sixteen years' confinement, when he died of general dropsy, following disease of the liver. Autopsy. Great general emaciation; the fat had entirely disappeared from the thoracic and abdominal regions. No morbid appearances were noticed in the contents of the cranium. Partial firm adhesion of the left lung. Considerable but not general tuberculation of the upper and back part of this lung, with a vomica of moderate size. The right lung was healthy, and not adherent. The heart healthy. Immense enlargement of the liver, which was at the same time very heavy. It descended below the cartilaginous margin of the chest, nearly filling the left hypochondrium, and pushed the diaphragm upwards, encroaching so much on the chest that the lungs did not collapse when the pleuræ were opened. This increase of size was caused by the deposition throughout the organ of adventitious masses, varying in size from that of a small pea to a diameter of three or four inches, generally of circular figure, immediately surrounded and continuous with healthy hepatic structure, without any intervening capsule. They were firm, and of whitish colour, and of nearly homogeneous substance; they were flattened on the surface of the liver, and the smaller resembled in colour and consistence the secondary deposits in the liver in cases of cancer. Some absorbent glands near the pancreas, and in two or three other situations, were discovered similarly enlarged. There were numerous hard flattish tubercles, not large, in the great omentum, and still smaller ones in the peritoneum, at the lower part of the abdomen. The hepatic substance connecting the morbid deposits was healthy, and of dark colour from vascular turgescence. It was considerably less in quantity than the amount of the morbid growths. The gall-bladder was moderately full of healthy bile. The abdomen contained dropsical fluid of strong bilious tinge, and the skin was of the same colour. Several ulcers in the cœcum and neighbouring part of the colon. Incipient granular degeneration of the kidneys, with partial adhesion of the capsules. (To be continued.) ART. VI.-INTEMPERANCE CONSIDERED AS A FORM OF MENTAL DISORDER. THERE cannot be a more fertile subject for the student of psychology than to elucidate the direct and indirect consequences of intemperance, not only for its ravages on the vital organs generally, but for its special injurious effects on the mental faculties, and as a predisposing cause of many forms of insanity. We shall examine some of the facts to prove that excessive intemperance tends, not only to injure those who indulge in this habit, but that it also affects their offspring, occasioning an excessive craving in them for the gratification of similar tastes, which is often so irresistible as to constitute a special form of disease. It is, therefore, essential to trace the modus operandi of alcoholic poison on the system, which induces, besides the above consequences, many forms of moral depravity. This latter view is obvious by an inspection of our jails and workhouses, which present ample proof of its devastating effects on the higher attributes of man; and our infirmaries and hospitals will furnish indubitable evidence that it predisposes to many forms of corporeal disease; whilst our county lunatic asylums present many lamentable cases of mental affections induced by excessive intemperance. Lastly, it is now a well-established fact, that all those abnormal conditions are transmitted as heirlooms by inebriates to their unfortunate children. In one short paper we can give little more than a mere outline of the subject, but yet sufficient to show that the evils which will be enumerated are not exaggerated for any special purpose. They are patent to every observer, and demand not only the sympathy of philanthropic men, but some effort to prevent their continuation. Finally, we shall submit a few reflections, in order to show how this result may be accomplished by means similar to those made use of to cure various mental affections. So that for our purpose there is not needed any novel treatment or startling new views. The inferences will be deduced from the premises, and may therefore be regarded as simply consistent; for, prior to submitting our deductions, we shall endeavour to prove that drunkenness in some of its forms should be treated as a type of insanity, and that in all inveterate cases the victims should be regarded as patients to be placed under restraint, and forcibly prevented from continuing their debased habits! It will be acknowledged that intemperance is a leveller! All its votaries, whether illiterate or learned, rich or poor, are brought down to the same low moral condition. And just for this reason, it acts on the mind through the organization in general, and the brain in particular. And if we select an example of one highly cultivated, we have the advantage of his experience of its minddestroying tendency. Its continued excess and the fatal consequences are thus graphically described :- "'till the brain became In its own eddy boiling, and o'erwrought, The effects on a worshipper of this modern Moloch is unmistakable havoc. He is rendered abject and reckless, and qualified for deeds of violence; daily he is rendered more savage and infuriated, and becomes desperate and dangerous even to his habitual associates. His criminal outrages are perpetrated under a certain amount of excitement, but he abstains from great excess until he has performed his immoral ravages, and then "he drinks deep," and "steeps his senses in forgetfulness." He is, under such circumstances, impotent to act; his expression is then most idiotic, his appearance desolate, and if he attempts to move, he is in danger of clasping his kindred clod, and presents a being of such disfigured form, as if he had lost every trait of humanity. And in verity it is difficult to believe one so uneducated and so brutalized had ever felt the pure and refined emotions arising from moral perceptions; or that he had ever experienced the love of the beautiful and the true, by contemplating the works of creation. We shudder at beholding the mental degradation of an immortal agent, and we come to the conclusion that Government, in its paternal character, is bound to use means to prevent the great mass of the working population becoming similar to the sketch we have made of one slave to intemperance, with its necessary concomitant, crime! Intemperance is indeed a giant vice, and requires commensurate means to prevent its