prominent symptoms in these two cases also were excruciating pain, a vomiting of the food in a half-digested state, followed by extreme emaciation. These subjects had indulged freely in the use of alcoholic drinks for years, and continued the habit until the stomach would no longer receive it. In these cases of scirrhus and cancer, the pyloric portion of the stomach is more frequently the seat of the disease than the left or cardiac portion; but the cardiac portion of the organ does not always escape, as the following case, which occurred in my practice some years ago, will show. HEALTH V. DRINKING CUSTOMS. to the Stomach obstructed. Mr. C., a sea-faring man of forty-five, belonged for many Another case. years to the class of temperate [moderate] drinkers; but as he lived on, he became a regular hard drinker, though never a sot. At length he began to complain of occasional fits of dyspepsia, heartburn, and acrid eructations; and these symptoms were followed by a difficulty in passing solid food into the stomach, unless when masticated very finely, and swallowed in small portions. As he expressed himself, there appeared to be an obstruction in the passage near the stomach. The Passage His case was examined by several physicians, who pronounced it to be a stricture in the lower part of the œsophagus. But the obstruction did not yield to the remedies for that disease, and the difficulty increased, until nothing but liquids would pass; and finally, even the liquids returned after reaching the point of obstruction. He suffered from gnawing and lancinating pains in the region of the stomach, as well as from extreme hunger and thirst. I have known him to swallow two gallons of water in successive mouthfuls in a single night, which would pass to the point of obstruction and then be regurgitated, affording only momentary relief; and this was his condition several weeks previous to his dissolution. examination. Upon opening the body after death, about three inches of Condition on the lower portion of the œsophagus was found in a thickened and scirrhus state; the disease extending to the stomach, and so thickening the cardiac orifice, as nearly to obliterate the opening and prevent the passage of food and drink. The mucous coat of the stomach exhibited strong traces of the effects of intemperance, and the pyloric portion of the organ was found in a scirrhus state.* * This case is not given in the Enquirer, but, being so remarkable, has S Scirrhosity of the Pylorus. HEALTH V. PLATE 7 represents the appearance of the stomach of the PLATE 7-Sto- drunkard who dies in a state of mania a potu, or delirium mach after Death from History of the case, Plate 7. Ocular Spectra. Condition of the Stomach tremens. The history of the case from which this drawing was made, and which occurred in my practice some years since, will illustrate the character of the disease and the morbid condition of the stomach. The subject was a man amiable in disposition, courteous in manners, and high in public life. By degrees he became intemperate, and although he drank daily, his excessive indulgence was confined to paroxysms of greater or less duration. Several times during the continuance of these paroxysms, he was drawn into a state of delirium tremens, but from which he soon recovered. At length, one of these paroxysms of drinking came upon him which was of longer continuance than usual, and of greater severity. For more than a week his mind was entirely deranged; and it required two persons to confine him to his room, He imagined that his nearest friends were his greatest enemies and persecutors, and were constantly laying plans for his destruction. He fancied that he saw spectres, and devils, and files of armed soldiers entering his apartment, deadly serpents crawling over his body, and wild beasts ready to devour him. There was one individual in particular, a certain man who had often won his money at the billiard table, whom he imagined he saw grinning and skulking round the chamber, waiting an opportunity to rob him of his money. His bodily functions became more and more disturbed, accompanied with great debility, a cold profuse clammy sweat, and small and sinking pulse. These symptoms were followed by general spasms, which soon closed the scene. After death the body was examined. Upon laying open after Death. the stomach, it presented the appearance exhibited in the plate. It contained a considerable quantity of dark fluid, resembling coffee-grounds; the inner surface was covered with a dark-brown, flaky substance, upon removing which, it exhibited marks of having been in a high state of inflammation; some portions appearing of a deep red or mahogany color, and others quite black, as if in a state of incipient mortification. It was obvious that the dark, flaky matter been transcribed from Appendix C to Dr. Lees' "Illustrated History of Alcohol." HEALTH V. Drinkers digest their which lined the inner coat, as well as that lying loosely in the cavity of the organ, was blood, which had exuded from the vessels of the inflamed surface, and had been acted upon own Blood!! by the