| 1898 | 1899 | 1900 | 1901 | 1902 | |
|---|---|---|---|---|---|
| Ale and Beer | $759.00 | $793.90 | $1,062.00 | $723.00 | $605.00 |
| Wines and liquors, | 1,563.00 ———— |
2,209.00 ———— |
1,348.00 ———— |
1,063.00 ———— |
799.00 ———— |
| Total for alcoholic drinks, | $2,321.00 | $3,002.00 | $2,410.00 | $1,786.00 | $1,404.00 |
| Total for other medicines, | $8,424.00 | $10,013.00 | $10,132.00 | $9,168.00 | $9,772.00 |
| Number of patients, | 5,005 | 5,203 | 5,012 | 5,495 | 5,342 |
| Cost of alcohol per patient, | $0.46 | $0.57 | $0.48 | $0.32 | $0.26 |
| Cost of medicine per patient, | 1.68 | 1.92 | 2.02 | 1.66 | 1.88 |
| 1903 | 1904 | 1905 | 1906 | 1907 | |
|---|---|---|---|---|---|
| Ale and Beer | $338.00 | $431.00 | $301.00 | $192.00 | $203.00 |
| Wines and liquors, | 688.00 ———— |
904.00 ———— |
144.00 ———— |
546.00 ———— |
610.00 |
| Total for alcoholic drinks, | $1,026.00 | $1,335.00 | $445.00 | $738.00 | $813.00 |
| Total for other medicines, | $7,815.00 | $9,162.00 | $7,018.00 | $5,981.00 | $5,492.00 |
| Number of patients, | 5,429 | 5,709 | 5,531 | 5,513 | 5,966 |
| Cost of alcohol per patient, | $0.19 | $0.23 | $0.09 | $0.13 | $0.13 |
| Cost of medicine per patient, | 1.43 | 1.60 | 1.26 | 1.00 | 0.92 |
Dr. Cabot says:—
“Since there has been no fall in the price of stimulants or medicine, the diminished expenditure corresponds to a diminution in the number of doses of medicine and stimulants, and indicates a rapid and striking change of view among the members of the staff of the hospital, especially in the past five years, when it has become generally known that alcohol is not a stimulant but a narcotic and that drugs can cure only about half a dozen of the diseases against which we are contending.
“There has been during this period no increase in the proportion of surgical cases among the whole number treated, so that the decreased use of medicines and alcoholic beverages has not resulted from an increased resort to surgical remedies. On the other hand, there has been a great increase in the utilization of baths (hydrotherapeutics), of massage, of mechanical treatment and of psychical treatment, all of which accounts no doubt for part of the falling off in the use of alcohol and drugs.”
CHAPTER V.
THE EFFECTS OF ALCOHOL UPON THE HUMAN BODY.
The body is made up mainly of cells, fibres and fluids. The cell is the most important structure in the living body. Life resides in the cell, and every animal may be considered a mass of cells, each of which is alive, and each of which has its own work to accomplish in the building up of the body.
The matter which forms the mass of a cell is called protoplasm, or bioplasm. It resembles somewhat the white of a raw egg, which is almost pure albumen. Cells make up the body, and do its work. Some are employed to construct the skeleton, others are used to form the organs which move the body; liver-cells secrete bile, and the cells in the kidneys separate poisonous matters from the blood in order that they may be expelled from the system.
These cells, composing the mass of the body, being very delicate, are easily acted upon by substances coming into contact with them. If substances other than natural foods or drinks are introduced into the body, the cells are injuriously affected. Alcohol is especially injurious to cells, “retarding the changes in their interior, hindering their appropriation of food, and elimination of waste matters, and therefore preventing their proper development and growth.”
