TONGUE IN DISEASE DIAGNOSIS:

Introduction:



Tongue is a muscular organ associated with the function of deglutition,taste and speech.It acts as an easily accessible organ for the assessment of health of an individual and shows the state of hydration of the body.It is said that tongue is the mirror of the gastrointestinal system and any abnormal functioning of the stomach and intestines will be reflected on the tongue.



Some characteristic changes occur in the tongue in some particular diseases.That is why the examination of the tongue is very essential and will give some clues for diagnosis.All doctors examine the tongue and they consider the changes in size,shape,,colour,moisture,coating,nature of papillae and movements ect.



Appearance of tongue in some abnormal conditions:-



1) Movements of the tongue:-



a) In one sided paralysis of the body(hemiplegia)tongue moves towards the parylised side when protruded.



b) Tremulus movement of the tongue is seen in diseases like thyrotoxicosis,delirium tremens and parkinsonisum.Tremor is also seen in nervous patients.



c) In progressive bulbar palsy there will be wasting and paralysis of the tongue with fibrillation.Eventually the tongue gets shrivelled and lies functionless in the floor of the mouth.This condition is associated with dribbling of saliva and loss of speech.



d) In chorea(involuntary rhythmic movements) the patient may not be able to keep the protruded tongue in rest,it will be moving involuntarily.



2) Moistness of the tongue:-



The moistness of the tongue gives some indication about the state of hydration of the body.Water volume depletion leads to peripheral circulatory failure characterised by weakness,thirst,restlessness,anorexia,nausea,vomiting ,dry and parched tongue.



Dryness of the tongue is seen in following conditions.



a) Diarrhoea

b) Later stages of severe illness

c) Advanced uraemia

d) Hypovolumic shock

e) Heat exhaustion

f) Hyponatraemia

g) Acute intestinal obstruction

h) Starvation

i) Prlonged fasting.



3) Change in colour of tongue:-



a) Central cyanosis:-



Cyanosis is the bluish discolouration of the mucus membrane due to decrease in the amount of oxygen in the blood.This is seen in heart failure,respiratory failure and in anoxia.In cyanosis tongue,lips ect becomes pale bluish.



b) Jaundice:-



This is the yellowish discolouration of all mucus surfaces of the body (including tongue)due to increase of bilirubin in the blood.Jaundice is seen in hepatitis,bile duct obstruction,increased destruction of RBCs and ect...



c) Advanced uremia:-



This is the increase of urea and other nitrogenous waste products in the blood due to kidney failure.Here the tongue become brown in colour.



d) Keto acidosis:-



This is the acidosis with accumulation of ketone bodies seen mainly in diabetes mellitus.Here the tongue become brown with a typical ketone smell from the mouth.



e) Riboflavin deficiency:-



Deficiency of this vitamin (vitamin B2) produces megenta colour of the tongue with soreness and fissures of lips.



f) Niacin deficiency:-



Deficiency of niacin (vitamin B3)and some other B complex vitamins results in bright scarlet or beefy red tongue.



g) Anaemia:-



It is the decrease in haemoglobin percentage of the blood.In severe anaemia tongue becomes pale.



4) Coating on the tongue:-



a) Bad breath:-



The main cause for bad breath is formation of a pasty coating(bio film) on the tongue which lodges thousands of anaerobic bacteria resulting in the production of offenssive gases.Those who complain about bad breath may have thick coating on the posterior part of the tongue.



b) Typhoid fever:-



In typhoid fever tongue becomes white coared like a fur.



c) Candidiasis;-



It is a fungal infection which affects the mucus surfaces of the body.On the tongue there will be sloughing white lesions.



d) In diabetes and hypoadrenalism there will be sloughing white lesions.



e) Secondary syphilis:-



Syphilis is a sexually transmitted diseased caused by trepenoma pallidum infection.In secondary stage of this disease we can see mucous patches which are painless,smooth white glystening opalescent plaques which can not be scraped off easily.



f) Leokoplakia:-



Here white keratotic patches are seen on the tongue and oral cavity.This is a precancerous condition.



g) AIDS:-



In these patients hairy leukoplakia is seen.



h) Peritonitis:-



It is the inflammation of the peritonium(inner covering of abdominal cavity which also covers the intestines and keep them in position) in this condition there is white furring of the tongue.



i) Acute illness:-



Furring is also seen in some acute diseases.



