“Our feeling of being warm depends on the nerves of the skin. We have no nerves which tell us whether heart or muscles or brain, are warmer or cooler. These inside parts are always hotter than the skin, and if blood which has been made hot in them flows in large quantity to the skin, we feel warmer because the skin is heated. As alcoholic drinks make more blood flow through the skin, they often make a man feel warmer. But their actual effect upon the temperature of the whole body is to lower it. The more blood that flows through the skin, the more heat is given off from the body to the air, and the more blood, so cooled, is sent back to the internal organs. The consequence is that alcohol, in proportion to the amount taken, cools the body as a whole, though it may for a time heat the skin.”

“While fresh animal food, and especially fat, is absolutely essential to the inhabitants and travelers in Arctic countries, alcohol, in almost any shape, is not only completely useless, but positively injurious.”

“The common opinion that alcohol becomes in some way a necessity in cold countries is entirely a mistaken one. This has been conclusively proved by the expedition. In making up his list of the Fram’s equipments, Nansen did not include any spirits, with the exception of some spirits of wine for lamps and stoves.”

“We found most decidedly that alcohol was no substitute for bread and meat. We also found that it was no substitute for coals. We of the army had to sleep outside Paris on the frozen ground. We had plenty of alcohol, but it did not make us warm. Let me tell you there is nothing that will make you feel the cold more, nothing which will make you feel the dreadful sense of hunger more, than alcohol.”

“Alcohol is clearly proved to be not a fuel-food, for if it were it would enable the body to resist cold, instead of making it colder; and in the extreme degrees of cold it would go on burning like other fuel-foods, and would maintain, instead of helping to destroy, life.”—Richardson’s Lesson Book.

“The falsity of all such stories is made apparent by the fact that nineteen-twentieths of all the alcoholic drinks given to the sick are given in connection with sugar, milk, eggs or meat-broths, which furnish the nutriment, and would support the patients better if given with the same perseverance without the alcohol than with it. While we have quite a number of examples of men living on nothing but water forty or fifty days, I have never seen or learned of a well-authenticated case of a man’s taking or receiving into his system nothing but alcohol for half of that length of time, without becoming sick with either gastro-duodenitis, nephritis, or delirium tremens.”

“A careful study of the conditions and processes necessary for both tissue building or nutrition, and tissue waste or disintegration, in all the higher order of animals, will show that neither process can be materially retarded without retarding or preventing the other. Both processes take place only in bioplasm or vitalized matter, supplied with oxygen, water and heat. Neither the assimilation of new material food, nor its use in tissue building can be effected without the presence of free oxygen and nuclein, or corpuscular elements of the blood. And without the presence of the same elements we can have no natural tissue disintegration and removal of the waste. The processes of tissue building and tissue disintegration, are therefore, so intimately related, and dependent upon the same materials and forces, that neither can be hastened or retarded from day to day without influencing the other. When alcohol or any other substance, introduced into the blood, retards the tissue waste, as shown by the diminished amount of excretory products, it must do so by either diminishing the amount of free oxygen in the blood, by impairing the vasomotor and trophic nerve functions or by direct impairment of the properties of the nuclein or protogen elements of the blood and tissues. The popular idea, both in and out of the profession is, that the alcohol, by further oxidation in the blood, lessens the amount of oxygen to act on the tissues, and generates heat or ’some kind of force.’ Those who advocate this theory of saving the tissues by combining the oxygen with alcohol seem to forget that in doing so they are diverting and using up the only agent, oxygen, capable of combining with, and promoting the elimination of, all natural waste products as well as the various toxic elements causing disease.

“But the theory that alcohol directly combines with the oxygen of the blood by which it would be converted into carbonic acid and water with evolution of heat is completely refuted by the well-known fact that its presence in the blood diminishes both temperature and elimination of carbonic acid as already stated. Physiologists of the present day very generally agree that the capacity of the blood to receive oxygen from the lungs, and convey it to the systemic capillaries and various tissues, depends chiefly on its hemoglobin (red coloring matter), protein, or albuminous and saline elements.

