Some very puzzling differences of opinion about the use of alcoholic
beverages find expression. This is natural enough, since alcohol is a
very curious drug, and the human organism a very complex mechanism. The
effects of this drug upon this mechanism are often very mystifying. Not
many persons are competent to analyze these effects in their totality.
Still fewer can examine any of them quite without prejudice. But in
recent years a large number of scientific investigators have attempted
to substitute knowledge for guesswork as to the effects of alcohol,
through the institution of definitive experiments. Some have tested its
effects on the digestive apparatus; others, its power over the heart
and voluntary muscles; still others, its influence upon the brain. On
the whole, the results of these experiments are singularly consistent.
Undoubtedly they tend to upset a good many time-honored preconceptions.
But they give better grounds for judgment as to what is the rational
attitude toward alcohol than have hitherto been available.
The traditional rôle of alcohol is that of a stimulant. It has been
supposed to stimulate digestion and assimilation; to stimulate the
heart's action; to stimulate muscular activity and strength; to
stimulate the mind. The new evidence seems to show that, in the final
analysis, alcohol stimulates none of these activities; that its final
effect is everywhere depressive and inhibitory (at any rate, as regards
higher functions) rather than stimulative; that, in short, it is
properly to be classed with the anesthetics and narcotics. The grounds
for this view should be of interest to every user of alcohol; of
interest, for that matter, to every citizen, considering that more than
one thousand million gallons of alcoholic beverages are consumed in the
United States each year.
I should like to present the new evidence far more fully than space
will permit. I shall attempt, however, to describe some of the more
significant observations and experiments in sufficient detail to enable
the reader to draw his own conclusions. To make room for this, I must
deal with other portions of the testimony in a very summary manner.
As regards digestion, for example, I must be content to note that
the experiments show that alcohol does indeed stimulate the flow of
digestive fluids, but that it also tends to interfere with their normal
action; so that ordinarily one effect neutralizes the other. As regards
the action on the heart, I shall merely state that the ultimate effect
of alcohol is to depress, in large doses to paralyze, that organ.
These, after all, are matters that concern the physician rather than
the general reader.
The effect of alcohol on muscular activity has a larger measure of
popular interest; indeed, it is a question of the utmost practicality.
The experiments show that alcohol does not increase the capacity to do
muscular work, but distinctly decreases it. Doubtless this seems at
variance with many a man's observation of himself; but the explanation
is found in the fact that alcohol blurs the judgment. As Voit remarks,
it gives, not strength, but, at most, the feeling of strength. A man
may think he is working faster and better under the influence of
alcohol than he would otherwise do; but rigidly conducted experiments
do not confirm this opinion. "Both science and the experience of life,"
says Dr. John J. Abel, of Johns Hopkins University, "have exploded
the pernicious theory that alcohol gives any persistent increase of
muscular power. The disappearance of this universal error will greatly
reduce the consumption of alcohol among laboring men. It is well
understood by all who control large bodies of men engaged in physical
labor, that alcohol and effective work are incompatible."
It is even questionable whether the energy derived from the oxidation
of alcohol in the body can be directly used at all as a source of
muscular energy. Such competent observers as Schumberg and Scheffer
independently reached the conclusion that it cannot. Dr. Abel inclines
to the same opinion. He suggests that "alcohol is not a food in the
sense in which fats and carbohydrates are food; it should be defined
as an easily oxidizable drug with numerous untoward effects which
inevitably appear when a certain minimum dose is exceeded," He thinks
that alcohol should be classed "with the more or less dangerous
stimulants and narcotics, such as hasheesh, tobacco, etc., rather
than with truly sustaining foodstuffs," Some of the grounds for this
view will appear presently, as we now turn to examine the alleged
stimulating effects of alcohol upon the mental processes.
_Alcohol as a Brain Stimulant_
The celebrated physicist Von Helmholtz, one of the foremost thinkers
of the nineteenth century, declared that the very smallest quantity
of alcohol served effectively, while its influence lasted, to banish
from his mind all possibility of creative effort; all capacity to
solve an abstruse problem. The result of recent experiments in the
field of physiological psychology convince one that the same thing is
true in some measure of every other mind capable of creative thinking.
Certainly all the evidence goes to show that no mind is capable of
its best efforts when influenced by even small quantities of alcohol.
If any reader of these words is disposed to challenge this statement,
on the strength of his own personal experience, I would ask him to
reflect carefully as to whether what he has been disposed to regard as
a stimulant effect may not be better explained along lines suggested
by these words of Professor James: "The reason for craving alcohol is
that it is an anesthetic even in moderate quantities. It obliterates a
part of the field of consciousness and abolishes collateral trains of
thought."
