CHAPTER XX FOOD ACCESSORIES, DRUGS, ALCOHOL, AND TOBACCO (Part 1)

CHAPTER XX FOOD ACCESSORIES, DRUGS, ALCOHOL, AND TOBACCO 1. Food Accessories and Drugs. — Through the alimentary and respiratory tracts there are received into the blood not only substances such as proteids, gelatin, fats, carbohy- drates, salts, and water, which we have described as sup- plying the material for power and for growth and repair, but also other substances capable of modifying in one way or another the course of events within the body. The flavors which contribute to the enjoyment of foods play an important rdle in the secretion of the gastric juice ; and yet the substances which cause these flavors are negli- gible as sources of power. Salt belongs under the same head; for we use in cooking more salt than is needed to make good the daily loss from the body, and we do this to develop an agreeable flavor in our food. Substances of this kind are spoken of as food accessories, and among them must be included coffee and tea, for their effect is not chiefly a matter of nutrition; certain constituents of tea and coffee absorbed into the blood affect the ner- vous system, and it is largely for this reason that we use them. We may pass in this way from the necessary food acces- sories through those, like coffee and tea, which, while not essential, may still be regarded as part of the food of a large portion of mankind, to the great number of chem- ical compounds known as drugs, which also act by chan- ging the course of events within the body; and it is difficult to draw any sharp line of distinction between those which HS 357 353 THE HUMAN MECHANISM occasionally serve as medicine or “stimulants” and those of which daily use is made as food accessories. Animals as a rule take substances into their bodies only to satisfy hunger or thirst or appetite ; man alone takes, in addition to his nutriment, food accessories and drugs for the sake of their special effect upon the nervous sys- tem or other organs. Many of the numerous food acces- sories which human ingenuity has discovered or devised are harmless enough in the form used; but others con- tain substances which are capable of poisoning the body. ‘It is an important part of the study of personal hygiene to learn of what these substances consist, what is their ac- tion on the human organism, and wherein lie their special dangers. 2. The Drug Habit. — It is a lamentable fact that large amounts of drugs are swallowed by men and women apart from any medical need which compels their use. In a sub- sequent chapter we shall show reasons for avoiding an undue dependence ‘upon drugs as a remedy for various” minor ills. Bad as this practice is, with its tendency to rely upon the uncertain action of a drug instead of taking proper hygienic care of the body, it is far worse to make habitual use of drugs for their special effects upon the healthy body, for the habit is one which is only too easily cultivated. There is no reason why a healthy human being, living a normal life amid healthful surroundings, should need to use drugs habitually, and a little consider- ation will show that the practice is dangerous. 3. Dangers of the Drug Habit. — When we eat meat, or vegetables, or when we breathe air, we take into the body materials needed for normal living. These things have always formed part of the food of the race, and, unless wrongly taken, do good and not harm. When, on the other hand, we take a drug, such as chloroform, or cocaine, or opium, or alcohol, or coffee, or tea, we take something DRUGS, ALCOHOL, AND TOBACCO 359 which is foreign to the body, in so far as it has not been a regular constituent of animal food in the past. It is not needed, as proteid and salt and water are needed ; there is no special preparation for its reception; and, while it may do good, there is danger that it may do harm. In the second place, the exact action of many drugs is only imperfectly understood. In an emergency the physi- cian uses them temporarily, for some effect which he desires to produce, thus tiding over a difficulty. He uses the drug only a few times at most, and is consequently not greatly concerned about unfavorable attendant effects ; it accom- plishes some needed purpose, and if it does any harm, the organism may be trusted to recover from it. It is very different, however, with the habitual use of any drug. The very fact that it gives some new direction to the events taking place within the body means that abnormal conditions of life are being maintained; and we have already learned that abnormal conditions of life are apt to be unhygienic. Again, the use of drugs is only too apt to be substituted for the hygienic conduct of life. We may, for example, take drugs to accomplish something which the healthy - body should accomplish for itself without outside help. When any one drinks a cup of black coffee to facili- tate mental work which his fatigued condition would not otherwise allow him to do, he is trying to get from a drug the power which he could and probably should secure by normal sleep. The coffee acts like a whip to a tired horse; the same work is done as might have been done had the horse been allowed a little rest; but the horse is not as well off when he does the work under the lash as when he does it in a properly rested condition. Similarly, persons suffering from sleeplessness often take drugs used to produce sleep (hypnotics), and, superficially at least, the sleep thus secured resembles normal sleep ; but experience 360 THE HUMAN MECHANISM shows that few if any hypnotics can be used for any length of time without bad effects. Here again a drug is being depended