Alcohol: A Dangerous and Unnecessary Medicine, How and Why

“If alcohol had become a candidate for recognition years ago instead of centuries ago it is safe to say that its application in medicine would have been very much more limited than we find it at the present time. Its wide therapeutic use is to be attributed in part to fallacies and misconception regarding its pharmacology, and in part to a disinclination on the part of the average practitioner of medicine to depart from old and well-beaten lines.” – Winfield S. Hall, M. D., Professor of Physiology, Northwestern University Medical School, Chicago.

“In its relation to the human system, alcohol is never constructive and always destructive.” – Prof. Frank Woodbury, M. D., Philadelphia, Pa.

“The clinicians who decide for the deleterious action of alcohol in infectious conditions have what evidence of an experimental nature we possess at the present time to support their impressions. The advocates of the continuous use of the drug have this evidence against them.” – Henry F. Hewes, M. D., Harvard Medical School, Boston, Mass.

“I am very glad that you are undertaking so important a work as this in connection with the terrible problem of alcoholism. Physicians need awakening in this matter; they need reform. The evil results of alcohol are unfortunately brought to my notice each day of my life as I pursue my vocation and my public duties as Health Officer, and a reform in prescribing so as to eliminate alcohol would undoubtedly have far-reaching beneficent effects.” – Edward von Adelung, M. D., Health Officer, Oakland, Cal.

“I am forwarding you a report of 303 cases of typhoid fever treated without alcohol, and my reasons for not using it. I believe the results will not suffer by comparison with those obtained in other hospitals where alcohol is used. Wishing you lasting success in your war upon the greatest evil of the times.” – J. H. Landis, M. D., Cincinnati, O.

“Only precise evidence that it (alcohol) is able to protect albumen from destruction can warrant its employment and establish its value as a food in the sick diet. And this evidence which is of determinative importance must be looked upon as having failed, according to the recent investigations of Stammreich and Miura (who both worked under von Noorden’s direction), as well as by Schmidt, Schöneseiffen and Roseman. The uniform result of all these experiments, arrived at by altogether different methods, is that alcohol does not possess albumen sparing power; that it even brings about an undoubted breaking down of albumen, and consequently it is entirely unequal to carbohydrates and fat.” – Dr. Julian Marcuse, a contributing editor of Die Heilkunde, a German medical magazine. See issue of July, 1900.

“Thirty years ago the general principle of practice was stimulation. Alcohol was supposed to rouse up and support vital forces in disease. Twenty-three years ago the first practical denial was put into a permanent position in a public hospital in London, where alcohol was seldom or never used. * * * Doctor Richardson’s researches showing the anæsthetic nature of alcohol have had a great influence in changing medical practice in England. * * * On the Continent a number of scientific workers have published researches confirming Doctor Richardson’s conclusions, and bringing out other facts as to the action of alcohol on the brain and nervous system. These papers and the discussions which followed have been slowly working their way into the laboratory and hospital, and have been tested and found correct, materially changing current opinions, and creating great doubts of the value of alcohol.

“In 1896, the prosecution of Doctor Hirschfeld, a Magdeburg physician, in the German courts, for not using alcohol in a case of septicemia, seemed to be the central point for a new demonstration of the danger of the use of alcohol in medicine. Doctor Hirschfeld was acquitted on the testimony of a large number of leading physicians from the large hospitals and universities of Europe. It was proved that alcohol was not a remedy which was specifically required in any disease; also that its value was most seriously questioned as a general remedy by many able men, and its substitution was practical and literal in most cases. Statistics were presented proving that alcohol was dangerous, and never a safe remedy, and laboratory investigations confirming and explaining its action were given. Since then a sharp reaction has been going on in Europe, and alcohol is rapidly declining and passing away as a common remedy.

