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Lecture.

THE USE AND ABUSE OF "STIMULANTS."
By W. JACKSON CUMMINS, M.D.,

PHYSICIAN TO THE CORK SOUTH INFIRMARY AND COUNTY GENERAL
HOSPITAL, EX-PRESIDENT CORK MEDICAL SOCIETY, ETC.
(A Lecture delivered before the "Cork Young Men's Association,"
January 7th, 1868.)

MR. PRESIDENT, LADIES, AND GENTLEMEN-The sub-
ject under our notice this evening-the Use and Abuse of
Stimulants-is a grave one. The more I have thought
about it, the more deeply have I become impressed with
its vast importance, and with the responsibility of my
position here as its exponent.

If the use of alcohol were forbidden in any part of the inspired pages, there would be an end to all argument on its behalf, even on the plea of urgent necessity, for the act of disobedience would in itself constitute it a sin, which stealing, and other breaches of the commandments of God; would take its place side by side with murder, lying, but after careful study, I am unable to find that any part of the inspired record can be legitimately strained into condemnation of the "use" of stimulants, although their "abuse" is denounced in no measured terms in both Old and New Testaments.

"In the week that ended on July 25, 4384 births and 4050 | The air has been dry. The difference between the mean dew deaths were registered in London and in 13 other large towns of point temperature and air temperature was 15-3 deg. The the United Kingdom. The annual rate of mortality was 33 per mean degree of humidity of the air was 59, and on two days 1000 persons living. The annual rate of mortality last week was Monday and Wednesday-it was as low as 49, complete 31 per 1000 in London, 22 in Edinburgh, and 23 in Dublin; saturation being represented by 100. Rain fell only on 25 in Bristol, 38 in Birmingham, 37 in Liverpool, 40 in Man- Wednesday to the amount of 0·01 in. The general direction chester, 35 in Salford, 39 in Sheffield, 40 in Bradford, 35 in of the wind was variable. Ozone was observed on every day Leeds, 34 in Hull, 26 in Newcastle-upon-Tyne, and 37 in except Sunday and Friday. According to a return furnished Glasgow. The rate in Vienna was 29 per 1000 during the by the engineer of the Metropolitan Board of Works week ending the 18th inst., when the mean temperature was the average daily quantity of sewage pumped into the River 0.9 Fahrenheit higher than in the same week in London, where Thames at the Southern Outfall Works, Crossness, was the rate was 27. The mortality from diarrhoea showed a fur- 45,822,141 gallons, or 208,191 cubic metres, equivalent to ther increase during last week in nearly all the large English about as many tons by weight." towns, and was at the annual rate of 4 per 1000 in Newcastleupon-Tyne, 6 in Bristol, 7 in London, 9 in Liverpool and Sheffield, 10 in Manchester and Salford, 11 in Hull, 12 in Leeds, and, highest, 14 per 1000 in Birmingham. In London the temperature in the shade rose to 96.6 deg. Fahrenheit, and the mean temperature of the week was 69.2 deg.; but there was no approach to these high temperatures in the other towns, the highest recorded in the shade being 916 deg., and the highest mean of the week 64.4 deg., both in Sheffield. It will be observed that in the English towns the lowest mortality from diarrhoea occurred in Newcastle, where the mean temperature of the week was only 60.3 deg., and lower than in any of the other towns. The deaths of 945 males and 940 females, in all 1885 persons, were registered in London during the week. It was the thirtieth week of the year, and the average number of deaths for that week is, with a correction for increase of population, 1575. The deaths in the present return exceed by 310 the estimated amount, and are more by 243 than the number recorded in the preceding week. The deaths from zymotic diseases were 800, the corrected average number being 631. Seven deaths from small-pox, 35 from measles, 47 from scarlatina, 10 from diphtheria, 45 from whooping-cough, and 57 from typhus were registered. Fifty-eight deaths by choleraic diarrhoea or summer cholera were registered in the week; 38 were children under one year of age, eight aged one year, one aged three years, and two aged five years. Four hundred and fortytwo persons died of diarrhoea, of whom 353 were children under one year of age, 49 were one year and less than two years, and 23 were of persons aged 20 years and upwards. The mortality from diarrhoea and choleraic diarrhoea or cholera differs little in the London waterfields. Eleven persons died of sunstroke. At the Royal Observatory, Greenwich, the mean height of the barometer in the week was 29.969 in. The barometrical reading increased from 29.83 in. at the beginning of the week to 29.94 in. by 9 A.M. on Monday, July 20; decreased to 29-86 in. by 3 P.M. on the same day; increased to 29.93 in. by 9 A.M. on Tuesday, July 21; decreased to 29.78 in. by 3 P.M. on Wednesday, July 22; increased to 30.25 in. by 9 A.M. on Friday, July 24, and decreased to 30-03 in. by the end of the week. The mean temperature of the air in the week was 69.2 deg., which is 7.6 deg. above the average of the same week in 50 years (as determined by Mr. Glaisher). The highest day temperature was 96'6 deg., on Wednesday, July 22. The lowest night temperature was 50-9 deg., on Friday, July 24. The entire range of temperature in the week was, therefore, 45-7 deg. On Wednesday, July 22, the maximum temperature of the air observed-viz., 96 6 deg., is a higher value than has been recorded at the Royal Observatory as far back as authentic record extends, and the mean temperature for the day, 77.9 deg., has only been exceeded on the following occasions:-On the 24th of July, 1818, when the mean temperature was 79-2 deg., and on the 15th, 18th, and 19th of July, in the year 1825, when the mean temperatures were respectively 79.1 deg., 78-2 deg., and 78.6 deg. The mean of the highest temperatures of the water of the Thames was 70·7 deg.; that of the lowest was 70.2 deg.

