Chapter XVI: Recent Researches Upon Alcohol

In the year 1900 Prof. Taav Laitinen, of the University of Helsingfors, Finland, published an account of experiments made upon 342 animals--dogs, rabbits, guinea pigs, fowls and pigeons--to determine the effects of alcohol upon the resistance of the body to infectious diseases. He used as infecting agents, anthrax bacilli, tubercle bacilli, and diphtheria bacilli. The doses of alcohol given varied with the animal. For his "small dose" experiments he used the quantity of alcohol given as a food or as a medicine, or both, in a neighboring sanitorium. The alcohol employed was, as a rule, a 25 per cent. solution of ethyl alcohol in water. It was given either by esophageal catheter, or by dropping it into the mouth from a pipette. It was administered in several ways, and for varying times; sometimes in single large doses, at others in gradually increasing doses for months at a time, in order to produce here an acute, and there a chronic poisoning; in fact, he produced the conditions consequent upon steady, moderate drinking.

His first conclusion from these experiments, most carefully carried out, is that alcohol, however given, induces in the animal body a markedly increased susceptibility to infectious diseases; and he maintains that his experiments indicate that the use of alcohol, at least in the treatment of anthrax, tuberculosis, and diphtheria, is not only useless but probably injurious. From a number of other experiments carried out with scrupulous care he comes to the same conclusion as Abbott, Welch, and others that the predisposing to disease of alcohol must be explained by its action in producing abnormal conditions--pathological changes in the alimentary canal, liver, kidneys, heart, and nervous system. He found that the alkalinity of the blood was slightly diminished, and the number of leucocytes somewhat decreased. He also draws attention to the fact that his experiments prove that pregnant animals and their offspring are markedly affected by the continued use of small doses of alcohol. He shows, too, that the temporary lowering of the body temperature by alcohol produces the most favorable condition for the invasion of disease germs.

Since the publication of these experiments, and of others similar to them, the use of alcohol in diphtheria and tuberculosis has very largely ceased. Boards of health and charity organizations unite in warning against indulgence in alcoholic drinks as conducive to tuberculosis.

At the International Congress on Alcoholism, held in London in July, 1909, Professor Laitinen delivered two lectures. The first was upon "The Influence of Alcohol on Immunity." The following is taken from this lecture:--

"Modern researches have done much to explain the extent and
nature of the protective powers by which the organism endeavors
to defend itself against the attacks of all kinds of injurious
agencies, and especially against invasion by the germs of
infective diseases. It is now a well-established fact that
alcohol weakens the normal resisting power of the body against
the above-named disease-producing influences. In the hope of
contributing something to the explanation of the way in which
alcohol weakens the organism, I have made a number of
experiments bearing upon the question of the influence of
alcohol on immunity.

"Early in this century careful experiments went to show that
alcohol certainly had some influence upon immunity. Two
Americans, Abbott and Bergey, were the first to discover that
this agent produces a diminution of the haemolytic complement in
the blood-serum of certain animals which were tested. They
showed also that the formation of specific haemolytic receptors
(immune bodies) may be retarded by the action of alcohol.

"The extent of the evil effects upon the human body resulting
from the consumption of alcoholic liquors is as yet far from
being fully known, and stands in need of scientific
verification. Many other injurious influences such as unsanitary
dwellings, bad feeding, excessive toil, and toxic agents like
nicotine, etc., may produce somewhat similar morbid effects. It
is therefore necessary, in the scientific study of the question,
to take these possibilities into consideration. In my
investigations, the results of which I am now to lay before you,
I have endeavored to select as subjects for my experiments both
abstainers from alcohol, and those who indulge more or less in
its use, in such a way that their conditions of life and their
habits in other respects should be as nearly as possible the
same. All persons, for instance, suffering from any acute or
chronic disease were rejected, and very few of the persons
selected were smokers. The subject of this research has been
human blood, and especially its two principal components,
namely, red blood-corpuscles and blood-serum, both of which up
to the present time have been very little studied in relation to
the question under discussion. I have gone into these matters
chiefly because the modern theoretical study of immunity during
the last few years has, in general, attracted greater attention
to the blood, and shown the important role which the different
parts, properties, and capacities of the blood play in defending
the organism against internal and external injurious agencies.
Further, the subtle methods employed in the study of immunity
(such as organic reactions, and reactions between greatly
attenuated organic liquids) would also seem to be available for
our purpose, as they allow of the detection of the minutest
differences which alcohol may produce in any part of the
organism in question.