The experimental evidence that tends to establish the position of
alcohol as an inhibitor and disturber rather than a promoter of mental
activity has been gathered largely by German investigators. Many of
their experiments are of a rather technical character, aiming to test
the basal operations of the mind. Others, however, are eminently
practical, as we shall see. The earliest experiments, made by Exner in
Vienna so long ago as 1873, aimed to determine the effect of alcohol
upon the so-called reaction-time. The subject of the experiment sits at
a table, with his finger upon a telegraph key. At a given signal--say
a flash of light--he releases the key. The time that elapses between
signal and response--measured electrically in fractions of a second--is
called the simple or direct reaction-time. This varies for different
individuals, but is relatively constant, under given conditions, for
the same individual. Exner found, however, that when an individual had
imbibed a small quantity of alcohol, his reaction-time was lengthened,
though the subject believed himself to be responding more promptly
than before.
These highly suggestive experiments attracted no very great amount of
attention at the time. Some years later, however, they were repeated by
several investigators, including Dietl, Vintschgau, and in particular
Kraepelin and his pupils. It was then discovered that, in the case
of a robust young man, if the quantity of alcohol ingested was very
small, and the tests were made immediately, the direct reaction-time
was not lengthened, but appreciably shortened instead. If, however, the
quantity of alcohol was increased, or if the experiments were made at
a considerable interval of time after its ingestion, the reaction-time
fell below the normal, as in Exner's experiments.
Subsequent experiments tested mental processes of a somewhat more
complicated character. For example, the subject would place, each
hand on a telegraph key, at right and left. The signals would then
be varied, it being understood that one key or the other would be
pressed promptly accordingly as a red or a white light, appeared. It
became necessary, therefore, to recognize the color of the light,
and to recall which hand was to be moved at that particular, signal:
in other words, to make a choice not unlike that which a locomotive
engineer is required to make when he encounters an unexpected signal
light. The tests showed that after the ingestion of a small quantity
of alcohol--say a glass of beer--there was a marked disturbance of
the mental processes involved in this reaction. On the average, the
keys were released more rapidly than before the alcohol was taken,
but the wrong key was much more frequently released than under normal
circumstances. Speed was attained at the cost of correct judgment.
Thus, as Dr. Stier remarks, the experiment shows the elements of two
of the most significant and persistent effects of alcohol, namely, the
vitiating of mental processes and the increased tendency to hasty or
incoördinate movements. Stated otherwise, a levelling down process is
involved, whereby the higher function is dulled, the lower function
accentuated.
Equally suggestive are the results of some experiments devised by Ach
and Maljarewski to test the effects of alcohol upon the perception and
comprehension of printed symbols. The subject was required to read
aloud a continuous series of letters or meaningless syllables or short
words, as viewed through a small slit in a revolving cylinder. It was
found that after taking a small quantity of alcohol, the subject was
noticeably less able to read correctly. His capacity to repeat, after
a short interval, a number of letters correctly read, was also much
impaired. He made more omissions than before, and tended to substitute
words and syllables for those actually seen. It is especially
noteworthy that the largest number of mistakes were made in the reading
of meaningless syllables,--that is to say, in the part of the task
calling for the highest or most complicated type of mental activity.
Another striking illustration of the tendency of alcohol to impair the
higher mental processes was given by some experiments instituted by
Kraepelin to test the association of ideas, In these experiments, a
word is pronounced, and the subject is required to pronounce the first
word that suggests itself in response. Some very interesting secrets
of the subconscious personality are revealed thereby, as was shown,
for example, in a series of experiments conducted last year at Zürich
by Dr. Frederick Peterson of New York. But I cannot dwell on these
here. Suffice it for our purpose that the possible responses are of
two general types. The suggested word being, let us say, "book," the
subject may (1) think of some word associated logically with the idea
of a book, such as "read" or "leaves"; or he may (2) think of some
word associated merely through similarity of sound, such as "cook" or
"shook." In a large series of tests, any given individual tends to show
a tolerably uniform proportion between the two types of association;
and this ratio is in a sense explicative of his type of mind. Generally
speaking, the higher the intelligence, the higher will be the ratio of
logical to merely rhymed associations. Moreover, the same individual
will exhibit more associations of the logical type when his mind is
fresh than when it is exhausted, as after a hard day's work.
In Kraepelin's experiments it appeared that even the smallest quantity
of alcohol had virtually the effect of fatiguing the mind of the
subject, so that the number of his rhymed responses rose far above the
normal. That is to say, the lower form of association of ideas was
accentuated, at the expense of the higher. In effect, the particular
mind experimented upon was always brought for the time being to a lower
level by the alcohol.
