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tissue, no organic mechanism. Passive them-
selves, they nevertheless separate all structures
into their respective positions and adaptations.

The animal receives from the vegetable world
and from the earth the food and drink it requires
for its sustenance and motion. It receives colloidal
food for its muscles ; combustible food for its mo-
tion ; water for the solution of its various parts ;
salt for constructive and other physical purposes.



The Animal Membranes. 151

These have all to be arranged in the body ; and they
are arranged by means of the membranous envel-
opes. Through these membranes nothing can pass
that is not for the time in a state of aqueous solu-
tion like water or soluble salts. Water passes freely
through them, salts pass freely through them, but
the constructive matter of the active parts that ic
colloidal does not pass ; it is retained in them until it
is chemically decomposed into the soluble type of
matter. When we take for our food a portion of
animal flesh, it is first resolved, in digestion, into a
soluble fluid before it can be absorbed ; in the blood
it is resolved into the fluid colloidal condition ; in
the solids it is laid down within the membranes
into new structure, and when it has played its part
it is digested again, if I may so say, into a crystal-
loidal soluble substance -ready to be carried away
and replaced by addition of new matter, then it is
dialysed or passed through the membranes into
the blood, and is disposed of in the excretions.

See then what an all-important part these mem-
branous structures play in the animal life. Upon
their integrity all the .silent work of the building
up of the body depends. If these membranes are
rendered too porous, and let out the colloidal fluids
of the blood the albumen for example the body
so circumstanced dies ; dies as if it were slowly
bled to death. If,- on the contrary, they become
condensed or thickened, or loaded with foreign
material, then they fail to allow the natural fluids
to pass through them. They fail to dialyse, and
the result is, either an accumulation of the fluid in
a closed cavky, or contraction of the substance



152 On Alcohol.

enclosed within the membrane, or dryness of mem.
brane in surfaces that ought to be*freely lubricated
and kept apart. In old age we see the effects of
modification of membrane naturally induced ; we
see the fixed joint, the shrunken and feeble muscle,
the dimmed eye, the deaf ear, the enfeebled nervous
function.

It may possibly seem at first sight that I am
leading immediately away from the subject of the
secondary action of alcohol. It is not so. I am
leading directly to it. Upon all these membranous
structures alcohol exerts a direct perversion of
action. It produces in them a thickening, a shrink-
ing, an'd an inactivity that reduces their functional
power. That they may work rapidly and equally
they require to be at all times charged with water to
saturation. If into contact with them any agent
is brought that deprives them of water, then is their
work interfered with ; they cease to separate the
saline constituents properly, and, if the evil that is
thus started be allowed to continue, they contract
upon their contained matter in whatever organ it
may be situated, and condense it.

In brief, under the prolonged influence of alco-
hol those changes which take place from it in the
blood corpuscles, and which have already been
described, extend to the other organic parts, in-
volving them in structural deteriorations, which
are always dangerous, and are often ultimately
fetal.

PRIMARY EFFECTS ON* VITAL FUNCTIONS.

I remarked in my last lecture that the slow or



Effects on Vital Functions. 153

chronic effect of alcoholic drink upon the body
was to induce a series of stages analogous in all
respects, except in period of duration, to the process
of acute poisoning by the same agent. In the first
prolonged stage there occur phenomena of disease
which are as characteristic of the agency, when it
is known, as they are deceptive when the agency
is not known.

The ultimate changes that follow the use of alco-
hol by those who indulge in it, in what is too often
considered a temperate degree, are actual local
changes within one or other of the vital organs.
But before such actual deterioration obtains there
are usually other phenomena transitory in character
yet unequivocal. I pointed out certain of these in
the last lecture, but I did not specify them all.

