ALCOHOL; EFFECTS OF ALCOHOLISM

Without entering into the controversy as to whether the moderate consumption of alcohol, or its total disuse, is the more conducive to personal health and comfort—whether, as Dr Anstie and others have a erted it acts, when prudently taken, as a food—or whether, as other medical authorities contend, even its moderate use is a disturbing factor in the human economy—there need be no qualification of the a ertion, that when the drinking of spirituous liquids of any kind is indulged in to exce , the habit, if persisted in, must sooner or later terminate in impaired health, serious disease, and premature death. A powerful array of facts could be brought in support of this statement. For instance, in Nelson’s statistics we find it mentioned that— | A temperate person’s chance of living is— | An intemperate person’s chance of living is— | | At | 20 | = | 44·2 | years. | At | 20 | = | 15·6 | years. | | ” | 30 | = | 36·5 | ” | ” | 30 | = | 13·8 | ” | | ” | 40 | = | 28·8 | ” | ” | 40 | = | 11·6 | ” | | ” | 50 | = | 21·25 | ” | ” | 50 | = | 10·8 | ” | | ” | 60 | = | 14·285 | ” | ” | 60 | = | 8·9 | ” | The average duration of life after the commencement of habits of intemperance is— | Among | mechanics, working and labouring men | 18 | years. | | ” | traders, dealers, and merchants | 17 | ” | | ” | profe ional men and gentlemen | 15 | ” | | ” | females | 14 | ” | Again, Dr Dick in son, writing “on the morbid effects of alcohol in persons who trade in liquor,” gave the results of an examination of 149 traders in liquor, as compared with 149 persons of various trades. The general results were diseases of the liver much more common in those who dealt in alcoholic drinks. In the lungs tubercle affected sixty-one persons of the alcoholic, forty-four of the non-alcoholic. Tubercle in the brain, liver, kidneys, spleen, bowels, mesenteric glands, and peritoneum were twice as common in the alcoholic as in the non-alcoholic. The verdict, therefore, is unavoidable that alcohol (in exce ) engenders tubercle in the brain, inflammations, atrophy, hæmorrhages; in the heart and ve els atheroma, hypertrophy, and other affections, were all more common in the alcoholic than in the non-alcoholic series. The evidence in kidney disease did not appear so conclusive, but some forms of kidney disease appear to be increased. The author sums up thus:—“Alcohol causes fatty infiltration and fibroid encroachment; it engenders tubercle, encourages suppuration, and retards healing; it produces untimely atheroma, invites hæmorrhage, and anticipates age. The most constant fatty change, replacement by oil of the material of epithelial cells and muscular fibres, though probably nearly universal, is most noticeable in the liver, the heart, and the kidney.” Alcohol also seems to be the cause of special diseases, besides those more common and generally known ones, delirium tremens, alcoholism, . Of these we may mention one recorded by M. Galezowski , a peculiar affection of the eyes, which the doctor found very prevalent during the siege of Paris in 1870-1. In the five months of the siege fifty patients were affected by it, whilst during the twelve months preceding the siege only nineteen were to be found. Dr Galowski ascribed the malady to the habit of taking alcoholic drinks in the morning fasting. A peculiar kind of palsy has also been referred to alcoholic poisoning. The following table, compiled by Dr Joseph Williams, lends support to the fact that an indulgence in alcohol is either the cause of insanity, or that it tends to its increase: | Total admi ion. | Proportion caused by intemperance. | | Char ent on | 855 | 134 | | Bicêtre and Salpêtrière | 2012 | 414 | | Bordeaux | 156 | 20 | | Turin, 1830-31 | 158 | 17 | | Turin, 1831-36 | 390 | 76 | | Gard | 209 | 4 | | United States | 551 | 146 | | Palermo | 189 | 9 | | Caen | 60 | 16 | | Dundee | 14 | 4 | | M. Parchappe | 167 | 46 | | M. Batten | 288 | 54 | | ——— | ——— | | 5019 | 940 | Commenting on these figures, Mr Walter Blyth remarks, “There may be another explanation of the fact that many mad people have been great drinkers. A large proportion of those subject to insanity are driven by their morbid minds to drink; so that it may be that insanity causes drink, and not drink causes insanity.” Many medical writers who are no advocates for the total abandonment of alcohol limit its consumption, in healthy people, to one or two fluid ounces a day, in the form of wine, beer, or spirits and water; two fluid ounces is, we believe, the quantity apportioned daily to every able-bodied seaman in the Royal Navy. Any slight habitual departure from this standard—even when the evidences of exce are not perceptible to others—all authority, historical, pathological, and physiological (unle it be given as a medicine), shows to be injurious. The researches of Anstie, Parkes, and Count Wollowicz, appear to prove that any quantity of alcohol exceeding an ounce and a half taken by an adult showed itself in the urine, a circumstance which these writers look upon as tending to show that the system has taken more alcohol than can be used in the body itself. In slight doses the action of alcohol is to produce a sedative effect upon the nerves, to redden slightly the lining membrane of the stomach, and to stimulate the secretion of the gastric juice. Thus, in small doses alcohol may, and doubtle does, promote appetite. In exce , however, all these effects are turned to evil, and then ensue an inflammatory condition of the stomach, compre ion of the gland ducts from thickening of the ti ue around them, exce ive mucous secretion, and great lo of appetite. When carried into the circulation it greatly increases the force of the heart’s action, and at the same time paralyses, as it were, the restraining nervous supply to the arteries and small ve els, so that they can no longer oppose themselves to the blood-current, but dilate. This action in a small degree, occurring in persons of a weak and languid circulation, is no doubt beneficial; on the other hand, when in exce , it is most dangerous, and is a cause of the greater part of the diseases of the heart and great ve els. “There appears to be a slight fall of temperature with moderate doses of alcohol, a very decided fall with exce ive doses; the muscular and nervous systems are transitorily stimulated, and may do more work when small doses are given in cases of fatigue, but in other cases there is a marked torpor of the nervous and a want of co-ordination of the muscular system.”