which take place within the cells of the body, all other steps of nutrition being either antecedent or succedent accessories. The antecedent accessories of nutrition are the preparation of the food, its mastication, its deglutition, its digestion, its absorption, its distribution by the circulatory system, and its selection by the individual cells from the capillaries direct or from the tissue plasma. Physiologists and biologists believe that all foods are built up into protoplasm; that is, they are selected and made part of the living cell. A food must therefore satisfy the following conditions: First, it must be digestible and absorbable by the organism which it is to nourish; second, it must be assimilable by the living cells of the organism, in order to build up new tissue; third, after assimilation it must be capable of catabolic changes accompanied by oxidation, in order to liberate energy; fourth, the energy must be liberated at such a time and place as to be advantageous and beneficial to the organism. It is not enough to prove that potential chemical energy is changed into kinetic energy. The oxidation must take place at the right time and place, before the energy liberated can be useful in function. All food is tissue-building in its assimilation; all food is energy-yielding in its catabolism. The only points alcohol possesses in common with the foods are two: first, it is oxidized within the body; secondly, it diminishes carbonaceous and perhaps proteid catabolism—the so-called "sparing" action of alcohol. This "sparing" is accompanied by an accumulation of the carbonaceous materials of the body and an actual deposit of fat. But this condition is brought about by reducing the activity of the cell by the narcotic effect of the alcohol, and is not in any sense to be compared with the increased demand for food by the cell, resulting from proper mental and physical exercise and all conditions which favour vigorous nutrition. Yet the advocates of alcohol as a food in health base upon their physiological misconceptions a superstructure of fallacious reasoning.
A detailed consideration of the effects of alcohol upon the individual organs and tissues will perhaps elucidate the foregoing statements. Applied to the skin, alcohol excites a sense of heat and superficial inflammation if evaporation be prevented. It coagulates the albumen and hardens the animal textures. If evaporation is not prevented, the surface temperature is reduced. The lining of the mouth is corrugated by it—a result due to the abstraction of water and condensation of the albumen. In the stomach it causes a sensation of warmth which is diffused over the abdomen and quickly followed by a general glow of the body. In moderate quantity, it induces an increased blood-supply which enables the mucous follicles and gastric glands to produce a more abundant secretion of stomach juices. When habitually taken, a gastric catarrh is established with the production of a fluid abnormal both in quantity and quality. The increased blood supply also sets up irritation of the structural framework (connective tissue) of the stomach, resulting in its overgrowth, with the crowding out of the working-cells, which gradually shrink. Alcohol also affects directly the chemistry of the gastric secretion by precipitating the pepsin—a necessary ferment to the digestion of albuminoid food. The abnormal mucus, which is elaborated in great quantity, sets up pathological fermentation in the starchy saccharrine and fatty elements of the food, giving rise to acidity, heartburn, regurgitation of food, and a peculiar retching in the morning.
Alcohol enters the blood with great facility, and probably almost all taken into the stomach passes into the blood from this organ, and goes directly to the liver by way of the portal vein. In the liver, it increases at first the functional activity of the working-cells, and a more abundant production of bile is the result. Frequent stimulation and consequent overaction result in impairment or loss of the proper function of the part, as is the universal law. The liver cells shrink, the structural framework increases in size at first but subsequently contracts, producing the small, nodular, hard liver, to which the term cirrhosis has been applied. Alcohol also diminishes the normal storage of glycogen, leaving less to draw upon when needed by the system during stress. In small doses alcohol increases the action of the heart and the cutaneous circulation; a slight rise of temperature is observed, and all the functions are for the time being more energetically performed. On the nervous system its first effect is to increase the functional activity of the brain; the ideas flow more easily, the senses are more acute, the muscular movements more active. With increased action of the alcohol, the excitement becomes disorderly, the ideas incoherent and rambling, the muscular movements uncontrolled and inco-ordinated. With an excessive quantity, the functions of the cerebrum are suspended, and complete unconsciousness results. By an extension of the poisonous influence to the nervous centres governing respiration and circulation, these functions may cease, and death result. Alcohol has a special affinity for nervous tissue, and as a result chiefly of its direct contact, but partly from its effects on the blood current, the working cells of the brain shrink, the supporting structure hardens, the cerebrospinal fluid, which should act as a protective water-jacket, increases in quantity and exerts injurious pressure, giving the familiar picture of "wet brain" so common in the autopsy room of hospitals caring for large numbers of habitual drunkards. Existing in a less degree, these brain changes are objectively shown in the impaired mental power, the muscular trembling, the shambling gait, and the lack of moral sense of the chronic drinker. Delirium tremens is a variety of alcoholism occurring in some subjects from sudden excess of a periodical kind, in others from a failure of the stomach to dispose, not only of food, but of the accustomed stimulus, and in another group—common in hospitals and jails—to sudden deprivation of liquor in steady drinkers when under confinement for injury or crime. Idiosyncrasy is an important factor in the causation of delirium tremens, as is also the use of alcoholic beverages rich in fusel oil—like the cheaper whiskeys. The long-continued action of alcohol on the nervous system produces many other chronic disorders. Loss of sensation, epilepsy, motor-paralysis, and blindness often result from alcoholic excess. It is probable that if alcohol could be stamped out for a century insanity would shrink in prevalence seventy-five per cent. The best and latest authorities all agree that the action of alcohol upon the nervous system is always that of a narcotic, whether the dose be large or small. On the bodily temperature there is no longer any doubt that alcohol produces a reduction, after the primary and transient sensation of heat has passed away. All northern explorers know that the use of alcohol endangers life through cooling of the body. It is useful, in the form of hot drink, to revive a person who has been exposed to cold, but only after the exposure has ceased. Dr. Parkes, in the Ashantee campaign, found that the fatigue of marching in the tropics is better borne without the aid of a spirit ration. The power of alcohol to diminish muscular work and agility is so well known that athletes rigorously abstain during training, and the records of the prize-ring demonstrate that only the pugilist who has no alliance with alcohol is able to remain in the game.
There is no difference of opinion among physiologists regarding the facts of the action of alcohol in