“Both experimental and clinical facts in abundance show that alcohol at all ordinary temperatures displays a much stronger affinity for these elements of the blood and tissues, than it does for oxygen. And when present in the blood, it rapidly attracts both water and hemoglobin from the corpuscular and albuminoid elements of that fluid, and thereby diminishes its reception and distribution of oxygen. We are thus enabled to see clearly how the alcohol diminishes the oxygenation and decarbonization of the blood, and retards all tissue changes both of nutrition and waste without itself undergoing oxidation with evolution of heat. Consequently, instead of acting as a shield or conservator of the tissues by simply combining with the oxygen, the alcohol directly impairs the properties and functions of the most highly vitalized elements of the blood itself, and thereby not only retards tissue waste but also equally retards the highest grades of nutrition, and favors only sclerotic, fatty and molecular degenerations, as we see everywhere resulting from its continued use. Can an agent displaying such properties and effects be called a food, either direct or indirect, without a total disregard for the proper meaning of words?”

“This lessening of the elimination of tissue waste is simply an evidence of the accumulation of poisonous substances within the body, through the lessened activity of liver and kidneys and the impairment of the blood.”

“It sounds conservative of health to say of a substance that it delays the breaking down of tissue, but the physiologist does not allow a substance which occasions such delay, to possess, because of that, either dietetic or remedial value. To increase weight by prolonged constipation is not a physiological process.”

“The importance of tissue change to the maintenance of life is readily shown by the injurious effects which follow upon its disturbance. If the discharge of the excrementitious substances be in any way impeded or suspended, these substances accumulate either in the blood or tissues, or both. In consequence of this retention and accumulation they become poisonous, and rapidly produce a derangement of the vital functions. Their influence is principally exerted upon the nervous system, through which they produce most frequent irritability, disturbance of the special senses, delirium, insensibility, coma, and finally, death.”

“If a man drinks daily 8 or 10 quarts of the best Bavarian beer, in a year he will have taken into his system the nutritive constituents contained in a 5 pound loaf of bread.”

“Distilled liquors, if unadulterated, contain literally nothing but water and alcohol, except traces of juniper in gin, and the flavor of the fermented material from which they have been distilled.”—Influence of Alcohol, by N. S. Davis, M. D.

“Consequently it is antagonistic to all true stimulants or remedies capable of increasing vital activity. Instead, therefore, of meriting the name of stimulant, alcohol should be designated and used only as an anæsthetic and sedative, or depressor of vital activity.”

“Drs. Sidney Ringer and H. Sainsbury in a carefully executed series of experiments on the isolated heart of the frog, found that all the alcohol when mixed with the blood circulating through the heart, uniformly diminished the action of that organ in direct proportion to the quantity of alcohol used, until complete paralysis was induced. In closing their report in regard to the action of different alcohols, they say that ‘by their direct action on the cardiac tissue these drugs are clearly paralyzant, and that this appears to be the case from the outset, no stage of increased force of contraction preceding.’

“Professor Martin, while in connection with the Johns Hopkins University, performed an equally careful series of experiments in regard to the action of ethylic, or ordinary alcohol, directly on the cardiac structures of the dog, and with the same results. He makes the following explicit statement of the results obtained by him. ‘Blood containing one-fourth per cent. by volume, that is two and a half parts per 1000 of absolute alcohol, almost invariably diminishes, within a minute, the work done by the heart; blood containing one-half per cent. always diminishes it, and may even bring the amount pumped out by the left ventricle to so small a quantity that it is not sufficient to supply the coronary arteries.’

“In 1883, R. Dubois, by direct experimenting upon animals, found that the presence of alcohol in the blood much intensified the action of chloroform and thereby rendered a much less dose fatal.

“Prof. H. C. Wood of the University of Pennsylvania, in an address upon Anæsthesia to the Tenth International Medical Congress, of Berlin, in 1890, said: ‘In my own experiments with alcohol, an eighty per cent. fluid was used largely diluted with water. The amount injected into the jugular vein varied in the different experiments from 5 to 20 c. c.; and in no case have I been able to detect any increase in the size of the pulse or in the arterial pressure produced by alcohol, when the heart was failing during advanced chloroform anæsthesia. On the other hand, on several occasions, the larger amounts of alcohol apparently greatly increased the rapidity of the fall of arterial pressure, and aided materially in extinguishing the pulse.

“Sir Henry Thompson says: ‘That alcohol is an anæsthetic and paralyzant is a fact too well established to be questioned or contradicted.’

