CHAPTER VIII.

FERMENTED DRINKS.

=Properties of Alcohol.=—When a saccharine solution is subjected to the influence of warmth and moisture, and exposed to the air, it rapidly undergoes a process of =fermentation=. The most favourable temperature is about 70° Fahr. The ferment or agent exciting the change in the sugar is derived from the atmosphere; it is a minute fungus (_torula cerevisiæ_), the spores of which are constantly floating in the air. When once fermentation has started, exposure in the air is no longer necessary; the process continues in closed vessels. The essential change occurring in the vinous fermentation is that grape sugar (C₆H₁₂O₆,H₂O) becomes split up into alcohol (C₂H₅OH) and carbonic acid (CO₂). Thus—

C₂H₆O } C₂H₆O } Two of alcohol C₆C₆H₁₂O₆ = CO₂ } CO₂ } Two of carbonic acid.

There are other fermentations allied to the vinous. Thus the =Acetous= fermentation results in the conversion of alcohol into vinegar, as in the souring of beer or wine. The =Lactic= fermentation leads to the conversion of milk-sugar into lactic acid, with consequent souring of the milk.

=Alcohol=, or more correctly ethylic alcohol, is a colourless liquid, having a pleasant vinous odour, and evaporating rapidly on exposure to air. It burns with a bluish sootless flame, and is a capital solvent for resins and other substances.

_Rectified spirit_ is absolute alcohol mixed with 16 per cent. of water. _Proof-spirit_ is a mixture of 42·7 per cent. by volume of absolute alcohol, and 57·3 per cent. of water. Thus the ratio of alcohol to proof-spirit being as 1: 1·76, the amount of alcohol in any liquid being given, the amount of proof-spirit can readily be calculated. The fermented drinks containing alcohol may be classed as (1) malt liquors, (2) wines, and (3) distilled spirits. The relative properties of these will be considered afterwards; in the next two sections will be considered the effects of diluted alcohol in whatever form it is taken.

=Effects of Moderate Doses of Alcohol on the System.=—In studying the physiological effects of alcohol, one has to guard against the fallacy that these are the same, only differing in degree, whatever the dose may be. The effects of large doses of alcohol are almost exactly the reverse of those produced by small doses. It will be necessary to define, therefore, what we mean by a moderate dose. By a moderate dose, we understand the amount of alcohol which can be taken without any alcohol being eliminated in the urine. Dr. Anstie found that 1½ ounces, that is three tablespoonsful, of absolute alcohol, taken in twenty-four hours, caused its appearance in the urine; and Dr. Parkes and Count Wollowicz obtained almost precisely the same result. Anything below some quantity between 1 and 1½ fluid ounces per day can be disposed of in the system, and is probably oxidised like ordinary foods.

The amount of alcohol, in the form of alcoholic beverages, corresponding to this =maximum dose= of absolute alcohol is approximately as follows:—

One imperial pint (20 fluid ounces) of bottled beer (5 per cent. of alcohol).

One tumblerful (10 „ „ ){of claret, hock, and} {other weaker wines } (10 „ „ ).

2½ glasses (5 „ „ ){of port, sherry, and} {other strong wines } (20 „ „ ).

One glass (2 „ „ )of brandy or whiskey (50 „ „ ).

It will be understood, therefore, that in describing the effects of a moderate amount of alcohol on the system, an amount below 1½ ounces of absolute alcohol per day is meant, freely diluted, and taken as a rule with meals.

1. =Effect on the Stomach.=—In very small quantities, alcohol seems to stimulate digestion in the same way as mustard. But like all other artificial helps to digestion, it is best avoided in the healthy condition.

2. The =Effect on the Liver= is similar to that on the stomach—a temporary redness and congestion being produced; this effect soon disappearing if the dose is small and well diluted. But in all cases where there is a tendency to biliousness, even small doses of alcohol are injurious.

