The fact that it can be proven that only a very limited quantity is retained and replaces or saves other components of food, is not characteristic of a true food, which if not used at once for the production of energy or cell growth is at least stored and in the process undergoes changes in composition. Moreover, food gives strength but alcoholics lessen it at least if more than small quantities are taken. They also interfere with or modify the normal function of organs and lead ultimately to destructive changes in many tissues.

The fact that it does not appear in the excretions of the body when not more than one ounce is taken in a day hardly demonstrates its utility as food. The most recent researches point to its being a poison to protoplasm, but it is probable that this amount may be taken without noticeable impairment. Hutchison1 says: "Alcohol is a protoplasmic poison or anesthetic, but is itself easily burnt up in the body." Because of this effect, he continues," If alcohol gets access to the cell and partially paralyzes or anesthetizes it, the cell will lose its power of breaking down those compounds, such as fat, with which it has, even in a condition of full activity, most difficulty in coping. Alcohol then saves fat from combustion; in other words, it is a fat sparer. It also appears, though with greater difficulty, to be able to spare carbohydrate, but it is exceedingly doubtful whether it is ever able so far to paralyze the cell as to destroy its power of dealing with protein." It exerts much the same influence upon cells generally, interfering with or lessening their normal functions, that it does upon the red blood-corpuscles with whose power to take up and set free oxygen it interferes. It does this by making with hemoglobin a compound that is an inefficient oxygen carrier. Is it not probable that it unites similarly with some cell constituents and modifies their functions? We know that when applied directly to cells it coagulates a part of their albumin, as has been explained of its topical action on mucous membranes.

One ounce of alcohol should yield as much heat by combustion as one ounce of butter - about 200 calories. But practically this is not the result. In 1851, the late N. S. Davis first demonstrated that alcohol lowers temperature. Two factors help to cause this loss. Even small doses dilate the peripheral arterioles, bringing thereby a large amount of hot blood rapidly to the surface of the body, from which radiation quickly takes place. Therefore more rapid radiation of heat is one factor causing a lowered temperature when alcohols are drunk. Considerable doses also lessen oxidation or heat-production. The fact that bodily temperature is thus lowered has caused those who send men into cold regions to forbid the use of alcohol, because it increases greatly their liability to freeze.

1 "Food and the Principles of Diet," page 344, London, 1911.

Alcohol has been advised in fevers as an antipyretic. It has, however, the same mode of action and the same faults as other chemical antipyretics and is less efficient than several of them.

Nor does alcohol increase muscular energy. Experiments with the ergograph and with the dynamometer, as well as the cruder ones that have been so frequently repeated, of having the same work done by two sets of men, alcohol being given to one set only - all demonstrate that more muscular work can be done without it than with it. After a dose of alcohol a man feels that he can lift a great weight, or in other ways exhibit unusual strength, and is surprised to find that he cannot. The subjective error is due to the same interference with the perceptive faculties that permits after-dinner trivialities to pass as weighty utterances. Fatigue is hastened, not delayed, by it.

As alcohol does not modify protein metabolism, it will not materially change the output of urea. Experiments upon this point are conflicting. H. C. Wood, however, believes that it lessens the products of tissue waste. In fevers the albuminoids of the body suffer greatly and they are not proportionally, if at all, protected, by alcohol, as fats, and to a limited extent carbohydrates, are said to be. If alcohol is not taken in sufficient quantity to produce intoxication, only a very small percentage will escape from the body unchanged; but if enough is taken to intoxicate, 10 per cent, or more may do so.

