Popular Science Monthly/Volume 78/April 1911/Alcohol - Its Use and Abuse
|ALCOHOL—ITS USE AND ABUSE|
WHEN the writer was a former student in Munich about 1890, there was a very great quantity of beer partaken of by the inhabitants of the town, and also by the German people in general. The "beer duel" consisted in draining a large jug of beer which was lifted from the table at a given sign, and he who first brought the empty jug back on the table was the winner of the duel. In fact, the writer has heard pleasure measured in terms of glasses of beer partaken. For example, such and such a holiday trip on the Rhine could not be indulged in because it cost the equivalent of so and so many glasses of beer.
A considerable change in the manners of the people was noticed on a visit to Germany in 1906. At a luncheon in Heidelberg, both lemonade and white wine were placed on the table, and the white wine was scarcely touched. This great change has been due to two factors. There has been great development of what the Germans call "Sport." The young men indulge in an out-of-door life to a very much greater extent than formerly. Skiing among the Alps in the winter-time, for example, is something which is the delight of many of the students, and all this has tended to decrease on their part the quantity of alcohol consumed. A second powerful influence is that of the Kaiser's edict that his health can be drunk in water. As long as it was impossible to drink the Kaiser's health in water without its being considered a dire and fatal insult to His Majesty, just so long was it impossible for the development of a temperance spirit.
Besides these factors, the physiologist Bunge has for many years railed at those who would partake of the excreta of yeast, and Friedrich Müller and Kraepelin of Munich have neither of them lost an opportunity before their medical classes to drive home the evils accompanying excessive drinking. They have done this to the great trepidation of the beer brewers of Munich.
At a recent lecture in London, Dr. Mott has said that it was desirable to approach this subject in a scientific spirit and without prejudice, and following him. Sir Clifford Albutt has called attention to the fact that much of the literature of alcohol is of a rhetorical rather than of a scientific order, and has stated that the sooner scientific order and method are introduced the better.
Alcohol is frequently used as a flavor for food. Pure alcohol itself is never taken, but the various alcoholic beverages are prized on account of their various flavors. There is no more powerful stimulant to the flow of the gastric juice than alcohol. Introduced directly into the small intestine or even into the rectum, alcohol may produce a flow of gastric juice. However, it has been shown that a single glass of wine containing between five and ten per cent, of alcohol is as effective as a stomachic as when much larger quantities are ingested. Indeed there can be no doubt that the healthy stomach needs no such stomachic whatever. This is known, because the materials of which ordinary food consists are perfectly digested and perfectly absorbed without recourse to anything beyond the ordinary flavors of the table.
In cases where there is no appetite, it may be that a single glass of wine may help the digestion of food. So Pawlow describes that when he was convalescent from a fever and could digest nothing, a glass of sherry brought about an initial flow of his gastric juice and with its aid digestion of the food was possible. It is stated that the value of a liqueur which is taken with after-dinner coffee, lies merely in its irritant action upon the wall of the stomach—an action which promotes a discharge of material from the probably too well-filled stomach of the individual who has been dining.
Alcohol is also a nutrient material. The publication by Atwater and Benedict showing that alcohol could replace other foodstuffs in nutrition, led Mr. Dooley to remark that his saloon was really a restaurant. In normal nutrition the cells of the body are provided with fuel by fat or by sugar. When protein is given, most of it is converted into fat or into sugar within the organism. So, in the ultimate analysis, it is found that the motions of the cells, which motions constitute life, are maintained at the expense of fat and carbohydrates. When these are oxidized, energy is liberated which impels to motion the particles of protoplasm, and these motions constitute the machinery of life.
Atwater and Benedict gave a man ordinary food for thirteen days. The food contained 2,496 calories, and the man destroyed materials within himself, so that he daily produced 2,221 calories. On this diet, he retained within his body 33.7 grams of fat daily. Then the same man was given a diet for ten days which had the same number of calories as before, but only 1,996 of these were in the ordinary food materials, whereas 600 calories were in alcohol. This quantity of alcohol is what would be found in a bottle of claret. The alcohol was given in six small doses daily. The alcohol was almost completely burned, only a small quantity appearing in the urine and breath. The heat production during this second period, amounted to 2,221 calories daily or exactly the same as in the previous normal experiment. The quantity of fat retained by the patient on the alcohol days amounted to 34.1 grams daily. It is evident from this experiment that alcohol can replace fat or carbohydrates in metabolism in accordance with its heat value. So we can say that the cells of the organism may be maintained in their vital activities by alcohol instead of by normal nutrient substances.
It is apparent, therefore, that alcohol may have a very considerable value as food. If an alcoholic beverage should contain materials other than alcohol such as the extractive materials in Bavarian beer, the food value rises to a very considerable amount. Thus, a liter of Bavarian beer contains 450 calories. These facts, however, do not at all justify the substitution of alcohol for carbohydrates and fats in the dietary.
Many experiments have been accomplished to see whether alcohol has any effect upon the protein balance in the body. Sometimes alcohol has been found to spare protein, sometimes it has been found to cause a waste of protein. The effect, however, of alcohol upon the general metabolism of protein is certainly without very great significance.