“Bioplasm is living matter; it is structureless, semi-fluid, transparent and colorless. It is the only matter that can grow, move, divide itself and multiply, the only matter that can take up pabulum (food) and convert it into its own substance; and is the only matter that can be nourished. The bioplasm in the cell gets its nourishment by drawing in of the pabulum through the cell wall, and in that way building up the formed material while it is being disintegrated on the outer surface. This process is continually being carried on, and is what is meant by nutrition. Disintegration of the formed material is as essential as the building up of it. All organic structure is the result of change taking place in bioplasm. These small cell-like bioplasts are the workmen of the organism. All wounds are repaired by them, all fractures are united, and all diseased tissues brought back to their normal and healthy condition, unless there is not vitality enough to overcome disease, or they have been injured or killed by poisonous material. The body is kept in repair by this living matter, and all the functions of the body are but the result of its action. We may examine, watch and study bioplasm under the microscope; we see it take up pabulum and convert that which is adapted to itself into its own substance, while all other substances are rejected. We take a solution of what we call a stimulant and immerse the bioplasm in it, and we find that it increases its activity, moves faster, takes up more pabulum, and divides more rapidly than in the unstimulated condition. We next add an astringent, and it begins to move more slowly, and soon contracts into a spherical shape and remains contracted, or may move slowly to a limited extent, depending on the strength of the solution. We next take a relaxant, and gradually the living matter begins to spread in all directions, in a laxy-like manner, and becomes so thin as to be almost undiscernible, and takes up very little, if any, pabulum. If sufficiently relaxed or astringed, the movements may entirely cease so as to appear lifeless, but when a stimulant is again added the same result is obtained as before—it begins to move, and acts as vigorous as ever, which shows that it was not injured in the least by the agents used. Alcohol is called a stimulant. We take a weak solution of alcohol and try it in the same way; but we find that almost instantly the living matter contracts into a ball-like mass. Now, we may through ignorance suppose that alcohol acts as an astringent, and so we try to stimulate it with the same harmless agent before used, but no impression is made on it; it does not move; it is dead matter. These are demonstrable facts, and lie at the foundation of physiology, pathology and the practice of medicine. Alcohol destroys the very life force that alone keeps the body in repair. For a more simple experiment as to the action of alcohol, take the white of an egg (which consists of albumen, and is very similar to bioplasm), put it into alcohol, and notice it turn white, coagulate and harden. The same experiment can be made with blood with the same result—killing the blood bioplasts. Raw meat will turn white and harden in alcohol. Alcohol acts the same on food in the stomach as it does on the same substances before introduced into the stomach, and acts just the same on blood and all the living tissues in the system as out of it; and this alone is enough to condemn its use as a medicine.” From Alcohol, Is It a Medicine? by W. F. Pechuman, M. D., of Detroit, Michigan.
ALCOHOL AND STOMACH DIGESTION.
The nitrogenous portions of the food are the only ones digested in the stomach. The oily and fatty, as well as the starchy portions, are digested in the small intestines.
Very little was known about digestion until 1833, when Dr. Beaumont published the results of his investigations upon the stomach of Alexis St. Martin. St. Martin received a severe wound in the left side from a shot-gun. The wound in healing left an opening into the stomach about ⅘ of an inch in diameter, closed on the inside by a flap of mucous membrane. Through this opening the interior of the stomach could be thoroughly examined. Dr. Beaumont made hundreds of observations upon this young man, who was in his home several years. He says:—
“In a feverish condition, from whatever cause, obstructed perspiration, excitement by alcoholic liquors, overloading the stomach with food, fear, anger or whatever depresses or disturbs the nervous system, the lining of the stomach becomes somewhat red and dry, at other times pale and moist, and loses its smooth and healthy appearance, the secretions become vitiated, greatly diminished or entirely suppressed.”
One day after giving St. Martin a good wholesome dinner, digestion of which was going on in regular order, Dr. Beaumont gave him a glass of gin. The digestive process was at once arrested, and did not begin again until after the absorption of the spirit, after which it was slowly renewed, and tardily finished.
Gluzinski made some conclusive experiments with a syphon. He drew off the contents of the stomach at various times with and without liquor. He concluded that alcohol entirely suspends the transformation of food while it remains in the stomach.
Dr. Figg, of Edinburgh, fed two dogs with roast mutton; to one of them he gave 1½ounces of spirit. Three hours later he killed both dogs. The dog without liquor had digested the mutton; the other had not digested his at all. Similar experiments have been made repeatedly with like result.
The elements of our food which the stomach can digest depend upon the pepsin of the gastric juice for their transformation. Alcohol diminishes the secretions of the gastric juice, unless given in very minute quantities, and kills and precipitates its pepsin. It also coagulates both albumen and fibrine, converting them into a solid substance, thus rendering them unfit for the action of the solvent principles of the gastric juice. Hence, any considerable quantity of alcohol taken into the stomach must for the time retard the function of digestion.
Many experiments have been made with gastric juice in vials, one, having alcohol added, the other, not having alcohol. The meat in the vials without alcohol, in time dissolved till it bore the appearance of soup; in the vials to which alcohol was added the meat remained practically unchanged. In the latter a deposit of pepsin was found at the bottom, the alcohol having precipitated it. Dr. Henry Munroe, of England, one of the experimenters in this line of research, says:—
“Alcohol, even in a diluted form, has the peculiar power of interfering with the ordinary process of digestion.
