External

Four parts of alcohol to one of water form the Lotio Spiritus of many pharmacopoeias. Cotton or lint dipped in it are applied to sprained joints, bruises, etc. The alcohol evaporates, cools the part, consequently the vessels contract, and inflammation may thus be checked. At the same time the local anaesthetic effect of the cold relieves the pain. In a similar way many varieties of headache may be soothed by bathing the forehead with eau de Cologne or Bay Rum. Brandy or some other form of alcohol is often used to bathe the skin in order to harden it, by abstraction of water, and thus prevents the formation of bed-sores or cracked nipples. Spirit lotions dabbed on the skin may, by means of the vascular contraction produced, stop sweating. Alcohol rubbed in, as in the use of Linimentum Saponis, is commonly employed for its rubefacient effect, to aid the absorption of inflammatory products and relieve pain, as in chronic rheumatism, myalgia, etc.

Internal

Mouth. - A little brandy held in the mouth will be a local anaesthetic and relieve toothache. Alcohol is used as a gargle of port wine for its power of precipitating albumin and acting as an astringent in cases of chronic sore throat, excessive salivation, or inflammation of the gums.

Stomach

Because it increases the secretion of gastric juice, the vascularity and the movements of the stomach, alcohol aids digestion. It must only be taken in small quantities, for large amounts paralyze the secretion and cause gastritis, and ultimately lead to atrophy of the gastric glands. It should be given just before or during a meal. It is harmful in acute dyspepsia, but for the indigestion of the aged and feeble, or for those who are thoroughly exhausted by overwork, it is very valuable, as the stomach shares in the general exhaustion. It is also useful because it increases the appetite. Owing to its anaesthetic property it may relieve painful dyspepsia, and may check vomiting, especially if taken with carbon dioxide, as, for example, in the form of champagne or brandy and soda-water, and because it increases the activity of the gastric movements it may relieve flatulence. A single dose of strong spirits poured into the stomach is often employed with great benefit for its reflex stimulant effects on the circulation for those who have fainted, or who are collapsed from cold or any other cause.

Intestines

Brandy and water will often check diarrhoea. Perhaps this is owing to the astringent power of the brandy.

Fever

Alcohol has been largely used in all sorts of febrile conditions. We have seen that it impairs oxidation by its action on the red corpuscles, that it is oxidized and is therefore a food, and that it is mildly antipyretic and diaphoretic. These results would be beneficial in fever. On the other hand, the acceleration of the pulse would be distinctly harmful, although it must be remembered that very often, for some unexplained reason, alcohol lowers the pulse in fever; the indigestion caused by the taking of large quantities, and the liability to depression of the respiratory and cardiac centres, would be very undesirable. The best rules are that while alcohol may be given, often with immense advantage in fever, either to aid digestion, to slow the pulse, as a cardiac stimulant if the patient be much collapsed, or to produce sleep, yet it may, in any of the ways alluded to, do harm. Therefore, when it is being used, the effect must be carefully watched, and if the pulse becomes quick and feeble, or, as indicating gastric irritation, the tongue becomes dry and brown, or the skin becomes hot and dry, or the breathing hurried, or the patient suffers from insomnia, the alcohol should be stopped. On the other hand, if the pulse becomes stronger and slower, the tongue and skin moist, the breathing tranquil, and the patient sleeps well, the drug is doing good, and may be continued. We have so many more powerful diaphoretics and antipyretics that alcohol is not often given for these purposes. Of all fevers it is most used for acute lobar pneumonia, and, speaking generally, it is most likely to be valuable when our object is to keep up the patient's strength for a few days only, till the termination of a specific fever of short duration; but it is often given when it is quite unnecessary.

Nervous System

Alcohol may, as just mentioned, be used as a soporific in fever. Many persons who suffer from insomnia find that they can sleep better for a glass of whiskey and water just before going to bed, no doubt because of its depressant action upon the highest centres.

Kidneys And Skin

Alcohol is occasionally given as a diuretic. Gin is the best form, because it usually contains some juniper, which is also diuretic. Although but little alcohol is excreted by the kidneys, it seems to be particularly irritant to the urethra in cases of gonorrhoea and gleet, and some authorities consider that chronic Bright's disease may be induced by alcohol. Almost the only use made of its diaphoretic effect is as a help to cure a cold in the head, for which purpose a glass of strong spirits and water may be taken immediately before going to bed.

Toxicology

Large doses of Alcohol will produce death, either instantly by reflex stoppage of the heart, or later by cardiac and respiratory depression after absorption.

Chronic poisoning causes so many diseases that it is really the part of a text-book upon medicine to enumerate them. Very often confirmed drunkards, particularly if they take much spirits, are very thin; this is probably due to the fact that strong spirits cause such marked indigestion that sufficient nourishing food is not absorbed. Other drunkards are fat, especially if they drink beer. Chronic gastritis, cirrhosis of the liver, gout, peripheral neuritis, delirium tremens, mania, and perhaps chronic Bright's disease, may all be directly due to excessive indulgence in alcohol. It renders patients particularly liable to phthisis, and makes them bad subjects for withstanding. any severe illness, especially pneumonia, or to undergo severe surgical operations. Alcoholic beverages contain other bodies than alcohol, which are probably partly responsible for these evil effects.