to digestion and counteract to some extent any retarding influence due to the coffee taken during the meal, but the large quantity of sugar which they contain may in the process of digestion be a prolific cause of acidity. On the process of digestion, the action of liqueur is practically identical to that of pure alcohol. Liqueurs can only delay digestion by virtue of the alcohol which they contain. In moderate quantities, the influence is probably favorable rather than otherwise, owing to the vegetable bitters which they contain. Their acidity is so slight that they have but small untoward effect on salivary digestion. CONCLUSIONS AS TO THE USE OF ALCOHOL Alcohol is undoubtedly an unnecessary article of diet in normal health, but it can be consumed without harmful effects within certain limits in quantities up to two ounces per day, the maximum amount that can be metabolized by the average individual within twenty-four hours. For some this estimate is too low, while for others even this amount cannot be utilized without unpleasant after-effects. From the foregoing study of alcohol and its various preparations, we have been able to determine that its use as a food is practically nil; that it can replace, only to a certain extent, a small amount of fat and perhaps also an infinitesimal amount of carbohydrate in the body, while its secondary effects on the nervous and muscular system counteract, to a large extent, the benefits derived from the production of heat and energy by its oxidation. Clinical experimentation has shown that the consumption of alcohol does not favorably induce sustained muscular effort and that on the other hand it may even do harm by paralyzing the sense of fatigue which is the natural check on excessive exertion. Its use does not stimulate the performance of mental labor, but instead retards mentality unfavorably in the performance of perfectly healthy brain work. Abel in writing on the "Physiological Aspects of the Liquor Problem" says: "He who has mental labor of an exacting kind to perform, and he upon whom great responsibilities devolve, is forced, if he would be at his best, to use alcohol as a restorative agent only at the proper time and place, as he would other pleasures and luxuries in his environment." There can be no question but that even daily moderate drinking reduces considerably the rapidity with which the habitual association of ideas are formed in the mind. The effect of alcohol is cumulative and increases as time goes on. The idea that alcohol "stimulates" a person to the performance of mental tasks. is not founded on fact; neither is the widespread notion that its use helps an artisan in his task corroborated by tests. The work of scientific investigators has likewise robbed alcohol of its traditional glory as a digestive stimulant. While it is granted that alcohol does at first stimulate the digestive organs, yet this effect is counterbalanced by its inhibitory effect upon the chemical process of diges tion. It is the opinion of careful students of the subject that the moderate use (two ounces per day) of alcohol in health is harmless, but Dr. Murchison on the other hand asserts that (a) “a man in good health does not require alcohol and is probably better off without it. Its occasional use will do him no harm; its habitual use, even in moderation, may, and often does, induce disease gradually; (b) there are a large number of individuals in modern society to whom alcohol, even in moderate amount, is a positive poison.' The use of alcohol in disease is a subject on which volumes have been written. It undoubtedly has a place in disease, but like other poisons and narcotics should be prescribed with caution. Just as the effect of alcohol on the digestion is the test for its value in health, so its effects upon the circulation and nervous system are the criterion of its usefulness in most cases of acute disease. Alcohol may be employed in fevers and other wasting diseases, where, by its oxidation, it limits the destruction of the bodily tissues, reduces the temperature and stimulates the heart and circulation. A dry brown tongue, restlessness and a feeble, irregular pulse are indications for its use. It is best given in the form of whiskey or brandy in definite quantity, according to the condition of the pulse and heart, the general strength, the height of the fever, the ability to take nourishment and the age and previous habits of the patient. It is not indicated in every case of fever, and many cases will be aggravated by its use. Armstrong and Greves found (a) it is doing good if the tongue becomes moist, the pulse slower, the breathing more tranquil and the skin moist; (b) it is doing harm if the tongue becomes dry and brown, the pulse quicker, the respirations more rapid and the skin hot and parched. Young children and aged persons bear stimulants well. Habitual drinkers when coming to the sick bed do not react to stimulation. Alcohol is lauded as a check to tissue waste in febrile conditions so marked in prolonged wasting diseases, though we have seen reason to doubt this at least so far as nitrogenous tissues are involved. There are reasons for the theory that alcohol actually increases the resisting power of the body to the poisonous toxins of septic fevers. In some chronic diseases, such as diabetes, alcohol is used advantageously to replace a certain amount of carbohydrate in the diet. WINE (34) Wine is produced by the fermentation of grape juice. The juice is first extracted from the grape by pressing and kept for a few days at ordinary temperature, when it changes into wine, the dextrose and levulose content being transformed into alcohol and carbonic acid gas according to the following equation: The ferment which produces these changes is present in the grapes or their stalks and in the atmosphere of the manufactories. There are a number of factors, such as the character of the grape utilized, its cultivation and the method of manufacturing, that enter into the production of good wines. Wine has been celebrated from time immemorial, as indicated in the writings of ancient peoples, such as the Hebrews, Chaldeans, Greeks and Romans. About the year 2347 B.c. we hear that "Noah planted a vineyard and drank the wine thereof." Composition of Wine.