_ CHAPTER V. NOT A FOOD, AND VERY LIMITED IN ITS RANGE AS A MEDICINE
The use of alcohol as a medicine has been very large. If his patient was weak and nervous, the physician too often ordered wine or ale; or, not taking the trouble to refer his own case to a physician, the invalid prescribed these articles for himself. If there was a failure of appetite, its restoration was sought in the use of one or both of the above-named forms of alcohol; or, perhaps, adopting a more heroic treatment, the sufferer poured brandy or whisky into his weak and sensitive stomach. Protection from cold was sought in a draught of some alcoholic beverage, and relief from fatigue and exhaustion in the use of the same deleterious substance. Indeed, there is scarcely any form of bodily ailment or discomfort, or mental disturbance, for the relief of which a resort was not had to alcohol in some one of its many forms.
It is fair to say that, as a medicine, its consumption has far exceeded that of any other substance prescribed and taken for physical and mental derangements.
The inquiry, then, as to the true remedial value of alcohol is one of the gravest import; and it is of interest to know that for some years past the medical profession has been giving this subject a careful and thorough investigation. The result is to be found in the brief declaration made by the Section on Medicine, of the
INTERNATIONAL MEDICAL CONGRESS,
which met in Philadelphia in 1876. This body was composed of about six hundred delegates, from Europe and America, among them, some of the ablest men in the profession. Realizing the importance of some expression in relation to the use of alcohol, medical and otherwise, from this Congress, the National Temperance Society laid before it, through its President, W.E. Dodge, and Secretary, J.N. Stearns, the following memorial:
"The National Temperance Society sends greeting, and respectfully invites from your distinguished body a public declaration to the effect that alcohol should be classed with other powerful drugs; that, when, prescribed medicinally, it should be with conscientious caution and a sense of grave responsibility; that it is in no sense food to the human system; that its improper use is productive of a large amount of physical disease, tending to deteriorate the human race; and to recommend, as representatives of enlightened science, to your several nationalities, total abstinence from alcoholic beverages."
In response to this memorial, the president of the society received from J. Ewing Mears, M.D., Secretary of the Section on Medicine, International Congress, the following official letter, under date of September 9th, 1876:
"DEAR SIR: I am instructed by the Section on Medicine, International Medical Congress, of 1876, to transmit to you, as the action of the Section, the following conclusions adopted by it with regard to the use of alcohol in medicine, the same being in reply to the communication sent by the National Temperance Society.
"1. Alcohol is not shown to have a definite food value by any of the usual methods of chemical analysis or physiological investigation.
"2. Its use as a medicine is chiefly that of a cardiac stimulant, and often admits of substitution.
"3. As a medicine, it is not well fitted for self-prescription by the laity, and the medical profession is not accountable for such administration, or for the enormous evils arising therefrom.
"4. The purity of alcoholic liquors is, in general, not as well assured as that of articles used for medicine should be. The various mixtures, when used as medicine, should have definite and known composition, and should not be interchanged promiscuously."
The reader will see in this no hesitating or halfway speech. The declaration is strong and clear, that, as a food, alcohol is not shown, when subjected to the usual method of chemical or physiological investigation, to have any food value; and that, as a medicine, its use is chiefly confined to a cardiac stimulant, and often admits of substitution.
A declaration like this, coming, as it does, from a body of medical men representing the most advanced ideas held by the profession, must have great weight with the people. But we do not propose resting on this declaration alone. As it was based on the results of chemical and physiological investigations, let us go back of the opinion expressed by the Medical Congress, and examine these results, in order that the ground of its opinion may become apparent.
There was presented to this Congress, by a distinguished physician of New Jersey, Dr. Ezra M. Hunt, a paper on "Alcohol as a Food and Medicine," in which the whole subject is examined in the light of the most recent and carefully-conducted experiments of English, French, German and American chemists and physiologists, and their conclusions, as well as those of the author of the paper, set forth in the plainest manner. This has since been published by the National Temperance Society, and should be read and carefully studied by every one who is seeking for accurate information on the important subject we are now considering. It is impossible for us to more than glance at the evidence brought forward in proof of the assertion that
ALCOHOL HAS NO FOOD VALUE,
and is exceedingly limited in its action as a remedial agent; and we, therefore, urge upon all who are interested in this subject, to possess themselves of Dr. Hunt's exhaustive treatise, and to study it carefully.
