the body; and that a large part passes off speedily, unchanged, while there is no evidence whatever that such part as is retained a longer period is either assimilated or converted into any form of force.

Dr. Richardson, of London, the eminent sanitarian, experimental physiologist, and physician, and the author of numerous works, has long held similar views to these of Dr. Wilkes, or rather has had from. his experiments and observations similar knowledge; and our own observations, which have continued on this subject for a long time, have, years ago, brought us to similar conclusions. There is, in our minds, no question of their correctness as applied to the ordinary physiological state.

In studying the effects of alcohol on the system, we must go beyond these acute or immediate effects in the physiological state. These acute effects show the essential nature of the article, but there are more remote effects, especially more permanant ones arising from its continued use, of much more importance than its immediate action.

In the habitual use of this article four stages of alcoholic change are recognized by Dr. Richardson, corresponding in many respects with the four acute stages which have been described. There is a mild first stage, where the indulgence is very limited, in which the condition deviates but little from the physiological state. There is a second stage where a change from the normal state is more perceptible, but yet where the subject of it is not regarded as a drunkard. A third stage where there is recognized unquestioned intemperance or inebriety; and fourth, where the man is a complete sot, given up to continued indulgence, is in the most debased condition, suffering from chronic and extreme alcoholism, tottering upon the verge of destruction, unfit for any useful occupation, a disgrace to himself, and a nuisance to all about him.

There are no differences of opinion as to the injurious, the pathological, and the destructive effects of alcohol upon the individual, physically, mentally, morally, and socially, and upon the family and society, when its indulgence is carried to the extent of inducing these latter stages. The whole controversy, if there is room for controversy, is respecting the lesser degrees of indulgence. All that admits of any honest and intelligent difference of opinion and expression, pertains to the

matter of moderate drinking. Is there real benefit, or palpable injury? Is there safety or danger? Is there pleasure not overbalanced by suffering? Is there greater or less happiness and well being in what by many is called the "temperate use" of alcoholic drinks?

It is true that a person may take a quantity so small occasionally, or even habitually, or a moderately larger quantity at considerable intervals, as not to be seriously affected by it. There are many people who may be classed as temperate, who are not total abstainers. They may never carry the effect beyond the first degree of chronic alcoholic action. What is their condition, and how do they compare with total abstainers? Negatively, we may say, they are not stronger or more healthy. They cannot do more or endure more. They are not clearer headed, or purer hearted. We think it must be conceded by all of us that moderate drinkers are no better physically, mentally, morally, or socially, than those who totally avoid these beverages. In this country, at least, where so many are abstainers, and where there are such large opportunities of comparison, this will be admitted. If the preceding view taken of the essential action of alcohol be correct, the moderate drinkers are not in quite as good a condition as the abstainers. No doubt, many temperate drinkers are better men, physically, mentally, morally, and socially, than are many others who are total abstainers. There are those who take a very moderate quantity of wine daily with their dinner who are superior, mentally and morally, to most ordinary men who do not take any; but the former are not superior because of their wine, and the latter are not inferior because of their abstinence. The contrast, as a rule, would be grea er if the abstainers took wine.

But what is the particular condition of the average moderate drinker, as affected by his indulgence? His physical and mental condition, compared with what it would be without the alcohol, must be judged of by what we have seen to be the essential effect of the article. Can a debilitating, paralyzing narcotic agent, certainly poisonous in larger quantity, really improve the physiological or ordinary healthy condition of the system? This seems contrary to reason, and is contrary to correct observation and actual experience. The fact is, alcohol, in whatever quantity, taken in the physiological state'

when perceptible effects are produced, is weakening instead of strengthening, is lowering instead of elevating.

But with the moderate drinker in course of time there comes to be, I may say inevitably, a feeling of the want of the narcotic influence whenever the accustomed dram or sip is omitted. A sense of uneasiness is felt which is relieved by the drink. With many, especially in our exciting climate, and with our fast habits, this becomes a feeling of urgent necessity, which is with difficulty resisted. The feeling is akin to that of the smoker when deprived of his accustomed cigar or pipe. When this is the case, the drinker's system is changed from the natural or physiological to an artificial-to the alcoholic state. He is constantly in a different condition from the habitual abstainer.

