although it adds no energy whatever to the system; just as the poker will make the fire burn brighter, although it adds no heat or brightness of its

own.

Stimuli may be applied externally or administered internally, and the more stimulus the body encounters among its surroundings the less does it require mixed with its food. The man who takes a cold bath every morning before going to business does not require strong coffee to goad his nervous system to its daily toil. Those who have abundant openair exercise may live entirely on vegetable diet, which contains but little stimulus; while those whose life is monotonous and sedentary require a more stimulating diet. But the healthiest stimulus is unquestionably the external. Open-air exercise, cold bathing, and pleasurable mental excitement, will give sounder and better stimulation than the most savoury of diet. Internal stimuli must only be resorted to when the external cannot be secured. There is one criterion by which you can always distinguish whether or not any agent is a stimulus, viz., by its power to increase the demand for food. The more you employ your poker the more coal you burn; and just as you can extinguish your fire by a too-vigorous application of the poker and without adding fresh supplies of coal, so you may extinguish life by using too much stimulus without giving at the same time an increased supply of food. For example, if you feed a dog entirely on Liebig's extract of meat, which contains the stimulating properties of beef without much of the nutrient property, it will not live so long as if you fed it upon water alone.

This proves that the extract of meat is a true stimulus, and that it induces a greater necessity for food; it is thus useful for invalids with failing appetite, provided that true food be given at the same time. Now alcohol is not a true food, neither is it a stimulus as ordinarily taken, for it rather diminishes the desire for food. Indeed, the boast of its advocates is

that it enables a man to do with less food, and even to do without food altogether for considerable periods.

III. How then does alcohol affect the animal tissues? It is not equivalent to the coal of the fire, nor to the poker-where, then, can we find an analogous agent? Alcohol has the same effect upon the nerve-cells that water has upon a coal fire. Apply water in small quantity and your fire will burn more slowly; apply a large enough bucketful, and it will cease to exist. When the cook rakes up the ashes and covers her fire before going to bed, she performs the same physical experiment as her master who soothes his nerves with alcohol before retiring for the night. The cook wishes her fire to smoulder during the night, she therefore applies an agent which will check combustion by partially excluding oxygen from her fuel; her master applies to his nervous system an agent which diminishes oxidation, and thus seriously interferes with vital action. In both cases there will be less material burned-less coal and less explosive food.

But is this a real advantage to the usefulness of the fire or of the human machine? The cook would be very late with breakfast if she trusted to such a fire to cook the bacon, and the work accomplished by a brain much affected by alcohol is both small in quantity and inferior in quality. It is as difficult to send proper messages along a nerve under the influence of alcohol as it is to fire a train of damp gunpowder. "Trust in God and keep your powder dry," said the great Oliver Cromwell. Trust in God and keep your brain clear would have been his burning advice had he lived in these latter days.

In the present day we can calculate with precision the exact time, to a minute fraction of a second, which is required to transmit a message from the brain to the hand or any other portion of the body, and it has been distinctly shown that it takes much longer to send such a message after the person experimented upon has taken even a small dose of a narcotic. A message which could be sent in o°1904

of a second required 0.2970 seconds for its performance after two glasses

of hock had been administered to the subject of experiment, thus showing how much even a slight narcotic effect interferes with the vital action of nervous tissue.

Alcohol prevents waste of tissue, and thus enables a man who drinks to live on less food. This is considered a very strong argument in favour of drinking, and if good food could not be obtained it might have very great force; but plain wholesome diet is cheap, and easily procured. Moreover, 66 waste of tissue" is an expression which conveys an utterly false impression. There is no such thing as waste of tissue unless the body is wearing away more rapidly than new substance can be reproduced, as in certain fevers, consumption, &c. The tissues of the body are not a fixed quantity like the framework of a steam-engine; they are ever changing-the old wearing away to be replaced by the new. Life is a constant series of changes, and the healthier the man the more rapid, within certain limits, will be his change of tissue. You can only preserve the tissue of a healthy man by lowering his vitality; the tissues thus preserved cannot bear the strain which can be borne by those of recent manufacture, and thus the working power is diminished.

An employer of labour in Liverpool, anxious for the elevation of his workmen, suggested that they might with advantage give up the use of beer and tobacco. They, however, informed him that in such a contingency their wages would not support them, so great would be their increase of appetite.