3. The =Effect on the Heart and Blood-Vessels= is first to increase the force of the heart’s action and the rapidity of the pulse. The stimulation of the heart is rapidly followed by a universal dilatation of the small arteries of the body, which diminishes the blood-pressure. Parkes and Wollowicz found that the daily administration of from 1 to 7½ ounces of rectified spirit raised the pulse rate by ten beats per minute, as compared with other periods; and that this effect was followed by a period of depression in which the beat was both slower and feebler than usual.

4. The =Effect on the Nervous System= varies. In persons unaccustomed to its effects, even small doses dull the power of thought and the rapidity of perception, owing to the paralyzing effect which it exerts on nerve cells. In most cases, however, it at first produces increased rapidity of thought and excites the imagination, though even here it makes it more difficult to keep to one train of thought. This is clearly owing to the more rapid circulation of blood through the brain. Dr. E. Smith’s experiments show that it diminishes the acuteness of the senses. Its influence even in dietetic doses, on the capacity for mental work, is slightly to diminish it.

5. The =Effect on the Muscular System= is never beneficial. Even when only small quantities are taken, the power of controlling delicate movements is slightly diminished. For persons engaged in laborious occupations, a small quantity does not produce much apparent effect, but where the quantity exceeds two fluid ounces per day the capacity for strong and sustained muscular work is manifestly lessened (Parkes). This effect is probably due partly to the dulling of the nervous system, rendering the muscles less amenable to the will, and partly to the over-excitation of the heart causing palpitation and breathlessness.

6. The =Effect on Metabolism= is to diminish it, thus favouring the deposit of fat in the tissues. It acts as a poison to the protoplasm of the cells of the body, diminishing their power to break down the floating nutriment, especially fat and carbohydrate.

The =Effect on the Temperature= is to lower it; but unless the dose is excessive, this effect is hardly appreciable. The resistance to excessive cold is diminished by even moderate doses of alcohol, still more by large doses. In the Arctic regions, this has been abundantly proved. This effect is produced, notwithstanding the fact that alcohol becomes oxidised in the system. The dilatation of the surface blood vessels leads to a greater loss of heat than that produced by the oxidation of the alcohol.

EFFECTS OF IMMODERATE DOSES OF ALCOHOL ON THE SYSTEM.—Bearing in mind the definition given of a moderate dose, one is bound to admit that a large number of individuals exceed this amount daily, apparently without any very serious results. The system becomes habituated to large doses, and if the occupation is a laborious one, they may in part be oxidised in the system. Such, however, are exceptional cases. In the majority of cases evil results are by no means confined to those who indulge in very large quantities of alcohol at varying intervals. In fact these very often escape comparatively free, while others who never take a quantity sufficient to incapacitate them for their work, are sowing the seeds of chronic and oft incurable disease. The labourer who has a drinking bout at intervals is thoroughly nauseated; and the condition of liver and stomach induced, enforces abstinence on him for a time sufficient to bring his organs back to a normal condition; while the city merchant who indulges more moderately, but whose organs are almost continuously impregnated with alcohol, becomes gouty and prematurely old.

The =Stomach= may become acutely inflamed, when a large dose of alcohol is taken. The chronic irritation of alcohol, especially when taken apart from meals, causes atrophy of the walls of the stomach, and a change analogous to that in the liver.

The =Liver=, when alcohol is daily taken immoderately, becomes seriously diseased. In some cases it becomes large and fatty; in others the chronic irritation excites an overgrowth of fibrous tissue between the lobules of the liver, which, gradually shrinking, squeezes the liver cells and causes them to atrophy, at the same time obstructing the small branches of the portal vein in the substance of the liver. The consequence of this obstruction to the flow of blood through the liver is that all the organs from which the portal vein brings blood become overloaded with blood, and vomiting of blood and dropsy of the abdomen occur at a later period.

The =Lungs= are irritated to a less extent by alcohol in large doses. The tendency to chronic bronchitis is increased, followed by emphysema, and sometimes an overgrowth of fibrous tissue (cirrhosis) like that in the liver occurs.

The =Heart and Blood-vessels= tend to become diseased, owing largely to the gouty condition of system developed.

