THE ACTION OF ALCOHOL UPON THE CIRCULATION. 



By Horatio C. Wood and Daniel M. Hoyt. 

 INTRODUCTION. 



When Dr. H. C. Wood graduated in medicine in 1862 the profession knew of but two 

 heart stimulants, namely, ammonia and alcohol; for it was taught that digitalis is a powerful 

 heart sedative, to be used in cases of excessive heart, excitement, and when, as in aneurism, it 

 was desirable to lessen the force of the blood current. 



Not many years after the physiologists, and subsequently the clinicians, began to learn that 

 digitalis is not a cardiac depressant but a most powerful and useful cardiac stimulant — a stimu- 

 lant which for most purposes still stands at the head of the list of remedies of the class. Alco- 

 hol, on the other hand, yet remains a question of dispute, so far as concerns its action upon the 

 circulation. Probably since the days of Noah, certainly up to the present moment, whatever 

 the judgment of the profession may be, the action of the laity is that alcohol is a prompt heart 

 stimulant. If a man faints in a drug store, or in a public assembh*, or in the street, unless the 

 crowd be so far given to temperance principles that no whisky flask is available, said tiask is 

 forthcoming. 



Nearly fifty years of medical life has led Dr. H. C. Wood to attach much importance to 

 widespread popular beliefs, not in regard to the truth of their theory but of their practical 

 results. For years the profession looked upon the mediaeval practice of the use of balsams on 

 wounds as a dirty, obnoxious procedure. Now we know that the old vulnarian used remedies 

 which were actively germicidal, and that in the midst of mediaeval tilth, with its hosts of hungry 

 organisms, he was practicing a rude antiseptic surgery. 



For years indefinite there has been a widespread belief that fistula in ano and similar dis- 

 charging tubercular sores ought not to be healed in consumptive people; the profession decided 

 that they simply helped to exhaust the system and must be done away with; but the latest 

 specialists in tuberculosis have come to the belief that these tubercular sinuses may be really 

 curative by the antitoxin which they produce interfering with tubercular processes more 

 serious because situated in a more vital part. The facts that alcohol is used to the amount 

 of tons annually in diseased conditions affecting the circulation; that it is not powerless for 

 good or for evil; that the physiologists are in absolute discord in regard to its influence, upon 

 the circulation, and that the clinicians are becoming, in the presence of this physiological diversity 

 of opinion, doubtful and uncertain in the use of the drug, can not be gainsaid. As proof of the 

 divergency of opinion among competent pharmacologists, two quotations may be cited — one, 

 written in 1900, by H. C. Wood, professor of therapeutics in the University of Pennsylvania, as 

 follows; 



Upon the heart the small dose of alcohol acts as a direct stimulant, the large dose as a depressant or paralyzant. 

 The influence of minute doses upon the vasomotor system is not thoroughly worked out, but there appears to be a 

 widening of the blood paths at a time when the heart is still stimulated, so that there is a marked quickening of the 

 blood movement. (Treatise on Therapeutics. J. B. Lippincott Co., 11th ed., p. 287.) 



The other coming from the pen of John .1. Abel, professor of pharmacology in Johns Hopkins 

 University is: 



So far as present experimental evidence goes, we may say: 1. That alcohol as such, that is, when it is introduced 

 into the circulation with the avoidance of local irritation, is not a circulatory "stimulant." 2. Alcohol in moderate 

 quantities, say a pint of wine, has no direct action on the heart itself, either in the way of stimulating or depressing 



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