If the reader will refer to the quotation made by us in the second chapter from Dr. Henry Monroe, where the food value of any article is treated of, he will see it stated that "every kind of substance employed by man as food consists of sugar, starch, oil and glutinous matter, mingled together in various proportions; these are designed for the support of the animal frame. The glutinous principles of food--fibrine, albumen and casein--are employed to build up the structure; while the oil, starch and sugar are chiefly used to generate heat in the body."
Now, it is clear, that if alcohol is a food, it will be found to contain one or more of these substances. There must be in it either the nitrogenous elements found chiefly in meats, eggs, milk, vegetables and seeds, out of which animal tissue is built and waste repaired; or the carbonaceous elements found in fat, starch and sugar, in the consumption of which heat and force are evolved.
"The distinctness of these groups of foods," says Dr. Hunt, "and their relations to the tissue-producing and heat-evolving capacities of man, are so definite and so confirmed by experiments on animals and by manifold tests of scientific, physiological and clinical experience, that no attempt to discard the classification has prevailed. To draw so straight a line of demarcation as to limit the one entirely to tissue or cell production, and the other to heat and force production through ordinary combustion, and to deny any power of interchangeability under special demands or amid defective supply of one variety, is, indeed, untenable. This does not in the least invalidate the fact that we are able to use these as ascertained landmarks."
How these substances, when taken into the body, are assimilated, and how they generate force, are well known to the chemist and physiologist, who is able, in the light of well-ascertained laws, to determine whether alcohol does or does not possess a food value. For years, the ablest men in the medical profession have given this subject the most careful study, and have subjected alcohol to every known test and experiment, and the result is that it has been, by common consent, excluded from the class of tissue-building foods. "We have never," says Dr. Hunt, "seen but a single suggestion that it could so act, and this a promiscuous guess. One writer (Hammond) thinks it possible that it may 'somehow' enter into combination with the products of decay in tissues, and 'under certain circumstances might yield _their_ nitrogen to the construction of new tissues.' No parallel in organic chemistry, nor any evidence in animal chemistry, can be found to surround this guess with the areola of a possible hypothesis."
Dr. Richardson says: "Alcohol contains no nitrogen; it has none of the qualities of structure-building foods; it is incapable of being transformed into any of them; it is, therefore, not a food in any sense of its being a constructive agent in building up the body." Dr. W.B. Carpenter says: "Alcohol cannot supply anything which is essential to the true nutrition of the tissues." Dr. Liebig says: "Beer, wine, spirits, etc., furnish no element capable of entering into the composition of the blood, muscular fibre, or any part which is the seat of the principle of life." Dr. Hammond, in his Tribune Lectures, in which he advocates the use of alcohol in certain cases, says: "It is not demonstrable that alcohol undergoes conversion into tissue." Cameron, in his Manuel of Hygiene, says: "There is nothing in alcohol with which any part of the body can be nourished." Dr. E. Smith, F.R.S., says: "Alcohol is not a true food. It interferes with alimentation." Dr. T.K. Chambers says: "It is clear that we must cease to regard alcohol, as in any sense, a food."
"Not detecting in this substance," says Dr. Hunt, "any tissue-making ingredients, nor in its breaking up any combinations, such as we are able to trace in the cell foods, nor any evidence either in the experience of physiologists or the trials of alimentarians, it is not wonderful that in it we should find neither the expectancy nor the realization of constructive power."
Not finding in alcohol anything out of which the body can be built up or its waste supplied, it is next to be examined as to its heat-producing quality.
ALCOHOL NOT A PRODUCER OF HEAT.
"The first usual test for a force-producing food," says Dr. Hunt, "and that to which other foods of that class respond, is the production of heat in the combination of oxygen therewith. This heat means vital force, and is, in no small degree, a measure of the comparative value of the so-called respiratory foods. * * * If we examine the fats, the starches and the sugars, we can trace and estimate the processes by which they evolve heat and are changed into vital force, and can weigh the capacities of different foods. We find that the consumption of carbon by union with oxygen is the law, that heat is the product, and that the legitimate result is force, while the result of the union of the hydrogen of the foods with oxygen is water. If alcohol comes at all under this class of foods, we rightly expect to find some of the evidences which attach to the hydrocarbons."