_The Effect of a Bottle of Wine a Day_
When a single dose of alcohol is administered, its effects gradually
disappear, as a matter of course. But they are far more persistent than
might be supposed. Some experiments conducted by Fürer are illuminative
as to this. He tested a person for several days, at a given hour, as to
reaction-time, the association of ideas, the capacity to memorize, and
facility in adding. The subject was then allowed to drink two litres of
beer in the course of a day. No intoxicating effects whatever were to
be discovered by ordinary methods. The psychological tests, however,
showed marked disturbance of all the reactions, a diminished capacity
to memorize, decreased facility in adding, etc., not merely on the day
when the alcohol was taken, but on succeeding days as well. Not until
the third day was there a gradual restoration to complete normality;
although the subject himself--and this should be particularly
noted--felt absolutely fresh and free from after-effects of alcohol on
the day following that on which the beer was taken.
Similarly Rüdin found the effects of a single dose of alcohol to
persist, as regards some forms of mental disturbance, for twelve hours,
for other forms twenty-four hours, and for yet others thirty-six hours
and more. But Rüdin's experiments bring out another aspect of the
subject, which no one who considers the alcohol question in any of
its phases should overlook: the fact, namely, that individuals differ
greatly in their response to a given quantity of the drug. Thus,
of four healthy young students who formed the subjects of Rüdin's
experiment, two showed very marked disturbance of the mental functions
for more than forty-eight hours, whereas the third was influenced for a
shorter time, and the fourth was scarcely affected at all. The student
who was least affected was not, as might be supposed, one who had been
accustomed to take alcoholics habitually, but, on the contrary, one who
for six years had been a total abstainer.
Noting thus that the effects of a single dose of alcohol may persist
for two or three days, one is led to inquire what the result will
be if the dose is repeated day after day. Will there then be a
cumulative effect, or will the system become tolerant of the drug
and hence unresponsive? Some experiments of Smith, and others of
Kürz and Kraepelin have been directed toward the solution of this
all-important question. The results of the experiments show a piling
up of the disturbing effects of the alcohol. Kürz and Kraepelin
estimate that after giving eighty grams per day to an individual for
twelve successive days, the working capacity of that individual's mind
was lessened by from twenty-five to forty per cent. Smith found an
impairment of the power to add, after twelve days, amounting to forty
per cent.; the power to memorize was reduced by about seventy per cent.
Forty to eighty grams of alcohol, the amounts used in producing these
astounding results, is no more than the quantity contained in one to
two litres of beer or in a half-bottle to a bottle of ordinary wine.
Professor Aschaffenburg, commenting on these experiments, points the
obvious moral that the so-called moderate drinker, who consumes his
bottle of wine as a matter of course each day with his dinner--and
who doubtless would declare that he is never under the influence of
liquor--is in reality never actually sober from one week's end to
another. Neither in bodily nor in mental activity is he ever up to what
should be his normal level.
That this fair inference from laboratory experiments may be
demonstrated in a thoroughly practical field, has been shown by
Professor Aschaffenburg himself, through a series of tests made on
four professional typesetters. The tests were made with all the rigor
of the psychological laboratory (the experimenter is a former pupil
of Kraepelin), but they were conducted in a printing office, where
the subjects worked at their ordinary desks, and in precisely the
ordinary way, except that the copy from which the type was set was
always printed, to secure perfect uniformity. The author summarizes the
results of the experiment as follows:
_A Loss of Ten Per Cent. in Working Efficiency_
"The experiment extended over four days. The first and third days were
observed as normal days, no alcohol being given. On the second and
fourth days each worker received thirty-five grams (a little more than
one ounce) of alcohol, in the form of Greek wine. A comparison of the
results of work on normal and on alcoholic days showed, in the case
of one of the workers, no difference. But the remaining three showed
greater or less retardation of work, amounting in the most pronounced
case to almost fourteen per cent. As typesetting is paid for by
measure, such a worker would actually earn ten per cent. less on days
when he consumed even this small quantity of alcohol."
In the light of such observations, a glass of beer or even the cheapest
bottle of wine is seen to be an expensive luxury. To forfeit ten per
cent. of one's working efficiency is no trifling matter in these days
of strenuous competition. Perhaps it should be noted that the subjects
of the experiment were all men habituated to the use of liquor, one
of them being accustomed to take four glasses of beer each week day,
and eight or ten on Sundays. This heaviest drinker was the one whose
work was most influenced in the experiment just related. The one whose
work was least influenced was the only one of the four who did not
habitually drink beer every day; and he drank regularly on Sundays. It
goes without saying that all abstained from beer during the experiment.
We may note, further, that all the men admitted that they habitually
found it more difficult to work on Mondays, after the over-indulgence
of Sunday, than on other days, and that they made more mistakes on
that day. Aside from that, however, the men were by no means disposed
to admit, before the experiment, that their habitual use of beer
interfered with their work. That it really did so could not well be
doubted after the experiment.