5) Papillae:-



These are small projections on the rongue associated with taste.There are different type of papillae on the healthy tongue.In some diseases there are some abnormal changes which are following.



a) Hairy tongue:-



This condition is due to elongation of filiform papillae seen in poor oral hygeine ,general debility and indigestion.



b) Geographic tongue:-



Here irregular red and white patches appear on the tongue.These lesions looks like a geographic map.The excact cause is not known.



c) Median rhomboid glossitis:-



In this condition there is smooth nodular red area in the posterior mid line of the tongue.This is a congenital condition.



d) Nutritional deficiency:-



In nutrional deficiency there is glossitis(inflammation of tongue) leading to papillary hypertrophy followed by atrophy.



e) Benign migratory glossitis:-



It is an inflamatory condition of the tongue where multiple annular areas of desquamation of papillae appear on the tongue which shift from area to area in few days.



f) Thiamine and riboflavin deficiency:-



Deficiency of these vitamins cause hypertrophied filiform and fungiform papillae.



g) Niacin and iron deficiency:-



In this condition there is atrophy of papillae.Smooth tongue is encountered in iron deficiency.



h) Vitamin A deficiency:-



This causes furrowed tongue.



i) In nutritional megaloblastic anaemia tongue becomes smooth.



j) Folic acid deficiency:-



Here macrocytic megaloblastic anaemia with glossitis is seen.



k) Cyano coblamine deficiency:-



Here glossitis with macrocytic megaloblastic anaemia and peripheral neuropathy is encountered.



l) Scarlet fever;-



In this streptococcal infection there is bright red papillae standing out of a thick white fur ,later the white coat disappear leaving enlarged papillae on the bright red surface and is called strawberry tongue.



6) Ulcers on the tongue:--



a) Apthous ulcer:-



These are round painful ulcers appear in stressed individuals frequently. May be associated with food allergy.Usual sites are tongue,lips,oral mucosa and ect.



b) Herpes simplex:-



It is an acute vesicular eruptions produced by herpes simplex virus.When these vesicles rupture it forms ulcers.



c) Ulcer in cancer:-



Cancerous ulcers are having everted edges with hard base.Bleeding is also seen.Cancer of the tongue is common in tobacco chewers.



d) Syphilitic ulcers:-



Syphilitic fissures are longitudinal in direction.In primary syphilis extra genital chancre is seen on the tongue.In secondary syphilis multiple shallow ulcers are seen on the under surface and sides of the tongue.In tertiary syphilis gumma may be seen on the midline of the dorsum of the tongue.



e) Dental ulcers:-



These ulcers are produced by sharp edges of carious teeth.

BRIEF IDEA ABOUT PILES (Hemorrhoids)

What is piles ?



Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.



Depending upon the situation there are two types of piles.



1) External piles. 2) Internal piles.



1) External piles:-



This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.



2) Internal piles:-



It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.



Some times internal and external piles occure in same individual.



Factors responsible for piles:--



1) This is a familial disease.



2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.



3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.



4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.



5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.



6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.



Signs and symptoms of piles:--



1) Pain:-



Pain is common in external piles which will be worse while straining at stool.



2) Bleeding:-



Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.



3) Protruding mass:-



In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.



4) In some cases there will be discharge of mucus with itching around the anal orifice.



Complications of piles:--



1,Infection: The infection can spread to deep veins resulting in septicaemia.

2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.

3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.

4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.

5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.



Treatment of piles:--



Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.



1) The thrombosed external pile is excised under local anaesthesia.



2) Sclerosant injection therapy can reduce the size of piles.



3) Rubber band ligation around the neck of piles is useful in some cases.



4) Cryosurgery is very effective.



5) Anal dilatation can reduce constipation and pain.



6) Haemorrhoidectomy is the surgical removal of piles.





