Alcohol and Man: The Effects of Alcohol on Man in Health and Disease
Edited by Haven Emerson, M.D. JNew York: The Macmillan Company, 1932. Pp. 451. $3.50.
This book has been, greatly needed for a long time and its publication is especially timely. It represents the marshalling, by a group of scientists, of facts concerning alcohol, presented as objectively as possible and with conclusions as circumspect as possible. The plan of the book is moreover admirably adapted for reaching independent conclusions by analytical and conscientious readers. Basic facts in the physiology and pharmacology of alcohol are first presented. Its effects when used in excess are then discussed both specifically and as a predisposing factor in the production of pathologic processes. This is followed by a very important and authoritative discussion of its psychological effects on the individual, presented both in a personal and in a social setting. Finally, the relation between alcohol and longevity and the problem of alcohol from a community health standpoint are considered. Most of the contributors are authorities in this particular field and nearly all the contributions are written clearly and systematically. Duplication of subject matter has to some extent been unavoidable. Probably the most interesting and valuable feature of the presentation has been the conscious effort made by the various contributors to emphasize in their discussions the effects of small doses of alcohol, inasmuch as they correctly feel that the character of such effects constitutes the debatable and presumably unsettled aspects of the problem. It is generally agreed that the results of the taking of large doses are harmful.
A surprising unanimity in the conclusions is apparent as the various sections are read. Such unanimity, it would seem, is inevitable if one reads the basic chapters on the physiological and pharmacological action of this substance. It is indeed gratifying that a group of men, scientifically trained and minded, can come to such fairly uniform conclusions on such fairly uniform evidence. To paraphrase the expression of one of the contributors, men will, whatever their bias, listen at some time or other to the evidence at hand, and possibly act on the evidence presented. The most vital conclusion is that for the most part the effects of even small doses of alcohol are harmful. It is shown that, even in small doses, it is a depressant of nervous tissues, that it has a deleterious effect on motor control, that it handicaps the learning and memory processes, that it has a detrimental effect on the ability to discriminate and concentrate and that it clouds perception. “While most of it is oxidized in the body, these depressant effects limit its otherwise non-specific value as a source of energy. It apparently has no influence on the utilization of foodstuffs. Taken in excess it may so undermine an individual’s constitution as to lessen his chances of overcoming some infectious diseases, though there is no evidence that it predisposes to the likelihood of contracting these diseases. A definite chronic inflammation of the stomach follows its prolonged abuse, but its position in producing other specific pathologic conditions seems to be merely contributory. Perhaps only in the sections on therapeutics does one find the greatest residuum of impressions unaffected by controlled objective findings. It is asserted here “that as therapeutic agents alcoholic beverages have a place in rendering more comfortable and peaceful the disturbances of chronic disease and old age.” But here too, it will be noted, the findings are not in opposition to those previously mentioned. They merely constitute an instance in which a desirable subjective effect is sought in otherwise irremediable conditions. It would seem therefore, in conclusion, from the evidence presented that the usefulness of alcohol as a drug or food is at the present time decidedly limited. It may have some useful functions, among which the most important are as an unimportant source of energy, as a sedative in some chronic diseases and in old age, and as a tonic to stimulate appetite in convalescence. Other effects, though in some instances exhilarating and sought after, are from an ultimate personal and social standpoint harmful. The general high level of the contributions is worthy of additional mention. Especially outstanding is the section on the “Psychological Effects of Alcohol on Man” by Walter R. Miles and the section “Alcohol as a Psychiatric Problem” by Adolph Meyer. The latter contribution is a masterful and comprehensive treatment of this exceedingly complex and important problem.
D. R. Meranze, M.D. Mt. Sinai Hospital, Philadelphia
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