Small doses of alcohol may be beneficial, stimulating the secreton of gastric juice and increasing peristalsis. For this reason it has been used when the stomach is weak and is doing its work imperfectly. When the stomach is inflamed, alcoholic beverages aggravate the condition. Certain of them produce acidity, as will be explained later, and are therefore counterin-dicated in many digestive disorders. Intoxicating doses interfere with digestion because of the nervous and vascular depression that they cause. Alcoholic beverages habitually used in generous amounts cause sufficient irritation of the mucous membrane to give rise to the formation of an excess of mucus that, enveloping food particles, prevents the digestive juices from gaining access to them, and, by coating the interior of the stomach, lessens the secretion of gastric juice.

Alcohol is readily absorbed from the stomach. It undergoes no change before being taken into the blood. By the portal vessels it is carried to the liver and thence into the general circulation. When alcohol is absorbed from the stomach, it provokes a counterflow of water from the tissues into that organ four times as great as its own weight.

After absorption into the blood it forms a compound with hemoglobin, which causes that body to part with its oxygen more slowly than is natural. This in part explains the disturbed metabolism that exists after taking alcohol.

Imbibed in small amounts, alcohol causes the heart to beat faster and more forcefully. These effects are often noticeable before the beverage has been absorbed; in that case they are caused reflexly by irritation of the mouth, for they are also produced by sipping other pungent or hot fluids. In the arterioles it causes a muscular relaxation or loss of tone. Because of this the blood flows more readily from the arteries into the veins, blood pressure is lowered, and the heart beats faster. The pulse seems bounding, because in the intervals between the beats it is so completely emptied, the blood flowing rapidly into the capillaries and veins. The pulse is typically dicrotic. The habitual use of alcoholic beverages often produces persistent vascular paralysis. This is seen in the full red capillaries of the cheeks and noses of steady drinkers. Alcohol is often used because of its effects upon heart and blood-vessels. It helps to make the circulation more uniform and the heart beat faster and more effectively if the drug be given when the skin is blanched, the pulse small and hard, and the heart feeble. These conditions are met with in collapse, and occasionally in acute diseases accompanied by intense congestion of viscera, and sometimes in infections.

If alcohol is used under these circumstances, it must be remembered that frequently repeated doses will cause its accumulation, when its sedative effects upon the nervous system will show themselves. A large dose is also counterindicated for the same reason. The so-called cardiac stimulation of alcohol is of short duration and not well maintained, either in those accustomed to its use or in others to whom it is given repeatedly in full doses. There are other medicaments capable of producing similar results, and that by constant repetition, do not produce sedation. When the effect of alcohol upon the heart has worn off, the latter beats less vigorously and more slowly than at first; in other words, its stimulation of the heart is followed by a period of depression. The heart has been known to stop suddenly when a pint of whisky or more was drunk at once. This is probably due to strong reflex action produced by irritating the mouth, gullet, and stomach. From the fact that depression follows stimulation it is evident that alcohol does not act as a food to the heart muscle, but as a spur or stimulant. This stimulant effect is obtained only from small doses. Large ones directly depress and paralyze the heart. Very large ones cause it to dilate.

The habitual use of alcohol makes the heart actually beat faster than is natural. For instance, according to B. W. Richardson, one ounce of alcohol daily will increase its beats 430, two ounces 1872, four ounces 12,960, six ounces 30,670. This makes the heart do much more work than it does when alcohol is not taken. That a period of unnatural enfeeblement should follow its use is not, therefore, surprising, especially as it does not feed the heart.

There is much discussion as to whether or not alcohol is a food. If a food is defined as anything that can be decomposed in the tissues and eliminated in a form different from that in which it enters, alcohol is a food. The inadequacy of this definition is self-evident. Water is a most valuable food, yet it is not decomposed, but eliminated as ingested. Many poisons are decomposed, at least in part, in the body, as most foods are. If food is defined as a body that contributes to the growth of cells or their multiplication, and to the generation of heat and energy by them, it is very questionable if alcohol can be classed as a food. When limited amounts, not exceeding one or one and a half ounces a day, are taken in small doses at a time, it seems to be decomposed by the tissues and does not appear in the exhalations from the lungs or skin or in the urine. This would suggest that it has a food value. Its effect upon heat and energy production will be referred to later. Hammond found that when he was upon an insufficient diet and was losing weight, the addition of a little alcohol made him gain. This also suggests its having a food value. The calorimetric experiment of Atwater points to its having a limited food value. For three days he measured the number of calories produced by a man on non-alcoholic diet in the calorimeter. For the next three days he made similar observations upon the man but substituted an isodynamic quantity of alcohol for an equivalent amount of carbohydrate and found the resultant in calories in both instances was the same within a small fraction of 1 per cent. But if alcohol is taken generously or in large quantities most of it escapes through the lungs, skin and kidneys without being utilized in the body. It is often, although not uniformly, noticed that habitual drinkers put on flesh. This does not, however, demonstrate that the alcohol has entered into the structure of cells in a beneficial way. It modifies oxidation processes, prevents the complete utilization of foods, and causes a retention of fats and some waste-products in the system.