How to prevent piles?



1) Eat plenty of fruits and vegetables.



2) Take fibrous food.



3) Avoid excess intake of meat,prawns,crabs ect.



4) Keep a regular timing for food.



6) Drink sufficient quantity of water.



7) Keep a regularity in bowel habits.



8) Take treatment for constipation.

PROSTATE CANCER

Introduction:-



Prostate is a glandular organ present only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.



Diseases of the prostate gland:-



1) Prostatitis:-



This is the inflamation of the prostate gland due to bacterial infection.



2) Benign enlargement of the prostate:-



This is a non cancerous tumour of the prostate seen after the age of 50. 3,Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.



Cancer of the prostate.



Cancer of the prostate is directly linked with the male sex hormones(androgens).If the levels of sex hormone increases the growth rate of cancer also increases.It is found that after the removel of testes there is marked reduction in the size of tumour.



Site of tumour:-



Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.



Changes in the gland in cancer:-



The gland becomes hard with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)



Growth :-



Growth rate is very fast in prostate cancer .The tumour compresses the urethra and produce difficulty in urination.



Spread of tumour:-



Metastasis in cancer of prostate is very early.



1) Local spread:-



From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.



2) Lymphatic spread:-



Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)



3) Spread through the blood:-



Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.



Signs and symptoms of prostate cancer:--



Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen.



1) No symptoms:-



Tumour is small and only in the posterior lobe. This is diagnosed accidentely.



2) Slight difficulty in urination:-



Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.



3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.



4) Retention of urine:-



When the urethra is completely compressed there will be retention of urine.This can lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and finally coma.



5) Signs of metastasis:-



Some patients come with the signs and symptoms of metastasis.



a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.



b) Fracture of spine due to cancerous growth in the spine.



c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.



d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.



e) General weakness due to spread of cancer to different parts of the body.



f) Anaemia due to involment of bone marrow and increased destruction of RBCs.



Clinical examination :-



Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.



Investigations:-



1) Complete blood investigations;-



RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.



2) Urine analysis:-



Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.



3) Renal function tests:-



Blood urea level,serum creatinine level,electrolyte level ect.



4) Serum acid phosphatase:-



Increased in cancer of prostate.



5) x-ray of the spine:-



To detect any tumour or fracture.



6) Ultra sonography;-



Gives idea about prostate,bladder,kidney ect.



7) C T scan:-



More detailed information about organs and tumour.



8) MRI of the spine:-



Gives detailed information about spine ,disc and nearby soft tissues.



9) Lymphangiography:-



Gives idea about lymphatic spread of cancer.



10) Biopsy to confirm cancer:-



Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This will detect the presence of cancer cells.



Treatment:-



1) If there is retention of urine catheterisation is needed.

2) Dialysis if kidney failure.

3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.

4) Specific treatment is prostatectomy(removal of prostate)



Partial prostatectomy :-



Here only the affected lobe is removed.



Radical prostatectomy :-



Total removal of prostate along with nearby lymphnodes.



5, Hormone therapy :-



Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.



6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.



7) Radiotherapy is also done for some cases.



8) Homoeopathy:-



Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms.Constitutional homoeopathic medicine will give great relief and can increase the life span.



9) Yoga and meditation is also healpful.

NAILS IN HEALTH AND DISEASE.

Introduction:



The nails are present at the end of each finger tip on the dorsal surface.The main function of nail is protection and it also helps for a firm grip for holding articles.It consists of a strong relatively flexible keratinous nail plate originating from the nail matrix. Under the nail plate there is a soft tissue called nail bed.Between the skin and nail plate there is a nail fold or cuticle.Normal healthy nail is slight pink in colour and the surface is convex from side to side.Finger nails grow 1 cm in three months and toe nails take 24 months for the same.



Importance of nails in disease diagnosis:



The colour ,appearance,shape and nature of the nails give some information about the general health and hygiene of a person . Nails are examined as a routine by all doctors to get some clues about underlying diseases.Just looking at nails we can makeout the hygiene of a person.The abnormal nail may be congenital or due to some diseases.The cause for changes in the nail extend from simple reasons to life threatening diseases.Hence the examination by a doctor is essential for diagnosis .Some abnormal findings with probable causes are discussed here for general awareness.