The sin lies in the abuse; and just as eating may degenerate into gluttony, or love into sensuality and idolatry, so may the use of both moral and physical stimulants, lawful in themselves, pass on into an excess which unfits for the responsible duties of life.

We must not, however, argue against the use of any thing because it may be abused, and herein lies the chief difficulty of combating the majority of sins into which mankind is prone to fall; for it is not always easy to draw the line of demarcation between use and abusea difficulty which is increased in the case of alcohol, by its different effects upon different constitutions, and by the treacherous tolerance of its immediate effects arising out of habit.

It has been truly said that "if alcohol were unknown, half the sin and three parts of the poverty and unhappiness in this world would disappear;" and if this be admitted, as I think it must be, by the most enthusiastic advocate of stimulants, no question of the day presses more urgently on the attention of the political economist, the statesman, the physician, the philanthropist, and the Christian minister; bearing, as it does, upon the social, political, and physical condition of man in the present, and upon the eternity for which this life is only a period of probation.

Alcoholic abuse is a monster evil which degrades and enslaves mankind, and limits human progress. It has been stated that2 60,000 lives are annually lost in Great Britain through its direct or indirect effects, and this terrible mortality is the least part of the evil which results to the nation from its favourite vice; for the moral and

1 Parkes on Hygiene."

2 "Alcohol, its Place and Power." By Professor Millar.

social effects of bad example, misery, and want, and still more, the impaired mental and physical condition handed down to posterity from generation to generation effect a degeneracy and degradation in the population which cannot be measured by figures.

The vice of alcoholic abuse is1 hereditarily transmissible and often leads to2 insanity after one or two generations. The child of a drunkard is generally a dipsomania by inheritance, his grandchild may inherit a tendency to epilepsy and insanity, while his great grandchild is liable to be an idiot, brutalized and destroyed by no fault of his own.3 The sins of fathers have thus been visited on their children to the third and fourth generation, and it is not easy to say how many a noble race has thus died out, or how many an historic name has thus become extinct. Most of the great sewers which drain the offscourings of mankind towards jails, workhouses, and hospitals-the cesspools, as they have been called, of humanity-are connected in one part or other of their course with strong drink, for crime, poverty, and disease follow hard and fast upon the footsteps of intemperance. Can we wonder then that to use the words of a late author4-"Divines have preached, legislature has enacted laws, sanitary philosophers and physicians have written, taught, and practised; temperance societies have laid down rules and administered pledges;" 66 'orators and oratresses have thundered;" "parents have whispered words of caution to the erring son"... have 'commanded, threatened, punished,' and as a last resource, prayed by his love for them, by his fear of disgrace, by his danger of losing reputation, by all his hopes for this world and the next, to give up the cursed indulgence." To all this I may add that even judges on the bench have, from time to time, reasoned with juvenile criminals, and earnestly endeavoured to put down this vice which limits our national greatness, brutalises our population, and threatens our institutions, and the only wonder is that even more has not been attempted, for the magnitude of the evil calls, trumpet-tongued, upon philanthropists to exert themselves. When a physician is called to prescribe for a disease, he first sets himself to ascertain, if possible, the cause of the symptoms presented by his patient, knowing that, as long as it continues in operation, he can do little more than palliate; just so, in seeking to remove a social evil, it is incumbent on us to seek out its cause.