“Dr. J. J. Ridge, of London, has published elaborate tables, showing that even small doses of alcohol, averaging one tablespoonful of spirits—not quite half a wineglass of claret or champagne, and not quite a quarter of a pint of ale—impair vision, feeling, and sensibility to weight, without the subject’s being conscious of any alteration. Dr. Scougal, of New York, has repeated and confirmed these experiments, and also demonstrated that the hearing was similarly affected.

“Drs. Nichol and Mossop, of Edinburgh, conducted a series of experiments on each other, examining the eye by means of the ophthalmoscope while the system was under the influence of various drugs. They found that the nerves controlling the delicate blood-vessels of the retina were paralyzed by a dose of about a tablespoonful of brandy.

“Dr. T. D. Crothers, of Hartford, Conn., has deduced some valuable facts from his experiments with the sphygmograph, upon the action of the heart. He has found by repeated experiments that while alcohol apparently increases the force and volume of the heart’s action, the irregular tracings of the sphygmograph show that the real vital force is diminished, and hence its apparent stimulating power is deceptive.”—Extract from the Annual Address before the Medical Temperance Association at San Francisco, Cal., June 8, 1894, by Dr. I. N. Quimby, of Jersey City, N. J.

“It would seem that no further evidence could be required that alcohol is a narcotic and an anæsthetic, rather than a stimulant, and that its use as a supporting and tonic remedy is a practice without foundation in either scientific theory or natural clinical experience.”

“Increased frequency of pulsation is often the strongest evidence of diminished power—as the fluttering pulse of extreme weakness.”

“If chloroform is a narcotic, alcohol is a narcotic. If chloroform is an anæsthetic, alcohol is an anæsthetic. If one is essentially a depressing agent, so is the other. Their strong resemblance no one can question. The chief difference is that the alcoholic narcosis is longer continued, and its secondary effects are more severe.”

“We said it was a direct heart exciter. 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.”

“Alcoholics are very generally prescribed in that weakness of the heart sometimes met with in low forms of fever and in the advanced stage of other acute diseases. It is claimed that these agents are capable of strengthening and sustaining the action of the heart under the circumstances just named, and also under the first depressing influence of severe shock.

“There is nothing in the ascertained physiological action of alcohol on the human system, as developed by a wide range of experimental investigation, to sustain this claim. I have used the sphygmograph and every other available means for testing experimentally the effects of alcohol upon the action of the heart and blood-vessels generally, but have failed in every instance to get proof of any increased force of cardiac action.

“The first and very transient effect is generally increased frequency of beat, followed immediately by dilatation of the peripheral vessels from impaired vasomotor sensibility, and the same unsteady or wavy sphygmographic tracing as is given in typhoid fever, and which is usually regarded as evidence of cardiac debility. Turning from the field of experimentation to the sick-room, my search for evidences of the power of alcohol to sustain the force of the heart, or in any way to strengthen the patient has been equally unsuccessful. I was educated and entered upon the practice of medicine at a time when alcoholic drinks were universally regarded as stimulating and beat-producing, and commenced their use without prejudice or preconceived notions. But the first ten years of direct clinical or practical observation satisfied me fully of the incorrectness of those views, and very nearly banished the use of these agents from my list of remedies. While it is true that during the last thirty years I have not prescribed for internal use the aggregate amount of one quart of any kind of fermented or distilled drinks, either in private or hospital practice, yet I have continued to have abundant opportunity for observing the effects of these agents as given by others with whom I have been in council; and simple truth compels me to say that I have never yet seen a case in which the use of alcoholic drinks either increased the force of the heart’s action or strengthened the patient beyond the first thirty minutes after it was swallowed. * * * * *

“Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of patient and friends something must be done. A little wine or brandy is given, and, as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither wine nor brandy had been used.”

“The result of all recent investigation is to show that the use of alcohol when a stimulant effect is desired, is an error; and that, from first to last alcohol acts as a narcotic.”

“By giving alcohol as a stimulant in exhausting diseases, I believe we always do as we should in giving a dose of opium and brandy and water to comfort a half suffocated patient; i. e., increase his danger. If that be so, we reduce alcohol not only from the position of food medicine, but we reduce it from the position of a goad; and we say that the supposititious stimulating or goading influence of alcohol is a mere delusion; that in fact alcohol always lessens the power of the patients, and always damages their chance of recovery, when it is a question of their getting through exhausting diseases.”