1) Hygiene:-



We can make out an unhygienic nail very easily .Deposition of dirt under the distal end of nail plate can make a chance for ingestion of pathogens while eating.If nail cutting is not done properly it can result in worm troubles in children.When the worms crawl in the anal orifice children will scratch which lodges the ova of worms under the nails and will be taken in while eating.Prominent nail can also complicate a skin disease by habitual scratching.Sharp nails in small kids cause small wounds when they do feet kicking or hand waving.



2) Colour of the nails:-



a) Nails become pale in anaemia.



b) Opaque white discolouration(leuconychia) is seen in chronic renal failure and nephrotic syndrome.



c) Whitening is also seen in hypoalbuminaemia as in cirrhosis and kidney disorders.



d) Drugs like sulpha group,anti malarial and antibiotics ect can produce discolouration in the nails.



e) Fungal infection causes black discolouration.



f) In pseudomonas infection nails become black or green.



g) Nail bed infarction occures in vasculitis especially in SLE and polyarteritis.



h) Red dots are seen in nails due to splinter haemorrhages in subacute bacterial endo carditis, rheumatoid arthritis, trauma, collagen vascular diseases.



i) Blunt injury produces haemorrhage and causes blue/black discolouration.



j) Nails become brown in kidney diseases and in decreased adrenal activity.



k) In wilsons disease blue colour in semicircle appears in the nail.



l) When the blood supply decreases nail become yellow .In jaundice and psoriasis also nail become yellowish.



m) In yellow nail syndrome all nails become yellowish with pleural effusion.



3) Shape of nails:-



a) Clubbing: Here tissues at the base of nails are thickened and the angle between the nail base and the skin is obliterated. The nail becomes more convex and the finger tip becomes bulbous and looks like an end of a drumstick. When the condition becomes worse the nail looks like a parrot beak.



Causes of clubbing:-



Congenital Injuries



Severe chronic cyanosis



Lung diseases like empyema,bronchiactesis,carcinoma of bronchus and pulmonary tuberculosis.

Abdominal diseases like crohn's disease,polyposis of colon,ulcerative colitis,liver cirrhosis ect...



Heart diseases like fallot's tetralogy,subacute bacterial endocarditis and ect..



b) Koilonychia:-



Here the nails become concave like a spoon.This condition is seen in iron deficiency anaemia.In this condition the nails become thin,soft and brittle.The normal convexity will be replaced by concavity.



c) Longitudinal ridging is seen in raynaud's disease.



d) Cuticle becomes ragged in dermatomyositis.



e) Nail fold telangiectasia is a sign in dermatomyositis ,systemic sclerosis and SLE.



4) Structure and consistancy:-



a) Fungal infection of nail causes discolouration,deformity,hypertrophy and abnormal brittleness.



b) Thimble pitting of nail is charecteristic of psoriasis ,acute eczema and alopecia aereata.



c) The inflamation of cuticle or nail fold is called paronychia.



d) Onycholysis is the seperation of nail bed seen in psoriasis,infection and after taking tetracyclines.



e) Destruction of nail is seen in lichen planus,epidermolysis bullosa.



f) Missing nail is seen in nail patella syndrome.It is a hereditary disease.



g) Nails become brittle in raynauds disease and gangrene.



h) Falling of nail is seen in fungal infection,psoriasis and thyroid diseases.



5) Growth:-



Reduction in blood supply affects the growth of nails. Nail growth is also affected in severe ilness. when the disease disappears the growth starts again resulting in formation of transverse ridges.These lines are called Beau's lines and are healpful to date the onset of illness.

MENTAL DISTURBANCES CAUSED BY ALCOHOL.

The physical disasters that follow the continued use of intoxicating beverages are sad enough, and terrible enough; but the surely attendant mental, moral and spiritual disasters are sadder and more terrible still. If you disturb the healthy condition of the brain, which is the physical organ through which the mind acts, you disturb the mind. It will not have the same clearness of perception as before; nor have the same rational control over the impulses and passions.



