Alcohol, a Dangerous and Unnecessary Medicine. Martha Meir Allen

of the physiologic processes which stand between the patient and death.

      The more this question is studied the more apparent is it that, other things being equal, the sick person who is cared for by a non-alcoholic physician has a much better chance of recovery than the one dosed by "a brandy doctor."

      EFFECTS OF ALCOHOL UPON THE KIDNEYS.

      "The kidneys, being the chief organs for the excretion of nitrogen waste, are among the most important organs of the body. Any defect in their healthy activity leads to serious interference with the working of many organs, due to the accumulation in the body of nitrogenous waste products. If both kidneys be cut out of an animal, it dies in a few hours from blood-poisoning, due to the accumulation of waste poisonous ​substances which the kidneys should have got rid of. Serious kidney-disease amounts to pretty much the same thing as cutting out the organs, since they are of little use if not healthy. It is always fatal if not checked, and often kills in a short time. The things which most frequently cause kidney disease are undue exposure to cold, and indulgence in alcoholic drinks."—Martin's Human Body.

      "The kidneys are supplied with arterial blood, which, having given up water, urea, salt, and certain other substances, either secreted or simply strained from it, returns to the kidneys nearly as bright and fresh as when it entered them. While the lungs are concerned in removing carbonic acid—the ashes of the furnace—it is the peculiar province of the kidneys to remove the products of the wear and tear of the bodily machinery—the wasted nerve and muscle—in the form of urea, or other crystallizable substances, the presence of which in the economy for any considerable time is attended with disastrous results.

      "Now, nature has put these organs, charged with so important work, as far away as possible from any source of irritation. Could alcohol get as direct access to them as to the liver, there is no doubt that their function would be destroyed almost at once, since the change in arterial blood by alcohol is much more extensive and damaging than that wrought in such venous blood as the liver receives from the portal veins. Thus while the liver takes the alcohol immediately from the alimentary canal, the kidneys receive it only after it has passed through the liver, the heart, the lungs, and the heart again; by which time much of it has escaped, while the remainder has been greatly diluted by the blood of the general circulation; yet coming to the kidneys even so considerably diluted, it has power to congest, irritate, and excite them to the excretion of an unusual amount of the watery elements of the urine, as if to wash the irritant away.

      "But it is only the watery element that is increased, not the ​urea, which is the substance representing the waste of vital action, and is a poison to the system; this it is the special office of the kidneys to remove. Not only does alcohol not increase its elimination, but actually lessens the discharge. And should the irritation of the spirit continue, or be augmented in force, inflammation would follow, and the excretion of urea nearly or entirely cease and life be in the greatest jeopardy. Relief or death then must speedily follow."—Dr. E. Chenery, of Boston, in Alcohol Inside Out.

      "Alcohol causes kidney-disease in several ways. In the first place it unduly excites the activity of the organs. Next, by impeding oxidation it interferes with the proper preparation of nitrogen wastes: they are brought to the kidneys in an unfit state for removal, and injure those organs. Third, when more than a small quantity of alcohol is taken, some of it is passed out of the body unchanged, through the kidneys, and injures their substance. The kidney-disease most commonly produced by alcohol is one kind of "Bright's disease," so called from the physician who first described it. The connective tissue of the organ grows in excess, and the true excreting kidney-substance dwindles away. At last the organ becomes quite unable to do its work, and death results.

      "The three most common causes of Bright's disease are an acute illness, as scarlet fever, of which it is a frequent result; sudden exposure to cold when warm (this often drives blood in excessive quantity from the skin to internal organs, and leads to kidney-disease); and the habitual drinking of alcoholic liquids."—Dr. Newell Martin in The Human Body.

      "Every physician knows or should know, that the quantity and quality of the effete, or waste, material separated from the blood by the kidneys and voided in the urine, is such as to render a knowledge of the action of any remedy or drink on the function of these organs, of the greatest importance in the treatment of all diseases, and especially those of an acute febrile character. As was long since demonstrated by clinical ​observation, and more recently by patient and accurate experiments by Bouchard and others, the amount of toxic, or poisonous, material naturally separated from the blood by the kidneys and passed out in the urine is so great that if wholly retained by failure of the kidneys to act for two or three days, speedy death ensues. Equally familiar to every observing physician is the fact that in all the acute febrile and inflammatory diseases, not only is the quantity of the urine secreted generally diminished, but its quality or constituency is also changed to a greater degree than even its quantity. Thus, some of the more important constituents are increased, others diminished, and often new or foreign elements are found present, all resulting from the disordered metabolic processes taking place throughout the system during the progress of these diseases.

      "It is, therefore, hardly necessary to remind the physician that it is of the greatest importance to know as correctly as possible both the direct and the indirect influence of every medicine or drink on the action of the kidneys and all other eliminating organs and structures, lest he unwittingly allow the use of such as may not only retard the elimination of the specific causes of disease, but also favor auto-intoxication by retarding the elimination of the natural elements of excretion.

      "That the presence of alcohol in the living system positively lessens the reception and internal distribution of oxygen, and consequently retards the oxidation processes of disassimilation by which the various products for excretion are perfected and their elimination facilitated, is so fully demonstrated, both by observation and experiment, as no longer to admit of doubt.

      "As nearly all the toxic elements of urine are the results of these oxidation processes, the presence of alcohol in the system could hardly fail to interfere with them in a notable degree.

      "The direct and somewhat extensive series of experiments instituted by Glazer. as published in the Deut. Med. Wochensch., Leipsic, Oct. 22, 1891, demonstrated this, as shown by the following conclusions: 'Alcohol, in even relatively ​moderate quantities, irritates the kidneys, so that the exudation of leucocytes and the formation of cylindrical casts may occur. It also produces an unusual amount of uric acid crystals and oxalates, due to the modified tissue changes produced by the alcohol. The effect of a single act of over-indulgence in alcohol does not last more than thirty-six hours, but it is cumulative under continued use.'

      "Dr. Chittenden kept several dogs under the influence of alcohol eight or ten days, and found it to increase the amount of uric acid in their urine more than 100 per cent, above the normal proportion.

      "Mohilansky, house-physician to Manassein's clinic, in the conclusions drawn from his interesting experiments on fifteen young men to determine the effects of alcohol on the metabolic processes generally, stated that 'it does not possess any diuretic action; but rather tends to inhibit the elimination of water by the kidneys.' It is further stated that this result is owing to the coincident effect of diminished systemic oxidation and of blood pressure.

      "On the other hand, several observers have reported that the flow of urine was increased by the use of alcohol. From as full an examination of the subject as I have been able to make, it appears that the diverse results obtained have depended upon the previous habits of those experimented on, and the widely varying quantities of water drank with the alcohol. When the alcohol is taken with large quantities of water, as is usual with those who use beer and fermented drinks generally, the total amount of urine passed is usually increased, but not more than is found to result from taking the same quantity of water without any alcohol. When alcoholic drinks are taken by those already habituated to its use, it has less marked effect on the quantity and quality of the urine than when taken by those who had previously been total abstainers. This was illustrated by the experiments of Mohilansky on the fifteen men, some of whom ​were habitual drinkers, some occasional drinkers, and others total abstainers. When all were subjected to the same diet and