VIII. Alcohol Absorption

Alcohol is highly diffusible, and is promptly absorbed from mucous surfaces as well as from subcutaneous tissue.

Its effect is always more immediate when taken into an empty stomach. It is then rapidly absorbed, and its influence is exerted suddenly: When there is food in the stomach, some of the alcohol is temporarily taken up by it like water by a sponge, its absorption is delayed, and, since its elimination is quite rapid, the system is less likely to become overcharged with it.

Alcohol is well absorbed from the rectum, and to patients who for any reason are unable to retain it in the stomach it may be given in this manner. For this purpose it is best to use spirits diluted with from one to four parts of water, and an ounce of whisky or brandy should be given for a dose.

Hypodermic Use

Very little alcohol can be made to pass into the body by rubbing it upon the skin, although it is a diffusible substance, but it is very promptly absorbed when injected hypodermic-ally, and where its immediate stimulating effect is required it can be thus sooner obtained. Owing to the local irritant action of alcohol, not over a drachm or two should be placed beneath the skin at any one point, for it is often quite painful. The surface should be rubbed to promote its absorption. In emergency, two or three ounces may be quickly given in this way in divided doses.

IX. Elimination

The questions of what intermediate products may be formed by the splitting up of alcohol in the blood or tissues, of the influence of the combustion of alcohol, and of the combustion of the tissues themselves, involve great difficulties in the way of chemical analysis, and the liabilities to error are considerable. It may be regarded as proved, however, that when taken in moderation alcohol is completely consumed within the body, or so completely that a mere trace escapes in the urine and perspiration, and a little more in the exhaled air. If the dosage of alcohol is very much increased, however, its elimination, unaltered, becomes proportionately active, although it is still consumed in large amount in the body. The excretion of COz by the lungs is lessened.

Alcohol is believed to prevent the elimination of tissue waste under some conditions, and, in spite of the fact that it acts as a diuretic, it may lessen the excretion of urea and uric acid.

X. Alcohol Poisoning

This topic will be more conveniently discussed with the treatment under the heading Alcoholism.

XI. Alcohol And Climate

It is an established fact that climatic conditions exercise an important influence upon the degree to which alcohol influences the system. Many persons find that they can drink more spirits and wine during a prolonged residence in a climate like that of England without apparent ill effect than they can in the more stimulating and bracing climate with greater extremes of temperature which exists in many parts of the United States. If men are to be exposed to cold and hardship for a considerable period of time it is highly unwise for them to indulge freely in alcoholic drinks on account of the rapid fall in the body temperature, which is promoted by the external cold when alcohol relaxes the capillaries. In illustration of this principle, a story is told of a party of engineers who were lost during the winter in the Rocky Mountains, where, after prolonged exposure to cold and hardship, they were one night obliged to sleep without shelter with the thermometer below zero. They had whisky with them and but little food; some of the party drank heavily, others drank in moderation, and a few of the wiser took no alcohol at all.

In the morning the latter awoke, cold but refreshed by the night's rest, while others who drank in moderation were very much more uncomfortable and had suffered far more from the exposure, and one or two of those who had drunk freely were frozen to death.

Otto Snell interrogated sixty expert mountain-climbers, and only five declared that liquor was not injurious if taken before or during their exertions.

In the arctic expeditions of Greely, De Long, and others, although pure alcohol was carried for cooking purposes, very stringent regulations had to be enforced to prevent the men from drinking alcoholic beverages, which were only kept for emergencies and sickness. The northern Eskimos are ignorant of such drinks, having nothing which they can ferment to produce them. On the other hand, the natives of tropical climates are in the habit of distilling many varieties of alcoholic drink from the fermentation of vegetable food.