FREDERICK M. ROSSITER, M. D.
(Battle Creek, Mich.)
ACTION ON THE HEART AND THE CIRCULATION.
In studying the action of alcohol upon these organs, let us first consider it as a stimulant. Is alcohol a stimulant? Nearly the entire medical profession regards this drug as one of the most efficient cardiac stimulants. Personally I do not look upon it as such, for it meets none of the requirements of a stimulant, even when the term is considered in its original meaning. The word “stimulant” comes from the Latin word stimulans, the present participle of stimulare, meaning, to prick, to goad on, to incite or animate to action, or more vigorous action,—to exasperate.
To goad on an elephant with an iron probe, or to use a whip on a horse about to stop on a hill with a heavy load, is a stimulant. It does not put any more energy or strength into the animal, but it simply enables it to utilize in a short period of time all its available reserve force. In other words, a stimulant gets increased action out of an animal or out of a man, but does not put any energy into either. A man returning from a hard day’s work, so tired that he can hardly drag one foot after the other, is suddenly set upon by thieves. He forgets his weariness at once, and runs. He runs faster than he ever did before. The attack of the robbers acts as a stimulant in this case. The entire central nervous system is aroused, every motor center is intensely excited, and compels the muscles to work in spite of being tired. This is the effect of a stimulant. When the excitement is over, the man sinks from exhaustion, for he has used up his store of surplus vital energy. This is the reaction from a stimulant, or the secondary effect.
Strychnia, cocaine, and caffeine are all stimulants in this sense, but alcohol does not meet even these requirements.
The results obtained from the action of any stimulant depend upon the degree of excitation of nerve centers. Caffeine and cocaine excite the nerve centers of the central nervous system, and actually enable one to do more work for the time being; but after the nerve center has expended all its energy, fatigue and exhaustion follow. This action of stimulants, an action we see in all conditions of life, demonstrates a great law in drugs; namely, that a drug which stimulates when given in moderation, will depress and paralyze if given to excess.
An ordinary meal of wholesome food energizes body and mind, giving one a feeling of satisfaction, exhilaration, and strength; but if an enormous meal is eaten, stupor and drowsiness take the place of mental and physical activity, and one feels like a boa constrictor after a full meal,—he must sleep it off.
A natural or physiological nerve energizer differs from a stimulant in that, in the former case, while a nerve cell or a nerve center is expending energy, vital processes are at work replenishing the loss of energy. Oatmeal is a physiological excitant for this reason. “A horse feels his oats,” we say. He feels like doing more work, and he is able to do more work. Eating oats will make even a hog frisky and playful. Cold water is a physiological invigorator, for while it arouses the nerve centers by its action upon the skin, at the same time it stirs every glandular structure into vigorous action to supply the working nerve cell with more energy.
The working capacity of a muscle depends upon its connection with a nerve center, and upon the condition of that particular nerve center. In order for a muscle to work, or to do more work, its nerve center must be in a condition receptive to stimulation, and nothing must prevent the effect of the stimulation from reaching the muscle. Alcohol interferes with both these processes.
The latest scientific data on this subject, gathered from numerous experiments carried on by men of world-wide reputation,—men who have reported conscientious conclusions, though some of them do not hesitate to drink the social cup,—show that alcohol in the smallest quantities tends to lessen the activity of the nerve centers; that in the smallest quantities it is a narcotic. It has also been shown that alcohol lessens the contracting power of a muscle and diminishes its working capacity.
Based upon these facts, it is difficult to see how alcohol acts as a heart stimulant even; for the heart is a muscle, and is subject to all the conditions governing the action of muscle. In experiments upon animals it has been shown that the first effect of alcohol on the heart is to lessen its efficiency and to weaken its power of contraction. (Cushney, on “Action of Drugs,” 1900.)
As soon as alcohol enters the stomach, and the sensation of warmth is diffused over the body, the heart begins to beat more rapidly in consequence of the depression of the nerve that slows the heart, and of the depression of nerves that control the caliber of the small arteries, with a distention of both the heart and the arteries. The flushing that soon follows imbibing, is not confined to the face, but occurs in every organ of the body, and is due to a vasomotor paralysis. This enlarging of the blood channels removes the resistance to the heart’s action and hence it beats more rapidly, just as an engine would spurt ahead if it should break away from its train. In this condition the blood moves more rapidly for a time through the arteries. Alcohol in this respect acts very much like amyl nitrite, one of the most powerful and quickly acting heart depressants known. Amyl nitrite is made from alcohol, and affects the heart in a fraction of a minute, when simply inhaled, relaxing the blood vessels, lowering the blood pressure, and allowing the heart to beat more rapidly. No physician would claim that amyl nitrite is a heart stimulant, and yet it acts on the heart the same as alcohol, only much more rapidly and powerfully. Alcohol exhausts the heart by allowing it to beat more rapidly, and hence to lift a greater weight of blood. Six ounces of spirits of alcohol increase the number of heart-beats one sixth, or twelve beats every minute, thus making 17,280 beats in twenty-four hours. This, multiplied by six, the number of ounces of blood expelled from the heart at each contraction, equals, when reduced, 6,480 foot pounds of blood, or the equivalent of raising more than three tons one foot high. Alcohol, by interfering with the nervous control of the heart, allows the organ to wear itself out by doing extra work that is not required by the body, just in the same way that an engine will shake itself to pieces when the governors are removed.
Alcohol is very likely to produce heart failure because of its depressing influence upon the nerve centers in the brain that regulate the heart’s action. Large doses of alcohol frequently cause sudden heart failure. The constant use of alcoholic drinks produces a permanent relaxation of the blood vessels in the skin and the organs of the body. The “rum blossom” and bloated face of the heavy drinker indicate this.
With the blood vessels in a relaxed condition, and the nerve centers narcotized so that they but poorly respond to energizing influences, and in turn slowly and feebly transmit these to the organs and muscles, we can see that such a person is in a poor condition to resist disease; for the “blood is the life,” and the health of any part of the body depends upon the perfection of the circulation in that organ.