“As long as alcohol remains in the stomach in any degree of concentration, the process of digestion is arrested, and is not continued until enough gastric juice is thrown out to overcome its effects.”—Tracy’s Physiology, page 90.
In The Human Body, Dr. Newell Martin says:—
“A vast number of persons suffer from alcoholic dyspepsia without knowing its cause; people who were never drunk in their lives and consider themselves very temperate. Abstinence from alcohol, the cause of the trouble, is the true remedy.”
Sir B. W. Richardson:—
“The common idea that alcohol acts as an aid to digestion is without foundation. Experiments on the artificial digestion of food, in which the natural process is closely imitated, show that the presence of alcohol in the solvents employed interferes with and weakens the efficacy of the solvents. It is also one of the most definite of facts that persons who indulge even in what is called the moderate use of alcohol suffer often from dyspepsia from this cause alone. In fact, it leads to the symptoms which, under the varied names of biliousness, nervousness, lassitude and indigestion, are so well and extensively known.
“From the paralysis of the minute blood-vessels which is induced by alcohol, there occurs, when alcohol is introduced into the stomach, injection of the vessels and redness of the mucous lining of the stomach. This is attended by the subjective feeling of a warmth or glow within the body, and according to some, with an increased secretion of the gastric fluids. It is urged by the advocates of alcohol that this action of alcohol on the stomach is a reason for its employment as an aid to digestion, especially when the digestive powers are feeble. At best this argument suggests only an artificial aid, which it cannot be sound practice to make permanent in place of the natural process of digestion. In truth, the artificial stimulation, if it be resorted to even moderately, is in time deleterious. It excites a morbid habitual craving, and in the end leads to weakened contractile power of the vessels of the stomach, to consequent deficiency of control of those vessels over the current of blood, to organic impairment of function, and to confirmed indigestion. Lastly, it is a matter of experience with me, that in nine cases out of ten, the sense of the necessity, on which so much is urged, is removed in the readiest manner, by the simple plan of total abstinence, without any other remedy or method.”
In Medicinal Drinking, by John Kirk, M. D., this passage occurs:—
“Especially in the matter of support, it is essential to our inquiry to examine fully into alcoholic influence on the change by which food introduced into the stomach becomes capable of passing into the circulation and constituent elements of the living frame. It may be best to suppose a case for illustration. Here, then, is a child of, say, six or seven years of age. This child is of the slenderer sex and has been brought into a state of extreme weakness as the consequence of fever. The fury of the disease is expended, but it has, as nearly as may be, extinguished life. The medical man’s one hope for saving this child is now concentrated in what he fancies to be ‘support.’ Beef-tea, arrowroot and port wine are prescribed. Let it be kept in mind that the pure wine of the grape is discarded in favor of alcoholic wine. Our question is, What effect will the alcohol in this wine have on that process by which the food is to prove really nourishing, and so to be that support which is the only hope for this child? Will it help her? or will it so hinder the necessary change in the food as to kill her, unless she has sufficient strength left to get above its influence? These are surely important questions. Neither of them can be set at rest by the fact that she recovers; for she may have strength enough, as many have had, to survive even a serious error in her treatment.
“What light, then, does true science throw on these important questions? All who know anything on the subject are aware that alcohol, instead of dissolving food, or aiding in its dissolution, is one of the most powerful agents in preventing that dissolution. On what principle, then, is it possible that its being mixed with the materials of food, in this case, can aid in their dissolution, so that they may more easily be changed into the fresh blood required to sustain and recover life in this child?”
He then refers to the experiments with gastric juice in vials, and proceeds:—
“Here, then, is indisputable evidence that alcohol effectually prevents that process which is known as digestion, and which is essential to food’s being of any use to support life in man. On what principle can the physician explain his introduction of it into the stomach of a child whose thread of life is attenuated to the slenderest hair?
“We urge the chemical truth that the alcohol, given to promote support, is of such a nature as to prevent that which would nourish, from effecting the end so much to be desired, and for which true food is adapted.”
The pure, unfermented juice of the grape, free from chemical preservatives, is now used by many physicians where the miserable concoction of drugs and alcohol, known as port wine, was once considered essential. Unfermented grape juice contains all the nutriment of the grape, without any of the poison, alcohol. After being opened it should be kept in a cool place, or it will ferment and produce alcohol. Fruit juices are very grateful to a fever patient, and should not be withheld as they are in so many cases. Dr. J. H. Kellogg, and other non-alcoholic physicians, recommend them highly. They are better than milk, as milk frequently produces “feverishness,” while fruit juices allay it.