Heavenly order in the body.

--------------------------



In order to understand a subject clearly, certain general laws, or principles, must be seen and admitted. And here we assume, as a general truth, that health in the human body is normal heavenly order on the physical plane of life, and that any disturbance of that order exposes the man to destructive influences, which are evil and infernal in their character. Above the natural and physical plane, and resting upon it, while man lives in this world, is the mental and spiritual plane, or degree of life. This degree is in heavenly order when the reason is clear, and the appetites and passions under its wise control. But, if, through any cause, this fine equipoise is disturbed, or lost, then a way is opened for the influx of more subtle evil influences than such as invade the body, because they have power to act upon the reason and the passions, obscuring the one and inflaming the others.



We know how surely the loss of bodily health results in mental disturbance. If the seat of disease be remote from the brain, the disturbance is usually slight; but it increases as the trouble comes nearer and nearer to that organ, and shows itself in multiform ways according to character, temperament or inherited disposition; but almost always in a predominance of what is evil instead of good. There will be fretfulness, or ill-nature, or selfish exactions, or mental obscurity, or unreasoning demands, or, it may be, vicious and cruel propensities, where, when the brain was undisturbed by disease, reason held rule with patience and loving kindness. If the disease which has attacked the brain goes on increasing, the mental disease which follows as a consequence of organic disturbance or deterioration, will have increased also, until insanity may be established in some one or more of its many sad and varied forms.



Insanity.

--------



It is, therefore, a very serious thing for a man to take into his body any substance which, on reaching that wonderfully delicate organ the brain, sets up therein a diseased action; for, diseased mental action is sure to follow. A fever is a fever, whether it be light or intensely burning; and so any disturbance of the mind's rational equipoise is insanity, whether it be in the simplest form of temporary obscurity, or in the midnight of a totally darkened intellect.



We are not writing in the interest of any special theory, nor in the spirit of partisanship; but with an earnest desire to make the truth appear. You must not accept anything simply because we say it, but because he sees it to be true. Now, as to this matter of insanity, let him think calmly. The word is one that gives us a shock; and, as we hear it, we almost involuntarily thank God for the good gift of a well-balanced mind. What, if from any cause this beautiful equipoise should be disturbed and the mind lose its power to think clearly, or to hold the lower passions in due control? Shall we exceed the truth if we say that the man in whom this takes place is insane just in the degree that he has lost his rational self-control; and that he is restored when he regains that control?



In this view, the question as to the hurtfulness of alcoholic drinks assumes a new and graver aspect. Do they disturb the brain when they come in contact with its substance; and deteriorate it if the contact be long continued? Fact, observation, experience and scientific investigation all emphatically say yes; and we know that if the brain be disordered the mind, will be disordered, likewise; and a disordered mind is an insane mind. Clearly, then, in the degree that a man impairs or hurts his brain temporarily or continuously in that degree his mind is unbalanced; in that degree he is not a truly rational and sane man.



We are holding your thought just here that you may have time to think, and to look at the question in the light of reason and common sense. So far as he does this, will he be able to feel the force of such evidence as we shall educe in what follows, and to comprehend its true meaning.



Other substances besides alcohol act injuriously on the brain; but there is none that compares with this in the extent, variety and diabolical aspect of the mental aberrations which follow its use. We are not speaking thoughtlessly or wildly; but simply uttering a truth well-known to every man of observation, and which every man, and especially those who take this substance in any form, should, lay deeply to heart. Why it is that such awful and destructive forms of insanity should follow, as they do, the use of alcohol it is not for us to say. That they do follow it, we know, and we hold, up the fact in solemn warning.



Another consideration, which should have weight with every one, is this, that no man can tell what may be the character of the legacy he has received from his ancestors. He may have an inheritance of latent evil forces, transmitted through many generations, which only await some favoring opportunity to spring into life and action. So long as he maintains a rational self-control, and the healthy order of his life be not disturbed, they may continue quiescent; but if his brain loses its equipoise, or is hurt or impaired, then a diseased psychical condition may be induced and the latent evil forces be quickened into life.