In addition to that irritation of mind and suffer-
ing " of wounds without cause," to which I then
drew attention, an extreme emotional derangement
is often produced. The afflicted man and I fear
I must say woman also, for women are sometimes
afflicted the afflicted man under this primary
prolonged influence of alcohol becomes nervous
and excitable, ready at any moment to cry or to
laugh, without valid reasons for either act. The
emotional centres are alternately raised and de-
pressed in function by the poison, but after a time
the depression overcomes the exhilaration, and the
impulse is to a maudlin sentimentality extending
even to tears. The slightest anxieties are then ex-
aggerated, and there is experienced at the same
time an indecision and deficiency of self-confidence
which is doubly perplexing. When an act is done



154 On Alcohol.

when a letter, for instance, or other piece of business
has been finished and despatched, an uneasy feeling
of distrust is felt that perhaps some mistake has
been made, which distrust passes rapidly into a
sentiment that the thing cannot be helped ; it is
bad luck, but it must take its chance. In various
other directions this distrust shows itself, and the
worst of all is, that the very doubt prompts the
desire for another application for relief to the evil
that is the cause of the burthen. A small dram
more of the stimulant, not an overpowering draught
that will cause quick and sure insensibility, but just
a mouthful, that is the assumed remedy, and that
is the certain promoter of the sorrow.

We know now, as surely as if we could see with-
in the body, what is the condition of the organs of
the person afflicted in the manner thus denned.
We are conscious that the vessels of the brain, of
the lungs, of the* liver, of the kidneys, of the stomach
are paralysed, and are injected to full distention
with blood. Some of these parts have actually
been seen under this state, and the fact of the red
injected condition directly demonstrated.

Alcoholic Dyspepsia.

Of all the systems of organs that suffer under
this sustained excitement and paralysis, two are
injured most determinately, viz., the digestive and
the nervous. The stomach, unable to produce in
proper quantity the natural digestive fluid, and
also unable to absorb the food which it may im-
perfectly digest, is in constant anxiety and irrita-
tion. It is oppressed with the sense of nausea ; it



Nervous Derangements. 155

is oppressed with the sense of emptiness and pros-
tration ; it is oppressed with a sense of distention ;
it is oppressed with a loathing for food, and it is
teased with a craving for more drink. Thus there
is engendered a permanent disorder which, for
politeness' sake, is called dyspepsia, and for which
different remedies are often sought but never found.
Antibilious pills whatever they may mean Seid-
litz powders, effervescing waters, and all that phar-
macopoeia of aids to further indigestion, in which
the afflicted who nurse their own diseases so liber-
ally and innocently indulge, are tried in vain. I do
not strain a syllable when I state that the worst
forms of confirmed indigestion originate in the
practice that is here explained. By this practice
all the functions are vitiated, the skin at one mo-
ment is flushed and perspiring, at the next is pale,
cold, and clammy, and every other secreting struc-
ture is equally disarranged.

Nervous Derangements.

The nervous structures follow, or it may be pre-
cede, the stomach in the order of derangement.
We have not yet traced out with sufficient care
the conditions of the centres of the organic chain
of nerves, but we know that they are reduced in
power ; and, in regard to those higher and reason-
ing centres, the brain and its subsidiary parts, the
spinal cord and voluntary nerves, we are aware
that they are supplied with blood through vessels
weakened, and in a condition either of undue ten-
sion or undue relaxation. Moreover, the delicate
membranes which envelope and immediately sur-



156 On Alcohol.

round the nervous cords are acted upon more
readily by the alcohol than the coarser membra-
nous textures of other parts, and thus a combined
arrangement of evils afreets the nervous matter.
The perverted condition of the nervous Centres
gives rise to many striking phenomena, extending
from them to the nervous cords and to the organs
of sense. The irregular supply of blood to the
retina causes temporary disturbances of vision,
with appearances before the eyes of those specks
and small rounded semi-transparent discs, which
are called by the learned muscce volitantes. From
the imperfect tension of the arteries, the blood
which rushes through them causes their dilatation,
and in the bony canals of the skull an impingement
is made upon the bony structure. Vibrations
which extend to the neighboring organs of hear-
ing are thus produced, giving rise to sounds of a
murmuring, ringing, or humming character, ac-
cording to the modification of the arterial ten-
sion.

The perverted condition of the membranous
covering of the nerves gives rise to pressure within
the sheath of the nerve, and to pain as a conse-
quence. To the pain thus excited the term neu-
ralgia is commonly applied, or tic ; or if the large
nerve running down the thigh be the seat of the
pain, " sciatica." Sometimes this pain is devel-
oped as a tooth-ache. It is pain commencing in
nearly every instance at some point where a nerve
is enclosed in a bony cavity, or where pressure is
easily excited, as at the lower jawbone near the
centre of the chin, or at the opening in front of



Alcoholic Insomnia or Sleeplessness. 157

the lower part of the ear, or at the opening over
the eyeball in the frontal bone.