“The action of alcohol in relaxing unstriped muscular fibre, which entitles it to be called an anti-spasmodic, robs it of all claim to give tone. The sense of exhilaration which follows small doses of alcohol has been mistaken for real strength and increase of vitality. It is well known that relaxation of the blood-vessels throughout the body is one of the first effects of alcohol. The arteries of the retina have been observed to dilate after very small doses of alcohol. The diminution of tone is well seen in the tracings of the pulse under the influence of alcohol. If one needs a tonic, therefore, alcohol is one of the things to be shunned altogether.

“But alcoholic beverages contain other things beside alcohol. Beer contains infusion of hops, or other bitter stomachics. Some wines contain tannin. These ingredients, by creating or stimulating the appetite, increase the strength and vital power in certain cases. But we have a large number of drugs which will do the same without the disadvantages arising from the presence of alcohol, and, if the flavor be objected to, many of them can be taken in the form of coated pills.

“The external use of cold, either by a dripping sheet, cold sponging, or a shower-bath, according to the power of reaction, is a valuable means of giving real tone.

“Wine is frequently prescribed for those young persons who are growing rapidly, and whose strength does not seem to keep pace with their growth. It is important to know that alcohol is not desirable in such circumstances. There is often found in such cases a defective appetite, perhaps even sub-acute gastric catarrh, which may be due to imperfect mastication through bad teeth, or aggravated by it. There are other causes, such as late hours, bad habits, improper food or irregular meals. In such cases those means must be resorted to which are so effectual in improving the condition and strengthening the heart of athletes. Regular and regulated meals, exercise in the fresh air, a good amount of rest and sleep—these will do more than anything else to invigorate the bodily health.”

“Although I was taught, like all others, to use alcohol as a tonic when patients were sick, to hasten their recovery and promote their strength, yet it did not take me very long to find out that here and there was one already a teetotaler who would not take wine long, nor any kind of alcoholic drink unless prescribed, just as castor-oil, dose by dose, but who, when he got beyond the necessity of having it as a medicine, took no more. What was the comparison? My patients who refused, or did not take alcohol, got strong quicker and had less tendency to relapse than those who continued its use. Here was the first step in progress, and consequently I came soon to cease the recommending it merely to hasten recovery of strength. As a tonic, I found it of no value.”

“It may be well here to correct an important error, yet very current, in regard to the medicinal use of alcohol. People regard it as a simple and common tonic; and are ready to accept its supposed help as such in every form of weakness and general disorder of health. But it is ordinarily, no true tonic.”

“There is in the jail at Elizabeth, N. J., a woman who was arrested while participating in wild drunken orgies with a gang of tramps in the woods near the town. She appears nothing but a besotted hag, but was only a short time ago a dutiful wife of a respectable man, and the mother of three beautiful children. Her father, who is said to be living in a village in New York State, is a highly respected minister of the Methodist Episcopal Church. Her children are in an asylum, and her husband is a wanderer in the West. The cause of her ruin was beer, prescribed for her by the family physician as a tonic. At first she refused to take it, having always been a teetotaler, but persuaded to obey the physician, she soon acquired a taste for the drink that speedily developed into the overmastering appetite, which has brought her and hers to this sad condition.”

“Alcohol, chiefly in the form of spirits, is often given to procure sleep and to relieve pain, such as that of neuralgia, dyspepsia, colic and diarrhœa. It is as a sedative that alcohol is so insidious and seductive in cases of chronic disease, as, if frequently resorted to, the drink craving is almost certainly developed. Hence the importance in many cases of rather bearing the ills we have than of flying to others that we know not of. It is clear that other narcotics, such as opium, morphia, chorodyne, chloral, are open to the same objection, and the victims of these drugs are terribly numerous. * * * * * In many instances some form of dyspepsia is the cause of the sleeplessness, palpitation or other uneasy feeling for which a sedative is desired, and when this is cured the symptoms vanish.”

“By the power of alcohol to retard the evolution of heat in retarding molecular changes in the tissues, the liquids containing it may be used as antipyretics when the temperature is too high, and to retard the processes of waste when these are too rapid. But the antipyretic influence of alcohol is so feeble in comparison with the proper application of water to the surface, or with the internal administration of sulphate of quinia, salicylic acid, digitalis, etc. that no one thinks of using it for antipyretic purposes.”—Dr. N. S. Davis in Principles and Practice of Medicine.

“Oxidizability cannot be made the measure of usefulness in regard to this substance.”

