Chapter 05 - Government's Role and Government Failure

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Chapter 05 - Government's Role and Government Failure

McConnell Brue Flynn 21e

DISCUSSION QUESTIONS

1. Why might citizens interested in maximizing economic efficiency be happy to invest their
government with the right to coerce them in at least some situations? LO1

Answer: The government’s ability to coerce allows it to correct for market failures and to
enforce laws that reduce risks for those engaging in economics transactions. With respect
to market failures, the government can use its power to tax, to collect the money
necessary to pay for public goods and to subsidize the production of products that offer
positive externalities. With respect to reducing risk, the government can use its power to
coerce, to both threaten and then punish those engaging in fraud, extortion, and other
unethical business practices as well as to enforce environmental, health, and safety
regulations.

2. Jean Baptiste Colbert was the Minister of Finance under King Louis XIV of France. He
famously observed, “The art of taxation consists in so plucking the goose as to obtain the largest
possible amount of feathers with the smallest possible amount of hissing.” How does his
comment relate to special interests and the collective-action problem? LO2

Answer: The logic above applies to special interests and collective action as well. In the
case of special interest and collective action, the large gains to the smaller group
motivates these individuals to be more active politically and financially than the larger

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Chapter 05 - Government's Role and Government Failure

group who faces small losses at the individual level. That is, the smaller group will
extract resources from the larger group until it is no longer politically feasible.

3. What is rent seeking and how does it differ from the kinds of profit maximization and profit
seeking that we discussed in previous chapters? Provide an actual or hypothetical example of rent
seeking by firms in an industry. By a union. By a professional association (for example,
physicians, school teachers, or lawyers). Why do elected officials often accommodate rent-
seeking behavior, particularly by firms, unions, and professional groups located in their home
states? LO2

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Chapter 05 - Government's Role and Government Failure

Answer: Rent-seeking is an appeal to the government for special benefits at taxpayers or

someone else's expense. The term 'rent' refers to any payment is excess of the minimum
amount that is necessary to keep the resource employed in its current use.
Rent-seeking is different from profit maximization because rent-seeking attempts to
influence the political process to gain increased profit or income. Standard profit
maximization and profit seeking is driven by market forces, such as new products, cost
minimization, etc...
Examples will vary. An industry may try to block imports explicitly or implicitly using
tariffs and/or non-tariff barriers. Canada's beef producers might argue that they are
concerned about mad-cow disease to block imports of U.S. beef. A union may restrict
access to employment or negotiate as a block to keep wages higher than the market wage.
Professional associations may require certification and testing to actively participate in
the market.
These groups tend to be politically more active and willing to spend resources supporting
individuals who support their respective objectives. Thus, a politician is likely to support
their activities.

4. How does the problem of limited and bundled choice in the public sector relate to economic
efficiency? Why are public bureaucracies possibly less efficient than firms? LO2

Answer: Limited and bundled choice in the political process tends to reduce economic
efficiency because blocks of public goods and social programs are provided. That is,
instead of evaluating each public good and social program on its respective costs and
benefits the politician chooses all programs together. Some of these goods and programs
may benefit society (positive net benefits), but others may hurt society (negative net
benefits).
The private market is driven by profit. If a company continues to lose money or produces
a good that society does not want it goes out of business. If the public sector, a
bureaucracy, fails to use its resources efficiently then the market is not there to discipline
it. In this case, the bureaucracy continues to operate inefficiently and may actually grow
in size in an attempt to 'fix' the inefficiency. However, we need to look carefully at the
logic underlying this argument. Most bureaucratic operations do not provide private
goods. They provide public goods and social services that correct potential market
failures through regulation and direct provision. Thus, the market analogy may not
apply.

5. Discuss the political incentives that helped motivate federal politicians to approve budget
deficits in all but five years between 1960 and 2015. LO2

Answer: Voters like the benefits of increased government spending, but do not like
having to pay the taxes necessary to fund all the costly government programs that they
like. So, politicians have a political incentive to support high levels of spending by only
moderate levels of taxation. A common result is budget deficits, as those political
tendencies promote situations in which spending exceeds tax revenues. To bridge the
gap, governments borrow money, usually by selling bonds.

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Chapter 05 - Government's Role and Government Failure

6. Explain: “Politicians would make more rational economic decisions if they weren’t running
for reelection every few years.” LO2

Answer: Because political officeholders must seek voter support every few years, they
favor programs with immediate and clear-cut benefits and with vague or deferred
costs. Conversely, politicians will reject programs with immediate and easily identifiable
costs but with long term, less measurable benefits. Such biases can lead politicians to
reject economically justifiable programs and to accept programs that are economically
irrational.
Politicians may make these and other irrational decisions in order to curry favor with the
voters. But what kind of irrational decisions might be made by politicians who did not
have to face the voters again and stand for reelection?

7. Critique: “Thank goodness we have so many government regulatory agencies. They keep Big
Business in check.” LO2

Answer: Government regulatory agencies sometimes fall under the sway of the
industries that they are supposed to be regulating. Those instances of “regulatory
capture” imply that this statement is overly confident in the ability of government
regulatory agencies to keep powerful businesses in check. If regulatory capture occurs,
the captured regulator ceases to be a truly independent watchdog looking out for the
better interests of the public. Instead, it often imposes regulations that reduce
competition and promote high levels of profit in the “regulated” industry.

8. LAST WORD How do the concepts of pork-barrel politics and logrolling relate to the
items listed in the Last Word?

Answer: Both of these political techniques are examples of special interest

effects. “Pork-barrel” politics refers to the practice that congressional
representatives follow when they obtain unneeded benefits for their own districts,
and “logrolling” is a related practice whereby one group of legislators helps
another with the understanding that at some point in the future they, in turn, will
be helped.
The Last Word contains some examples of public spending that undoubtedly
resulted from such practices. These include the purchasing of equipment that is
not asked for by the military and buying equipment from a single firm both to
benefit particular Congressional districts; building projects that are outlandishly
costly; and appropriations bills that are so large, contain so much detail, with
provisions that benefit small groups or individuals.

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Chapter 05 - Government's Role and Government Failure

REVIEW QUESTIONS

1. Select all of the following that are true. To an economist, a coercive government can be useful
in order to: LO1
a. Reallocate resources in order to improve efficiency.
b. Fight negative externalities.
c. Ensure low gasoline prices.
d. Provide a low-risk economic environment for individuals and firms.