Alcoholic Insomnia or Sleeplessness.

Lastly on this head, the perverted state of the
vessels of the brain itself, the unnatural tension to
which they are subjected from the stroke of the
heart they are now so incompetent to resist, sets
up in the end one telling, and of all I have yet
named, most serious phenomenon ; I mean insomnia
inability to partake of natural sleep. There is a
theory held by some physiologists that sleep is in-
duced by the natural contraction of the minute
vessels of the brain, and by the extrusion, through
that contraction, of the blood from the brain. I
am myself inclined, for reasons I need not wait
to specify now, to consider this theory incorrect :
but it is nevertheless true that during natural sleep
the brain is receiving a reduced supply of blood ;
that when the vessels are filled with blood without
extreme distention, the brain remains awake, and
that when the vessels are engorged and over-
distended, there is induced an insensibility which
is not natural sleep, but which partakes of the
nature of apoplexy. This sleep is attended with
long and embarrassed breathing, blowing expira-
tions, deep snoring inspirations, and uneasy move-
ments of the body, even with convulsive motions.
From such sleep the apparent sleeper awakes un-
refreshed and unready for the labors of the day.
The effect of alcohol then on the brain is to main-
tain the relaxation of vessels, to keep the braid



158 On Alcohol.

charged with blood, and so to hold back the natu-
ral repose. Under this form of divergence from
the natural life, the sleepless man lies struggling
with unruly and unconnected trains of thought.
He tries to force sleep by suppressing with a great
effort all thought, but in an instant wakes again.
At last the more he tries the less he succeeds, until
the morning dawns. By that long time the spirit
that kept his cerebral vessels disabled and his
heart in wild unrest having become eliminated, he
is set free, and the coveted sleep follows. Or per-
haps, wearied of waiting for the normal results, he
rises, and with an additional dose of the great dis-
turber, or with some other tempting narcotic drug
of kindred nature, such as chloral, he so intensifies
the vascular paralysis as to plunge himself into the
oblivion of congestion, with those attendant apo-
plectic phenomena, which he himself hears not,
but which, to those who do hear, are alarming
in what they forebode, when their full meaning is
appreciated. Connected with this sleep there is
engendered in some persons a form of true epi-
lepsy, which all the skill of physic is hopeless to
cure, until the cause is revealed and removed.

And now I think I have said everything that I
have time to say respecting the general phe-
nomena incident to this primary stage of slow
alcoholic intoxication in those who, in the world's
eye, as well as in their own, are temperate indi-
viduals individuals who enjoy the choice things
of this life heartily ; who understand a glass of
wine, and who can take a good many glasses or
a good many little " goes " of spirit if that be all



Organic Deteriorations. 159

but who are never known by friend or foe to
be worse for anything they take ; who grow mel-
low as an apple under the mellowing cheer, but
never fall, nor lose their power of taking less
guarded companions safely home.

ORGANIC DETERIORATIONS.

The continuance of the effects of alcohol into a
more advanced stage leads to direct disorganisation
of vital structures. When once this stage has been
reached not one organ of the body escapes the
ravage. According to the build or the hereditary
construction of the individual, however, or accord-
ing sometimes to what may be considered as a lo-
cal accident, some particular organ undergoes a
change which gives a specific character to the
whole of the phenomena that are afterwards pre-
sented. We then say of the person in whom such
change occurs that he is afflicted with such a par-
ticular disease, letting the general sink into the lo-
cal manifestation. Many purely local modifica-
tions of structures and parts are in this manner in-
duced in the blood, in the minute structure of the
moving organs the muscles, in the fixed vital or-
gans, such as the brain, the lungs, the liver, the heart,
the kidneys. In the blood the influence is exerted
upon the plastic fibrine and upon the corpuscles ;
in the brain, on the membranes at first, and after-
wards on the nervous matter they enclose ; in the
lungs, on the elastic, spongy, connective tissue,
which is, strictly speaking, also membranous ; in
the heart, on its muscular elements and mem-
branes : in the liver, primarily on its membranes ;



160 On Alcohol.

in the kidneys, on their connec'.ive tissues and
membranes.