"During the course of this research, which has lasted over a
period of three years, I sought to investigate the action of
alcohol on the resistive power of human red blood-corpuscles. I
wished to ascertain whether the resistivity of the red
blood-corpuscles in a healthy man could be lowered by the
consumption of alcohol. * * *

"It may be well for me here to explain that in this lecture I
mean by the term 'drinker' a person who has taken alcohol in any
quantity whatever. Many of these 'drinkers,' therefore, were in
fact most moderate consumers of alcohol. By the term 'abstainer'
I mean a person who has never taken alcohol in any quantity
worth mentioning. In the course of my investigations I have
examined blood from two hundred and twenty-three persons. They
were of different classes and ages. There were professors of
medicine and other physicians, University fellows, students of
both sexes, hospital nurses, school-teachers, waiters, and other
men and women belonging to the working-classes."

The rest of the lecture as given here is an abstract made by Professor Laitinen:--

"My studies have been directed to an investigation of the
following points:

"1. I sought to ascertain whether the resistance of human red
blood-corpuscles against a heterogeneous normal serum, or an
immune serum, can be diminished by the use of alcohol.

"2. I have studied the action of alcohol in drinking and
abstaining persons on the haemolytic power of blood-serum over
heterogeneous red blood-corpuscles (rabbits). I have studied not
only the haemolytic power of the human blood-serum, but also its
power of precipitation in the presence of rabbit-serum, with a
view to ascertain if the reaction between a known dilution of
rabbit-serum and a certain dilution of serum of alcohol-users
and non-drinking persons is different or not, and if the
reaction is more apparent with the former or with the latter.

"3. The resisting power of serum obtained both from
alcohol-drinking and from non-drinking persons was further
tested by human blood, with the object of discovering whether
any difference in reaction existed between the same immune serum
and the two kinds of human sera above mentioned.

"4. I have studied the problem as to whether the haemolytic
complement in the blood-serum of alcohol-drinking and
non-drinking persons is altered in any way by alcohol.

"5. The bactericidal power of blood-serum from both
alcohol-drinking and non-drinking persons was determined by some
experiments.

"The above experiments have given the following results:

"1. The normal resistance of human red blood-corpuscles appears
to be somewhat diminished against a heterogeneous normal serum
or an immune serum by the consumption of alcohol, provided that
tolerably large equal, or nearly equal, numbers of drinkers and
abstainers of both sexes be examined, and the average of
resistance be taken on both sides: this last-named precaution
being necessary because the resistance of red blood-corpuscles
from different human beings varies largely. The difference is
often greater when using weaker solutions than when using
stronger dilutions of lysin.

"2. These experiments have shown the normal haemolytic power of
human blood-serum to be less in the case of alcohol-drinkers
than in that of abstainers.

"3. The precipitating reaction between a solution of 1 per cent.
human blood-serum and different dilutions of immune serum was
greater in the case of drinkers than in that of abstainers.

"4. These experiments have also shown that the bactericidal
power of blood-serum against typhoid bacteria was less in the
case of drinkers than in that of abstainers.

"It seems clear, therefore, that alcohol, even in comparatively
small doses, exercises a prejudicial effect on the protective
mechanism of the human body."

The lecturer made his points clear by a carefully prepared series of charts. At its close Sir Victor Horsley, Professor Sims Woodhead, A. Pearce Gould, and several other distinguished physicians spoke in high terms of the painstaking care exhibited in the experiments.

Professor Laitinen's second lecture was upon "The Influence of Alcohol Upon Human Offspring." He sent out 15,000 circulars to his countrymen, asking many questions relative to themselves and their infant children, and received 5,845 replies relative to 20,008 children. He also studied personally a large number of drinking and abstaining families. From these studies he shows by careful tables that the drinking of alcohol by parents, even in small quantities, has an injurious influence upon human offspring. His studies in former years showed the same unfavorable influence upon the offspring of animals. One of his tables gives percentages of deaths of children in the homes of abstaining parents, moderate drinkers, and harder drinkers. Children of abstainers dying in the first year, 13.45 per cent.; of moderates, 23.17 per cent.; of harder drinkers, 32.02 per cent. Other tables show that abstainers' children gain in weight more steadily in the first year than drinkers' children, and have their teeth earlier, as a rule.