Answer: The government's ability to coerce allows it to correct for market failures and to
enforce laws that reduce risks for those engaging in economic transactions.

2. To an economist, any government program is too big if an analysis of that program finds that
MB _______ MC. LO1
a. Is greater than
b. Is less than
c. Is equal to
d. Is less than twice as large as
e. Is more than twice as large as

Answer: a, less than.

As with other resource allocation decisions, government programs should only be
expanded up to the point where MB=MC. They are expanded further so that MB<MC,
then they are too big and should be shrunk.

3. Tammy Hall is the mayor of a large U.S. city. She has just established the Office of Window
Safety. Because windows sometimes break and spray glass shards, every window in the city will
now have to pass an annual safety inspection. Property owners must pay the $5-per-window
cost—and by the way, Tammy has made her nephew the new head of the Office of Window
Safety. This new policy is an example of: LO2
a. political corruption
b. earmarks
c. rent seeking
d. adverse selection

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Chapter 05 - Government's Role and Government Failure

Answer: Rent-seeking. This new policy is an example of rent seeking.

By creating the new set of regulations, Mayor Hall has provided her nephew with a way
to collect an economic rent, which by definition is a payment in excess of the minimum
amount needed to keep an economic resource employed in its current use. In this case,
all of the city’s windows would have kept on being employed in their current use—as
windows—even without the new window inspection fees. Thus the entire $5-per-
window fee that is collected by her nephew will be an economic rent.
By contrast, the window-inspection policy is not an example of political corruption,
earmarks, or adverse selection.
It is not an example of political corruption because what is being done here is perfectly
legal. Nobody is bribing public officials to either do something illegal or to get them to
perform a service that they should be providing to the public for free. The new policy is
stupid, but Tammy’s nephew will in fact be obeying the law when making inspections
and demanding $5 for each one. So there is no political corruption going on here.
There are also no earmarks because this new policy has nothing to do with legislators
authorizing special expenditures for political supporters or friends.
Finally, this law has nothing to do with adverse selection because it has nothing to do
with one party to a contract possessing more information than another party to the
contract.

4. A few hundred U.S. sugar makers lobby the U.S. government each year to make sure that it
keeps taxing imported sugar at a high rate. They do so because the policy drives up the domestic
price of sugar and increases their profits. It is estimated that the policy benefits U.S. sugar
producers by about $1 billion per year while costing U.S. consumers upwards of $2 billion per
year. Which of the following concepts apply to the U.S. sugar tax? LO2
Select one or more of the choices shown.
a. Political corruption.
b. Rent-seeking behavior.
c. The collective-action problem.
d. The special-interest effect.

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Chapter 05 - Government's Role and Government Failure

Answer: Rent-seeking behavior, the collective-action problem, and the special-

interest effect.

The economic concepts of rent-seeking behavior, the collective-action problem, and the
special-interest effect apply to the U.S. sugar tax; but the concept of political corruption
does not.
The tax is an example of rent-seeking behavior because U.S. sugar producers are
receiving rents—payments in excess of the minimum amount that would be needed to
keep a resource employed in its current use. This is true because U.S. sugar producers
receive a price that is higher than what would be necessary to get them to continue using
their land, labor and capital to supply sugar.
The tax is an example of the collective-action problem because the benefits of the tax are
highly concentrated among just a few hundred sugar producers while the costs are
disbursed widely over the over 300 million people currently living in the United
States. Thus those who benefit from the tax are highly motivated to lobby Congress to
keep it, while those who are hurt by the tax are only hurt a little bit each—making them
hard to organize into an effective opposition.
The tax is an example of the special-interest effect because it is maintained thanks to the
lobbying efforts of a special interest group, domestic sugar producers.
Finally, the tax is not an example of political corruption because what is being done here
is perfectly legal. Nobody is bribing public officials to either do something illegal or to
get them to perform a service that they should be providing to the public for free. The
sugar tax is widely condemned, but it remains true that it is legal for both individuals and
companies to ask politicians for laws that favor their personal interests. And it is also
perfectly legal to make political donations to politicians who support the laws you would
like to see enacted.

5. ___________________ occur when politicians commit to making a series of future

expenditures without simultaneously committing to collect enough tax revenues to pay for those
expenditures. LO2
a. Budget deficits
b. Debt Crises
c. Loan guarantees
d. Unfunded liabilities

Answer: d, unfunded liabilities.

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Chapter 05 - Government's Role and Government Failure

PROBLEMS

1. Suppose that there are 1 million federal workers at the lowest level of the federal bureaucracy
and that above them there are multiple layers of supervisors and supervisors-of-supervisors.
Assume that each higher level is one-tenth the size of the one below it because the government is
using a 10:1 ratio of supervisees to supervisors. That is, for every 10 workers at the bottom, there
is 1 supervisor; for every 10 of those supervisors, there is 1 supervisor-or-supervisors; for every
one of those supervisors-of-supervisors, there is a supervisor-of-supervisors-of-supervisors; and
so on, all the way up the bureaucratic pyramid to the president. LO1
a. How many supervisors will there be in each supervisory layer of the federal bureaucracy? Start
with the layer of supervisors directly above the 1 million workers at the bottom.
b. How many supervisors are there in total at all levels of the federal bureaucratic pyramid,
including the president?
c. If you count the 1 million workers at the bottom as the first layer of the federal bureaucracy,
how many total layers are there, including the president?
d. How many federal employees are there in total at all layers, including the president?
e. What fraction of all federal employees are supervisory, including the president?

Answer:
a. 100,000; 10,000; 1,000; 100; 10; 1.
b. 111,111 = (100,000+10,000+1,000+100+10+1).
c. 7 total layers corresponding to the 1 million workers at the bottom and then six layers
of supervisors above them (the 100,000, then the 10,000, then the 1,000, then the
100, then the 10, then the president.)
d. There are 1,111,111 total federal employees (=1 million workers at the bottom +
111,111 supervisors, including the president).
e. 9.999 percent (which can be rounded up to 10 percent) of all federal employees,
including the president, are supervisory.

