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Good Health and Bad Medicine:
 Obesity - Part 3

 Nervousness

 Insomnia

 Fatigue, Weakness, Poor Appetite And Tonics - Part 1

 Fatigue, Weakness, Poor Appetite And Tonics - Part 2

 Sexual Weakness, Impotence And Frigidity

 Stimulants-coffee, Alcohol, Tobacco And 'pep' Pills

 Physical Therapy

 Arthritis And Rheumatism

 Feet

 Read More Articles About: Good Health and Bad Medicine

Stimulants - Coffee, Alcohol, Tobacco and 'Pep' Pills

( Originally Published 1940 )

THE desire for a stimulant is frequently based upon the laudable ambition or need to complete an important piece of work. The student taking an examination, the business-man launching a new enterprise, the physician keeping a night vigil, look for some stimulant that will whip up the flagging energy of the body or keep the mind alert and clear. The most useful and safest drug for such occasions is caffeine.

This drug is the principal active ingredient of coffee and tea. The main effect of caffeine is on the nervous system. A moderate amount such as is contained in one or two cups of coffee (there are 2-3 grains of caffeine to the average cup of coffee) heightens the intellectual functions, producing a quicker flow of thought and a lessening of nervous fatigue. When more than three or four cups are taken, the stimulation may be increased to such an extent as to produce nervous excitement, insomnia and even a lessening of mental efficiency. Some people are sensitive to caffeine and require only one cup of coffee, or 2 to 3 grains of caffeine, for stimulation. Such persons may suffer from insomnia or nervous excitement after two cups of coffee or tea. The individual tolerance for caffeine, as for all other drugs, varies widely and must be respected if trouble is to be avoided.

Caffeine is also of some value for temporary physical fatigue. It increases the efficiency of the muscles and lessens the feeling of fatigue. Following the stimulating effect, however, the fatigue will return unless rest and relaxation are obtained.

The average cup of tea contains about i to 2 grains of caffeine. Maté, or Paraguay tea, has none of the remarkable properties acclaimed for it by advertising. Like any other tea, it simply contains tannin and caffeine. It differs from other teas only in name and to a slight extent in taste. A bottle of Coca-Cola contains about one grain of caffeine. It is reported that in the South a bottle contains about 2 grains. The "pick-up" effect of Coca-Cola is due mainly to its caffeine content. Almost all "pep" pills on the market consist of caffeine. Caffeine in pill form has the same properties as caffeine in coffee, tea or Coca-Cola.

Moderate amounts of these caffeine-containing drinks pro-duce pleasant effects, usually without any serious or even undesirable after-effects. Large amounts (4-8 cups a day), how-ever, may cause insomnia, palpitation, gastro-intestinal disorders and mental and physical fatigue. Children should never be given coffee, tea or Coca-Cola. Stimulation of the child by beverages or drugs is decidedly undesirable.

Benzedrine sulphate is a relatively new drug which has been found to have a markedly stimulating effect on the nervous system and on the activity of the muscles of the digestive tract. There is no doubt that it can stimulate psychic activity and overcome mental fatigue. But it can also pro-duce severe reactions. Among some of the undesirable or dangerous effects that the drug has been responsible for in many people are forceful and rapid beating of the heart, loss of appetite, indigestion, skin eruptions, anxiety, mental depression and insomnia. The use of "pep" pills containing benzedrine sulphate as "energizers," is extremely dangerous without medical supervision.

Alcohol

Although alcohol is frequently used as a stimulant, its real effect is to depress the nervous system. In fact, it acts as a narcotic, like ether and chloroform. The stimulating effect which so many people claim for it is a deceptive one. What happens is that the functions of inhibition and self-criticism are depressed so that a sense of well-being and freedom of movement is produced. Psychologically, there is also an overvaluation of one's own personality. In some people even a single drink will tend to reduce mental and physical efficiency. At the same time it promotes a feeling of self-esteem. This is a dangerous combination. Because it makes them feel that they are doing better, persons may be tempted to take a drink to carry them through a situation requiring a high degree of skill and efficiency. As a matter of fact, it has been shown experimentally that the drinking of small amounts of alcohol leads to poorer coordination in doing and thinking, to delayed and weakened muscular performance. In work of precision, errors are more frequent and physical efficiency is diminished.

In testing the effects of alcohol on coordination and control, such complex skilled acts as shooting at a target, type-writing, and threading a needle were used. The control of speech and of eye movements were studied with the help of special tests. All these tests were done with moderate amounts of alcohol, usually not more than the amount contained in one or two glasses of wine. And it was found that the various movements of the body were slowed up by alcohol, that they became more random and less coordinated in character, and therefore not so well adapted to the performance of skilled acts. A wise rule, therefore, is never to take a drink during working hours.

