Speaking of diseases of the liver, Dr. Trotter said in his _Essay on Drunkenness_:--

"The chronic species is not a painful disease; it is slow in its progress, and frequently gives no alarm, till some incurable affection is the consequence. Hence, the fallacy and danger of judging merely by the feelings of the beneficial effects of the use of intoxicating drinks; for the liver and stomach may be seriously diseased, while a man imagines himself in moderate health."

Hardening of the liver, or "hob-nailed" liver, is said to be the result, largely, of taking liquor upon an empty stomach. Dr. E. Chenery, of Boston, in his excellent book, _Facts for the Millions_, tells of a patient of his who was well up to the evening before, when he went out and drank with some companions, taking the liquor on an empty stomach.

That night, vomiting and pain in the right side came on, with high fever. Headache began and increased, followed by delirium and a general jaundiced condition. He died as a result. The disease was acute inflammation of the liver, brought on by the one broadside of alcohol poured "point blank" into the organ.

Dr. Chenery says further on in the same book:--

"There is another disorder of a very serious nature which science is now laying at the doors of the liver--_diabetes mellitus_, or sugar in the urine. Till quite recently, this formidable affection has been regarded as having its seat in the kidneys; and it is so cla.s.sified in medical writings. Later researches, however, show that the sugar has been formed in the economy before it reaches the kidneys, and that these organs act only as strainers with respect to it, removing it from the blood as they remove salt and various other substances. In seeking for the fountain-head of diabetic sugar, it is found that the liver is the great glycogenic, or sugar-originating factory of the body. In an ordinary state of health this substance is produced in just the proper amount for the uses for which it is intended, so that it is all disposed of in the organism, and does not pa.s.s off by the kidneys. If any cause interrupts the processes by which the sugar is consumed, while its manufacture goes on normally, there will come to be an over-supply of sugar in the blood, which, when it reaches 3 parts to 1,000 of the blood, will begin to pa.s.s off by the kidneys and appear in the urine.

On the other hand, if an undue amount of it is formed, the consumption remaining normal, it will also acc.u.mulate in the circulation, and be eliminated by the kidneys. In either case we have diabetes, the sugar irritating and diseasing the kidneys as it pa.s.ses."

Dr. Harley, of the Royal Society of London, has made the subject of alcohol and diabetes matter for considerable study. He says a small quant.i.ty only of alcohol injected into the portal (liver) circulation of healthy animals will cause diabetic urine.

"If any one doubt the truth of the a.s.sertion that alcohol causes diabetes, let him select a case of that form of the disease arising from excessive formation, and after having carefully estimated the daily amount of sugar eliminated by the patient, allow him to drink a few gla.s.ses of wine, and watch the result.

He will soon find the ingestion of the liquor is followed by an increase of sugar. If alcoholics increase the amount of saccharine matter in the urine of the diabetic, we can easily understand how their excessive use may induce the disease in individuals _predisposed_ to it."--DR. HARLEY.

Some physicians claim that in jaundice and certain other bilious disorders even medicines prepared in alcohol are decidedly prejudicial and aggravating.

Dr. J. H. Kellogg, and other writers draw attention to the effects of alcohol in hindering the liver in its duty of destroying the toxic substances generated within the system of a sick person by the specific microbes to which the disease owes its origin, saying that the activity of the liver in destroying these poisons is one of the physiologic processes which stand between the patient and death.

The more this question is studied the more apparent is it that, other things being equal, the sick person who is cared for by a non-alcoholic physician has a much better chance of recovery than the one dosed by "a brandy doctor."

EFFECTS OF ALCOHOL UPON THE KIDNEYS.

"The kidneys, being the chief organs for the excretion of nitrogen waste, are among the most important organs of the body.

Any defect in their healthy activity leads to serious interference with the working of many organs, due to the acc.u.mulation in the body of nitrogenous waste products. If both kidneys be cut out of an animal, it dies in a few hours from blood-poisoning, due to the acc.u.mulation of waste poisonous substances which the kidneys should have got rid of. Serious kidney-disease amounts to pretty much the same thing as cutting out the organs, since they are of little use if not healthy. It is always fatal if not checked, and often kills in a short time.