For those who think beer or ale an incentive to appetite, Dr. N. S. Davis, and others, recommend an infusion of hops, made fresh each day. It is the bitter which promotes appetite, not the alcohol. For the sake of the little bitter in beer, it is not wise to vitiate the tone of the stomach with the alcohol it contains, and which is its active principle. Many mothers have become drunkards, secret drunkards, possibly, through the use of beer as a fancied aid to digestion. Multitudes of men suffer untold horrors from dyspepsia, caused by the beer which they mistakenly suppose to be a friend to their stomach.
EFFECTS OF ALCOHOL UPON THE BLOOD.
“The blood is a thick, opaque fluid, varying in color in different parts of the body from a bright scarlet to a dark purple, or even almost black.” If a drop of blood be placed under a microscope, immense numbers of small bodies will be seen. These are called blood-globules, or corpuscles, or discs. There are both red, and white or colorless, corpuscles. Each red corpuscle is soft and jelly-like. Its chief constituent, besides water, is a substance called hemoglobin, which has the power of combining with oxygen when in a place where that gas is plentiful, and of giving it off again in a region where oxygen is absent, or present only in small quantity. Hence, as the blood flows through the lungs, which are constantly supplied with fresh air, its corpuscles take up oxygen, which, as it flows on, is carried by them to distant parts of the body where oxygen is deficient, and there given up to the tissues. This oxygen-carrying is the function of the red corpuscles.
Hemoglobin, as the coloring-matter of the blood is called, is dark purplish-red in color; combined with oxygen it is bright “scarlet red.” Accordingly, the blood which flows to the lungs after giving up its oxygen is dark red in color, its dark color being due to the impurities it contains; and that which, having received a fresh supply of oxygen, flows away from the lungs is bright scarlet—having been cleansed of its impurities. The bright red blood is called arterial, and the dark red venous.
The work assigned to the blood in the economy of the human system is: first, to pick up nutriment in its course through the walls of the alimentary canal, and oxygen, as it flows through the lungs, and convey these to all other parts of the body. Second, to act as a sort of sewage stream that drains off waste matter, and to carry this to the organs of excretion by which waste is expelled from the body.
“The blood is the great circulating market of the body, in which all the things that are wanted by all parts, by the muscles, the brain, the skin, the lungs, liver and kidneys, are bought and sold. What the muscles want they buy from the blood; what they have done with, they sell back to the blood; and so with every other organ and part. As long as life lasts this buying and selling is forever going on, and this is why the blood is forever on the move, sweeping restlessly from place to place, bringing to each part the thing it wants, and carrying away those with which it has done. When the blood ceases to move, the market is blocked, the buying and selling cease, and all the organs die, starved for lack of the things they want, choked by the abundance of things for which they have no longer any need.”—Foster.
This is one way of saying that the processes of repair and waste are constantly going on in the body. Every action of the body, every impulse of the mind uses up some cell-matter, which must then be passed from the body as waste. This is called tissue disintegration. New cells to repair tissue waste are built up from the nutriment which the blood carries from the alimentary canal after the process of food digestion is accomplished. This is called tissue construction, or the process of assimilation. Technically, these are the metabolic, or destructive and constructive processes. Both are essential to health and life. Any substance taken into the body, which will interfere with these processes of nutrition and waste is inimical to health, and in time of disease, dangerous to life.
Alcohol is such a substance.
The cells and tissues of the body which are touched by alcohol are more or less hardened and injured by it, hence are less perfectly nourished than they are when alcohol is not present in the blood. Even a teaspoonful of alcohol to a ½ gallon of water hinders natural growth. If liquor is given to puppies it keeps them small. Young growing-cells are most affected by it, because they are most tender. There are growing-cells in adults as well as in children, for people are growing and changing all through their lives.
Hence, when alcohol is administered in sickness the cells are hindered in the full performance of their function of taking up food for the building up of tissue, and as a consequence, the patient’s body is really robbed of nutriment by the agent which is supposed to be “keeping up his strength.” Truly, “Wine is a mocker, strong drink is raging, and whosoever is deceived thereby is not wise.”
That alcohol interferes with the passage of waste matter from the body is generally conceded. Indeed this is claimed by the advocates of its medicinal use as one of its virtues: the fact that less waste passes from the body being urged as evidence that there is less waste, that in some way alcohol preserves tissue from being used up in the natural way. Those who speak thus seem to think that they know better than the Creator how the body should be treated. He made the body so that in health, work, waste and repair should be equal to one another.
