Название: Alcohol: A Dangerous and Unnecessary Medicine, How and Why
Автор: Allen Martha Meir
Издательство: Public Domain
Жанр: Зарубежная классика
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“The period of rest for the heart was shortened, though, perhaps, not to such an extent as would be inferred from the number of beats, for each contraction was sooner over. The heart, on the fifth and sixth days after alcohol was left off, and, apparently at the time when the last traces of alcohol were eliminated, showed in the sphygmographic tracing signs of unusual feebleness; and, perhaps, in consequence of this, when the brandy quickened the heart again, the tracings showed a more rapid contraction of the ventricles, but less power than in the alcoholic period. The brandy acted, in fact, on a heart whose nutrition had not been perfectly restored.”
Richardson quotes these experiments of Parkes and Wollowicz as if he agrees with them that increased heart-beat must of necessity mean increased work done by the heart. Dr. Nathan S. Davis, Dr. Newell Martin, Dr. A. B. Palmer, and some other investigators, show conclusively that mere increased frequency of beat above the natural standard is no evidence of increased force or efficiency in the circulation.
“The more frequent beats under the influence of alcohol constitute no exception to the general rule, for while the heart beats more frequently, its influence on the vasomotor nerves causes dilatation of the peripheral and systemic blood-vessels, as proved by the pulse-line written by the sphygmograph, which more than counterbalances the supposed increased action of the heart. The truth is, that under the influence of alcohol in the blood the systolic action of the heart loses in sustained force in direct proportion to its increase in frequency, until, by simply increasing the proportion of alcohol, the heart stops in diastole, as perfectly paralyzed as are the coats of the smaller vessels throughout the system. This was clearly demonstrated by the experiments of Professor Martin of Johns Hopkins University, to determine the effects of different proportions of alcohol on the action of the heart of the dog; and those of Drs. Sidney Ringer and H. Sainsbury, to determine the relative strength of different alcohols as indicated by their influence on the heart of the frog. Professor Martin states that blood containing ¼ per cent. by volume of absolute alcohol, almost invariably diminishes, within a minute, the work done by the heart.”
(This estimate would equal in an adult man an amount equal to the absolute alcohol in two or three ounces of whisky or brandy.)
“These investigations of Professor Martin, being directly corroborated by those of Drs. Ringer and Sainsbury, complete the series of demonstrations needed to show the actual effects of alcohol on the cardiac, as well as on the vasomotor, and also on the direct contractability of the muscular structure, when supplied with blood containing all gradations in the relative proportion of alcohol, leaving no longer any basis for the idea, popular both in and out of the profession, that alcohol in any of its forms is capable of increasing, even temporarily the force or efficiency of the heart’s action.” – Dr. N. S. Davis in Influence of Alcohol On the Human System.
The following letter will be of great interest to all students of the physiological effects of alcohol: —
“Madam: Your letter asking my attention to the apparent contradiction of authorities concerning the work done by the heart when influenced by alcohol was received yesterday.
“The explanation is not difficult. It depends entirely on the different views of what constitutes the work of the heart.
“One class of investigators, led by the original and valuable experiments of Parkes and Wollowicz base their estimate of the heart’s work entirely on the number of times it contracts or beats per minute. Thus Dr. Parkes, finding that moderate doses of alcohol increased the number of contractions of the heart from three to six beats per minute more than natural, readily estimated the number of additional contractions that would occur in twenty-four hours, and thereby demonstrated a large amount of increased work done by the heart under the influence of alcohol. All writers who speak of ‘stimulating’ or increasing the action of the heart by alcohol follow this method of measuring the amount of work done. They generally add that it is like applying ‘the whip to a tired horse.’
“The other class of investigators who claim that alcohol diminishes the actual work done by the heart base their estimates on the amount of blood the heart passes through its cavities into the arteries in a given time. This is the physiological function of the heart; i.e. to aid in circulating the blood. Professor Martin’s experiments were admirably contrived to determine, not how frequently the heart beat, but the amount of blood it delivered per minute under the influence of alcohol and without alcohol.
“He, and all others who take this basis of work, found that alcohol in any dose diminished the efficiency of the heart in circulating the blood in direct ratio to the quantity taken.
“My own original experiments, made fifty years ago, uniformly showed that alcohol quickly increased the number of heart beats per minute, but at the same time diminished the efficiency of the circulation generally. Every experienced practitioner knows that the weaker the heart becomes, the faster it beats. Consequently, the number of times the heart contracts per minute is no measure of the efficiency of its work in circulating the blood. Indeed the mechanism of the heart is such that there must be sufficient time between each of its contractions for its cavities to fill, or it is made to contract on an insufficient supply, and the efficiency of the circulation is diminished.
The International Medical Congress of 1876 adopted as its reply to the Memorial of the National Temperance Society, and of the National Woman’s Christian Temperance Union respecting “Alcohol as a Food and as a Medicine,” the paper by Dr. Ezra M. Hunt, one conclusion of which was, “Its use as a medicine is chiefly that of a cardiac stimulant.”
As experiments conducted since that time show that it is not a cardiac stimulant, but a direct cardiac paralyzant, what excuse is there for using it as a medicine now?
“Whenever the heart is compelled to more rapid contraction than is natural, it has less time to rest. Although it seems to be constantly at work, it really rests more than half the time, so that, although the periods of relaxation are very short, they are so numerous that the aggregate amount of rest in a day is very great. Now, if the rapidity of the contractions is increased materially and continuously, although the aggregate amount of time for rest may be the same as before, yet the waste caused by the contractions is greater, while the time for rest after each one is shorter. This lack of rest produces exhaustion of the heart-muscle, ending in partial change of the muscular tissue into fat. The heart then becomes flabby and weak and its walls become thinner, a condition known to physicians as a ‘fatty heart,’ often resulting in sudden death.” —Tracy’s Physiology, page 158.
Dr. T. D. Crothers, of Hartford, Conn., has made many observations with the sphygmograph to learn the effects of alcohol upon the heart. He says: —
“On general principles, and clinically, the increased activity and subsequent diminution of the heart’s action brings no medicinal aid or strength to combat disease. This is simply a reckless waste of force for which there is no compensation. Without any question or doubt the increased heart’s action, extending over a long period, is dangerous.
“The medicinal damage done by alcohol does not fall exclusively upon the heart, although this organ may show it more permanently than others.” —Transactions of Second Annual Meeting of A. M. T. A.
Dr. I. N. Quimby, of Jersey City, N. J., in an address before the American Medical Temperance Association, after describing two clinical cases which ended in death, made the following statement:
“There was nothing so strange about the death СКАЧАТЬ