spreading,-means only possessed by the rulers of the country; and if they neglect their duty, let them not imagine that even the most innocent, pure, and holy will not suffer from the malignant consequences thus unrestrained; and rendered liable, whatever their station, to be injured in the midst of such a vortex of ruin. It so corrupts, that servants sacrifice their integrity to it, and violate the misplaced confidence of their employers; and it pollutes the minds of women, that nurse-maids may corrupt the innocent beings under their charge. So that even as individuals we dare not remain unconcerned spectators; we must combine to stop the torrent of evils which are more devastating than pestilence and plague. We pity the obtuseness of those who consider that, although it may be the source of some crimes, the revenue could not dispense with the sale of that which induces intemperance. Verily they have eyes and see not, ears, and hear not; for the injuries to life and property are more than commensurate to the monetary advantages, and that, if it were possible to prevent altogether the sale of alcoholic compounds, there would be a vast amount of property saved, besides the absolute millions sacrificed for their purchase. And in these advantages we have not added that there would be prevented a number of bad husbands, fathers, mothers, wives, sons, and daughters, which are made by intemperance, and if a list of them could be annually exposed to public gaze it might startle and probably deter some few of the noviciates of this fearful habit. Adding to these brief facts the searing effects of intemperance, and that its tendency is "to drain every drop of the milk of human kindness" from the hearts of its votaries, and then leave them steeped and saturated with extreme and inveterate selfishness, which is confirmed at every session for the trial of criminals. These are simple truisms, for inebriating stimulants damage the organization, render the moral sentiments callous, and prostrates the God-like attribute of reason, often driving its worshippers to madness or murder! There requires little reasoning to explain why such must be the ultimate results, as the primary effect of alcohol is to increase the circulation of the blood; in the first stage brightening the eyes, and exciting symptoms of greater vivacity, as the mental faculties become stimulated. If the doses are continued, there is soon manifested a vast change in the expression-the eyes become slightly injected, the face flushed, the mouth hot and dry, the body feverish, and the brain congested. This latter state is indicated by a sense of heaviness and stupor. If, despite these warnings, additional draughts are quaffed, the individual is in that ominous condition approximating to actual disease. We shall, after these. general statements, submit some few particulars under the following heads : 1. The physical and moral ravages of intemperance. 2. The intellectual lesions. 3. That the inordinate craving for alcohol is an hereditary affection. 4. That drunkenness must be regarded as itself a form of insanity, irrespective of delirium tremens. 5. Concluding reflections. It is well known that the stomach of the drunkard suffers from the effect of his excesses, and that its functions are much impaired, so that it can ill perform its allotted task. The proof of all these effects is graphically expressed in the countenance; for the inebriate either looks very pale and pasty, or else bloated with an accumulation of diseased fat. In the latter case, the slightest scratch, which would be unheeded by a healthy man, will often induce mortification and death. But if the drunkard does not become unwieldly, then he has a cadaverous expression, with, at times, feverish and hectic symptoms. The intemperate are also liable to affections of the liver, bladder, kidneys, and so forth; and he pays the penalty of his excesses by all the complications of dyspepsia, and by having to endure the racking, gnawing pains of gout. Besides these diseased conditions, the thoracic organs are implicated. The heart or its valves may become ossified, or it may lose its contractile power in some degree, producing many distressing consequences; and if the inebriate has inherited weak lungs, his career may be cut short by rapidly developed consumption.* It is patent to every practitioner that the tendencies of these diseased organs may be transmitted to the children of the intemperate besides the other affections to which we shall subsequently allude. These brief statements will suffice our present purpose, as we merely wished to indicate that intemperance, among its other evils, deranges the whole of the chylypoietic viscera, involving the organic functions. It also disfigures the outward form, but this latter is of less consequence than the changes induced by this vice on the inner life of the individual. Before we treat on this important part of our subject, we must call attention to the fact, that the fatal habit of intemperance injures the nervous system generally, and the brain in particular. A vast many of the patients attending the ophthalmic institutions are either drunkards or their children, and the disorders they suffer are, inflammation of the eyes, amaurosis, and very often loss of sight. Many also suffer from deafness and the absolute loss of the senses of taste and smell. Writers on the deaf mutes attribute the affection to intemperance as one of the causes. And it also induces paralysis, epilepsy, and apoplexy. Whilst the brain gives surety of its functional disturbance in delirium tremens, which specially is induced by intemperance, in this affection the victim sees the most frightful objects mocking him, or threatening him with ribald jests or horrid denunciations, and often exciting in him a sense of terror from their demoniac expressions. We will only cite one case as an instance that, after the active attack, the hallucination still, at times, annoyed and irritated the individual. Mr. R was a drinker of brandy to great excess, and although a man of great talent, he had lost all moral control over himself. During one of his attacks of delirium tremens, instead of threatening creditors stunning him with their demands, he fancied that a large black raven was pecking at his right shoulder. Drunkards who have scrofula transmit this dreadful disease in an aggravated form; whilst they are also liable to jaundice and fits of melancholy depression, which, when inherited, is a predisposing cause of suicide. |