MEDICAL TESTIMONY ON ALCOHOL.

Dr. Ezra M. Hunt says: "The capacity of the alcohols for impairment of functions and the initiation and promotion of organic lesions in vital parts, is unsurpassed by any record in the whole range of medicine. The facts as to this are so indisputable, and so far granted by the profession, as to be no longer debatable . Changes in stomach and liver, in kidneys and lungs, in the blood-vessels to the minutest capillary, and in the blood to the smallest red and white blood disc disturbances of secretion, fibroid and fatty degenerations in almost every organ, impairment of muscular power, impressions so profound on both nervous systems as to be often toxic these, and such as these, are the oft manifested results. And these are not confined to those called intemperate."



Professor Youmans says: "It is evident that, so far from being the conservator of health, alcohol is an active and powerful cause of disease, interfering, as it does, with the respiration, the circulation and the nutrition; now, is any other result possible?"



Dr. F.R. Lees says: "That alcohol should contribute to the fattening process under certain conditions, and produce in drinkers fatty degeneration of the blood, follows, as a matter of course, since, on the one hand, we have an agent that retains waste matter by lowering the nutritive and excretory functions, and on the other, a direct poisoner of the vesicles of the vital stream."



Dr. Henry Monroe says: "There is no kind of tissue, whether healthy or morbid, that may not undergo fatty degeneration; and there is no organic disease so troublesome to the medical man, or so difficult of cure. If, by the aid of the microscope, we examine a very fine section of muscle taken from a person in good health, we find the muscles firm, elastic and of a bright red color, made up of parallel fibres, with beautiful crossings or striae; but, if we similarly examine the muscle of a man who leads an idle, sedentary life, and indulges in intoxicating drinks, we detect, at once, a pale, flabby, inelastic, oily appearance. Alcoholic narcotization appears to produce this peculiar conditions of the tissues more than any other agent with which we are acquainted. 'Three-quarters of the chronic illness which the medical man has to treat,' says Dr. Chambers, 'are occasioned by this disease.' The eminent French analytical chemist, Lecanu, found as much as one hundred and seventeen parts of fat in one thousand parts of a drunkard's blood, the highest estimate of the quantity in health being eight and one-quarter parts, while the ordinary quantity is not more than two or three parts, so that the blood of the drunkard contains forty times in excess of the ordinary quantity."



Dr. Hammond, who has written, in partial defense of alcohol as containing a food power, says: "When I say that it, of all other causes, is most prolific in exciting derangements of the brain, the spinal cord and the nerves, I make a statement which my own experience shows to be correct."



Another eminent physician says of alcohol: "It substitutes suppuration for growth. It helps time to produce the effects of age; and, in a word, is the genius of degeneration."



Dr. Monroe, from whom "Alcohol, taken in small quantities, or largely diluted, as in the form of beer, causes the stomach gradually to lose its tone, and makes it dependent upon artificial stimulus. Atony, or want of tone of the stomach, gradually supervenes, and incurable disorder of health results. Should a dose of alcoholic drink be taken daily, the heart will very often become hypertrophied, or enlarged throughout. Indeed, it is painful to witness how many persons are actually laboring under disease of the heart, owing chiefly to the use of alcoholic liquors."



Dr. T.K. Chambers, physician to the Prince of Wales, says: "Alcohol is really the most ungenerous diet there is. It impoverishes the blood, and there is no surer road to that degeneration of muscular fibre so much to be feared; and in heart disease it is more especially hurtful, by quickening the beat, causing capillary congestion and irregular circulation, and thus mechanically inducing dilatation."



Sir Henry Thompson, a distinguished surgeon, says: "Don't take your daily wine under any pretext of its doing you good. Take it frankly as a luxury one which must be paid for, by some persons very lightly, by some at a high price, but always to be paid for. And, mostly, some loss of health, or of mental power, or of calmness of temper, or of judgment, is the price."