Now those who are anxious to remove the great evil of alcoholic abuse, generally not satisfied with attributing it to habit growing out of the drinking customs of the people, and to a certain extent they are right, but would it not be better to go a step further back, and ascertain, if possible, the cause or causes of the drinking customs themselves?

It shall be my endeavour to do this, and I think I shall be able to show that they originate in our national character, and are closely connected with our institutions. But it may be said, and said truly, that the taste for wine and strong drink long preceded the Anglo-Saxon race, and the sources of its national intemperance, that the juice of the grape is intertwined with the earliest records and traditions, with the poetry and history of mankind, from its infancy to the present day.

Father Noah, we are told, had some prescience of sanitary law, and disdained to drink water because it contained organic impurity.5 The pretty German legend tells us that "an angel visiting the earth some time after the deluge, found the patriarch sitting at noon in the shadow of a figtree, looking very disconsolate. The angel inquired the cause of his grief. Noah replied that he was thirsty, and had nothing to drink.' 'Nothing to drink'! replied the angel. Look around! Do not the rains fall, and the rivers run, and is there not a spring of water bubbling up at thy cottage-door?' 'It is true,' replied Noah, smiting his breast, that there is abundance of water in which thy

1 "Morel. Quoted in Aitken's Practice of Medicine."

2 "Whitehead, Adams, Quoted in Aitken's Practice of Medicine." 3 "See History of Fourfold Transmission in Aitken's Practice of Medicine," vol. i., p. 145.

4 "Reformatories for Drunkards." By Dr. Belcher. 5 "Blackwood."

servant can bathe; but, alas! when I think of the multitude of strong men, of beautiful women, and of innocent children, and the countless hosts of animals that were drowned in the flood, the idea of water becomes distasteful, and my lips refuse to drink.' 'There is reason in what thou sayest,' replied the angel, and spreading his snowwhite wings, he flew up to heaven swift as a lightningflash; and while the eyes of Noah were still dazzled with the brightness of his presence, returned with some stocks of the vine, which he taught the grateful patriarch how to plant and tend, and when the fruit was ripe, to press it into wine. This," says the story, 66 was the source of all the beneficent and benevolent drinks which the world owes to the grape."

It is true that although the Anglo-Saxon race has developed intemperance into a master-passion, there have been drinking-customs from the very earliest times, and it is also true that their increase has often been coeval with the downfall of great dynasties. Nor is it to be wondered at that strong drink should have been enjoyed among all nations and at all times, for the sources of human imperfection and human exhaustion commenced at the fall, when mankind shared the curse pronounced on creation, and learned that "in the sweat of his brow he should eat bread." There was a time when our first parents lived in a condition of peace and contentment, surrounded by everything "pleasant to the eye, and good for food." The fresh, pure atmosphere of the virgin earth was untainted by the corruption of death; the spring, clear and sparkling, was presented to them in all its native purity and freedom from the germs of disease. Thus their perfect vitality was.stimulated, and thus was the warm and well-nourished blood kept circulating with vigour in its proper channels. Conscious of no exhaustion after the light duties of each day, they lay down amid earth's choicest gifts to enjoy calm and undisturbed repose, and awake, free from anxiety and care, to derive nourishment from everything "good for food." Let us pause and mark the contrast between man then and mankind now! Dwelling in a world subject to the curse, "thorns and thistles shall it bring forth," man himself labours under the edict which was thundered forth six thousand years ago, "In the sweat of thy brow shalt thou eat bread." The civilized earth has become a vast graveyard, full of impurities, which taint its waters and load its atmosphere with pestilential vapours. Over-crowded cities and over-populated countries swarm with anxious and careworn men and women, seeking-many of them in vainfor employment: suppliants for the work that "wins a meal," instead of being negotiators for a fair day's wages for a fair day's work-victims of excessive competition-illnourished and ill-requited-too often obliged to barter the hours of repose for less than the bare necessaries of lifeexisting rather than living-famishing, perhaps, and yet viewing other mortals wallowing in excess, and depriving themselves of the power to enjoy what their ample means can provide. Mental activity goes often hand in hand with physical decay, because the battle of life has been becoming harder and harder through succeeding generations. This is the age of mental and bodily activity, when men travel hundreds of miles in a few hours-when fortunes are made in a day, and lost in an hour-when news flashes in from the ends of the earth, creating a stir and a bustle, and a greed to be rich, and a national and individual competition, which keeps the energies of all who have anything to gain or to lose in a constant whirl of excitement-highpressure is placed on all classes of society, and even the rising generation has learned to live fast. Like a thoroughbred charger, champing the bit and pawing the ground, with nostril dilated, and every vein swelling with restless impatience, the young man of the nineteenth century chafes at restraint, and when once let free starts into convulsive life, and too often drives headlong into a mad and unreflecting career.

