a sense of fatigue as may opium, coca leaves, or other narcotics, but its secondary effects render it undesirable for such purposes; and the proper remedy for fatigue is easily digested food and rest.

We would not prescribe it with the view of preventing or curing consumption, and scarcely ever for the relief of any particular symptoms in that disease. We would never give it in cholera, even if deprived of every other remedy.

We would seldom give it in typhoid or other low forms of fever, especially in non-alcoholized persons-perhaps never when food could be taken and appropriated, and when the other articles of the materia medica were at hand; and certainly never with the view of its operating as a direct and permanent stimulant of the heart's action. We would avoid it in all diseases of the liver, organic as well as functional, and also in Bright's disease, and other affections of the kidneys. It might be tried in some acute inflammations of the lungs, and in severe external inflammations, where the severity of the suffering produced decided shock and consequent depression, and in the absence of opium, quinine, the salicylates, and other remedies. Indeed, in full doses it might arrest or markedly abate an inflammation in its incipiency, but not so certainly as the other remedies just named, or as jaborandi, antipyrine, or various other articles. In the absence of ether and chloroform we might give it in free doses, sufficient to produce drunkenness, to relieve the suffering and shock of a cutting operation, or for reducing a dislocation.

In short, we would use it on the same general principle as other powerful and poisonous medicines, bearing in mind its essential physiological actions as governing its applicabili ty considering its limited therapeutical powers, and the mischief mmediate and remote it may do; and when prescribed at all, it should be in definite quantities, with proper dilution, and with particular precautions and directions. We would never advise it to be left in the hands of the patient to be taken at his discretion, according to his feelings, or to be controlled by the whims of an ignorant nurse or attendant; and we would never sanction or allow its continuance for an indefinite period of time. The formation of an alcohol habit should be guarded against with the same precaution as that of the opium habit,

both of which, by an unguarded manner of prescribing and leaving to the discretion or rather indiscretion of the patient, have wrecked many a valuable life.

We would consider it our duty by our precept and example to discourage its use as a social indulgence, or as a frequent resort as a medicine for slight affections, or on any other than important and clearly necessary occasions. In our judgment these occasions occur but seldom.

It has already been stated that the habitual user of alcohol is in a different condition from that of an habitual abstainer, and this is particularly true in reference to the immediate effect of the alcohol itself on the system. The habitual user of opium will take quantities that would kill several persons, with only the immediate effect of relieving the miserable sensations his habit entails, and of perhaps brightening his intellect, while it would extinguish that of many others. So, to a greater or less extent, with the habitual user of tobacco and other narcotics. In a severe illness of an opium habitue, it might not be prudent to withhold his long indulged narcotic. In the case of an alcoholic habitue, affected with an acute disease, it might not be prudent to withdraw his accustomed glass of wine or spirits. At any rate, the wine or spirits will have a different effect upon him from what it would have upon one who had not formed that habit. This fact accounts in part for the common recommendation in many of our medical works of a moderate quantity of wine or spirits in the dietary of the sick. Most of the patients in the foreign hospitals, and very many in the large cities everywhere in the places where most of our books are written-are more or less alcoholized habitually. That such a "dietary" is neither necessary, best, or, as a rule, innocent with our abstemious non-alcoholized patients, is our deliberate and positive conviction; and we doubt most decidedly its propriety in many of the hospital cases where it is prescribed. In the total abstinence hospitals in England (there are some such), though it is possible some patients might be benefited by alcohol who do not get it, yet the proportion of recoveries is much greater than in the hospitals where alcohol is freely used. A very respectable and an increasing number of practitioners in Great Britain are protesting against the prevalent use of this article in the treatment of the sick.

Though many other thoughts upon this subject press upon our minds, this paper, already grown far beyond our intentions, must be brought to a close.

The preceding view of this subject prompts us in conclusion to say, that as our scientific knowledge of alcohol advances our practice with it and our language respecting it should change.

As to its physiological effects, we have certainly in many respects been mistaken in the past. We have said it excited the vaso-motor nerves of the surface, and thus caused increased vascular action in the cutaneous circulation. We know now it depresses those nerves and causes passive dilatation of the surface vessels. We thought it increased animal heat. The thermometer shows it diminishes it. We thought that from more blood coming to the surface and sometimes causing a feeling of warmth, it would diminish the danger from exposure to cold. We find that from less heat being produced in the centres, and more being lost from the surface by the increased blood in the superficial vessels, the danger of exposure to cold under its influence is greatly increased.

We said the alcohol taken was oxidized in the lungs, and that increased heat and other forms of force were thus produced. We find it is not thus oxidized, or if at all, in so small a quantity that its effect is ordinarily much.more than counterbalanced by the diminution of the oxidation of other hydro-carbons which it produces; so that under its influence heat and the other forms of force are lessened.

We thought it increased muscular strength, and it was taken to aid men in their work. We find that it diminishes muscular power, both for immediate action and with reference to endur

ance.

We thought as it often makes one feel stronger, that this was evidence that one is stronger. We now know that this feeling deceptive, and is not even presumptive evidence of increased strength. We see that the drunken man while boasting of his strength falls to the ground.

We said it was a direct heart excitor. We now know it is a direct heart depressor.

We said, and nearly all the text books still say, it is a direct cardiac stimulant. We know from most conclusive experiments it is a direct cardiac paralyzant.

We thought, and we may sometimes still think, it makes us witty. We know from observation it makes men silly.

We thought it brightened the intellect and might make men wiser. We find that in the long run, at least, it dulls the intellect and makes men foolish.

Wine has been called the "milk of age," and we thought it supported advanced life. We know that the aged live longer and retain their powers better without its use.

As a medicine, or prophylactic measure, we thought it protected against epidemic diseases. We now know it invites attacks.

We thought it prevented and even cured consumption. We know it is the most frequent cause of at least one form of that disease-fibroid phthisis.

We thought, moderately used, it was good for many things. Those who have given most careful attention to the subject believe it is good for very few things.

The demonstrations of modern science have shown the truth. of the ancient saying of the Wise Man: "Wine is a mocker, strong drink is raging, and whosoever is deceived thereby is not wise."

THE MICROSCOPE IN MEDICINE.

BY C. H. STOWELL, M. D., ANN ARBOR.

*

It is within the memory of us who are only in middle age that the majority of the people, including the medical profession, regarded the microscope as an elegant plaything, adapted only to the wants of the wealthy and idle. Thirty years ago the man who purchased a microscope was derided for his foolish expenditure. But the brilliant discoveries of Ehrenberg and others taught the whole world what things were in store for those who availed themselves of the new means of research.

So complete and satisfactory has been the work accomplished with this instrument during the past century, that it would take a life-time to review it.

It has been called "the only perfect imstrument of research," by which is understood that it is the only product of man's constructive genius whose performance equals its theory.

The past few years have given us more convenient and tasty stands; superior objectives; improved methods of illumination; the spectroscope; the photographer's plate; accurate micrometry; many useful accessories; and, not the least important, great reduction in price.

We regard it as an instrument worthy of being placed in the hands of the young, simply from the refined taste and the appreciation of the beautiful that must necessarily result from its intimate acquaintance.

It is an instrument that has revolutionized the sciences of zoology and botany, and has made heavy inroads on the old accepted theories of medicine.

But it is the purpose of this paper to show some of the relations of the microscope to the practice of medicine. Let us listen to some of the testimony on this point:

* Read before the Michigan State Medical Society, June 11, 1885.