IS ALCOHOL A STIMULANT?
A lady asked her family physician several years ago what he thought of the views of those medical writers who class alcohol as a narcotic, and not a stimulant. He answered with some heat, “Any one who says alcohol is not a stimulant is either a fool or a knave!” He could not have been aware that some of the most distinguished professors in American medical colleges teach that alcohol is not, properly speaking, a stimulant, but a narcotic.
The accepted definition of a stimulant in medical literature is some agent capable of exciting or increasing vital activity as a whole, or the natural activity of some one structure or organ.
Dr. N. S. Davis has said repeatedly that both clinical and experimental observations show that alcohol directly diminishes the functional activity of all nerve structures, pre-eminently those of respiration and circulation, thus decreasing the internal distribution of oxygen, which is nature’s own special exciter of all vital action.
“Consequently it is antagonistic to all true stimulants or remedies capable of increasing vital activity. Instead, therefore, of meriting the name of stimulant, alcohol should be designated and used only as an anæsthetic and sedative, or depressor of vital activity.”
The following is taken from an editorial article in the American Medical Temperance Quarterly for January, 1894:—
“Drs. Sidney Ringer and H. Sainsbury in a carefully executed series of experiments on the isolated heart of the frog, found that all the alcohol when mixed with the blood circulating through the heart, uniformly diminished the action of that organ in direct proportion to the quantity of alcohol used, until complete paralysis was induced. In closing their report in regard to the action of different alcohols, they say that ‘by their direct action on the cardiac tissue these drugs are clearly paralyzant, and that this appears to be the case from the outset, no stage of increased force of contraction preceding.’
“Professor Martin, while in connection with the Johns Hopkins University, performed an equally careful series of experiments in regard to the action of ethylic, or ordinary alcohol, directly on the cardiac structures of the dog, and with the same results. He makes the following explicit statement of the results obtained by him. ‘Blood containing one-fourth per cent. by volume, that is two and a half parts per 1000 of absolute alcohol, almost invariably diminishes, within a minute, the work done by the heart; blood containing one-half per cent. always diminishes it, and may even bring the amount pumped out by the left ventricle to so small a quantity that it is not sufficient to supply the coronary arteries.’
“In 1883, R. Dubois, by direct experimenting upon animals, found that the presence of alcohol in the blood much intensified the action of chloroform and thereby rendered a much less dose fatal.
“Prof. H. C. Wood of the University of Pennsylvania, in an address upon Anæsthesia to the Tenth International Medical Congress, of Berlin, in 1890, said: ‘In my own experiments with alcohol, an eighty per cent. fluid was used largely diluted with water. The amount injected into the jugular vein varied in the different experiments from 5 to 20 c. c.; and in no case have I been able to detect any increase in the size of the pulse or in the arterial pressure produced by alcohol, when the heart was failing during advanced chloroform anæsthesia. On the other hand, on several occasions, the larger amounts of alcohol apparently greatly increased the rapidity of the fall of arterial pressure, and aided materially in extinguishing the pulse.
“Sir Henry Thompson says: ‘That alcohol is an anæsthetic and paralyzant is a fact too well established to be questioned or contradicted.’
“Dr. J. J. Ridge, of London, has published elaborate tables, showing that even small doses of alcohol, averaging one tablespoonful of spirits—not quite half a wineglass of claret or champagne, and not quite a quarter of a pint of ale—impair vision, feeling, and sensibility to weight, without the subject’s being conscious of any alteration. Dr. Scougal, of New York, has repeated and confirmed these experiments, and also demonstrated that the hearing was similarly affected.
“Drs. Nichol and Mossop, of Edinburgh, conducted a series of experiments on each other, examining the eye by means of the ophthalmoscope while the system was under the influence of various drugs. They found that the nerves controlling the delicate blood-vessels of the retina were paralyzed by a dose of about a tablespoonful of brandy.
“Dr. T. D. Crothers, of Hartford, Conn., has deduced some valuable facts from his experiments with the sphygmograph, upon the action of the heart. He has found by repeated experiments that while alcohol apparently increases the force and volume of the heart’s action, the irregular tracings of the sphygmograph show that the real vital force is diminished, and hence its apparent stimulating power is deceptive.”—Extract from the Annual Address before the Medical Temperance Association at San Francisco, Cal., June 8, 1894, by Dr. I. N. Quimby, of Jersey City, N. J.
