When used in doses sufficient to give this result simply, alcohol is evidently favorable to digestion, but in larger quantities it has another and unfavorable action, namely, that of precipitating the pepsin of the stomach.

Overdoses produce this result; a small quantity, diluted as it is by the gastric fluids, has not sufficient power to act on the pepsin to any marked degree. If alcohol is constantly used to excess, an abnormal secretion of mucus - gastric catarrh - results, with various evidences of dyspepsia, viz.: loss of appetite, acidity of stomach, heartburn and pyrosis, nausea, and morning vomiting.

Other evidences of the alcohol habit are: constipation; pain on pressure over the stomach; brown, dry tongue with red tip; chronic pharyngitis; fat, flabby, soft hands.

Sleep, for the first part of the night, is sound, but is disturbed in the early morning, after which wakefulness remains, or broken sleep with bad dreams.

Confirmed drinkers age fast. The skin becomes dry, and feels waxy, soft, and unhealthy. The mind becomes sluggish and weak, and cirrhosis of the liver and kidneys, phthisis, epilepsy, paraplegia, insanity, and other disorders are among the sequels of alcoholism.

Alcohol enters the blood unchanged or as aldehyde,1 and reaches the tissues and organs, a small portion being changed into acetic and carbonic acids. In its passage through the tissues it is oxidized, if given in moderate amount, and changed into carbonic acid and water, like other carbo-hydrates, - thus becoming a food or source of heat and force.

In a healthy adult, ℥ iss. of absolute alcohol can be thus oxydized in twenty-four hours, and supplies to the organism as much heat and energy as is contained in the same amount of cod-liver oil or in about ℥ ix. of beef.

Beyond this, in health, it becomes injurious, and is eliminated by the kidneys, skin, and lungs; though in different morbid states large - even excessive - quantities can be safely taken.

Although alcohol is itself oxydized, it interferes with the oxidation of other substances, thus saving the tissues from wear and retarding the process of waste.

This, joined to its apparent stimulating action on the circulation and on the nervous system, gives it the power of sustaining life for a time, under the strain of acute exhausting disease, or during a period of temporary inability to take sufficient food.

Its apparently stimulant effect is shown on the heart by an increase in the strength of the contraction or systole. The pulse becomes strong and regular, full, and compressible. If it had, before, been rapid and weak, it will, under the favorable influence of alcohol, become reduced in frequency to near the normal; but, if over-stimulated, this shortening of the period of rest will in time exhaust the heart.

1 Alcohol deprived of a certain proportion of its hydrogen.

In giving alcohol as a medicine, it is important to be able to recognize the first evidences of over-stimulation as given by the pulse.

The "whisky pulse," as it is called, is unnaturally strong, full, frequent, and bounding.

On the brain and nervous system alcohol acts as a stimulant, up to a certain point; beyond that, as a depressant and narcotic.

On the circulation and bodily heat its action would, at first sight, seem to be contradictory. The sense of warmth given by a dose of alcohol seems incompatible with the well-proved facts that the bodily heat is, on the whole, lowered by alcohol, and that the power of resistance to cold is weakened by its use.

The physiological explanation is, that the blood-vessels are dilated by paralysis of the vaso-constrictors,- the blood rushes to the surface to fill the superficial vessels, and a feeling of warmth results, which, in a warm or moderately cool atmosphere, remains, and promotes the general comfort; but, in a cold atmosphere, the supply of blood to the surface being so much larger than ordinary and perspiration being also increased, while active tissue-changes are checked, heat is abstracted from the body by evaporation at a rate which soon affects the vital powers seriously.

In giving stimulants there are various points to notice by which to judge whether it is doing good or not.

The pulse has been mentioned; the tongue gives another indication. If a dry tongue becomes moist under the influence of alcohol, it is acting well; if the dryness of the tongue be increased, it is not, and the same rule applies to the skin. If nervousness is quieted, sleep induced, delirium and subsultus lessened by alcohol, it is acting favorably; if restlessness and 9 uneasiness follow, or increased delirium, or sleeplessness, - unfavorably.

In cases of sudden heart failure alcoholic stimulants are given hot and concentrated.

Dilute alcohol administered early is a valuable antidote in carbolic acid poisoning.

Symptoms Of Poisoning

A steady course of alcohol in excess, without taking food, will result in delirium tremens. Acute alcoholic poisoning presents the following symptoms: a short period of excitement, followed by coma; respirations irregular, sometimes sighing but usually stertorous; pupils either dilated or contracted, usually the former; face flushed; pulse hard, rapid, and strong.

Acute alcoholic poisoning may be mistaken for opium poisoning, apoplexy, or compression of the brain.

Death results from paralysis of the heart and respirations. The time at which death may occur varies from a few minutes to several days.

The smallest known fatal dose was between ℥ iii.-iv. of brandy swallowed by a child of seven. One pint or 200 Cc. of whisky at one time is a fatal dose.

Treatment of Poisoning.

The treatment consists in emptying the stomach; the application of heat to the extremities and cold affusions to the head; the inhalation of ammonia, and the use of electricity applied to the respiratory muscles.