_The Effect of Beer-drinking on German School-children_
Some doubly significant observations as to the practical effects
of beer and wine in dulling the faculties were made by Bayer, who
investigated the habits of 591 children in a public school in Vienna.
These pupils were ranked by their teachers into three groups, denoting
progress as "good," "fair," or "poor" respectively. Bayer found, on
investigation, that 134 of these pupils took no alcoholic drink; that
164 drank alcoholics very seldom; but that 219 drank beer or wine once
daily; 71 drank it twice daily; and three drank it with every meal.
Of the total abstainers, 42 per cent. ranked in the school as "good,"
49 per cent. as "fair," and 9 per cent. as "poor." Of the occasional
drinkers, 34 per cent. ranked as "good," 57 per cent. as "fair," and
9 per cent. as "poor." Of the daily drinkers, 28 per cent. ranked as
"good," 58 per cent. as "fair," and 14 per cent. as "poor." Those
who drank twice daily ranked 25 per cent. "good," 58% "fair," and 18
per cent. "poor," Of the three who drank thrice daily, one ranked
as "fair," and the other two as "poor." Statistics of this sort are
rather tiresome; but these will repay a moment's examination. As
Aschaffenburg, from whom I quote them, remarks, detailed comment is
superfluous: the figures speak for themselves.
Neither in England nor America, fortunately, would it be possible to
gather statistics comparable to these as to the effects of alcohol on
growing children; for the Anglo-Saxon does not believe in alcohol for
the child, whatever his view as to its utility for adults. The effects
of alcohol upon the growing organism have, however, been studied
here with the aid of subjects drawn from lower orders of the animal
kingdom. Professor C. F. Hodge, of Clark University, gave alcohol to
two kittens, with very striking results. "In beginning the experiment,"
he says, "it was remarkable how quickly and completely all the higher
psychic characteristics of both the kittens dropped out. Playfulness,
purring, cleanliness and care of coat, interest in mice, fear of dogs,
while normally developed before the experiment began, all disappeared
so suddenly that it could hardly be explained otherwise than as a
direct influence of the alcohol upon the higher centers of the brain.
The kittens simply ate and slept, and could scarcely have been less
active had the greater part of their cerebral hemisphere been removed
by the knife."
_The Development of Fear in Alcoholized Dogs_
Professor Hodge's experiments extended also to dogs. He found that the
alcoholized dogs in his kennel were lacking in spontaneous activity
and in alertness in retrieving a ball. These defects must be in part
explained by lack of cerebral energy, in part by weakening of the
muscular system. Various other symptoms were presented that showed the
lowered tone of the entire organism under the influence of alcohol;
but perhaps the most interesting phenomenon was the development of
extreme timidity on the part of all the alcoholized dogs. The least
thing out of the ordinary caused them to exhibit fear, while their
kennel companions exhibited only curiosity or interest. "Whistles and
bells, in the distance, never ceased to throw them into a panic in
which they howled and yelped while the normal dogs simply barked." One
of the dogs even had "paroxysms of causeless fear with some evidence of
hallucination. He would apparently start at some imaginary object, and
go into fits of howling."
The characteristic timidity of the alcoholized dogs did not altogether
disappear even when they no longer received alcohol in their diet.
Timidity had become with them a "habit of life." As Professor Hodge
suggests, we are here apparently dealing with "one of the profound
physiological causes of fear, having wide application to its phenomena
in man. Fear is commonly recognized as a characteristic feature in
alcoholic insanity, and delirium tremens is the most terrible form
of fear psychosis known," The development of the same psychosis, in
a modified degree, through the continued use of small quantities of
alcohol, emphasizes the causal relation between the use of alcohol
and the genesis of timidity. It shows how pathetically mistaken is
the popular notion that alcohol inspires courage; and, to anyone who
clearly appreciates the share courage plays in the battle of life, it
suggests yet another lamentable way in which alcohol handicaps its
devotees.
_Is Alcohol A Poison?_
It is perhaps hardly necessary to cite further experiments directly
showing the depressing effects of alcohol, even in small quantities,
upon the mental activities, Whoever examines the evidence in its
entirety will scarcely avoid the conclusion reached by Smith, as
the result of his experiments already referred to, which Dr. Abel
summarizes thus: "One half to one bottle of wine, or two to four
glasses of beer a day, not only counteract the beneficial effects
of 'practice' in any given occupation, but also depress every form
of intellectual activity; therefore every man, who, according to
his own notions, is only a moderate drinker places himself by this
indulgence on a lower intellectual level and opposes the full and
complete utilization of his intellectual powers." I content myself with
repeating that, to the thoughtful man, the beer and the wine must seem
dear at such a price.
To any one who may reply that he is willing to pay this price for
the sake of the pleasurable emotions and passions that are sometimes
permitted to hold sway in the absence of those higher faculties of
reason which alcohol tends to banish, I would suggest that there is
still another aspect of the account which we have not as yet examined.