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Time was when "the morning stars sung together, and all the sons of God shouted for joy;" time is when the whole creation groaneth and travelleth in pain together."

Time was when the high physical condition of man ministered to complete and perfect enjoyment; time is when imperfect development, inadequate nutrition, unnatural wear and tear, and uneasy and insufficient repose, go hand in hand to make man restless and impatient in the present -ever-craving for that which flies from his grasp. What are the consequences of all these things? First. Exhaustion has become a common condition of poor and rich.

Secondly. Stimulants are greedily sought for; and third, we must make rules for men as they are, and not as we would wish them to be.

The more we examine into this subject, the more are conclusions such as these, drawn from a superficial and general view, confirmed; for there is a strange power of adaptation to circumstances and surrounding conditions in man, and a physiological law by which a bent given in a certain direction in one generation, may be taken up by the next, and still further developed. This gradual adaptation to circumstances and conditions, progressing through many generations, is a means of imparting national peculiarities to masses of men, and a variety of constitutions to individuals. It is well-known that a temperate climate such as that of our favoured land, generates energy of character, and, as a natural consequence, the rise of great cities, and the development of industrial pursuits; these, in their turn, bring men together into monster communities, and produce that over-competition, over-speculation, and over-activity, which I have described.

It is scarcely credible to what an extent the human race is thus deteriorated, for the causes of decay and exhaustion in large cities are almost as numerous as the houses.1 A committee of the Statistical Society of London, found in one lane in that modern Babylon only 90 bedsteads for 463 people, i.e., about one bed for five persons, while some rooms had 22 persons living in them, and2 Dr. Letheby, in reporting on the condition of the dwellings, says, that the air is not only "deficient in due proportion of oxygen, but contains three times the usual amount of carbonic acid," "blighting the existence of the rising population, rendering their hearts hopeless, their acts ruffianly and incestuous, and scattering the seeds for increase of crime." The inhabitants of great cities are not as much overworked since the passing of the Factory Act in 1802 as they were before that time, when we are told, "thes laws of nature were wholly disregarded, and hundreds of the most helpless and sensitive of beings were annually used up by their remorseless task-masters, only to have their places filled by fresh victims."

It would take generations to efface the effect on masses of men still living, of such an overstrain upon the physical and mental powers of their ancestors. But even to this day the sources of exhaustion among our people, and especially among children in manufacturing towns are almost incredible. The reports issued within the last few years (up to 1866) contain information which is most horrifying. Children of five, ten, and even three, are habitually overworked day and night, and denied the repose which exhausted nature requires; worked, too, sometimes in close confined atmospheres. Imagine girls of 10 years and upwards, in London and Manchester, kept at work 14, 15, and occasionally 18 hours a day, making artificial flowers in "dark" and "foted " rooms; or poor little girls in metal manufactories, blowing a bellows 14 hours a day, standing on a platform to enable their little hands to reach the handle; girls of nine and ten wielding sledge-hammers and forging iron-chains from morning till night. Such are a few, and scarcely the worst, out of many such frightful instances contained in the reports I have

alluded to.

No wonder these poor little creatures had never known 1 Quoted by Rev. Dr. Guthrie, appendix to "City, its Sins and

Sorrows."

