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.

Bad breath is a common health problem which greately affects the daytoday activities of somany people. The offenssive odor from the mouth is unpleasent to those who come in close contact with bad breathers. The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem wil be isolated from the society. This can even lead to marital disharmony.

Literally speaking all humanbeings are badbreathres. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrifies them. This process results in the formation of offenssive gases like hydrogen sulphide,methyl mescaptan,cadaverin,skatol,putrescine ect causing bad odor. If oral hygiene is not maintained properly all will suffer from bad breath. Most of us control this by regular brushing,tongue cleaning and gargling. Even after maintining cleanliness in the mouth some individuals suffer from offenssive smell due to various causes which has to be diagnosed and treated properly.

Some common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offenssive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken inbetween meals can also produce bad breath because of improper cleaning.
Badbreath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva conains oxygen molecules which is needed to make oral cavity aerobic. So the reduction in it’s quantity during sleep makes a favourable condition for anaerobic bacteria.

2) Food habits:

The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favours bad breath. Meat,fish,milk products, eggs,cakes,nuts,pear and ect can cause bad breath. Some food articles can produce particular type of smell which may be unpleasent. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away,a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:

There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteriae are seen .The thick coating on the tongue is always associated with badbreath. Even a thin biofilm can make anaerobic condition favourable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with distruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli . Food particles are deposited inside these cavities and are putrified by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrified completely. Caries are common in schoolgoing children and in those who donot maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:

Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling,pain and discharge. If the condition become worse the infection spread towards peridontal area leading to continuous discharge called pyorrhoea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis.All these conditions can produce offenssive smell.

6) Gum retraction:

When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.

Ulcerative lesions& coatings:

Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria,viruses,food allergies or due to autoimmune disorders. Apthous ulcer is the commonest amoung ulcerative lesions. Others are herpes,fungal infections,vincents angina,infectious mononucleosis,scarlet fever,diphtheria,drug reactions and ect. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating(candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth & tongue. It is considered as a precancerous condition. Offenssive breath is associated with these conditions.

9) Diseases of the salivary glands:

Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavourable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors.Cancer of the salivary gland is associated with offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques & tonsillar fluid:

If bad breath persists even after maintaining proper oral hygeine there is possibility of this condition. Serous fluid secreated from the folds of tonsil is very offenssive. Some patients complain that they hawk some cheesy materials from the throat;which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.

12) Pharyngitis& pharyngial abscess:

Pharynx is a fibromuscular tube which forms the upper part of the digestive & respiratory tract. Inflmmation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offenssive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell due to lodgement of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these causes offenssive smell.

15) Smoking:

Smokers always have bad smell. It can also produce lesions in the mouth & lungs causing bad breath.Smoking increases carbon dioxide in the oral cavity & reduces oxygen level,causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose & ear:

Bad breath is occasionally seen in sinusitis(infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the eustachian tube(passage from middle ear to the throat)can also cause offenssive odor. Chronic rhinitis(infection of mucus membrane of nose) and forign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue,ulcers &coatings in the mouth ,increased sugar level in tissues ect are responsible for bad breath.Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:

Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis , AIDS ect produce bad smell.

19) Fasting & dehydration:

Dry mouth favours bacterial activity. So any condition which produce dryness in the mouth makes the breath offenssive. Eventhough the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offenssive breath due to thick coating on the tongue. water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:

Eructation of gas and food produce unpleasent smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis,gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative collitis..Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis ect.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess,chronic bronchitis,bronchiectasis,tuberculosis, lung cancer ect can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis,can cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.

25) Psychiatric patients:

Bad breath is common in psychotic patients due to poor hygiene,irregular food habits,less water intake and ect.

26) Somatisation disorder:

This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain,nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is a psychiatric disorder it has to be managed with a psychological approach.

[ THE POINTS MENTIONED IN THIS ARTICLE IS FOR GENERAL INFORMATION. ANY PERSON HAVING BAD BREATH SHOULD CONSULT A QUALIFIED DOCTOR ]

The action of alcohol on the stomach is extremely dangerous that it becomes unable to produce the natural digestive fluid in sufficient quantity and also fails to absorb the food which it may imperfectly digest. A condition marked by the sense of nausea emptiness, prostration and distention will always be faced by an alcoholic. This results in a loathing for food and is teased with a craving for more drink. Thus there is engendered a permanent disorder which is called dyspepsia. The disastrous forms of confirmed indigestion originate by this practice.

