Beer. — Even under the excessive use of malt liquors, subjects rarely fail to put on fat. The blood shows an increased proportion of red and a diminished pro portion of white corpuscles. Sudden cessation of drinking causes no other disturbances than a temporary longing, a rapid loss of flesh, and a decline in color. Stone in the bladder and cystic diseases are uncommon. Digestion is not re tarded. Excess in beer is apt to produce subacute gastritis, especially in the slim mer. Cirrhotic kidney and hobnail liver are not found in beer-drinkers. Acute alcoholism is much more common than delirium tremens. (Lambert Ott.) Four quarts of beer may be estimated to contain 240 grains of carbohydrates and scarcely 32 grains of albumin.
Strtimpell (Quarterly Jour. of Inebriety, Jan., '94).
The diminished vital resistance caused by the imbibition of alcohol renders the inebriate more liable to the development of disease than the temperate. Clinical experience has clearly sustained this view.
Experience in India and other warm countries has indicated an extreme fatal ity from sun-stroke in persons using alcohol to excess. Fifty cases of sun stroke brought into the Presbyterian Hospital of New York.
The use of alcohol seemed to have a direct unfavorable influence. The habit was marked in 32 per cent., moderate in 46 per cent., denied in 10 per cent.; in the remaining 12 per cent. no history could be obtained. Eight persons were markedly alcoholic on admission, and of these four died. Editorial (Quarterly Jour. of Inebriety, Apr., '97).
Study of 247 recovered personal cases of delirium tremens: of these cases 202 were uncomplicated and 45 complicated by other diseases. Twenty-two cases were complicated by pneumonia, and when, also, the lethal eases observed by the author are taken in account, more than 12 per cent. of all cases of delirium tremens were combined with pneumonia. The delirium usually began on the fourth day of the pneumonia, but the evolution of the two diseases was individual, the one in no way influencing the other dis ease. Jacobson (Hospitalstidende, p. 143, '97).
The normal vital resistance of rabbits to infection by streptococcus pyogenes (erysipelatos) is markedly diminished through the influence of alcohol when given daily to the stage of acute intoxi cation. A similar, though by no means so conspicuous, diminution of resistance to infection and intoxication by the bacillus coli communis also occurs in rabbits subjected to the same influences.
While in alcoholized rabbits inoculated in various ways with staphylococcus pyogenes aureus, individual instances of lowered resistance are observed, still it is impossible to say from these experiments that, in general, a marked difference is noticed between alcoholized and non alcoholized animals as regards infection by this particular organism.
It is interesting to note that the sults of inoculation of alcoholized rabbits with the erysipelas coccus correspond in a way with clinical observations on human beings addicted to the excessive use of alcohol when infected by this organism. A. C. Abbott (Quarterly Jour. of Inebriety, Oct., '97).
Treatment. — The essential condition of cure is the entire discontinuance of all alcoholic beverages, whether spirits, wines, beers and other malt liquors, cider, etc. Records of reliable scientific hospitals and homes throughout the world show that, on an average, fully one-third of the cases so treated have been permanently cured.
Under scientific treatment one-third of inebriate patients are permanently cured. After an interval of from seven to ten years, in two thousand cases treated at Fort Hamilton, the proportion was 38 per cent. After eight to ten years. 35
per cent. of the survivors who had been discharged (numbering, in all, three thou sand) from the Washingtonian Home, in Boston, under Day, were temperate. Of two hundred and sixty-six who passed through the Dalrymple Home, in Eng land, full 40 per cent. have kept firm. Crothers (Quarterly Jour. of Inebriety, Apr., '02).
Development of patient's will-power most important part of curative meas ures. Norton (Brit. Med. Jour., May 25, '95).
After a prolonged trial of the Keeley and other treatments, that described by C. de Martines was adopted at the Cery retreat for inebriates. Almost always the patient during the first few days be comes violently agitated, throws things about and attempts to hurt himself and others; so, as restraint has a bad effect, he is allowed free movement in a room with padded walls and devoid of furni ture. Two glasses of wine a day are allowed during the first week or two, but no longer. As soon as the mental excite ment subsides, the patient is made to walk in fresh air until tired, and takes a warm bath for half to one hour each day. The only drugs used are chloral hydrate, 20 to 30 grains, to produce sleep, preferably given in a little wine or beer, or, if this is refused, '/,, grain of duboisine or hyoscine hypodermically. Morphine is never employed, as it is con sidered responsible for many untoward effects in the treatment of these cases. The bowels are regulated by artificial Carlsbad salt or other saline purgative. The lungs are examined every morning, as at any time a pneumonia may develop. Any medication is more rapidly absorbed if it is given in a slightly alcoholic mixt ure. (Revue Med. de la Suisse Rom., Mar. 20, 1900).
There is no specific. After treating the immediate symptoms of breakdown, delirium, etc., by flushing the intestinal canal and administering food and effer vescents suited to the harassed and irri tated digestive apparatus, the chief drug reliance should he on nerve-tonics. such as strychnine and nux vomica, combined with cinchona, quinine, iron, chiretta, gentian, and ealumba. Complications must also be attended to, as syphilis by mercury or potassium or sodium iodide, and ague by quinine, bebeerine, or ar senic.
The indications arc to prevent the alcoholic poisoning going further, by the immediate withdrawal of alcoholic bev erages, which superabundant experience —in prisons, work-houses, hospitals, and homes for the treatment of the disease of alcoholism—has shown to be quite safe; to antagonize or remove the exciting causes; and to reconstruct healthily body and brain. The highest influences of art, intellect, morals, and religion should be invoked to restore inhibition and re establish the lost will-power. Massage, galvanism, muscular exercise, especially in the open air, working at a congenial occupation, bathing (including the Turk ish or Roman bath), with all healthful and invigorating hygienic exertions, are useful adjuncts to medicinal therapeusis.
The bath is applied with advantage to promote elimination, restore natural function, and quiet irritated and in flamed organs. Patients debilitated from acute inflammation and pain have en joyed the bath twice daily for months.
Shepard (Jour. Amer. Med. Assoc., Jan.
9, '92).
The peculiarities of each case should be studied, and it is important to instill into the alcoholist's mind the necessity for life-long abstinence from the toxic substance, just as in chronic lead or arsenic poisoning, with both of which intoxications alcoholism has much in