2 Ibid.

3 Review in Blackwood on Parliamentary Reports on Children's Labour in Factories. 4 Ibid.

the gladsome gaiety of a spring morning in the green fields, and could not tell what flowers, fishes, birds, rivers, mountains, or seas were.

No wonder that girls of 12 years old, when asked, "what is a violet?" replied that "it is a pretty bird;" that " a primrose is a red-rose ;" that "a lilac is a bird," and were unable to tell whether a robin redbreast or an eagle were birds. Is it not horrible to think that children with such necessarily degenerate constitutions and minds, should become the fathers and mothers of our population? "Do ye hear the children weeping, O my brothers, Ere the sorrow comes with years? They are leaning their young heads against their mothers, And that cannot stop their tears. The young lambs are bleating in the meadows, The young birds are chirping in the nest, The young fawns are playing with the shadows, The young flowers are blooming towards the westBut the young, young, children, O my brothers, They are weeping bitterly. They are weeping in the play-time of the others, In the country of the free.

'For oh!' say the children, we are weary,

And cannot run or leap,

If we cared for any meadows, it were merely to drop down in them, and sleep;

Our knees tremble sorely in the stooping,

We fall upon our faces trying to go;

And underneath our heavy eyelids drooping,
The reddest flower would look as pale as snow;
For all day we drag our burden, tiring
Through the coal-dark underground,
Or, all day we drive the wheels of iron,

In the factories round and round.'" 1

Can we wonder that our people crave for anything which affords even temporary relief from such exhaustion as they acquire and inherit, and that drinking customs prevail?

The same reports tell also of dreadful overwork of children in agricultural districts, and we all know that want of proper nutriment is a fertile source of exhaustion among country labourers, especially in Ireland.

"The child is father to the man," and if a child is overworked or insufficiently sustained during the period when mind and body are undergoing development, its manhood will never acquire full vigour, its constitution will always be below par, and it will be ready to grasp at any stimu lant which affords even a temporary and treacherous power to sustain the burden of life.

Hours might be spent in detailing the many sources of exhaustion among the lower orders of our overgrown cities which lead them to intemperance, but as the time at our disposal is brief, I shall pass on to the middle and upper classes, upon whom the great pressing necessity for toil through day and night does not fall.

But the Anglo-Saxon is the same in labour, in business, or in pleasure; his energy of character leads him to impose exorbitant exactions upon the poor material frame, and to deny it the repose which exhausted nature demands. Ambition lures on the middle class to exhaustion, to stimu lation, and through it to premature decay, which is handed down to posterity, almost as surely as absolute necessity does the lower orders. Our statesmen, our divines, our physicians, our lawyers, our men of business, are continually exhausting their energies by over work, while both middle and upper classes follow pleasure and excitement with such eagerness, that exhaustion speedily follows and leads to "habitual tippling."

A late writer upon the increase of inebriety among the upper classes says "Almost everyone can plead medical advice as the beginning of the habit," but the truth is (as hinted in an article which I lately saw in one of the newspapers) that ambitious mothers, angling for earls, and viscounts, and eldest sons for their daughters, carry them, nothing loath, of course, to balls and routes, kettledrums, and dinner parties, night after night, with little intermission, through a London, Paris, and Brighton seasonexcitement after excitement-exertion after exertion

night turned into day from year's end to year's end. This sort of dissipation soon leads its victims to "galvanize” 1 Poetry, by Elizabeth Barrett Browning.

2 Pall-Mall Gazette.

him the vitality of the sufferer engaged in mortal conflict with a deadly foe, and instead of drawing away the life blood, and starving out the garrison, he throws in supplies through every available channel, and assists nature to expel her enemy in her own way. Food thus becomes the the digestive organs generally share in the general depression of the system induced by disease, and cannot further those chemico-vital operations through which food has to pass before it can be changed into vital force.

their exhausted energies into some show of vitality with champagne and sparkling Moselle, and when exhaustion has gone beyond a certain limit, to send for a doctor to sanction the use of brandy. This is, perhaps, prescribed at regular intervals, in moderate quantities, and to carry out the prescription accurately, the bottle is taken to the bed-most important ally of the physician; but unfortunately room; private drinking thus commences, the habit is formed, and before the victim is well aware of the precipice which yawns before her, she has fallen from all that was lovely and refined in a British maiden, and becomes a candidate for admission to one of those asylums for female inebriates which shock the readers of newspaper advertise

ments.

