Tobacco and Alcohol

Here we come upon Mr. Parton's second blunder. He talks about the "decomposition" of food, and appears to think that digestion is a kind of putrefaction, so that alcohol, which arrests the latter, must also arrest the former. He says: We do not need to experiment, for we know that alcohol, which is a preserver, cannot digest food by decomposing it. This unlucky remark illustrates the danger of writing on a subject, the rudiments of which you have not taken time to get acquainted with. Before attempting to lay down the law upon an abstruse point connected with the subject of digestion, common prudence would appear to dictate that one should first acquire some dim notion of what digestion is. The veriest tyro in physiology should know that the gastric juice is itself a preventer of putrefaction. It will not only keep off organic decay, but it will stop it after it has begun.42 In this sense of the word, it is as much a preserver as alcohol.

As it takes time to expose all the fallacies which Mr. Parton can crowd into one short paragraph, we have thus far admitted that alcohol impairs the quality of the gastric juice by diluting it: as a matter of fact, it does not so impair it. If it is a preserver, it is also a coagulator. It coagulates the albuminous portions of the food, thus enabling them to be more easily acted upon by the gastric secretion.43 So that, on looking into the matter, we find the stimulant dose of alcohol doing everything to quicken, and nothing whatever to slacken, digestion. It coaxes out more digestive fluid, and it lightens the task which that fluid has to perform.

Daily experience tells us that the glass of wine taken with our dinner, or the thimble-full of liqueur taken after dessert, diminishes the feeling of heaviness, and enables us sooner to go to work. Of indigestion and its accompanying sensations, we are unable to speak from experience; but Mr. Parton feelingly describes the effects of alcohol as follows. "When we have taken too much shad for breakfast, we find that a wineglass of whisky instantly mitigates the horrors of indigestion, and enables us again to contemplate the future without dismay." Now, if Mr. Parton's ideas on this subject were correct, his dose of whisky ought to exasperate his torment. The fact that it comforts him shows that it serves to quicken the too sluggish stomach to its normal activity. It is a very good clinical experiment indeed.

Alcohol, however, aids digestion only when taken in moderate quantities. A narcotic dose, by paralyzing the medulla and the sympathetic, interferes with the flow of gastric juice. Here, as in most cases, the large quantity does just the reverse of what the small quantity will do. The same is true of food. Digestible food, in moderate amount, stimulates the gastric secretion; in excessive amount, it arrests its action. "Another curious fact is, that although the addition of organic acids increases the digestive power of this fluid, there is a limit at which this increase ceases, and beyond it, excess of acid suspends the whole digestive power."44 It is therefore a wise thing to eat heartily, but a silly thing to eat voraciously; it is wise to eat pickles, but silly to make one's dinner of them; it is wise to drink a glass of sherry, but silly to empty the bottle. The happy mean is the thing to be maintained, in digestion as in every thing else.

Mr. Parton next proceeds to deny that alcohol is a heat-producing substance. "On the contrary," he says, "it appears in all cases to diminish the efficiency of the heat-producing process." And he cites the testimony of Arctic voyagers, New York car-drivers, Russian corporals, and Rocky Mountain hunters, in support of the statement that alcohol diminishes the power of the system to resist cold. He thinks he could fill a whole magazine with the evidence on this point. Nevertheless, so far as we have examined the reports of Arctic travellers,45 they appear by no means decisive. They do not keep in mind the distinction between stimulation and intoxication. We do not doubt that "men who start under the influence of liquor are the first to succumb to the cold, and the likeliest to be frost-bitten," if the phrase "under the influence of liquor" be understood, as it usually is, to mean "partly drunk." On the other hand, it is a familiar fact that a glass of whisky, taken on coming into the house after exposure to cold, will in many cases prevent sore throat or inflammation of the nasal passages. In our own experience, we know of no more efficient agent for removing the effects of a chill from the system. Before this question can be settled, however, we must ascertain whether alcohol is, or is not, a true food. If the food-action of alcohol is, as Liebig maintains, to be ranked with that of fat, starch and sugar, its heat-producing power will follow as an inevitable inference. To this point we shall presently come; and meanwhile we may content ourselves with citing the excellent authority of Johnston in support of the opinion that ardent spirits "directly warm the body."46

