Frequent intoxication with alcohol, opium, coca, or haschisch, brings about a structural degeneration of the nerve-material; the consequences of which are to be seen in delirium, softening of the brain, and other forms of general paralysis. "By degrees the nervous centres, especially those on which the particular narcotic used has the most powerful influence, become degraded in structure." A permanent pathological state is thus induced, in which the production of a given narcotic effect is not so easy as in the healthy organism. "A certain quantity of nervous tissue has in fact ceased to fill the rôle of nervous tissue, and there is less of impressible matter upon which the narcotic may operate, and hence it is that the confirmed drunkard, opium-eater, or coquero, requires more and more of his accustomed narcotic to produce the intoxication which he delights in. It is necessary now to saturate his blood to a high degree with the poison, and thus to insure an extensive contact of it with the nervous matter, if he is to enjoy once more the transition from the realities of life to the dreamland, or the pleasant vacuity of mind, which this or the other form of narcotism has hitherto afforded him."40 It is easy to see how this structural degeneration may be produced. It takes a certain time for the nervous system to recover from the effects of each separate narcotic dose; and if a fresh dose is taken before recovery is completed, it is obvious that the diseased condition will by and by be rendered permanent. The entire process of nutrition will adapt itself gradually to this new state of things; and no efficiency of repair will afterward make the nervous system what it was before. It is in this way that the narcotic craving for continually increased doses is originated and kept alive.
In the case of the milder narcotics – tea, coffee and tobacco – this craving, though the symptom of a depraved state of the organism, does not directly demoralize the character. But the moral injury wrought by alcohol, opium and haschisch is known to every one, and the effects of coca-drunkenness are said to be no less frightful. This is because the milder narcotics affect chiefly the medulla, the spinal cord and the sympathetic, while the fiercer ones chiefly affect the cerebrum. Tobacco may paralyze the brain sufficiently to cause nocturnal wakefulness; but it cannot impair one's self-control or one's sense of responsibility. It never transforms a man into a selfish brute, who will beat his wife, neglect his business, and allow his children to starve. Here then we arrive at a supremely interesting distinction. The craving for tobacco is principally a craving of those inferior nerve-centres which exert comparatively little direct influence upon the mental and moral life. But the craving for alcohol is a cerebral craving. The habitual indulgence of it involves a continual suppression of those loftier guiding qualities which, as we have seen, are the later effects of civilization upon the individual character; while the attributes of savagery, the lower sensual passions – our common inheritance from pre-social times – are allowed full play in supplying material for the imagination and in shaping the purposes of life. Mr. Parton's remark, therefore, which is absurd as applied to tobacco, is a profound physiological verity as applied to the narcotic action of alcohol, – it tends to make us think and act like barbarians, for it allies us psychologically with barbarians.
These considerations throw some light upon the way in which chronic narcosis, like other diseases entailing structural derangements, may be transmitted from father to son. As a matter of observation it is known that drunkenness may run through whole families, no less than gout or consumption. Or, like other diseases, it may skip one or two generations and then reappear. It is evident that the children of a drunkard, born after the establishment of nervous degeneration in the father's system, may inherit structural narcosis attended by a latent craving for alcohol. Some unfortunate persons thus seem to be born sots, as others are born lunatics or consumptives.
The hygienic rule in all cases of structural narcosis, whether acquired or inherited, is total abstinence once and always. These unfortunate creatures cannot be temperate, they must therefore be abstinent. As Sainte-Beuve profoundly remarks concerning that ferocious Duke of Burgundy for whom Fénelon wrote his "Télémaque," he was such a wretch that they could not make a man of him, they could only make him a saint: that is, he was got up on such wrong principles that, whether bad or good, he must be somewhat morally lop-sided and abnormal. Just so with those whose nervous systems are impaired by alcohol: we cannot make them healthy men who can take a stimulant glass and want no more, – we can only make them teetotalers.
Those too who have not got themselves into this predicament will do well to remember that there is extreme danger in the common practice of drinking as much as one likes, provided one does not get drunk. "Getting drunk" means paralysis of the cerebral hemispheres; but, as we have seen, paralysis of the cervical sympathetic, shown in flushed face and moist forehead, occurs some time before the more conspicuous symptom. It is a narcotic effect, and must be always avoided, if the narcotic craving is to be kept clear of. Therefore a man who wishes to enjoy alcohol, and reap benefit from it, and be ready at any time to do without it, like any other wholesome aliment, must always keep a long way this side of intoxication. If ten glasses of sherry will make him garrulous, he will do well never to drink more than four.
Before leaving this part of the subject, it may be well to note certain cases, collected by Theodore Parker, of consumptive families, in which those members who were topers did not die of consumption. It appeared that, in certain families whose histories he gave, nearly all those who did not die of consumption were rum-drinkers! And from these data Mr. Parker drew the inference that "intemperate habits (where the man drinks a pure, though coarse and fiery liquor like New England Rum) tend to check the consumptive tendency, though the drunkard, who himself escapes the consequences, may transmit the fatal seed to his children." Mr. Parton, who quotes this, thinks it poor comfort for topers. We doubt if there is any "comfort" to be found in it. It is contrary to all our present science to suppose that consumption can be prevented by narcosis. The prime cause of consumption is defective assimilation: the tissues, from lack of sufficient nerve-stimulus, are incapable of appropriating food. How absurd, therefore, to suppose that narcosis, which impairs the stimulating energy of the nerves, can check an existing tendency to consumption! What the consumptive person needs is stimulus, not paralysis. But it is easy to believe that the same impaired nutrition of the nerves which may in one person end in consumption, may in another person act as a predisposing cause of narcosis. Insanity, consumption, and drunkenness, are diseases which appear to go hand in hand. Dr. Maudsley, in his great work on the "Pathology of Mind," gives instructive tables which show that these three diseases may alternate with each other in the same family for several generations, culminating finally in epilepsy, idiocy, paralysis and impotence, when the family becomes happily extinct. This consanguinity of diseases appears more marked when we extend our view over a certain extensive locality. The figures cited by Gov. Andrew appear to show that both drunkenness and insanity are far more common in New England than in other parts of the Union; and consumption is proverbially the New England disease. We are inclined to suspect, therefore, that in the families mentioned by Mr. Parker, the children inherited structurally defective nervous systems, the consequent symptoms being in one case pulmonary and in another case cerebral.
