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The Pamphlet Collection of Sir Robert Stout: Volume 75

Drink and Disease

Drink and Disease.

In dealing with questions regarding alcohol it is well to stand on firm ground and have some definite standard as a basis for one's inferences and conclusions. To the writer it seems as if at times this matter were not sufficiently attended to, and that its neglect is responsible for the great contrariety of opinion existing on the subject, leading to statements which clearly point to their origin in prejudice or mental bias in either the one direction or its opposite.

A definite standard is taken with reference to the action of all other drugs and the standard is their physiological action, the action, in other words, of the drug on the human body.

There is no reason why this attitude should not be adopted in the case of alcohol, as happily it has been the subject of careful experiment. And indeed if we are to arrive at a scientific, passionless and unprejudiced conception of the matter we must finally refer our questions to the court of observation and experiment.

In the phase of the question "Drink and Disease" as it is placed on your syllabus, there are materials enough of both observation and experiment and there is little hope for an appeal from their results. And I hope to bring in the short time at command some evidence that these results are definite enough.

One question of vital importance, as it defines the line between moderation and immoderation is, How much may a man consume in 24 hours without prejudicial results? This question has been answered by Professor Hammond, of New York, Dr. Parkes, of London, and Professor Fraser, of Edinburgh.

Professor Hammond's experiments were conducted in three series, each series extending over live days, with the view of ascertaining—
1st.the effect of alcohol when the weight of the body was maintained at a nearly uniform standard by a regulated diet, which was at the same time a sufficient one.
2nd.Its effects when the diet was an insufficient one as was proved by loss of bodily weight.
3rd.Its effects when excess of food was taken, the weight of the body during such time increasing.

During these experiments careful attention was paid to all attendant circumstances such as exercise, &c.

The amount used was 1½ ounces of absolute alcohol divided into three portions, and in order to ensure dilution each dose was taken during meals.

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The results arrived at were shortly:—In the first series of experiments—those in which a sufficient diet was taken—there was a slight increase of bodily weight, but at the same time the general health suffered slightly as was manifested by increase in pulse-rate, headache, sensations of heat on the surface of the body, and the mental faculties became less clear, the appetite variable, and there was a general feeling of lassitude and indisposition to work.

In the second series, where the dietary was insufficient, the loss of weight ceased and there was a slight increase above that previously normal, there was an entire absence of bad symptoms, the mental faculties were unimpaired, sleep was sound and refreshing, and the bodily strength was very good and satisfactory.

In the third series, where the increase of weight from the excessive dietary and addition of alcohol was 2lbs. a day, the health became disordered, there was constant headache, sleep was troubled, pulse rapid, bounding and strong, appetite capricious, indisposition to mental fork, and Dr. Hammond's conclusion was that if the experiment had been carried on five days longer his health would have broken down.

Dr. Parkes has shown that a healthy well-fed man undergoing moderate physical exertion was upset by 2 ounces of absolute alcohol a day, and that 1½ ounces were entirely consumed and unattended by any disagreeable result.

But as this man was selected on account of his exceptionally healthy state Professor Fraser is inclined for this reason, and from experiments of his own, to adopt 1 ounce of absolute alcohol as a standard of moderation.

These results seem to the writer of the highest possible value as they fix the standard of moderation which, when overstepped, leads to disease, and the first series of experiments clearly does away once for all with the widely spread statement that alcohol is necessary for everyday life. It is not a necessity and few medical men now would be bund to maintain such a position.

Whether this standard is rigorously adhered to by those who habitually indulge in stimulants is another story. Any excess of this however must lead to a departure from health, and disease may roughly be defined as any departure from health.

The inexorable limits of time preclude any detailed statement of disease produced by the immoderate use of alcohol, and it must be sufficient to say that there is scarcely a page of a medical text book but bears reference to alcohol as either an exciting or a predisposing cause of disease.

The gin drinker's liver may be cited as a type of the irritant results of alcoholism with its gross changes and its concomitant functional derangements, and the same sort of results occur in all the other organs of the body.

These results of immoderation are not disastrous alone on the physical side of the individual but are equally so on the mental side.

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Dr. Mandsley has a striking statement in his book "Responsibility in Mental Disease." He says "If all hereditary causes referring to Insanity were cut off and if the disease were then stamped out for a time it would assuredly soon be created anew by intemperance and other excesses." He gives to a forcible illustration of intemperance in the direct production of insanity, instancing the experience of the Glamorgan County Asylum. During the second half of the year 1871 the admissions of male patients were only 24, whereas they were 47 and 73 in the preceeding and succeeding half-years. During the first quarter of the year 1873 they were 10, whereas they were 21 and 18 in the preceding and succeeding quarters. There was no corresponding difference as regards female admissions. There was however a similar experience at the County Prison, the production of crime as well as insanity being diminished in a striking manner.

Now the interest and instruction of these facts lies in this—that the exceptional periods correspond exactly with the last two "strikes" in the coal and iron industries, in which Glamorganshire is extensively engaged. The decrease was undoubtedly due mainly to the fact that the labourers had no money to spend in drinking and debauchery, that they were sober and temperate by compulsion, the direct result of which was that there was a marked decrease in the production of insanity and crime."

Dr. Mandsley in another place says "There are at least live distinct varieties of mental derangement which own alcoholic intemperance as their direct and efficient cause," and he goes on to add "were men with one consent to give up alcoholic and other excesses, were they to live temperately, soberly and chastely, or which is fundamentally the same thing holily, that is healthily, there can be no doubt that there would soon be a vast diminution in the amount of insanity in the world.

In another book "Body and Mind" Dr. Mandsley writes "Idiocy is mainly a manufactured article, and although we are not always able to tell how it is manufactured, still its important causes are known and are within control. Many cases are distinctly traceable to parental intemperance and excess. Out of 300 idiots in Massachusetts Dr. Howe found as many as 145 to be the offspring of intemperate parents.

Dr. Mandsley elsewhere says, the chain of causation in the production of insanity is frequently drunkenness in the parent, epilepsy in the child and insanity in the grand-child. The iniquities of the fathers are visited upon the children to the third and fourth generation."

Sometimes we hear of the power of alcohol to prevent disease and large quantities have been given especially in those epidemics of microbic origin. Dr. Sirus Woodhead, the Director of the Research Laboratories of the College of Surgeons in London, a recognised authority on these disease germs and all that pertains to them is also a leading spirit in the largely growing Medical Temperance Society, and he speaks with no uncertain sound as to the fallacy of this attitude.

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I have not been able to put my hands on his writings in this respect, but they may be summed up in these lines of Rudyard Kipling—

When the cholera comes, as it will past a doubt,
Keep out of the wet and don't go on the shout,
For the sickness gets in as the liquor dies out,
And it crumples the young British soldier.

There can scarcely be drawn a line of demarcation between accidents and disease if we accept the rough definition that disease is any departure from health, and the writer was at college when the house-surgeon became an abstainer because in comparing notes he found that 9-10ths of the injuries he was called upon to treat were either directly or indirectly due to immoderation in the matter of drink.

The writer is quite conscious of the desultory and somewhat incoherent nature of the foregoing remarks, and must plead as his excuse that in a short time such as this it is impossible to present a full or connective view of such a wide subject as "Drink and Disease." but it has been his aim to bring forward only the highest authorities, whose statements cannot be impeached and to abstain as much as possible from technicalities. Habit in alcoholism as in other eases tolds, and the necessity for such a Convention as this is evidence, and the most superficial observation confirms it, that it is easy for an individual to drift into the breakers and be cast up on shore—a wreck.