The surface vessels, especially of the face, are apt to be dilated, giving a reddish or bluish color to the countenance. The action of the heart is apt to be perceptibly changed. It is usually too rapid, but from modification of the innervation it may be too slow; and if no feverish excitement or irritability is induced, it is too feeble. The digestion is indifferent until the alcohol dilates the vessels of the stomach, and impresses in the accustomed mode its nerves. The mind is generally duller, until the vessels of the brain are dilated, so that more blood goes to that organ. Sensations of coldness are apt to be felt, until relieved by the soothing potion. The general sense is that of discomfort, until the peculiar; sensation produced by the narcotic is experienced. An artificial state has been induced in which relief and comfort to the sensibilities arise from the wine, the beer, or the whisky and water; and that relief is to such an extent, and so common, that, losing sight of the fact that the unpleasant feelings are the result of the alcohol habit, the wisest men are often persuaded of the utility to themselves, and by parity of reasoning to others, of this moderate drink ing. (Richardson.) They often feel better and can do more work when they have their accustomed drink than when temporarily deprived of it.

But the worst is to come. Everybody knows that, in this country at least, very few stop long at this stage of moderate habitual drinking. When the indulgence goes beyond this moderation, we have chronic alcoholism of different degrees of

severity, as there are different degrees of indulgence, and differences in the powers of resistance and endurance. The effects that follow are familiar to all of us. The diseases of the stomach, the liver, the lungs, the heart, the kidneys, the brain, the whole body, we daily see. Gout, always the effect of alcohol in the individual or his ancestors-(Garrod),-neuralgias, nervousness, irritability, broken sleep, debility, inefficiency, moral perversion, indifference to obligations, malfeasance, in short, every form of physical, mental, and moral degradation follows. Some endure this state long, but an accident or a casual disease is badly borne, and the possibility not only of well living but of long living is destroyed.

Says Prof. Flint: "The toxical condition called alcoholism enters directly into the constitution of many affections, such as cirrhosis of the liver, fatty liver, epilepsy, muscular tremors, gastritis, pyrosis, and various dyspeptic disorders. Indirectly, alcoholism favors the production of nearly all diseases, by lessening the power of resisting their causes, and contributes to their fatality by impairing the ability to tolerate or overcome them."

An alcoholic patient is dreaded both by the surgeon and the physician. A fracture, an amputation, the ligation of an artery, or the removal of a tumor is apt to be followed by severe consequences; and a pneumonia, a hepatitis, a fever, the cholera, or almost any internal disease, is usually much more severe and more likely to be fatal. Such cases require different management from the same class of accidents and diseases occurring in non-alcoholized persons; and the hospital experience and conclusions in large cities, derived from such cases, embodied in books, and followed by private and country practitioners in the treatment of unalcoholized people, destroy another proportion of human life. These remarks apply to cases falling short of positive drunkenness, to the cases of habitual, steady drinking, to persons who may maintain a show of health, but who are on the verge of a crater, into which they are liable at any moment to fall. If they escape until age approaches, their powers much sooner decay, and they may be permitted to die of premature senility. Their chances of life are even less than those of the periodical drunkards, whose extreme excesses

attract much more attention, but whose periods of abstinence afford an opportunity for partial recuperation.

These facts are being recognized by life insurance companies, and these companies are becoming very wary of beer and wine drinkers, who maintain for a time a fair exterior.

Sir Henry Thompson, the distinguished surgeon of London, says: "Few are aware of the mischief done in England by what is regarded as the moderate use of fermented liquors."

We will not dwell upon the extreme and more terrible conditions of inebriety and alcoholism, mental, moral, or physical, lest we should be considered "sensational" or "fanatical." The evils of intemperance, however, are sensational, and their contemplation is apt to produce what by many is called "fanaticism." In a report to a medical society like this, there should be the statement of scientific truths, rather than appeals made to sentiment or feeling; but important truths, whether scientific or otherwise, affecting the deepest and most sacred of human interests, are felt by all benevolent and sensitive minds.

In considering the effects of alcohol and the relations of its use to the welfare of the race, we cannot everlook the subject of heredity. Every permanent condition of the organism, every habit of body or mind in the parent, has an influence greater or less upon the qualities and tendencies of the offspring. This is a fact now so generally acknowledged as to require no proof or discussion. Our instincts are chiefly the transmitted habits of our parents and ancestors; and we are to a larger extent than we often realize, the aggregate of qualities we have inherited. We can make of ourselves what we will, only within certain limitations, and our innate propensities at least, however they may be controlled, are received from our ancestors, and are apt to govern us. This is particularly true of physical conditions. Gout, as already stated, is the result of alcoholic indulgence, as it is a disease unknown among people, as the Mahommedans, who, from religious restrictions, or from other causes, have never for generations used alcohol in any form; and this abnormal state is well known to be transmitted as well as acquired. Other evil qualities and defects produced by drink, as well as by other sins that establish characteristics, are visited upon the children unto the third and fourth and later generations.