How the liver gets affected.
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The organic deteriorations caused by the continued use of alcohol are often of a fatal character. The organ which most frequently undergoes structural changes from alcohol, is the liver. Normally, the liver has the capacity to hold active substances in its cellular parts. In instances of poisoning by various poisonous compounds, we analyse liver as if it were the central depot of the foreign matter. It is practically the same in respect to alcohol. The liver of an alcoholic is never free from the influence of alcohol and it is too often saturated with it. The minute membranous or capsular structure of the liver gets affected, preventing proper dialysis and free secretion. The liver becomes large due to the dilatation of its vessels, the surcharge of fluid matter and the thickening of tissue. This follows contraction of membrane and shrinking of the whole organ in its cellular parts. Then the lower parts of the alcoholic becomes dropsical owing to the obstruction offered to the returning blood by the veins. The structure of the liver may be charged with fatty cells and undergo what is technically designated ‘fatty liver’.

How the Kidneys deteriorate.
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The Kidneys also suffer due to the excessive consumption of alcohol. The vessels of Kidneys lose elasticity and power of contraction. The minute structures in them go through fatty modification. Albumin from the blood easily passes through their membranes. This results in the body losing its power as if it were being run out of blood gradually.

Congestion of the lungs.
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Alcohol relaxes the vessels of the lungs easily as they are most exposed to the fluctuations of heat and cold. When subjected to the effects of a rapid variation in atmospheric temperature, they get readily congested. During severe winter seasons, the suddenly fatal congestions of lungs easily affects an alcoholic.

Alcohol weakens the heart.
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Consumption of alcohol greatly affects the heart. The quality of the membraneous structures which cover and line the heart changes and are thickened, become cartilaginous or calcareous. Then the valves lose their suppleness and what is termed valvular disorder becomes permanent. The structure of the the coats of the great blood-vessel leading from the heart share in the same changes of structure so that the vessel loses its elasticity and its power to feed the heart by the recoil from its distention, after the heart, by its stroke, has filled it with blood.

Again, the muscular structure of the heart fails owing to degenerative changes in its tissue. The elements of the muscular fibre are replaced by fatty cells or, if not so replaced, are themselves transferred into a modified muscular texture in which the power of contraction is greatly reduced.

Those who suffer from these organic deteriorations of the central and governing organ of the circulation of the blood learn the fact so insidiously, it hardly breaks upon them until the mischief is far advanced. They are conscious of a central failure of power from slight causes such as overexertion, trouble, broken rest or too long abstinence from food. They feel what they call a ’sinking’ but they know that wine or some other stimulant will at once relieve the sensation. Thus they seek to relieve it until at last they discover that the remedy fails. The jaded, overworked, faithful heart will bear no more. it has run its course and the governor of the blood-streams broken. The current either overflows into the tissues gradually damming up the courses or under some slight shock or excess of motion ceases wholly at the centre.

“Suppose, then, a certain measure of alcohol be taken into the stomach, it will be absorbed there, but, previous to absorption, it will have to undergo a proper degree of dilution with water, for there is this peculiarity respecting alcohol when it is separated by an animal membrane from a watery fluid like the blood, that it will not pass through the membrane until it has become charged, to a given point of dilution, with water. It is itself, in fact, so greedy for water, it will pick it up from watery textures, and deprive them of it until, by its saturation, its power of reception is exhausted , after which it will diffuse into the current of circulating fluid.”

It is this power of absorbing water from every texture with which alcoholic spirits comes in contact, that creates the burning thirst of those who freely indulge in its use. Its effect, when it reaches the circulation, is thus described by Dr. Richardson:

“As it passes through the circulation of the lungs it is exposed to the air, and some little of it, raised into vapor by the natural heat, is thrown off in expiration. If the quantity of it be large, this loss may be considerable, and the odor of the spirit may be detected in the expired breath. If the quantity be small, the loss will be comparatively little, as the spirit will be held in solution by the water in the blood. After it has passed through the lungs, and has been driven by the left heart over the arterial circuit, it passes into what is called the minute circulation, or the structural circulation of the organism. The arteries here extend into very small vessels, which are called arterioles, and from these infinitely small vessels spring the equally minute radicals or roots of the veins, which are ultimately to become the great rivers bearing the blood back to the heart. In its passage through this minute circulation the alcohol finds its way to every organ. To this brain, to these muscles, to these secreting or excreting organs, nay, even into this bony structure itself, it moves with the blood. In some of these parts which are not excreting, it remains for a time diffused, and in those parts where there is a large percentage of water, it remains longer than in other parts. From some organs which have an open tube for conveying fluids away, as the liver and kidneys, it is thrown out or eliminated, and in this way a portion of it is ultimately removed from the body. The rest passing round and round with the circulation, is probably decomposed and carried off in new forms of matter.