upon to do what the normal body should do for itself. Pepsin tablets may be taken to aid digestion, and thereby an attack of indigestion may sometimes be pre- vented or relieved; but a healthy stomach should furnish its own pepsin; and the fact that it does not do so is a sure warning that something is wrong in the conduct of life. It is irrational to neglect the duty of attending to the cause of the ailment, and it is foolish to substitute tem- porary relief for permanent cure. Perhaps if the drug did all that the proper care of the body does, and did no more, no serious objection could be made to its use ; but there is probably no drug of which this is true, and for this reason it is foolish and rash to try to substitute the use of drugs for the hygienic conduct of life. Lastly, ifthe drugs do not accomplish in the long run what should be done by the hygienic conduct of life, their extensive use becomes all the more dangerous in view of the unquestioned fact that we are apt thereby to become their slaves. Every man is the slave, broadly speaking, of the habits he forms, and it is only a question as to whether he will be the willing slave of good habits or the abject slave of bad habits. The man who leads a hygienic life is the slave of muscular activity, of correct feeding, of proper clothing, of rest, etc.; that is to say, these things become necessary to his life; he cannot get along without them. If for these proper agents of health he persistently sub- stitutes some drug, whether it be alcohol, or tobacco, or coffee, or tea, or chocolate, or opium, the habit of using the drug is substituted for that of maintaining normal conditions. But since drugs cannot entirely take the place of such conditions, the constitution goes from bad to worse, and increasing dependence must be placed upon the drug. It is a safe rule that whenever we are uncomfortable or DRUGS, ALCOHOL, AND TOBACCO 361 unhappy without the use of a certain drug we should cease using it until, with the help of hygienic living, we can get along without it. There are people who are slaves of coffee, of tea, of chocolate, of patent medicines, of candy, and of soda water, just as truly as there are slaves of tobacco, or of alcohol, or of opium. It is worse to be the slave of alcohol than of coffee, because the evil consequences of alcohol are greater than those produced by the corresponding use of coffee; but it is by the same process in both cases that the man or woman becomes a slave to the drug, and that process is the formation of bad habits. With these practical considerations about the use of drugs, — by which term it will be seen that we mean, not simply the medicines purchased from the apothecary, but all those substances which are taken into the body in order to give some new or abnormal direction to the course of events in the organism, — we may pass on to the discussion of those in common use. 4. Tea and Coffee. — Different as are these drinks in taste and appearance, their most important physiological effects are due essentially to the same substances, viz. caffeine (or theine) and tannic acid (or tannin). Caffeine is a very powerful stimulant, especially of the nervous system, and also of the heart, although probably to a lesser degree; tannin, on the other hand, is a bitter, astringent substance, which may considerably hinder digestion and directly injure the mucous membrane of the stomach. Tea contains about twice as much tannin as an equal weight of coffee, but as coffee is frequently made much stronger than tea the actual amount per cup may often be more nearly equal in the two drinks than these figures indicate. The amount of tannin dissolved in tea varies greatly with the method of preparation, and largely for this reason tea should not be boiled, nor allowed to steep too long. The 362 THE HUMAN MECHANISM proper method of making tea is to pour over the dry leaves water which has been brought just to the boiling point, and then to allow the infusion to stand, without further heating, for not more than a few minutes. Both tea and coffee seem to have a slightly retarding influence upon gastric digestion. In healthy people this is of little consequence, but when the digestive powers are in any way impaired the use of these beverages may be inadvisable. The more important effect, however, of both tea and coffee is in their stimulating action on the nervous system. No satisfactory explanation has yet been given of the fact that some people can use tea and not coffee, while with others the reverse is true. It is probably safe to say that when used in moderation, tea and coffee are usu- ally harmless to those leading an otherwise hygienic life. They should be used sparingly by nervous people and by those in whom digestion is feeble and slow (Hutchinson). | Even by the perfectly healthy they should not be used to excess, nor should the habit be acquired of using them as the whip to the tired horse. Drinking strong coffee in order to keep awake for evening study is objectionable, and the substitution of afternoon tea for a little rest or sleep is also unwise. 5. Cocoa is made from the seeds of trees of the genus Theobroma, and chocolate is prepared from cocoa. In the solid form both are highly nutritious, as shown by the following average results of analyses. Proteid Fat Carbohydrate Cocoayrs. os rauky vce eee Os 28.9% 37.7% Chocolate,” ¥ 0) mucus ueunele. Ou, 48.7% 30.3% When used as a beverage, however, the nutriment derived from them is small. In addition, cocoa and chocolate both contain theobromine, a substance closely related chemically to caffeine and possessing much the same stimulating prop- erties. In general, the same hygienic considerations which DRUGS, ALCOHOL, AND TOBACCO 363 apply to the use of tea and coffee should guide us also in the use of chocolate and cocoa. 