Dr. Ezra M. Hunt says in Alcohol as a Food and as a Medicine:—
“We believe that any one who will candidly review the claims put forth for alcohol, in that it delays in any of these hypothetical ways, tissue-change, will conclude that it has no such power in a salutary sense, and that it is unwarrantably assumed that to retard tissue metamorphosis (change) is equivalent to tissue nutrition.”
Dr. N. S. Davis says:—
“It seems hardly possible that men of eminent attainments in the profession should so far forget one of the most fundamental and universally recognized laws of organic life as to promulgate the fallacy here stated. The fundamental law to which we refer is, that all vital phenomena are accompanied by, and dependent upon, molecular or atomic changes; and whatever retards these retards the phenomena of life; whatever suspends these suspends life. Hence, to say that an agent which retards tissue metamorphosis is in any sense a food, is simply to pervert and misapply terms.”
Non-alcoholic physicians unite in declaring that the retention of waste matter in the system, caused by alcohol, invites disease, and tends to inflammatory action; and in illness retards, and frequently prevents, recovery, for the germs of disease remain longer in the body than they would were it not for the delay in the passage of effete matter.
Alcohol not only hinders the blood in its work of tissue nutrition; it also prevents the full oxidation of the blood in the lungs.
“In order that a steam engine may work and keep warm it is not merely necessary that it have plenty of coal, but it must also have a draft of air through its furnace. Chemistry teaches us that the burning in this case consists in the combination of a gas called oxygen, taken from the air, with other things in the coals; when this combination takes place a great deal of heat is given off. The same thing is true of our bodies; in order that food matters may be burnt in them and enable us to work and keep warm, they must be supplied with oxygen; this they get from the air by breathing. We all know that if his supply of air be cut off a man will die in a few minutes. His food is no use to him unless he gets oxygen from the air to combine with it; while he usually has stored up in his body an excess of food matters which will keep him alive for some time if he gets a supply of oxygen, he has not stored up in him any reserve, or, if any, but a very small one, of oxygen, and so he dies very rapidly if his breathing be prevented. In ordinary language we do not call oxygen a food, but restrict that name to the solids and liquids which we swallow; but inasmuch as it is a material which we must take from the external universe into our bodies in order to keep us alive, oxygen is really a food as much as any of the other substances which we take into our bodies from outside, in order to keep them alive and at work. Suffocation, as death from deficient air supply is named, is really death from oxygen-starvation.”—Martin’s Human Body.
Much of the food taken into the body is burned to supply energy and heat. This burning is called oxidation. When food is burned, or oxidized, either in the body, or out of it, three things are produced, carbon dioxide (carbonic acid gas), water and ashes. These are waste matters, and must be expelled from the body, or they will clog up the various organs, as the ashes and smoke of an engine would soon put its fire out if they were allowed to accumulate in the furnace. It is the duty of the lungs to pass the carbon dioxide out to the air. With every breath exhaled, this poison gas, generated in the body through the oxidation of food, passes from the system. With every breath inhaled the life-giving oxygen is taken into the body; providing that the person is not in a close room from which the fresh air is excluded.
Any substance taken into the body which interferes with the reception of oxygen into the blood, and with the giving off of carbon dioxide from the same is a dangerous substance.
Alcohol is such a substance.
It has already been stated that it is the duty of the little red corpuscles in the blood to take up oxygen in the lungs, and carry it to every part of the body, and upon the return passage to the lungs to convey the débris, or used-up material, from the tissues, called carbon dioxide gas. A little vapor and ammonia accompany this gas. The action of alcohol upon these little corpuscles, or carriers of the blood, is to somewhat harden and shrivel them, so that they are unable to take up and carry as much oxygen as they can when no injurious substance is present in the blood. In consequence of this, the blood can never be so pure when alcohol is present, as it may be in the absence of this agent.
