How to Live Part 22

[31] Aschaffenburg, _Ibid._

[32] Stockard, C. R.: _A Study of Further Generations of Mammals from Ancestors Treated with Alcohol_, Proc. Soc. Exper. Biol. and Med., 1914, XI, p. 136.

[33] Quensel, Ulrik: _The Alcohol Question from a Medical Viewpoint--Studies in the Pathology of Alcoholism_, Year Book, United States Brewers' a.s.sociation, 1914, p. 168.

Bastedo, Walter A.: _Materiel Medico, Pharmacology and Therapeutics_, W. B. Saunders Company, Philadelphia and London, 1913, p. 318.

Bertillon, Jacques: _On Mortality and the Causes of Death According to Occupations_, Proceedings of the Fifteenth International Congress on Hygiene and Demography, Was.h.i.+ngton, 1912, I, p. 345.

Boos, William F.: _The Relation of Alcohol to Industrial Accidents and to Occupational Diseases_, Proceedings of the Fifteenth International Congress on Hygiene and Demography, Was.h.i.+ngton, 1912, I, p. 829.

Cabot, Richard C.: _The Consumption of Alcohol and of Other Medicines at the Ma.s.sachusetts General Hospital_, Boston Med. Jour., CLX, 1909, pp. 480-81.

Dixon, W. E.: _Alcohol in Relation to Life_, The Nineteenth Century, 1910, LXVII, pp. 516, 523.

"Ethyl Alcohol," _The Dispensatory of the United States of America_, J. B. Lippincott & Company, Philadelphia, 19th edition, p. 102.

Ewald: _Alcohol in Relation to Infectious Diseases_, Med. Rec., 1913, Lx.x.xIV, p. 75. Read before the Fourth National Congress on Physiotherapy, Berlin, March 26, 1913.

Horsley, Sir Victor: _Discussion on Alcohol in Therapeutics_, Med. Rec., 1912, LXXI, p. 951. Read before the Hunterian Society.

Hunter, Arthur: _Can Insurance Experience be Applied to Lengthen Life?_ Proceedings of the a.s.sociation of Life Insurance Presidents, Eighth Annual Meeting, 1914, pp. 27-37.

Kelynak, T. M.: _The Drink Problem_, London, Methuen & Company, 1907.

Landau, Anastazy: _Beitrage zur hehre vom Purinstoffwechsel und zur Frage uber den Alkoholeinfluss auf die Harnsaureausscheidung_, Deutsch.

Arch. f. klin. Med., XCV, 1908-9, pp. 280-328.

Miller, Joseph L.: _The Physiologic Action, Uses and Abuses of Alcohol in the Circulatory Disturbance of the Acute Infection_, Jour. A. M. A., 1910, LV, pp. 2034-2037. Read in the joint session of the Sections of Practice of Medicine and Pharmacology and Therapeutics of the A. M. A., Sixty-first Annual Session, held at St. Louis, June, 1910.

Neff, Irwin H.: _The Problem of Drunkenness_, Proceedings of the Fifteenth International Congress on Hygiene and Demography, Was.h.i.+ngton, 1912, IV, p. 510.

Phelps, Edward Bunnell: _The Mortality from Alcohol in the United States_, Proceedings of the Fifteenth International Congress on Hygiene and Demography, Was.h.i.+ngton, 1912, Vol. I, p. 813.

Proceedings: a.s.sociation of Life Insurance Medical Directors, October, 1911.

Report of the Committee of Fifty on: Physiological Aspects of the Liquor Problem, Houghton, Mifflin & Company, two volumes, 1903.

Togel, O., Brezina, E., and Durig, A.: _Ueber die kohlenhydratsparende Wirkung des Alkohols_, Biochem. Ztschr., 1913, I, 296; Editorial, Jour.

A. M. A., 1913, LXI, p. 967.

Williams, Henry Smith: _Alcohol, How it Affects the Individual, the Community and the Race_, The Century Company, New York, 1909.

Woods, Robert A.: _The Prevention of Inebriety: Community Action_, Proceedings of the Fifteenth International Congress on Hygiene and Demography, Was.h.i.+ngton, 1912, IV, p. 517.