The =powers of Metabolism= are diminished. Corpulence is, consequently, a common result of alcoholism. There may also be fatty deposit in the internal organs, such as the heart. This must not, however, be confounded with a much more serious condition, fatty _degeneration_ of the heart, in which the substance of the muscular fibres becomes partially converted into fat, and which also is sometimes due to alcoholism.

The =Nervous System= is more prone to suffer in chronic alcoholism than any other part of the body, except perhaps the liver. The first effect of a large dose of alcohol is to stimulate the nervous system, as already described. This is followed by a dulling of the nervous faculties, which comes on rapidly in proportion to the amount taken. The phenomena of _intoxication_ are unhappily too familiar to require description, mental incoherence and muscular incoordination (lack of control over the muscles) being the most prominent features.

When the dose of alcohol is still larger, a condition of profound unconsciousness is produced (_coma_), which may be difficult to distinguish from other forms of unconsciousness.

=Delirium Tremens= is another nervous condition, which may rarely follow a single debauch, but much more commonly affects the chronic toper. In some cases the immediate exciting cause is a mental shock, or lack of food, or a surgical injury. Alcoholic subjects suffering from any acute disease are liable to this form of delirium, and their chance of recovery is greatly diminished.

=Insanity= of a more prolonged character than that characterising delirium tremens is an occasional result of alcoholism.

Besides the nervous diseases already named, a chronic thickening of the membranes covering the brain and spinal cord, gradually progressing and finally fatal, is often the consequence of prolonged alcoholic indulgence.

=Various Degenerative Diseases= are produced by alcohol. It has been well called by Dickinson the very “genius of degeneration.” Such degenerations are by no means confined to the intemperate; they are seen in those who are of what would usually be considered moderate habits. The stomach, liver, lungs, and probably the kidneys, are the main organs to suffer in this way. It is probable that the effect on the kidneys only occurs when a gouty condition is developed. In all these cases there is an overgrowth of fibrous tissue, with atrophy of the proper gland structures.

=Gout= is the common nemesis of those indulging in alcoholic beverages, more especially wine and beer, due to the excessive formation or retention of urate of soda in the body. This produces inflammation of the joints, and other evils—among them the gouty kidney, named above, which is always ultimately fatal. Rigid arteries are likewise commonly due to alcoholism and gout. If one of these bursts in the brain, apoplexy results.

=Longevity= is diminished by immoderate indulgence in alcohol. The statistics of Temperance Insurance Societies, show much better results among teetotalers than among moderate drinkers. It is only fair to add that although the latter are supposed to consist of moderate drinkers—and particular enquiries are always made on this point before insurance—it is probable that a large proportion of them exceed 1½ ounces of alcohol per day. Making due allowance for this fact, the statistics show a great superiority in the expectation of life of teetotalers.

=Factors Modifying the Effects of Alcohol.=—1. =Age and Sex.=—Until adult life is reached, total abstinence from alcohol should be enforced. The delicate nervous system of children is easily disturbed by it, and it appears in some measure to retard growth. Another argument against giving alcohol before adult age is reached, is still more important. It is at this period of life that habits are chiefly formed, and a craving for alcohol may be insidiously produced, destined to have most baneful results.

Old people, if ordered spirits for medical reasons, should drink them well diluted.

Women are much more easily affected by alcohol than men, and if they acquire the habit of excess, the hope of reformation is even less than with men.

2. =Exercise= has a most important influence in modifying the effects of alcohol. Those of sedentary occupations and living in towns, cannot oxidise as much as those engaged in active out-door work, and are consequently much more prone to suffer. A game-keeper in the Scotch Highlands may possibly live to a good old age, notwithstanding the fact that he consumes an amount of whiskey that would have sent a sedentary man to his grave in the course of a few years.

3. =The Condition of the Stomach= has also great influence. When the stomach is empty, alcohol produces at once a powerful reflex stimulation of the heart, and becomes quickly absorbed into the circulation. Thus intoxication may be produced by a quantity that would have had little effect if taken with a meal.

