Alcohol as a Beverage and Medicine
By H. D. Didama
The evolution of medical science through the elimination of error and discovery of truth has been continuous, although sometimes restrained by conservatism and hampered by prejudice. Many theories which were at one time regarded as Gibraltar principles have been consigned to merited oblivion. Of these traditions, one which traces its origin to almost prehistoric times, was that alcohol in some form—as beer, wine, whisky, or brandy—is harmless, and valuable as a beverage, important in the management of minor disorders, and sine qua non in the treatment of dangerous ones. Regarding the use of alcohol as a beverage, opinions differ radically. The advocates of the canteen claim that when the soldiers could buy wine, beer, and other “soft drinks,” there was little or no drunkenness, but that now, since the abolition of this great temperance promoter, the men resort to outside saloons, and buy whisky as well as beer. It is well to remember that the active principle in the soft drinks is identical with that in the strong ones. Whisky contains an indefinite amount of alcohol, from twenty to forty per cent.; beer ranges from four to eight per cent.; claret, nine per cent.; champagne, eleven per cent.; tokay, the favorite prescription of some physicians, twelve per cent.; port, eighteen per cent.; and sherry, another soft drink, twenty-two per cent. People can and do get drunk on any one of these beverages; and a high authority holds that beer rather than whisky is the cause of certain forms of neuralgia. The canteen is the primary school, the kindergarten, for the saloon. Many a new recruit tasted an alcoholic beverage for the first time in the canteen. The acquired taste led him with boon companions to the grogshop. Many newspapers advocate the restoration of the canteen, ostensibly for temperance reasons, and at the same time advertise in another column some favorite brand of whisky side by side with an account of an assault or horrible murder committed by an inebriate. Some readers may remember that Dr. ——, claimed by a leading daily paper to be one of New York’s most eminent medical authorities, read an essay advocating the daily use of old whisky as a stimulant, an excellent predigested food, and a healthful beverage. Every day we read accounts of men who tarry long at night, and spend their money, in those restaurants—clerically christened “poor men’s clubs”—where the precious liquid food is furnished, and who then go home, and in their hilarity abuse, beat, and maim their half-starved wives and children. The unanimous testimony of those who train for athletic exercises—football, foot races, rowing matches, pugilistic contests—is very emphatic that alcoholic drinks are always harmful. It is ancient history that Kane, Nansen, and other arctic explorers gave to their men not a drop of alcohol—this so-called king of stimulants—although the thermometer in those frigid nights sometimes indicated a temperature of eighty degrees below zero. Business men, also, and employers of laborers testify that the abstainers in their service not only endure cold and heat, hunger and exposure and fatigue, better, but they recover sooner than those who indulge in intoxicants. This testimony of practical men, who know what they are talking about, would seem to overbalance the statements of a few tippling surgeons that alcoholic drinks are indispensable in hot climates. An important lecture was delivered in London by Victor Horsley, who is acknowledged to be a great authority on the brain, and who is known not only as a fearless investigator for truth, but as the servant of science. The lecture is published in The British Medical Journal of May 5, 1900. Horsley’s experiments demonstrated that the effect of alcohol upon the brain was first an apparent quickening of the cerebral act, which lasted but a few minutes, and then for a period of two to four hours the cerebral activity was diminished; that is, it took longer for a person who had had a small quantity of alcohol to think. And he asserted that the evidence was overwhelming that alcohol in small amounts had a most deleterious effect on voluntary muscular work. Alcohol was employed in the treatment of diphtheria by nearly all physicians in Europe up to seven years ago, and by a majority in our own country. The mortality abroad was sixty-eight per cent., but was not so great in America; and this lessened death rate here was attributed by many practitioners to the use of Rhine and domestic wines, which contain but a small percentage of alcohol. After the introduction of Behring’s antitoxin the mortality in Europe was reduced to thirty per cent.; still this enormously high rate continuing in spite of, if not in consequence of, the persistent employment of the accustomed alcohol. At home the early use of antitoxin sine alcohol brought the mortality nearly to the vanishing point. Notwithstanding the evolution, resulting from scientific experiments, observation, and experience, of the conviction that alcohol is harmful as a beverage, promotive of many diseases, and useless in medical practice, it is to be regretted that a large number of authors—especially those who have already embalmed their opinions in printer’s ink—still adhere to their ancient views, and advocate them vehemently. Many teachers in medical colleges—the number, it is to be hoped, is growing beautifully less every year—follow their leaders, the bookmakers, who in too many instances are not so much original idealists as transcribers. And not a few of the worthy rank and file of the medical profession who have little time and few conveniences for experimentation, are content to adopt as their excuse for administering alcohol the one given by a candid young practitioner at a discussion of the subject in New York City, “I use it because other doctors do.” The number of careful and scientific observers at home and abroad who have proved that alcohol is an anæsthetic and depressant instead of a stimulant is rapidly increasing. The small army of physicians who have had the courage to relinquish the use of alcohol in the treatment of diseases have come to rejoice at the daily addition to its list of recruits. “The acorn is small, but it has in it the potentiality of the giant oak.” The science of medicine is intimately associated with practice. As a rule, those who best know, best do. Their philanthropy, instead of halting at easy benedictions, passes forward to practical benefactions. Their delight as well as their duty inspires them not only to alleviate suffering, but to anticipate and ward it off. They indorse the popular maxim, “An ounce of prevention is worth a pound of cure”—sixteen to one. In conclusion, those physicians who neither use alcohol in so-called moderation, as a beverage, nor prescribe it in heroic or minute doses as a medicine, and who have personal experience for their belief that the non-alcoholic treatment of any disease is far more satisfactory than the alcoholic management which they formerly employed, are liable and likely to have many pleasant and gratifying experiences. For instance, gastric catarrh is a complaint abundantly prevalent among those who use beer, wine, or whisky in asserted moderation. The statement of not a few of the victims is possibly well founded, that the whisky was prescribed by a reputable physician to improve digestion. A careful investigation of the case results in the regulation of the diet, and the exaction of a promise to abstain permanently from the use of every form of alcoholic beverages. And it is not an uncommon occurrence for the patient to return after a week or two and express his gratification, to inquire why other doctors had not given the same counsel, and to renew his total abstinence pledge. Satisfactory experiences like this, which any physician may possess, are already enjoyed by a rapidly increasing number of medical men who are counted among the most eminent in this country and abroad—in Germany and France, as well as in England.—H. D. Didama, M. D., LL. D., Dean of College of Medicine, Syracuse University, in the Christian Advocate.