the mental collapse is, that the brain, like every other organ of the body, while in a state of functional activity, draws to it a super-supply of blood, and consequently, when alcohol is taken, it adds to the already existing engorgement of the cerebral vessels arising directly from the brain's activity, by accelerating the heart's action, and thereby augmenting its deleterious effects by still further increasing the pressure exerted on the nerve-cells and fibers by the already dilated and engorged vessels.
We shall now for a moment glance at the injurious effects of small quantities of alcohol exerted on the brain through the intermedium of the hepatic derangements that stimulants induce.
The very large number of nerve affections, more especially in the form of intellectual disturbances, which come under the notice of liver specialists, are in a great measure attributable to the disorder of the biliary functions brought about by the habitual indulgence in small quantities of alcohol between mealtimes; for, as is well known, scarcely a more formidable cerebral poison than bile exists.
Sometimes one learns from a patient a great deal which he may turn to account in the treatment of others; and one of the things a patient taught me was the marvelously depressing after-effects that a single glass of spirits will occasionally produce in a bilious subject. A leading member of our own profession, who is a martyr to biliousness, made a number of experiments upon himself regarding the depressing after-effects of alcoholic stimulants, and he tells me that he has repeatedly found that a single glass of gin, whisky, or brandy, taken diluted with water, either at dinner-time or in the evening, when he is bilious, and feels exhausted after his day's work, will be followed in from five to fifteen hours with such a morbid depression of spirits that he scarcely knows what to do with himself; yet the primary effect of the stimulant is, he says, not only refreshing but exhilarating. This, although an exceptional case in so far as its severity is concerned, is but the type of many others that have come under my notice; for some have said that a single tablespoonful of brandy, whisky, or gin, will induce depressing aftereffects when their livers are out of order.
The only way in which I can account for this depressing aftereffect of small quantities of alcohol, when taken by bilious persons, is by imagining that the small amount has the power to exert a more than usual deleterious influence on the cerebral tissues in consequence of their having been already materially weakened by the direct poisonous effects exerted on the nerve tissues by the bile in the circulation. I am led to this opinion from noticing how much less the depressing after-effects of spirits become so soon as the liver's functions are put to rights.