Mr. Parton next indicts alcohol on the ground that it is not a strength-giver. "On this branch of the subject," he observes, "all the testimony is against alcoholic drinks."47 Yet in his own statement of the case may be found contradictions enough. On the one hand he cites Tom Sayers, Richard Cobden and Benjamin Franklin in support of his opinion;48 and he tells us how Horace Greeley, teetotaler, coming home the other day, and finding terrible arrears of work piled up before him, sat down and wrote steadily, without leaving his room, from ten A.M. till eleven P.M. – no very wonderful feat for a healthy man. But on the other hand, it appears from some of his own facts that when a supreme exertion of strength is requisite, then we must take alcohol. "During the war I knew of a party of cavalry who, for three days and three nights, were not out of the saddle fifteen minutes at a time. The men consumed two quarts of whisky each, and all of them came in alive. It is a custom in England to extract the last possible five miles from a tired horse, when those miles must be had from him, by forcing down his most unwilling throat a quart of beer." (p. 86.) From these unwelcome facts Mr. Parton draws the sage inference that alcohol, like tobacco, supports us in doing wrong! "It enables us to violate the laws of nature without immediate suffering and speedy destruction." Now there is one much abused faculty of mankind, which nevertheless will sometimes refuse to be insulted, – that faculty is common sense. And in the present case, common sense declares that when we are taxing our strength, no matter whether "laws" are violated or not, we do not keep ourselves up by drinking a substance which can only weaken us. It may be unfortunate that alcohol is a strength-giver; but the fact that we can travel farther with it than without it shows that, unfortunate or not, the thing is so. But Mr. Parton believes that Nature is even with us afterward. "In a few instances of intermittent disease, a small quantity of wine may sometimes enable a patient who is at the low tide of vitality to anticipate the turn of the tide, and borrow at four o'clock enough of five o'clock strength to enable him to reach five o'clock." This is sheer nonsense. There is no such thing as borrowing at four o'clock the strength of five o'clock. The thing is a physiological absurdity. The strength of to-morrow is non-existent until to-morrow comes; it is not a reserved fund from which we can borrow to-day. If Mr. Parton's notion were correct, his patient ought to be weaker at five o'clock by just the same amount that he is stronger at four o'clock. If the strength has been borrowed, it cannot be used over again. You cannot eat your cake and save it. In an hour's time, therefore, the patient should be weaker than if he had contrived to get along without the wine. But this is not found to be the case: he is stronger at four and he is stronger at five, he is stronger next day, and he convalesces more rapidly than if he had not taken alcohol. This is a clinical fact which there is no blinking.49 It shows that the only source from which the strength can possibly come is the alcohol. Whether it be food or not, the action of alcohol in these cases is precisely similar to that of food. It calms delirium and promotes refreshing sleep, exactly like a meat broth, except that it is often more rapidly efficient. It can produce these effects only by acting as a genuine stimulant, by either nourishing, or facilitating the normal nutrition of, the nervous system.50

When therefore Lawyer Heavy-fee and the other allegorical personages mentioned by Mr. Parton sit up working all night, and then quiet their nerves by a glass of wine or a cigar, they are no doubt shortening their lives and committing "respectable suicide." But it is because they sit up all night and waste vital force, not because they resort to an obvious and effective means of repairing the loss. It is well to keep early hours and avoid over-work. But on rare occasions, when the circumstances of life absolutely require it, he who cannot sit up all night for a week together, without inflicting permanent injury upon himself, is rightly considered deficient in recuperative vigour. When such occasions come, most persons instinctively seek aid from alcohol; and it helps them because it is an imparter, or at least an economizer, of nervous force. The fact that it is resorted to, when supreme exertion is demanded, shows that it is recognized as a strength-saver, if not as a strength-giver. Our inquiry into its food-action will show that it is both the one and the other.

