Alcohol in small doses is a useful stomachic tonic. It is best taken for this purpose after or with meals. It is specially serviceable in the feeble digestion of old people, the atonic dyspepsia of the sedentary, and in the slow and inefficient digestion of convalescence from acute diseases. It should be prescribed with caution in these cases, especially in the atonic dyspepsia of women and of sedentary men, because of the danger that an alcohol habit may be formed. When it is prescribed in the convalescence of acute diseases, the stimulant should be withdrawn at the earliest period.

Excellent results are obtained from the use of brandy in the apepsia of infants. The summer diarrhoea, both of children and adults, may be arrested by a full dose of brandy. Irritating matters and undigested food should be removed before the brandy is administered. The vomiting of cholera-morbus and of cholera may, frequently, be arrested by small doses of iced brandy (a tea spoonful in pounded ice every half-hour), or table spoonful doses of iced champagne. Other forms of vomiting, when due to irritation or inflammation of the stomach—as, for example, the vomiting of pregnancy—can sometimes be promptly cured by the same remedy. It not infrequently happens that, in delirium tremens, nothing is retained by the stomach, and the life of the patient is put into imminent danger, by reason of the failure of the food-supply to the blood. A little brandy and ice will sometimes settle the stomach under these circumstances, and enable the patient to take and digest the much-needed aliment.

Notwithstanding the theoretical objections which may be urged against this practice, clinical experience is strongly in favor of the use of alcoholic stimulants to counteract the depressing influence of certain agents on the action of the heart—as, for example, aconite, veratrum viride, conium, digitalis, and the poison of venomous snakes. Before commencing the inhalation of chloroform, an ounce or two of whisky or brandy should be given the patient. This serves a double purpose: it sustains the heart and prolongs the chloroform narcosis.

Alcohol in some form is constantly prescribed in low conditions in fevers, acute inflammations, and depressing maladies of all kinds. It is serviceable in these diseases when it lessens the pulse rate, but increases the contractile power of the heart and elevates the arterial tension. It does harm when the pulse becomes more rapid and the blood-pressure is lowered by it. It does good when the tongue, before dry, becomes moister under its use, and harm when the dryness of the tongue is increased. It does good when the temperature is reduced, the delirium and subsultus lessened, and the sleep becomes more continuous and refreshing; and does harm when it increases fever, exaggerates the delirium, and induces coma vigil. The chief utility of alcohol in these forms of disease is not as a stimulant, but as a food. It furnishes material, easily oxidizable, which can be applied as nervous, muscular, and gland force. Furthermore it stimulates digestion, and enables more food to be taken and disposed of, and thus contributes indirectly to the maintenance of the powers of life. It follows from these considerations, that alcohol should be given in these low conditions of the organism, with milk, eggs, broth, and other suitable aliment.

Undoubtedly the stimulant treatment of adynamic states is often carried to great excess. The large doses of alcoholic substances administered, disorder the stomach and suspend digestion; and thus the condition of things which they are intended to relieve is only made worse. Furthermore, stimulants are excessively used in these disorders, from a wrong notion of their therapeutic action, and a conviction that diseases characterized by depression are best treated by arterial stimulants. The reaction which has set in against the antiphlogistic methods is in part answerable for the great freedom with which alcohol is now used in fevers and inflammations.

As respects its action on the nervous system, alcohol is a narcotic. It may be used to relieve pain, to promote sleep, and to quiet delirium. The various neuralgiae may be temporarily alleviated by intoxicating doses of alcohol, but such a prescription is dangerous to the moral health of the patient. The subjects of neuralgia, or those who possess the neurotic temperament, have as a rule an inherited or acquired weakness of constitution, and a mobility of the nervous system, which render the effects of alcoholic stimulants peculiarly grateful.

When wakefulness is due to a condition of cerebral anaemia, a full dose of some alcoholic fluid, whisky or brandy, will procure sound and refreshing sleep. In some subjects a glass of ale or beer answers better. Some cases of delirium tremens are greatly benefited by alcoholic stimulants. When the delirium is the result of sudden excess and of the direct action of the alcohol on the cells of the gray matter, the use of this agent will only add to the existing disorder; but when, as is so frequently the case, the attack is determined by the failure of the stomach to appropriate not only the stimulant but the food also, the careful administration of alcoholic stimulants with suitable aliment renders an incontestable service.

As alcohol stops waste, promotes constructive metamorphosis by increasing the appetite and the digestive power, and favors the deposition of fat, it is directly indicated in chronic wasting diseases, especially in phthisis. Clinical experience is in accord with physiological data: alcohol is an important remedy in the various forms of pulmonary phthisis. It is frequently given with cod-liver oil, or an ounce or two of whisky may be taken with some bitter or aromatic immediately after meals. If alcohol disagrees, if it does not improve but lessens the appetite, it will do harm in phthisis. It is an interesting fact that an intractable form of phthisis is induced by alcoholic excess.