from consumption, scrofula, apoplexy, paralysis, and hepatic, cardiac and renal dropsies and the amount of alcoholic drinks consumed by the people. I believe there is no better authority in any country upon the subject of alcoholism than Dr. William Hargreaves of Philadelphia. There is no branch of it with which he is not become familiar by long and profound investigation, while his conservative and conscientious character joined with experience in his profession both in war and peace, unite to give weight to his opinions. His great works, "Alcohol and Man" and "Alcohol and Science," are two vast arsenals furnished with every weapon for the destruction of the liquor traffic. I insert his entire communication. PHILADELPHIA, PA., July 16, 1887. Respected Sir:-Yours of June 25th was duly received, asking my opinion, Whether on man alcohol was a poison or a food? and under what circumstances, if any, is it useful, necessary or indispensable ? For more than fifty years, as boy, man, medical student, and medical practitioner of over twenty-five years, I have read, investigated and endeavored to obtain by observation, experiments and other means all the knowledge obtainable of the nature and effects of alcohol. My own views of the subject, and others, are given in a limited extent in my two works," Alcohol and Science " and " Alcohol and Man," but I will answer your questions as concisely as I can, and refer you to the above-named books for a more extended and particular account of the Nature and Effects of Alcohol upon the human body and mind. Hoping the inclosed statement and opinions will be of service to you and the cause of Truth, Science and Humanity, believe me Your very obedient servant, Hon. HENRY W. BLAIR, U. S. Senate, Washington, D. C. WM. HARGREAVES, M. D. |