#Additional Notes on Alcohol#

[Sidenote: Nutrition Laboratory Experiments]

There has lately been undertaken at the Nutrition Laboratory of the Carnegie Inst.i.tution at Was.h.i.+ngton a very broad and comprehensive study of the effect of moderate doses of alcohol on the healthy and normal human body. The immense scope of the investigation planned may be judged by the fact that under the physiological division of the research, as laid out by Professors Raymond Dodge and E. C. Benedict, there are seven main sections and one hundred and sixty subdivisions. The program has been arranged after conferences, either in person or by letter, with the leading physiologists of the world, and may take ten years to complete.

[Sidenote: Psychological Effects]

The psychological program, carried out with the co-operation of Dr. F.

Lyman Wells, has already been completed and the results recently published.[34] These results must be accepted as the testimony of pure science, free from all bias or even remote suggestion of propaganda.

They were based upon experiments with moderate doses of alcohol (30 cubic centimeters, or about 8 teaspoonfuls, and 45 cubic centimeters) upon ten normal subjects, very moderate users of alcohol, and may be summarized as follows:

[Sidenote: Lower Levels Spinal Cord]

A very simple reflex act, the "knee-jerk," a nervous mechanism controlled by a center at the lower level of the spinal cord, was markedly depressed, the time of response being increased 10 per cent.

and the thickening of the muscles concerned in the act decreased 45 per cent. In some subjects the larger dose, 45 cubic centimeters, practically abolished the knee-jerk.

The eye-lid reflex, elicited by a sudden noise, showed the next largest effect, the time of response being increased 7 per cent. and the degree of movement decreased 19 per cent.

[Sidenote: Higher Levels]

Other nervous mechanisms, or reflex arcs, at the higher levels of the cord, were next investigated: (1) eye-reaction to suddenly appearing stimulus, and (2) speech reaction to visual word stimuli. Dose A (30 cubic centimeters), accelerated the eye-reaction, while dose B (45 cubic centimeters) positively depressed it, agreeing with the simple reaction experiments of Kraepelin. This was the only instance of acceleration of movement of the voluntary muscles through alcohol, all the other tests showing it to be a consistent depressant. The speech reaction showed a positive depressant effect of 3 per cent.

[Sidenote: Memory]

Free a.s.sociation of ideas and memory tests were also made, and showed practically no effect from alcohol, but, unfortunately, the smaller dose only was used in these tests.

The sensitiveness to electrical stimulation was decreased 14 per cent.

Motor co-ordination, as evidenced by eye-movements in fixating seen objects, was next investigated. The velocity of these movements was decreased 11 per cent. Finger-movements, measured in an exceedingly delicate way, were reduced in speed 9 per cent.

[Sidenote: Heart and Pulse]

The effect on the pulse while these tests were made was observed, and electrocardiograms taken. The pulse was found to be accelerated, but not increased in force, that is, the "brake" was taken off the heart, but no driving force supplied by alcohol. The condition of the circulation was impaired by the narcotic effect of alcohol on the cardio-inhibitory center which holds the heart action in check.

[Sidenote: Decreases Organic Efficiency]

According to the investigators, the effect is to "decrease organic efficiency." This should shut off such little debate as still persists with respect to alcohol having any value as a heart stimulant.

[Sidenote: Always a Depressant]

While these investigations only confirm in part the contention of the Kraepelin school that alcohol first acts by depressing the higher centers, and tend to show that its first and most profound effect is on the lower levels of the spinal cord and the simpler nervous mechanisms, it confirms the view of these and other investigators, that the total effect of alcohol is that of a narcotic, depressing drug, even in the smallest doses usually taken as a beverage.

[Sidenote: Resistance of Higher Brain Function]

The possible reactions are more complex than those supposed by Kraepelin, and there is evident in the higher centers (the effect on highest brain functions, were not measured by Dodge and Benedict) a power of "autogenic reinforcement," which is well exemplified by the ability of a half-intoxicated person to sober up under some shock or strong incentive. When social conditions do not stimulate this reinforcement, but, on the contrary, dull and r.e.t.a.r.d it, as in convivial company, there is reinforcement of the lower, more animal mechanisms of the nervous system, and we have exhibited revolting and foolish reactions to alcohol, which are consistent with these findings.

[Sidenote: Explanation of Memory Effects]

The slight effect on memory and free a.s.sociation is explained partly by the methods used in the laboratory (difference in time of recognizing words suddenly exposed a second time), which are more in the nature of "short cuts" and perhaps not so accurate a reproduction of normal memorizing as those employed by Kraepelin and Vogt (memorizing numbers and verse), and partly by the power of "autogenic reinforcement," which it is difficult to eliminate in a laboratory test.