A further criticism by M. Baudot, supported by renewed experiments, is still more decisive. M. Baudot justly observes that in order to substantiate their conclusions, Messrs. Lallemand, Duroy and Perrin should have at least been able, with their excessively delicate tests, to discover in the excretions a large part of the alcohol which had been taken into the system. This, however, they never did. In all cases, the amount of alcohol recovered was very small, and bore but a trifling proportion to the amount which had been taken. According to these physiologists, the elimination always takes place chiefly through the kidneys. But M. Baudot, in a series of elaborate experiments, has proved that, unless the dose has been excessive, no sensible amount of alcohol reappears in the kidney-excretions for more than twenty-four hours. The quantity is so minute that the alcoometer is not in the least affected by it, and it requires the chromic acid test even to reveal its presence. Similar results have been obtained by experiments upon the breath.
Finally, the gravest doubts have been thrown upon the trustworthiness of the chromic acid test relied on by Messrs. Lallemand, Duroy and Perrin. It is considered possible, by good chemical authority, that the reactions in the test-apparatus, which they attributed to the escaping alcohol, may equally well have been caused by some of the results of alcoholic transformation. For reasons above given, however, it is probable that in cases of narcosis some alcohol always escapes. When we reflect upon its absorbability and its ready solubility in water, it seems likely beforehand that a considerable quantity must escape. But all that these able Frenchmen can be said to have accomplished, is the demonstration of the fact that when you take into your system a greater quantity of alcohol than the system can manage, a part of it is expelled in the same state in which it entered. And this may be said of other kinds of food.
These experiments have, therefore, instead of settling the question, left it substantially just where it was before. But we have now a more remarkable set of facts to contemplate. In many cases of typhoid fever, acute bronchitis, pneumonia, erysipelas, and diphtheria, occurring in Dr. Anstie's practice, it was found that the stomach could be made to retain nothing but wine or brandy. Upon these alcoholic drinks, therefore, the patients were entirely sustained for periods sometimes reaching a month in duration.[27] In nearly every case convalescence was rapid, and the emaciation was much slighter than usual: the quality of the flesh was also observed to be remarkably good. Dr. Slack, of Liverpool, had two female patients who, loathing ordinary food, maintained life and tolerable vigour for more than three months upon alcoholic drinks alone. Mr. Nisbet reports "the case of a child affected with marasmus, who subsisted for three months on sweet whisky and water alone, and then recovered; and that of another child, who lived entirely upon Scotch ale for a fortnight, and then recovered his appetite for common things." Many similar examples might be cited.
It may be said that alcohol maintained these persons by retarding the waste of the tissues. This is no doubt an admissible supposition. There is no doubt that alcohol, by its waste-retarding action, will postpone for some time the day of death from starvation.[28] But to this action there must be some limit. Though the waste is retarded, it is not wholly stopped. Though there is relatively less waste, there is still absolutely large waste. The mere act of keeping up respiration necessitates a considerable destruction of tissue. Then the temperature of the body must be kept very near 98° Fahrenheit, or life will suddenly cease; and the maintenance of this heat involves a great consumption of tissue. Now this waste, under the most favourable circumstances, will soon destroy life, unless it is balanced by actual repair. You may diminish the draught on your furnace as much as you please,—the fire will shortly go out unless fresh coal is added. Upon these points the data are more or less precise. The amount of waste material daily excreted from the body, under ordinary circumstances, is a little more than seven pounds.[29] Of this the greater part is water, the quantity of carbon being about twelve ounces, and the quantity of nitrogenous matter about five ounces.[30] To make up for this waste we usually require at least two and a half pounds of solid, and three pints of liquid, food.[31] In Dr. Hammond's experiments, the weight-sustaining power of the alcohol taken seems to have amounted to four or five ounces.[32] It will be seen, therefore, that in spite of any stimulant effect of alcohol upon nutrition, unless at least ten or twelve ounces of nitrogenous or carbonaceous matter be eaten daily, the weight of the body must rapidly diminish.
Now the experiments of Chossat have demonstrated that no animal can suddenly lose more than two-fifths of its normal weight without dying of starvation. If a man, therefore, weigh 150 lbs., for him 90 lbs. is the starvation-point; as soon as he reaches that weight he dies. Usually, indeed, death occurs before this degree of emaciation can have been attained,—in most cases, on the fifth or sixth day; though there are a few authentic instances of persons who have lived for twelve, and even sixteen, days before finally succumbing.
In view of these facts, we are willing to grant that people may in rare cases live for three months on their own tissues, if waste be duly retarded. We are willing to grant it, though we do not believe it. But we are not prepared to admit that this process can go on for six months or a year; and we believe that the cases now to be cited can in nowise be got rid of by such an interpretation.