“When we know the course which the alcohol takes in its passage through the body, from the period of its absorption to that of its elimination, we are the better able to judge what physical changes it induces in the different organs and structures with which it comes in contact. It first reaches the blood; but, as a rule, the quantity of it that enters is insufficient to produce any material effect on that fluid. If, however, the dose taken be poisonous or semi-poisonous, then even the blood, rich as it is in water and it contains seven hundred and ninety parts in a thousand is affected. The alcohol is diffused through this water, and there it comes in contact with the other constituent parts, with the fibrine, that plastic substance which, when blood is drawn, clots and coagulates, and which is present in the proportion of from two to three parts in a thousand; with the albumen which exists in the proportion of seventy parts; with the salts which yield about ten parts; with the fatty matters; and lastly, with those minute, round bodies which float in myriads in the blood (which were discovered by the Dutch philosopher, Leuwenhock, as one of the first results of microscopical observation, about the middle of the seventeenth century), and which are called the blood globules or corpuscles. These last-named bodies are, in fact, cells; their discs, when natural, have a smooth outline, they are depressed in the centre, and they are red in color; the color of the blood being derived from them. We have discovered that there exist other corpuscles or cells in the blood in much smaller quantity, which are called white cells, and these different cells float in the blood-stream within the vessels. The red take the centre of the stream; the white lie externally near the sides of the vessels, moving less quickly. Our business is mainly with the red corpuscles. They perform the most important functions in the economy; they absorb, in great part, the oxygen which we inhale in breathing, and carry it to the extreme tissues of the body; they absorb, in great part, the carbonic acid gas which is produced in the combustion of the body in the extreme tissues, and bring that gas back to the lungs to be exchanged for oxygen there; in short, they are the vital instruments of the circulation.

“With all these parts of the blood, with the water, fibrine, albumen, salts, fatty matter and corpuscles, the alcohol comes in contact when it enters the blood, and, if it be in sufficient quantity, it produces disturbing action. I have watched this disturbance very carefully on the blood corpuscles; for, in some animals we can see these floating along during life, and we can also observe them from men who are under the effects of alcohol, by removing a speck of blood, and examining it with the microscope. The action of the alcohol, when it is observable, is varied. It may cause the corpuscles to run too closely together, and to adhere in rolls; it may modify their outline, making the clear-defined, smooth, outer edge irregular or crenate, or even starlike; it may change the round corpuscle into the oval form, or, in very extreme cases, it may produce what I may call a truncated form of corpuscles, in which the change is so great that if we did not trace it through all its stages, we should be puzzled to know whether the object looked at were indeed a blood-cell. All these changes are due to the action of the spirit upon the water contained in the corpuscles; upon the capacity of the spirit to extract water from them. During every stage of modification of corpuscles thus described, their function to absorb and fix gases is impaired, and when the aggregation of the cells, in masses, is great, other difficulties arise, for the cells, united together, pass less easily than they should through the minute vessels of the lungs and of the general circulation, and impede the current, by which local injury is produced.

“A further action upon the blood, instituted by alcohol in excess, is upon the fibrine or the plastic colloidal matter. On this the spirit may act in two different ways, according to the degree in which it affects the water that holds the fibrine in solution. It may fix the water with the fibrine, and thus destroy the power of coagulation; or it may extract the water so determinately as to produce coagulation.”

Hernia is an abnormal protrusion of internal organs through an abnormal opening in the wall of the cavity.A combination of increased pressure inside the body with weakness in the wall is responsible for this condition.In this condition internal organs or parts of organs are protruded out forming a swelling which will increase the size with coughing and lifting weight,and while passing stool and urine.In lying down position the swelling goes inside except in strangulated and irreducible hernia.

Causes:-

1, Weakness in the body wall:–

a) Congenital weakness.

b) Acquired weakness due to injuries,wasting of muscles,suppurative lesions in the wall and presence of weak natural openings,obesity,lack of exercise,repeated pregnancy.

c) Surgical operation with improper suturing or sepsis of operated site.

2) Increased pressure inside the body.

a) Chronic constipation.

b) Recurrent cough.

c) Weight lifting.

d) Stricture of urethra.