2. Consider a specific example of the special-interest effect and the collective-action problem. In
2012, it was estimated that the total value of all corn‐production subsidies in the United States
totaled about $3 billion. The population of the United States was approximately 300 million
people that year. LO2
a. On average, how much did corn subsides cost per person in the United States in
2012? (Hint: A billion is a 1 followed by nine zeros. A million is a 1 followed by six zeros.)
b. If each person in the United States is only willing to spend $.50 to support efforts to overturn
the corn subsidy, and if anti‐subsidy advocates can only raise funds from 10 percent of the
population, how much money will they be able to raise for their lobbying efforts?
c. If the recipients of corn subsidies donate just one percent of the total amount that they receive
in subsidies, how much could they raise to support lobbying efforts to continue the corn subsidy?
d. By how many dollars does the amount raised by the recipients of the corn subsidy exceed the
amount raised by the opponents of the corn subsidy?

Answers: (a) $10 (b) $15 million (c) $30 million (d) $15 million

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Chapter 05 - Government's Role and Government Failure

Feedback: Consider the following example: In 2012, it was estimated that the total
value of all corn‐production subsidies in the United States totaled about $3 billion. The
population of the United States was approximately 300 million people that year.

Part a:
On average, how much did corn subsides cost per person in the United States in
2012?

$10.00 (= $3 billion divided by 300 million).

Part b:
If each person in the United States is only willing to spend $.50 to support efforts to
overturn the corn subsidy, and if anti‐subsidy advocates can only raise funds from 10
percent of the population, how much money will they be able to raise for their lobbying
efforts?

To find the answer to this question, we first calculate the number of individuals willing to
fund the antisubsidy advocates. Since only 10 percent of 300 million are willing to
provide funding, we have 30 million people providing funding (= 0.10 × 300 million).
Each of these individuals is only willing to provide $0.50. This results in a total funding
of $15 million (= $0.50 × 30 million).

Part c:
If the recipients of corn subsidies donate just one percent of the total amount that they
receive in subsidies, how much could they raise to support lobbying efforts to continue
the corn subsidy?

Since the recipients of corn subsidies receive a total of $3 billion from the government, 1
percent of this amount is $30 million (= 0.01 × $3 billion).

Part d:
By how many dollars does the amount raised by the recipients of the corn subsidy exceed
the amount raised by the opponents of the corn subsidy?

$15 million (= $30 million – $15 million).

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Chapter 05 - Government's Role and Government Failure

3. Consider a corrupt provincial government in which each housing inspector examines two
newly built structures each week. All the builders in the province are unethical and want to
increase their profits by using substandard construction materials, but they can’t do that unless
they can bribe a housing inspector into approving a substandard building. LO2
a. If bribes cost $1,000 each, how much will a housing inspector make each year in bribes?
(Assume that each inspector works 52 weeks a year and gets bribed for every house he inspects.)
b. There is a provincial construction supervisor who gets to hire all of the housing inspectors. He
himself is corrupt and expects his housing inspectors to share their bribes with him. Suppose that
20 inspectors work for him and that each passes along half the bribes collected from builders.
How much will the construction supervisor collect each year?
c. Corrupt officials may have an incentive to reduce the provision of government services to help
line their own pockets. Suppose that the provincial construction supervisor decides to cut the
total number of housing inspectors from 20 to 10 in order to decrease the supply of new housing
permits. This decrease in the supply of permits raises the equilibrium bribe from $1,000 to
$2,500. How much per year will the construction supervisor now receive if he is still getting half
of all the bribes collected by the 10 inspectors? How much more is the construction supervisor
getting now than when he had 20 inspectors working in part (b)? Will he personally be happy
with the reduction in government services?
d. What if reducing the number of inspectors from 20 to 10 only increased the equilibrium bribe
from $1,000 to $1,500? In this case, how much per year would the construction supervisor
collect from his 10 inspectors? How much less is the construction supervisor getting than when
he had 20 inspectors working in part (b)? In this case, will the construction supervisor be happy
with the reduction in government services? Will he want to go back to using 20 inspectors?

Answer:
a. $104,000 (=52 weeks times 2 bribes per week times $1,000 per bribe).
b. $1,040,000 (=20 inspectors times one half times each inspector’s annual total bribe
amount of $104,000).
c. $1,300,000 (=10 inspectors times one half times each inspector’s new annual total
bribe amount of $260,000). That annual total bribe amount of $260,000 = $2,500 per
bribe times two bribes per week times 52 weeks per year. The construction
supervisor will personally be happy with this reduction in government services
because it substantially increases his personal income.
d. $780,000 (=10 inspectors times one half times each inspector’s new annual total
bribe amount of $156,000.) The construction supervisor will not be happy with this
reduction in government services. He will want to go back to using 20 inspectors
because he personally received a higher income from bribes when there were 20
inspectors.

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Another random document with
no related content on Scribd:
and the measured forms of articulation offer the only vocal drill that
possesses any permanent value. It is especially essential in the
stutterer's case that the patient be protected from ridicule and from
all disturbing emotions: the burden of difficult speech is sufficient to
greatly depress the nervous system without the added suffering of
emotional distress. It is evident that childhood, characterized as it is
by especial instability of the nervous system, is the period when we
can hope for the best results from care and training; the long-formed
habits of the adult are rarely broken.

We have thus traced the disorders of speech to their origin as

symptoms of grave central lesions of the nervous system, as results
of heredity or of a general neurasthenic condition; very rarely are
they dependent upon malformations of the organs of speech.

The treatment of such malformations, when they occur, is largely

unsatisfactory and is seldom curative.

The thorough treatment of those speech disorders that are not

susceptible of surgical aid would embrace such mental and physical
hygiene and training as should ensure the formation of a thoroughly
conceived vocabulary and its co-ordinated expression by words
either spoken or written. The study of expression in its highest forms
would necessarily conduct the investigator far into the realm of the
plastic, harmonic, and literary arts.

ALCOHOLISM.
 BY JAMES C. WILSON, M.D.

DEFINITION.—Alcoholism is the term used to designate collectively the

morbid phenomena caused by the abuse of alcohol.

SYNONYMS.—Alcoholismus, Ebrietas, Ebriositas, Temulentia,

Drunkenness, Delirium potatorium, Mania potatorium, Delirium
tremens, Chronic alcoholic intoxication, Dipsomania; Ger.
Trunkenheit, Trunksucht; Fr. Ivresse, Ivrognerie.

These terms are in common use to describe such conditions and

outbreaks in alcoholic individuals as amount to veritable morbid
states or attacks of sickness, but they are not interchangeable, nor
are they all sufficiently comprehensive to constitute true synonyms.
They are names applied to various conditions due to acute or
chronic alcohol-poisoning properly and distinctively comprehended
under the general term alcoholism.