gastric juice, converting it into the black vomit. I have had several opportunities of inspecting the body, after death, of those who have fallen by intemperance, in a state of delirium tremens, and I have found not only the symptoms attending the affection, but the morbid appearance to be extremely uniform; and my observations fully confirm the opinion entertained by most modern physiologists, that the disease has its seat originally in the stomach, and that the affection of the brain is purely sympathetic and secondary ; an opinion sustained also by the course found most successful in the treatment of the disease. Delirium tremens an effect of Disease of the Stomach. SECTION II. other Organic from drinking derangements I have thus briefly spoken of intemperance as affecting the condition of the stomach only; but it should be borne in mind, that while alcoholic drinks make their first and strongest impression here, their morbid effects are not limited to this organ: the whole of the intestinal canal participates more or less in their influence. The internal coat becomes irritated, inflamed, and ulcerated; and occasionally affected The Bowels. by those other organic changes [scirrhus, cancer, &c.] delineated in the drawings of the stomach. Nor are the consequences of intemperance confined to the digestive canal alone. The distant parts of the body become, in time, affected also.* The liver, the brain, the heart, the lungs, and the kidneys, become the seat of alcoholic influence, an influ [* “Scirrhus of the bowels, scirrhus of the stomach, at least of the pylorus and liver," says Dr. Trotter, "are frequent concomitants of ebriety. But the intestines, pancreas, spleen, and perhaps the kidneys, are also liable to the same affection; all of which after a certain period are incurable, and often speedily fatal. The dram and purl drinker may sooner experience these evils [because in a given time he consumes more of the alcoholic or other poison,] than other drunkards, but even the guzzler of small-beer has no security against them. Nay, so sure and uniform is this effect of producing diseased bowels by fermented liquors, that in distilleries and breweries, where hogs and poultry are fed on the sediments of barrels, their livers and other viscera are observed to be enlarged like those of the human body."-Dr. Trotter on Drunkenness.-Vide Standard Temp. Library, p. 40.] The Liver, Brain, Heart, NOTE. Scirrhus of Bowels and other organs. HEALTH V. ence which is transmitted to them in two ways. The first is upon the principle of sympathy [i. e. one organ participating in the suffering of another]; while the second is through the medium of the circulation, and the immediate action of the alcoholic principle upon the organs as it passes through them, mingled with the blood. Both may' be illustrated by familiar examples. The individual who has become exhausted by labor and fasting, finds his muscular power diminished, and ease through his whole system enfeebled. Upon partaking of his food, his strength is immediately restored-restored long before his food is digested, or any nourishment can have been derived from it. This effect is produced by the stimulus of the food upon the stomach, which impression is transmitted to all the other organs of the body through the medium of the nervous system, upon the principle of sympathy. Organic dis Sympathy. Organic dispase through tion. The second, through the medium of the circulation, may the circula- be shown by two facts. The odor of the drunkard's breath furnishes us with one of the earliest indications of intemperance. This is occasioned by the exhalation of the alcoholic principle from the bronchial vessels and air cells of the lungs; not of pure alcohol, as taken into the stomach, but as it has been absorbed and become mingled with the blood and subjected to the action of the different organs of the body, and not containing any principle which contributes to the nourishment or renovation of the system, is cast out with other excretions as poisonous and hurtful. Magendie long since ascertained by experiment, that diluted alcohol, when subjected to the absorbing power of the veins, is taken up by them, is mingled with the blood, and afterwards passes off by the pulmonary exhalents. The case of a drunkard is menard's breath a tioned, who used to amuse his comrades by passing his breath through a narrow tube and setting it on fire as it issued from it. The drunk consuming fire. The Circula hol. Wines, &c. shown to cir The perspirable matter which passes off from the skin tion of Alco- becomes charged with the odor of alcohol in the drunkard, and in some cases furnishes evidence of the kind of spirit drunk. Two cases are related by Dr. Macnish, the one in a claret, and the other in a port drinker, in which the moisture exhaled from their bodies had a ruddy complexion, similar to the wine upon which they had committed the debauch. These facts show us that alcoholic drinks are absorbed, mingle, and circulate with the blood, and therefore act immediately upon the different organs of the body. culate through the system. |