LIQUOR
Current studies in medicine and psychiatry are bringing enlightenment
to the 30,000-year-old problem of drinking.

By Francis Sill Wickware
Life Magazine, May 27, 1946

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In the last five years, and especially since the publication of Charles Jackson's somber novel about an alcoholic,
The Lost Weekend, an unprecedented amount of attention has been paid to the drinking of alcohol and the problems arising there from.
Authorities on the subject estimate that since 1940 alcoholism has made more news and stirred up more interest than during the whole
preceding century. In some ways this phenomenon is like the great public preoccupation with venereal diseases which swept the country about
a decade ago. Like the venereal-disease campaign, the new concern with drinking and alcoholism has had two beneficial effects. First, it
has brought a somewhat disreputable subject into the open for discussion and has dispelled much of the prejudice, superstition and
misunderstanding which formerly obscured the fact. Second, it has moved the serious and complicated disease of alcohol addiction out of the
realm of morals and has placed it correctly in the sphere of psychiatry and medicine. The process is far from complete, but science today
takes a more optimistic view of the outcome than was believed possible even a few years ago. Perhaps the greatest advance yet made is
precisely the spread of public information that has occurred lately.
It is impossible to study the anatomy of alcohol intelligently without reference to its great antiquity. The colorful beverages pictured
on pages 70 to 73 have modern trademarks and flavoring (the 30 favorite drinks are prepared from recipes of the head bartender at New York's
Hotel Astor), but basically they are the same as concoctions accidentally discovered by very early primitive man. Probably alcohol first
was tasted in wine, which anthropologists believe came after the invention of open bowls or similar vessels where fruit fermented when
invaded by yeast particles in the air. Brewing was a much later development which probably closely followed the first attempts at
agriculture, while distilling is a comparatively modern refinement thought to have emerged in the Orient before the time of Christ. There
is no difference in principle between ancient methods of producing alcoholic beverages and those shown in the diagrams on pages 70 and 71.
The chief difference between the beverages themselves is that the ancient ones were unrefined and therefore had much greater food value
(including vitamins) than the modern varieties, though they were less palatable.
Alcoholic beverages were discovered independently by widely separated peoples, who used whatever fermentable materials they had at hand.
These included honey, dates, fruits and berries of all kinds, tree sap (notably many kinds of palm in the tropics) and a long list of other
things. The Mexicans make pulque from the maguey in their country, while the Mongols ferment mare's milk to produce a potent 160-proof
beverage. The Eskimos, the South Pacific Melanesians, and nomadic Indian tribes were about the only early peoples without alcohol, but they
took to it enthusiastically later on.
Primitive man undoubtedly considered alcohol a divine gift. Here, for the first time, was a substance that enabled him to rise above his
environment. Alcohol let him forget, however briefly, the constant menaces of famine, sickness, cold and tribal warfare--in a word, his
anxieties. It became an essential part of religious ceremonies, and tribal drinking celebrations were the beginning of polite society, when
men for a time left off quarreling among themselves, assumed by mutual agreement that the hostile world was a wonderful place and practiced
a few airs and graces. In the course of doing this, they habitually became very drunk. Deep intoxication still is the goal of drinking
ceremonies among primitive tribes today.
However, this drunkenness was a carefully regulated communal affair, occurring at specified times and under special conditions.
Individual drinking between the periods of mass intoxication was taboo and the festivals themselves frequently began with divine invocations
and appeals for protection against the evil demons of alcohol. Ancient man was aware of the dangers of intoxication though enjoying its
effects, and early writings contain many comments on both the benefits and the risks. Let him drink, and forget his poverty, and remember
his misery no more, the Bible states. In Isaiah there is a quotation germane to the phenomenon of excessive wartime drinking, about which
more than a little was heard lately: There is a crying for wine in the streets; all joy is darkened, the mirth of the land is gone. Any
period of stress historically produces a rise in drinking roughly proportionate to the severity of the stress.