The following is taken from The Temperance Lesson Book, by B. W. Richardson, M. D.:—
“When the blood in the veins is floating toward the right side of the heart, which communicates with the lungs, it carries with it the carbonic acid (carbon dioxide), and, as I have found by experiment, a great part of this gas is condensed in these little bodies, the corpuscles. Arrived at the lungs, the blood comes into such contact with the air we breathe, that the oxygen gas in the air is freely absorbed by the little corpuscles, while the carbonic acid is given up into the air-passages of the lungs, and is thrown off with every breath we throw out. In this process the blood changes in color. It comes into the lungs of a dark color; it goes out of them a bright red. * * * * * The parts of the blood on which alcohol acts injuriously are the corpuscles and the fibrine. The red corpuscles are most distinctly affected. They undergo a peculiar process of shrinking from extraction of water from them. They also lose some of their power to absorb oxygen from the air. In confirmed spirit-drinkers the face and hands are often seen of dark mottled color, and in very bad specimens of the kind, the face is sometimes seen to be quite dark. This is because the blood cannot take up the vital air in the natural degree. * * * * *
“If anything whatever interferes with the proper reception of oxygen by the blood, the blood is not properly oxidized, the animal warmth is not sufficiently maintained, and life is reduced in activity. If for a brief interval of time the process of breathing is stopped in a living person, we see quickly developed the signs of difficulty, and we say the person is being suffocated. We observe that the face becomes dark, the lips blue, the surface cold. Should the process of arrest or stoppage of the breathing be long continued the person will become unconscious, will stagger and fall, and should relief not be at hand, he will in a very few minutes die.
“I found by experiment that in presence of alcohol in blood the process of absorption of oxygen was directly checked, and that even so minute a quantity as one part of alcohol in five hundred of blood proved an obstacle to the perfect reception of oxygen by the blood. The corpuscles are reduced in size, when large quantities of alcohol are taken, and become irregular in shape.”
Dr. J. J. Ridge says in Addresses on the Physiological Action of Alcohol:—
“It has been found by experiment that, when alcohol is taken, less carbonic acid comes away in the breath than when it is not. This is partly because the blood-corpuscles cannot carry so much, and partly because so much is not produced, because there is less oxygen to join with the food and produce it. Just as burning paper smokes when it does not get enough oxygen, so other things are formed and get into the blood when there is not enough oxygen to make carbonic acid. These things make the blood impure, and cause extra work and trouble to get rid of them. This is why persons who drink alcohol are more liable to have gout and other diseases, than total abstainers.”
Dr. Alfred Carpenter, formerly president of the Council of the British Medical Association, says in Alcoholic Drinks:—
“A blood corpuscle cannot come into direct contact with an atom of alcohol, without the function of the former being spoiled, and not only is it spoiled, but the effete matter which it has within its capsule cannot be exchanged for the necessary oxygen. The breath of the drunken man does not give out the quantity of carbonic acid which that of the healthy man does, and the ammoniacal compounds are in a great measure absent. Some of the carbon and effete nitrogenous matter is kept back. The retention of these poisonous matters within the body is highly injurious. Let the drinker suffer from any wound or injury and this effete matter in his blood is ready at a moment’s notice to prepare and set up actions called inflammatory or erysipelatous, or some other kind; by means of which too often the drinker is hurried into eternity, although, perhaps, he may have been regarded as a perfectly sober man, and have never been drunk in his life.”
In the light of these scientific facts, what can appear more utterly foolish than the swallowing of alcoholic patent medicines which are widely advertised as “Blood Purifiers”? That they will render the blood impure is only too evident in the light of scientific truth.
Dr. Nathan S. Davis has written much in disapproval of the use of alcohol in fevers, pneumonia and diphtheria, putting stress upon the fact that these diseases, of themselves, interfere with the reception of oxygen into the blood, and hence the use of all remedies that notably diminish the internal distribution of oxygen, or impair the corpuscles of the blood, should be avoided. Not only is alcohol of such a nature, but all the coal-tar series of antipyretics also. Since the internal distribution of oxygen, and the processes of tissue change are essential to the repair of the body, and alcohol hinders the blood in the full performance of its duties in these respects, it certainly seems clear that those physicians, who are extremely cautious in the use of this drug, or who do not use it at all, are more likely to be successful in saving their patients than are those who use it freely. Death-rates, with and without alcohol, show conclusively the superiority of the latter treatment.
ALCOHOL AND THE HEART.
The organs of circulation are the heart and the blood-vessels. The blood-vessels are of three kinds, arteries, capillaries and veins. The arteries carry blood from the heart to the capillaries; the veins collect it from the capillaries and return it to the heart. There are two distinct sets of blood-vessels in the body, both connected with the heart; one set carries blood to, through and from the lungs, the other guides its flow through all the remaining organs; the former are known as the pulmonary, the latter as the systemic blood-vessels.