What, then, is the result of experiments in this direction? They have been conducted through long periods and with the greatest care, by men of the highest attainments in chemistry and physiology, and the result is given in these few words, by Dr. H.R. Wood, Jr., in his Materia Medica. "No one has been able to detect in the blood any of the ordinary results of its oxidation." That is, no one has been able to find that alcohol has undergone combustion, like fat, or starch, or sugar, and so given heat to the body. On the contrary, it is now known and admitted by the medical profession that
ALCOHOL REDUCES THE TEMPERATURE OF THE BODY,
instead of increasing it; and it has even been used in fevers as an anti-pyretic. So uniform has been the testimony of physicians in Europe and this country as to the cooling effects of alcohol, that Dr. Wood says, in his Materia Medica, "that it does not seem worth while to occupy space with a discussion of the subject." Liebermeister, one of the most learned contributors to Zeimssen's Cyclopaedia of the Practice of Medicine, 1875, says: "I long since convinced myself, by direct experiments, that alcohol, even in comparatively large doses, does not elevate the temperature of the body in either well or sick people." So well had this become known to Arctic voyagers, that, even before physiologists had demonstrated the fact that alcohol reduced, instead of increasing, the temperature of the body, they had learned that spirits lessened their power to withstand extreme cold. "In the Northern regions," says Edward Smith, "it was proved that the entire exclusion of spirits was necessary, in order to retain heat under these unfavorable conditions."
ALCOHOL DOES NOT GIVE STRENGTH.
If alcohol does not contain tissue-building material, nor give heat to the body, it cannot possibly add to its strength. "Every kind of power an animal can generate," says Dr. G. Budd, F.R.S., "the mechanical power of the muscles, the chemical (or digestive) power of the stomach, the intellectual power of the brain--accumulates _through the nutrition of the organ_ on which it depends." Dr. F.R. Lees, of Edinburgh, after discussing the question, and educing evidence, remarks: "From the very nature of things, it will now be seen how _impossible_ it is that alcohol can be strengthening food of either kind. Since it cannot become a _part_ of the body, it cannot consequently contribute to its cohesive, organic strength, or fixed power; and, since it comes out of the body just as it went in, it cannot, by its decomposition, generate _heat_-force."
Sir Benjamin Brodie says: "Stimulants do not create nervous power; they merely enable you, as it were, to _use up_ that which is left, and then they leave you more in need of rest than before."
Baron Liebig, so far back as 1843, in his "Animal Chemistry," pointed out the fallacy of alcohol generating power. He says: "The circulation will appear accelerated at the expense of the force available for voluntary motion, but without the production of a greater amount of mechanical force." In his later "Letters," he again says: "Wine is quite superfluous to man, * * * it is constantly followed by the expenditure of power"--whereas, the real function of food is to give power. He adds: "These drinks promote the change of matter in the body, and are, consequently, attended by an inward loss of power, which ceases to be productive, because it is not employed in overcoming outward difficulties--i.e., in working." In other words, this great chemist asserts that alcohol abstracts the power of the system from doing useful work in the field or workshop, in order to cleanse the house from the defilement of alcohol itself.
The late Dr. W. Brinton, Physician to St. Thomas', in his great work on Dietetics, says: "Careful observation leaves little doubt that a moderate dose of beer or wine would, in most cases, at once diminish the maximum weight which a healthy person could lift. Mental acuteness, accuracy of perception and delicacy of the senses are all so far opposed by alcohol, as that the maximum efforts of each are incompatible with the ingestion of any moderate quantity of fermented liquid. A single glass will often suffice to take the edge off both mind and body, and to reduce their capacity to something below their perfection of work."
Dr. F.R. Lees, F.S.A., writing on the subject of alcohol as a food, makes the following quotation from an essay on "Stimulating Drinks," published by Dr. H.R. Madden, as long ago as 1847: "Alcohol is not the natural stimulus to any of our organs, and hence, functions performed in consequence of its application, tend to debilitate the organ acted upon.
"Alcohol is incapable of being assimilated or converted into any organic proximate principle, and hence, cannot be considered nutritious.
"The strength experienced after the use of alcohol is not new strength added to the system, but is manifested by calling into exercise the nervous energy pre-existing.
"The ultimate exhausting effects of alcohol, owing to its stimulant properties, produce an unnatural susceptibility to morbid action in all the organs, and this, with the plethora superinduced, becomes a fertile source of disease.
"A person who habitually exerts himself to such an extent as to require the daily use of stimulants to ward off exhaustion, may be compared to a machine working under high pressure. He will become much more obnoxious to the causes of disease, and will certainly break down sooner than he would have done under more favorable circumstances.
