Alcohol differs fundamentally from the other articles of food, albumen, fats, carbohydrates, in so far as it never becomes, either directly or indirectly, an integral part of the organism. The fat of alcohol is to be burned. In process of oxydation it displaces other substances, in particular fat, and prevents their combustion, and it does this in proportion to the caloric value of the two substances. When 9.3 g of alcohol are burned in the body, 7 g of fat less are oxydized than would have been the case if no alcohol had been administered. In other words, alcohol should be a good and useful means of fattening. Unfortunately its toxic properties militate against its extended use. It is unnecessary at the same time to "spill the baby with the bath"; in other words, to withhold small harmless doses, because large doses of alcohol are undoubtedly injurious. One may even occupy the standpoint of total abstinence as a matter of principle on social and ethical grounds and still not deny the therapeutic value of alcohol and hence employ it as a drug. Unfortunately this error is frequently committed by extreme advocates of anti-alcoholism, and objections to the use of alcohol that correspond in no way with scientific facts are frequently formulated by these people.

In fattening cures the use of alcohol is not essential and it may even occasionally be injurious. Everything depends upon the individual peculiarities of the person one is dealing with. In other cases again, one cannot get along without alcohol, unless one wants to dispense from the beginning with a valuable and under certain conditions determining adjuvant to the course of treatment. The caloric value of the alcohol is a minor consideration, for one will rarely give more than 50 g of alcohol per diem, and this amounts to only 350 calories, a very modest sum that can readily be supplied by other means. Only in severe cases of diabetes in which, to judge from my experience, that is being constantly corroborated, larger quantities of alcohol (up to 100 g a day) play an important and life-saving role, does the caloric value of the alcohol administered count. In fattening cures, as a rule, alcohol serves more as a stomachic and a nerve tonic by enabling the patients often, though not invariably, to eat larger quantities of food. It is also a well-known fact, borne out by common experience, that the addition of alcohol to the food aids in the assimilation of the fats. It is too bad that these advantages must be continuously dinned into the ears of temperance advocates.

For the purposes enumerated above very small quantities of alcohol frequently suffice. I prefer wines containing from 15 to 20% of alcohol (so-called dessert wines) given in quantities not to exceed 50 ccm at a time and, in addition, in the evening after the last meal and to end the day with, occasionally a glass of heavy beer containing abundant extractives. A beer of this character, for instance, is Munich Bock beer (Salvator) or English porter. Among the Austrian brands of beer, double malt beer (St. Stefan) is particularly to be recommended. A combination of the extractives of meat with alcohol seems to exercise a particularly favorable influence upon the appetite and hence possesses considerable significance in fattening cures. The refinements of the culinary art have been utilizing this principle for a long time. I mention the addition of Madeira and of other wines to strong meat broths, oxtail soup, mock turtle soup and many sauces. Not only is the taste of these preparations improved thereby, but a stimulating effect upon the appetite is at the same time attained. There are several preparations in the market that utilize this old experience. I mention, for instance, Vial's Tonic Wine, that in addition to meat extractives also contains certain bitter tonics. Erb, who is otherwise no great advocate of alcohol in nervous diseases, praises the importance of this preparation as an adjuvant to the dietetic treatment of neurasthenic individuals. Basing on a recommendation coming from so eminent an authority, I have frequently used this preparation, and can verify that, while introducing relatively small quantities of alcohol, it decidedly fulfills the above purposes.