CLASSIFICATION.—It was formerly the custom to restrict this term to

affections of the general nervous system induced by continued
excesses in the use of alcoholic drinks.1 But the nervous system
bears the brunt of the attack and suffers beyond all others alike in
transient and in continued excesses. The artificial restriction of the
term to the cases caused by continued excesses was therefore
illogical in itself, and has been productive of much needless difficulty
in the treatment of the subject and in the classification of the cases.
The use of the term chronic alcoholism to denote an established
condition, and of acute alcoholism to describe outbreaks of various
kinds which occur in individuals subject to that condition, has also
proved a source of embarrassment to the student. Not less vague
has been the employment of such terms as delirium tremens, mania-
a-potu, and the like, which are unsatisfactory in themselves, and
tend to exalt symptoms at the expense of the morbid condition of
which they are only in part the manifestation. I am of the opinion—
which is at variance with established usage—that the systematic
discussion of alcoholism requires that all forms of sickness, including
drunkenness, due to that poison must receive due consideration,
and that the term acute alcoholism, hitherto used in a sense at once
too comprehensive and too variable, should be reserved for those
cases in which the sudden energetic action of the poison is the
occasion of like sudden and intense manifestations of its effects.
Furthermore, the uncertainty and lack of precision in the use of the
terms acute and chronic alcoholism are due to errors of theory
formerly almost universal in medical writings and popular belief
concerning the disease. The chief source of these errors was the
recognition only of the more acute nervous affections caused by
alcoholic excess—delirium tremens, maniacal excitement, and
terrifying hallucinations—and the belief that these conditions
occurred only after a temporary abstinence in the course of habitual
or prolonged indulgence. It has now long been known that
abstinence from drink by no means necessarily precedes the
outbreak of mania or delirium, and modern researches have
established the existence of a chronic alcoholic intoxication of long
duration extending over a period of months or years, in which such
outbreaks merely exhibit the full development of symptoms that have
already been occasionally and partially recognizable.
1 Anstie, Reynolds's System of Medicine, vol. ii., 1868.

The following arrangement of the topics will facilitate the discussion

of the subject in the present article, and serve, I trust, a useful
purpose for the classification of cases in accordance with existing
knowledge:2

I. Acute Alcoholism: Drunkenness, Debauch.

A. Ordinary or Typical Form.
B. Irregular Forms.
1. Maniacal;
2. Convulsive;
3. In persons of unsound mind.
 C. Acute Poisoning by Alcohol: Lethal doses.

II. Chronic Alcoholism.

A. Visceral Derangements.
1. Local disorders:
a. Of the digestive system;
b. Of the liver;
c. Of the respiratory system;
d. Of the circulatory system;
e. Genito-urinary system.
2. Disorders of special structures:
a. Of the locomotor apparatus;
b. Of the skin.
3. General disorders:
a. The blood;
b. Obesity;
c. Cachexia.
B. Derangements of the Nervous System: Cerebro-spinal
Disorders.
1. Cerebral disorders.
2. Spinal disorders.
3. Disorders of the peripheral nerves.
4. Disorders of the special senses.
C. Psychical Derangements.
1. The moral sense.
2. The will.
3. The intellect.
4. Alcoholic delirium in general.
5. Delirium tremens.
6. Alcoholic insanity:
a. Melancholia;
b. Mania;
c. Chronic delirium;
d. Dementia;
e. Paretic dementia.

III. Hereditary Alcoholism.

IV. Dipsomania.
2 This classification is in part based upon that of Lentz, De l'Alcoholism et de ses
Diverses manifestations, etc., Bruxelles, 1884—a prize essay.

HISTORY.—The history of the abuse of alcohol would be the history of

society from the most remote period until the present time, not only
among civilized but among barbarous races of men, for the abuse of
narcotics, of which alcohol is at once the most important and the
most widely used, forms a dark background to the broad picture of
healthful human progress. In truth, the most sketchy account of our
knowledge of the effects of alcoholic excess, as manifested in the
individual and in society at large, interesting as it might prove to the
general reader, would be out of place in this article. To be of real
value it would necessarily embody a record of experiences so vague,
facts so indeterminate, opinions so at variance, and citations so
numerous, that they would require for their mere presentation a
volume rather than an article. The object of the writer in the following
pages shall be, therefore, to present the subject in its present
aspect, without reference, beyond that which is absolutely
necessary, to considerations of mere historical interest. This being
the case, he considers further apology for the lack of laborious
historical studies unnecessary.

ETIOLOGY.—A. Predisposing Influences.—We are at this point

confronted with a series of problems the complex nature and grave
importance of which appeal with peculiar urgency to all thoughtful
physicians. Their discussion, however, involving as it does unsettled
questions of great moment in social science, is beyond the scope of
the present article. A few practical points only can occupy our
attention.

The influences which predispose to alcoholism arise from

unfavorable moral, social, and personal conditions.

Among the unfavorable moral conditions may be mentioned a want

of wholesome public sentiment on the subject in communities. This
arises too often, but by no means exclusively, from poverty and its
attendant evils ignorance and vice. Rum is at once the refuge and
the snare of want, destitution, and sorrow. To the vacant and
untrained mind it brings boons not otherwise to be had—excitement
and oblivion. That both are brief and bought at a ruinous cost exerts
little restraining influence. Of equal if not greater importance are the
influences which spring from ill-regulated and demoralizing domestic
relations, and the absence of motive and the contentment which
properly belong to the family as an organization. Everywhere also do
we find in example a potent influence. In the individual, in addition to
hereditary propensities, the evil results of a lax, over-indulgent, or
vicious early training, as shown in a want of power of application, of
moral rectitude, in self-indulgence, craving for excitement, and a
weak will, powerfully predispose to the temptations of alcoholic
excess.

Among social conditions which must be regarded as predisposing

influences occupation takes the first rank. The occupations which
render those pursuing them especially liable to alcoholism may be
divided into two classes—those in which the temptation to drink is
constantly present, and those in which the character of the work
begets a desire for stimulation, while the opportunities for the
gratification of the desire are but little restricted.

To the first of these groups belong all classes of workmen in

distilleries, breweries, and bottling establishments; keepers and
clerks of hotels, public houses, and restaurants; the barmen and
waiters in the same trades; the salesmen who travel for dealers in
wines and spirits. To this group must also be referred the
professional politician of the lowest order. These occupations have
furnished by far the larger number of cases that have come under
my care, both in hospital and in private practice.