Common sites for hernia:–

Hernia can occure anywhere in the body.However there are some common sites for hernia.Due to the presence of hard bony covering chest wall is normally not affected.Hernia in the lower back is also rare due to spine and back muscles and tough ligaments and sheeths.The common site for hernia is abdominal wall.Compared to other parts the abdominal wall is weak due to the presence of some natural orifices.There are some areas wherein the abdominal muscles are weaker and thin and all these factors make a chance for herniation.The common sites for hernia are following.

a) Inguinal hernia:

Here the abdominal contents protrude through the inguinal canal (passage in the lower abdominal wall just above the inguinal ligament.It is seen on either side).This type is common in males.Initially the swelling comes only while straining and goes back while lying down. Later the large portion of intestine may come out which may not go back easily.

b) Femoral hernia:

This type of hernia is more in females.Here the abdominal contents pass through the femoral canal which is seen just below the junction between the thigh and lower abdominal wall(Inside the femoral triangle).The contents pass downwards and comes out through saphenous opening in the thigh and forms a swelling under the skin.

c) Umbilical hernia:

This is common in children.The umbilicus is the weaker part of the abdomen.The contents of the abdomen may protrude as a bulb like swelling while crying and defecating.

d) Incisional hernia:

These hernias are seen in operated sites. Due to improper suturing or sepsis the operated site becomes weak resulting in hernia.

e) Epigastric hernia:

Here the hearniation occures in the epigastrium. It is a rare type.

f) Lumbar hernia:

Here the hernia appear in the lumbar area on either side of the lumbar spine(in the lumbar triangle).This is also a rare type.

g) Obturator hernia:

This is a rare type of hernia. Here the contents pass through obturator foramen in the pelvic bone.

Complications of hernia:–

1) Strangulation:

If the hernial orifice is narrow the abdominal contents may not go back easily, and later the blood flow to the herniated tissues may be blocked due to constricition.This can cause death of protruded intestine.

2) Intestinal obstruction:

This occures when the whole portion of the intestine is protruded in to the hernial sac. The narrow hernial orifice will block the passage of bowels.

3) Infection and peritonitis:

If there is strangulation with death of a portion of intestine there will be spread of infection to the abdomen resulting in peritonitis.

Treatment of hernia:–

Initial treatment: In the initial stages of hernia the following steps may be useful

1) Use of hernia belt:

Special types of hernia belts are available for each type of heania.This will prevent the protrusion and will reduce pain.

2) Constipation,recurrent cough,urinary obstruction ect should be treated.

3) Fat reduction will increase the strength of abdominal wall.

4) Abdominal exercises to increase the muscle tone.

5) Take plenty of leafy vegetables, fruits and fibrous diet for easy bowel movements.

6) Try other systems like Homoeopathy,Herbal medicine and ect

If no relief by the above steps consult a general surgeon for surgical management.

Surgical treatment.

The following operations are done depending up on the type and nature of hernia.

1) Hertniotomy : In this operation the contents of hernial sac is pushed in to the abdomen and neck of the sac is ligated with transfixion ligature and the sac is cut off.

2) Herniorrhaphy: Here along with herniotomy the posterior wall is repaired.

3) Hernioplasty: This operation is done if herniotomy is not possible due to wide neck of the sac.Here the repair is done with the healp of non absorbable materials like tantalum gauze,polypropylene mesh or stainless steel mesh.

Bad odor from the mouth in the early morning is seen in almost all individuals.This can be controlled by maintaining oral hygiene.Even after cleaning the mouth some individuals may suffer from bad breath due to some problem in the mouth or in the nearby areas.Some general disease condition can also produce bad breath.Exact cause has to be identified and should be treated accordingly.Some common measures to cure or reduce bad breath are discussed here.

1) Oral hygiene:

Mouth should be kept clean every time to reduce the bacterial action.After food gargling with lukewarm water is very essential.Even after small food articles like snacks,sweets,buscuits cleaning with water is needed.Brushing should be done twice daily.It is said that early morning brushing is for beauty and bed time brushing is for good health.

2) Brushing techniques:

Normal brushing technique should be followed for better result.Many people brush vigorously causing damage to the gums.Brushing after every food and drink can damage the enamel .Bristles of the tooth brush should be smooth but hard enough to remove the food particles from the gaps.The direction of brushing is the most important thing.The upper teeth should be brushed in a downward direction and the lower in upward direction.This is applicable to both inner and outer surfaces.Next comes the crown of the teeth;here brushing is done in anterior and posterior direction keeping the brush in same direction.This applicable to both upper and lower set of teeth.

3) Tongue cleaning:

White or yellowish coating on the tongue can cause bad breath.This is more well marked in the morning and should be removed twice daily with the healp of a tongue cleaner. Tongue cleaner must be used gently without damaging the taste buds on the tongue.

4) Tooth pick:

Tooth pick is a small strip of wood or plastic with a pointed end.This is used to remove food particles lodged between the gaps.Very useful after eating meat and fish.Should be used gently to avoid damage to gums.