Thus far we have considered alcohol only as an agent which affects the nutrition of the nerves. Whether it be also a food or not does not essentially alter the question of its evil or beneficent influence upon the system. As we saw in our chapter on Tobacco, the human organism needs, for its proper nutrition, stimulus as well as food, – force as well as material. No conclusion in physiology is better established than that narcotic-stimulants increase the supply of force while they diminish the waste of material;51 and it is by virtue of this peculiarity that they will often sustain the organism in the absence of food. Tobacco is not food, but if you give a starving man a pipe to smoke it will take him much longer to die. Opium and coca are not foods; but they will sometimes support life when no true aliment can be procured. The action of alcohol is similar to that of these substances, but immeasurably more effective. None of the inferior narcotic-stimulants is at all comparable with alcohol in the degree of its food-replacing power. We read that tobacco and coca will enable a man to go several days without anything to eat; and we interpret this result as due to the waste-retarding action of these substances. But when we find that alcohol will support life for weeks and months, we can no longer be content with such an explanation. When we recollect that Cornaro lived healthily for fifty-eight years upon twelve ounces of light food and fourteen ounces of wine per diem,52 and reflect upon the large proportion of alcoholic drink in this diet, the suspicion is forced upon us that alcohol is not only a true stimulant but also a true food.

Mr. Parton of course asserts that alcoholic drinks do not nourish the body, and denies to them the title of foods. He begins by quoting Liebig's assertion "that as much flour or meal as can lie on the point of a table-knife is more nutritious than nine quarts of the best Bavarian beer." Whereupon the reader, who is perhaps not familiar with the history of physiological controversy, thinks at once that Liebig's great authority is opposed to the opinion that alcohol is food. Nothing could be further from the truth. Perhaps nothing in Mr. Parton's book shows more forcibly the danger of "cramming" a subject instead of studying it. When Liebig wrote the above sentence, he believed that foods might be sharply divided into two classes, – those which nourish, and those which keep up the heat of the body. He believed that no foods except those which contain nitrogen can nourish the tissues; and he therefore excluded not only alcohol, but fat, starch and sugar also, from the class of nutritious substances. But Liebig was far from believing that alcohol is not food. On the contrary he distinctly classed it with fat, starch and sugar, as a heat-producing food, – a fact which Mr. Parton, if he knows it, takes good care not to quote! But this twofold classification of foods has for several years been known to be unsound. It has been shown that all true foods are more or less nutritious, and that all are more or less heat-producing. Starch and sugar have maintained their places in the class of nutritive materials from which Liebig tried to exclude them, and we have now to see whether the same can be said of the closely kindred substance, alcohol.

Mr. Parton thinks he has proved that alcohol cannot be food, when he has asserted that it is not chemically transformed within the body. As soon as it is taken, he tells us, lungs, skin and kidneys all set busily to work to expel it, and they send it out just as it came in: therefore it is an enemy. Now all this may be said of water. Water is not chemically changed within the body; as soon as we drink it, lungs, skin and kidneys begin busily to expel it; and it goes out just as good water as it came in. Nevertheless, water is one of the most essential elements of nutrition.

But it is by no means certain that alcohol is not transformed within the body. It is neither certain nor probable. Mr. Parton relies upon the experiments of Messrs. Lallemand, Duroy, and Perrin, who in 1860 thought they had demonstrated that all the alcohol taken into the system comes out again, as alcohol, through the lungs, skin and kidneys. By applying the very delicate chromic acid test, these gentlemen appeared to prove that appreciable quantities of alcohol always begin to be excreted very soon after the dose has been received by the stomach, and continue to pass off for many hours. "They failed, after repeated attempts, to discover the intermediate compounds into which alcohol had been represented as transforming itself before its final change; and, on the other hand, they detected unchanged alcohol everywhere in the body hours after it had been taken; they found the substance in the blood, and in all the tissues, but especially in the brain and the nervous centres generally, and in the liver."53 Mr. Parton has, it would appear, read their book, and he is fully persuaded by it that "if you take into your system an ounce of alcohol, the whole ounce leaves the system within forty-eight hours, just as good alcohol as it went in." These experiments, moreover, "produced the remarkable effect of causing the editor of a leading periodical to confess to the public that he was not infallible." The Westminster Review, it seems, in 1861, retracted the opinions which it had expressed in 1855, "concerning the rôle of alcohol in the animal body." The Westminster Review has now an opportunity to retract its recantations; for in 1863, these experiments were subjected to a searching criticism by M. Baudot, which resulted in thoroughly invalidating the conclusions supposed to flow from them.54 The case is an interesting one, as showing afresh the utter impossibility of getting at the truth concerning alcohol, without paying attention to the difference in the behaviour of large and small quantities.