At the International Medical Congress of 1909, held in Budapest, Professor Laitinen lectured again upon his researches, and summarized his conclusions thus:--

"1. The importance of alcohol as an article of food is rendered
very questionable by recent researches. 2. These researches
prove that alcohol diminishes the natural power of the tissues
to resist injury, promotes degeneration, and has a disastrous
effect on future generations. 3. The questions of relation of
alcoholic liquor to crime and of the manufacture and sale of
such beverages deserve the serious consideration of the
legislature. 4. It is the duty of medical men to direct more
attention than formerly to the alcohol question, and by careful
study to decide whether recent researches are justified or not
in regarding alcohol and alcoholic beverages as a poison and one
of the principal causes of degeneration in the human family;
they ought also to consider whether it would not be advisable in
medical practice, and especially in hospitals, either to banish
it altogether or at least to prescribe it with the same care as
other poisonous drugs. In this matter the attitude taken by
medical men as representatives of public hygiene was of quite
exceptional importance."

Metchnikoff, the illustrious Russian scientist, who has for some years been connected with the Pasteur Institute in Paris, was the discoverer of the work assigned by nature to the white corpuscles of the blood. These blood-cells are the "guardian-cells" of the body, and their duty is to destroy disease germs which may gain an entrance. They actually devour disease germs. Metchnikoff has been studying the effect of alcohol upon these protective cells, and he asserts that alcohol, even in small doses, has a harmful action on these agents of defence against disease. Alcohol seems to paralyze them more or less so that they are unable to do their full duty in destroying the infective microbes. Thus disease germs can multiply more rapidly when alcohol is in the blood. In his book called "The New Hygiene," Metchnikoff suggests that the administration of alcoholic liquors in infectious disease appears to be attended with danger to the patient.

The researches of Kraepelin, Ach, Aschaffenberg and other German scientists have become so well known through the articles by Henry Smith Williams in _McClure's Magazine_ that only brief reference need be made to them here. Kraepelin used very small doses of alcohol for some of his experiments. He found that after 1/4 to 1/2 ounce of alcohol had been taken the time occupied in making response to a signal was slightly shortened, but in a few minutes, in most cases, this quickening action passed and a slowing process began, and continued until the body was free from the influence of the alcohol, which was sometimes four or five hours.

The ability to add figures was tested, and this decreased very rapidly under minute doses of alcohol. Memory tests showed that only 60 figures could be remembered from numbers written in columns after alcohol had been taken, while 100 figures could be remembered correctly when the mind was free from the alcoholic influence. Type-setters were tested, and the average number of errors they made and the amount of work they did in a given time was carefully recorded. After a small dose of alcohol none of the men could in the same time do as much work, or as accurate work. Yet every one of the men experimented upon thought he was doing better work after his drink. This proves the narcotic effect of alcohol.

The economic loss to a people from beer and wine drinking is worthy of serious consideration since a bottle of wine or its equivalent in beer could diminish by ten to fifteen per cent. the amount of work done by these type-setters experimented upon by Professor Aschaffenberg.

Professor Kraepelin says:--

"I must admit that my experiments, extending over more than ten
years, have made me an opponent of alcohol."

He says again:--

"The laborer who wins his livelihood by the working power of his
arm strikes at the very foundation of his power by the use of
alcohol."

Professor Aschaffenberg says of moderate doses:--

"Any quantity of alcohol must be regarded as considerable which
causes a disturbance, even if only transitory, of bodily and
mental efficiency."

