disease has long been known, and the reason of this is not far to seek, seeing that it is the special duty of the kidneys to eliminate alcohol from the general circulation—as they do all other foreign materials. And the more work that is thrown upon an organ, the more prone are its tissues to become degenerated. Not only, however, do we know that the kidneys eliminate the imbibed alcohol (from its being met with in urine), but we likewise know that alcohol, as alcohol, saturates the renal tissue to such an extent that I and others have been able to obtain pure alcohol from the kidneys of persons who have died intoxicated by the simple process of distillation. Besides all this, however, there is a special reason why the kidneys should become diseased in so called moderate drinking; and that is on account of the circulation being incessantly increased in them, as it is elsewhere, from the accelerated heart's action induced by the repeated imbibition of stimulants in small quantities. For no doubt the diameter of the renal blood-vessels is augmented by their engorgement, and consequently they exert a deleterious pressure on the intervascular tissues, which will interfere with their proper nourishment. While, further, this engorgement of the renal vessels will render the kidneys more liable to the injurious effects of chills; and chills are, as is well known, the most fruitful cause of kidney disease. This view of the case appears to me to give not only the clew to the reason why Bright's disease is so particularly common among the inebriate, but likewise why transient attacks of albuminuria are so frequently met with in moderate drinkers, among both men and women. Spirit-drinking is said to be mainly instrumental in inducing the variety of renal disease named granular kidney; while beer-drinking is, on the other hand, thought to be most potent in bringing about fatty degeneration of the renal tissues. Be that as it may, I well know, from a long experience of urinary affections, that even small quantities of alcohol habitually indulged in sometimes bring on most troublesome forms of albuminuria, without there being any well marked symptoms of the existence of either granular or fatty degeneration of the tissues of the kidneys.
Alcohol, when taken in small quantity, is in general said to act as a direct cardiac stimulant, and its stimulating effect is supposed to be due to its possessing the faculty of increasing the muscular power of the heart. I take an entirely different view of the matter, and shall now endeavor to show how the increase in the force of the heart's movements, the quickening of the pulse, the flushing of the face, the congestion of the retinal blood-vessels, as well as all the other visible appearances of accelerated cardiac functional activity, are in reality in no wise due to the stimulating action of alcohol, either on the heart's