The researches of Bouchardat and Sandras,55 and of Duchek,56 have rendered it probable that, if alcohol undergoes any digestive transformation, it is first changed into aldehyde, from which are successively formed acetic acid, oxalic acid and water, and carbonic acid.57 But this transformation, like any other digestive process, cannot go on unless the nervous system is in good working order. Now when a narcotic dose of alcohol is taken, the flow of gastric juice is prevented by local paralysis of the nerve-fibres distributed to the stomach. What then must happen? Solid food may remain undigested, in the stomach;58 but liquid alcohol is easily absorbable, and has two ways of exit, – one through the portal system into the liver, the other through the lacteals into the general circulation, by which it will be carried chiefly to the organ which receives most blood, – namely, the brain. It is thus probable that no alcohol can be transformed after narcosis begins. But the absorbed alcohol, loading the circulation, begins at once to be excreted. Paralysis of the renal plexus of the sympathetic sets up a rapid diuresis, and considerable amounts of the volatile liquid escape through the lungs and skin. In examining, therefore, a drunken man or dog, we need not, on any theory, expect to find the intermediate products of alcoholic transformation; we must expect to find large quantities of undigested alcohol in the circulation, and notably in the brain and liver; and we need not be surprised if we detect unchanged alcohol in the excretions. Our experiment will not show that alcohol cannot be assimilated; it will only show how serious is the damage inflicted by a narcotic dose, in checking assimilation. Now all this applies with force to the experiments of Messrs. Lallemand, Duroy and Perrin. In their experiments, these gentlemen always tried intoxicating doses; thus paralyzing at the outset the whole digestive tract, and preventing the formation of those transformed products which they afterward vainly tried to discover. As so often happens in experimenting upon the enormously complex human organism, they began by creating abnormal conditions which rendered their conclusions inapplicable to the healthy body.

A further criticism by M. Baudot, supported by renewed experiments, is still more decisive. M. Baudot justly observes that in order to substantiate their conclusions, Messrs. Lallemand, Duroy and Perrin should have at least been able, with their excessively delicate tests, to discover in the excretions a large part of the alcohol which had been taken into the system. This, however, they never did. In all cases, the amount of alcohol recovered was very small, and bore but a trifling proportion to the amount which had been taken. According to these physiologists, the elimination always takes place chiefly through the kidneys. But M. Baudot, in a series of elaborate experiments, has proved that, unless the dose has been excessive, no sensible amount of alcohol reappears in the kidney-excretions for more than twenty-four hours. The quantity is so minute that the alcoometer is not in the least affected by it, and it requires the chromic acid test even to reveal its presence. Similar results have been obtained by experiments upon the breath.

Finally, the gravest doubts have been thrown upon the trustworthiness of the chromic acid test relied on by Messrs. Lallemand, Duroy and Perrin. It is considered possible, by good chemical authority, that the reactions in the test-apparatus, which they attributed to the escaping alcohol, may equally well have been caused by some of the results of alcoholic transformation. For reasons above given, however, it is probable that in cases of narcosis some alcohol always escapes. When we reflect upon its absorbability and its ready solubility in water, it seems likely beforehand that a considerable quantity must escape. But all that these able Frenchmen can be said to have accomplished, is the demonstration of the fact that when you take into your system a greater quantity of alcohol than the system can manage, a part of it is expelled in the same state in which it entered. And this may be said of other kinds of food.