On the other side of the question, Seneca says, ... Drunkenness is nothing but an insanity purposely assumed. In ancient India the
same word was used to designate intoxication and mental derangement. In short, all early societies recognized the Januslike nature of
alcohol (which psychiatrists would call ambivalence) and, while countenancing its use en masse for occasional ritual celebrations, took
steps to control drinking strictly at other times. Movements for total prohibition started very early in various countries and invariably
failed. The Hindus at one time decreed death for anyone making or using alcohol, but this was no more effective than the Volstead Act or
the short-lived prohibition
which the Russians attempted after the Revolution. Not only has this custom [drinking] been successful in terms of sheer survival, writes
Dr. Donald Horton in the symposium Alcohol, Science and Society, but it has been successful in the face of very severe opposition....We
have to conclude from this, then, that some important human value is involved here that makes alcohol hard to abolish.
No student of the subject doubts that the value involved is alcohol's immemorial power to relieve anxiety, which today has many
meanings, and the charts and pictures on pages 68 and 69 explain the method whereby this is accomplished. Stated most simply, alcohol is a
safe, easily controlled anesthetic which acts on successive centers of the brain, notably the ones which govern man's higher intellectual
activities. This brain area had been responsible for the highest human achievements, but it also has burdened man with chronic
self-reproach, apprehension and general discontent such as no lower animal experiences. In moderate amounts, alcohol is an easy and
harmless means of temporarily blunting the critical function of the upper brain without seriously disrupting the creative or intellectual
role. It unburdens the individual of his cares and fears, relieves him of his feelings of inferiority and weakness, Dr. Walter R. Miles
has written. The inhibitions and self-criticisms which ordinarily cramp his feelings tend, after alcohol, to be put aside....
Of the estimated 50,000,000 drinkers in the U.S., all but a fraction use alcohol moderately and more or less regularly because it makes
them feel better and more appreciative of themselves and their fellows. It also gives them better appetites, since it is an excellent
condiment. Taken for purposes of social relaxation or as a gustatory adjunct, alcohol never has damaged anyone. Even when taken in fairly
large amounts over a long period of time, the purely physical effects of alcohol by itself are almost negligible. Despite horrendous
warnings by temperance lecturers (who sometimes prove the point on the platform by coagulating an egg white in a glass of whisky), alcohol
does not attack or corrode the brain cells. It does not lead to insanity; rather, it is the other way around because excessive drinking
very often is a symptom of the onset of serious mental disorders, such as schizophrenia, manic-depressive psychosis and the general paresis
of tertiary syphilis. There are certain comparatively rare alcoholic psychoses--chiefly Korsakov's psychosis (loss of memory for recent
events), alcoholic paranoia and hallucinosis and the celebrated delirium tremens--but these now are widely recognized as symptoms of vitamin
deficiency and respond promptly to high-vitamin therapy. In the same category are dry and wet beriberi and pellagra, all caused by vitamin
shortages but not by drinking per se. They usually do not appear until after about 15 years of excessive drinking and result from the
tendency of constant heavy drinkers to depend on alcohol for most of their food. Absolute alcohol contains 210 calories per ounce by weight
but delivers no vitamins and, according to some theories, may actually impede absorption of vitamins from other foods. Excessive drinkers
could avoid the deficiency diseases in large measure by making sure of sufficient vitamin intake.
Apart from this somewhat tangential by-product of very prolonged heavy drinking, modern research gives alcohol a clean physiological bill
of health. The Drys have taught for years that drinking in any degree may blast the liver, kidneys and gastrointestinal tract, and make the
drinker prone to cancer, heart disease, ulcers, tuberculosis, arteriosclerosis and many other dire ailments. These claims, often
accompanied by fearful-looking pictures of inflamed organs, have no foundation in fact, according to Drs. Elvin M. Jellinek and Howard W.