Yet there are indications that alcohol does alter metabolism in the individual who partakes of it. Beebe found no effect upon the output of uric acid after taking alcohol with a diet which was free from the precursors of uric acid. This, however, has not been confirmed by others, and Landau found that usually there was a slight increase in the output of uric acid in the urine after the ingestion of alcohol.
Since the nucleus of the cell is characterized in its structure by the presence of nucleo-proteins whose destruction results in the increased elimination of uric acid, it is not impossible that these nuclei are somewhat affected by the presence of alcohol in the body. A similar effect upon the nuclei of the germ plasm may be considered in connection with the idea of the possible transmission of alcoholism through heredity.
Abbott has found that alcoholized rabbits not only show the effect of streptococcus inoculations earlier than do non-alcoholized rabbits, but the lesions produced are much more pronounced than those which usually follow inoculation with this organism.
Laitinen has administered to rabbits one cubic centimeter of pure alcohol per kilogram of body weight, which corresponds to between four and five ounces of whiskey daily for a man. This quantity of alcohol was not sufficient to intoxicate the animal. Animals which had received this amount of alcohol for a considerable period were found to have a much greater susceptibility to pathogenic bacteria than normal controls.
Hodge has found that alcoholic dogs show diminished resistance to distemper as compared with normal animals under the same kennel conditions.
Richards has shown that if the hearts of dogs which have received alcohol for some time be perfused with a nutrient solution containing alcohol, they are much more sensitive to alcohol than hearts of normal controls.
Another experiment which shows apparent change in the organism under the influence of alcohol, has been accomplished by Reid Hunt. Hunt determined the toxic dose of aceto-nitrile in mice, rabbits and guinea pigs. This substance acts as a poison through the liberation of hydrocyanic acid within the body. Hunt found that if animals were given alcohol for several days, their susceptibility to aceto-nitrile was very greatly increased. That is to say, hydrocyanic acid was much more readily liberated within their tissues than in the normal controls. Hunt interpreted this as indicating an increased oxidative power on the part of the cells for the methyl group contained in the poison. However this may be, it is certain that his experiments have shown that metabolism is different when alcohol is given than it is under conditions when fat and carbohydrates form the energy producers which maintain life.
Alcohol has long been given in disease on account of the belief that it was of benefit in certain disturbances of the circulatory system. The value of alcohol under these circumstances has been disputed. The reports of the Vienna General Hospital in 1897 show that $10,000 was spent for alcoholic beverages during that year, whereas in 1905, the sum so expended had fallen to one half. Dixon says that alcohol actsthe isolated heart as a food stuff, and favors its contraction. A recent discussion of this subject by Miller, of Chicago, shows that circulatory disturbances in acute affections are of vaso-motor origin, and that the heart itself is usually perfectly able to fully perform its work. He calls attention to the fact that alcohol in certain diseases acts as a cardio-vascular stimulant producing vasco-contraction of the blood vessels and thereby favoring the circulation. However, if the dose which brings about this reaction be but slightly exceeded, there is paralysis of the vaso-motor centers with resulting dilatation of the blood vessels. He regards alcohol, therefore, as a drug which is to be used in these conditions with extreme care.
Alcohol has a profound effect upon the central nervous system. There are two theories with regard to its action. By some it is considered a stimulant, by others it is thought always to cause depression. Small amounts of alcohol may bring about an increased sense of liveliness and a general feeling of well-being which is most pronounced when the lights are bright, and the company congenial. Larger quantities induce incoordination of speech and movement, whereas still larger quantities result in complete anesthesia which may be fatal to the individual. For the first few minutes after taking alcohol, it has been found that a larger quantity of physical work may be performed. This is followed, however, by a period of depression during which the quantity of mechanical energy which may be expended by the individual is greatly reduced. The sum total of the effect is very decidedly to reduce the amount of mechanical work which can be accomplished during the day. It is on this account that alcohol is no longer given to soldiers on the march in the hope of increasing their endurance. The actual result would be quite the contrary.
Experiments regarding the action of the brain after taking alcohol as compared with its action before taking alcohol have been made by Kraepelin. Typesetters were used as subjects. It was found that those who had partaken of alcohol made a greater number of errors and worked less rapidly than those who were abstemious. Kraepelin has found that this effect lasts as long as twenty-four hours after alcohol has been taken. Curiously enough, those who had taken alcohol thought they were doing their work to better advantage than those who had not.
Other experiments have been made upon people, the test being the length of time which was required to memorize twenty-five lines of poetry. Here, when alcohol was taken before breakfast, it was found that the length of time required to memorize was increased 69 per cent. Also, when these individuals were requested to repeat the lines which they had learned, it was found that they did so less readily and made more errors when they had previously taken alcohol, than when they were free from the effect of this drug.
