efforts; for while it shows that all exposed to the partaking of alcoholic stimulants in small quantities at a time are much more frequently affected with the fatal forms of cardiac diseases than others, it in an equally unmistakable way shows that men who, like brewers, require in the course of their trades to tax their muscular strength, and thereby throw additional work upon their hearts, are far more often attacked with the fatal forms of diseases affecting the circulatory system than men equally addicted to imbibe alcoholic stimulants, but who are not called upon to make similar kinds of straining muscular efforts.
The relative proportions of deaths from diseases of the circulatory system in the different classes are:
| Those not exposed to the temptation of drinking. | Those exposed by their vocations to the temptation of drinking. | ||
| Drapers and warehousemen | 75 | Commercial travelers | 100 |
| Gardeners and nurserymen | 82 | Vintners, waiters, and barmen | 146 |
| Printers | 93 | Brewers | 165 |
Moreover, it is equally known that intemperance is a most active agent in the induction of atheromatous (fatty granular) degenerations in the coats of the arterial system, and as such a fruitful source not only of death by cardiac syncope, but likewise by apoplexy, from the cerebral vessels being quite as frequently and as severely affected with the degeneration as those of the heart itself, and the coats of the one set being as liable to sudden rupture as those of the other, if not, indeed, even more so, from the less solid nature of the brain surroundings. I wish now to call special attention to what I believe to be a fact—namely, that what is termed "moderate drinking" is a far more general cause of atheromatous degeneration of the coats of the blood-vessels than is usually supposed.
It is, I believe, next to impossible to overrate the desirability of impressing patients laboring under heart-disease, as well as atheromatous degenerations of the blood-vessels, with the absolute necessity of being extremely temperate in the use of alcoholic stimulants, if they wish either to live long or to ameliorate the disease of the circulatory system under which they labor. For alcohol taken in the form of spirits—brandy, whisky, gin, or rum—even in teaspoonful doses, by increasing the heart's action has quite as pernicious an effect on the organic structural disease, be its form what it may, as belladonna itself. And I fancy all who have much experience with cardiac diseases know well the intrinsic significance of this remark.
In the early stages of organic disease of the heart or blood-vessels judicious regimen is quite as essential to the well-being of the patient as wise treatment: for, if the case be skillfully handled, it is not only possible for death to be long averted, but