Dr. Charles Jewett says: "The late Prof. Parks, of England, in his great work on Hygiene,dhaw efguctually disposed of the notion, long and very generally entertained, that alcohol is a valuable prophylactic where a bad climate, bad water and other conditions unfavorable to health, exist; and an unfortunate experiment with the article, in the Union army, on the banks of the Chickahominy, in the year 1863, proved conclusively that, instead of guarding the human constitution against the influence of agencies hostile to health, its use gives to them additional force. The medical history of the British army in India teaches the same lesson."



But why present farther testimony? Is not the evidence complete? To the man who values good health; who would not lay the foundation for disease and suffering in his later years, we need not offer a single additional argument in favor of entire abstinence from alcoholic drinks. He will eschew them as poisons.

HOW ALCOHOL RETARDS DIGESTION.

And here, in order to give those who are not familiar with, the process of digestion, a clear idea of that important operation, and the effect produced when alcohol is taken with food, we quote from the lecture of an English physician, Dr. Henry Monroe, on "The Physiological Action of Alcohol." He says:



"Every kind of substance employed by man as food consists of sugar, starch, oil and glutinous matters, mingled together in various proportions; these are designed for the support of the animal frame. The glutinous principles of food fibrine, albumen and casein are employed to build up the structure; while the oil, starch and sugar are chiefly used to generate heat in the body.



"The first step of the digestive process is the breaking up of the food in the mouth by means of the jaws and teeth. On this being done, the saliva, a viscid liquor, is poured into the mouth from the salivary glands, and as it mixes with the food, it performs a very important part in the operation of digestion, rendering the starch of the food soluble, and gradually changing it into a sort of sugar, after which the other principles become more miscible with it. Nearly a pint of saliva is furnished every twenty-four hours for the use of an adult. When the food has been masticated and mixed with the saliva, it is then passed into the stomach, where it is acted upon by a juice secreted by the filaments of that organ, and poured into the stomach in large quantities whenever food comes in contact with its mucous coats. It consists of a dilute acid known to the chemists as hydrochloric acid, composed of hydrogen and chlorine, united together in certain definite proportions. The gastric juice contains, also, a peculiar organic-ferment or decomposing substance, containing nitrogen something of the nature of yeast termed pepsine , which is easily soluble in the acid just named. That gastric juice acts as a simple chemical solvent, is proved by the fact that, after death, it has been known to dissolve the stomach itself."



It is an error to suppose that, after a good dinner, a glass of spirits or beer assists digestion; or that any liquor containing alcohol even bitter beer can in any way assist digestion. Mix some bread and meat with gastric juice; place them in a phial, and keep that phial in a sand-bath at the slow heat of 98 degrees, occasionally shaking briskly the contents to imitate the motion of the stomach; you will find, after six or eight hours, the whole contents blended into one pultaceous mass. If to another phial of food and gastric juice, treated in the same way, I add a glass of pale ale or a quantity of alcohol, at the end of seven or eight hours, or even some days, the food is scarcely acted upon at all. This is a fact; and if you are led to ask why, I answer, because alcohol has the peculiar power of chemically affecting or decomposing the gastric juice by precipitating one of its principal constituents, viz., pepsine, rendering its solvent properties much less efficacious. Hence alcohol can not be considered either as food or as a solvent for food. Not as the latter certainly, for it refuses to act with the gastric juice.



"'It is a remarkable fact,' says Dr. Dundas Thompson, 'that alcohol, when added to the digestive fluid, produces a white precipitate, so that the fluid is no longer capable of digesting animal or vegetable matter.' 'The use of alcoholic stimulants,' say Drs. Todd and Bowman, 'retards digestion by coagulating the pepsine, an essential element of the gastric juice, and thereby interfering with its action. Were it not that wine and spirits are rapidly absorbed, the introduction of these into the stomach, in any quantity, would be a complete bar to the digestion of food, as the pepsine would be precipitated from the solution as quickly as it was formed by the stomach.' Spirit, in any quantity, as a dietary adjunct, is pernicious on account of its antiseptic qualities, which resist the digestion of food by the absorption of water from its particles, in direct antagonism to chemical operation."