THE EFFECTS OF MODERATE DRINKING. 193 



efforts ; for while it shows that all exposed to the partaking of 

 alcoholic stimulants in small quantities at a time are much more 

 frequently affected with the fatal forms of cardiac diseases than 

 others, it in an equally unmistakable way shows that men who, 

 like brewers, require in the course of their trades to tax their 

 muscular strength, and thereby throw additional work upon 

 their hearts, are far more often attacked with the fatal forms 

 of diseases affecting the circulatory system than men equally 

 addicted to imbibe alcoholic stimulants, but who are not called 

 upon to make similar kinds of straining muscular efforts. 



The relative proportions of deaths from diseases of the circu- 

 latory system in the different classes are : 



Those not exposed to the temptation of 

 drinking:. 



Drapers and warehousemen 75 



Gardeners and nurserymen 82 



Those exposed by their vocations to the temp- 

 tation of drinking. 



Commercial travelers 100 



Vintners, waiters, and barmen 146 



Printers 93 i Brewers 165 



Moreover, it is equally known that intemperance is a most active 

 agent in the induction of atheromatous (fatty granular) degen- 

 erations in the coats of the arterial system, and as such a fruit- 

 ful source not only of death by cardiac syncope, but likewise by 

 apoplexy, from the cerebral vessels being quite as frequently 

 and as severely affected with the degeneration as those of the 

 heart itself, and the coats of the one set being as liable to sudden 

 rupture as those of the other^ if not, indeed, even more so, from 

 the less solid nature of the brain surroundings. I wish now to 

 call special attention to what I believe to be a fact — namely, that 

 what is termed " moderate drinking " is a far more general cause 

 of atheromatous degeneration of the coats of the blood-vessels 

 than is usually supposed. 



It is, I believe, next to impossible to overrate the desirability 

 of impressing patients laboring under heart-disease, as well as 

 atheromatous degenerations of the blood-vessels, with the abso- 

 lute necessity of being extremely temperate in the use of alcoholic 

 stimulants, if they wish either to live long or to ameliorate the 

 disease of the circulatory system under which they labor. For 

 alcohol taken in the form of spirits — brandy, whisky, gin, or 

 rum — even in teaspoonful doses, by increasing the heart's action 

 has quite as pernicious an effect on the organic structural dis- 

 ease, be its form what it may, as belladonna itself. And I fancy 

 all who have much experience with cardiac diseases know well 

 the intrinsic significance of this remark. 



In the early stages of organic disease of the heart or blood- 

 vessels judicious regimen is quite as essential to the well-being 

 of the patient as wise treatment: for, if the case be skillfully 

 handled, it is not only jjossible for death to be long averted, but 



VOL. XXXIII. 13 



