drank a little whiskey, and went to bed feeling very jolly and comfortable and some of them drank a lot of whiskey. In the morning the men who had not taken any whiskey got up all right; those who had taken a little whiskey got up feeling very unhappy; the men who had taken a lot of whiskey did not get up at all; they were simply frozen to death. "Some time ago Sir Joseph Fayrer was out deer stalking in the north of Scotland. He offered his flask to the keeper. 'No, Sir Joseph, I will not take any to-day; it is too cold.' Alcohol is not so injurious as many of the other substances which are contained in it. A great deal of the injurious effect of alcohol has been atributed not to the ethylic alcohol but to the amylic alcohol or fusel oil that is very frequently present in it as an impurity. These seem to have an injurious effect in rendering the mixture of ethyl and amyl alcohols more persistent in its action and tending perhaps to cause more headache afterwards. Other substances which probably have the most injurious effect are those which belong to the furfurane series. They are said by some to have great effect in producing crime." The use of alcohol in pulmonary tubercu losis dates back many years. But at all times, however, some physicians have recog. nized the danger and value of alcohol. "Let him (the pulmonary patient) forbear Wine and Spiritous Liquors," wrote Richard Morton, in 1689, "but especially a Debauch, and a Surfeit proceeding from over-charging the Stomach with them." He adds that as a vehicle for medicines or in small amounts beer may be useful. "Wine, spirits, and fermented liquors of all kinds, however diluted, and however anxiously longed for," wrote Reid, in 1785, "must be rigidly forbidden. They raise the spirits and relieve the languor and faintness always attending the morning sweats; but they infallibly increase the succeeding fever and aggravate every symptom." Bennet, in 1871, thought that moderate use of wine as a tonic and gentle stimulant to digestion was undoubtedly beneficial. "The daily ingestion," he adds, "of large quantities of nerve stimulating, carbon-producing sprit, certainly does not come under my idea of hygienic treatment." He points out the danger of indigestion from over doses (11⁄2 oz. of alcohol in 24 hours is the limit he sets) and advises an investigation of the amount of alcohol taken in all cases where a patient awakes with a dry, clammy, blanched or furred tongue in the morning. Brehmer, the Father of the Sanatorium idea, who, in 1859, first recommended fresh air in the treatment of pulmonary tuberculosis, was also one of the first to advise a systematic use of alcohol. His pupil, Dettweiler, was also an advocate of alcohol, but both placed some limit upon the quantity and usually recommended wine. The late Dr. Austin Flint, of New York, a physician of international reputation, advised many of his patients to use whiskey freely and many of them took up to a pint a day for months at a time. Evidence had been gradually collecting at this time to show that alcohol caused the formation of scar-tissue in the liver, kidneys and blood-vessels. It was well recognized that healing in pulmonary tuberculosis took place by the formation of scar tissue about the areas of disease. The deduction that alcohol, which caused the formation of scartissue elsewhere would prove of benefit in this disease was easily and in many instances willingly made. Backed by such authorities the opinion, no doubt, became widely accepted that alcohol was of great value in pulmonary tuberculosis but it was still regarded by some even at that time as an heroic intervention suited to a desperate condition. However this may be, many physicians without doubt recommended alcohol to their patients because it might help them to recovery and because it would undoubtedly help them in many cases to drown their sorrows. "Poor devils!" they probably argued, "they need it." No doubt they did at that time, for the diagnosis of lung trouble was not made in 90 per cent. of the cases, until all hope of recovery was past. As the diagnosis was made earlier and as the freshair-rest treatment became more widely known it was soon recognized that whiskey might save life to destroy it. Alcoholism is as tyrannical as tuberculosis and in many cases involves a greater number in ruin. Then, too, no positive proof was adduced that the scar-tissue which formed in pulmonary tuberculosis was due to the alcohol and not to the disease. Dr. West, a noted authority in London on tuberculosis, is of this opinion. About this time the French physicians began to investigate the relation of alcohol and tuberculosis. Their work has not yet ended and much evidence has been accumulated not only in France but in other countries to show that overdoses of alcohol are a direct cause of pulmonary tuberculosis. Osler states that more than 20 per cent. of patients with alcoholic cirrhosis (hardening) of the liver die of tuberculosis, which is often acute. "It was