re not required and no alcohol should be given. 3.
That in a 'majority of cases' the tendency toward dangerous
'nervous exhaustion' and 'heart failure' is so great that the
giving of 'more or less alcohol is required.' 4. The amount
required may vary from two to twelve or more ounces per day.

"In the two preceding numbers of this journal, I have endeavored
to show that the chief causes of nervous exhaustion and heart
failure, in typhoid and other fevers were impairment of the
hemoglobin and corpuscular elements of the blood, deficient
reception and internal distribution of oxygen, and molecular
degeneration of the muscular structures of the heart itself.
These important pathological conditions are doubtless caused by
the specific toxic agent or agents giving rise to the fever.
Consequently the rational objects of treatment are to stop the
further action of the specific cause, either by neutralization,
or elimination, or both; to stop the further impairment of the
hemoglobin and other elements of the blood; and to increase the
reception and internal distribution of oxygen, by which we will
most effectually prevent further fatty or granular degeneration
of cardiac and other structures. The language of the paragraphs
I have quoted, fairly assumes that alcohol is a _stimulant_
capable of relieving nervous exhaustion and cardiac failures,
regardless of the causes producing those pathological
conditions, and consequently its use is necessary in the
'majority of cases' of typhoid fever.

"Can such an assumption be sustained by either established
facts, or correct reasoning? Can nervous and cardiac exhaustion,
induced by the presence of toxic agents in the blood, with
deficiency of both hemoglobin and oxygen, be relieved by a
simple _stimulant_, that neither neutralizes nor eliminates the
toxic agents, nor increases either the hemoglobin or oxygen?
That alcohol does not neutralize or destroy toxic ptomaines, or
tox-albumins, is proved by abundant clinical experience, and
also by the fact that chemists use it freely in the processes
for separating these substances from other organic matters for
experimental purposes. That its presence in the living body
retards metabolic changes generally, and thereby aids in
retaining instead of eliminating toxic agents of all kinds, has
bee