It is under these circumstances that alcohol, which is directly absorbed by the veins of the stomach, and enters the circulation in a few moments, becomes all-powerful, and by a fourfold operation, conducts many a sick man past the very jaws of death to a renewal of life.

The human frame is not one that can bear habitual disregard of its requirements, or habitual trifling with its complicated mechanism. There is a limit to its power of adapting It is a question still under debate whether alcohol is itself to circumstances, which, when reached, everything | food or not,1 recent experiments would lead us to believe begins to go wrong, and disease is the result. The chemico- that it is so, although, even as a hydro-carbon, it is much vital operations momentarily taking place in the body re-inferior to sugar, starch, or oil; but its action in disease quire for their performance a perfect adjustment of func- is quite independent of any such assumed power, for tion and structure, which brooks no interference with even if it be admitted that it adds no real force to the impunity. Each thought, each movement, implies a waste system, it undoubtedly calls latent force into action through of the cell structure of the body; albuminous food is its primary influence on the languishing nerves. Just as necessary to repair the breach caused by every bodily or in one of those boat-races which attract the eager and inmental development of force, while hydro-carbons, such terested spectators of manly feats, emulation, ambition, as sugar, starch, and oil, supply material for the combus- hope, and a ringing cheer for the university, without addtion which maintains animal heat. Oxygen must be received ing anything to the power of jib, freshman, or fellow in due quantity at the lungs, and applied to further the commoner, stir up the latent energy, and put on the spurt changes which must take place in the debris of the struc- which drives them in to victory, outdoing themselves as tures before they can be cast out of the system. If the well as their competitors; just so alcohol spurs the visbalance between waste and nutrition is equally kept up, nervosa, and tides over the critical, and what without it and sufficient repose enjoyed to enable each part of the would often prove the fatal day. But it does more than body in its diurnal revolution to recover itself after exer- this, for it tends also to rouse the dormant power of digestion; if exercise of the moral, social, intellectual, and tion, secretion, and excretion, so that food may be again religious faculties accords with the amount of ability, assimilated, and poisons expelled from the blood. Further, physical and mental, which each man possesses, then life in most acute diseases, a rapid oxygenation is consuming ought to run on in an uninterrupted stream, and terminate the tissues, maintaining febrile heat, and burning off the painlessly after a peaceful old age. But the stormy life of supplies of life's garrison, this alcohol tends to check, for, adversity and toil, the vicious pursuit of sensational ex- in common with all hydro-carbons, it has a powerful affinity citement, the accidents to which all are liable, and the for oxygen, and by appropriating that element to itself, unnatural customs of civilised man, interrupt the course of makes a diversion in favour of vitality, and economises exlife, disturb the equilibrium of the system, and give rise to isting supplies; this latter object is also effected through diseased conditions of mind and body. the secondary narcotic action of alcohol. Thus, as I said before, alcohol is a medicine of fourfold operation in discase, and expended as it is in accomplishing the purposes for which it is given, it does not intoxicate, and may be consumed with safety in much larger quantities than in health. Just as the boiler of a steam-engine is safe while the locomotive moves freely along the rails, and the mighty force within is expended in propelling the ponderous mass, but bursts if the machinery is arrested, unless the safety-valve permits it to escape; so when the system is below par, alcohol expends its force in raising it to par, and when too rapid oxygenation is consuming the tissues, the hydro-carbon, by diverting oxygen to itself, preserves the structures from excessive waste. But how different its effect in health, especially during youth, when the func tions are habitually above par for purposes of growth and development, and when oxygen, the great purifier, is more especially required to perfect the ceaseless changes on which rapid motion depends! Then alcohol creates a morbid excitement which is followed by a corresponding depression; that depression necessitates a further supply of the stimulant--a hair of the biting dog-as the saying is, for its cure. This affords temporary relief, but at what a price for still greater depression soon steals over the victim, and in time an instinctive craving for alcohol is established, as strong as hunger, as uncontrollable as thirst. A revolution has taken place in the nutrition of the body, and every microscopic cell of the millions which compose its tissues and organs thirsts for alcohol, instead of hungering for food.

Two great sources of vitality exist in every human being, generating voluntary and involuntary force, the one presiding over thought and action, the other over the more directly animal functions. It would seem that one of these may be developed at the expense of the other, so that with apparent physical force there may be low animal power.