To the second class belong occupations involving great exposure to

the inclemency of the weather. We frequently find cabmen,
expressmen, coal-heavers, hucksters, and street-laborers habitually
addicted to excesses in alcohol. The stringent regulations of
corporations exert a powerful protective influence in the case of men
employed on railways, ferry- and other steamboat service, and in
and about dépôts and stations. Exhausting toil under unfavorable
circumstances as regards heat and confinement predisposes to
drink, as in the case of foundrymen, workers in rolling-mills, stokers,
and the like. The men-cooks who work in hotels and restaurants are
especially liable to alcoholism. Monotony of occupation, as in the
cases of cobblers, tailors, bakers, printers, etc., especially when
associated with close, ill-ventilated workrooms and long hours of toil,
exerts a strong predisposing influence. Persons following sedentary
occupations suffer from excesses sooner than those whose active
outdoor life favors elimination. To the monotony of their occupations
may be ascribed in part, at least, the disposition of soldiers,
ranchmen, sailors, etc. to occasional excesses as opportunities
occur. Irregularity of work, especially when much small money is
handled, as happens with butchers, marketmen, and hucksters, also
often leads to intemperance.

The lack of occupation exerts a baleful influence. Men-about-town,

the frequenters of clubs, dawdlers, and quidnuncs often fall victims
to a fate from which occupation and the necessity to work would
have saved them. In this connection it may be permitted to call
attention to the custom of treating as enormously augmenting the
dangers to which such persons are habitually exposed in the matter
of alcoholic excesses. The occasional moderate use of alcohol in the
form of wine with food and as a source of social pleasure is not
fraught with the moral or physical evils attributed to it by many
earnest and sincere persons. It is, on the contrary, probable that the
well-regulated and temperate use of sound wines under proper
circumstances and with food is, in a majority of individuals, attended
with benefit. Those who suffer from the effects of excesses do not
usually reach them by this route, nor would they be saved by any
amount of abstinence on the part of temperate and reasonable
members of society.

When we turn our attention to the unfavorable personal conditions

which predispose to alcoholism, we at once enter upon the familiar
field of work of the practical physician. Numerous influences having
their origin in the individual himself, some occasional, others
constant, all urgent, demand our careful consideration. Some of the
conditions out of which these predisposing influences spring are
tangible and easy of recognition; others are elusive and uncertain. To
point them out is, unfortunately, not to remedy them. As a rule, they
have wrought their evil effects long before the individual has cause
to regard himself in the light of a patient.

First in importance is heredity. A peculiar inherited constitution of the

nervous system is as influential in leading to alcoholic excess and in
aggravating its disastrous effects as any other cause whatsoever. A
considerable proportion of individuals who suffer from alcoholism are
found upon inquiry to come of parents who have been addicted to
drink. A still greater number belong to families in which nervous
disorders, and in particular neuralgia, epilepsy, and insanity, have
prevailed. Others, again, are the offspring of criminals. It can no
longer be doubted that particular causes of nervous degeneration in
one or both parents may lead to the hereditary transmission of a
feeble nervous organization, which, on the one hand, renders its
possessor peculiarly liable to neuroses of every kind, and, on the
other hand, an easy prey to the temptation to seek refuge from
mental and physical suffering in occasional or habitual narcotic
indulgence. Thus, as Anstie pointed out, “the nervous enfeeblement
produced in an ancestor by great excesses in drink is reproduced in
his various descendants, with the effect of producing insanity in one,
epilepsy in another, neuralgia in a third, alcoholic excesses in a
fourth, and so on.” When it is possible to obtain fairly complete family
histories, covering two or three generations, in grave nervous cases,
facts of this kind are elicited with surprising frequency. The part
which heredity plays in many of the more inveterate and hopeless
cases of alcoholism is wholly out of proportion to the obvious and
easily recognizable part played by momentary temptation. To the
failure to recognize the real agency at work in such cases must be
ascribed the disappointment of too many sanguine and unsuccessful
social reformers.
Various forms of disease exert a predisposing influence to alcoholic
excesses. In the first place, bodily weakness and inability to cope
with the daily tasks imposed by necessity impel great numbers of
persons of feeble constitution, especially among the laboring
classes, to the abuse of alcohol.

In the second place, many conditions of chronic disease attended by

suffering are susceptible of great temporary relief from the taking of
alcohol. Especially is this the case in the neuralgias, in phthisis, in
dysmenorrhœa and other sexual disorders of women, in the
faintness and depression of too-prolonged lactation, in the pains and
anxieties of syphilis, and in the malaise of chronic malaria. When the
patient has learned that alcohol is capable of affording relief from
suffering, it is but a short step through ignorance or recklessness to
habitual excess.

The administration of alcohol during convalescence from attacks of

illness is not unattended by the danger of subsequent abuse. It is
well for the physician to inform himself of the hereditary tendencies
and previous habits of the patient before assuming the responsibility
of continuing alcohol beyond the period of acute illness under these
circumstances; and it is a rule never to be disregarded that the
stimulant ordered by the physician is to be regulated by him in
amount, and discontinued when the patient passes out of his care.

Irregularities of the sexual functions in both sexes, and especially

sexual excesses, strongly predispose to alcoholism. The custom of
administering to young women suffering from painful menstruation
warming draughts containing gin, brandy, or other alcoholic
preparations in excessive amounts is a fertile cause of secret
tippling.

The abuse of tobacco, to the depressing effects of which alcohol is a

prompt and efficient antidote, must be ranked as an important
predisposing influence.

Depressing mental influences of all kinds tend strongly to drinking

habits. This is true of persons in all classes of society.
Habit constitutes an influence the importance of which can scarcely
be over-estimated. Much of the drinking done by active business-
men has no other cause than this. Alcohol, like opium and other
narcotics, exerts its most pernicious influence through the periodical
craving on the part of the nervous system for the renewal of the
stimulating effects which it causes, while it progressively shortens
the period and diminishes the effect by its deteriorating action upon
the nutrition of the peripheral and central nervous tissues.

B. The Exciting Cause.—Alcohol, or ethyl hydrate, is the product of

the fermentation of solutions which contain glucose or a substance
capable of transformation into glucose. Other alcohols, as propyl,
butyl, and amyl alcohol, etc., are also formed in small quantity in the
fermentation of saccharine liquids. Ethyl alcohol is the type of the
series, and forms the normal spirituous ingredient of ordinary
alcoholic beverages. The others when present, except in minute
quantities, constitute impurities. Their toxic effects are much more
pronounced than those of ethyl alcohol.