"The more frequently alcohol is had recourse to for the purpose of overcoming feelings of debility, the more it will be required, and by constant repetition a period is at length reached when it cannot be foregone, unless reaction is simultaneously brought about by a temporary total change of the habits of life.
"Owing to the above facts, I conclude that the DAILY USE OF STIMULANTS IS INDEFENSIBLE UNDER ANY KNOWN CIRCUMSTANCES."
DRIVEN TO THE WALL.
Not finding that alcohol possesses any direct alimentary value, the medical advocates of its use have been driven to the assumption that it is a kind of secondary food, in that it has the power to delay the metamorphosis of tissue. "By the metamorphosis of tissue is meant," says Dr. Hunt, "that change which is constantly going on in the system which involves a constant disintegration of material; a breaking up and avoiding of that which is no longer aliment, making room for that new supply which is to sustain life." Another medical writer, in referring to this metamorphosis, says: "The importance of this process to the maintenance of life is readily shown by the injurious effects which follow upon its disturbance. If the discharge of the excrementitious substances be in any way impeded or suspended, these substances accumulate either in the blood or tissues, or both. In consequence of this retention and accumulation they become poisonous, and rapidly produce a derangement of the vital functions. Their influence is principally exerted upon the nervous system, through which they produce most frequent irritability, disturbance of the special senses, delirium, insensibility, coma, and finally, death."
"This description," remarks Dr. Hunt, "seems almost intended for alcohol." He then says: "To claim alcohol as a food because it delays the metamorphosis of tissue, is to claim that it in some way suspends the normal conduct of the laws of assimilation and nutrition, of waste and repair. A leading advocate of alcohol (Hammond) thus illustrates it: 'Alcohol retards the destruction of the tissues. By this destruction, force is generated, muscles contract, thoughts are developed, organs secrete and excrete.' In other words, alcohol interferes with all these. No wonder the author 'is not clear' how it does this, and we are not clear how such delayed metamorphosis recuperates. To take an agent which is
"NOT KNOWN TO BE IN ANY SENSE AN ORIGINATOR OF VITAL FORCE;
"which is not known to have any of the usual power of foods, and use it on the double assumption that it delays metamorphosis of tissue, and that such delay is conservative of health, is to pass outside of the bounds of science into the land of remote possibilities, and confer the title of adjuster upon an agent whose agency is itself doubtful. * * * *
"Having failed to identify alcohol as a nitrogenous or non-nitrogenous food, not having found it amenable to any of the evidences by which the food-force of aliments is generally measured, it will not do for us to talk of benefit by delay of regressive metamorphosis unless such process is accompanied with something evidential of the fact--something scientifically descriptive of its mode of accomplishment in the case at hand, and unless it is shown to be practically desirable for alimentation.
"There can be no doubt that alcohol does cause _defects_ in the processes of elimination which are natural to the healthy body and which even in disease are often conservative of health. In the pent-in evils which pathology so often shows occurrent in the case of spirit-drinkers, in the vascular, fatty and fibroid degenerations which take place, in the accumulations of rheumatic and scrofulous tendencies, there is the strongest evidence that
"ALCOHOL ACTS AS A DISTURBING ELEMENT
"and is very prone to initiate serious disturbances amid the normal conduct both of organ and function.
"To assert that this interference is conservative in the midst of such a fearful accumulation of evidence as to result in quite the other direction, and that this kind of delay in tissue-change accumulates vital force, is as unscientific as it is paradoxical.
"Dickinson, in his able expose of the effects of alcohol, (_Lancet_, Nov., 1872,) confines himself to pathological facts. After recounting, with accuracy, the structural changes which it initiates, and the structural changes and consequent derangement and suspension of vital functions which it involves, he aptly terms it the 'genius of degeneration.'
"With abundant provision of indisputable foods, select that liquid which has failed to command the general assent of experts that it is a food at all, and because it is claimed to diminish some of the excretions, call that a delay of metamorphosis of tissue conservative of health! The ostrich may bury his head in the sand, but science will not close its eyes before such impalpable dust."
Speaking of this desperate effort to claim alcohol as a food, Dr. N.S. Davis well 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 allude is, that all vital phenomena are accompanied by, and dependent on, 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."
Well may the author of the paper from which we have quoted so freely, exclaim: "Strangest of foods! most impalpable of aliments! defying all the research of animal chemistry, tasking all the ingenuity of experts in hypothetical explanations, registering its effects chiefly by functional disturbance and organic lesions, causing its very defenders as a food to stultify themselves when in fealty to facts they are compelled to disclose its destructions, and to find the only defense in that line of demarcation, more imaginary than the equator, more delusive than the mirage, between use and abuse."