SPECIAL STRUCTURAL DETERIORATIONS.

The organ, of the body that perhaps the most
frequently undergoes structural changes from alco-
hol is the liver. The capacity of this organ for
holding active substances in its cellular parts is one
of its marked physiological distinctions. In in-
stances of poisoning by arsenic, antimony, strych-
nine, and other poisonous compounds, we turn to
the liver, in conducting our analyses, as if it were
the central depot of the foreign matter. It is,
practically, the same in respect of alcohol. * The
liver of the confirmed alcoholic is probably never
free from the influence of the poison ; it is too often
saturated with it.

The effect of the alcohol upon the liver is upon
the minute membranous or capsular structure of
the organ, upon which it acts to prevent the proper
dialysis and free secretion. The organ at first be-
comes large from the distention of its vessels, the
surcharge of fluid matter and the thickening of tis-
sue. After a time there follow contraction of
membrane, and slow shrinking of the whole mass
of the organ in its cellular parts. Then the shrunk-
en, hardened, roughened mass is said to be " hob-
nailed," a common but expressive term. By the
time this change occurs, the body of him in whom
it is developed is usually dropsical in its lower
parts, owing to the obstruction offered to the re-
turning blood by the veins, and his fate is sealed.

Now and then, in the progress to this extreme



Special Structural Deteriorations. 161

change and deterioration of tissue, there are inter-
mediate changes. From the blood, rendered pre-
ternaturally fluid by the alcohol, there may tran-
sude, through the investing membrane, plastic
matter which may remain, interfering with natural
function, if not creating active mischief. Again,
under an increase of fatty substance in the body,
the structure of the liver may be charged with
fatty cells, and undergo what is technically desig-
nated fatty degeneration. I touch with the lightest
hand upon these deteriorations, and I omit many
others. My object is gained if I but impress you
with the serious nature of the changes that, in this
one organ alone, follow an excessive use of alcohol.

In the course of the early stages of deterioration
of function of the liver from organic change of
structure, another phenomenon, leading speedily
to a fatal termination, is sometimes induced. This
new malady is called diabetes, and consists in the
formation in enormous quantity within the body
of glucose or grape sugar, which substance has to
be eliminated by dialysis, through the kidneys
often a fatal elimination. The injury causing this
disease through the action of alcohol may possibly
be traced back to an influence upon the nervous
matter ; but the appearance of the phenomenon is
coincident with the derangement of the liver, and I
therefore refer to it in this place.

The kidney, in like manner with the liver, suffers
deterioration of structure from the continued influ-
ence of alcoholic spirit. Its minute structure under-
goes fatty modifications ; its vessels lose their due
elasticity and power of contraction ; or its mem-



1 62 On Alcohol.

branes permit to pass through them that colloidal
part of the blood which is known as albumen.
This last condition reached, the body loses power
as if it were being gradually drained even of its
blood. For this colloidal albumen is the primi-
tively dissolved fluid out of which all the other tis-
sues are, by dialytical processes, to be elaborated.
In its natural destination it has to pass into and
constitute every colloidal part.

The lungs do not escape the evil influence that
follows the persistent use of alcohol. They, indeed,
probably suffer more than we at present know from
the acute evils imposed by this agent. The ves-
sels of the lungs are easily relaxed by alcohol ; and
as they, of all parts, are most exposed to vicissi-
tudes of heat and cold, they are readily congested
when, paralysed by the spirit, they are subjected
to the effects of a sudden fall of atmospheric tem-
perature. Thus, the suddenly fatal congestions of
lungs which so easily befall the confirmed alcoholic
during severe winter seasons.

Alcoholic Phthisis ; or, The Consumption of Drunkards.