“Doctor Frick, an eminent teacher of medicine in Zurich, Switzerland, and Doctor von Speyer, of the University of Berne, have made statistical studies of cases treated with and without alcohol, and have analyzed the effects of spirits as medicinal agents to check and antagonize disease, and assert very positively, that alcohol is a dangerous and exceedingly doubtful remedy. Doctor Meyer, of the University of Gottenburg, Doctor Möbius, of Leipsic, and Doctor Wehberg, of Dusseldorf, are equally prominent physicians who have taken the same position, and are equally emphatic in their denunciations of the current beliefs concerning alcohol in medicine.” —Journal A. M. A., January 6, 1900.

Dr. H. D. Didama, Dean of the Medical College of Syracuse University, Syracuse, N. Y., said in January, 1898, in the Voice: —

“For many years after my graduation at Albany, in 1846, I prescribed alcohol, and for twenty years, while occupying the chair of professor of the science and art of medicine in the College of Medicine of Syracuse University. I followed in my lectures – often reluctantly and usually afar off, but still I followed – the almost unanimous teaching of authors, ancient and modern, and the professors in the medical schools.

“Convinced that a great number of the diseases I was called to treat owed their existence or aggravation to the use, in alleged moderation, of alcoholic beverages, and that not in a few instances this use was commenced and even continued by the advice of the medical attendants; convinced also by the published experiments of many acute observers at home and abroad, and by my own observations, that almost all diseases could be managed as well if not better by the non-use of alcohol, and satisfied from the communications of some brother practitioners that the fatality in certain specified diseases was not delayed, to say the least, by the employment of increasing and enormous doses of wine, whisky and brandy, and influenced also, I must admit – overwhelmed, indeed – by what I know and what I read daily of the pauperism, domestic wretchedness, crime, insanity and incurable maladies transmitted to innocent offspring, I abandoned entirely, more than three years ago, the use of alcoholic remedies.

“I have endeavored by personal example and earnest council to dissuade my patients from the use of intoxicating beverages and medicines.

“The outcome of this practice, medically and morally, has been satisfactory to myself, and, I have reason to believe, to my patients also.

“Whatever regrets I may feel for my former teaching and practice, I have no apology to offer for my inconsistency except that once given by Gerrit Smith: – ‘I know more to-day than I did yesterday; the only persons who never change their minds are God and a fool.’

“Permit me to add that while there may be an honest difference of opinion regarding the efficacy of legislative enactments in overcoming or restraining the drink habit, there should be little doubt that a whole-hearted, persistent, precept-and-example effort of the medical profession exerted as individuals on their patients and the families of their patients, and as associations on the community at large, would do immeasurable good.

“And the newspapers might aid materially in this beneficent work if, while they continue to spread before our households every day the details of the brawls and fights of drunken men and the horrible murders which they commit, they would discontinue advertising, without warning or dissent, side by side with the atrocities, the ‘innocuous beers,’ the pure malt whiskies, the genuine brandies, guaranteed to prevent and cure all manner of diseases.”

The following testimony from an English physician is significant: —

“Although I know beforehand that their united testimony must be in favor of the practice of total abstinence from all intoxicating drinks, being most conducive to health and longevity of their patients, but very inimical to the pocket interests of themselves, my own experience is, that my teetotal patients are seldom ill, and that they get well very soon again, if they are attacked by disease. A higher principle than that of gain must influence a medical man’s mind, or he will never advocate the doctrine of total abstinence.” – J. J. Ritchie, M. R. C. S., Leek.

“One of the most dangerous phases of the use of alcohol is the production of a feeling of well being in weakly, dyspeptic, irritable, nervous or anæmic patients. In consequence of the temporary relief so obtained, the patient develops a craving for alcohol, which in many cases can end only in one way, and, as I felt compelled to tell an assembly of ladies a short time ago, the very symptoms for the alleviation of which alcohol is usually taken are those, the presence of which renders it exceedingly desirable that alcohol should not be taken.” – Dr. G. Sims Woodhead, of London.