5) Gargling:

After every meal gargling with lukewarm water is useful.For better result little common salt is dissolved in the lukewarm water .Different types of mouth wash is available in the market in different trade names.Gargling with mouth wash can also reduce bad breath.

6) Food habits:

Protein containing food articles are known to produce bad breath. Example; meat, milk, fish, egg etc. If these food articles are taken proper cleaning is essential.Some food articles are known to produce particular smell which may be unpleasent for others. Raw onion is the best example.It is said that an apple a day keeps the doctor away and a raw onion a day keep every body away.Small food articles taken in between can also cause bad smell(nuts,fried items etc).Maintaining regularity in food timing is the most important thing.

7) Water intake:

Dryness in the mouth can make a favourable condition for the bacterial activity resulting in bad odor.saliva is needed to keep the mouth moist and to reduce the bacterial proliferation.Production of saliva is closely related with water balance of the body and hence sufficient quantity of water should be taken to maintain the production of saliva.

Mouth freshners:

Natural and artificial mouth freshners can reduce the intensity of bad breath to some extent.Spicy articles are commonly used for this purpose.Chewing spices like clove,cumin seed,cardomom,cinnamon,ginger ect are useful. All citrus fruits can reduce bad odor.Mouth freshners and chewing gums are available in the market.these products are also helpful ,but some may cause damage hence should be used with caution.

If the above things doesn’t work then what to do ?

Consider the following:-

1) Remove the cause:

Bad breath is common in some general and systemic diseases like diabetes,fevers,gastric disorders,liver diseases and ect.By removing or reducing the primary cause the bad breath will go automatically.

2) Modern medicine:

If bad breath is due to any infection suitable antibiotics,anti fungal or anti viral medicines will help.If it is due to any autoimmune or chronic inflamatory conditions steroids may also be used.Saliva producing tablets can also be used.

3) Dental cleaning:

Dental cleaning done by a dentist can remove the dental plaques and tartar. This can reduce the severity of bad breath.Visit your dentist atleast once in a year.

4) Filling of caries:

Since caries are one of the main cause for bad breath it should be filled by a dentist.Earlier silver amalgam was used ,nowadays it is replaced by synthetic materials.If the pulp cavity is affected by the caries root canal treatment can be done.

5) Tooth extraction:

If caries are deep with destruction of teeth with bad smell extraction is the better choice and a dental implant can be kept in the gap.

6) Tonsillectomy:

Patients with recurrent tonsillitis can have bad breath due to offenssive discharges and release of pasty materials from the crypts of tonsils.Such patients get great relief after tonsillectomy(removal of tonsils).

7) Psychological counselling:

Those who suffer from bad breath may be very much depressed and they be away from the public .This isolation hampers their daytoday activities.Such people should understand the fact that all humanbeings are having bad breath, but with slight differences in intensities.Mostly all people control it by taking personal care.Every human body has got it’s own smell,that may or may not be tolerable for others.They should be adviced to do all hygienic meashures to reduce the intensity of smell.Improving the quality of life by all possible means can also help.Moral support from friends and family members are needed for such people.

Some individuals visit the doctor for bad breath without any real problem.It is included under somatisation disorder.They usually complain about pain, breathlessness,abdominal discomfort,bad smell ect.proper diagnosis is needed to rule out any real causes.These patients should be managed with a psychological approach.

Homoeopathy:

In Homoeopathy medicines are selected on the basis of physical ,mental,emotional,and social aspects of the diseased person.Considering the whole aspects a constitutional homoeopathic medicine is selected and given in suitable potency and dose.By this all health related problems including bad breath will be solved.On the basis of coating on the tongue,type of smell,cause for bad breath,and other associated complaints a medicine can be given to get relief from bad breath.In the homoeopathic medical repertory by Dr Robin Murphy there are 140 homoeopathic drugs mentioned for bad breath.On the basis of signs and symptoms of the individual a suitable medicine is given.Commonly used drugs are arnica, antim crud, pulsatilla, sulphur, psorinum, nux vomica, ars alb, merc sol, kreosot, hekla lava, silicea, asafoitida, graphites, kali bich, acid nitric etc.

Homoeopathic mother tinctures like cinnamon Q,kreosot Q,zingiber Q,rhus glabra Q,menthol Q and ect can be used for gargling after diluting in water.

[POINTS MENTIONED IN THIS ARTICLE IS FOR GENERAL AWARENESS. ANY BODY SUFFERING FROM BAD BREATH SHOULD CONSULT A DOCTOR.]

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, has effectually 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.

Heavenly order in the body.
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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.