That alcohol is not a food in any sense, has been fully shown; and now,
WHAT IS ITS VALUE AS A MEDICINE?
Our reply to this question will be brief. The reader has, already, the declaration of the International Medical Congress, that, as a medicine, the range of alcohol is limited and doubtful, and that its self-prescription by the laity should be utterly discountenanced by the profession. No physician who has made himself thoroughly acquainted with the effects of alcohol when introduced into the blood and brought in contact with the membranes, nerves and organs of the human body, would now venture to prescribe its free use to consumptives as was done a very few years ago.
"In the whole management of lung diseases," remarks Dr. Hunt, "with the exception of the few who can always be relied upon to befriend alcohol, other remedies have largely superseded all spirituous liquors. Its employment in stomach disease, once so popular, gets no encouragement, from a careful examination of its local and constitutional effects, as separated from the water, sugar and acids imbibed with it."
TYPHOID FEVER.
It is in typhoid fever that alcohol has been used, perhaps, most frequently by the profession; but this use is now restricted, and the administration made with great caution. Prof. A.L. Loomis, of New York City, has published several lectures on the pathology and treatment of typhoid fever. Referring thereto, Dr. Hunt says: "No one in our country can speak more authoritatively, and as he has no radical views as to the exclusion of alcohol, it is worth while to notice the place to which he assigns it. In the milder cases he entirely excludes it. As a means of reducing temperature, he does not mention it, but relies on cold, quinine, and sometimes, digitalis and quinine." When, about the third week, signs of failure of heart-power begin to manifest themselves, and the use of some form of stimulant seems to be indicated, Dr. Loomis gives the most guarded advice as to their employment. "Never," he says, "give a patient stimulants simply because he has typhoid fever." And again, "Where there is reasonable doubt as to the propriety of giving or withholding stimulants, it is safer to withhold them." He then insists that, if stimulants are administered, the patient should be visited every two hours to watch their effects.
It will thus be seen how guarded has now become the use of alcohol as a cardiac stimulant in typhoid fevers, where it was once employed with an almost reckless freedom. Many practitioners have come to exclude it altogether, and to rely wholly on ammonia, ether and foods.
In Cameron's "Hygiene" is this sentence: "In candor, it must be admitted that many eminent physicians deny the efficacy of alcohol in the treatment of any kind of disease, _and some assert that it is worse than useless_."
ACCUMULATIVE TESTIMONY.
Dr. Arnold Lees, F.L.S., in a recent paper on the "Use and Action of Alcohol in Disease," assumes "_that the old use of alcohol was not science, but a grave blunder_." Prof. C.A. Parks says: "It is impossible not to feel that, so far, the progress of physiological inquiry renders the use of alcohol (in medicine) more and more doubtful." Dr. Anstie says: "If alcohol is to be administered at all for the _relief_ of neuralgia, it should be given with as much precision, as to dose, as we should use in giving an acknowledged _deadly poison_." Dr. F.T. Roberts, an eminent English physician, in advocating a guarded use of alcohol in typhoid fever, says: "Alcoholic stimulants are, by no means, always required, and their indiscriminate use may do a great deal of harm." In Asiatic cholera, brandy was formerly administered freely to patients when in the stage of collapse. The effect was injurious, instead of beneficial. "Again and again," says Prof. G. Johnson, "have I seen a patient grow colder, and his pulse diminish in volume and power, after a dose of brandy, and, apparently, as a direct result of the brandy." And Dr. Pidduck, of London, who used common salt in cholera treatment, says: "Of eighty-six cases in the stage of collapse, sixteen only proved fatal, and scarcely one would have died, _if I had been able to prevent them from taking brandy and laudanum_." Dr. Collenette, of Guernsey, says: "For more than thirty years I have abandoned the use of all kinds of alcoholic drinks in my practice, and with such good results, that, were I sick, _nothing_ would induce _me_ to have resource to them--_they are but noxious depressants_."
As a non-professional writer, we cannot go beyond the medical testimony which has been educed, and we now leave it with the reader. We could add many pages to this testimony, but such cumulative evidence would add but little to its force with the reader. If he is not yet convinced that alcohol has no food value, and that, as a medicine, its range is exceedingly limited, and always of doubtful administration, nothing further that we might be able to cite or say could have any influence with him. _