THE EFFECTS OF MODERATE DRINKING. 197 



the mental collapse is, that the brain, like every other organ of 

 the body, while in a state of functional activity, draws to it a 

 super-supply of blood, and consequently, when alcohol is taken, 

 it adds to the already existing engorgement of the cerebral ves- 

 sels arising directly from the brain's activity, by accelerating the 

 heart's action, and thereby augmenting its deleterious effects by 

 still further increasing the pressure exerted on the nerve-cells 

 and fibers by the already dilated and engorged vessels. 



We shall now for a moment glance at the injurious effects of 

 small quantities of alcohol exerted on the brain through the in- 

 termedium of the hepatic derangements that stimulants induce. 



The very large number of nerve affections, more especially 

 in th% form of intellectual disturbances, which come under the 

 notice of liver specialists, are in a great measure attributable to 

 the disorder of the biliary functions brought about by the ha- 

 bitual indulgence in small quantities of alcohol between meal- 

 times ; for, as is well known, scarcely a more formidable cere- 

 bral poison than bile exists. 



Sometimes one learns from a patient a great deal which he 

 may turn to account in the treatment of others ; and one of the 

 things a patient taught me was the marvelously depressing 

 after-effects that a single glass of spirits will occasionally produce 

 in a bilious subject. A leading member of our own profession, 

 who is a martyr to biliousness, made a number of experiments 

 upon himself regarding the depressing after-effects of alcoholic 

 stimulants, and he tells me that he has repeatedly found that a 

 single glass of gin, whisky, or brandy, taken diluted with water, 

 either at dinner-time or in the evening, when he is bilious, and 

 feels exhausted after his day's work, will be followed in from 

 five to fifteen hours with such a morbid depression of spirits that 

 he scarcely knows what to do with himself ; yet the primary 

 effect of the stimulant is, he says, not only refreshing but exhil- 

 arating. This, although an exceptional case in so far as its 

 severity is concerned, is but the type of many others that have 

 come under my notice ; for some have said that a single table- 

 spoonful of brandy, whisky, or gin, will induce depressing after- 

 effects when their livers are out of order. 



The only way in which I can account for this depressing after- 

 effect of small quantities of alcohol, when taken by bilious per- 

 sons, is by imagining that the small amount has the power to 

 exert a more than usual deleterious influence on the cerebral 

 tissues in consequence of their having been already materially 

 weakened by the direct poisonous effects exerted on the nerve- 

 tissues by the bile in the circulation. I am led to this opinion 

 from noticing how much less the depressing after-effects of 

 spirits become so soon as the liver's functions are put to rights. 