Now it is clear that if alcohol is a food, it will be found to contain one or more of these substances. There must be in it either the nitrogenous elements found chiefly in meats, eggs, milk, vegetables and seeds, out of which animal tissue is built and waste repaired or the carbonaceous elements found in fat, starch and sugar, in the consumption of which heat and force are evolved.

“The distinctness of these groups of foods,” says Dr. Hunt, “and their relations to the tissue-producing and heat-evolving capacities of man, are so definite and so confirmed by experiments on animals and by manifold tests of scientific, physiological and clinical experience, that no attempt to discard the classification has prevailed. To draw so straight a line of demarcation as to limit the one entirely to tissue or cell production and the other to heat and force production through ordinary combustion and to deny any power of interchangeability under special demands or amid defective supply of one variety is, indeed, untenable. This does not in the least invalidate the fact that we are able to use these as ascertained landmarks”.

How these substances when taken into the body, are assimilated and how they generate force, are well known to the chemist and physiologist, who is able, in the light of well-ascertained laws, to determine whether alcohol does or does not possess a food value. For years, the ablest men in the medical profession have given this subject the most careful study, and have subjected alcohol to every known test and experiment, and the result is that it has been, by common consent, excluded from the class of tissue-building foods. “We have never,” says Dr. Hunt, “seen but a single suggestion that it could so act, and this a promiscuous guess. One writer (Hammond) thinks it possible that it may ’somehow’ enter into combination with the products of decay in tissues, and ‘under certain circumstances might yield their nitrogen to the construction of new tissues.’ No parallel in organic chemistry, nor any evidence in animal chemistry, can be found to surround this guess with the areola of a possible hypothesis”.

Dr. Richardson says: “Alcohol contains no nitrogen; it has none of the qualities of structure-building foods; it is incapable of being transformed into any of them; it is, therefore, not a food in any sense of its being a constructive agent in building up the body.” Dr. W.B. Carpenter says: “Alcohol cannot supply anything which is essential to the true nutrition of the tissues.” Dr. Liebig says: “Beer, wine, spirits, etc., furnish no element capable of entering into the composition of the blood, muscular fibre, or any part which is the seat of the principle of life.” Dr. Hammond, in his Tribune Lectures, in which he advocates the use of alcohol in certain cases, says: “It is not demonstrable that alcohol undergoes conversion into tissue.” Cameron, in his Manuel of Hygiene, says: “There is nothing in alcohol with which any part of the body can be nourished.” Dr. E. Smith, F.R.S., says: “Alcohol is not a true food. It interferes with alimentation.” Dr. T.K. Chambers says: “It is clear that we must cease to regard alcohol, as in any sense, a food”.

“Not detecting in this substance,” says Dr. Hunt, “any tissue-making ingredients, nor in its breaking up any combinations, such as we are able to trace in the cell foods, nor any evidence either in the experience of physiologists or the trials of alimentarians, it is not wonderful that in it we should find neither the expectancy nor the realization of constructive power.”

Not finding in alcohol anything out of which the body can be built up or its waste supplied, it is next to be examined as to its heat-producing quality.

Production of heat.
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“The first usual test for a force-producing food,” says Dr. Hunt, “and that to which other foods of that class respond, is the production of heat in the combination of oxygen therewith. This heat means vital force, and is, in no small degree, a measure of the comparative value of the so-called respiratory foods. If we examine the fats, the starches and the sugars, we can trace and estimate the processes by which they evolve heat and are changed into vital force, and can weigh the capacities of different foods. We find that the consumption of carbon by union with oxygen is the law, that heat is the product, and that the legitimate result is force, while the result of the union of the hydrogen of the foods with oxygen is water. If alcohol comes at all under this class of foods, we rightly expect to find some of the evidences which attach to the hydrocarbons.”

What, then, is the result of experiments in this direction? They have been conducted through long periods and with the greatest care, by men of the highest attainments in chemistry and physiology, and the result is given in these few words, by Dr. H.R. Wood, Jr., in his Materia Medica. “No one has been able to detect in the blood any of the ordinary results of its oxidation.” That is, no one has been able to find that alcohol has undergone combustion, like fat, or starch, or sugar, and so given heat to the body.

