The nervous system consists of a sort of hierarchy of centres, of which the highest subserve the highest functions of mind - reason and judgment - and the lowest (in immediate connexion with the non-nervous tissues) the more purely organic functions, such as muscular contraction and secretion.

In this hierarchy each level is in some degree dominated by that next above it, all levels below the highest being thus in some measure under the control of the highest. Now, speaking generally, it is found that the susceptibility of the various levels to the action of alcohol is in direct proportion to their hierarchal rank, the highest (psychic) centres being the most readily, the lowest (organic) centres, such as those presiding over the functions of the heart and the voluntary muscles, the least readily, affected. Thus we find that alcohol very early affects the mental activities. When the supreme psychic centres are in unrestrained activity, the emotional nature is under fullest control, and least apt to dominate thought and action; then it is that mental vision is clearest, judgment keenest. Alcohol, by weakening the sway of the highest centres and allowing the emotional nature to assert itself, blurs the judgment. When a man indulges in it his ideas may flow more readily, his tongue be loosened, and there may be a show of brilliancy, but it is brilliancy of the spurious and superficial kind, appraised at its true value by severely sober companions and often by his own cooler judgment the following day. The successful man of business does not act on judgments formed under the influence of the convivial glass, but is careful to check them subsequently by the cold, clear light of undrugged reason.

The alcoholized individual is apt to form an exaggerated estimate of his own powers, and on this account we must not too readily accept the opinion of people as to the effect of alcohol on their working capacity. They may be under the impression that alcohol increases their capacity for muscle and brain work when all the time it is actually having an opposite effect.

It is largely because alcohol relaxes the control over the emotions that its so-called "stimulant" action is due. If we define a stimulant as that which unlocks pent-up energy and renders it available for use, then alcohol may be said to act as a stimulant when it arouses the combative instinct and incites to acts of violence; but it should be noticed that in this case the liberated energy is misdirected - not turned to useful account - and being, moreover, followed by a period of reaction, we have scarcely here to do with a genuine instance of stimulation.

It is now, indeed, generally admitted that the action of alcohol is sedative and narcotic rather than stimulant. Its power to soothe is well shown in the case of the jaded and irritable brain-worker and in the muttering delirium of typhoid fever. Alcohol may, however, act as a genuine cardiac stimulant in fainting, while its effect is certainly stimulant in many cases of general debility with feeble digestion, in which it operates essentially by improving digestion.

We have seen that the highest psychic centres exercise control over the lower. There are occasions when it is good to relax somewhat this inhibitory influence. Some people, be it from natural temperament or as the result of deliberate self-repression, suffer from an excess of psychic inhibition, always reining themselves in, never "letting themselves go," as we say. An occasional relaxation of control may in such cases be of benefit. It may be brought about by congenial social intercourse, by going away for a holiday, when many a man casts off his habitual reserve and surprises his friends by his unwonted geniality, or again by recourse to alcohol, under the influence of which the most reserved natures will sometimes expand astonishingly. We are naturally chary in recommending alcohol for the purpose of diminishing psychic inhibition, but it cannot be denied that a little stimulant may sometimes do real good in this way. Take such a case as the following : A sensitive, retiring, self-conscious, and somewhat taciturn man loses, after a couple of glasses of champagne, all his self-consciousness and becomes the life and soul of his party. We cannot, of course, advise a man of this type habitually to indulge in alcohol in order to break down his excessive reserve, but it must be admitted that the condition of mind induced by it in him, and which finds expression in joyous-ness and the abundant flow of pleasing thoughts, is yet, though certainly not that in which the intellect is most discriminating, in many respects superior to his habitual mental state. Such a case is interesting to us because it raises the question whether those who are naturally vivacious and chatty may not owe their mental temperament to the habitual presence in the blood of substances so far similar to alcohol as to be productive of similar results.