formerly thought," he states, "that alcohol was in some way antagonistic to tuberculous disease, but observation of late years indicates that the reverse is the case and that chronic drinkers are more liable to both acute and pulmonary tuberculosis. It is probably altogether a question of altered tissue soil, the alcohol lowering the vitality and enabling the bacilli (germs) more readily to develop and grow." Dr. Samuel West, of London, says whether or not tuberculosis occurs more frequently among alcoholics than among temperate persons, there can be no doubt that when consumption attacks an alcoholic person it is likely to run an acute course. Jacquet has shown that the mortality in France runs parallel with consumption of alcohol. Lancereaux thinks that pulmonary tuberculosis is caused by alcohol in that it diminishes oxidation in the body and is eliminated by the lungs and so weakens them in two ways and renders them less resistent to the tubercle germ. He, together with Kraus and Launay, believes that it hastens the course of the disease. Cotton, on the contrary, calls attention to the fact that in his experience the habitual drunkard-he who is always in his cups-is not often the subject of pulmonary tuberculosis. Dr. Mircoli, of Genoa, is an advocate of alcohol. His statistics seem to prove that alcoholics do not frequently die from tuberculosis and on the contrary copious use without excess appears to protect the or ganism against tuberculosis. The dangers of alcohol lie in excesses, or in the sub. stances often found in the ordinary alcoholic drinks, such as etherial oils, etc. In a hand-book on the prevention of tuberculosis, issued by the Charity Organization Society, New York, is the following: "It has been suggested that alcoholism, in particular, to which the single and widowed have more temptation than the married, is probably an important factor in increasing the prevalence of consumption among them. Alcoholism is admitted by all authorities to be an important factor in pre disposing to tuberculosis. Since this view has obtained credence the story of the sportloving English gentleman, whose recovery was formely attributed to the regular imbibing of seven tumblers of punch every night is quoted as evidence of the value of duckshooting and angling in the treatment of this disease. The susceptibility of cabdrivers to consumption is now explained, not by their exposure to the weather, but by the intemperance which characterizes them as a class. For frequenters of saloons the weakening effect of alcohol on the system is supplemented by exposure to a germ-laden atmosphere. It has been estimated that the excessive use of alcohol triples the suscepti bility to consumption." That alcohol is of great use in many pulmonary diseases cannot be denied. Jaccoud, a noted French physician, says he constantly uses alcohol in some form in pulmonary tuberculosis. Dr. Kingston Fowler, of London, a man of great experi ence in pulmonary diseases, thinks that "stout, bitter ale, wine or alcohol in some form taken with meals is often of great service by promoting the appetite and it may enable a patient to take a much larger quantity of food than he otherwise would. There is no evidence that the admittedly injurious action of alcohol taken apart from food is not experienced in this disease and we frequently observe that patients who have previously been addicted to alcoholic excess suffer when attacked with tuberculosis, far more severely, chiefly from loss of appetite, inability to digest food and a very irritable cough than those who have led temperate lives." Winternitz is of the opinion that 50 gramms of alcohol (about 11⁄2 ozs.) may be used daily with advantage. It may increase the appetite, enable more nourishing, fatproducing food to be taken or aid in sustaining a forced diet. As patients with pulmonary tuberculosis are already susceptible to many nervous diseases, Hezel thinks they should be warned that too much alcohol ("anything more than small doses") may cause them further damage. In young men with a family history of pulmonary disease, far from advising alcohol, it should be prohibited as the late hours, careless and irregular habits that it fosters frequently precipitates the individual into the disease he seeks to avoid. Dr. Harris treated 26 cases of pulmonary tuberculosis with whiskey containing 53 per cent. of alcohol, during a period of nine months. The dose was at first two teaspoon fuls and was increased to three tablespoonfuls of whiskey every four hours day and night. Dr. Ransome, who saw some of the cases, expressed the opinion that at certain times of the day the dose of alcohol was unnecessarily large, for some of the patients at times were distinctly flushed and slept heavily even in the daytime. "No case left the hospital in a worse state than in which he entered. Little change could be detected in the lungs and no case was cured." A Dr. Flick, head of the Phipps Institute, Philadelphia, says that the popular idea