Haggard in their recent study, Alcohol Explored. Of course the habitual heavy drinker who neglects his diet and general health is more
susceptible to almost any disease than a nondrinker and consequently has a shorter life expectancy. But there is no difference in the
average life expectancies of moderate drinkers and nondrinkers, and by and large the former may be somewhat healthier. They show a slightly
lower death rate from heart disorders and cancer, and tend--in spite of popular belief--to develop stomach ulcers less often than
nondrinkers. This probably is because the average moderate drinker is apt to be a more relaxed individual than the abstainer.

THE MYTHS OF DRINKING

Two other old stand-bys of Dry propaganda include cirrhosis of the liver and kidney trouble. It is true that cirrhosis occurs much
more commonly among heavy drinkers than among abstainers and this used to be accepted as prima facie evidence of the baleful effect of
alcohol. But the fact that it occurs at all among nondrinkers indicates that other causes are involved, and medical research now inclines
to the theory that nutritional factors may be responsible. As for kidney trouble, the increased flow of urine which accompanies drinking
seems to have been the basis of the notion that alcohol injures the kidneys. It is now believed that urine formation normally is retarded
by an inhibitory secretion from the pituitary. When alcohol reaches this gland the secretion is reduced, whereupon the kidneys release
more than the ordinary amounts of urine--in fact, more than the equivalent of the liquid consumed by the drinker. This does no
harm to the kidneys, however.
One of the most persistent myths in the folklore of alcohol is that drinking injures germ plasm and has an evil hereditary influence, but
the evidence does not bear this out; indeed it is somewhat to the contrary. Alcohol perhaps assists sperm selection, for in weak
concentrations occurring in the body fluid it seems to affect the feebler and less active sperms while not affecting the vigorous ones
except to slightly reduce their motility. Certainly it does not appear to have any adverse effect on fertility because, on all social and
economic levels, drinking families have more children, on the average, than nonalcoholic ones. This superficially may testify to the
legendary aphrodisiac qualities of alcohol, but what commonly passes for true sex stimulation is actually libido release following
anesthetizing of the moral censor.
Probably the word stimulant always will be used in connection with alcohol despite the fact that research has proved many times the
fallacy of this idea. By its action on the brain alcohol creates an illusion of stimulation, but the actual effect is otherwise. With the
intellectual self-critic lulled, the drinker's self-esteem rises, and both his sense of discrimination and his behavior restraints decline.
Alcohol dulls his perception of cold, pain or other discomfort and fills him with an easy warmth, a fine expansiveness and sense of
well-being known as euphoria. In this mood he is absolutely certain that he can drive a car, ride a horse, compose a song or fight a duel
better than when sober. He is stimulated.
Meanwhile his ability to do any of these things has declined in ratio to his blood concentration of alcohol. Psychiatrists have
summarized a large number of tests which show that all functions are measurably impaired a short time after consumption of relatively small
amounts of alcohol. For example, an hour after taking six ounces of whisky, subjects' visual reactions (i.e., response to a flashing light)
were slowed by more than a third. In other tests, with varying amounts of alcohol administered, memorizing poetry took subjects twice as
long as when sober; performance of mathematical problems declined 13%; there was a 67% increase in errors of reasoning. And while subjects
were less conscious of fatigue after alcohol, a laboratory test machine showed that their muscular strength actually had dropped by 10%.
It is not drunken driving but the combination of sluggish reactions and subjective certainty of fine performance in moderate drinkers
which makes alcohol such a large factor in motor accidents, for pedestrians as well as drivers. During the war years national summaries of
fatal accidents showed that about 20% of adult pedestrians killed were under the influence of alcohol to some extent, compared to about 12%
of the drivers involved. Only about half of them were intoxicated in the legal sense and very few were conspicuously drunk. In states
which administer blood tests police report that drivers who have been drinking moderately often are offended by suggestions that their
coordination is less than perfect. They are eager to take tests to prove their innocence.