Dr. J. H. Kellogg, of Battle Creek, Mich., has made extensive experiments as to the effects of alcohol. In summing up the results of these he says:—
“It would seem that no further evidence could be required that alcohol is a narcotic and an anæsthetic, rather than a stimulant, and that its use as a supporting and tonic remedy is a practice without foundation in either scientific theory or natural clinical experience.”
Sir B. W. Richardson at a medical breakfast in London in 1895, stated that though alcohol produced an increase in the motion of the heart it was ultimately weaker in its action, so he resolved to give up using such an agent.
Dr. A. B. Palmer of the University of Michigan prepared a “Report” upon alcohol in 1885 for the Michigan State Medical Society in which he cited experiments showing that the opinion that alcohol stimulates the heart by an increase of real force, is an error. It creates a flutter, but decreases power.
“Increased frequency of pulsation is often the strongest evidence of diminished power—as the fluttering pulse of extreme weakness.”
He classes alcohol with chloroform.
“If chloroform is a narcotic, alcohol is a narcotic. If chloroform is an anæsthetic, alcohol is an anæsthetic. If one is essentially a depressing agent, so is the other. Their strong resemblance no one can question. The chief difference is that the alcoholic narcosis is longer continued, and its secondary effects are more severe.”
In closing his summary of the changes in scientific knowledge of this drug he says:—
“We said it was a direct heart exciter. We now know it is a direct heart depressor. We said, and nearly all the text-books still say, it is a direct cardiac stimulant. We know from most conclusive experiments it is a direct cardiac paralyzant.”
The following is taken from one of the many excellent papers upon alcohol written by that Nestor among physicians, Dr. N. S. Davis:—
“Alcoholics are very generally prescribed in that weakness of the heart sometimes met with in low forms of fever and in the advanced stage of other acute diseases. It is claimed that these agents are capable of strengthening and sustaining the action of the heart under the circumstances just named, and also under the first depressing influence of severe shock.
“There is nothing in the ascertained physiological action of alcohol on the human system, as developed by a wide range of experimental investigation, to sustain this claim. I have used the sphygmograph and every other available means for testing experimentally the effects of alcohol upon the action of the heart and blood-vessels generally, but have failed in every instance to get proof of any increased force of cardiac action.
“The first and very transient effect is generally increased frequency of beat, followed immediately by dilatation of the peripheral vessels from impaired vasomotor sensibility, and the same unsteady or wavy sphygmographic tracing as is given in typhoid fever, and which is usually regarded as evidence of cardiac debility. Turning from the field of experimentation to the sick-room, my search for evidences of the power of alcohol to sustain the force of the heart, or in any way to strengthen the patient has been equally unsuccessful. I was educated and entered upon the practice of medicine at a time when alcoholic drinks were universally regarded as stimulating and beat-producing, and commenced their use without prejudice or preconceived notions. But the first ten years of direct clinical or practical observation satisfied me fully of the incorrectness of those views, and very nearly banished the use of these agents from my list of remedies. While it is true that during the last thirty years I have not prescribed for internal use the aggregate amount of one quart of any kind of fermented or distilled drinks, either in private or hospital practice, yet I have continued to have abundant opportunity for observing the effects of these agents as given by others with whom I have been in council; and simple truth compels me to say that I have never yet seen a case in which the use of alcoholic drinks either increased the force of the heart’s action or strengthened the patient beyond the first thirty minutes after it was swallowed. * * * * *
“Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of patient and friends something must be done. A little wine or brandy is given, and, as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither wine nor brandy had been used.”
In the Medical Pioneer of November, 1895, Prof. E. MacDowel Cosgrave, Professor of Biology, Royal College of Surgeons in Ireland, says:—
“The result of all recent investigation is to show that the use of alcohol when a stimulant effect is desired, is an error; and that, from first to last alcohol acts as a narcotic.”
Dr. Edmunds, of London, said in an address given in Manchester:—
“By giving alcohol as a stimulant in exhausting diseases, I believe we always do as we should in giving a dose of opiumand brandy and water to comfort a half suffocated patient; i. e., increase his danger. If that be so, we reduce alcohol not only from the position of food medicine, but we reduce it from the position of a goad; and we say that the supposititious stimulating or goading influence of alcohol is a mere delusion; that in fact alcohol always lessens the power of the patients, and always damages their chance of recovery, when it is a question of their getting through exhausting diseases.”
Many more such quotations might be adduced. Enough are given to show that the popular use of alcohol, when a stimulant is required, is considered a grave error by those who have most thoroughly studied the effects of this drug.