These experiments have, therefore, instead of settling the question, left it substantially just where it was before. But we have now a more remarkable set of facts to contemplate. In many cases of typhoid fever, acute bronchitis, pneumonia, erysipelas, and diphtheria, occurring in Dr. Anstie's practice, it was found that the stomach could be made to retain nothing but wine or brandy. Upon these alcoholic drinks, therefore, the patients were entirely sustained for periods sometimes reaching a month in duration.59 In nearly every case convalescence was rapid, and the emaciation was much slighter than usual: the quality of the flesh was also observed to be remarkably good. Dr. Slack, of Liverpool, had two female patients who, loathing ordinary food, maintained life and tolerable vigour for more than three months upon alcoholic drinks alone. Mr. Nisbet reports "the case of a child affected with marasmus, who subsisted for three months on sweet whisky and water alone, and then recovered; and that of another child, who lived entirely upon Scotch ale for a fortnight, and then recovered his appetite for common things." Many similar examples might be cited.

It may be said that alcohol maintained these persons by retarding the waste of the tissues. This is no doubt an admissible supposition. There is no doubt that alcohol, by its waste-retarding action, will postpone for some time the day of death from starvation.60 But to this action there must be some limit. Though the waste is retarded, it is not wholly stopped. Though there is relatively less waste, there is still absolutely large waste. The mere act of keeping up respiration necessitates a considerable destruction of tissue. Then the temperature of the body must be kept very near 98° Fahrenheit, or life will suddenly cease; and the maintenance of this heat involves a great consumption of tissue. Now this waste, under the most favourable circumstances, will soon destroy life, unless it is balanced by actual repair. You may diminish the draught on your furnace as much as you please, – the fire will shortly go out unless fresh coal is added. Upon these points the data are more or less precise. The amount of waste material daily excreted from the body, under ordinary circumstances, is a little more than seven pounds.61 Of this the greater part is water, the quantity of carbon being about twelve ounces, and the quantity of nitrogenous matter about five ounces.62 To make up for this waste we usually require at least two and a half pounds of solid, and three pints of liquid, food.63 In Dr. Hammond's experiments, the weight-sustaining power of the alcohol taken seems to have amounted to four or five ounces.64 It will be seen, therefore, that in spite of any stimulant effect of alcohol upon nutrition, unless at least ten or twelve ounces of nitrogenous or carbonaceous matter be eaten daily, the weight of the body must rapidly diminish.

Now the experiments of Chossat have demonstrated that no animal can suddenly lose more than two-fifths of its normal weight without dying of starvation. If a man, therefore, weigh 150 lbs., for him 90 lbs. is the starvation-point; as soon as he reaches that weight he dies. Usually, indeed, death occurs before this degree of emaciation can have been attained, – in most cases, on the fifth or sixth day; though there are a few authentic instances of persons who have lived for twelve, and even sixteen, days before finally succumbing.

In view of these facts, we are willing to grant that people may in rare cases live for three months on their own tissues, if waste be duly retarded. We are willing to grant it, though we do not believe it. But we are not prepared to admit that this process can go on for six months or a year; and we believe that the cases now to be cited can in nowise be got rid of by such an interpretation.

Mr. Nisbet mentions the case of a man who lived for seven months entirely on spirit and water. At Wavertree, a young man afflicted with heart-disease lived for five years principally, and for two years solely, on brandy. His allowance was at first six ounces, afterward a pint, per diem. His weight was not materially decreased, when, at the end of the five years, he died of his disease. But the next case is still more remarkable. Dr. Inman had a lady-patient, about twenty-five years old, plump, active and florid, but somewhat deficient in power of endurance. "This lady had two large and healthy children in succession, whom she successfully nursed. On each occasion she became much exhausted, the appetite wholly failed, and she was compelled to live solely on bitter ale and brandy and water; on this regimen she kept up her good looks, her activity and her nursing, and went on this way for about twelve months; the nervous system was by this time thoroughly exhausted, yet there was no emaciation, nor was there entire prostration of muscular power."65