Alcohol is a colorless mobile liquid having an agreeable spirituous

odor and a pungent, caustic taste, becoming fainter upon dilution. It
mixes with water and ether in all proportions.

Alcoholic beverages form three principal groups: 1, spirits, or distilled

liquors; 2, wines, or fermented liquors; and 3, malt liquors.

1. The various spirituous liquors, as whiskey, gin, rum, brandy, etc.,

contain, in addition to the ethyl alcohol and water common to them
all, varying minute proportions of ethereal and oily substances to
which each owes its peculiar taste and odor. These substances are
œnanthic, acetic, and valerianic ethers, products of the reaction
between the corresponding acids and alcohol, and various essential
oils. Traces of the other alcohols are also present. Amyl alcohol, the
so-called fusel oil, is present in new and coarse spirit, but especially
in that derived from potatoes, in considerable amounts. It is to this
ingredient that potato spirit owes its peculiarly deleterious properties.
Richardson3 experimentally produced with amyl alcohol phenomena
analogous to delirium tremens in man. Spirits also frequently contain
sugar, caramel, and coloring matters derived from the cask, to which
certain products of the still also owe in part their flavor. These liquors
are of varying strength, and contain from 45 to 70 per cent. of
absolute alcohol by volume.4
3 On Alcohol, Lond., 1875.

4 Vide Baer, Der Alcoholismus, Berlin, 1878.

Liqueurs (anise, kümmel, curaçoa, Benedictine, etc.) are the

products of the distillation of alcohol with various aromatic herbs,
sweetened, or of its admixture with ethereal oils and sugar. These
compounds contain a very high percentage of alcohol. Two of them,
absinthe and kirsch, by reason of their peculiarly dangerous
properties deserve especial mention.

Absinthe is an alcoholic distillate of anise, coriander, etc. with the

leaves and flowers of the Artemisia absinthium, which yields a
greenish essence. This liqueur contains from 60 to 72 per cent. of
alcohol, and exerts a specific pernicious effect upon the nervous
system, largely due to the aromatic principles which it contains.5
Kirsch, which owes its peculiar flavor to the oil of bitter almonds and
hydrocyanic acid which it contains in varying and often relatively
large proportions, is still more dangerous. The toxic effects produced
by these liqueurs are of a very complex kind, and scarcely fall within
the scope of this article.
5 As early as 1851, Champouillon (referred to by Husemann, Handbuch der
Toxicologie) called attention to the fact that the French soldiers in Algiers, in
consequence of excessive indulgence in absinthe, suffered especially from mania and
meningitis. Decaisne (La Temperance, 1873, Étude médicale sur les buveurs
d'absinthe) found absinthe in equal doses and of the same alcohol concentration to
act much more powerfully than ordinary spirits, intoxication being more rapidly
induced and the phenomena of chronic alcoholism earlier established. Pupier
(Gazette hébdom., 1872) found in those addicted to the use of absinthe marked
tendency to emaciation and to cirrhosis of the liver; and Magnan (Archives de
Physiol., 1872) asserts that the chronic alcoholism due to this agent is characterized
by the frequency and severity of the epileptic seizures which accompany it. There is
 reason to believe that the consumption of absinthe in the cities of the United States is
increasing.

2. Wines are the product of the fermentation of the juice of the grape.
Their chemical composition is extremely complex. They owe their
general characteristics to constituents developed during
fermentation, but their special peculiarities are due to the quality of
the grape from which they are produced, the soil and climate in
which it is grown, and the method of treatment at the various stages
of the wine-making process. So sensitive are the influences that
affect the quality of wine that, as is well known, the products of
neighboring vineyards in the same region, and of different vintages
from the same ground in successive years, very often show wide
differences of flavor, delicacy, and strength.

The most important constituent of wine is alcohol. To this agent it

owes its stimulating and agreeable effects in small, its narcotic
effects in large, amounts. The proportion of alcohol, according to
Parkes, Bowditch, Payen, and other investigators, varies from 5 to
20 per cent. by volume, and in some wines even exceeds the latter
amount. The process of fermentation, however, yields, at the most,
not more than 15 to 17 per cent. of alcohol, and wines that contain
any excess of this proportion have been artificially fortified.

Further constituents of wine are sugar, present in widely varying

amounts, and always as a mixture of glucose and levulose—inverted
sugar; traces of gummy matter, vegetable albumen, coloring matters,
free tartaric and malic acid, and various tartrates, chiefly potassium
acid tartrate, or cream of tartar. In some wines there are found also
traces of fatty matters. Tannin is likewise found. Small quantities of
aldehyde and acetic acid are due to the oxidation of alcohol. The
acetic acid thus formed further reacts upon the alcohol, forming
acetic ether. To the presence of traces of compound ethers, acetic,
œnanthic, etc., wines owe their bouquet. Carbon dioxide, produced
in the process of fermentation, is retained to some extent in all
wines, and is artificially developed in large quantities in champagnes
and other sparkling wines.
Much of the stuff sold as wine, even at high prices, in all parts of the
world, is simply an artificial admixture of alcohol, sugar, ethereal
essences, and water. The wines rich in alcohol are especially liable
to imitation.

Wine is the least harmful of alcoholic drinks. In moderate amounts

and at proper times its influence upon the organism is favorable. In
addition to its transient stimulating properties, it exerts a salutary and
lasting influence upon the nutrition of the body. Only after prolonged
and extreme abuse, such as is sometimes seen in wine-growing
countries, does it lead to alcoholism.

3. Malt liquors—beer, ale, porter, stout, etc.—are fermented

beverages made from a wort of germinated barley, and usually
rendered slightly aromatic by hops. This process is known as
brewing. Malt liquors, of which beer may be taken as the type,
contain from 3.75 to 8 per cent. by volume of alcohol, free carbon
dioxide, variable quantities of saccharine matters, dextrin,
nitrogenized matters, extractive, bitter and coloring matters, essential
oil, and various salts. Much importance has been ascribed to the
quantity of malt extractive in beer: it has even been seriously spoken
of as fluid bread. But, granting the nutritive value of the malt
extractives, it is, as compared with the nutritive value of the grain
from which they are derived, so small that beer must be regarded as
a food of the most expensive kind.

