ALCOHOL AS AN ANTIPYRETIC.

"By the power of alcohol to r.e.t.a.r.d the evolution of heat in r.e.t.a.r.ding molecular changes in the tissues, the liquids containing it may be used as antipyretics when the temperature is too high, and to r.e.t.a.r.d the processes of waste when these are too rapid. But the antipyretic influence of alcohol is so feeble in comparison with the proper application of water to the surface, or with the internal administration of sulphate of quinia, salicylic acid, digitalis, etc. that no one thinks of using it for antipyretic purposes."--Dr. N. S. Davis in _Principles and Practice of Medicine_.

PROFESSOR At.w.a.tER'S CONCLUSIONS UPON ALCOHOL AS A FUEL-FOOD.

In 1899 a decided sensation was caused by the announcement that Prof.

At.w.a.ter, of Middletown, Conn., had proved that alcohol is a fuel-food equal in value to carbohydrates and fats. The study later of Prof.

At.w.a.ter's report of his investigations led to prolonged discussions among medical men interested in the alcohol question, and his theory that alcohol is a food because it is oxidized in the body was vigorously opposed by many scientists of high standing. Professor Abel, of Johns Hopkins University, Baltimore, an investigator of alcohol who worked with the Committee of Fifty, said on this point:--

"Oxidizability cannot be made the measure of usefulness in regard to this substance."

Professor Gruber, president of the Royal Inst.i.tute of Hygiene, Munich, said:--

"Does alcohol truly deserve to be called a food substance?

Obviously, only such substances can be called food material, or be employed for food, as, like alb.u.men, fat, and sugar, exert non-poisonous influence in the amounts in which they reach the blood and must circulate in it in order to nourish * * * *

Although alcohol contributes energy it diminishes working ability. We are not able to find that its energy is turned to account for nerve and muscle work. Very small amounts, whose food value is insignificant, show an injurious effect upon the nervous system."

Sir Victor Horsley, the well-known London surgeon, said:--

"We know that alcohol lowers the temperature of the body. It can only do that by diminishing the activity of the vital processes.

It also diminishes very greatly the power of the muscles, and it diminishes the intellectual power of the nervous system. To call an agent that causes such diminution of activity throughout the whole body a food is ridiculous."

An editorial in the _Journal of the American Medical a.s.sociation_ said:

"The fallacy of the reasoning which would place alcohol among the foods is very apparent when we put it in the form of a syllogism: All foods are oxidized in the body; alcohol is oxidized in the body; therefore alcohol is food. As logically we might say: 'All birds are bilaterally symmetrical; the earthworm is bilaterally symmetrical; therefore the earthworm is a bird.'

Oxidation within the body is simply one of several important properties of food, as bilateral symmetry is one of several important characteristics of a bird."

Schafer's Physiology says:--

"It cannot be doubted that any small production of energy resulting from the oxidation of alcohol is more than counterbalanced by its deleterious influences as a drug upon the tissue elements, and especially upon those of the nervous system."

The _Bulletin_ of the A. M. T. A. for July, 1899, contained an article upon Prof. At.w.a.ter by Dr. J. H. Kellogg, from which the following is taken:--

"Starch, sugar and fats become foods or fuels only through their a.s.similation. Abundant physiological evidence attests that no substance can act as a food, or as a true source of energy, unless it has first entered into the composition of the body. It must be a.s.similated. The forces manifested by the body, the muscular forces, or nervous energy, are the result of the breaking down of organized structure into simpler forms. For example, in the case of nervous energy, material from which nerve energy is derived is stored up in the nerve cell, and can be seen with the microscope in the form of minute granules, which disappear as the cell energy is expended, leaving the cell blank and shriveled when in a state of extreme fatigue from overwork. The same is essentially true of the muscle cell. The source of muscular energy is glycogen, an organized substance which becomes a part of the muscle tissue in a well-nourished muscle in a state of rest.

"Experiments have clearly shown that fat, sugar and starch must all alike be converted into the form of glycogen and enter into the muscle structure before they can become a source of energy.

"Professor At.w.a.ter tells us that alcohol can not form tissue, hence the query is pertinent, How can it be a source of vital energy? The body does not burn food as a stove does fuel. Food can be called fuel only in a highly figurative sense. The oxidation of food in the body does not take place directly. Food is a.s.similated, becoming a part of the tissue. Oxygen is also a.s.similated, entering into the composition of the tissue along with the food elements under the action of special organic ferments brought into play by nervous impulses received from the central ganglia.

