REPORT OF THE SUB-COMMITTEE ON THE

PHYSIOLOGICAL AND PATHOLOGICAL ASPECTS OF THE DRINK PROBLEM,

PRESENTED TO THE

COMMITTEE OF FIFTY.

REPORT.

Ar the meeting for the organization of the Committee of Fifty, held in April, 1893, the following named gentlemen were appointed a Committee on the Physiological and Pathological Aspects of the Drink Problem, namely, Dr. J. S. Billings, U. S. Army, Director of the Medical Museum and Library, Washington; General Francis A. Walker, President of the Massachusetts Institute of Technology; and Professor R. H. Chittenden, Director of the Sheffield Scientific School of Yale University. This committee was requested to report to the General Committee as to what investigations should be made into the effects of alcoholic drinks upon the human body, in order to settle, as far as possible, the questions as to the nature and amount of such effects, and to lead to a sound judgment as to the merits of the widely divergent opinions with regard to the effects of the moderate use of alcoholic drinks which are at present found among writers and teachers on this subject.

In the following month, May, 1893, a report was presented to the committee, stating that investigations are needed upon the following subjects:

"I. The effects of each usual, or, as it might be termed, normal constituent of various kinds of alcoholic drinks, including more especially malt liquors, the wines in ordinary use, whiskeys, brandy, rum, gin, and liquors or cordials. The constituents referred to are ordinary or ethyl alcohol, various higher alcohols, such as amyl, propyl, butyl, etc., alcohol and their derivative ethers, extractive, bitter, aromatic, and coloring matters, volatile oils, tannin, salicylic acid, and other preservatives, etc.

"II. The effects of certain unusual and abnormal substances which are at times found in alcoholic drinks, and which may be either purposely added or be accidental contaminations.

"III. The effect of the various combinations of these normal and abnormal constituents which form the alcoholic drinks of

commerce.

"IV. The effects to be observed may be divided into immediate, secondary, and remote. The immediate and secondary effects, such as those on body temperature, digestion, absorption, secretion, the vascular and nervous systems, and especially on metabolism or nutrition in general, are to be ascertained by experiments on animals and on man. By secondary effects are meant those which follow within a day or two. This investigation would chiefly be a matter for skilled experimental physiologists to undertake.

"V. The remote effects are those due to the action for a considerable period of time of the substances in question, being manifested by changes in tissues, organs, and functions, together with the resultant influence on nutrition produced by a more or less habitual use of alcoholic drinks of various kinds. This branch of the inquiry pertains more especially to pathology, and requires a careful collection and comparison of records by competent observers. Experiment on this part of the question has but a limited field of usefulness, although the results bearing on nutrition may be of direct value.

"VI. It is believed in a general way that the results of the habitual use of the different kinds of alcoholic drinks differ in different individuals, and also according to the form and amount of drink used. Thus physicians commonly believe that the habitual excessive use of malt liquors tends to produce fatty degenerations of various organs, more especially of the liver and kidneys; that the habitual use of wine, more especially of burgundy, and the finer clarets and port, tends to produce gout; that the excessive use of distilled liquors tends to produce excessive development of the inter-cellular tissue in the liver and kidneys, resulting in what is called cirrhosis; and that the use of the cheaper kinds of spirits, and especially of those containing the higher kinds of alcohols in the form of fusel oil, is especially likely to produce delirium tremens. At present, however, such statements as these are usually matters of individual opinion and do not rest upon any scientific statistical basis. One of the lines of inquiry would be to obtain positive data on these points, to compare the results observed in beer drinkers, for example, with those observed in spirit drinkers.

"VII. Another branch of the inquiry into remote effects relates to the influence upon offspring of the habitual use of

alcohol, or of its excessive use just prior to fecundation and during pregnancy. Upon these points we have little definite and accurate information. Connected with this is the question of hereditary predisposition to alcoholism, and that of periodical alcoholism or so-called dipsomania, in which the desire for alcoholic drinks is considered to be due to abnormal nerve structure, and to be, therefore, a symptom of a particular form of disease.

"VIII. In each of these lines of inquiry, the first step should be to prepare a concise statement of what is known, carefully distinguishing facts reported by reliable experimenters and observers and paying little attention to speculations and theories, except for the purpose of formulating definite questions with an indication of the possible sources from which positive answers may be derived. This part of the work can probably be best done in the library of the Surgeon-General's office in Washington, and it would occupy the time of a skilled man for several months."

The general conclusions of this report were approved by the main committee. The Committee on the Physiological and Pathological Aspects of the Drink Question was continued, and Professor H. P. Bowditch of the Harvard Medical School, Boston; Dr. William H. Welch, Professor of Pathology in Johns Hopkins University, Baltimore; and Dr. G. Alder Blumer, Director of the State Insane Asylum, Utica, N. Y., were added to the committee, which, somewhat later, was increased by the addition of Dr. W. O. Atwater, Professor of Chemistry in Wesleyan University, Middletown, Conn. The committee thus organized proceeded to enter on the following investigations:

I. A research on the influence of pure ethyl alcohol and some alcoholic drinks upon the purely chemical processes of digestion, carried out under the direction of Professor R. H. Chittenden ;

II. A research upon the pathological effects on the tissues produced by the long-continued use of alcoholic drinks, made under the direction of Professor W. H. Welch ;

III. A research on the influence of alcoholic drinks and of pure ethyl alcohol upon the growth and development of certain animals, made under the direction of Dr. C. F. Hodge, Professor of Physiology in Clark University, Worcester, Massachusetts;