Alcohol and reduction of temperature.
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instead of increasing it; and it has even been used in fevers as an anti-pyretic. So uniform has been the testimony of physicians in Europe and America as to the cooling effects of alcohol, that Dr. Wood says, in his Materia Medica, “that it does not seem worth while to occupy space with a discussion of the subject.” Liebermeister, one of the most learned contributors to Zeimssen’s Cyclopaedia of the Practice of Medicine, 1875, says: “I long since convinced myself, by direct experiments, that alcohol, even in comparatively large doses, does not elevate the temperature of the body in either well or sick people.” So well had this become known to Arctic voyagers, that, even before physiologists had demonstrated the fact that alcohol reduced, instead of increasing, the temperature of the body, they had learned that spirits lessened their power to withstand extreme cold. “In the Northern regions,” says Edward Smith, “it was proved that the entire exclusion of spirits was necessary, in order to retain heat under these unfavorable conditions.”

Alcohol does not make you strong.
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If alcohol does not contain tissue-building material, nor give heat to the body, it cannot possibly add to its strength. “Every kind of power an animal can generate,” says Dr. G. Budd, F.R.S., “the mechanical power of the muscles, the chemical (or digestive) power of the stomach, the intellectual power of the brain accumulates through the nutrition of the organ on which it depends.” Dr. F.R. Lees, of Edinburgh, after discussing the question, and educing evidence, remarks: “From the very nature of things, it will now be seen how impossible it is that alcohol can be strengthening food of either kind. Since it cannot become a part of the body, it cannot consequently contribute to its cohesive, organic strength, or fixed power; and, since it comes out of the body just as it went in, it cannot, by its decomposition, generate heat force.”

Sir Benjamin Brodie says: “Stimulants do not create nervous power; they merely enable you, as it were, to use up that which is left, and then they leave you more in need of rest than before.”

Baron Liebig, so far back as 1843, in his “Animal Chemistry,” pointed out the fallacy of alcohol generating power. He says: “The circulation will appear accelerated at the expense of the force available for voluntary motion, but without the production of a greater amount of mechanical force.” In his later “Letters,” he again says: “Wine is quite superfluous to man, it is constantly followed by the expenditure of power” whereas, the real function of food is to give power. He adds: “These drinks promote the change of matter in the body, and are, consequently, attended by an inward loss of power, which ceases to be productive, because it is not employed in overcoming outward difficulties i.e., in working.” In other words, this great chemist asserts that alcohol abstracts the power of the system from doing useful work in the field or workshop, in order to cleanse the house from the defilement of alcohol itself.

The late Dr. W. Brinton, Physician to St. Thomas’, in his great work on Dietetics, says: “Careful observation leaves little doubt that a moderate dose of beer or wine would, in most cases, at once diminish the maximum weight which a healthy person could lift. Mental acuteness, accuracy of perception and delicacy of the senses are all so far opposed by alcohol, as that the maximum efforts of each are incompatible with the ingestion of any moderate quantity of fermented liquid. A single glass will often suffice to take the edge off both mind and body, and to reduce their capacity to something below their perfection of work.”

Dr. F.R. Lees, F.S.A., writing on the subject of alcohol as a food, makes the following quotation from an essay on “Stimulating Drinks,” published by Dr. H.R. Madden, as long ago as 1847: “Alcohol is not the natural stimulus to any of our organs, and hence, functions performed in consequence of its application, tend to debilitate the organ acted upon.

Alcohol is incapable of being assimilated or converted into any organic proximate principle, and hence, cannot be considered nutritious.

The strength experienced after the use of alcohol is not new strength added to the system, but is manifested by calling into exercise the nervous energy pre-existing.

The ultimate exhausting effects of alcohol, owing to its stimulant properties, produce an unnatural susceptibility to morbid action in all the organs, and this, with the plethora superinduced, becomes a fertile source of disease.

A person who habitually exerts himself to such an extent as to require the daily use of stimulants to ward off exhaustion, may be compared to a machine working under high pressure. He will become much more obnoxious to the causes of disease, and will certainly break down sooner than he would have done under more favorable circumstances.

The more frequently alcohol is had recourse to for the purpose of overcoming feelings of debility, the more it will be required, and by constant repetition a period is at length reached when it cannot be foregone, unless reaction is simultaneously brought about by a temporary total change of the habits of life.

Driven to the wall.
——————

Not finding that alcohol possesses any direct alimentary value, the medical advocates of its use have been driven to the assumption that it is a kind of secondary food, in that it has the power to delay the metamorphosis of tissue. “By the metamorphosis of tissue is meant,” says Dr. Hunt, “that change which is constantly going on in the system which involves a constant disintegration of material; a breaking up and avoiding of that which is no longer aliment, making room for that new supply which is to sustain life.” Another medical writer, in referring to this metamorphosis, says: “The importance of this process to the maintenance of life is readily shown by the injurious effects which follow upon its disturbance. If the discharge of the excrementitious substances be in any way impeded or suspended, these substances accumulate either in the blood or tissues, or both. In consequence of this retention and accumulation they become poisonous, and rapidly produce a derangement of the vital functions. Their influence is principally exerted upon the nervous system, through which they produce most frequent irritability, disturbance of the special senses, delirium, insensibility, coma, and finally, death.”