We have seen that alcohol may be a potent disturber of the functions
of digestion, of muscular activity, and of mental energizing. But we
have spoken all along of function and not of structure. We have not
even raised a question as to what might be the tangible effects of
this disturber of functions upon the physical organism through which
these functions are manifested. We must complete our inquiry by asking
whether alcohol, in disturbing digestion, may not leave its mark upon
the digestive apparatus; whether in disturbing the circulation it may
not put its stamp upon heart and blood vessels; whether in disturbing
the mind it may not leave some indelible record on the tissues of the
brain.
Stated otherwise, the question is this: Is alcohol a poison to the
animal organism? A poison being, in the ordinary acceptance of the
word, an agent that may injuriously affect the tissues of the body, and
tend to shorten life.
Students of pathology answer this question with no uncertain voice.
The matter is presented in a nutshell by the Professor of Pathology at
Johns Hopkins University, Dr. William H. Welch, when he says: "Alcohol
in sufficient quantities is a poison to all living organisms, both
animal and vegetable." To that unequivocal pronouncement there is, I
believe, no dissenting voice, except that a word-quibble was at one
time raised over the claim that alcohol in exceedingly small doses
might be harmless. The obvious answer is that the same thing is true of
any and every poison whatsoever. Arsenic and strychnine, in appropriate
doses, are recognized by all physicians as admirable tonics; but no one
argues in consequence that they are not virulent poisons.
Open any work on the practice of medicine quite at random, and whether
you chance to read of diseased stomach or heart or blood-vessels
or liver or kidneys or muscles or connective tissues or nerves or
brain--it is all one: in any case you will learn that alcohol may be
an active factor in the causation, and a retarding factor in the cure,
of some, at least, of the important diseases of the organ or set of
organs about which you are reading. You will rise with the conviction
that alcohol is not merely a poison, but the most subtle, the most
far-reaching, and, judged by its ultimate effects, incomparably the
most virulent of all poisons.
_Alcohol and Disease_
Here are a few corroborative facts, stated baldly, almost at random:
Rauber found that a ten per cent. solution of alcohol "acted as a
definite protoplasmic poison to all forms of cell life with which he
experimented--including the hydra, tapeworms, earthworms, leeches,
crayfish, various species of fish, Mexican axolotl, and mammals,
including the human subject." Berkely found, in four rabbits out
of five in which he had induced chronic alcohol poisoning, fatty
degeneration of the heart muscle. This condition, he says, "seems to be
present in all animals subject to a continual administration of alcohol
in which sufficient time between the doses is not allowed for complete
elimination." Cowan finds that alcoholic cases "bear acute diseases
badly, failure of the heart always ensuing at an earlier period than
one would anticipate." Bollinger found the beer-drinkers of Munich
so subject to hypertrophied or dilated hearts as to justify Liebe in
declaring that "one man in sixteen in Munich drinks himself to death."
Dr. Sims Woodhead, Professor of Pathology in the University of
Cambridge, says of the effect of alcohol on the heart: "In addition
to the fatty degeneration of the heart that is so frequently met with
in chronic alcoholics, there appears in some cases to be an increase
of fibrous tissue between the muscle fibers, accompanied by wasting
of these tissues.... Heart failure, one of the most frequent causes
of death in people of adult and advanced years, is often due to fatty
degeneration, and a patient who suffers from alcoholic degeneration
necessarily runs a much greater risk of heart failure during the
course of acute fevers or from overwork, exhaustion, and an overloaded
stomach, and the like, than does the man with a strong, healthy heart
unaffected by alcohol or similar poisons."
It must be obvious that these words give a clue to the agency of
alcohol in shortening the lives of tens of thousands of persons with
whose decease the name of alcohol is never associated in the minds of
their friends or in the death certificates.
Dr. Woodhead has this to say about the blood-vessels: "In chronic
alcoholism in which the poison is acting continuously, over a long
period, a peculiar fibrous condition of the vessels is met with; this,
apparently, is the result of a slight irritation of the connective
tissue of the walls of these vessels. The wall of the vessel may become
thickened throughout its whole extent or irregularly, and the muscular
coat may waste away as a new fibrous or scar-like tissue is formed. The
wasting muscles may undergo fatty degeneration, and, in these, lime
salts may be deposited; the rigid, brittle, so-called pipestem vessels
are the result." Referring to these degenerated arteries, Dr. Welch
says: "In this way alcoholic excess may stand in a causative relation
to cerebral disorders, such as apoplexy and paralysis, and also the
diseases of the heart and kidneys."
From our present standpoint it is particularly worthy of remark that
Professor Woodhead states that this calcification of the blood-vessels
is likely to occur in persons who have never been either habitual
or occasional drunkards, but who have taken only "what they are
pleased to call 'moderate' quantities of alcohol." Similarly, Dr.
