Proper Time For Giving Alcoholic Beverages

Whenever an alcoholic beverage is prescribed by the physician, the time at which it is to be given should be explicitly stated, and there should be supervision over the quantity used, depending upon the influence upon appetite and activity of digestion. When needed as a tonic, the beverage should be given either immediately before or in connection with meals, in order that its effect may be modified by that of other foods. There is less fear of establishing a craving for drink if this rule be observed. It is the habit of drinking between meals without definite purpose which is particularly dangerous.

In some cases of neurasthenia, anaemia, etc., it may be advisable to recommend a glass of claret or sherry between the principal meals, in the middle of the morning or afternoon, but even then it should be taken with some article of light and easily digestible food, such as a biscuit or sandwich. The fact that moderate doses of alcohol improve the functional activity of the stomach affords an opportunity for the better digestion of food given in connection with alcohol, which should not be lost by giving the latter alone.

There are some patients having chronic atonic dyspesia and persons with but limited nervous energy for whom it is better to prescribe alcohol half an hour or more before eating in order that its stimulating influence may be felt in the system before the nervous forces are called upon for digestive functions.

Selection Of The Proper Form Of Alcoholic Beverage

In all severe cases in prescribing alcohol it is a rule that the stomach is much less likely to be upset by adhering to a single form of beverage than by making frequent changes. Persons having robust physiques may be able to assimilate several kinds of wines, including champagne, at dinner, followed by liquors and brandy; but these beverages, if taken in such variety without food, will almost invariably derange the stomach, and the unpleasant after-effects which characterise even moderate overindulgence in this respect are usually more decided if a variety of beverages have been used than if only one kind has been taken. The combination of whisky and beer or strong liquors and champagne will promptly disagree with many persons who could take either form of alcohol alone with impunity. In fever the stomach is always temporarily enfeebled, and the importance of adhering to one simple form of alcoholic beverage is emphasised. It may be changed from time to time in conformity with the taste of the patient, but mixtures of beverages should never be given.

With persons who are predisposed to irritating coughs the use of malt liquors sometimes increases the difficulty, whereas strong liquors and wines may prove beneficial. Beer, ale, porter, stout, etc., cannot be drunk by some persons without producing a subsequent feeling of lassitude and drowsiness with headache and suffusion of the face, and yet diluted spirits may be well borne. Some persons find that sherry produces acid dyspepsia, and others find that different sweet wines, such as port, similarly disagree, and in others again they excite attacks of gout. When porter, ale, or stout do not derange the stomach, they may be advantageously used by those who suffer from exhausting discharges or by women who are weakened by prolonged suckling. Alcohol should be emphatically forbidden in all forms of gonorrhoea and syphilis, and a single infringement of this rule may often aggravate the complaint. Some clinicians prefer the use of wines which are well charged with volatile compound ethers as a stimulant for enfeebled heart action and weak digestion.

The use of beer as a beverage for fevers is more common in Continental Europe than in the United States. If there is no tendency to flatulent dyspepsia, it may sometimes be used with advantage in such cases, when it will slake the thirst which is not quenched by other drinks. Passing fashion to some extent influences the variety of alcoholic beverage consumed, as illustrated by the fact that in this country the annual importation of Scotch whisky has lately risen from 30,000 to 100,000 gallons for a single firm. Rum and port are much less drunk than formerly.

As a preventive of drunkenness and the evils of chronic alcoholism, the introduction of the milder malt liquors into this country to partially supersede the use of strong spirits has proved a decided advantage. The total annual consumption of all alcoholic beverages in the United States exceeds one billion gallons. In 1870 the per capita consumption of distilled liquors was 2.07 gallons, and twenty-five years later this fell to 1.12 gallons, whereas during the same period the consumption of malt liquors rose from 5.31 to 14.95 gal-Ions. The consumption of wines has remained at about 0.32 gallon.

The annual per capita consumption of alcoholic beverages in 1900 in several countries as compared with the United States is estimated in gallons as follows:

Beer.

Wine.

Spirits.

England

30.31

0.39

I.02

France

5.1

21.8

I.84

Germany

25.5

1.34

I.84

United States

12.3

0.44

O.84

Italy, France, and Spain grow two thirds of the world's wine, and in France the annual consumption of spirits is only 3.80 litres per capita.

A Committee of Fifty for the Investigation of the Liquor Problem was organised in this country in 1893. The committee consists of eminent jurists, physicians, physiologists, philanthropists, and others, and their object is to collect and study impartial scientific data regarding the consumption of liquor which shall furnish a reliable basis for controlling future legislation in regard to the liquor problem and influence public opinion in regard to its evils. In co-operation with this investigation, Prof. Henry W. Farnam states (in 1899) that "the native-born Americans fall midway, being, as a rule, more addicted to liquor than the Germans and Scandinavians, but less so than the English, Canadians, and Scotch. The coloured race, however, as compared with the white, shows a good record".