In some circumstances certain individuals seem to be exceptions to the rule that alcohol invariably reduces mental and physical
efficiency. These persons actually do increase their output and improve their skills after drinking, particularly in competitive
situations. The reason seems to be that in the sober state they are so subject to feelings of anxiety and inferiority that they feel beaten
before they start and never achieve their potential efficiency. With the release from inhibitions through alcohol, they gain confidence to
such a degree that they better their customary sober standards. The alcohol still works to retard them, but the lessening of the anxiety
state more than counterbalances this factor. Here, probably, is the explanation of the many writers and artists who have done their best
work while intoxicated. Creative effort suffers just as much as any other activity from alcohol, but many authors at least seem to require
constant alcoholic disinhibiting in order to do any work at all.
Still partly unanswered is the question of the wide individual differences in alcohol tolerance. Alcohol has a similar effect on every
drinker and is burned at the constant rate of three quarters of an ounce per hour by every drinker. But on the same number of drinks one
person will become noticeably intoxicated while another shows no signs of any reaction. The size of the drinker has bearing on this, since
a large man with more body fluid will need somewhat more alcohol than a small one to reach the same concentration. However, it is believed
that the important factor is the drinker's personality and his attitude toward alcohol. In general, people who normally are sedate seem to
stay sober longer than those of an excitable temperament, and the hardened drinker can control the effects of alcohol longer than the
beginner, at least up to a point. After deep intoxication is reached, one drinker's control is no better than another's, for when alcohol
concentrated in the blood is in the neighborhood of .4% he automatically becomes unconscious. If it were not for this safety factor, deaths
from alcohol poisoning probably would be very common instead of exceedingly rare. Short of deliberately drinking about a pint of
undiluted alcohol all at once, it is impossible to bring the blood concentration to the point (from .7% to .9%) where the automatic nervous
system is paralyzed and breathing
and heart action stop.
Today, in defining types of drinkers, doctors and psychiatrists no longer pay so much attention to the amount of alcohol consumed or the
frequency of consumption but instead analyze the drinker in terms of his psychological relationship to alcohol. As stated before, there are
an estimated 50,000,000 users of alcohol in the country, of whom about 46,000,000 are purely social drinkers and no problem.
Then there is a group estimated at some 3,000,000 which comprises the excessive drinkers in various degrees. An excessive drinker
frankly likes to get drunk and out of control every once in a while, as at conventions, reunions and other tribal rites, but the rest of the
time he handles alcohol carefully and may not drink at all. He usually is not a problem except when on a bender and behaving like an oaf.
Finally, there are the estimated 750,000 alcohol addicts, or chronic alcoholics. They are not easy to define as a group because they
drink in different ways and for different reasons. Some begin as social drinkers and drift into the vicious circle of alcoholism wherein
drinking causes the loss of a job or disruption of the family or some other disappointment which in turn seems to demand more drinking, and
so on. Others drink because of neurotic states which prevent them from adjusting to the world of reality and cause them to retreat to the
perpetual fantasy of alcohol. Still others seem to be engaged in slow suicide. To all, however, alcohol has become the main reason for
existence. It may take a long time for an incipient alcoholic to reach this stage, but medical men consider that the danger line is crossed
when a drinker allows alcohol to interfere with any of his important life activities.
The alcoholics come from all social and economic groups and from all races. People of Irish, English and Scandinavian descent seem most
prone to alcoholism while Jews and Italians are least susceptible. Male alcoholics heavily outnumber women, and there is a high incidence
of people of both sexes who were only children and probably overly attached to one parent or the other. On this point Charles Jackson in
a recent article stated, It is my belief that alcoholism is largely the fault of parents who overindulge or overprotect their children to
the point where they (the children, grown older but still childish) cannot face reality and seek 'escape' in drink. Certainly a prominent
characteristic of the alcoholic personality is selfishness--an inability to tolerate reverses or even simple boredom, a kind of naïve
expectation that whatever he desires should be his for the asking, and little regard for the opinions or feelings of others. His drinking
inevitably involves his family, friends and business associates, if any, and usually makes him familiar with the police, the public
hospitals and various social agencies. Thus the problem of alcoholism concerns far more than the fate of the alcoholics.