Welch declares that "alcoholic diseases are certainly not limited
to persons recognized as drunkards. Instances have been recorded in
increasing number in recent years of the occurrence of diseases of
the circulatory, renal, and nervous systems, reasonably or positively
attributable to the use of alcoholic liquors, in persons who never
became really intoxicated and were regarded by themselves and by others
as 'moderate drinkers.'"
"It is well established," adds Dr. Welch, "that the general mortality
from diseases of the liver, kidney, heart, blood-vessels, and nervous
system is much higher in those following occupations which expose them
to the temptation of drinking than in others." Strumpell declares that
chronic inflammation of the stomach and bowels is almost exclusively
of alcoholic origin; and that when a man in the prime of life dies of
certain chronic kidney affections, one may safely infer that he has
been a lover of beer and other alcoholic drinks. Similarly, cirrhosis
of the liver is universally recognized as being, nine times in ten, of
alcoholic origin. The nervous affections of like origin are numerous
and important, implicating both brain cells and peripheral fibres.
_How the Poison Works_
Without going into further details as to the precise changes that
alcohol may effect in the various organs of the body, we may note
that these pathological changes are everywhere of the same general
type. There is an ever-present tendency to destroy the higher form of
cells--those that are directly concerned with the vital processes--and
to replace them with useless or harmful connective tissue. "Whether
this scar tissue formation goes on in the heart, in the kidneys, in
the liver, in the blood-vessels, or in the nerves," says Woodhead,
"the process is essentially the same, and it must be associated with
the accumulation of poisonous or waste products in the lymph spaces
through which the nutrient fluids pass to the tissues. The contracting
scar tissue of a wound has its exact homologue in the contracting scar
tissue that is met with in the liver, in the kidney, and in the brain."
It is not altogether pleasant to think that one's bodily tissues--from
the brain to the remotest nerve fibril, from the heart to the minutest
arteriole--may perhaps be undergoing day by day such changes as these.
Yet that is the possibility which every habitual drinker of alcoholic
beverages--"moderate drinker" though he be--must face. This is an added
toll that does not appear in the first price of the glass of beer or
bottle of wine, but it is a toll that may refuse to be overlooked in
the final accounting.
_Alcohol and Acute Infections_
In connection with experiments in rendering animals and men immune
from certain contagious diseases through inoculation with specific
serums, Deléarde, working in Calmette's laboratory in Lille, showed
that alcoholized rabbits are not protected by inoculation, as normal
ones are, against hydrophobia. Moreover, he reports the case of
an intemperate man, bitten by a mad dog, who died notwithstanding
anti-rabic treatment, whereas a boy of thirteen, much more severely
bitten by the same dog on the same day, recovered under treatment.
Deléarde strongly advises any one bitten by a mad dog to abstain from
alcohol, not only during the anti-rabic treatment but for some months
thereafter, lest the alcohol counteract the effects of the protective
serum.
Similar laboratory experiments have been made by Laitenan, who became
fully convinced that alcohol increases the susceptibility of animals to
splenic fever, tuberculosis, and diphtheria. Dr. A. C. Abbott, of the
University of Pennsylvania, made an elaborate series of experiments to
test the susceptibility of rabbits to various micro-organisms causing
pus-formation and blood poisoning. He found that the normal resistance
of rabbits to infection from this source was in most cases "markedly
diminished through the influence of alcohol when given daily to a stage
of acute intoxication." "It is interesting to note," Dr. Abbott adds,
"that the results of inoculation of the alcoholized rabbits with the
erysipelas coccus correspond in a way with clinical observations on
human beings addicted to the excessive use of alcohol when infected by
this organism."
Additional confirmation of the deleterious effects of alcohol in this
connection was furnished by the cats and dogs of Professor Hodge's
experiments, already referred to. All of these showed peculiar
susceptibility to infectious diseases, not only being attacked earlier
than their normal companions, but also suffering more severely, This
accords with numerous observations on the human subject; for example,
with the claim made some years ago by McCleod and Milles that Europeans
in Shanghai who used alcohol showed increased susceptibility to Asiatic
cholera, and suffered from a more virulent type of the disease.
Professor Woodhead points out that many of the foremost authorities now
concede the justice of this view, and unreservedly condemn the giving
of alcohol, even in medicinal doses, to patients suffering from cholera
or from various other acute diseases and intoxications, including
diphtheria, tetanus, snake-bite, and pneumonia, as being not merely
useless but positively harmful. Even when the patient has advanced far
toward recovery from an acute infectious disease, it is held still
to be highly unwise to administer alcohol, since this may interfere
with the beneficent action of the anti-toxins that have developed in
the tissues of the body, and in virtue of which the disease has been
overcome.