The things which most frequently cause kidney disease are undue exposure to cold, and indulgence in alcoholic drinks."--Martin's _Human Body_.

"The kidneys are supplied with arterial blood, which, having given up water, urea, salt, and certain other substances, either secreted or simply strained from it, returns to the kidneys nearly as bright and fresh as when it entered them. While the lungs are concerned in removing carbonic acid--the ashes of the furnace--it is the peculiar province of the kidneys to remove the products of the wear and tear of the bodily machinery--the wasted nerve and muscle--in the form of urea, or other crystallizable substances, the presence of which in the economy for any considerable time is attended with disastrous results.

"Now, nature has put these organs, charged with so important work, as far away as possible from any source of irritation.

Could alcohol get as direct access to them as to the liver, there is no doubt that their function would be destroyed almost at once, since the change in arterial blood by alcohol is much more extensive and damaging than that wrought in such venous blood as the liver receives from the portal veins. Thus while the liver takes the alcohol immediately from the alimentary ca.n.a.l, the kidneys receive it only after it has pa.s.sed through the liver, the heart, the lungs, and the heart again; by which time much of it has escaped, while the remainder has been greatly diluted by the blood of the general circulation; yet coming to the kidneys even so considerably diluted, it has power to congest, irritate, and excite them to the excretion of an unusual amount of the watery elements of the urine, as if to wash the irritant away.

"But it is only the watery element that is increased, not the urea, which is the substance representing the waste of vital action, and is a poison to the system; this it is the special office of the kidneys to remove. Not only does alcohol not increase its elimination, but actually lessens the discharge.

And should the irritation of the spirit continue, or be augmented in force, inflammation would follow, and the excretion of urea nearly or entirely cease and life be in the greatest jeopardy. Relief or death then must speedily follow."--Dr. E.

Chenery, of Boston, in _Alcohol Inside Out_.

"Alcohol causes kidney-disease in several ways. In the first place it unduly excites the activity of the organs. Next, by impeding oxidation it interferes with the proper preparation of nitrogen wastes: they are brought to the kidneys in an unfit state for removal, and injure those organs. Third, when more than a small quant.i.ty of alcohol is taken, some of it is pa.s.sed out of the body unchanged, through the kidneys, and injures their substance. The kidney-disease most commonly produced by alcohol is one kind of "Bright's disease," so called from the physician who first described it. The connective tissue of the organ grows in excess, and the true excreting kidney-substance dwindles away. At last the organ becomes quite unable to do its work, and death results.

"The three most common causes of Bright's disease are an acute illness, as scarlet fever, of which it is a frequent result; sudden exposure to cold when warm (this often drives blood in excessive quant.i.ty from the skin to internal organs, and leads to kidney-disease); and the habitual drinking of alcoholic liquids."--Dr. Newell Martin in _The Human Body_.

"Every physician knows or should know, that the quant.i.ty and quality of the effete, or waste, material separated from the blood by the kidneys and voided in the urine, is such as to render a knowledge of the action of any remedy or drink on the function of these organs, of the greatest importance in the treatment of all diseases, and especially those of an acute febrile character. As was long since demonstrated by clinical observation, and more recently by patient and accurate experiments by Bouchard and others, the amount of toxic, or poisonous, material naturally separated from the blood by the kidneys and pa.s.sed out in the urine is so great that if wholly retained by failure of the kidneys to act for two or three days, speedy death ensues. Equally familiar to every observing physician is the fact that in all the acute febrile and inflammatory diseases, not only is the quant.i.ty of the urine secreted generally diminished, but its quality or const.i.tuency is also changed to a greater degree than even its quant.i.ty.

Thus, some of the more important const.i.tuents are increased, others diminished, and often new or foreign elements are found present, all resulting from the disordered metabolic processes taking place throughout the system during the progress of these diseases.

"It is, therefore, hardly necessary to remind the physician that it is of the greatest importance to know as correctly as possible both the direct and the indirect influence of every medicine or drink on the action of the kidneys and all other eliminating organs and structures, lest he unwittingly allow the use of such as may not only r.e.t.a.r.d the elimination of the specific causes of disease, but also favor auto-intoxication by r.e.t.a.r.ding the elimination of the natural elements of excretion.