Mr. Nisbet mentions the case of a man who lived for seven months entirely on spirit and water. At Wavertree, a young man afflicted with heart-disease lived for five years principally, and for two years solely, on brandy. His allowance was at first six ounces, afterward a pint, per diem. His weight was not materially decreased, when, at the end of the five years, he died of his disease. But the next case is still more remarkable. Dr. Inman had a lady-patient, about twenty-five years old, plump, active and florid, but somewhat deficient in power of endurance. "This lady had two large and healthy children in succession, whom she successfully nursed. On each occasion she became much exhausted, the appetite wholly failed, and she was compelled to live solely on bitter ale and brandy and water; on this regimen she kept up her good looks, her activity and her nursing, and went on this way for about twelve months; the nervous system was by this time thoroughly exhausted, yet there was no emaciation, nor was there entire prostration of muscular power."[33]
For the accuracy of this statement there is to be had the testimony of Dr. Inman, the attendant physician, as well as that "of the lady's husband, of mutual friends occasionally residing in the house with her, of her mother, of her sisters, and of her nurse." We have apparently no alternative but to believe it; and if it is true, it is certainly decisive. It is nothing less than an experimentum crucis. The suggestion that this lady might have kept up her normal activity while nursing children, for a whole year, with no aliment except her own tissues and the water and vegetable matter contained in her ale and brandy, is too absurd to need refutation. The thing is an utter impossibility. Moreover, not being emaciated at the end of the year, she had probably been consuming her own tissues but very little. Her weight, her muscular activity, and the natural heat of her body, could have been sustained by nothing but the alcohol; which thus appears as a true food, at once nourishing, strength-giving, and heat-producing.
This conclusion is further re-enforced by the numerous cases on record of persons who have lived actively for many years upon a diet of alcoholic liquor accompanied by a quantity of solid food notoriously inadequate to support life. The case of Cornaro is outdone by some of those quoted by Dr. Anstie, as having occurred under his own observation. Of twelve cases which are described in detail, the most remarkable is that of a man aged 83, whose diet for twenty years had consisted of one bottle of gin and one small fragment of toasted bread daily. This old fellow, says Dr. Anstie, "would have been of little service as a practical illustration of the bodily harm wrought by drinking, being in truth rather an unusually active and vigorous person for his time of life." Probably the old man was not narcotized by his daily bottle of gin; or he would, long before the twenty years had elapsed, have shown symptoms of nervous disease. In most of these cases of abnormal diet, there occurs after a while a general breaking down of the nerve-centres, shown in delirium tremens, epileptic fits, or a sudden stroke of paralysis. They are not quoted, therefore, as examples to be followed, but as very important items of evidence in favour of the opinion that alcohol is food.
Taking all these considerations together, we believe it to be tolerably well made out that alcohol, whether changed within the body or not, is a true food, which nourishes, warms and strengthens. And Dr. Brinton, in the following passage, declares it to be, in many cases, a necessary food. "That teetotalism is compatible with health, it needs no elaborate facts to establish; but if we take the customary life of those constituting the masses of our inhabitants of towns, we shall find reason to wait before we assume that this result will extend to our population at large. And, in respect to experience, it is singular how few healthy teetotalers are to be met with in our ordinary inhabitants of cities. Glancing back over the many years during which this question has been forced upon the author by his professional duties, he may estimate that he has sedulously examined not less than 50,000 to 70,000 persons, including many thousands in perfect health. Wishing, and even expecting to find it otherwise, he is obliged to confess that he has hitherto met with but very few perfectly healthy middle-aged persons, successfully pursuing any arduous metropolitan calling under teetotal habits. On the other hand, he has known many total abstainers, whose apparently sound constitutions have given way with unusual and frightful rapidity when attacked by a casual sickness." "This," says an English reviewer of the French experiments, "is quite in accordance with what I have myself observed, and with what I can gather from other medical men; and it speaks volumes concerning the way in which we ought to regard alcohol. If, indeed, it be a fact that in a certain high state of civilization men require to take alcohol every day, in some shape or other, under penalty of breaking down prematurely in their work, it is idle to appeal to a set of imperfect chemical or physiological experiments, and to decide, on their evidence, that we ought to call alcohol a medicine or a poison, but not a food. I am obliged to declare that the chemical evidence is as yet insufficient to give any complete explanation of its exact manner of action upon the system; but that the practical facts are as striking as they could well be, and that there can be no mistake about them. And I have thought it proper that, while highly-coloured statements of the results of the new French researches are being somewhat disingenuously placed before the lay public, there should not be a total silence on the part of those members of the profession who do not see themselves called upon to yield to the mere force of agitation."[34] If this view of the case, which so strongly recommends itself to the mind of the practical physician, be the true one, we are forced to regard teetotalism, considered not in its moral but in its physiological aspects, as a dietetic heresy nearly akin to vegetarianism. Man can do without wine, as he can do without meat; but the rational course is to adopt that diet from which we can obtain the greatest amount of available vital power.