_The Ally of Tuberculosis_
Not many physicians, perhaps, will go so far as Dr. Muirhead of
Edinburgh, who at one time claimed that he had scarcely known of a
death in a case of pneumonia uncomplicated by alcoholism; but almost
every physician will admit that he contemplates with increased
solicitude every case of pneumonia thus complicated. Equally potent,
seemingly, is alcohol in complicating that other ever-menacing lung
disease, tuberculosis. Dr. Crothers long ago asserted that inebriety
and tuberculosis are practically interconvertible conditions; a view
that may be interpreted in the words of Dr. Dickinson's Baillie
Lecture: "We may conclude, and that confidently, that alcohol
promotes tubercle, not because it begets the bacilli, but because it
impairs the tissues, and makes them ready to yield to the attacks
of the parasites." Dr. Brouardel, at the Congress for the Study of
Tuberculosis, in London, was equally emphatic as to the influence of
alcohol in preparing the way for tuberculosis, and increasing its
virulence; and this view has now become general--curiously reversing
the popular impression, once held by the medical profession as well,
that alcohol is antagonistic to consumption.
Corroborative evidence of the baleful alliance between alcohol and
tuberculosis is furnished by the fact that in France the regions
where tuberculosis is most prevalent correspond with those in which
the consumption of alcohol is greatest. Where the average annual
consumption was 12.5 litres per person, the death rate from consumption
was found by Baudron to be 32.8 per thousand. Where alcoholic
consumption rose to 35.4 litres, the death rate from consumption
increased to 107.8 per thousand. Equally suggestive are facts put
forward by Guttstadt in regard to the causes of death in the various
callings in Prussia. He found that tuberculosis claimed 160 victims
in every thousand deaths of persons over twenty-five years of age.
But the number of deaths from this disease per thousand deaths among
gymnasium teachers, physicians, and Protestant clergymen, for example,
amounted respectively to 126, 113, and 76 only; whereas the numbers
rose, for hotelkeepers, to 237, for brewers, to 344, and for waiters,
to 556. No doubt several factors complicate the problem here, but one
hazards little in suggesting that a difference of habit as to the use
of alcohol was the chief determinant in running up the death rate due
to tuberculosis from 76 per thousand at one end of the scale to 556 at
the other.
Pneumonia and tuberculosis combined account for one-fifth of all deaths
in the United States, year by year. In the light of what has just been
shown, it would appear that alcohol here has a hand in the carrying
off of other untold thousands with whose untimely demise its name is
not officially associated. I may add that certain German authorities,
including, for example, Dr. Liebe, present evidence--not as yet
demonstrative--to show that cancer must also be added to the list of
diseases to which alcohol predisposes the organism.
_Hereditary Effects of Alcohol_
If additional evidence of the all-pervading influence of alcohol is
required, it may be found in the thought-compelling fact that the
effects are not limited to the individual who imbibes the alcohol, but
may be passed on to his descendants. The offspring of alcoholics show
impaired vitality of the most deep-seated character. Sometimes this
impaired vitality is manifested in the non-viability of the offspring;
sometimes in deformity; very frequently in neuroses, which may take the
severe forms of chorea, infantile convulsions, epilepsy, or idiocy. In
examining into the history of 2554 idiotic, epileptic, hysterical, or
weak-minded children in the institution at Bicêtre, France, Bourneville
found that over 41 per cent. had alcoholic parents. In more than 9 per
cent. of the cases, it was ascertained that one or both parents were
under the influence of alcohol at the time of procreation,--a fact
of positively terrifying significance, when we reflect how alcohol
inflames the passions while subordinating the judgment and the ethical
scruples by which these passions are normally held in check. Of
similar import are the observations of Bezzola and of Hartmann that
a large proportion of the idiots and the criminals in Switzerland
were conceived during the season of the year when the customs of the
country--"May-fests," etc.--lead to the disproportionate consumption of
alcohol.
Experimental evidence of very striking character is furnished by the
reproductive histories of Professor Hodge's alcoholized dogs. Of 23
whelps born in four litters to a pair of tipplers, 9 were born dead, 8
were deformed, and only 4 were viable and seemingly normal. Meantime, a
pair of normal kennel-companions produced 45 whelps, of which 41 were
viable and normal--a percentage of 90.2 against the 17.4 per cent. of
viable alcoholics. Professor Hodge points out that these results are
strikingly similar to the observations of Demme on the progeny of ten
alcoholic as compared with ten normal families of human beings. The ten
alcoholic families produced 57 children, of whom 10 were deformed, 6
idiotic, 6 choreic or epileptic, 25 non-viable, and only 10, or 17 per
cent, of the whole were normal. The ten normal families produced 61
children, two of whom were deformed, 2 pronounced "backward," though
not suffering from disease, and 3 non-viable, leaving 54, or 88.5 per
cent., normal.