4. =The State of Concentration or Dilution= modifies greatly the action of alcohol, the local action on the stomach and the reflex stimulation being much greater than when it is concentrated, and injurious effects being much more likely to occur.

5. =Cold and Heat= modify the action of alcohol. A smaller quantity of hot spirits and water will intoxicate than of cold; the heat stimulating the heart, and so making the absorption of the alcohol more rapid. A glass of hot spirits and water will often cause sleep, by drawing the blood towards the abdominal organs. The fact that persons, who have been drinking spirits in a warm room, on going out into the cold air become suddenly intoxicated, seems opposed to what has been already said. But probably this is due to the cold causing contraction of the arteries of the skin, and so driving more of the blood loaded with alcohol to the internal organs and the brain (Brunton).

6. =Mental Occupation= has some influence in modifying the effects of alcohol. Topers have found that if they try to converse during their debauch—the conversation implying increased functional activity of the brain, and therefore a freer circulation of blood in it—intoxication occurs much more readily, than when the mind is not active.

7. =Disease= modifies greatly the effects of alcohol. In some diseases, as in inflammation of the lungs and in fevers, it can be given in large quantities without producing intoxication; and in these conditions it lowers the temperature. In other diseases, especially gout and kidney disease, its use is nearly always followed by bad results.

=The Advisability of Alcohol as an Article of Diet in Health.=—In dealing with this difficult point, two sets of facts require consideration, those obtained as the result of =Physiological= observations (see page 56), and those which are the result of =Experience=. There can be no doubt that the former are much more reliable than the latter. Experience is very prone to give fallacious results, especially when questions of appetite are concerned. In making a trial of abstinence, the mistake has been commonly made of only prolonging the investigation for a few weeks, and then comparing results. Such a method is, however, very unfair, and is certain to lead to an unreliable conclusion.

The records of experience under certain conditions have, however, been so extensive, as to lead to trustworthy results. It has been abundantly proved that prolonged muscular work is best undergone during total abstinence from alcohol; and that the extremes of heat and cold and the exposure and exertions of marching armies, are best borne under similar conditions.

The artificial character of town life is commonly adduced as an argument for the moderate use of alcohol. In the case of healthy workers, this does not hold good; many of our hardest workers and thinkers take no alcohol.

The universality of the habit of taking stimulants is a curious argument on the same side, though if the habit be bad, this can be no more reason for continuing it than can the prevalence of vice be an excuse for indulgence in it.

The two chief physiological points bearing on the advisability of alcohol as a part of one’s daily diet are—its =food properties=, and its effect on the appetite and digestion.

It has been already stated that a quantity of alcohol under 1 or 1½ ounces may become oxidised in the system, and may thus form a source of heat. But in all probability, although it may be regarded as a food, it is a most inconvenient one, inasmuch as it diminishes the oxidation of other foods. It has been aptly compared in this respect to sulphur, which is an oxidisable material, but which, when it is burnt in a chimney, in which the soot is on fire, will put an end to the combustion of the latter. Its value as a food, under normal conditions, is practically nil.

Its =Effect on the Digestive Organs= is three-fold. (_a_) The contact of alcohol with the mucous membrane of the mouth and stomach, acts as a reflex nervous stimulus, which in moderation excites an increased flow of gastric juice. (_b_) It also increases the activity of the movements of the stomach. In cases of weak digestion, therefore, small doses of alcohol may, at times, be useful. (_c_) The effect of alcohol on the food taken varies with its degree of dilution. Concentrated alcohol coagulates albumin, and so stops digestion; largely diluted alcohol has no such effect.

The late Dr. Parkes, the greatest authority on the dietetic use of alcohol, has summarised the argument as to the dietetic use of alcohol as follows:—

“But what, now, should be the conclusion as to the use of alcohol in health after growth is completed? Admitting the impossibility of proving a small quantity to be hurtful, and at the same time acknowledging the dangers of excess, there arises an argument which seems to me somewhat in favour of total abstinence. No man can say when he has passed the boundary which divides safety from harm; he may call himself temperate, and yet may be daily taking a little more than his system can bear, and be gradually causing some tissue to undergo slow degeneration. He may be safe, but he may be on the verge of danger.