It may be that the prodigions exertions in thought and deed of the men of this generation have developed their brains and voluntary muscles at the expense of those internal organs which support animal life, but, however that may be, certain it is that a condition of low vitality marks the generation, and becomes apparent when accident or disease have disturbed the harmonious co-operation of the various functions of life. It was not without reason that St. Paul wrote to the overworked Bishop of the early Church, "Use a little wine for thy stomach's sake, and thine often infirmities," for the labour of organising a new Church amid prejudice and persecution must have been most exhausting. But although this first recorded prescription of alcohol as a medicine proceeded from such a high, moral, and religious authority, there are well-intentioned men mistaken enough to carry their extreme teetotalism even to the bed of sickness.

Physiology and chemistry, aided by modern appliances for discovering and analyzing vital operations, have of late years explained many things which our ancestors considered mysterious, and have thus gradually affected a change in the practice of the healing art. Now, instead of blindly groping after specifics by which to cure disease, and thwart nature, the physician often has to recognize in the paroxysm of disease, an effort of the system to free itself from something which, generated within, or received from without, is opposed to its operations; he sees before

(To be continued.)

1 See experiments by Dr. A. Fick and Dr. J. Wislicenus, quoted in

Dr. Letheby's 2nd Cantor Lecture on Food, MEDICAL PRESS AND CIR CULAR, February 26, 1868. (The author is unable to refer to the paper in which he first read these experiments.)

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THE anatomico-pathological phenomena were in general the same as have been observed and described by others. The animals experimented on were rabbits, whose stomachs are almost always filled with tolerably consistent ingesta. The mucous membrane of the stomach was often entirely intact, which, perhaps, depended partly on the fact that the granules of phosphorus, divided in the food, did not always come in contact with the wall of the stomach. Sometimes circumscribed hyperæmias and ecchymoses were met with; never ulcerations. The mucous membrane of the duodenum was usually also swollen; sometimes it was suffused with blood, but never ulcerated. The jaundice, which is so constantly observed in phosphorus poisoning, must therefore be regarded as gastroduodenal (as which, moreover, Munk and Leyden considered it) if it should be shown that a similar affection of the duodenal mucous membrane occurs also in men after poisoning with phosphorus. A peculiar alteration of the cells in the pepsinglands in the stomach, observed by Virchow, was seen by Bamberger only once in his animals. The rapid occurrence of fatty degeneration of some organs, which was often demonstrable even after two or three days, was always striking. The liver frequently consisted, as it were, of a single fatty mass, so that scarcely an hepatic cell was discoverable which did not contain drops of fat. The kidneys were also in a state of advanced fatty degeneration; they were large, of a yellowish appear ance. The urinary canals in the cortical substance were quite filled with fat. The epithelium was, for the most part, in a state of degeneration, and was loaded with fat. The pyramids were less degenerated.

This degeneration gave Bamberger the idea of a passive process. He could scarcely look upon it as active. In the muscular structure of the heart the transverse striæ were indistinct, or entirely wanting. The fibrille were studded throughout with drops of fat. In almost all the organs hæmorrhages or petechiae were met with. They were particularly numerous in the lower lobes of the lungs.

To demonstrate the presence of phosphorus in the blood, he took at different times blood from various parts of the vascular system, as from the carotid artery, the inferior vena cava, and the vena porta. The first experiments were negative. It soon appeared, however, that this negative result depended on defects in the method of investigation; for, as phosphorus in the form of vapour is very volatile, it might be volatilized even in the preparatory manipulations. In the examination of the parenchymatous organs this must take place to a still higher degree, as, for the sake of investigation, they must be introduced into the vessel in small pieces, and must therefore in every case remain long in contact with the air, whereby evaporation and oxidation are favoured. To avoid this Bamberger introduced a small glass tube into the vessel from which the blood was to be taken, connected this with an Indian-rubber tube, into which, again, a bent glass tube was inserted; this last was conducted into a receiver containing a solution of sulphate of soda, to prevent the coagulation of the blood. In this mode the blood drawn scarcely came into contact with the atmosphere, and Bamberger then succeeded in demonstrating the presence of phosphorus in the blood from the vena cava, beyond the junction of the hepatic veins, which must there fore have passed unchanged through the capillary system of the liver. On the other hand, it was not possible, after the internal administration of phosphorus, to demonstrate its presence beyond the pulmonary circulation in the blood from the carotid, but if the phosphorus, dissolved in oil, was injected subcutaneously, it could be demonstrated in the blood from the carotid-a proof that it can pass, partly unchanged, even through the capillary system of the lungs.