Dr. Reid Hunt, chief of the Division of Pharmacology, Hygienic Laboratory, United States Public Health and Marine Hospital Service, made some very interesting experiments to determine the physiological changes upon animals which would result from the strictly moderate use of alcohol. These are described in Bulletin No. 33 of the Hygienic Laboratory, published in 1907. Mice and guinea-pigs were used. The food, usually oats, was soaked in diluted alcohol, at first of five per cent. strength, then gradually increased to forty or fifty per cent. By carefully observing the weight of the mice, and not increasing the strength of the alcohol too rapidly, it was possible to keep the animals for months on this diet without any material loss of weight. After the lapse of weeks, in some cases, and months in other cases, these alcohol fed animals were given small doses of a poison known as acetonitrile. Other mice to whom no alcohol was fed were given similar doses of this poison. In the first series the mice which had received alcohol died from about one-half the quantity of acetonitrile required to kill those which had not received alcohol. In the second series with a somewhat stronger dilution the alcohol mice succumbed to one-half to one-third the dose necessary to kill the non-alcoholized animals. In no case was enough alcohol given for any symptoms of intoxication to appear, nor was there any outward indication of any injury being done by the alcohol. In another experiment a mouse was kept for four months on a diet of oats soaked in water, then 0.5 milligram of acetonitrile per gram body weight was injected. The mouse recovered. It was then fed on oats soaked in an alcoholic solution which was gradually increased to 45 per cent. After a little more than a month of this diet 0.2 milligram acetonitrile per gram body weight proved fatal. The weight of the mouse had remained about the same throughout.

Alcohol increased the susceptibility of the guinea pigs also.

Dr. Hunt says on page 33 of the bulletin:--

"These experiments with alcohol and acetonitrile are of interest
in another connection. The greatest advance in recent years in
our knowledge of the physiological action of alcohol has been
the clear demonstration that alcohol is oxidized in the body,
and may replace fats and carbohydrates and to a certain extent,
the proteids of an ordinary diet. So clear has been this
demonstration that the view that alcohol, in moderate amounts,
should be regarded as a food is almost universally accepted by
physiologists, and the drift of opinion is certainly toward the
view that it is in all respects strictly analogous to sugar and
fats, provided always that the amount used does not exceed that
easily oxidized by the body. Under these premises it would be
expected that alcohol in a diet would have the same effect upon
an animal's susceptibility to acetonitrile as has dextrose, for
example. This is by no means the case, however; on the contrary,
the action of these substances in this regard is entirely
different. Mice fed upon oats soaked in a solution of dextrose
or upon cakes containing considerable dextrose, or upon rice,
show a very distinct increase in their resistance to
acetonitrile; such mice may recover from two or three times the
dose fatal to controls. (Controls are the animals fed in the
ordinary way without alcohol or in this case dextrose.--Ed.)
While these facts are not sufficient to justify the conclusion
that in many cases alcohol has not a true food value, yet they
are sufficient to indicate caution in applying, without further
consideration, the brilliant and very exact results on the
proteid sparing power of alcohol to practical dietaries."

Various other experiments were made, but there is not room here for a record of them.

In the summary Dr. Hunt says:--

"It is believed that these experiments afford clear experimental
evidence for the view that extremely moderate amounts of alcohol
may cause distinct changes in certain physiological functions,
and that these changes may, under certain circumstances, be
injurious to the body. The results also afford further evidence
that in some respects the action of alcohol as a food is
different from that of carbohydrates, and finally that in all
probability certain physiological processes in 'moderate
drinkers' are distinctly different from those in abstainers."

Professor Chittenden, of Yale University, has made extensive researches upon alcohol and digestion. A full report of these may be found in the "Physiological Aspects of the Liquor Problem." In the _Medical News_, vol. 86, page 721, Professor Chittenden says of the theory that alcohol is a food similar to sugar and fats:--

"It is, I think, quite plain that while alcohol in moderate
amounts can be burned in the body, thus serving as food in the
sense that it may be a source of energy, it is quite misleading
to attempt a classification or even comparison of alcohol with
carbohydrates and fats, since, unlike the latter, alcohol has a
most disturbing effect upon the metabolism or oxidation of the
purin compounds of our daily food. Alcohol, therefore, presents
a dangerous side wholly wanting in carbohydrates and fats. The
latter are simply burned up to carbonic acid and water, or are
transformed into glycogen and fat, but alcohol, though more
easily oxidizable, is at all times liable to obstruct, in some
measure at least, the oxidative processes of the liver, and
probably of other tissues also, thereby throwing into the
circulation bodies such as uric acid, which are inimical to
health; a fact which at once tends to draw a distinct line of
demarcation between alcohol and the two non-nitrogeneous
foods--fat and carbohydrate."

