ALCOHOL. 139 



supplied with alcohol ; first, that less oxygen is absorbed ; 

 secondly, that the temperature falls, and the albuminous 

 tissues, whilst they do not waste, tend to degenerate into fat, 

 so that the body as a whole grows fat and gross ; thirdly, and 

 chiefly, that the amount of urea, uric acid, carbonic acid, and 

 salts excreted, is decidedly diminished. These are settled 

 facts ; the explanation of them is more difficult. The inter- 

 ference of alcohol with the oxygenating function of the red 

 corpuscle is one obvious cause of impaired metabolism ; another 

 is the extreme readiness of the alcohol when it reaches the 

 to seize upon the oxygen which is there, thus robbing as 

 it were the fixed elements of their necessary share, and arresting 

 their decomposition af the middle stage of fat. This remark- 

 able property of alcohol of saving tissue waste is one of the 

 foundations of its employment in fever, to be presently 

 discussed. 



(3) Alcohol as a stimulant and narcotic. The circulation in 

 every part of the body is stimulated by a moderate dose of 

 alcohol. The rise in the force and frequency of the heart, and 

 the dilatation of the peripheral blood-vessels, which together 

 constitute this increased circulatory activity, are both so far 

 reflex effects from the mucous membrane of the stomach, as 

 we have already seen ; but they are also in part direct, the 

 alcohol exciting the nerve-muscular structures of the heart, the 

 cardiac centre, possibly the vaso-dilator centres in the medulla 

 and cord, and certainly the nervo-muscular tissue of the middle 

 coat of the vessels. To these causes of circulatory excitement 

 must be added the voluntary muscular movements which are 

 much exaggerated under the influence of alcohol. When 

 alcohol is taken in large quantities, its stimulant effect passes 

 into depression, both reflex and direct, and death may result, 

 in part at least from cardiac failure. 



Upon the nervous system, the first effect of alcohol in 

 moderate quantity is one of stimulation. The nervous centres 

 are increased in vigour from the highest to the lowest, and in 

 the same order of sequence. The imagination becomes brilliant, 

 the feelings are exalted, the intellect is cleared, the will is 

 strengthened, the senses become more acute, the feeling of 

 bodily strength and ability is raised, and some of the app- tites 

 are temporarily excited. The centres of speech, and of muscu- 

 lar movements generally, are specially exalted, givinir 

 animated talk and lively gesticulations ; and, thnvwith. 

 of bien etre, referable to the combined nervous and circulatory 

 excitement, spreads over the system. 



If the dose of alcohol be larger, these phenomena of 

 stimulation are more pronounced, but very soon give place to 



