THYROID INSUFFICIENCY 65 



age, etc. Probably the less the better, but we 

 must remember that alcohol in itself is not a 

 pressure- raiser ; and that, especially in old age, it 

 may be a help, while the pressure is being lowered. 

 Alcohol wisely chosen and only used as an aid to 

 digestion is often of value, but when used as a 

 frequent stimulant to enable a tired mind or body 

 to carry on or to increase endurance for pleasure 

 and excitement, it certainly does harm. Brun- 

 ton said, " All the alcohols tend to dilate vessels, 

 to lessen blood-pressure, and ultimately to 

 diminish activity of the nervous tissues, although 

 at first they may seem to have a stimulant 

 action." It contains so little nutritious material 

 (with the exception of the sugars and extractives 

 in wines and beers) that in itself it may be said 

 to give little or nothing to the blood ; it only 

 enables a man to draw on his reserves. This 

 may be a helpful thing, but the reservoir has to 

 be refilled. Coffee and tobacco both raise pressure 

 slightly, and should be used in great moderation. 

 Therapeutically in hyperpiesis we want to reduce 

 arterial tension, and with it arterial resistance, 

 to remove, if possible, the thickening of the 

 arterial coats which may have commenced and 

 to enable the heart to meet effectually the un- 

 natural resistance it has to encounter, After 

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