EFFECTS OF ALCOHOL. 183 



others it undoubtedly produces gradual and permanent changes, 

 chiefly of a cirrhotic character, in the blood-vessels and viscera, 

 such as the liver and kidneys. These alterations, which may 

 be slow and subtile in character, may not in themselves mate- 

 rially impair the health or cause an ultimately fatal result ; but 

 they tend to weaken vital organs and produce a condition of 

 premature senility, so that if the patient be overtaken by any 

 severe disease, as, for example, by an acute infection like 

 pneumonia, or a chronic one like pulmonary tuberculosis, the 

 resistance of the body to the force of the disease is materially 

 impaired, and the danger to the patient is seriously enhanced. 



" 4. There are many persons whose constitutional inherit- 

 ance is such that they should be particularly warned against 

 the use of alcohol ; and in some such cases, as, for example, 

 among those who are subjects of well-marked gouty diathesis, 

 it is better that the use of alcohol should be imperatively for- 

 bidden. 



" 5. The abuse of alcoholic stimulation is invariably inju- 

 rious, although the extent to which evil influences become 

 manifest depends upon the constitution of the individual, in 

 connection with the two factors of heredity and environment. 



" 6. There are a number of diseases in which the temporary 

 use of alcohol is of positive service, and there are a number of 

 cases in which it becomes a necessity in order to prolong life. 



'* 7. In many cases of malnutrition and malassimilation of 

 food, alcohol is itself a food ; and its consumption under proper 

 direction results in an increase of body weight and strength, 

 and improvement of functional activity. These results are 

 accomplished in part through the action of the alcohol as a 

 definite food, and in part through its remarkable effect in force 

 production. The latter is due to its own direct combustion, 

 by which in chronic diseases and in critical, acute, and exhaust- 

 ing affections it spares that of the tissues of the body. 