— Blyth . Notwithstanding the researches of Percy, Strauch, Masing, Lallemand, Duroy, Parkes, Dupré, Anstie, Thudichum, and others, there is still a considerable divergence of opinion as to how alcohol is eliminated from the body. By some of the authorities just named it is affirmed to be eliminated as aldehyd, by others as carbonic acid; as to the latter, the experiments of Dr E. Smith show that the carbonic acid is decreased when brandy and gin are drunk, and increased by rum. The only probable supposition, which facts support, tends to show that the alcohol is turned into acetic acid in the body, some of which unites with potash and other bases, and some is destroyed. All are pretty well agreed that in the form of spirits alcohol as a food is valuele , but that in the form of beer and wine it is po e ed of a slight dietetic power, naturally varying with the amount and nature of the different substances held in solution in these beverages. The imports of spirits into this country, in the seven years from 1850 to 1857, amounted to 70,740,980 gallons; whilst the imports in the seven years following, viz. from 1857 to 1864, were 78,016,071 gallons, showing an increase of 7,305,091 gallons. The population has, however, increased in the time, and a deduction on that account, as well as correction on one or two other heads, are required; still, that there is an increase is indisputable. As respects France, a considerable increase in the consumption of spirits has taken place of late years, as the following table by M. Hu on will illustrate: The Mean Consumption of Spirits for each Inhabitant. | Litres. | | Litres. | | From | 1825 | to | 1830 | 8·96 | yearly. | ·024 | daily. | | ” | 1831 | ” | 1835 | 8·74 | ” | ·023 | ” | | ” | 1836 | ” | 1840 | 10·15 | ” | ·026 | ” | | ” | 1841 | ” | 1845 | 11·14 | ” | ·031 | ” | | ” | 1846 | ” | 1850 | 11·03 | ” | ·030 | ” | | ” | 1851 | ” | 1854 | 14·25 | ” | ·039 | ” | In the United States, during the period from 1807 to 1828, the average was 27 litres for every inhabitant, which is even greater than the highest of the two sets of figures just quoted. The demoralisation of the French army during the late Franco-Pru ian war has been also unanimously ascribed to the exce ive consumption of spirituous liquids. The following results of an inquiry instituted in 1870 by the Ma achusetts Board of Health into the comparative sobriety of different nations are gathered from an able paper which appeared in the ‘Medical Times and Gazette’ of April 15th, 1872, by Dr Druitt, in which he di ects and summarises the results in question. Dr Druitt writes: “Highest in the scale of temperance come the Turks and Arabs; next the Iberians, Levantines, Greeks, and Latin races; lower down the Japanese, Scand in avians, Belgians, and the Irish Celt; lowest of all the so-called Anglo-Saxon of either continent.” Profe or Levi contributes to our knowledge on this subject by giving the following statistics:—In 1860 the committals for drunkenne in England and Wales were 88,000, and in 1870 134,000, an increase of 50 per cent. In Manchester the increase from 1860 to 1870 was 375 per cent., or computed according to the increase of population 35·3 per cent. In London drunkenne is in the proportion of 5·43 per 1000, in Leeds 7·40, in Manchester 31·13, and in Liverpool 42·82. It must, however, be remembered that these figures are based on mere committals, which greatly depend on the activity of the police, and the noisy or quiet character of the drunkard. We quote the following from Dr Blyth’s work on ‘Hygiene,’ without, however, attempting either to endorse or controvert what he says on the subject. “ Whether is Alcohol nece ary or not. All experience, both at home and abroad, shows by facts that cannot be disputed that a person can do quite as hard work without alcohol as with it; and probably as the limits between moderation and exce are easily pa ed, and as the generality of mankind, even without intending it, err on the latter side, the result is that a comparison between total abstainers and even temperate men generally terminates in favour of the former. It would appear that total abstainers live longer, are better citizens, and can do more work than the rest of mankind. The figures of the “United Kingdom Temperance and General Provident Institution” go far to prove the above. This insurance society is divided into two sections. One section consists of abstainers, the other of persons selected as not known to be intemperate. The claims for five years anticipated in the temperance section were £100,446, but the actual claims were only £72,676. In the general section of the anticipated claims were £196,352; the actual claims no le than £330,297. In war the march of 2000 miles in his War of Independence by Cornwall is and his troops (1783), the Maroon war of Jamaica, the 400 miles’ march of an English army acro the Desert from Komer, on the Red Sea, a march of 1000 miles in the Kaffir war, experiences at sieges, in action, in hot, temperate, and cold climates, where abstinence was either forced through circumstances or followed, shows to every unprejudiced mind that soldiers endure more fatigue, are healthier, and fight better, without stimulants than with them; and this fact is endorsed by every commander of the present day. The exce and abuse of spirits, as before remarked, lost the French their military prestige in the Franco-German war. In very hot and very cold climates the Indian observers and the Arctic explorers all unite in condemning its (that is, the use of alcohol) use in the slightest exce , or even in moderate doses. It does not warm the body in cold climates, and the reaction that follows the exciting of the circulation is followed by a dangerous depre ion; whilst in hot it combines with the climate, and quickly produces disease.”