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alcohol, action, effect, amounts, food and blood

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ALCOHOLISM, a term applied to the symptoms produced by poisoning with ethyl alcohol (see ALCOHOL). Alcoholism may be acute, subacute or chronic, and in order to understand its phases a brief review of the more important features of the physiological action of alcohol is necessary. Locally alcohol is an irritant, and induces congestion and in creased cellular activity. There appears to be some foundation for the popular view that taken before a meal alcohol increases the wish to eat, for although in any marked it greatly reduces or altogether inhibits the action of the digestive ferments it is probable that the in creased amount of gastric juice secreted under the influence of small amounts more than makes up for this effect. Some authorities maintain that while the alcohol remains in the stomach digestion is retarded, but that after absorption of the alcohol the process advances more rapidly than would otherwise have been the case. The most important effect of the administration of alcohol is manifested through the nervous sys tem. There is no doubt that physiologically alcohol is always a poison. Its psychological effects, however, need special attention. Experi ments show that tasks like the addition of columns of figures or reading series of discon nected syllables are performed less rapidly and more inaccurately when the person had taken moderate amounts of alcohol, though he usually feels increased self-confidence and is convinced that the actually inferior work he is doing is especially good. It is in this way that alcohol often aids the after-dinner speaker, who by moderate amounts of wine is relieved of diffi dence or embarrassment and is enabled to speak with a fluency apparently rarely at his command under ordinary conditions. It is probable that the capacity for muscular work also is only apparently augmented by alcohol, the slight in crease in efficiency at the start being neutral ized by the earlier onset of fatigue. According to modern observers alcohol has but little direct effect on the circulation, though there is some change in the distribution of the blood through dilatation of the peripheral vessels. Respira

tion is little if at all affected. The question of whether or not alcohol is a food has elicited much controversy, but the experiments of At water, Neumann and others show beyond doubt that a certain amount of alcohol can be com pletely burnt in the body and serve as a source of heat and energy. In this %Nay a saving of other food stuffs is effected, and in this sense alcohol is undoubtedly a food. The view up held by some of the older authors that alcohol has the power of lessening the oxidation of the tissues is, however, unfounded. The modern tendency is to regard alcohol not as a physio logical stimulant but as a universal depressant. From the above it might be inferred that alco hol does not possess the traditional value as cribed to it in medicine, and to some extent this is true. On the other hand, there are many legitimate indications for its use that cannot be met by other drugs and few thoughtful clinicians would be willing to do without its aid. Alcohol is often used in popular medicine without a correct conception of its action. Con trary to general belief it does not raise the bodily temperature, but actually causes it to fall on account of the increased radiation of heat from the surface of the body accompanying the dilatation of the blood vessels of the skin. Con sequently alcoholic drinks should not be taken before exposure with the idea of avoiding fatigue or chilling, though there is no objection to its use when the exposure is over and the individual has returned home wet or chilled through.

Acute alcoholic poisoning follows the talc mg of very large quantities of strong spirits in a short time, and is not often seen. The patient promptly becomes comatose, the face is con gested or purplish, there is complete muscular relaxation, weak heart action and collapse, end ing in death through paralysis of the heart or of respiration or both, unless medical aid is given.

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