“Does alcohol truly deserve to be called a food substance? Obviously, only such substances can be called food material, or be employed for food, as, like albumen, fat, and sugar, exert non-poisonous influence in the amounts in which they reach the blood and must circulate in it in order to nourish * * * * Although alcohol contributes energy it diminishes working ability. We are not able to find that its energy is turned to account for nerve and muscle work. Very small amounts, whose food value is insignificant, show an injurious effect upon the nervous system.”

“We know that alcohol lowers the temperature of the body. It can only do that by diminishing the activity of the vital processes. It also diminishes very greatly the power of the muscles, and it diminishes the intellectual power of the nervous system. To call an agent that causes such diminution of activity throughout the whole body a food is ridiculous.”

“The fallacy of the reasoning which would place alcohol among the foods is very apparent when we put it in the form of a syllogism: All foods are oxidized in the body; alcohol is oxidized in the body; therefore alcohol is food. As logically we might say: ‘All birds are bilaterally symmetrical; the earthworm is bilaterally symmetrical; therefore the earthworm is a bird.’ Oxidation within the body is simply one of several important properties of food, as bilateral symmetry is one of several important characteristics of a bird.”

“It cannot be doubted that any small production of energy resulting from the oxidation of alcohol is more than counterbalanced by its deleterious influences as a drug upon the tissue elements, and especially upon those of the nervous system.”

“Starch, sugar and fats become foods or fuels only through their assimilation. Abundant physiological evidence attests that no substance can act as a food, or as a true source of energy, unless it has first entered into the composition of the body. It must be assimilated. The forces manifested by the body, the muscular forces, or nervous energy, are the result of the breaking down of organized structure into simpler forms. For example, in the case of nervous energy, material from which nerve energy is derived is stored up in the nerve cell, and can be seen with the microscope in the form of minute granules, which disappear as the cell energy is expended, leaving the cell blank and shriveled when in a state of extreme fatigue from overwork. The same is essentially true of the muscle cell. The source of muscular energy is glycogen, an organized substance which becomes a part of the muscle tissue in a well-nourished muscle in a state of rest.

“Experiments have clearly shown that fat, sugar and starch must all alike be converted into the form of glycogen and enter into the muscle structure before they can become a source of energy.

“Professor Atwater tells us that alcohol can not form tissue, hence the query is pertinent, How can it be a source of vital energy? The body does not burn food as a stove does fuel. Food can be called fuel only in a highly figurative sense. The oxidation of food in the body does not take place directly. Food is assimilated, becoming a part of the tissue. Oxygen is also assimilated, entering into the composition of the tissue along with the food elements under the action of special organic ferments brought into play by nervous impulses received from the central ganglia.

“The molecules of these residual tissues which form the storehouse of energy in the body are rearranged in simpler forms, thereby giving up a portion of the energy which holds them together in the state in which they exist in the tissues, and this energy thus set free appears as muscle force, mental activity, glandular work and various other forms of functional activity.”

“There is some doubt expressed by many authorities as to the potency of a drug which is covered up in a strong tincture. It is clear that the value of a drug is not enhanced, and it is certain that a new force-producing, or exploding agency, has been added to the body.

“In experience, any drug which contains alcohol can not be given to persons who have previously used it without rousing up the old desire for drink, or at least producing a degree of irritation and excitement that clearly comes from this source. It is also the experience of persons who are very susceptible to alcohol, that any strong tincture is followed by headache and other symptoms that refer to disturbed nerve centres.

“In many studies I have been surprised at the increased action of drugs when given in other forms than the tincture. Gum and powdered opium, have far more pronounced narcotic action than the tincture. Yet the tincture is followed by a more rapid narcotism, but of shorter duration, and attended with more nerve disturbance at the onset.

“I am convinced that a more exact knowledge of the physiologic action of alcohol on the organism will show that its use in drugs as tinctures is dangerous and will be abandoned.

“There are many reasons for believing that its use in proprietary drugs will be punished in the future under what is called the poison act.”

