Oscar steadied himself on the large gray stone beside his barn. Breathing heavily, he cursed at everything and nothing. Turning, he sat down on the stone and tried to catch his breath. The dizziness had become more frequent, preceded by tightness in his chest and shortness of breath. With great effort, he pushed himself off the rock to a standing position, grunting in frustration.
Oscar woke up to Dr. Jack Parker standing over him with his bushy gray eyebrows furrowed above milky blue eyes. “Your heart rate is too high, I’m going to prescribe alcohol twice daily. You need to rest for at least a week, no farmwork”. Dr. Parker wrote down ‘16 mils each morning and evening’ on a piece of paper, then packed up his equipment and left out the front door. Oscar watched the doctor exit the dirty screen door with his left overall strap hanging down under his arm and his worn brown satchel in the other.
The next morning, Oscar went out to milk the cows. He pulled out his home-made grain alcohol in a mason jar and took a sip. It was cold, and he had work to do. He didn’t have time to stay in bed, no one else was going to do the work. He took an extra sip and mumbled to himself that he was following the doctor’s orders.
Alcohol is widely known for its medicinal use in the past. Some of its uses are shocking, but in the day, they felt it made sense. Without the regulations that we have today that make sure medications and practices are safe, it was trial and error in the hopes that nothing bad would happen. John Foote, M.D. authored the Lippincott’s Nursing Manuals, The Essentials of Materia Medica and Therapeutics for Nurses1 in its third edition of 1918, the original version was in the year 1910. This book was written for nurses who are studying for their State Boards with the focus on 'therapeutics', or in other words medicinal remedies. Foote tells us in the preface that he presents two actions for each medicine, one is ‘physiological’ ( based on experimental pharmacology), and therapeutic actions as to not cause a conflict between the two.
The subheading for the use of alcohol as a drug is labeled, ‘Alcohol and the Anesthetics Alcohol’. Foote lists the types of alcohol used in medicine: brandy, whiskey, some wines, and malted liquors. He goes on to tell the percentage of alcohol in each type, and then states that grain alcohol is used in elixirs, tinctures and official preparations and therefore are essential in pharmacy.
The usual oral dose of alcohol was 4 to 16 mils (it’s not a typo, that is how they wrote it back then).
Alcohol’s physiological actions are listed by Foote as including effects on the ‘higher centres’ of the brain, invoking less self-control and talkativeness with what appears to be simulation of the brain. He goes on to say that alcohol actually paralyzes the brain, and large quantities lead to an alcoholic coma. We know these things to be true today but with much more intricacy.
We know that alcohol affects the neurotransmitters in the brain which are the chemical messengers sending signals to the body and thought processes. Alcohol affects inhibitory as well as excitatory processes in the brain and increases dopamine which creates the false sense of feeling good.
The shocking fact is that diluted brandy and alcohol were given intravenously in those days. This allowed not only bacteria into the bloodstream, but the kidneys weren’t allowed to do their job of filtering so then the person could get alcohol poisoning. Normally alcohol takes 20 minutes to reach the brain, but injected, it goes immediately to the brain and can be fatal. The thought process was that since alcohol increased circulation by dilating the peripheral vessels, and increased the heart rate, its effects were similar to digitalis or caffeine. Alcohol was also prescribed as a gastric stimulant to increase appetite, but in less than 50% strength because of its irritation to the gastric mucosa.
Foote details alcohol as a food, one that helps to produce energy and heat in the body. It was given for extreme exhaustion. He states, “It acts in this capacity by sparing body tissues that otherwise might be broken down to furnish heat and energy”.
Now onto alcohol’s ‘Therapeutic Uses’. He tells us that alcohol is used as a food and also in helping the heart with typhoid, pneumonia, exhausting fevers and more. It is also cited as widely used as a stimulant in shock and ‘collapse from any cause’. Gastric atony is treated with light wine or in digestive elixirs that have 20% alcohol. He ends by warning that alcoholism is easily formed by ‘neurasthenic and hysterical individuals’. He names Peruna by name, calling out its popularity due to its alcohol content (28%). Peruna was one among many concoctions masquerading as medicinal with many false claims attached. See the picture, and how they marketed to women as the more hysterical and susceptible species. But that is a whole other article, isn’t it?
When I was reading this section of the book on alcohol, the part that stood out to me was the injection of alcohol into a vein for medicinal reasons. The following link talks more about the practice, and tells of an operation in which a surgeon used this method of treatment. Today, there are people who inject alcohol as a way of getting drunk without having the smell of it on their breath. However, it often has very caustic effects and can be fatal.
We have learned much from good and/or misguided practices of the past. Medicine is a practicing profession, one that learns and expands on experience. I have enjoyed writing this, as I always do when looking into the forgotten world of nursing and medicine history. What are your thoughts on this practice, or knowledge of a practice that has now become part of “An Era Gone By’.
References
1Foote, J. M.D.1918. Lippincott’s Nursing Manuals: The Essentials of Materia Medica and Therapeutics For Nurses. Philadelphia & London: J.B. Lippincott Company.
The history (and effects) of injecting alcohol