-Dupré (35), writing on "What is Wine?", gives the constituents of grape juice and the wine manufactured from it. According to his investigations grape juice or "must" contains: 1 He also found on analysis that wine contains the following: 1 Taken from Popular Science Monthly, vol. vii, by Hutchison, p. 576; Ruhräh, p. 184. Preparation of Wine. The wine-making season begins about the middle of August and ends the last of September. The juice of the grapes is expressed in a wine press, unripe, decayed or withered fruit being carefully rejected. Great care should be taken in expressing the juice to avoid crushing the grape seeds and stalks; therefore, the old method of pressing out the juice by "treading" is much preferable to the wine-press method. "The 'must,' as the liquor is now called, consists of: 70 to 85 per cent of water; 10 to 30 per cent of dextrose and levulose, and tartaric, racemic, malic and tannic acids, albuminous, fatty and mucoid substances, essential oils, mineral and coloring matters." The "must" is run into tanks where fermentation is brought about by the action of various yeasts and other organisms that are present in the juice. The most important of these yeasts is Saccharomyces ellipsoideus, but many other ferments are also present. The fermentation continues from one to several weeks, depending on the character of the "must" and the variety of wine to be made. The liquid is then drawn off from the "lees" and is filtered, clarified and put into bottles or barrels or vats for storage in cool cellars. If the temperature is carefully regulated, a second fermentation takes place, providing enough sugar remains to induce it, and the wine is greatly improved by maturation. In the manufacture of wines the process of fermentation must be carefully regulated. In still wines the primary fermentation must be allowed to complete itself, or else it must be stopped by the addition of alcohol or preservatives. Thus the formation of carbonic acid gas will be prevented and the following changes will not be noticeable. Sparkling wines demand a different procedure. In champagne, for example, primary fermentation is soon checked so that the succeeding process, i.e., secondary fermentation, may take place in the bottle and impart the sparkles and froth so essential to this type of wine. In certain wines made from black grapes only the juice is used, the skins being discarded on account of their coloring matter and tannin. "Must" is placed in cellars to ferment. On the deposit of the "lees" the liquid is transferred from cask to cask until fermentation is at the right stage. The wine is then clear and bright. Vin brut is natural wine to which no liquor is added. When ready for sale the wine may contain considerable sugar; or again, it may contain very little, and is then known as sec, or dry wine. When the amount of sugar contained is negligible the wine is très sec, or very dry. Varieties of Wines.—Wines may be classified according to character and composition(36): (a) Natural Wine (b) Strong Dry Wines (c) Strong Sweet Wines (e) Acid Wines (h) Rough or Astringent Wines (i) Sophisticated Wines (a) NATURAL WINE.-Natural wine is made from fresh grapes alone. No spirit is added. In this beverage there should be not less than 7 per cent of alcohol by volume, and not more than 16 per cent. Red wine owes its color to the natural coloring matter contained in the skins of the grapes. However, artificial coloring agents are often used. White wine is made from grape pulp, no skins being used-unless those of white grapes. After the reducing sugar has been extracted, this wine should not contain more than 1.7 per cent of dry extract. (b) STRONG DRY WINES.-Strong dry wines are those in which the destruction of sugar by fermentation is complete; they are sometimes "fortified" by the addition of brandy or grain spirit. Examples of this class of wines are port, sherry and Madeira. In cases of fever these wines are sometimes used in place of whiskey. Port contains from 15 to 20 per cent of alcohol; sherry from 15 to 22 per cent, and Madeira about 17 per cent. (c) STRONG SWEET WINES.-Strong sweet wines are those in which the fermentation is partially completed in the bottle. A sediment is formed and removed and sugar or syrup is added. Varieties of this class are Tokay, Malaga and sweet champagne. They contain from 18 to 22 per cent of alcohol and 3 to 5 per cent of sugar. (d) AROMATIC WINES.-Aromatic wines are rior flavor due to the presence of essential oils. are Moselle, Capri and some of the Rhine wines. varies from 10 to 12 per cent. those possessing a supeExamples of this class Their alcoholic content |