As I am writing this article, the latest report of the Craig Colony for
Epileptics, at Sonyea, New York, chances to come to my desk. Glancing
at the tables of statistics, I find that the superintendent, Dr.
Spratling, reports a history of alcoholism in the parents of 313 out
of 950 recent cases. More than 22 per cent. of these unfortunates are
thus suffering from the mistakes of their parents. Nor does this by any
means tell the whole story, for the report shows that 577 additional
cases--more than 60 per cent, of the whole--suffer from "neuropathic
heredity"; which means that their parents were themselves the victims
of one or another of those neuroses that are peculiarly heritable, and
that unquestionably tell, in a large number of cases, of alcoholic
indulgence on the part of their progenitors. "Even to the third and
fourth generation," said the wise Hebrew of old; and the laws of
heredity have not changed since then.
I cite the data from this report of the Epileptic Colony, not because
its record is in any way exceptional, but because it is absolutely
typical. The mental image that it brings up is precisely comparable
to that which would arise were we to examine the life histories of
the inmates of any institution whatever where dependent or delinquent
children are cared for, be it idiot asylum, orphanage, hospital, or
reformatory. The same picture, with the same insistent moral, would be
before us could we visit a clinic where nervous diseases are treated;
or--turning to the other end of the social scale--could we sit in the
office of a fashionable specialist in nervous diseases and behold the
succession of neurotics, epileptics, paralytics, and degenerates that
come day by day under his observation. It is this picture, along with
others which the preceding pages may in some measure have suggested,
that comes to mind and will not readily be banished when one hears
advocated "on physiological grounds" the regular use of alcoholic
drinks, "in moderation." A vast number of the misguided individuals
who were responsible for all this misery never did use alcohol except
in what they believed to be strict "moderation"; and of those that did
use it to excess, there were few indeed who could not have restricted
their use of alcohol to moderate quantities, or have abandoned its use
altogether, had not the drug itself made them its slaves by depriving
them of all power of choice. Few men indeed are voluntary inebriates.
_Alcohol and the "Moderate" Drinker_
It does not fall within the scope of my present purpose to dwell upon
the familiar aspect of the effects of alcohol suggested by the last
sentence. It requires no scientific experiments to prove that one of
the subtlest effects of this many-sided drug is to produce a craving
for itself, while weakening the will that could resist that craving.
But beyond noting that this is precisely in line with what we have
everywhere seen to be the typical effect of alcohol--the weakening of
higher functions and faculties, with corresponding exaggeration of
lower ones--I shall not comment here upon this all too familiar phase
of the alcohol problem. Throughout this paper I have had in mind the
hidden cumulative effects of relatively small quantities of alcohol
rather than the patent effects of excessive indulgence, I have had in
mind the voluntary "social" drinker, rather than the drunkard. I have
wished to raise a question in the mind of each and every habitual user
of alcohol in "moderation" who chances to read this article, as to
whether he is acting wisely in using alcohol habitually in any quantity
whatever.
If in reply the reader shall say: "There is some quantity of alcohol
that constitutes actual moderation; some quantity that will give me
pleasure and yet not menace me with these evils," I answer thus:
Conceivably that is true, though it is not proved. But in any event,
no man can tell you what the safe quantity is--if safe quantity there
be--in any individual case. We have seen how widely individuals
differ in susceptibility. In the laboratory some animals are killed
by doses that seem harmless to their companions. These are matters of
temperament that as yet elude explanation. But this much I can predict
with confidence: whatever the "safe" quantity of alcohol for you to
take, you will unquestionably at times exceed it. In a tolerably wide
experience of men of many nations, I have never known an habitual
drinker who did not sometimes take more alcohol than even the most
liberal scientific estimate could claim as harmless. Therefore I
believe that you must do the same.
So I am bound to believe, on the evidence, that if you take alcohol
habitually, in any quantity whatever, it is to some extent a menace to
you. I am bound to believe, in the light of what science has revealed:
(1) that you are tangibly threatening the physical structures of your
stomach, your liver, your kidneys, your heart, your blood-vessels,
your nerves, your brain; (2) that you are unequivocally decreasing
your capacity for work in any field, be it physical, intellectual, or
artistic; (3) that you are in some measure lowering the grade of your
mind, dulling your higher esthetic sense, and taking the finer edge
off your morals; (4) that you are distinctly lessening your chances
of maintaining health and attaining longevity; and (5) that you may
be entailing upon your descendants yet unborn a bond of incalculable
misery.
Such, I am bound to believe, is the probable cost of your "moderate"
indulgence in alcoholic beverages. Part of that cost you must pay in
person; the balance will be the heritage of future generations. As a
mere business proposition: Is your glass of beer, your bottle of wine,
your high-ball, or your cocktail worth such a price?
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