In an address upon the London Temperance Hospital delivered shortly before his death, Sir B. W. Richardson gave a brief review of the influences which led him to abandon the medical use of alcohol. The following is taken from that address as reported in the Medical Pioneer: —

“I was a member of the Vestry of St. Marylebone, and we had in our parish a very serious outbreak of small-pox, attended with a considerable mortality. In his report to us Dr. Whitmore stated that in his treatment of earlier cases of the confluent and hemorrhagic, and malignant forms of disease, stimulants of wine and brandy were freely administered without any apparent benefit; and, that after consultation with Mr. Cross, the resident surgeon, they resolved to substitute simple nutriments, such as milk, eggs and beef-tea, at frequent intervals, with discontinuance of stimulants altogether. The result of the change was most satisfactory, and many bad cases did well, which under the stimulant plan they believed would have terminated fatally. Again I was struck very much by a report made by Mr. Cadbury, in which that gentleman showed the course that was going on in various hospitals. The amount of alcohol in twelve hospitals in London, taken by the inpatients, varied in ounces from 37,531 in one establishment to 300,094 in another during the year 1878. I also found, from the same author, that the whole cost in St. George’s Union Infirmary for the year 1878 was £8. 3s. 6d., amongst 2,496 patients, while the cost of the same number at the average of the twelve hospitals was £124. About this same time I also remarked that in many of the public institutions of England there was a reduction something similar in kind, if not to the same extent, and that the number of persons who suffered seemed to make better recoveries than those who were taking the free amount of stimulant. The effect of these observations chimed in very remarkably with the physiological experiments it had been my duty to carry out, and which tended to show in a most striking manner that the action of alcohol in the body very much differed from the ordinary opinion that had been held upon it, and thereupon, in my own practice, I abandoned the use of alcohol, and began to give instead small quantities of simple, nourishing, dietic food, a course I pursued up to the present time with the most satisfactory results, results I have never felt any occasion to regret. By these steps, learned in the first place from the study of alcohol in its action on man, I was led to become a believer that alcohol is of no more service in disease than it is in health, and a lengthened experience in this matter has really confirmed the correctness of the idea.”

In his last report as physician to the Temperance Hospital Dr. Richardson made some remarkable statements upon the fallacy of the general ideas of stimulation. So interesting are his views that they are incorporated here: —

