Use As A Tonic

Very moderate doses of alcohol increase the flow of gastric juice, and for this reason it may be employed with advantage in cases such as the following: 1. By those whose nervous system is readily overtaxed and who when fatigued or worried lose all appetite. 2. By persons of sedentary habits who have greatly enfeebled digestions. 3. In protracted convalescence from severe forms of acute diseases. For any of these patients a mild cocktail, a little whisky and water, or a glass of simple bitters may be ordered to be taken directly before meals in order to improve the "tone " of the stomach. In all cases care should be exercised, especially among persons who may possibly inherit the alcoholic habit, that the beverage be not prescribed too often, for sometimes cases of chronic alcoholism originate among persons who begin by resorting to this food and stimulant to tide them over emergencies such as the above, and who find when the emergency is passed that they are unable to relinquish the acquired fondness for the drink. When troops have been exposed to exhausting service in a hot, humid atmosphere such as that of some of the Philippine Islands they suffer greatly from nervous exhaustion and insomnia.

In such cases, besides an ample ration, the use of from two to four ounces of whisky or other liquor per diem, greatly diluted, appears to be of value as a tonic and digestible food. Writing of this matter, Major Charles E. Woodruff says: "Experience has demonstrated that in a hot climate the moderate use of intoxicating drink is essential to continued health and efficiency".

2. Use As A Vascular And Cardiac Stimulant

If there is general arterial relaxation from debilitating disease, the use of alcohol in proper quantities contracts the vessels and improves the firmness and quality of the pulse to a remarkable degree. Alcohol undoubtedly can be given the first place among the cardiac stimulants, for its combined action in strengthening the heart and regulating the calibre of the blood vessels is most useful. For this purpose it is best to use strong liquors, such as brandy or whisky, which vary but little in composition, and which may be diluted according to need. In all cases of sudden heart failure occasioned by shock, violent haemorrhages, either internal or external, fainting, etc., it is best to give alcohol in the form of diluted spirits.

It is an interesting fact that the mere mechanical action of deglutition stimulates the heart action and increases the rate of pulse beats by fifteen or twenty in the minute. Stimulants sipped slowly by repeated acts of swallowing for this reason alone may have a greater effect than the same quantity of fluid drunk all at once. In extreme emergencies, whether the patient is able to swallow or not - as, for example, in shock from prolonged anaesthesia, or from the use of anaesthetics which are not well tolerated, and in an urgent case when the alcohol is given by hypodermic injection - it may be used undiluted. Its influence in these conditions is almost immediate, and the stimulation of the pulse may be appreciated in two or three minutes. A little more time is required for the full effect if the stimulant is given by the stomach or rectum. The benefit of alcohol is further shown by the tongue and skin becoming more moist, by the slowing of the pulse, and by the breathing becoming more tranquil. Since alcohol regulates arterial tone and brings the pulse to a nearer normal standard, the volume of the pulse is not so important a consideration as is its compressibility as a factor in estimating the value of alcohol in a given case.

The very soft pulse of considerable volume may diminish in volume under the use of alcohol, but it becomes firmer and of better character, showing an improvement in the arterial tone. The rules for observing the effect of alcohol may be definitely applied in almost every case, and the dosage can be regulated accordingly. In acute diseases, such as pneumonia, in which the emergency of cardiac failure or great prostration may be fairly anticipated, it is often better to withhold alcohol until there are definite indications for its use than it is to prescribe it in a routine manner at the commencement of the disease; its effect when actually needed is enhanced if it has not been already given for too long a time. For persons with feeble constitutions, however, and for aged people it may be necessary to commence the use of alcohol at an earlier period. In urgent cases full doses, such as an ounce an hour, may become necessary for a few times, and the quantity and intervals for its administration may then be gradually reduced. Usually when the stimulating and supporting influence of alcohol is urgently needed it is better to give it in quite frequent doses and in moderate quantity than in large amount infrequently.

The stimulation is then more uniform and constant, and the digestive organs are less likely to be deranged.