This, we believe, is all that we need contribute at present to the subject of alcoholic narcosis. It will be seen that in maintaining that the Coming Man will drink wine, we are not recommending that the Coming Man should go to bed drunk. An argument drawn from purely scientific data, when once thoroughly mastered, is likely to be of more avail in checking intemperance than all the "spurts of extravagance" which teetotalers can emit between now and doomsday. Mr. Parton asks, Why have the teetotalers failed? They have failed because they have exaggerated. They have failed because they have not been content with the simple truth. They want the truth, the whole truth, and twice as much as the truth. If they would only hoard up the nervous energy which they expend in making a vain clamour, in order to use it in quietly investigating the character, causes, and conditions of alcoholic drunkenness, they might make out a statement which the world would believe, and by and by act upon. At present the world does not follow them, because it does not believe them. When the zealous aquarian anathematizes a rum-shop, we sympathize with him; but when he rolls up his eyes in holy horror at a glass of lager-bier, we laugh at him. When he says that a quart of raw gin taken at a couple of gulps will kill a man stone-dead, we cheerfully acquiesce. But when he says that the gill of sherry taken at dinner will impair our digestion, render us susceptible to cold, steal away some of our vigour, and muddle our head so that we cannot write an article in the evening, – we can but good-naturedly smile, and try another gill to-morrow.
The stimulant effects of alcohol upon the nervous system are very similar to those of tobacco. Like tobacco, alcohol stimulates the alimentary secretions, slightly quickens and strengthens the pulse, diminishes weariness, cures sleeplessness, puts an end to trembling, calms nervous excitement, retards waste, and facilitates repair. By its antiparalytic action, it checks epilepsy, quiets delirium, and alleviates spasms and clonic convulsions; and in typhoid fever, where excessive waste of the nervous system is supposed to be one of the chief sources of danger, it is used, as we shall presently see, with most signal success. It thus appears, like tobacco, to be in general an economizer of vital energy and an aid to effective nutrition. It also directly assists digestion; but as Mr. Parton thinks it does not do this, we will first quote his opinion, and then see how much it is worth.
"Several experiments have been made with a view to ascertain whether mixing alcohol with the gastric juice increases or lessens its power to decompose food, and the results of all of them point to the conclusion that the alcohol retards the process of decomposition. A little alcohol retards it a little, and much alcohol retards it much. It has been proved by repeated experiment that any portion of alcohol, however small, diminishes the power of the gastric juice to decompose. The digestive fluid has been mixed with wine, beer, whisky, brandy, and alcohol diluted with water, and kept at the temperature of the living body, and the motions of the body imitated during the experiment; but, in every instance, the pure gastric juice was found to be the true and sole digester, and the alcohol a retarder of digestion. This fact, however, required little proof. We are all familiar with alcohol as a preserver, and scarcely need to be reminded that, if alcohol assists digestion at all, it cannot be by assisting decomposition." (p. 64.)
We would give something to know how many readers, outside of the medical profession, may have detected at the first glance the fatal fallacy lurking in this argument. Of its existence Mr. Parton himself is blissfully unconscious. The experiment, no doubt, seems quite complete and conclusive. We have the gastric juice mixed with alcoholic liquor, we have the suitable temperature, and we have an imitation of the motions of the stomach. What more can be desired? We reply, the most important element in the problem is entirely overlooked. It is the old story, – the play of Hamlet with the part of Hamlet left out; and nothing can better illustrate the extreme danger of reasoning confidently from what goes on outside the body to what must go on inside the body. For in order to have made their experiment complete, Mr. Parton's authorities should have manufactured an entire nervous system, as well as a network of blood-vessels through which the alcohol might impart to that nervous system its stimulus. In short, before we can make an artificial digestive apparatus which will work at all like the natural one, we must know how to construct a living human body! In the case before us, the nervous stimulus, ignored by Mr. Parton, is the most essential factor in the whole process. There is no doubt that a given quantity of undiluted gastric juice will usually perform the chemical process of food-transformation more rapidly than an equal quantity of gastric juice which is diluted.41 But there is also no doubt that when we take a small quantity of alcohol into the stomach, the amount of gastric juice is instantly increased. This results from the stimulant action of alcohol both upon the pneumogastric nerves and upon the great splanchnic or visceral branches of the sympathetic. Just as when tobacco is smoked, though probably to a less extent, the gastric secretion is increased; and the motions of the stomach are also increased. This increase in the quantity of the digestive fluid, due to nervous stimulus, is undoubtedly more than sufficient to make up for the alleged impairment of its quality caused by mixing it with a foreign substance. The action of saliva and carbonate of soda supply us with a further illustration. In artificial experiments, like those upon which Mr. Parton relies, alkaline substances are found to retard digestion by neutralizing a portion of the acid of the gastric juice. Yet the alkaline saliva, swallowed with food, does not retard digestion; and Claude Bernard has shown that carbonate of soda actually hastens, to a notable degree, the digestive process. Why is this? It is because these alkalies act as local stimulants upon the lining of the stomach, and thus increase the quantity of gastric juice. It is in this way that common salt, eaten with other food, also facilitates digestion; although salt is a preserver, as well as 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.