The smallest arteries pass into the capillaries, which have very thin walls, and form very close networks in nearly all parts of the body; their immense number compensating for their small size. It is while flowing in these delicate tubes that the blood does its nutritive work, the arteries being merely supply-tubes for the capillaries, through whose delicate walls liquid containing nourishment exudes from the blood to bathe the various tissues.
The quantity of blood in any part of the body at any given time is dependent upon certain relations which exist between the blood-vessels and the nervous system. The walls of the arteries are abundantly supplied with involuntary muscular fibres, which have the power of contraction and relaxation. This power of contraction and relaxation is controlled by certain nerves called vasomotor nerves, because they cause or control motion in the vessels to which they are attached. When arteries supplying blood to any particular part of the body contract, the supply of blood to that part will be diminished in proportion to the amount of contraction. If the nervous control be altogether withdrawn, the arterial walls will completely relax, and the amount of blood in the part affected will be increased correspondingly.
Alcohol, even in moderate doses, paralyzes the vasomotor nerves which control the minute blood-vessels, thus allowing these vessels to become dilated with the flowing blood.
“With the disturbance of power in the extreme vessels, more disturbance is set up in other organs, and the first organ that shares in it is the heart. With each beat of the heart a certain degree of resistance is offered by the vessels when their nervous supply is perfect, and the stroke of the heart is moderate in respect both to tension and to time. But when the vessels are rendered relaxed, the resistance is removed, the heart begins to run quicker like a clock from which the pendulum has been removed, and the heart-stroke is greatly increased in frequency. It is easy to account in this manner for the quickened heart and pulse which accompany the first stage of deranged action from alcohol.”—Richardson.
Dr. Parkes of England, assisted by Count Wollowicz, conducted inquiries upon the effects of alcohol upon the heart, with a young and healthy man. At first they made accurate count of the heart beats during periods when the young man drank water only; then of the beats during successive periods in which alcohol was taken in increasing quantities. Thus step by step they measured the precise action of alcohol on the heart, and thereby the precise primary influence induced by alcohol. Their results are stated by themselves as follows:—
“The average number of beats of the heart in 24 hours (as calculated from eight observations made in 14 hours), during the first, or water period, was 106,000; in the earlier alcoholic period it was 127,000, or about 21,000 more; and in the later period it was 131,000, or 25,000 more.
“The highest of the daily means of the pulse observed during the first, or water period, was 77.5; but on this day two observations are deficient. The next highest daily mean was 77 beats.
“If, instead of the mean of the eight days, or 73.57, we compare the mean of this one day; viz. 77 beats per minute, with the alcoholic days, so as to be sure not to over-estimate the action of the alcohol, we find:—
“On the 9th day, with one fluid ounce of alcohol, the heart beat 4,300 times more.
On the 10th day, with two fluid ounces, 8,172 times more.
On the 11th day, with four fluid ounces, 12,960 times more.
On the 12th day, with six fluid ounces, 20,672 times more.
On the 13th day, with eight fluid ounces, 23,904 times more.
On the 14th day, with eight fluid ounces, 25,488 times more.
But as there was ephemeral fever on the 12th day, it is right to make a deduction, and to estimate the number of beats in that day as midway between the 11th and 13th days, or 18,432. Adopting this, the mean daily excess of beats during the alcoholic days was 14,492, or an increase of rather more than 13 per cent.
The first day of alcohol gave an excess of 4 per cent., and the last of 23 per cent.; and the mean of these two gives almost the same percentage of excess as the mean of the six days.
Admitting that each beat of the heart was as strong during the alcoholic period as in the water period (and it was really more powerful), the heart on the last two days of alcohol was doing one-fifth more work.
“Adopting the lowest estimate which has been given of the daily work of the heart; viz. as equal to 12.2 tons lifted one foot, the heart during the alcoholic period, did daily work excess equal to lifting 15.8 tons one foot, and in the last two days did extra work to the amount of 24 tons lifted as far.
“The period of rest for the heart was shortened, though, perhaps, not to such an extent as would be inferred from the number of beats, for each contraction was sooner over. The heart, on the fifth and sixth days after alcohol was left off, and, apparently at the time when the last traces of alcohol were eliminated, showed in the sphygmographic tracing signs of unusual feebleness; and, perhaps, in consequence of this, when the brandy quickened the heart again, the tracings showed a more rapid contraction of the ventricles, but less power than in the alcoholic period. The brandy acted, in fact, on a heart whose nutrition had not been perfectly restored.”