that alcohol is a preventative of consumption is due to the fact that a moderate use of alcohol stimulates the nutrition, gives a ruddy complexion and a round form which is in strong contrast with the pale face and emaci ated form of the consumptive. The popular mind jumps at the conclusion that because alcohol does this for certain persons it would do it for the consumptive. Healthy nutrition prevents consumption and within certain limits alcohol stimulates nutrition. Herein, no doubt, lies a germ of truth. small amount of alcohol may stimulate, and a larger amount irritate and check nutrition. Alcohol causes changes in the liver and kidneys. They try to protect the system but wear out in doing so. This in turn throws the burden upon the heart and blood vessels. As a result the blood is not pumped properly and becomes more or less stagnant, which is conducive to implantation and growth of the tubercle bacillus. When a family is exposed to tuberculosis the members who use alcohol to excess are among the first to contract the disease. The coincidence of alco hol and tuberculosis does not necessarily prove that alcohol is a predisposing cause of consumption, but it does prove that it does not prevent it. Alcoholism in the parent may cause weakened resistance in the offspring, which renders it more liable to all sorts of diseases including tuberculosis. Gardiner believes that 60 per cent. of his curable cases do better without alcohol in any form. To reduce such widely divergent and even contradictory ideas to a schema for practical every day use is not an easy task. However, it behooves each of us to face the matter squarely and to decide what course is best for him to pursue. First and most important, alcohol (all drinks containing alcohol are included in this name) cannot be regarded as an indifferent article of food but as a drug, a medicine. It is no new thing to state that no drugs should be taken except upon the physician's orders. Alcohol is no exception to this rule. It is questionable whether in health alcohol is beneficial. Some state that man's life is no longer simple but complex and he needs a "stimulant" Sir Henry Thompson, one of the greatest authorities on the subject of foods gives as his opinion that the great majority of the human race, at any age or of either sex, will enjoy better health, both of body and mind, and will live longer without any alcoholic drinks whatever, than with habitual indulgence in their use, even although such use be what is popularly understood as quite moderate. "Why whip," some say, "a willing horse?" It must be recognized, however, that many will continue to use alcohol and some begin to do so upon the advice of their physician. In the spirit of compromise with the first. and of warning for the latter it is urged that they keep constantly in mind the danger attendant upon the use of alcohol. It has been stated that alcohol affects different individuals very differently, so differently that in many instances they are no judge of the effect upon themselves. If you use alcohol be frank with your physician and tell him of every drop you take. The danger of acquiring the alcohol habit is considered so great that it is entirely dispensed with in many sanatoriums and the patients prohibited its use. Such institu tions obtain as good results and in some instances better than those where alcohol is used. Great danger, too, lies in the fact that many patients at open health resorts eas ily acquire the habit of treating and being treated. The danger of this is easily seen and for a patient who has formed a habit of indulging in alcoholic excesses the only hope is to leave his boon companions and seek health elsewhere. There can be no question that in some instances small quantities of alcohol are beneficial in health as well as in disease as it increases the ability and desire for food and food of a proper sort. The maximum quantity of pure alcohol that can be borne without injury is three tablespoonfuls in twenty-four hours. If more than this be taken, the excess acts as a toxin or poison. Taking brandy and whiskey to contain 50 per cent. by volume of alcohol, three fluid ounces or six tablespoonfuls of these spirits would contain the maximum allowable daily dose, says the Lancet in a recent editorial. This would be the equivalent of about two glasses of brandy or whiskey and water per diem, each containing three tablespoonfuls of spirit and half a pint of water, to exceed which would be to risk a toxic result. Port and sherry, with their average of 20 per cent. of alcohol, contain the same amount in seven ounces or a little over two wineglassfuls, assuming each wineglass to contain about three fluid ounces. The limited quantity of white wines, claret, or champagne, with 10 per cent. of alcohol, would be 15 fluid ounces. while one and a half fluid ounces of alcohol represent about 30 fluid ounces or a pint and a half of table beer. The question is, however, complicated in the case of wines and