ALCOHOL. 141 



ability to consume food, the previous habits, and the age of the 

 patient. It must be distinctly understood, however, that alco- 

 hol is by no means essential in every case of fever ; the very 

 opposite being the case. In delirium tremens (acute alcohol- 

 ism), -where food, in the ordinary sense of the word, can often 

 be given only with the greatest difficulty, the very substance 

 which, as a stimulant, has caused the disease, must be judiciously 

 continued as a form of nourishment for a time. 



In chronic diseases attended by great debility, want of appe- 

 tite, and. possibly sickness, such as pulmonary phthisis, alcohol 

 will also find its place as a true food. 



As a stimulant the principal use of alcohol is in connection 

 with the heart. This, as we have just seen, is an important 

 part of its action in fever. Of all remedies in threatening death 

 by cardiac failure (syncope, fainting), spirits are the best, being 

 at once available, convenient, rapid in their action, and almost 

 invariably successful, if recovery be possible. For this purpose, 

 brandy, whisky, etc., should be given either pure or only 

 slightly diluted, by the stomach, bowel, or even under the skin. 

 Hardly less valuable is alcohol, given continuously in small 

 regular doses, in chronic disease of the heart, when natural 

 hypertrophy fails and dilatation ensues. Wine, rectified spirit, 

 or various tinctures, may be given in such cases. 



In nervous depression alcohol must be ordered with the 

 greatest hesitation. In melancholia, or in despondency be- 

 gotten by grief, anxiety, suspense, over- work, excess, and espe- 

 cially by indulgence in alcohol itself, this drug affords only too 

 ready relief, as also in neuralgia, hysteria, and allied disorders 

 and sleeplessness ; and the recommendation of it by the practi- 

 tioner is frequently abused, being employed as a pretext for 

 continued intemperance. In such cases the best rule is to 

 order a definite amount of some weak alcoholic drink, such as 

 ale or claret, at meal times only ; but even this recommendation 

 is by no means always safe. Severe pain, such as neuralgia, is 

 often successfully relieved on the same principle. Some forms 

 of sleeplessness are readily overcome by warm alcoholic 

 draughts at bed-time, or malt liquors; but here again great 

 discrimination is requisite in ordering the remedy. 



6. REMOTE LOCAL ACTION AND USES. 



Alcohol given in medicinal doses is, as we have seen, 

 almost entirely oxydised in the system, only 16 percent, passing 

 out unchanged, chiefly by the lungs, less by the kidn 

 least by the skin. This amount, however, includes ethereal and 

 other complex bodies associated with alcohol in win 