“This description,” remarks Dr. Hunt, “seems almost intended for alcohol.” He then says: “To claim alcohol as a food because it delays the metamorphosis of tissue, is to claim that it in some way suspends the normal conduct of the laws of assimilation and nutrition, of waste and repair. A leading advocate of alcohol (Hammond) thus illustrates it: ‘Alcohol retards the destruction of the tissues. By this destruction, force is generated, muscles contract, thoughts are developed, organs secrete and excrete.’ In other words, alcohol interferes with all these. No wonder the author ‘is not clear’ how it does this, and we are not clear how such delayed metamorphosis recuperates.

Not an originator of vital force.
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which is not known to have any of the usual power of foods, and use it on the double assumption that it delays metamorphosis of tissue, and that such delay is conservative of health, is to pass outside of the bounds of science into the land of remote possibilities, and confer the title of adjuster upon an agent whose agency is itself doubtful.

Having failed to identify alcohol as a nitrogenous or non-nitrogenous food, not having found it amenable to any of the evidences by which the food-force of aliments is generally measured, it will not do for us to talk of benefit by delay of regressive metamorphosis unless such process is accompanied with something evidential of the fact something scientifically descriptive of its mode of accomplishment in the case at hand, and unless it is shown to be practically desirable for alimentation.

There can be no doubt that alcohol does cause defects in the processes of elimination which are natural to the healthy body and which even in disease are often conservative of health.

These membranes are the filters of the body. “In their absence there could be no building of structure, no solidification of tissue, nor organic mechanism. Passive themselves, they, nevertheless, separate all structures into their respective positions and adaptations.”

Membranous deteriorations.
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In order to make perfectly clear to your mind the action and use of these membranous expansions, and the way in which alcohol deteriorates them, and obstructs their work, we quote again from Dr. Richardson:

“The animal receives from the vegetable world and from the earth the food and drink it requires for its sustenance and motion. It receives colloidal food for its muscles: combustible food for its motion; water for the solution of its various parts; salt for constructive and other physical purposes. These have all to be arranged in the body; and they are arranged by means of the membranous envelopes. Through these membranes nothing can pass that is not, for the time, in a state of aqueous solution, like water or soluble salts. Water passes freely through them, salts pass freely through them, but the constructive matter of the active parts that is colloidal does not pass; it is retained in them until it is chemically decomposed into the soluble type of matter. When we take for our food a portion of animal flesh, it is first resolved, in digestion, into a soluble fluid before it can be absorbed; in the blood it is resolved into the fluid colloidal condition; in the solids it is laid down within the membranes into new structure, and when it has played its part, it is digested again, if I may so say, into a crystalloidal soluble substance, ready to be carried away and replaced by addition of new matter, then it is dialysed or passed through, the membranes into the blood, and is disposed of in the excretions.

“See, then, what an all-important part these membranous structures play in the animal life. Upon their integrity all the silent work of the building up of the body depends. If these membranes are rendered too porous, and let out the colloidal fluids of the blood the albumen, for example the body so circumstanced, dies; dies as if it were slowly bled to death. If, on the contrary, they become condensed or thickened, or loaded with foreign material, then they fail to allow the natural fluids to pass through them. They fail to dialyse, and the result is, either an accumulation of the fluid in a closed cavity, or contraction of the substance inclosed within the membrane, or dryness of membrane in surfaces that ought to be freely lubricated and kept apart. In old age we see the effects of modification of membrane naturally induced; we see the fixed joint, the shrunken and feeble muscle, the dimmed eye, the deaf ear, the enfeebled nervous function.

“It may possibly seem, at first sight, that I am leading immediately away from the subject of the secondary action of alcohol. It is not so. I am leading directly to it. Upon all these membranous structures alcohol exerts a direct perversion of action. It produces in them a thickening, a shrinking and an inactivity that reduces their functional power. That they may work rapidly and equally, they require to be at all times charged with water to saturation. If, into contact with them, any agent is brought that deprives them of water, then is their work interfered with; they cease to separate the saline constituents properly; and, if the evil that is thus started, be allowed to continue, they contract upon their contained matter in whatever organ it may be situated, and condense it.

“In brief, under the prolonged influence of alcohol those changes which take place from it in the blood corpuscles, extend to the other organic parts, involving them in structural deteriorations, which are always dangerous, and are often ultimately fatal.”