It is very apparent from such experiments as these, that alcohol does not stimulate to mental activity. The theory of Schmiedeberg is that the effect of alcohol is always a depressant one. The first depression upon the mind acts upon those highest faculties which are developed latest in life. That is, the faculties of self-control and self-respect. If these faculties are paralyzed first through the depression of alcohol, then it is as Cushny has pointed out, as though the brakes were removed from the mind, and the man becomes a child again. He becomes regardless of the ordinary conventions of life, regardless of the feelings of other people, regardful of himself alone. It is easy to see that where restraint is removed from the mind so that the normal action of self-control is abolished, the individual becomes open to all kinds of suggestions which he otherwise would not suffer. The mental condition is truly pathological.
It is thus that alcohol becomes the principal power behind prostitution. It is thus that the saloon in politics becomes dominant. The saloon through the alcohol which it furnishes is perfectly able to reduce the self-respect of the individual to such a level that he is glad and willing to accept a bribe for his action with regard to a political matter. It is easy to see to what extent alcohol becomes the auxiliary of crime. It is stated that 60 per cent, of the crimes of violence are due to drink. All these various activities which are due to alcohol tend to break up homes, and indeed Cushny has stated that if alcohol were a new synthetic drug imported from Germany and a few cases of alcoholism had been discovered as resulting from it, there would be such an outcry against it that it would be forever prohibited. A much more valuable drug, cocaine, he says, has nearly come to this fate on account of a few isolated cases in which the cocaine habit has been formed. The writer is not a teetotaler, and yet he does not think that any one can listen to an exposition of the effects of alcohol without being willing to join in a movement for its entire prohibition, provided such a prohibition could be really effective. The trouble, of course, with such movements has been that prohibition has not in reality prohibited.
The English medical journals have of late contained several articles regarding the relationship between alcohol and insanity, and also between alcohol and heredity. Dr. Mott, who is both a physician and a pathologist, quotes from Dr. Branthwaite, that 62 per cent, of the alcoholics committed to reformatories under the English Inebriates' Act, are found to be insane or mentally defective. However, Dr. Mott is very unwilling to believe that alcohol is the cause of insanity in any such proportion. He attributes the statistics mentioned above to the marked intolerance of the mentally defective for alcohol. Dr. Mott has made many autopsies in connection with his service at the Charing Cross Hospital and the Claybury Insane Asylum. In the general service of the Charing Cross Hospital he has found cirrhosis of the liver in about 7.7 per cent, out of a total of 1,099 adult autopsies, whereas at the Claybury Insane Asylum, out of 1,271 adult autopsies he has found only 1.8 per cent, of cirrhosis of the liver. In the asylum he has had only one case of cirrhosis of the liver with ascites, and this person had been convicted 400 times in the criminal courts before having been declared insane.
Among the hospital patients, on the contrary, there were many cases of cirrhosis of the liver with ascites. Mott therefore comes to the conclusion that a person who can drink to a condition of advanced cirrhosis of the liver has inherited an inborn stable mental organization. Such individuals he finds may exhibit no previous mental symptoms beyond a weakened will and a loss of moral sense. He says there can be no doubt that neurasthenics, epileptics, imbeciles, degenerates and potential lunatics possess marked intolerance for alcohol, and failure to discriminate between what is hereditary and what is the result of alcoholism has been the cause of much confusion. Those who are alcoholics and show only weakened will-power and failing memory do not necessarily become permanently insane.
Hodge has given dogs alcohol from puppyhood to maturity in such quantities as to materially reduce their mental ability, but on the withdrawal of alcohol, normal intelligence was awakened.
Statistics have been collected which show that in the mining counties of England there is much alcoholism and little insanity, whereas in the country districts the reverse is true. The explanation given by Sullivan is that the more feeble minded among the English stay in agriculture and procreate their species, whereas the more intellectually active move to the town environment. So it may be, that perhaps no more than 10 per cent, of the insane are really produced by the direct action of alcohol, the rest having inherited conditions of weak intellectuality,
A further question is the action of alcohol on heredity, a matter which has been taken up by some of the most prominent English authorities. The question is, does parental alcoholism influence the physical and mental ability of the offspring. This question is discussed by Hyslop in a recent number of the Lancet. It is still doubtful whether the heritage from alcoholic parents is due to the alcoholism or whether it is due to the inherent parental degeneracy with the accompanying tendency towards alcoholism, and here again one must consider the association of the child with its alcoholic parent usually in an unwholesome poverty-stricken environment, Hodge has demonstrated that alcoholized dogs give birth to offspring of low vigor and low viability.
It is stated that the only true solution of this question in human beings is to be obtained through a number of instances in which children have been born to parents before the alcoholism, during alcoholism and after recovering from alcoholism. Such experimental conditions, of course, are not to be thought of as premeditated, and the history of such cases as actually occur in the tragedy of life are only with difficulty obtainable with accuracy. It is but recently that hereditary studies have been made on the subject of the color of the eyes, of the hair, and in other problems the work of necessity becomes more and more complicated. However, such statistics as have been collected seem to indicate that with each successive generation addicted to alcoholism there is a shorter period of existence before alcoholism sets in in the offspring. Thus Hyslop says that parental alcoholism accentuates the downward trend of an inherited neurosis and physical degeneracy.
There can be no doubt that this question of the use and abuse of alcohol is one of the most serious with which the modern world to-day has to deal.
- Annual address before the Alpha Omega Alpha Society of the University of Pennsylvania.