Under the influence of full doses of alcohol the vessels of the brain, like those of the skin, become greatly relaxed and filled with blood. When this change is first produced, the mind seems invigorated. It is generally asserted that mental work is for a time more easily accomplished. This is doubtful. All parts of the brain are not affected with equal quickness or by the same doses. The brain-cells are poisoned or partly paralyzed, the higher ones before the lower. The portion of the brain that is most influenced by external inhibitants or that itself restrains the other portions is first affected. So soon as the normal restraints are lessened, one becomes garrulous, ready to say and to do things that otherwise he would not do or say. The effects thus produced may easily deceive and lead one to think that the mind has been stimulated, when it has only been unchecked. It has been shown that continuous mental work of a high grade cannot be done as well with alcohol as without its influence. Activity of neurons may multiply the trains of association and quicken the succession of images, but the weakening of inhibition prevents concentrated choice. Thus judgment is affected early, while imagination may be left untrammeled. The emotions may be more than usually active. The drinker is easily made combative, affectionate, lachrymose. Moral perception is less keen in the habitual user of alcohol than in others. Mental diseases are often due to it. The motor centers are also easily involved, sometimes even before judgment is materially affected. Speech is made thick, and later the movements of the extremities are unsteady or uncertain. Walking and other movements show imperfect muscular coordination.

It requires very large doses of alcohol to affect the spinal cord. When it is involved, the respiratory center is paralyzed before the heart is. The vasomotor center is, however, early involved. The various portions of the central nervous system are affected in the same order as when ether is administered. They may all be overwhelmed, producing stupor or even death.

Quantities of alcohol not sufficient at any one time to produce intoxication or outwardly visible effects will, if their drinking be habitually repeated, seriously injure the tissues by interfering with oxidation. The brain and nervous system are especially likely to feel the effects. Degenerative changes are excited in these structures. In these, as in all tissues, even if alcohol enters them only in small amounts yet is present constantly or with frequency, the chemical energy of the cells is diminished or changed. The disturbed metabolism leads to fibroid and later, to fatty metamorphosis. The disturbed metabolism of proteins increases or creates a tendency to attacks of gout or to the more chronic or obscure lithemic or alloxuremic disturbances. Sometimes the disturbing influence of alcohol upon carbodydrate decomposition and appropriation aids in the production of diabetes.

Although it is claimed that alcohol when given in small doses, is not eliminated as such, it is well known that all infiammations of the urinary organs are aggravated by it. Those who have been steady, moderate, or heavy drinkers are especially prone to renal diseases. Two or three glasses daily of a beverage containing so small an amount of alcohol as is present in beer will cause casts to appear in the urine. The liver is also especially susceptible to disease when alcoholic drinks are used. The stronger beverages are most likely to affect it.

Individuals vary greatly in their susceptibility to alcohol. Some show ill effects from small doses, and others are seemingly resistant to large ones. Certain persons are stimulated by it to eat more heartily and to do less, and as oxidation goes on more slowly in these persons, they easily accumulate fat. Although plump, they are not resistant to disease, nor capable of prolonged hard work.

Because alcohol is an antiseptic it has been tried as an internal antiseptic in infectious diseases. Experiments have shown, however, that alcohol given to animals lessens their power to resist inoculation with numerous micro-organisms. When given in infectious diseases, no antiseptic influence has been demonstrable.

Alcohol is unnecessary in health, and those who have not strong self-control or who inherit a love of liquor or a tendency to inebriety, to gout, to arteriosclerosis, or to other degenerative changes are better off without it. Many individuals can use it in strict moderation without apparent harm. The majority sooner or later find that even with moderation they are not so well when they use it habitually, and they cease to drink it, or they take it more rarely. The abuse of alcoholic beverages is invariably harmful. The wisdom or unwisdom of the use of alcoholic beverages in health is not a question that the physiologist alone can determine. The ease with which the habit of using them grows to an excess and the injury done thereby to society make the desirability of their use a social problem as well as a physiologic one. This is not, however, the place to discuss the sociologic phase of the subject.

There are drugs that may be substituted for alcohol which are equally potent with the latter for the treatment of the sick. Its use is, therefore, not necessary either in health or in sickness. When prescribed in disease, it must be regarded as a medicine and not as something to be used at will by the patient. As the percentage in all beverages varies greatly, it would seem best, as urged especially by B. W. Richardson and by the late N. S. Davis, to prescribe pure alcohol diluted to the desired strength. Doses can then be regulated with the certainty deemed necessary when other medicines are given. It must be remembered, when in the following pages percentages of alcohol in various beverages are mentioned, that they are averages, the variation in different samples often being considerable.