beer, because these contain nutritive matters in addition. Apart from the fact that to avoid injury to health the amount of alcohol consumed per diem should be limited strictly to one and a half fluid ounces, it cannot be regarded for practical purposes as a food in the sense of a true reparative. It is at best a producer of heat and energy and then frequently at the expense of healthy cellular activity, while its cost from the point of view of actual food value has been calculated to be eight times more than that of bread. In conclusion the Journal of The Outdoor Life would like to emphasize again the most important fact that alcohol is not to be considered as a food but as a drug and accordingly should never be taken except on and under a physician's direction. How to Get Well. In a circular issued by the Presbyterian Hospital Dispensary is the following advice to tuberculous patients: Your improvements and final recovery depend largely on your own conduct. The right way of living must be continued for many months, or even years. Before doing anything, ask yourself, Will this help me to get well? Be careful always to burn or disinfect your expectoration. Avoid soiling your person or clothing with it. Never swallow it. Do not kiss any one on the lips, especially children. Wash your hands, and rinse out your mouth before eating. Cough as little as possible. When you cough or sneeze, turn your head aside, and hold a handkerchief before your face. Spend as much time out-of-doors as you can. The parks and roofs of many city houses are good places to take the fresh-air treatment. Avoid violent exertion of any kind. Whatever makes you short of breath or makes your heart beat fast is injurious. If you have fever take no active exercise, but rest in bed or on a reclining chair. Your bedroom should be the largest, sunniest, and best ventilated you can get. Carpets and curtains are undesirable. Do not occupy dark rooms opening on shafts or in basements. Keep your windows open, but do not expose yourself to drafts. Avoid a stooping position. Keep shoulders back and head erect. Keep out of crowds and away form dust, dampness, and high winds. Do not wear chest protectors or porous plasters. The underclothing should be woolen throughout the year, but of light weight during the summer. Take a daily sponge bath, with brisk rubbing afterward. The bath should not be cold enough to make you feel chilly, but the temperature may be gradually reduced until a lukewarm or cold bath may be taken. Eat as much wholesome, nourishing food as your stomach will digest. From one to two quarts of milk a day should be taken, and in addition, from four to six eggs are desirable. Do not drink wine, beer, or spirits in any form unless prescribed by your physician. If you cough so hard after eating that you vomit, wait a little and eat again-do not lose the nourishment. Smoking is harmful, cigars and pipes less so than cigarettes. If you must smoke, do so only in the open air. Smoke in moderation, and do not inhale the smoke into your lungs. Do not take patent medicines, or remedies advised by friends, or advertised as consumption cures. Stop any drug which spoils your appetite or gives you indigestion. However well you may appear to be doing, continue under the regular observation of your physician, and follow his directions faithfully. Unquestioning Obedience. "Oh! Patrick! What has happened to the lawn? There's not a green spot on it!" "Yez told me to take th' weeds out, mum." Stevenson and Saranac. Reminiscences of the Celebrated Author's Stay in the Adirondacks. health by his New York physician," said Dr. Trudeau, the other day. "He was accompanied by his stepson, Lloyd Osbourne, and took up his abode early in the fall of 1887 in Mr. Andrew Baker's cottage, where he soon was joined by his mother, a. most picturesque and attractive old lady. He remained in Saranac Lake until the following April, and although the snow and ice, the gray skies and the intense cold did not appeal to such a temperament as Mr. Stevenson's, his health was nevertheless much im. proved by his stay. "He used to rail in such forcible but beautiful language at the cold, the snow, the succession of cloudy days, and the lack of color and sunshine, that had his remarks fire and a cigarette in his mouth, ready for a chat on any topic that I might care to bring up. As we held very different ideas on many subjects the discussions were often most animated, and I remember one occasion, at least, on which the limit of parliamentary language was almost reached. His idealistic and artistic temperament clung to all that was beautiful in life as expressed in nature, in art, in form, light and color, in thought, in poetry and imagination, and he deliber ately turned his back on the cold facts of science and life; ignored them as much as possible, and shunned the discussion of such subjects as poverty, disease, sorrow and suffering, with which we were more or less surrounded. His life had been spent among, |