The Aphorism In Vino Veritas is only partly correct. True, alcohol by weakening restraint allows many potential characteristics to reveal themselves, but if the real man is to be estimated by all his psychic potentialities, by all the emotions, thoughts, and acts of which he is capable under drug influence, then assuredly none of us would see salvation. Rather should we take the measure of the man when his will has undisputed sway and when the baser part of him slumbers in the depths of his unconscious being.

V. Kraepelin has submitted the influence of alcohol on mental operations to a variety of ingenious tests. He finds that even a moderate quantity interferes with mentation (e.g. with the rate of arithmetical calculation), that it causes a lengthening of the reaction time (i.e. the period intervening between the occurrence of a stimulus, such as the disclosure of an object to vision or the sounding a bell, and the voluntary response to that stimulus), and that it renders less precise movements requiring delicate manipulation, such as those employed in playing musical instruments, billiards, golf, or in shooting. Thus it has been shown that compositors can work more rapidly without alcohol than with it, although when under its influence they may themselves be firmly convinced that they are getting through more work than they could without it.

This is the place to consider the part played by alcohol in the causation of insanity. In asylum reports, inebriety easily heads the list among the causes stated, and most authorities regard it as responsible for at least 20 per cent of all cases of insanity; some go so far as to attribute to it, directly or indirectly, 50 per cent of them. There can be no doubt that alcoholism, on account of the poverty which it entails and the syphilis which follows in its wake, is indirectly responsible for a large amount of insanity, but recent researches tend to show that its role as the direct cause has been over-estimated. Mott has noticed that while on the one hand the insane but rarely exhibit the tissue degeneration of the drunkard, on the other their minds are often peculiarly susceptible to the influence of alcohol, many pillars of society imbibing with apparent impunity an amount which would make the susceptible raving lunatics. It would appear, therefore, that those whose insanity is attributable to alcohol are by nature predisposed to insanity, and that they are so organized that a very small quantity of the drug suffices to upset their mental balance : many of this class would no doubt have become insane, even had they never tasted a drop of intoxicating liquor. That chronic alcoholism of a pronounced kind is not per se greatly productive of insanity is borne out, we think, by daily experience. Among the large number of inveterate inebriates one meets in the ordinary social way, how many, we would ask, become insane? We ourselves cannot recall a single instance. The chronic alcoholic certainly degenerates mentally : his memory fails, he becomes suspicious and untruthful (largely on account of his defective memory and his inability to visualize his mental images clearly); he loses self-respect and will-power, or at least will-power directed to virtuous purpose, for he often displays abundant strength of will in gaining his own drunken ends - but he only exceptionally becomes insane.

Persons afflicted with so-called alcoholic insanity can, then, only in exceptional cases be described as genuine inebriates : it is rare for them to indulge in large quantities of alcohol. On the other hand, there is a class of congenital inebriates who readily take to alcohol but who do not become insane. Indeed, so high an authority as Dr. Branthwaite, His Majesty's Inspector under the Inebriates' Act, maintains that the sot becomes a sot essentially because he possesses a defective nervous organization, either congenitally or as the result of shock or illness, and that the normally constituted person rarely takes to drink. Alcohol, he contends, is, in fact, an effective test of soundness of nervous organization, and the circumstance that so many of our hardest workers and profoundest thinkers partake of it liberally without becoming drunkards is ipso facto evidence of the stability of their nervous systems. We accept Dr. Branthwaite's dictum if stated thus : a person who under average exposure to temptation becomes a drunkard is probably defective as regards his nervous system. This qualification seems needful, for assuredly the large percentage of drunkenness among publicans and potmen is due to excess of temptation rather than of proclivity.

Nor even among those who become drunkards under an average exposure to temptation must we overlook the influence of the personal liking for alcohol, which liking has no necessary relation to unsoundness of nervous constitution. For though an inordinate love of alcohol is probably strongest among nervous degenerates, persons of sound nervous constitution may have it, and we can conceive of its leading such occasionally into intemperance, just as, on the other hand, pronounced degenerates often remain sober under ordinary temptation simply because alcohol has no special attraction for them.