But there is another side to this question, and it is that such men would be able to do more work, and consequently earn larger wages, by discontinuing the narcotics. Men of all classes are very slow to learn that sound bodily health is the best possible investment. The human machine is very easily kept in order, but once let it get out of repair and it is the most difficult to set right. And it can only be kept in thorough repair when every joint, muscle, and nerve is maintained

in a condition of persistent activity. I do not mean that a man should always be engaged in exercising his various tissues and organs in order to preserve health; but I do maintain that every tissue should be so actively exercised that it will be compelled to employ its entire time of so-called rest in laying up fresh stores of explosive material, and in healing up those rents which have taken place in their actual substance. In the region of nerve and muscle a man ought always to live up to his income. He can save nothing by sparing exertion so long as he does not go beyond his income. Give your brain sufficient food and an abundant supply of oxygen, and thus give it a fair amount of good hard work every day if you wish to maintain it in a high state of healthy activity. Barristers and clergymen, who use their brains much, are the longestlived men in the country; showing plainly that regular brain work is good for the general health as well as for the efficiency of the nervous system in particular. The muscular system must be treated in a similar manner if you do not wish it to become subject to fatty degeneration. An unused muscle shrinks and becomes soft and flabby, presenting an appearance of marked contrast to the brawny arm of the blacksmith. Instances of the feebleness of tissues thus preserved frequently present themselves to the notice of the surgeon. A muscle is called upon to perform a vigorous contraction, but it snaps in the effort. The heart itself is sometimes torn asunder in attempting to send an extra supply of blood to some needy limb. No man can afford to lower his general vitality for the sake of mere idle gratification. He never knows when he may require all the energy which can be stored up in his tissues. A railway accident, a runaway horse, a run to catch a train, a fall on the ice, or even a fit of coughing, may bring a life of misery or an early death to one who would have passed unscathed through them all had he allowed his nerves and muscles to wear away in vigorous activity, instead of carefully preserving them, like anatomical specimens, in

spirits of wine. I do not attempt to deny that all narcotics possess the power to prolong life in the absence of food. I have elsewhere referred to the case of an old woman who lived for two years on opium and gin-andwater, without any food whatever, but she might as well have been in her grave. Hers was, I would not say a living death, but rather a dead life. Some may be inclined to doubt the accuracy of this story, but such will discern a possibility of its truth when I say that a narcotic seems to produce a condition of the nervous system closely resembling that of hybernating animals. The dormouse sleeps for many weeks without any food what

ever.

Its tissues are then in the condition of the cook's fire when covered with ashes, and if you can produce a similar condition in human tissues you may attain the same result of prolonged fasting. We are apt to consider the winter sleep of the dormouse as a great waste of existence; but what can we think of a reasonable man who artificially reduces himself to a similar condition during a considerable portion of the prime of life?

Alcohol soothes the exhausted and irritable nervous system after a hard day's work, and prevents the brain worrying about difficulties that may never come. The advocates of alcohol maintain that in this manner it gives rest to the nervous system, and thus enables it to throw off work for the time, and resume it again with renewed energy.

Now, the mistake which our opponents make here is that they ignore the necessity for anything but rest. What would you think of the farmer who allowed his men an hour's rest at various intervals during the day, but who, at the same time, forbade them to take food at such times, lest the muscular movements involved in carv

ing and mastication should interfere with their complete and absolute repose? Every cell in the body is a counterpart of the whole organism. Just as the man cannot work without eating, so the cell cannot carry on its explosive action without fresh

supplies of explosive material. Now alcohol and other narcotics not only prevent the nervous matter exhibiting energy, they also prevent it absorbing its proper food, so that the rest which it obtains by means of nar. cotism does not enable it to resume work with renewed energy. But more, the nervous matter is thereby rendered incapable of throwing off its own ashes, which are its most deadly poison. Just as decomposing animal matter is highly deleterious to the health of the body, so the dead portions of nervous tissue become disastrous to the life and activity of their living successors.

I do not attempt to deny that the relief afforded by a narcotic is most delightful and seductive. When the

merchant goes home from his office, worried by a thousand trifles, and saddled with a load of cares, his nerves are agitated and restless, and the busy wheels of life seem to speed round with unceasing velocity. How delightful it is to be able, by the magic spell of alcohol, to stop those busy wheels and to translate himself from the pains of a commercial pandemonium into the Elysian fields of perfect bliss. I confess that alcohol does all in the way of soothing that its admirers attest; it is my duty, however, to exhibit the other side of the shield, and to proclaim that the luxurious pleasure of the bottle is physiologically so expensive that the nervous system cannot afford to indulge in it. The muscles suffer along with the nerves; for without nervous influence the muscles are unable to supply themselves with the nourishment which is carried by the blood into their very substance. If you cut the nerves leading to a muscle, that muscle will cease to retain its firmness and contractive vigour; and if you paralyse the same nerves by a narcotic, its power of contraction will be similarly diminished.

Any spirit drinker will tell you that it requires no very large amount of his favourite beverage to incapacitate him for severe muscular exertion. When a man has indulged

in alcohol to any but the smallest extent, you are more likely to find him dreaming in a corner than ascending a mountain. When you observe what an amount of lounging lethargy is produced by drinking, you scarcely require an ounce of science to account for the smaller appetite of the worshippers of Bacchus.