Until quite recently it was almost axiomatic that the only cure for alcoholism was self-cure. The sick drinker was supposed to decide to
stop drinking and then simply stop, with or without outside help. Since this was a good deal like deciding to give up malaria without
taking atabrine or quinine, the outlook was more than dubious, and for all practical purposes the disease was considered incurable. Doctors
wasted as little time as possible on such hopeless cases and the public attitude was a derisive, Once a drunk, always a drunk.
Today, thanks to the development of new psychotherapeutic techniques, alcoholics are being cured in large numbers. It is no longer
necessary, though still desirable, for patients to be grimly determined to quit drinking, as long as they approach treatment with the
realization that they cannot control alcohol.
The psychiatric phase of treatment initially consists of uncovering the basic motivation for the inebriate's behavior. Since most
alcoholics fit into well-established patterns, this exploratory work generally is not too long or difficult and rarely entails anything as
elaborate as psychoanalysis. It can be accomplished in most cases by narcohypnosis, the psychiatric examination of the unconscious mind
while the conscious is blacked out by drugs.
Furthermore, in cases where other treatments have been unsuccessful, a majority of patients can be brought to stop drinking at once by a
form of conditioned reflex known as aversion therapy. This is similar in principle to an ancient Roman cure whereby an alcoholic had to
drink wine in which live eels were swimming, on the theory that this would create disgust. In the modern treatment the institutionalized
patient is given an injection of a drug called emetine which in a few minutes produces nausea and vomiting of a spectacular sort. Just
before it takes effect the therapist hands the patient a glass of his favorite liquor and urges him to drink it down. Immediately afterward
it comes up again and the treatment is repeated daily for about a week, then at intervals of a month, two months, six months and a year
until the patient is sickened by the thought of drinking. After two years of total abstinence he is considered cured, and so far the method
has been reported successful in 60% of all cases. The average of cures reported for all treatments now in use is said to be above 50%,
compared to a scant 20% in 1930. Even more hopeful, in the opinion of psychiatrists, is the fact that the average age of patients
voluntarily arriving at clinics is steadily declining. This means that prealcoholics are becoming aware of the dangers ahead of them and
are applying for treatment when cures can be accomplished most easily and most successfully. The trend in cures is matched by expanding
activity of Alcoholics Anonymous, a national organization of ex-inebriates which works on the principle that loneliness is one of the main
causes of drinking
and substitutes friendship and mutual encouragement for the bottle. Statistically the results have been even more impressive and
individually beneficial, since the psychiatric root of the problem is attacked, than those of the aversion therapy. Numerous church and
civic groups interested in the rehabilitation of alcoholics are also having a vital role in the over-all campaign.
Encouraging as these recent achievements are, it is probable that a 100% cure for alcoholism never will be devised. And the point is
that, curable or not, it is a condition to be avoided; smallpox, pneumonia and typhus also have a high and increasing incidence of cure, but
no sane person would knowingly expose himself to them. The particular deadliness of alcoholism lies in the fact that it affects not only
its victims but their families and society at large. Thousands of divorces have had their origins in alcoholism, and likewise the
alcoholism of parents is often a contributing factor in juvenile delinquency. Financially the loss due to this form of human erosion is
comparable to that of soil erosion, which has enjoyed more governmental attention: expenses for hospitalization, the cost of accidents and
crimes, the maintenance of drunken persons in jail, the support of persons dependent on alcoholics, plus potential wages lost because of
alcoholism, are approaching a billion dollars a year, as indicated in Some Economic Aspects of Alcohol Problems by Benson Y. Landis.
Somewhat less than that, if used to support such groups as Alcoholics Anonymous and to endow psychiatric clinics where the potential
alcoholic could be helped before his neurosis is too far advanced, would prevent not only economic loss but many personal tragedies.



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