“Sir B. W. Richardson, M. D., who was unable to be present, communicated (through the secretary) his annual report as physician to the hospital. After twelve months further trial of the treatment of all kinds of disease in this institution without the assistance of alcohol, either as a diet or a medicine, he (Sir B. W. Richardson) was fully sustained in the belief that the plan pursued had been attended with every possible advantage. About 500 cases had come under his observation and treatment as in previous years, and these cases had been of the most varied kind, including all patients who were not directly suffering from contagious disease. In not one instance had alcohol been administered, nor had anything like it been used in the way of a substitute, and there had not been a single case in which he could conceive that it was ever called for, while the success which had attended the treatment generally had been superior to anything he had ever seen following upon the administration of alcoholic stimulants. One great truth which had forced itself upon him had reference to the doctrine of stimulation generally. It had been one of the grand ideas in medicine that there came times when sick people were benefited by being stimulated. It was argued that they were low, and in order that they might be raised and brought nearer to the natural life they required something like alcohol to quicken the circulation, quicken the secretion, and help to preserve the vitality. But the experience which was learned here tended to show in the most distinct manner that that very old and apparently rational idea was fallacious. Such stimulation only tended ultimately to wear out the powers of the body, as well as change the physical conditions under which the body worked. True lowness meant practical over-fatigue, and when the body was spurred on, or stimulated, over-fatigue was simply intensified and increased. What, therefore, was wanted was not stimulation, but repose. The sufferer was placed in the best position to gain entire rest, and all the surroundings or environments were employed which tended to prevent waste. The air was kept at the proper temperature, the body of the patient kept warm, and the simplest and most easily digested foods were used; the patient’s condition then swung round to a natural state, and he began to get well. In other cases where the sick were brought under observation suffering already from excitable condition of the senses, with congestions here and there of the circulatory or nervous systems, with imperfect condition of the brain, and with the elements of what was usually denominated inflammatory or febrile state – the stimulant was already present (was, indeed the cause of the symptoms) and did not want in any degree to be enforced further by the acts of treatment. Here, therefore, they were on the safest grounds as regarded methods of administration, for they calmed as well as they possibly could both mind and body and left nature to do the rest, which she did with the best and most tranquilizing effect. On both sides, therefore, in the treatment of disease, they did good, and that was the reason, he believed, why their returns were so satisfactory. It often happened in an institution where some particular plan was carried out that the old ideas in which they had been bred were without intention refined or suppressed. For example, he had been taught, and believed for a number of years, that some medicament of a particular kind was needful for some particular train of symptoms, be the surrounding conditions what they might. There was no doubt that this same feeling had given rise to the persistent use of alcohol; but, greatly to his own surprise, he discovered that when the surroundings were all good, the rule that applied to alcohol constantly applied to other substances that were called remedies, with the result that recovery was often just as good without the particular remedies as with them, so that a revision came quite simply with regard to stimulating agents and their properties, and also with regard to every medicine that might at earlier times have been employed. He had seen many cases in this hospital recover without any other aid than that of the environments, which cases he would have said could not possibly have gone on well, or towards complete recovery, unless some special recipe had been followed. He believed the day would come when others, learning this same truth as he had been obliged to learn it, would act on such simple principles that the books of remedies would have to be vastly curtailed. It would be seen that there was such a tendency of disease to get well of itself, or by virtue of natural processes, of which people had at present but a very poor idea, that the art of physic would pass into directions how to live rather than into dogmatic assertions that particular means must be employed in addition to the common details of life for the process of cure. If therefore they learned in this hospital by their reduced death-rates the true lesson, the institution would have performed a double duty, and become one of the test objects in medicine, and in the field of disease. They made no attempt by selection, or by any side action, to exaggerate their results. The cases were taken indiscriminately, except that they gave admission to the worst cases first; that was to say, they never caused patients to come under their treatment if they saw they were only slightly affected, and were bound to get well.” —Medical Pioneer.

Dr. Landmann, of Boppard-on-the-Rhine, Germany, says: —

“The members of the Association of Abstaining Physicians, reject the use of spirituous liquors in every form, and particularly declare the use of alcohol at the sick-bed a scientific error of the saddest kind. In order to war against this abuse, they earnestly appeal to the officers having charge of funds for the sick, henceforth, under no circumstances, any longer to permit the prescription of wine, whisky and brandy for sick members; but to resist to the utmost, according to the right given them by the laws insuring the sick, the taking of spirituous liquors, under the false pretext that they have a curative and strengthening effect.”

Dr. Bleuler, Rheineau, Switzerland, says: —

“The treatment of chronic diseases with alcohol is contrary to our knowledge of the physiological effects of alcohol. There is no probability that its use will be beneficial, certainly its benefits have not been established. Often an injurious result is proved.

“It is not implied that there may not be some benefit in the use of alcohol in cases of sudden weakness with or without fever. But even in such cases the benefit is not demonstrated. At any rate, other remedies can with advantage be substituted for alcohol.

“The essential thing in the treatment of all alcoholic diseases, delirium tremens included, is total abstinence.

“The physiological effect of alcohol is that of a poison, whose use is to be limited to the utmost. Even the moderate use as now practiced is injurious.

“The customary beneficial results unquestionably depend chiefly on suggestion, and by making the patient believe falsely that the momentary subjective better feeling means actual improvement.

“Physicians share the blame of the present flood of alcoholism. They are, therefore, morally bound to remedy the evil. Only by means of personal abstinence can this be done.”