Richardson quotes these experiments of Parkes and Wollowicz as if he agrees with them that increased heart-beat must of necessity mean increased work done by the heart. Dr. Nathan S. Davis, Dr. Newell Martin, Dr. A. B. Palmer, and some other investigators, show conclusively that mere increased frequency of beat above the natural standard is no evidence of increased force or efficiency in the circulation.
“The more frequent beats under the influence of alcohol constitute no exception to the general rule, for while the heart beats more frequently, its influence on the vasomotor nerves causes dilatation of the peripheral and systemic blood-vessels, as proved by the pulse-line written by the sphygmograph, which more than counterbalances the supposed increased action of the heart. The truth is, that under the influence of alcohol in the blood the systolic action of the heart loses in sustained force in direct proportion to its increase in frequency, until, by simply increasing the proportion of alcohol, the heart stops in diastole, as perfectly paralyzed as are the coats of the smaller vessels throughout the system. This was clearly demonstrated by the experiments of Professor Martin of Johns Hopkins University, to determine the effects of different proportions of alcohol on the action of the heart of the dog; and those of Drs. Sidney Ringer and H. Sainsbury, to determine the relative strength of different alcohols as indicated by their influence on the heart of the frog. Professor Martin states that blood containing ¼ per cent. by volume of absolute alcohol, almost invariably diminishes, within a minute, the work done by the heart.”
(This estimate would equal in an adult man an amount equal to the absolute alcohol in two or three ounces of whisky or brandy.)
“These investigations of Professor Martin, being directly corroborated by those of Drs. Ringer and Sainsbury, complete the series of demonstrations needed to show the actual effects of alcohol on the cardiac, as well as on the vasomotor, and also on the direct contractability of the muscular structure, when supplied with blood containing all gradations in the relative proportion of alcohol, leaving no longer any basis for the idea, popular both in and out of the profession, that alcohol in any of its forms is capable of increasing, even temporarily the force or efficiency of the heart’s action.”—Dr. N. S. Davis in Influence of Alcohol On the Human System.
The following letter will be of great interest to all students of the physiological effects of alcohol:—
“Chicago, Ill., March 3, 1899.
“To Mrs. Martha M. Allen,
“Syracuse, N. Y.,
“Madam: Your letter asking my attention to the apparent contradiction of authorities concerning the work done by the heart when influenced by alcohol was received yesterday.
“The explanation is not difficult. It depends entirely on the different views of what constitutes the work of the heart.
“One class of investigators, led by the original and valuable experiments of Parkes and Wollowicz base their estimate of the heart’s work entirely on the number of times it contracts or beats per minute. Thus Dr. Parkes, finding that moderate doses of alcohol increased the number of contractions of the heart from three to six beats per minute more than natural, readily estimated the number of additional contractions that would occur in twenty-four hours, and thereby demonstrated a large amount of increased work done by the heart under the influence of alcohol. All writers who speak of ‘stimulating’ or increasing the action of the heart by alcohol follow this method of measuring the amount of work done. They generally add that it is like applying ‘the whip to a tired horse.’
“The other class of investigators who claim that alcohol diminishes the actual work done by the heart base their estimates on the amount of blood the heart passes through its cavities into the arteries in a given time. This is the physiological function of the heart; i.e. to aid in circulating the blood. Professor Martin’s experiments were admirably contrived to determine, not how frequently the heart beat, but the amount of blood it delivered per minute under the influence of alcohol and without alcohol.
“He, and all others who take this basis of work, found that alcohol in any dose diminished the efficiency of the heart in circulating the blood in direct ratio to the quantity taken.
“My own original experiments, made fifty years ago, uniformly showed that alcohol quickly increased the number of heart beats per minute, but at the same time diminished the efficiency of the circulation generally. Every experienced practitioner knows that the weaker the heart becomes, the faster it beats. Consequently, the number of times the heart contracts per minute is no measure of the efficiency of its work in circulating the blood. Indeed the mechanism of the heart is such that there must be sufficient time between each of its contractions for its cavities to fill, or it is made to contract on an insufficient supply, and the efficiency of the circulation is diminished.
“Yours respectfully,
“N. S. Davis.”
The International Medical Congress of 1876 adopted as its reply to the Memorial of the National Temperance Society, and of the National Woman’s Christian Temperance Union respecting “Alcohol as a Food and as a Medicine,” the paper by Dr. Ezra M. Hunt, one conclusion of which was, “Its use as a medicine is chiefly that of a cardiac stimulant.”
As experiments conducted since that time show that it is not a cardiac stimulant, but a direct cardiac paralyzant, what excuse is there for using it as a medicine now?