Beer and ale are fermented liquors made from malted grain, hops and other bitter substances being added. Ale is produced by rapid fermentation, in which the yeast rises to the surface, and beer is the product of slow fermentation in cool cellars, the yeast falling to the bottom. Hence the name lager-beer. Porter embraces the qualities of beer and ale, and is so named on account of its strong quality, which endeared it to porters.

Composition

The proportion of alcohol varies somewhat. In Edinburgh ale it amounts to about six per cent; in brown stout, to six per cent; in porter, to four per cent; in beer, two to three per cent. Besides alcohol and water, these malt liquors contain extract of malt, five to fourteen per cent; carbonic acid, 0·16 to 0·60 per cent. In the extract are found also various aromatic substances, lactic acid, potash and soda salts, etc.

Physiological Actions

So far as the alcohol is concerned, beer, ale, and porter correspond in physiological actions to the spirituous liquors and to wines. As they contain malt extract, their nutritive value is greater than spirits and wine. An important constituent, the hop, being an aromatic bitter, the tonic and stomachic qualities of these malt liquors are also greater than their congeners. The process of fermentation, however, lessens in a remarkable degree the nutritive and stomachic qualities of the constituents which enter into the composition of malt liquors. Their value as foods is much exaggerated by the habitual consumers. They increase the appetite and favor the deposition of fat. Although the malt beverages do not cause to anything like the same extent the alterations in the nervous centers produced by the spirituous, they induce other and almost as important structural changes. They set up in the organism fatty degeneration of various tissues, notably of the liver and heart. The habitual beer-consumer is known by his obesity, his flushed face, embarrassed breathing, puffy hands, yellow conjunctiva, etc.; he is usually short-lived, and the end is reached by hepatic and cardiac disorders. It is certainly true that a moderate amount of beer may be taken daily, for a lifetime, without any obvious impairment of the functions; but excessive use produces with great certainty the unfavorable effects above described.

Therapy

Beer, ale, and porter are not usually prescribed in acute maladies. They are, however, much and justly esteemed as stomachic tonics and restoratives in chronic wasting diseases—for example, in convalescence from acute diseases and surgical injuries, in cases of profuse and protracted suppuration, prolonged lactation, diseases of the joints, scrofula, phthisis, etc. Strumpf finds, however, that alcoholic beverages only increase the amount of fat in milk, and not the quantity of milk as a whole.

The malt liquors are harmful in all stomach-disorders with acidity, and in chronic affections of the liver, especially fatty liver. When these beverages do not improve the appetite, when they cause a sense of epigastric oppression, and when they coat the tongue, they are not beneficial.

When wakefulness is due to cerebral anaemia, a glass of beer or ale at bedtime will frequently produce satisfactory sleep. Puerperal mania, delirium tremens, and acute maniacal delirium, when these symptoms coexist with a condition of adynamia, are greatly benefited by the liberal use of ale (pale or Edinburgh ale). The effect of this remedy is to arouse the appetite, to quiet delirium, and to produce sleep. In melancholia, excellent results are often obtained by the use of porter with a little tincture of opium.