Sound beer is wholesome and nutritious, and serves a useful

purpose in the every-day life of a considerable part of the earth's
population. But it is wholesome only in moderate amounts. Its
excessive consumption results in progressive deterioration of mind
and body. Undue accumulation of fat, diminished excretion of urea
and carbon dioxide, are followed by disturbances of nutrition.
Incomplete oxidation of the products of tissue-waste leads to the
abnormal formation of oxalates, urates, etc., to gout, derangements
of the liver, and gall-stones. In long-continued excesses in beer one
of the effects of the lupulin is to enfeeble the powers of the
reproductive organs. The inordinate consumption of beer induces
intellectual dulness and bodily inactivity, and lessens the powers of
resistance to disease. The dangers of acute and chronic alcoholism
are obvious. Five glasses of beer of 5 per cent. alcohol strength
contain as much alcohol as half a beer-glassful of spirits of 50 per
cent.

The moderate consumption of beer in communities is to some extent

a safeguard against alcoholism. To secure this end, however, the
beer must be sound and of light quality. The stronger beers, and
especially those which are fortified with coarse spirits, besides the
direct dangers attending their use, tend rapidly to the formation of
spirit-drinking habits.

The action of alcohol varies according to its degree of concentration,

the quantity ingested, and its occasional or habitual use. On the one
hand, when well diluted, taken in small amount and occasionally
only, it may be without permanent effect upon any function or
structure of the body; on the other hand, its frequent administration
in large doses and but little diluted is, sooner or later, surely followed
by widespread tissue-changes of the most serious kind.

The Physiological Action of Alcohol.—Alcohol is very rapidly taken

up by absorbent surfaces. According to Doziel,6 it has been detected
in the venous and arterial blood and in the lymph of the thoracic duct
a minute and a half after its ingestion. It is very slightly if at all
absorbed by the unbroken skin. Denuded surfaces and extensive
wounds permit its absorption, as in the case of surgical dressings,
and instances of intoxication from this cause have been recorded. It
is also freely absorbed in the form of vapor by the pulmonary
mucous surfaces. Some surfaces, as the pleura and peritoneum,
absorb it, as has been demonstrated by the effects following its
injection into those cavities. Its constitutional effects are also rapidly
developed after hypodermic injection. Under ordinary circumstances,
however, it is by the way of the absorbents and veins of the gastric
mucous membrane that alcohol finds its way into the blood. It is
probable that the greater part of the alcohol taken into the stomach
undergoes absorption from that organ, and that very little of it
reaches the upper bowel. Alcohol is readily absorbed by the rectal
mucous membrane. Having entered the blood, it reaches all the
organs of the body, and has been recovered by distillation not only
from the blood itself, but also from the brain, lungs, liver, spleen,
kidneys, and various secretions.7
6 Pflüger's Archiv für Physiologie, Band viii., 1874.

7 Strauch, De demonstratione Spiritus Vini in corpus ingesti, Dorpati, 1862.

Lentz and other observers believe that certain organs have a special
affinity for alcohol. The author named and Schulinus place the brain
first in this respect, and in the next rank the muscles, lungs, and
kidneys. But Lallemand and Perrin regard the liver and the brain as
having an equal affinity for alcohol. The opinion of Baer, who rejects
the view that alcohol has an especial predilection for particular
organs, is more in accordance with known physiological law. This
observer holds that alcohol, having found its way into the blood,
circulates uniformly throughout the whole organism, and explains the
greater amount recoverable from certain organs as due to the fact
that these organs contain more blood than others.

The elimination of alcohol is at first rapid, afterward very gradual. It

begins shortly after ingestion, and in the course of two or three hours
one quarter, and perhaps much more, of the amount passes from the
organism. Nevertheless, after the ingestion of large amounts traces
of alcohol were discovered on the fifth day in the urine by Parkes
and Wollowicz, although the elimination by the lungs had entirely
ceased.

Elimination takes place for the most part by way of the kidneys, the
lungs, and the skin; alcohol has been recovered also from the bile,
saliva, and the milk.

Whatever may be the affinity of certain organs for alcohol, whatever

the channels by which it is eliminated, the general belief is that some
portion of it undergoes chemical decomposition within the body. The
steps of this process and its ultimate results are as yet unknown; nor,
indeed, are the proportional amounts decomposed and eliminated
established. Some observers regard the amount eliminated as less
than that decomposed. Others suppose that the amount consumed
within the body is relatively very small as compared with that
disposed of by elimination. It is, however, established that the
sojourn of alcohol in the body, unlike that of many other toxic
substances, is transient, and that in the course of from twenty-four to
forty-eight hours after the ingestion of a moderate amount there
remain only traces of this substance.

The local action of alcohol upon organic tissues depends upon its
volatility, its avidity for water, its power to precipitate albuminous
substances from solution and to dissolve fats, and, finally, upon its
antiseptic properties.

Applied externally and permitted to evaporate, it produces a fall of

temperature and the sensation of cold; if evaporation be prevented,
a sensation of warmth is experienced, the skin reddens, and, if the
action be prolonged, desquamation results. The sensation produced
when diluted alcohol is applied to mucous surfaces is burning and
stinging; when concentrated, it may excite inflammation.

Dilute alcohol has been much employed as a surgical dressing for

wounds and ulcerated surfaces. Its value for this purpose depends
on its stimulating properties, by virtue of which it exerts a favorable
influence upon granulating surfaces; and on its antiseptic qualities,
which are, however, much inferior to those of salicylic and carbolic
acids among organic substances and to the chlorides among the
inorganic salts.

The direct action of alcohol upon the mucosa of the digestive system
depends upon the quantity ingested and degree of concentration. In
moderate amounts and diluted to the extent of 50 per cent. or more,
it produces a sensation of warmth in the tissues over which it
passes. This sensation is due in part to the impression upon the
nerve-endings, and in part to reflex hyperæmia, which is at once
excited. In individuals unaccustomed to its use reflex contractions of
the constrictor muscles of the pharynx, with gagging, are sometimes
provoked. The secretion of saliva and of the gastric juice is
increased, diluted alcohol being, in respect to its physiological effect
in stimulating the buccal and gastric mucous glands, inferior to no
other agent. This action is due as much to reflex as to local action,
as has been shown experimentally by the application of a few drops
of alcohol to the tongue of a dog with gastric fistula, increased
secretion of gastric juice immediately resulting.