Dr. A. Frick, professor in Zurich, is a careful student and an influential writer on alcohol. His statements are weighty. This is his testimony: —

“In larger doses, alcohol is absolutely injurious in the treatment of acute fevers, especially in case of pneumonia, typhus and erysipelas. They first of all injure the general state of the patient, they cause delirium, or increase it if already existing, and, secondly, they injure most seriously the organs of digestion and interfere with proper nourishment; thus they have a weakening effect, instead of preventing weakness, which they are usually supposed to do. In case no alcohol is used, the convalescence is much more rapid. In no case has the benefit of treatment with alcohol been established. According to the view of the most eminent pharmacologists, the stimulating effect of alcohol consists simply in a local irritation of the mucous membrane of the stomach, similar to that produced by a mustard plaster.”

The following selection from the excellent address of Dr. Harvey, president of the Virginia State Medical Society, at a recent meeting, is a most timely caution: —

“Our prisons, asylums and homes are filled with the victims of the careless and indiscriminate use by the medical profession of those twin demons, alcohol and opium, which, save tuberculosis, are doing more to debase and destroy the human race than all the other diseases together. I most earnestly beseech you, young men, who are just starting out in life, to stay your hand in the use of these agents in your own persons, and in your daily work, and to beware of the seductive needle, and the cup that inebriates. Make it an invariable rule, never to prescribe alcohol, nor one of the solinaceus or narcotic drugs, if you can possibly avoid it. The use of alcohol and opium debases the minds and morals of habitués, predisposes especially to Bright’s disease and insanity, and lays the foundation in the offspring for the majority of the neuroses and degenerations of modern civilized life. The physical fatigue of long working hours, loss of sleep, mental strain, worry and hunger, invite the tired physician, especially, to their seductive use. To totally abstain from them is always business, and very often character, and even life itself. I feel free to speak to you on this subject very earnestly, my younger brothers, for, having prescribed alcohol for over thirty years, I am familiar with its tendencies and its dangers.”

Dr. T. D. Crothers of Hartford, Conn., in an article upon “The Decline of Alcohol as a Medicine,” says: —

“Thoughtful observers recognize that alcohol as a medicine is rapidly becoming a thing of the past. Ten years ago leading medical men and text-books spoke of stimulants as essentials of many diseases, and defended their use with warmth and positiveness. To-day this is changed. Medical men seldom refer to spirits as remedies, and when they do, express great conservatism and caution. The text-books show the same changes, although some dogmatic authors refuse to recognize the change of practice, and still cling to the idea of the food value of spirits.

“Druggists who supply spirits to the profession recognize a tremendous dropping off in the demand. A distiller who, ten years ago, sold many thousand gallons of choice whiskies, almost exclusively to medical men, has lost his trade altogether, and gone out of business. Wine men, too, recognize this change, and are making every effort to have wine used in the place of spirits in the sick-room. Proprietary medicine dealers are putting all sorts of compounds of wine with iron, bark, etc., on the market with the same idea. It is doubtful if any of these will be able to secure any permanent place in therapeutics.

“The fact is, alcohol is passing out of practical therapeutics because its real action is becoming known. Facts are accumulating in the laboratory, in the autopsy room, at the bedside, and in the work of experimental psychologists, which show that alcohol is a depressant and a narcotic; that it cannot build up tissue, but always acts as a degenerative power; and that its apparent effects of raising the heart’s action and quickening functional activities are misleading and erroneous.

“French and German specialists have denounced spirits both as a beverage and a medicine, and shown by actual demonstration that alcohol is a poison and a depressant, and that any therapeutic action it is assumed to have is open to question.

“All this is not the result of agitation and wild condemnation by persons who feel deeply the sad consequences of the abuse of spirits. It is simply the outcome of the gradual accumulation of facts that have been proven within the observation of every thoughtful person. The exact or approximate facts relating to alcohol can now be tested by instruments of precision. We can weigh and measure the effects, and it is not essential to theorize or speculate; we can test and prove with reasonable certainty what was before a matter of doubt.