6. Soda Water and Similar Beverages. — Of these little need be said. In general they are harmless enough, espe- ' cially to those enjoying perfect digestion. The large amount of sugar which they contain is apt to make matters worse in many cases of dyspepsia; by taking them fre- quently between meals the appetite for wholesome food is impaired, and excessive indulgence in them under any circumstances is needless and foolish. 7. Alcoholic Beverages.—JIn the case of an alcoholic drink we have to deal with something which, like tea and coffee and cocoa and “temperance drinks,” is used as a beverage and to that extent must be classed in the same group. Alcoholic drinks are, however, taken as stimulants and so resemble tea and coffee and cocoa, but they differ _ from all of these in their action upon the body. Moreover, their abuse gives rise not only to degraded moral and social conditions but is also attended with bad hygienic effects. Every one should be informed of their nature and of the dangers attending their use. The common alcoholic beverages consist of (1) malt liquors, including beer and ale; (2) wines, such as hock, claret, Burgundy, sherry, and champagne; (8) distilled liquors, including brandy, whisky, rum, and gin; and (4) liqueurs and cordials. These groups are distinguished from one another largely by the method of preparation and by the amount of alcohol they contain. Malt liquors are fermented liquors which contain from three to eight per cent of alcohol; wines are also fermented liquors, but contain from seven to twenty per cent of alcohol; dis- tilled liquors, on the other hand, are first fermented and then concentrated by distillation, and contain from thirty to sixty-five per cent of alcohol. In all these the most important constituent, so far as their physiological action 364 — THE HUMAN MECHANISM upon the body is concerned, is the chemical compound known as ethyl alcohol (C,H,O or C,H; .OH). _ 8. Fermentation. — The ethyl alcohol in each of these beverages is produced by the action of yeast on sugar, and this action is known as alcoholic fermentation. Yeast is a unicellular plant, and when a small amount of it is added to a solution of grape sugar or fruit sugar it breaks up these substances, chiefly into al- cohol and carbon dioxide gas. The > latter passes off, while the alcohol remains behind -in the solution. In addition to these chief products of Fic. 110. Yeast cells fermentation there are always formed other products in small quantities, and to these, in part, the flavor of the fermented mixture is due. Different varieties of yeast produce different kinds of fermentation. Thus one variety (domesticated yeast) is used in making beer, and another (wild yeast) in making wine. The amount of alcohol produced differs with the yeast used, as do also the character and quantity of the secondary products. The growth of yeast, like that of all living ferments, is checked by the accumulation of the products of its own activity. Consequently when the alco- hol produced reaches a certain percentage (usually less than ten per cent) the fermentation ceases. Alcoholic drinks which contain higher percentages of alcohol are pre- pared by special processes which will be described later. 9. Malt Liquors. — Malt consists of sprouted grains (chiefly barley). The grains contain a large amount of starch which during the process of germination is converted into sugar by diastase, an enzyme produced by the living - cells of the plant,—the action of diastase being essentially similar to that of the ptyalin of the saliva. The germinat- ing plant thus comes to contain considerable quantities of « a * = DRUGS, ALCOHOL, AND TOBACCO 365 sugar, together with salts, proteids, and other substances. The watery extract of malt is known as wort, and it is this which, after being boiled with hops, is acted upon by the yeast. The liquid thus produced from wort by fermenta- tion is known as ale, beer, stout, porter, etc., according to the conditions under which the fermentation takes place and the character of the malt and the yeast employed. German beers contain from three to four per cent of alco- hol; ale contains from four to six per cent. 10. Wines. — Wine is produced by the fermentation of the juice obtained by crushing grapes, and the yeast comes from the “bloom” on the skin of the grapes. The juice, ‘or “ must,” thus extracted is allowed to undergo fermenta- tion, and the fermented liquid is wine. Most wines, how- ever, are subjected to subsequent treatment. Some are allowed to ripen in wooden casks, during which process there take place chemical changes which give to each _ wine its peculiar flavor. In other cases the wine is “fortified ” by the direct addition of alcohol. Wines differ from one another according to the variety of the grape used in making the must, according to the variety of yeast used for fermentation, and according to other cir- cumstances. 11. Distilled Liquors and Spirits. — This group of alco- holic beverages contains the highest percentage of alco- hol, and includes whisky, brandy, rum, and gin. In the making of-all of these the essential procedure is the same; namely, first to produce fermentation in some sugary liquid, and afterwards to distill from the products of this fermentation its alcohol and some other volatile constitu- ents. Whisky is made by distilling fermented corn or rye; brandy may be spoken of as distilled wine; rum is distilled from fermented molasses, and gin from a fer- mented mixture of rye