“This uncertainty, coupled with the difficulty at present of saying what dietetic advantage is gained by using alcohol, seems to me rather to turn the scale in favour of total abstinence instead of moderate drinking. But if any one honestly tries, and finds he is better in health for a little alcohol, let him take it, but he should keep within the boundary line, viz., that 1½ ounces of pure or absolute alcohol in twenty-four hours form the limit of moderation. I do not then think he can do himself any harm.”

=The Varieties of Fermented Drinks.=—The three chief kinds of alcoholic beverages are malt liquors, wines, and ardent spirits. In addition, we may mention cider and perry, which are the fermented juices of apples and pears respectively; and koumiss, which the Tartars prepare by fermenting mare’s milk, though it may also be made from the milk of other animals.

All =Beers=, =Ales=, and =Porters= are prepared from malt, which is the germinating grain of barley. The fermentation of the sugar in the barley produces alcohol, the amount of which varies in different cases. In Pilsener beer it is 3½ per cent. of absolute alcohol; in stout and porter 5 to 6 per cent. The hop which is added to the fermenting barley, gives to beer its characteristic bitterness.

=London Porter= is coloured with black or roasted malt; =stout= is only a stronger form of porter. Bottled ales are generally stronger than those on draught, and being slightly effervescent, may agree better.

The effect of alcohol in beer is modified by the _hops_, which help in producing drowsiness. Beer has a marked tendency to produce obesity, more so than any other alcoholic beverage. Its influence in the production of gout is also very great.

=Substitutes for Malt= have been largely used. Thus by the action of sulphuric acid on starch, an artificial form of sugar is produced, which is largely used in place of malt for making beer. Many recent cases of poisoning by arsenic have been traced to the use of impure sulphuric acid in manufacturing this form of sugar.

The detection of arsenic in organic liquids requires great care, as so many compounds of arsenic are volatile, especially in the presence of chlorides, as in beer. To _detect arsenic in beer_ a pint of the beer is evaporated to dryness, and treated with 20 c.c. of strong sulphuric acid, heated, and 20 c.c. of strong nitric acid added drop by drop. Violent action occurs: if possible 20 c.c. more of nitric acid are worked in. Transfer the liquid to a small flask, and expel the nitric acid by boiling. By this means all chlorine is expelled, the arsenic is oxidised and the organic matter destroyed. SH₂ gas is now passed into the acid liquid for some hours, the precipitated sulphur and any sulphide filtered off and extracted with ammonia, which dissolves any sulphide of arsenic. The liquid so obtained is subjected to Marsh’s test. (See page 216.)

In the making of beer from malt, the first stage is to malt the barley, _i.e._ leave it spread on floors for ten days after soaking. This allows germination to take place, in which process the insoluble starch is converted into starch, dextrine, maltose and glucose. After the dried malt has been screened to break off the sproutings, the brewer places it in the mash-tub, with water, at a temperature of 160° F. This completes the transformation of the starch into glucose. The =wort= is now boiled to stop the process, and the albumin from the grain is thus coagulated. Hops are added at this stage. The boiled liquid is passed into shallow vessels and cooled. The proper temperature for “top” yeast is 60° F., for “bottom,” or Bavarian yeast, a much lower temperature is desirable. When the desired temperature is reached, the liquid is run into the fermenting tun along with yeast. The varieties of beer are due in part to the degree of completeness of fermentation of sugar allowed. If too complete, the beer does not keep well.

=Wines= are produced by the fermentation of the juice of the grape. The wine produced may be bottled before or after fermentation is complete; in the former case, an effervescing wine is produced, such as the sparkling wines of the Rhine and the Moselle, or champagne. When the sugar is nearly all fermented a _dry_ wine is obtained, of which Bordeaux and Burgundy, Hock and Moselle, are examples.