"That the presence of alcohol in the living system positively lessens the reception and internal distribution of oxygen, and consequently r.e.t.a.r.ds the oxidation processes of disa.s.similation by which the various products for excretion are perfected and their elimination facilitated, is so fully demonstrated, both by observation and experiment, as no longer to admit of doubt.

"As nearly all the toxic elements of urine are the results of these oxidation processes, the presence of alcohol in the system could hardly fail to interfere with them in a notable degree.

"The direct and somewhat extensive series of experiments inst.i.tuted by Glazer, as published in the _Deut. Med.

Wochensch._, Leipsic, Oct. 22, 1891, demonstrated this, as shown by the following conclusions:--'Alcohol, in even relatively moderate quant.i.ties, irritates the kidneys, so that the exudation of leucocytes and the formation of cylindrical casts may occur. It also produces an unusual amount of uric acid crystals and oxalates, due to the modified tissue changes produced by the alcohol. The effect of a single act of over-indulgence in alcohol does not last more than thirty-six hours, but it is c.u.mulative under continued use.'

"Dr. Chittenden kept several dogs under the influence of alcohol eight or ten days, and found it to increase the amount of uric acid in their urine more than 100 per cent. above the normal proportion.

"Mohilansky, house-physician to Mana.s.sein's clinic, in the conclusions drawn from his interesting experiments on fifteen young men to determine the effects of alcohol on the metabolic processes generally, stated that 'it does not possess any diuretic action: but rather tends to inhibit the elimination of water by the kidneys.' It is further stated that this result is owing to the coincident effect of diminished systemic oxidation and of blood pressure.

"On the other hand, several observers have reported that the flow of urine was increased by the use of alcohol. From as full an examination of the subject as I have been able to make, it appears that the diverse results obtained have depended upon the previous habits of those experimented on, and the widely varying quant.i.ties of water drank with the alcohol. When the alcohol is taken with large quant.i.ties of water, as is usual with those who use beer and fermented drinks generally, the total amount of urine pa.s.sed is usually increased, but not more than is found to result from taking the same quant.i.ty of water without any alcohol. When alcoholic drinks are taken by those already habituated to its use, it has less marked effect on the quant.i.ty and quality of the urine than when taken by those who had previously been total abstainers. This was ill.u.s.trated by the experiments of Mohilansky on the fifteen men, some of whom were habitual drinkers, some occasional drinkers, and others total abstainers. When all were subjected to the same diet and drinks, with alcohol, in two the daily amount of urine voided remained unaltered, in five it was increased seven per cent., and in eight it decreased twelve per cent. But whatever may be the variations in the mere quant.i.ty of urine voided under the influence of alcohol, the alterations in quality pretty uniformly show an increase in the products of imperfect internal metamorphosis or oxidation, such as uric acid, oxalates, casts, leucocytes, alb.u.men and pota.s.sium, with less of the normal products, as urea and salts of sodium.

"During the past year I have met with three cases in which the regular daily use of alcoholic drinks for several months, in quant.i.ties not sufficient to produce intoxication, had so altered the blood, and the renal function, that the urine contained both casts and alb.u.men, and some degree of oedema was observable in the face and extremities. These changes were so marked as to justify a diagnosis of incipient nephritis, or Bright's disease. Yet after totally abstaining from the use of alcoholic drinks and remedies, and taking such vasomotor tonics as strychnine and digitalis, with a regulated diet and fresh air, they completely recovered.

"When it is remembered that in diphtheria, pneumonia and typhoid fever, the acute diseases in which a large part of the profession administer most freely alcoholic remedies, the function of the kidney is altered in almost the same direction as are found to take place under the influence of alcohol, it should certainly cause every pract.i.tioner to pause and critically review the pathological basis on which he has been prescribing. An anaesthetic, like alcohol, may certainly render a patient with diphtheria, pneumonia or typhoid fever more quiet, and cause him to say he feels better, but if it at the same time diminishes the internal distribution of oxygen, r.e.t.a.r.ds the oxidation and elimination of waste and toxic products through the kidneys and lungs, and lessens vasomotor force, it cannot fail to protract the duration of disease, and increase the ratio of mortality."--Dr. N. S. Davis, _A. M. T. A. Quarterly_, April, 1894.

