We have seen that alcohol through its action on the nervous system interferes with the accurate performance of delicate movements. Here we have to consider its influence on the muscles themselves - on the capacity of the muscle-machine to perform work. Does the taking of alcohol increase that capacity? Can a man, e.g. do more brickmaking or platelaying, or can a soldier march better, with alcohol than without it? This question can be answered definitely. It has been proved incontestably that while the taking of alcohol may doubtless, by its action on the nervous system, lead to a temporary spurt in muscular activity, it reduces the total daily output of work, and the fact is so well recognized by employers of labour that when it is urgently necessary to get the maximum of work out of their men, they do their best to keep alcohol from them. When, e.g. the gauge of the Great Western Railway had to be altered within the short time of 24 hours the contractors were careful to take this precaution. The testimony of experienced generals, again, is unanimous against allowing alcohol to the soldier on campaign, and their opinion is confirmed by that of Sir Frederick Treves : "As a work producer alcohol is exceedingly extravagant, and like all other extravagant measures, leads to physical bankruptcy. It is also curious that troops cannot work or march on alcohol. I was, as you know, with the relief column that moved on Lady-smith, and of course it was an exceedingly trying time by reason of the hot weather. In that enormous column of 30,000, the first who dropped out were not the tall men, or the short men, or the big men, or the little men - they were the drinkers, and they dropped out as clearly as if they had been labelled with a big letter on their backs".
Such experiences prepare us for the conclusion that alcohol should be avoided by the athlete in training. Professor Wood-head, himself in his day a noted athlete, is emphatic on this point. That all, however, do not share his view is shown by the fact that the University crews while in training are allowed a limited quantity.
What constitutes a moderate quantity of alcohol? - It is very necessary to define what we mean by "moderation" in regard to alcohol, for the term is an elastic one and susceptible of widely different interpretations. Presumably the physician means by a moderate quantity of alcohol one which is harmless. Hence the important question we have to decide is - What constitutes the maximum daily amount that can be taken without injury? Is it, say, two wineglasses of whisky, or their equivalent? Or is it some smaller quantity? At best this question can only be answered approximately. Even if we had at our command - which we have not - the data to furnish an answer to it, that answer could not state a rigidly fixed amount.
It would not suffice to say, categorically, that exactly so much alcohol is the maximum daily quantity that this, that, or any man can take with impunity. Our answer must take into account a number of points. For example, alcohol acts much more injuriously on the sedentary than on those leading an active outdoor life. Again, the effects of alcoholic drinks depend largely upon the kind of beverage consumed; malt liquors, wines, spirits, all have their peculiar effects, effects which cannot accurately be measured by the mere amount of alcohol they contain. Moreover, the effects of these various drinks vary with their quality. Three glasses of a well matured whisky are less injurious than one glass of the raw spirit, and several glasses of good old port than a single glass of adulterated stuff. Finally, the important factor of idiosyncrasy has to be reckoned with. Some people are made ill by even moderate quantities of alcohol in any form, and the wiser among them soon get to recognize the fact; on the other hand, there are those who can imbibe quite large quantities with apparent impunity. We meet with men of fourscore years and upwards who continue to take their daily bottle of champagne or port, and although most, if not all, of them would probably enjoy better health on a less liberal allowance, it is evident that they belong to a class which is peculiarly tolerant of alcohol. Thus it is clear that, even if we possessed accurate data regarding the effects of alcoholic drinks on health and longevity, the term "moderate drinking" does not admit of a rigid definition applicable to all. We cannot say, for instance, that one glass of whisky, or a pint of ale, or two glasses of port, even supposing them to be of sound quality, will constitute moderation for all alike, seeing that one person may be intolerant of all of these drinks, another may be intolerant of the port but not of the champagne, a third may tolerate port and champagne, but not ale, and a fourth may be able to take all three alone, or combined, and yet seemingly remain quite well. Our definition must therefore be couched in some such terms as the following : A moderate daily allowance of alcoholic drink for any given person is the maximum quantity (or any quantity below this) of such alcoholic drink as best suits him that can be taken without producing any appreciable harm.
This definition is, however, of little use for practical purposes, because very few people will take the trouble to test whether the alcohol they take is doing them harm. It should be remembered that our feelings are not a safe guide in this connexion, and that even though a person may claim to feel perfectly well while drinking alcohol, his tissues may all the time be undergoing insidious injury.
The only available method of estimating what constitutes the harmless maximum is by studying the influence of alcohol on length of life. Obviously the harmless maximum, as judged by this test, is the largest daily quantity of alcohol which can be taken without shortening life. That the inordinate consumption of alcohol shortens life is well known : no Insurance Company will accept the life of a confirmed drunkard. Insurance tables show that the average expectancy of total abstainers is considerably greater than that of non-abstainers, and many offices insure the latter at a reduced premium. We cannot, however, draw any conclusion from this as to the influence on length of life of the strictly moderate indulgence in alcohol, for many of those who are insured as non-abstainers but who regard themselves as moderate drinkers, certainly take very much more than is good for them - perhaps three-quarters of a bottle of whisky, or its equivalent, daily. It has to be remembered that nothing short of unmistakable inebriety would, so far as alcohol is concerned, be considered a bar to the acceptance of a life, and further that not a few who are strictly temperate when first insured subsequently drift into excess. It is evident that what we want is a comparison between total abstainers and strictly moderate drinkers.
An eminent physician, many years medical adviser to an Insurance Company, assures us that at its offices the greatest care is taken not to accept the lives of any non-abstainers but the most severely temperate, and that in spite of this the mortality of the total abstainers is found to be considerably below that of the temperate drinkers. This shows that what is regarded as strictly temperate drinking tends to shorten life, but it gives us no indication of what constitutes the harmless maximum for the average individual.
One way of discovering this would be for some Insurance Company to split up the insurable non-abstainers into two classes - the moderate and the very moderate drinkers, and then to compare the mortality of the two. Of course in order to carry out this experiment successfully, the term "very moderate drinker," would have to be accurately defined, those insuring under this head having to guarantee, say, never to take more than one glass of sound whisky, or its equivalent, daily.1