This power of the narcotic to interfere with the nutrition of the tissues produces serious consequences on the digestive organs of those who both drink much and eat well. The wine-bibber is often not content to suffer any diminution of the more solid pleasures of the table as a result of his glass. He therefore resorts to various means to induce in his digestive organs an artificial appetite. He is thus led to consume a much larger amount of nutritive material than can possibly be required by narcotised tissues. This nutritive material produces injury either to the stomach or liver, very frequently to both. The stomach is burdened with more work than a drinker's stomach can perform, hence the dyspepsia so frequently accompanying the bottle. The liver is doubly burdened. Its duties in connection with the food are many. It assists to prepare nutriment for nerve and muscle, and if such nutriment is not required its further duty is to break down such rejected nourishment in order that it may be the more easily expelled from the system.

The results of an overworked liver are apparent in the gout and biliousness so frequently following the regu

lar indulgence in port and other wines.

Alcohol destroys the physical conscience. My greatest objection as a physician to the use of alcohol is that it destroys what I have ventured to call the physical conscience.

The entire body is supplied with minute nerve twigs, which in the healthy man are maintained in a highly sensitive condition. Their function is to inform the brain when any derangement has taken place in the ultimate tissues. This network of nerves occupies a similar position in relation to health that the conscience does in relation to the moral condition. Whenever any muscle has any difficulty in contracting, a message of the fault is at once transmitted to the brain. The same Occurrence takes place when the stomach has difficulty in digesting its contents, when the liver is overburdened with excess of sugar or bile, and when the brain is being overtaxed with daily toil. These messages produce great uneasiness to the subject of their influences, just as a troubled conscience does in the mind of its possessor. Now, there are two ways of avoiding the inconvenience of the physical conscience, just as there are two ways of avoiding the pangs of a similar moral conscience. You may either do what is right, or you may lull your conscience to sleep. Alcohol enables a man to deaden his physical conscience, and thus he may go on ruining his health without knowing it until he is beyond all hope of recovery.

be at once the most important and the most inexplicable is the seemingly studied disregard, in the treatment of a patient's malady, of those minute conditions of his daily life which

practically make and unmake health, so that special management being almost nothing, and special medication almost everything—it would seem as if physiological principles were of no account in therapeuties. But a more critical study of disease will soon convince us that this inference is unsound and its application incorrect. Putting aside, for the moment, inherited affections and parasitic maladies of whatsoever sort, shall assume that chronic disease—a state of parts, and not a thing interposed between them-is the eventual outcome of continued violation, conscious or unconscious, of physiological laws as they exist for the race, or as they are conditioned by the peculiarities of the individual organism. I shall further assume that those violations are not exceptional and gross, but daily and minute; and that their effects, infinitesimal from day to day, become visible only after longer periods of time, and so escape recognition except by those who are trained to discern the casual connections of subtle things. And I shall furthermore assume that the organism, in virtue of the inherent forces maintaining its solidarity, tends to repair existing and to repulse threatened disorders, and that, when placed infavourable, and liberated from unfavourable, physiological conditions, this tendency issues and ends in successful action.

And now let us take for illustration a case of primitive uncomplicated gastric catarrh. Assuredly it does not come without a cause, and it is not introduced from without, but begotten within. It is, in fact, engendered out of a more or less prolonged, and perhaps petty, violation of the laws of stomach-digestion, and it is maintained by conditions which, although apparently too trivial to be worthy of notice, are yet sufficient to hinder the formation of healthy peptones, and to traverse the reparative powers of the organism. What is ordinarily done in such a case? The patient is told in a vague sort of way to have a light and nourishing diet, to take daily exercise, to avoid anxiety and over.

work, and to try bismuth and alkalies with an occasional alterative aperient.

Now, speaking, if I may be permitted to do so, from my own experience, it is certain that in such a case management is of more moment than medicine, and that without a rigid, and even minute, obedience to the physiological conditions of healthy digestion, the chances are small of a speedy and permanent recovery from the gastric catarrh.

He

But the instruction of "a light and nourishing diet " admits of the widest diversity of interpretation, and, with the most loyal desire for literal obedience, the patient, according to his age, habits, and station in life, may be unwittingly guilty of doings the most conflicting and injurious. may eat too often or too seldom; his food may be fresh or preserved, too highly seasoned or too insipid, too concentrated or too bulky. He may take too much liquid or too little, too often or too seldom, too hot or too cold, effervescent or still. And without a conscious, but yet real and great, departure from the intention of his instructions, he may frequently refresh himself with cups of tea and coffee, and make glad his heart by incidental glasses of wine or of beer.

Now, there is a right way and a wrong way in the management of every such case, and, although they lie so near together, and are so much alike that the distinction between them is not easy of discernment, it is necessary that the distinction shall be made. For it is upon a correct giving or not giving, a correct and minute attention to the physiological conditions affecting the quantity, quality, and character of the solid and liquid food, the times and circumstances of eating and drinking, the amount of exercise, work, and sleep, and the adequate discharge of the excrementitious functions, that our work will succeed or fail, that our case will turn for evil or for good, and that the patient will either recover his health or drift into permanent valetudinarianism.

If time permitted, and the occasion