Dr. S. P. Beebe, now of the Cornell Medical College Laboratory, New York City, has made some very valuable experiments with alcohol. It is well known that impairment of the functions of certain organs results in the appearance in the urine of nitrogeneous compounds which do not normally occur there. In certain diseases of the liver the same quantity of nitrogen may be excreted as in health, but a portion of it is in the form of acids never found in the urine during health. Dr. Beebe, with this knowledge in mind, sought to discover the effects of alcohol upon the excretion of uric acid in man. Most of the experiments were made on the same person, a young man in good health, of regular habits, unaccustomed to the use of alcohol in any form. Absolute alcohol, diluted with water, whisky, ale, and port wine were used at different times. Dr. Beebe reported his experiments in the _American Journal of Physiology_, vol. 12, No. 1. His conclusions are given as follows:--

"After a consideration of these experiments, it hardly seems
possible to doubt that alcohol, even in what is considered by
the most conservative as a moderate amount, causes an increase
in the excretion of uric acid, and this effect is seen almost
immediately after taking the alcohol. The following points
indicate that the effect is due to a toxic effect on the liver,
thereby interfering with the oxidation of the uric acid derived
from its precursors in the food: Alcohol taken without food
causes no increase. The maximum increase occurs at the same time
after a meal as it does when purin food but no alcohol is taken.
Alcohol is rapidly absorbed and passes at once to the liver, the
organ which has most to do with the metabolism of proteid
cleavage products.

"There is no evidence that the alcohol has merely hastened the
excretion of urates normally present in the blood; the increased
excretion means that a larger quantity has been in circulation,
and although it is classed by Van Noorden among the substances
easily excreted, still most physiologists would consider the
presence in the blood of this larger quantity as undesirable.
Certainly in pathological conditions it might be harmful.

"If we accept the origin of the increased quantity of uric acid
to be in the impaired oxidative powers of the liver, the results
of these experiments will have greater significance than can be
attributed to uric acid alone. For the impaired function would
affect other processes which are normally accomplished by that
organ, and the possibilities for entrance into the general
circulation of toxic substances, of intestinal putrefaction, for
instance, would be increased. The liver performs a large number
of oxidations and syntheses designed to keep toxic substances
from reaching the body tissues, and if alcohol, in the moderate
quantity which caused the increase in uric acid excretion,
impairs its power in this respect, the prevalent ideas regarding
the harmlessness of moderate drinking need revision."

Dr. Winfield S. Hall, professor of physiology at the Northwestern University Medical School, Chicago, has interpreted these researches of Beebe and Hunt in a very striking way. He says that they prove that the oxidation of alcohol in the body is a protective oxidation, the same as the oxidation of any other poisonous substance by the liver. His views have such an important bearing upon the commonly accepted theory that alcohol is in some sense a food that they are given here, somewhat abbreviated, as a fitting finish to this chapter. Dr. Hall says:--

"The fact that alcohol is oxidized in the body has been
generally misunderstood. The first impression naturally was:
'Foods are Oxidized; Alcohol is Oxidized; therefore alcohol is
a food.' But many difficulties appeared. A real food promotes
muscular, glandular and nerve activity, and its oxidation
maintains body temperature. But alcohol disturbs muscular,
glandular, and nervous activity, and its oxidation does not
maintain body temperature. When one eats a real food it is
assimilated largely by muscle tissue and is oxidized for the
purpose of liberating the life energy. When one ingests alcohol
it is carried by the blood to the tissues, mostly to the liver,
where it is oxidized, as any toxine would be, for the purpose of
making it harmless. Its oxidation liberates heat energy but this
energy cannot be utilized by the body even for the maintenance
of body temperature. If a food is defined as a substance which,
taken into the body, is assimilated and used either to build or
repair body structure, or to be oxidized in the tissues to
liberate the energy used by the tissue in its normal activity,
then alcohol is not a real food.

"But, if alcohol is not a real food, what is the significance of
its oxidation? It has been long known that the liver produces
oxidases and that it is the site of active oxidation of
mid-products of katabolism of toxins and of other toxic
substances. Alcohol, usually formed as an excretion of the yeast
plant, is also found as a mid-product of tissue katabolism. On a
priori grounds we should expect alcohol to be oxidized in the
liver along with leucin, tyrosin, uric acid, xanthin bodies, and
various amido bodies. There have recently appeared two most
important papers based upon extended researches upon man and
lower animals. These researches practically clear up this knotty
question."

