194 THE POPULAR SCIENCE MONTHLY. 



even the effects of tlie organic changes reduced, and, like the 

 cracked jng which goes often to the well, the life of the patient 

 may be prolonged for years ; while, on the other hand, if the 

 true nature of the case fail to be early recognized, and the patient 

 goes on living as if there were nothing the matter with him, the 

 disease rapidly advances, and ere long the time arrives when it 

 is utterly beyond human power to avert a more or less suddenly 

 fatal ending. 



After having so forcibly pointed out the baneful effects of 

 even small quantities of stimulants in diseases affecting the heart 

 and blood-vessels, I think it is time for me to show that in these 

 cases the laws of therapeutics are not, like those of the Medes 

 and Persians, unalterable. This arises from the fact that even 

 the same forms of organic disease affecting the circulatory sys- 

 tem occasionally differ very materially in their characters as 

 well as in their course, not only from the special constitutional 

 peculiarity of the patient, but likewise in a marked degree from 

 the different circumstances under which he is placed ; so that 

 stimulants may be employed in one case as a useful adjunct to 

 other treatment, in spite of their being absolutely forbidden in 

 another. In all cases, however, their employment can only be 

 sanctioned under medical advice, for, from its being always much 

 easier to put a thing wrong than to set a thing right, therapeu- 

 tical combined with pathological knowledge can alone be safely 

 intrusted to decide whether or not alcohol can be given with 

 either advantage or with safety in any given case of cardiac dis- 

 ease. Even here, however, some general rules for alcoholic treat- 

 ment can be notified ; for there is no doubt whatever that, in all 

 cases of cardiac syncope, spirits, in the shape of brandy, rum, 

 whisky, or gin, are potent heart revivers, especially when there 

 exists no actual organic disease of the organ. And even in cer- 

 tain cases where there are valvular derangements alcoholic stimu- 

 lants may be had recourse to with marked benefit. Moreover, 

 from the fact of alcohol being a powerful anti-flatulent, there is 

 scarcely a single case of organic disease of the heart in which it 

 may not sometimes be administered in small quantities at a time 

 with marked advantage. 



Finally, I think it may be said that the various facts adduced 

 appear to prove— 1. That alcohol, when indulged in, even well 

 within the limits of intemperance, has a most prejudicial effect 

 on heart-disease. 2. That sudden spurts of muscular exertion act 

 most deleteriously on all forms of organic cardiac affections. 3. 

 That mental excitement is a cause of rupture of atheromatous 

 blood-vessels. 4. That a mere extra-distension of a stomach by 

 wind may suffice to fatally arrest a diseased heart's action. The 

 knowledge of these facts has for some years past led me to make 