"The molecules of these residual tissues which form the storehouse of energy in the body are rearranged in simpler forms, thereby giving up a portion of the energy which holds them together in the state in which they exist in the tissues, and this energy thus set free appears as muscle force, mental activity, glandular work and various other forms of functional activity."

CHAPTER VII.

ALCOHOL IN PHARMACY.

In the _Journal of the American Medical a.s.sociation_ for November 13, 1897, Dr. T. D. Crothers, editor of the _Journal of Inebriety_, says in a paper upon "Concealed Alcohol in Drugs":--

"A very important question has been repeatedly raised, and answered differently by persons who claim to have some expert knowledge. The question is, can strong tinctures of common drugs be given in all cases with safety; tinctures of the various bitters which contain from 10 to 40 per cent. of alcohol, and are used very freely by neurotic and debilitated persons? It is a.s.serted with the most positive convictions that such tinctures are more sought for the narcotic effect of the alcohol than for the drugs themselves.

"In my experience a large number of inebriates who are restored, relapse from the use of these tinctures given for their medicinal effects. * * * * *

"The question is asked, how much alcohol can be used as a solvent in drugs without adding a new force more potent than that which is brought out by the alcohol? Opinions of experts differ. One writer thinks 10 per cent. of alcohol in any drug will, if given any length of time, develop the physiologic effect of alcohol in addition to that of the drug. An English writer says that in some cases a 5 per cent. tincture is dangerous from the alcohol which it contains.

"There is some doubt expressed by many authorities as to the potency of a drug which is covered up in a strong tincture. It is clear that the value of a drug is not enhanced, and it is certain that a new force-producing, or exploding agency, has been added to the body.

"In experience, any drug which contains alcohol can not be given to persons who have previously used it without rousing up the old desire for drink, or at least producing a degree of irritation and excitement that clearly comes from this source.

It is also the experience of persons who are very susceptible to alcohol, that any strong tincture is followed by headache and other symptoms that refer to disturbed nerve centres.

"In many studies I have been surprised at the increased action of drugs when given in other forms than the tincture. Gum and powdered opium, have far more p.r.o.nounced narcotic action than the tincture. Yet the tincture is followed by a more rapid narcotism, but of shorter duration, and attended with more nerve disturbance at the onset.

"I am convinced that a more exact knowledge of the physiologic action of alcohol on the organism will show that its use in drugs as tinctures is dangerous and will be abandoned.

"There are many reasons for believing that its use in proprietary drugs will be punished in the future under what is called the poison act."

Dr. J. J. Ridge published in May, 1893, in the _Medical Pioneer_, the following statement of the pharmacy of the London Temperance Hospital:--

"When the Temperance Hospital was first opened, it became a question of practical importance, what should be done with regard to the alcohol so largely employed as a vehicle and drug excipient. Not that the principle of the treatment of disease without the ordinary administration of alcoholic beverages precludes the employment of alcoholic tinctures, but it was felt that in such a test case as this it was important to obviate the objection that while withholding alcohol as a beverage, it was given in the medicine. As a matter of fact, it is surprising, when one looks into it, how much alcohol is often given merely as a vehicle for other drugs, and without the special action of alcohol being required or desired. In prescriptions which are to be seen in many text-books, it is not uncommon to find from one to two or three, or even four drachms of rectified spirit in the form of tinctures or spirits. This is very undesirable. If alcohol is needed it should be given in proper measured dose.

But if it is not indicated, then it is not well to administer it in this indirect manner.

"Experiments were therefore made, partly at the hospital and specially by Messrs. Southall Bros. & Barclay, of Birmingham, with the result that new non-alcoholic tinctures were made replacing the following alcoholic tinctures and wines:--

Tinct. Aloes.

" Arnicae.

" Aurantii.

" Belladonnae.

" Buchu.

" Calumbae.

" Camph. Co.

" Capsici.

" Cascarillae.

" Catechu.

" Chiratae.

" Cinchonae Co.

" " Flav.

" Cinnamomae.

" Colchici Sem.

" Conii.

" Digitalis.

" Ferri Acet.

" Ferri Perchlor.

" Gentiani Co.

" Hyosciami.

" Kino.

" Krameriae.