Dr. Hall then reviews the work of Dr. Reid Hunt and Dr. S. P. Beebe, and continues:--

"The value of this work can hardly be over-estimated. In the
first place the rapid oxidation of the alcohol in the liver is
explained. _Alcohol itself being one of the toxic substances
which reach the liver from the alimentary canal is at once
attacked by the liver, and if the oncoming tide of alcohol is
not too great it will practically all be oxidized._

"But the liver oxidation of other toxic substances is impaired
in the meantime so that they get past the liver to the tissues,
where they may do injury. Some of these toxins are excreted
unoxidized by the kidneys. There are three ways of accounting
for this condition: (1.) The oxidation capacity of the liver is
limited. The physiological limit of alcohol ingestion is that
amount which taxes the oxidation capacity of the liver to its
limit. When thus taxed all other toxic substances including uric
acid and the xanthin bodies pass through the liver unoxidized to
appear in the urine. (2.) The presence of alcohol in the blood,
through its toxic action upon the liver cells, impairs the
hepatic oxidation capacity and thus permits toxic substances to
pass unoxidized. (3.) A combination of these conditions may
represent the real situation. It is hardly conceivable that the
relation of alcohol to the liver activity is not covered in the
hypotheses above formulated.

"We may therefore accept it as practically demonstrated by the
researches of Beebe, Hunt, and others that the oxidation of
alcohol in the liver is simply one of the defensive activities
of that organ, _i. e._, it is a protective oxidation and belongs
strictly in the same category with the oxidation of uric acid,
xanthin bodies, leucin, tyrosins, and the amido acids.

"The next question which arises is, why does the liver select
alcohol first and oxidize that substance to the exclusion of
other toxic substances up to the oxidation capacity? The answer
is probably to be found in the chemical composition of alcohol.

"It oxidizes very easily, much more so than any of the other
toxic substances which gain access to the liver. Its early
oxidation may be due to this fact alone, or in part to an actual
selection on the part of the liver. Another question of
importance: Is the energy liberated in the oxidation of alcohol
in the liver available for the use of the muscles, nervous
system, or glands?

"If this question is answered affirmatively, then alcohol is a
food. If negatively then alcohol is not a food. Let us reason
together. All body oxidations may be classified in two groups:
(1.) _Active oxidations_ which take place in the active
tissues--muscles, nervous system, or glands--and take place
incident to action. It is under the perfect control of the
nervous system and is proportional to normal activity. (2.)
_Protective oxidations_ which take place in the liver. This
class of oxidation processes is wholly independent of the usual
tissue activity and is proportional to the ingestion of toxic
substances and quite independent of muscle action, brain action,
or gland action, other than liver action.

"If the oxidation of alcohol in the liver belongs to class 1,
the following consequences should be found: (1.) The ingestion
of alcohol would lead to an increase in muscular power and in
the working capacity of the brain or glands. (2.) The ingestion
of alcohol would serve to maintain body temperature in the
healthy individual subjected to low external temperature. (3.)
The accession of muscle, brain, or gland activity would be
proportional to the amount of alcohol ingested, but laboratory
observations and general experience show that none of these
things are true; _i. e._, the ingestion of alcohol decreases
muscle, brain, and gland work, and depresses body temperature
when external temperature is low.

"In the nature of the case there can be no proportional
relation. The oxidation of alcohol does not therefore belong to
class 1. If the oxidation of alcohol in the liver belongs to
class 2, the following consequences would be found: (1.) The
ingestion of alcohol would be followed by its early oxidation in
the organs in question. (2.) If the oxidation capacity of the
liver is limited this capacity may be overloaded by exceeding
the physiological limit of alcohol. (3.) If the oxidation
capacity of the liver is taxed nearly to its limit in the
oxidation of uric acid, xanthins, and other toxic substances,
the introduction of alcohol may seriously interfere with this
protective oxidation by overtaxing the capacity. (4.) If the
oxidation capacity is overtaxed, an excess of uric acid,
xanthin bodies, and other toxic substances will get by this
portal and reach the active tissues or the kidneys. Now all of
these things take place, so we are forced to the conclusion that
the oxidation of alcohol is a protective oxidation. In the light
of this presentation the significance of Dr. Hunt's work becomes
very clear. The alcohol given to the animals taxed the oxidation
capacity of the liver to the limit and left the organism
defenseless against bacterial or other toxic substances."