There are yet other and more prolonged, and
more certainly fatal mischiefs induced in the lungs
by the persistent resort to alcohol ; and to one of
these I would direct special attention. It is that
deterioration of lung tissue to which, in the year
1864, 1 gave originally the name of alcoholic phthisis,
or the consumption of drunkards. The facts were
elicited at first in this manner. In a public hospi-
tal to which I acted as physician, I had brought
before me, in the course of many years, two thou-



Alcoholic Phthisis. 163

sand persons who were stricken with consumption.
I gathered the history of the lives of these, and of
the reasons why they had passed into the all but
hopeless malady from which they suffered. In my
analysis of these histories I found that the leading
causes of the malady were, in the great majority
of instances, predisposition from hereditary taint ;
exposure to impure air ; want ; or certain other al-
lied causes. But the analysis being conducted
rigidly, I discovered that, when every individual
instance had been classified as due to the causes
stated above, there remained thirty-six persons, or
nearly two per cent., who were excluded from
them, who appeared to suffer purely from the ef-
fects of alcohol, and in whom the consumption had
been brought into existence by the use of alcohol.

The added observations of eleven years, since
the above named fact was recorded in the Social
Science Review, as a new fact in the history of the
disease, have only served to prove, in the minds of
other men as well as my own, the truth of the re-
cord.

The persons who succumb to this deterioration
of structure induced by alcohol are not the ex-
ceedingly young, neither are they the old. They
are usually over twenty-eight and under fifty-five.
The average age may be taken as forty-eight.
They are persons of whom it is never expected
that their death will be from consumption ; and
they are generally males. They are probably con-
sidered very healthy ; men who can endure any-
thing, sit up late at night, run the extreme of
amusements, and yet get through a large amount



164 On Alcohol.

of business. They sleep well, eat pretty well, and
drink very well. They are often men of excellent
build of body, and of active minds and habits.
They are not a class of drinkers of strong drinks
who sleep long, take little exercise, and grow
heavy, waxy, pale

" Sleek-headed men and such as sleep o' nights."

On the contrary, they take moderate rest, and sec
as much as they can. Neither in the ordinary
sense are they drunkards : they may never have
been intoxicated in the whole course of their lives;
but they partake freely of any and every alcoholic
drink that comes in their way, and they bear alco-
hol with a tolerance that is remarkable to ob-
servers. They are hard drinkers as distinguished
from sots. Beer is to them as water, wine is weak ;
the only thing that upsets them is stiff grog in re-
lays, or a mixture of spirituous drinks carried to
the extent of what they call, in grim joke in which
death surely joins " piling the agony."

As a rule these cannot live in what they consider
to be comfort without a daily excess of alcohol,
which excess must needs be renewed on emer-
gencies, if there be greater amount of work to be
done, less sleep to be secured, or more life to be
lived.

As specimens of animal build these persons are
often models of organic symmetry and power. In
fact they resist the enemy they court for so long a
time because of the perfection of their organisa-
tion. More than half of those whom I have seen
stricken down with alcoholic phthisis have said



Alcoholic Phthisis. 165

that they had never had a day's illness in their lives
before ; but questioned closely it was found that
none of them had actually been quite well. Some
of them had suffered from gout ; others from rheu-
matism or neuralgia. They had felt severely any
depression such as that which arises from ^ cold,
and if they had been subjected suddenly to causes
of excitement or exhaustion, they had detected,
without actually realising its full meaning, that
their balance of power against weakness was re-
duced, that the end of the beam called strength
was rising, and that an extra quantity of alcohol
was required to bring back equilibrium. As a rule
men of this class are thoughtless of their own
health and their own prospects, for they have an
abundant original store of energy. They are de-
signated as " happy-go-lucky " men, or as men who
" always fall on their feet," which truly they do,
but not without injury.

The countenance of the alcoholic consumptive
differs from that which is usually considered the
countenance of the consumptive person, and
equally from that which all the world adjudges as
belonging to the man who indulges freely in strong
drink. Who does not remember the wan, pale,
sunken cheek of the youth on whom ordinary con-
sumption has set its mark ? And who, again, does
not recall the fades alcoJiolica the blotched skin,
the purple-red nose, the dull, protruding eye, the
vacant stare of the confirmed sot? The alcoholic
consumptive has none of these characteristics.
His face is the best part of him in all his history.
When his muscles have lost their power, and his



1 66 On Alcohol.

clothes hang loosely on his shrunken limbs, he is


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Online LibraryBenjamin Ward RichardsonTen lectures on alcohol → online text (page 10 of 23)