The difference in colour between red and white wines is produced by allowing the juice in the former to ferment in contact with the skins, from which the colouring matter is extracted by the alcohol. Both red and white wines may be obtained from either red or white grapes. From the skins also are extracted a salt of iron, and a peculiar form of tannin. Tartaric and acetic acids, and tartrate of potass, are present in varying quantities in wines; in old wines the tartrate separates as bitartrate of potass, forming with tannin and colouring matter the “crust” of port and other wines. The “bouquet” of wines is due chiefly to certain volatile bodies, such as pelargonic ether. The proportion of alcohol in wines varies from 6 to 14 per cent. As fermentation is stopped by the presence of 14 per cent. of alcohol, any larger amount of alcohol than this must have been added to the wine.

Wine, like beer, has a strong tendency to produce gout, especially the sweet and strong wines. It has not, however, the same tendency to induce obesity.

=Spirits= differ from the two last groups, to begin with, in the amount of alcohol they contain. Thus, English beers contain from 3 to 6 per cent., German beers from 2 to 5 per cent., wines from 8 to 20, and all kinds of spirits from 37 to 58 per cent. of alcohol. They differ in the absence of the bitter principle of beer and much of the salts and sugar and ether of wines. They are all prepared by the distillation of some previously fermented liquor. =Brandy= ought to be made by the distillation of wine; and then contains, besides alcohol and water, small quantities of acetic, œnanthic, butylic, and valerianic ethers. But much of the brandy sold is simply made from potato spirit, by the addition of acetic ether, burnt sugar, etc. The starch of potatoes is converted into dextrin and dextrose by dilute acids, and then fermentation allowed. By the use of patent stills, all bye-products can be separated, a fairly pure alcohol known as _silent spirit_ being produced. This is largely employed in manufacturing spirits and in fortifying wines.

=Whiskey= is prepared from malted barley, or from a mixture of grains, to which a sufficiency of malt to convert their starch into sugar has been added. In _grain whiskey_ the distillation is effected by steam in a patent (Coffey’s) still, which separates most of the bye-products (fusel oil, etc.) from the spirit. In _malt whiskey_, distilled in the old-fashioned pot-still, these bye-products are not separated.

The improvement of whiskey effected by keeping is not due (Bell) to the diminution of fusel oil. Such a diminution does not occur. The percentage of alcohol diminishes by keeping, 6 to 8 per cent. proof spirit being lost by five years’ storage in wood. “Fusel oil” is a mixture of alcohols of higher boiling point than ethylic alcohol (amylic, propylic, etc.). Even in a bad whiskey not more than 1∕10 per cent. of fusel oil is present (about one grain in a glassful). Experimentally no marked effects have been produced by fusel oil, when it is less than 1 per cent. Possibly the presence of furfurol, of which there is a trace in malt whiskey, which disappears on keeping, may partially explain the disagreeable flavour of new whiskey. But it is fairly clear that those who argue that it is _bad_ whiskey and not _good_ whiskey which does harm are speaking without knowledge. It is not the quality but the quantity of whiskey which is responsible for so much moral and physical evil.

=Gin= and =Hollands= are obtained from barley, and flavoured with juniper berries and other materials. The oil of juniper stimulates the urinary excretion.

=Rum= is obtained by the distillation of molasses, and is usually kept for a long time in oak barrels. It is said thus to acquire more astringent matters than other spirits contain.

The =legal limits= of dilution of whiskey, brandy and rum is down to 25 degrees under proof, and of gin down to 35 degrees under proof. (For definition of proof spirit, see page 55). The amount of alcohol in an alcoholic liquor is determined by distillation of 100 c.c., making up the distillate to 100 c.c. by the addition of distilled water, and then taking the specific gravity of a portion of this liquid by the aid of the specific gravity bottle. The percentage of alcohol corresponding to a given specific gravity is given in tables prepared for this purpose.

Prolonged indulgence in spirits produces the various organic diseases already described, and unless well diluted they are more harmful than beers or wines. They differ from wines and beers in not tending to produce gout, and from beer in not leading to obesity.