of phosphorus there formed comes by diffusion unchanged into the mass of the blood (as the volatilization of phosphorus takes place with tolerable activity at the ordinary temperature, it must be decidedly favoured by the higher temperature of the stomach). Once taken into the blood, it circulates with the latter, becomes gradually oxidized by its oxygen, but at the same time produces essential changes in the organs.

This condition of the phosphorus in the system having been discovered, the question remains as to the fatty degeneration of the organs. This process is allied most closely to the acute yellow atrophy of the liver, though in phosphorus poisoning the fatty change is much more rapidly established. In this case a specific effect of phosphorus suggests itself, and we must distinguish between many possibilities. It is well-known that phosphorus dissolves in fats and oils; as the blood contains from one to three parts of fat in a thousand, it was conceivable that the phosphorus dissolved in this fat, was separated with it, and thus caused the fatty infiltration of the organs. Or it might be assumed that the albuminous bodies of the blood were, under the influence of the phosphorus, transformed into fat, as under some circumstances a metamorphosis of albumen into fat is observed; or, finally, the metamorphosis of the fat of the body might be hindered in one mode or another. In the first case the blood would become impoverished in fat; in the second and third cases an excess of fat must be met with. To discover the true state of the case Bamberger instituted some experi ments upon rabbits.

In the first place the amount of fat in the blood was ascer tained in two healthy rabbits, and in one it was found to be 2-656, in the other 1041 per mille; thus there are considerable differences even in the healthy state, as Becquerel established in man also a variation from 10 to 3.3 in health.

Further, the amount of fat in the blood of a rabbit which had fasted for a long time was estimated, and found to be 2087-this result is nearly the mean of the first two values. (This experiment was necessary, as the rabbits to which phos phorus is administered for several days do not take any nourishment).

Lastly, the fat was estimated in two rabbits, one of which had in four days got 40 mgrm. of phosphorus, in it 1·322 of fat was found; the other had in five days used 50 mgrm. of phosphorus, and the amount of fat in the blood was 0.891.

A diminution of the amount of fat was therefore demonstrable, but it does not appear to be so considerable as to be available for any definite theory; such a diminution might be explained, also, by other causes than the administration of phosphorus. In no case was there any increase of the amount of fat. It may, therefore, be assumed, that the phosphorus taken up into the blood effects such a change in the latter, that it be comes quite unsuitable for the nutrition of the organs, and that therefore the several organs fall into a state of retrogressive fatty metamorphosis, an acute marasmus, or it may be assumed that phosphorus supplied to the several organs, produces a new formation of fat in them. Bamberger, however, considered the first alternative to be the more likely.

If the mode of action of the phosphorus were once ascer tained, it would seem to be important to discover a suitable mode of treatment.

If phosphorus in the state of vapour has passed into the blood in large quantity, we can scarcely expect anything from medical treatment; at the most, transfusion might be tried, just as it has been employed, with some advantage, in poisoning with carbonic oxide. If in any given case it be probable that phosphorus still exists in the stomach, vomiting ought in every instance to be produced, though emetics are often of little use, as the particles of phosphorus adhere rather firmly to the wall of the stomach, and this organ does not always contract completely. The treatment now employed, consisting in the administration of magnesia, is scarcely of any use; for magnesia can act only as an alkali against the products of the oxidation of the phosphorus, by neutralising them, but these are to be considered as not injurious to the stomach.

Duflos proposed another method, namely, to give oxidizing bodies, and he recommended liquor chlori with magnesia usta, it was intended thus to hasten the oxidation of the phos phorus, and that the products should combine with the magnesia. Some assert that they have seen favourable results from this plan, others say that death has been at least postponed by it; most observers saw no result from it. Practically, we can scarcely promise much from this method, as the preparations of chlorine decompose so rapidly. As phos

From these experiments Bamberger came to the conclusion that phosphorus volatilizes in the stomach, and that the vapourphorus acts in the system in the form of vapour, it is an object

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