Dr. J. H. Kellogg, by a series of carefully executed experiments, conclusively demonstrated that alcohol hinders the elimination of poisonous matter by the kidneys. This property of alcohol is one of the objections which he sees to its use as a medicine. He says:--

"Water applied externally stimulates elimination by the pores of the skin, and employed freely internally by water drinking, and enemas to be retained for absorption, aids liver and kidney activity. If the patient dies it is because his liver and kidneys have failed to destroy and eliminate the poisons generated with sufficient rapidity to prevent their producing fatal mischief in the body."

CHAPTER VI.

ALCOHOL AS A MEDICINE.

Although nearly all of the foremost scientific investigators of the effects of alcohol upon the body have lost faith in the old views of the usefulness of alcoholic liquors as remedial agencies a considerable proportion of the medical profession do not seem yet to have learned how to treat disease without recourse to the alcohol therapy. This is largely due to the fact that the new thought has not yet crystallized to any large extent in the medical text-books, and also to the widely variant views held by professors of medicine.

The medical use of alcohol has been, and still is, the great bulwark of the liquor traffic. The user of alcoholics as beverages always excuses himself, if hard pressed by abstainers, upon the ground that they must be of service or doctors would not recommend them so frequently. In all prohibitory amendment, and no-license campaigns, the cry of "Useful as Medicine" has been the hardest for temperance workers to meet, for they have felt that they had to admit the statement as true, knowing nothing to the contrary. Indeed, thousands of those who advocate the prohibition of the sale of liquor as a beverage, use alcohol in some form quite freely as medicine, and are as determined and earnest in defence of their favorite "tipple" as any old toper could well be. Many use it in the guise of cordials, tonics, bitters, restoratives and the thousand and one nostrums guaranteed to cure all ills to which human flesh is heir.

The wide-spread belief in the necessity and efficacy of alcoholics as remedies is the greatest hindrance to the success of the temperance cause. It is impossible to convince the ma.s.s of the people that what is life-giving as medicine can be death-dealing as beverage. The two stand, or fall, together. Hence there is no more important question before the medical profession, and the people generally, than that of the action of alcohol in disease, and, as a goodly number of the most distinguished and successful physicians of Europe and America declare it to be harmful rather than helpful, it behooves thoughtful people to carefully study the reasons they a.s.sign for holding such an opinion. Certainly it is true that if physicians and people would all adopt the views of the advocates of non-alcoholic medication the temperance problem would be solved, and the greatest source of disease, crime, pauperism, insanity and misery would be driven from the face of the earth.

To understand the arguments advanced in favor of non-alcoholic medication it is needful to make some study of the effects of alcohol upon the body, and of the purposes for which alcoholics are prescribed medically.

_Alcohol is used in sickness as a food, when solid foods cannot be a.s.similated, "to support" or sustain, the vitality; it is used as a stimulant, a tonic, a sedative or narcotic, an anti-spasmodic, an antiseptic and antipyretic; it is used in combination with other drugs, in tinctures and in pharmacy._ It is not wonderful that the people esteem it above all other drugs, for none other is so variously and so generally employed. Those who discard it as a remedy teach that only in human delusions is it a food or a stimulant, and for the other uses to which it is put, outside of pharmacy, there are different agents which may be more satisfactorily employed.

IS ALCOHOL FOOD?

So well agreed are all the scientific investigators that alcohol has no appreciable food value that it would seem foolish to spend time upon a discussion of alcohol as food were it not that the idea of its "supporting the vitality" in disease, in some mysterious way is deeply rooted in the professional, as well as the popular mind.

_Foods are substances which, when taken into the body, undergo change by the process of digestion; they give strength and heat and force; they build up the tissues of the body, and make blood; and they induce healthy, normal action of all the bodily functions._

Alcohol does none of these. It undergoes no change in the stomach, but is rapidly absorbed and mixed with the blood, and has been discovered hours after its ingestion in the brain, blood and tissues, unchanged alcohol. In many of the experiments made with it upon animals, considerable quant.i.ties of the amount swallowed were recovered from the excretions of the body, without any change having taken place in its composition. This, of itself, is sufficient evidence to show that it is a substance which the body does not recognize as a food.