“When the Temperance Hospital was first opened, it became a question of practical importance, what should be done with regard to the alcohol so largely employed as a vehicle and drug excipient. Not that the principle of the treatment of disease without the ordinary administration of alcoholic beverages precludes the employment of alcoholic tinctures, but it was felt that in such a test case as this it was important to obviate the objection that while withholding alcohol as a beverage, it was given in the medicine. As a matter of fact, it is surprising, when one looks into it, how much alcohol is often given merely as a vehicle for other drugs, and without the special action of alcohol being required or desired. In prescriptions which are to be seen in many text-books, it is not uncommon to find from one to two or three, or even four drachms of rectified spirit in the form of tinctures or spirits. This is very undesirable. If alcohol is needed it should be given in proper measured dose. But if it is not indicated, then it is not well to administer it in this indirect manner.

“Experiments were therefore made, partly at the hospital and specially by Messrs. Southall Bros. & Barclay, of Birmingham, with the result that new non-alcoholic tinctures were made replacing the following alcoholic tinctures and wines:—

Tinct. Aloes.
  "         Arnicæ.
  "         Aurantii.
  "         Belladonnæ.
  "         Buchu.
  "         Calumbæ.
  "         Camph. Co.
  "         Capsici.
  "         Cascarillæ.
  "         Catechu.
  "         Chiratæ.
  "         Cinchonæ Co.
  "           "         Flav.
  "         Cinnamomæ.
  "         Colchici Sem.
  "         Conii.
  "         Digitalis.
  "         Ferri Acet.
  "         Ferri Perchlor.
  "         Gentiani Co.
  "         Hyosciami.
  "         Kino.
  "         Krameriæ.
  "         Limonis.
  "         Lobeliæ.
  "         Nucis Vomicæ.
  "         Opii.
  "         Quassiæ.
  "         Rhei.
  "         Scillæ.
  "         Serpentariæ.
  "         Stramonii.
  "         Valerianæ.
  "           "         Ammon.
Vin. Aloes.
  "         Colchici Rad.
  "           "         Sim.
  "         Ipecac.
  "         Opii.
  "         Rhei.

“These were made by extracting the principles of the drugs in the usual way except that instead of alcohol a mixture of glycerine and water was used in the proportion of one-fourth to one-third part of glycerine, and about five per cent. of acetic acid. These made very elegant preparations, and in the majority of cases appeared to have just the same, and just as great physiological action. Subsequently the ordinary tinctures were distilled, and the extracts thus obtained dissolved in the above menstruum, as far as was possible, in most cases the residuum being found to be inert.

“Gum resins and essential oils were found to be insoluble in this menstruum, and hence such drugs have been given in the form of pill, powder or mixture. Such tinctures are those of assafœtida, benzoin, cannabis indica, cantharides, castor, cubebs, lavender, myrrh, pyrethrum, sumbul, tolu and ginger. Out of 62 tinctures it was found that 46 made good preparations, and 16 did not.

“These were employed for several years. But for some time past, somewhat more reliable preparations have been made for us which contain all the constituents of the alcoholic tinctures without the alcohol. They are for the most part made by taking standardized tinctures, mixing with them sugar of milk, and distilling off the alcohol. The alcoholic extract remains behind in a finely divided condition mingled with sugar of milk. This is broken up, pulverized and compressed into tabloids of a definite dose, which can be taken either in that form or rubbed up and dissolved or suspended in gum water.

“The following have been made up in this form: aconite, belladonna, camph. co., cannabis indica, capsicum, cinchon. co., and cinchon. simpl., digitalis, gelseminum, hyosciamus, nux vomica, opium, strophanthus, ginger and Warburg. Other tinctures will be gradually added to this list.

“As external liniments those commonly used are the linimentum terebinthinæ and the linimentum terebinthinæ aceticum, which do not contain alcohol. A strong solution of iodine is made with iodide of potassium.

“The spiritus ammoniæ aromaticus is made without the spirit, the aromatic oils being emulsionized by means of rubbing up with fine sand, but most of these subsequently rise to the surface. The spiritus etheris nitrosi is impossible without alcohol, but nitrite of amyl, and nitrites of potash or soda can be substituted. The spiritus chloroformi is replaced by aqua chloroformi, or as a sweetening agent by solution of saccharin. Thus a favorite expectorant mixture contains carbonate of ammonia five grains, acetum ipecac, ten minims, and solution of saccharin in each dose.

“As a special stimulant a subcutaneous injection of a drachm of pure ether has been given in a few cases; in others digitalis, or caffeine or ammonia in some form, such as the carbonate dissolved in a cup of hot coffee; or hot solution of Liebig’s extract, or rectal injections of hot water.”