There are two official elixirs:

Elixir aromaticum, aromatic elixir (compound spirit of orange, 1.2; syrup, 37.5; alcohol, about 25 per cent., and water to make 100). It is used solely as a flavored vehicle.

Elixir glycyrrhizaeB - aromatic elixir, containing 12 per cent. of fluidextract of glycyrrhiza. It is used solely as a flavoring vehicle. The licorice is incompatible with acids.

In addition to the above, the following mixed drinks are worthy of note:

A highball is whisky diluted with a carbonated water, sometimes with the addition of lemon-peel.

A cocktail is an aromatic or bitter, strongly alcoholic, mixed drink, to be taken before meals as an appetizer. Its basis is usually gin.

A milk-punch is a mixture of sugar, milk, and whisky, served cold. It may have a little nutmeg sprinkled over its surface. Its flavor is improved by a dash of Jamaica rum.

A brandy milk-punch is made with brandy instead of whisky.

An egg-nog is a milk-punch shaken up with an egg and cracked ice, and strained.

It must be borne in mind that most liquid pharmaceutic preparations contain alcohol, and some of them are nearly all alcohol. Many of the nutritive peptone mixtures on the market (panopepton, liquid peptonoids, etc.) owe much of their nutritive value to the 15 or 20 per cent. of alcohol present.

The medicinal dose of a distilled liquor is 4 drams (15 c.c.), that of sherry or port, about twice as much. A sherry-glass holds 1 ounce (30 c.c.).

Pharmacologic Action

Having a great affinity for water and being a coagulant of protein, alcohol tends to irritate and destroy cells. It is, therefore, a general protoplasmic poison. The power to coagulate protoplasm gives alcohol its value as a hardening agent for anatomic specimens.

Micro-Organisms

In the preparation of alcoholic liquors by fermentation it is found that the activity of the yeast life is retarded when the alcohol reaches about 10 per cent. of the liquid, and is completely checked when the alcohol is about 15 per cent. Typhoid bacilli were completely destroyed in twelve hours in a mixture of equal parts of red wine (12 per cent.) and water (Sabrazes and Marcandier). It is evident, therefore, that, when its application is prolonged, alcohol has antiseptic properties. (See table in "Antiseptics.") Harrington and Walker found that a solution of about 70 per cent. strength has a greater germicidal power than stronger solutions. Strong alcohol (60 to 90 per cent.) has been used for the preservation of plant and animal specimens.

Skin

Applied to the skin and allowed to evaporate freely it is cooling, and tends to harden the skin and to check sweating. If not allowed to evaporate, as when covered with flannel or used on a compress, it is counterirritant, producing dilatation of the vessels, with warmth and reddening.

Mucous Membranes And Raw Tissues

To these it is irritant and astringent, for it abstracts water from the superficial cells and coagulates their protoplasm. On account of this, strong liquors for internal use should be well diluted. Hertz says that contact of alcohol with any part of the digestive canal gives rise to a sensation of heat.

Alimentary Tract

A chemic substance possessing such striking solvent powers and affinities requires separate consideration for - (a) Its effects on the chemistry of the contents of the stomach; (b) its effects on the stomach wall; and (c) its effects on the stomach functions. It is well to remember also that its local action depends upon the degree of its dilution, rather than upon the actual amount of alcohol involved.

1. Action On The Chemistry Of The Stomach-Contents

Experiments in vitro indicate that 50 per cent. alcoholic liquids, such as 21 whisky or brandy undiluted, will precipitate the proteins of food, will to some extent precipitate pepsin, and will check the activity of the digestive process. But by alcoholic liquids below 20 per cent. in strength pepsin in solution is not injured, and when the proportion of alcohol present does not exceed 10 per cent., or perhaps even 15 per cent., the effect upon proteins and upon the activity of the digestive ferments in the test-tube is practically negative. Solutions up to 2 per cent. in strength have been shown by Chittenden, Mendel, and Jackson to favor the activity of pepsin digestion.

But with alcohol there is a great difference between the actions in a test-tube and those in the stomach; for in the test-tube the alcoholic strength remains the same throughout the experiment, and the products of digestion are not removed, while in the stomach the products of digestion pass away and the alcohol strength becomes steadily less, owing to dilution with gastric juice and mucus and to absorption of the alcohol. We are safe in saying, therefore, that in the human alimentary tract the influence of moderate quantities of properly diluted alcohol upon the chemic processes of digestion is a negligible factor.

With the alcoholic drinks, however - and it is these and not pure alcohol that are in common use both in therapeutics and as beverages - the other constituents must be taken into consideration. The volatile constituents of wines have been studied by Krantwig and Vogel (Binz), and found to have a pharmacologic action similar to that of alcohol. Their proportion, however, is very small. Chittenden and Mendel have determined that the distilled liquors, which contain the same or similar volatile substances, exert an effect upon the digestive chemistry practically proportional to the amount of their alcohol. Hence if the distilled liquors are diluted to 10 per cent., they have no harmful effect on the chemistry of digestion.

But Chittenden and Mendel found that the wines and malt liquors tend to retard pepsin digestion, even when their alcohol is much below the harmful percentage, so if taken in considerable quantity they are deleterious to digestion. This is because of their organic acids and colloidal constituents, and not because of their alcohol. Red wines, because of their tannic acid, which tends to precipitate protein, have a retarding influence beyond that of white wine.