THE USE OF ALCOHOL IN MEDICINE. 89 



hot wine and water in this stage. However, I found that the 

 stage was very transitory, and that hot milk and water was quite 

 as restorative ; the patient soon went to sleep, and normal warmth 

 returned. 



Hepatic disease is not so frequent in the Punjab as it is found 

 down country, nor by any means so severe. I can not recollect 

 any deaths due to it directly during my stay, or any case of 

 hepatic abscess. Minor congestions and enlargements were a fre- 

 quent cause of sickness and invaliding. The treatment a few 

 years earlier consisted in blistering, stimulants, and a mercurial 

 course. Some time in 1863 a surgeon in Burmah, whose name I 

 can not now recall, recommended ammonium chloride. This I 

 tried, and thought it acted very favorably. About 1866 an im- 

 mense change for the better was brought about by the introduc- 

 tion of podophyllin. It was called the vegetable mercury, hav- 

 ing quite supplanted that metal, which indeed became on all 

 hands, in all diseases, quite decried. At the time I now refer to 

 (1870) I began to discontinue the use of podophyllin in hepatic 

 disease, finding Epsom salts far more active and rapid in effects. 

 I remember getting the idea from a translation in the Sydenham 

 Society series of some German researches on the effect of certain 

 saline springs, and made for myself an artificial mineral water. 

 This, the equivalent of the present white mixture, eased the pain 

 and reduced the size of the liver, a fact we are now familiar 

 with, but which was then to me a real discovery. After a few 

 days of this treatment the patients were very much the same as 

 convalescents from chest disease. They needed time and rest 

 and suitable food in short, nursing and had a chance of re- 

 gaining health. Hepatic disease is, however, ineradicable. It 

 soon recurs in the great heat of the climate and in men not very 

 abstemious, and few once ailing with it serve long in hot 

 climates. 



Thus, in one after the other of these important diseases, expe- 

 rience was altogether against the employment of alcohol. It 

 must be borne in mind that I began with no theory. I gave alco- 

 hol in pneumonia and hepatitis, while rigidly withholding it in 

 fever and diarrhoea. I delayed the alcohol, however, in those 

 diseases to a later stage, until the temperature was nearly nor- 

 mal, and at length discontinued it altogether, finding that it re- 

 tarded the cure and prolonged convalescence. I lost some cases, 

 of course, and, among others, one from delirium tremens an old 

 soldier, who had frequently suffered before and it was at first a 

 matter of great pain to me to think that, if I had followed the 

 usual routine of treatment, the cases might have ended differ- 

 ently. My colleagues, I knew, would probably have held so. 

 However, my confidence revived in watching their practice. I 