It is in consequence of this action that moderate doses of diluted

alcohol exert a favorable influence upon the appetite and digestion.
Increased amounts of food are well borne; fats especially are more
tolerable and better digested; and a more energetic peristalsis favors
the absorption of the food solutions. In those habituated to the use of
alcohol these effects do not always follow; and if the amount be
increased or the repetition become frequent, some part of the
alcohol undergoes in the stomach, with the food, acid fermentation,
and acid eructations or vomitings occur. With these phenomena is
associated gastro-hepatic catarrh with its characteristic symptoms—
loss of appetite, feeble digestion, diarrhœa alternating with
constipation, sallowness, mental depression, and headache. In still
greater amounts and little diluted, alcohol is capable of exciting acute
gastritis or congestion and catarrhal inflammation of the liver.

When we come to study the action of alcohol upon the circulatory

system, we find that in small doses it has little or no influence either
upon the action of the heart or the condition of the vessels. In
augmented amounts it increases the action of the heart both in force
and frequency, and the arterial blood-pressure. After large doses
these effects quickly pass away, and the circulation becomes
depressed. The heart's action grows feebler, often slower, the pulse
weaker; blood-pressure sinks and arterial tension is diminished. Its
physiological action is that of a direct stimulant to the heart and the
pneumogastric nerve; its toxic action, that of a depressant. Upon the
vaso-motor system the action is from the first that of a depressant.
Dilatation of capillary vessels and increased afflux of blood manifest
themselves in the flushed face, brilliant eyes, and warmth of surface
which are familiar phenomena. Frequent repetition tends to
permanently impair the activity of the peripheral circulation. Hence
the visible vascular twigs and rubicund nose that characterize the
physiognomy of the habitual drinker.

This congestion no less affects the internal organs, setting up, by

interference with their functions, chronic derangements of nutritive
processes on the one hand, and on the other the liability to acute
local diseases and complications.

The reactions which take place between the blood and alcohol
remain, notwithstanding the energy devoted to their investigation,
among the unsolved problems of physiological chemistry. It were a
profitless task to here review the researches into this subject or to
set forth their conflicting results. It may be stated that conclusions
based upon the reactions between blood drawn from the vessels and
tested with alcohol in the laboratory are wholly inapplicable to the
inquiry. While it is generally conceded that some part of the alcohol
ingested undergoes decomposition within the organism, what the
steps of the process are and what the products are have not yet
been demonstrated. Rossbach and Nothnagel8 state that it has not
yet been possible to detect in the organism the products of the
oxidation of alcohol—namely, aldehyde, acetic acid, and oxalic acid;
nevertheless, acetic acid formed in the economy by the general
combustion of alcohol may form acetates, which, undergoing
decomposition, are transformed into carbonates and water, and are
eliminated as such in the urine.9 This view is also held by Parkes.10
8 Cited by Peeters, L'Alcool, physiologie, pathologie, médecine légale, 1885.

9 Henri Toffier found in the brain of a man who died of acute poisoning by alcohol not
only alcohol, but also aldehyde: Considerations sur l'empoisonment aiqu par Alcohol,
Paris, 1880.

10 Journal of Practical Hygiene, 4th ed., Lond., 1873.

According to Peeters, the action of alcohol upon the blood may be

summed up as follows: That portion of the ingested alcohol which
undergoes decomposition takes from the blood some part of its
oxygen for this purpose, with the result of a diminished amount of
oxygen and an increase of carbon dioxide, the blood thus being
made to resemble venous blood. A part of the oxygen destined for
the oxidation of waste products being thus diverted, these
substances are not completely transformed. In this respect also
blood charged with alcohol resembles venous blood. Alcohol even
when diluted is capable of retarding the combustion of oxidizable
organic substances, and there is no reason to doubt that this agent
has in the blood the same chemical properties that it elsewhere
possesses.

The exhalation of some part of the alcohol circulating in the blood by

the way of the pulmonary mucous membrane interferes with the
elimination of carbon dioxide, with the result that the latter agent
further tends to accumulate in the blood.11
11 David Brodie, Medical Temperance Journal, October, 1880.

Alcohol must act, to some degree at least, directly upon the water of
the blood and upon its albuminoid principles. The products of the
reactions normally taking place within the corpuscles pass with
greater difficulty into serum containing alcohol as the current of
osmosis tends rather from the serum to the corpuscles. It is in
accord with this fact that the corpuscles of alcoholized animals have
been found relatively large.

The blood of individuals who have died in a state of alcoholic

intoxication has been frequently found to contain an unusual amount
of fatty matter in a fine state of subdivision.

Upon the respiration the influence of alcohol is twofold: it modifies

the respiratory movements and the results of the respiratory
processes. After moderate doses the movements are accelerated
without disturbances of rhythm; after large doses the respiratory acts
become embarrassed, feeble, irregular, finally wholly diaphragmatic.

Alcohol modifies the results of respiration in a constant manner and

in all doses. This modification consists in a decrease in the amount
of oxygen absorbed and carbon dioxide exhaled. This effect is
usually more marked when alcohol is taken fasting than during
digestion.

The influence of alcohol upon the renal secretion is that of a diuretic,

but the fact must not be overlooked that this tendency is much
increased by the large amount of water which alcoholic drinks
necessarily contain. But that alcohol acts as a diuretic, even in small
doses and altogether independently of the water with which it is
taken, does not admit of doubt. The changes in the urine are
qualitative as well as quantitative. The amount of urea, uric acid, and
other solids is always notably diminished. The diminution of the
amount of phosphoric acid is even greater than that of the
nitrogenized substances, especially during the period of excitation.

The diuretic effect of alcohol is dependent upon its direct action on

the parenchyma of the kidneys, the qualitative changes in the urine
upon its influence on nutrition.

Upon the temperature of the body alcohol has a marked effect. The
sensation of warmth experienced after moderate doses is chiefly
subjective, and is accompanied by a very slight actual rise in
temperature, amounting to some fraction of a degree Fahrenheit,
and of but short duration. This rise is followed by a rapid fall,
amounting to a degree or more below the norm. This effect is
manifested within the course of an hour after the administration, and
is of comparatively brief duration, being largely influenced by the
condition of the individual at the time as regards mental or physical
exercise, digestion, and the like. It is in part due to the increased loss
of heat from the surface of the body, favored by more active
cutaneous circulation, but chiefly to the action of alcohol in retarding
oxidation and the activity of nutritive changes. Toxic doses are
followed by marked fall of temperature. The influence of alcohol
upon the temperature is more pronounced in febrile conditions than
in health.

The influence of physiological doses of alcohol upon the nervous

system is, among all its effects, the most marked and the most