Overindulgence should always be avoided, but occasion-ally a person overestimates his capacity, with the result that the next day he has the impression that his hat is several sizes too small.

There are several popular beliefs about hangovers. One is that drinks should not be mixed. If one starts with rye, it is supposed to be unwise to switch to Scotch, gin, wine or brandy. Consider, however, that for centuries dinners (of the rich, of course) have been marked by service with a variety of beverages. Cocktails before dinner, wines with the dinner, brandy or cordials with the coffee, and Scotch later is the order in many a gourmet's home. Where, then, stands the rule of a single kind of liquor?

A second belief is that "grains and grapes do not mix." If one starts with wine, he is supposed to confine his drinking to wine and brandy; if one starts with whiskeys, he is sup-posed to leave rum and brandy alone. The most popular of the American cocktails are the Martini and the Manhattan. The vermouth used in these two drinks is a wine, and the distilled liquor is derived from grain. Yet neither the Martini nor the Manhattan enjoys a reputation for possessing any overdosage of "dynamite."

The prevailing opinion among amateur and professional experts is that the fundamental factor in intoxication, aside from the question of individual drinking capacity, is the quality of the liquor, and not its admixtures. A poor quality of gin, relatively high in chemicals known as aldehydes, will always have a more intoxicating effect than a good grade of gin distilled from grain. One professional liquor taster whom we consulted will not taste young whiskeys in the mornings, the time when his palate is keenest. It is his contention that the relative immaturity of these whiskeys exerts, for him, a definite tendency toward intoxication which the more mature liquors do not.

A person may feel confident, if he knows his tolerance and capacity, that the mere mixing of good liquors will not cause intoxication. Despite the best intentions, however, hangovers do occur.

The cause of the hangover varies in different people. In a few, the symptoms are psychological in origin. In most, however, they are due mainly to a stomach irritation or mild inflammation caused by the alcohol or other materials in the liquor. This is known medically as acute gastritis. A table-spoonful of milk of magnesia or a level teaspoonful of sodium bicarbonate in half a glass of water or seltzer may have a soothing effect. The reason many people swear by Alka-Seltzer is that the aspirin in the tablet relieves the headache, and the carbon dioxide and sodium bicarbonate which are released when the tablet bubbles in water have a soothing effect on the mucous membrane of the stomach.

Cold Vichy or seltzer, a large pinch of sodium bicarbonate and i or 2 aspirin tablets are probably the most useful agents for combating the headache, nausea and furry tongue. Some people swear by hot coffee as well. The hot fluid may relieve the nausea a bit and the caffeine present in coffee tends to relieve that dull, headachy feeling. Strong hot tea may be even better, because it contains a larger amount of tannin, a drug which acts as an astringent on the mucous membrane. Laxatives and cathartics are of no value. The diet, of necessity probably, should be light.

Tobacco

Advertisements for Camel cigarettes claim that smoking a Camel will give tired people a "lift." The fact that fatigue is a symptom of many disorders and that nicotine is never used in medical practice as a stimulant is no deterrent to slogans designed to boost one particular brand over another.

A thorough study of the most popular brands of cigarettes on the market by Consumers Union recently showed:

1. There is little difference perceptible between the various brands of any one type of cigarette.

2. None of the popularly advertised brands appears to be more harmful than any of the others.

3. If you are going to smoke, you may as well buy the cheapest brand of the type you prefer.

All cigarettes, depending on the nicotine content, will have a similar effect upon the body. Because of the widespread use of tobacco, it is worthwhile discussing it at length.

Just how smoking gratifies the smoker is not known. Most of the ideas advanced are rich in theory and poor in fact. While most regular smokers find themselves quite uncomfortable when suddenly deprived of tobacco, it is an established fact that the craving they experience is due entirely to psychological factors and not to any bodily need. The discomfort which the confirmed smoker may experience when he attempts to give up smoking is a mental reaction to being deprived of a form of activity he has enjoyed and a kind of gratification that has fulfilled some emotional need. For in-stance,. in some individuals smoking provides the same sort of gratification that thumb-sucking gives to a baby. Put thumb guards on the infant and he cries bitterly. Take away the adult's cigarette and he gets the "jitters." Smoking may also relieve nervous tension in moments of stress, or may calm an excited person, but it is certainly not a stimulant in the accepted sense of the word.

In spite of many careful experiments, little has been discovered about the precise physiological effects of smoking.

It is well known that tobacco contains nicotine—a poison. Other harmful substances, including carbon monoxide, ammonia, pyridine, prussic acid, wood alcohol, collidine, formaldehyde, tars, lead and arsenic, are either present in tobacco or are formed when tobacco is burned. The consensus today, however, is that the major harmful constituent is nicotine.

Certainly nicotine is a poison. And some of the nicotine that tobacco contains is carried, still unchanged, in the smoke of a burning cigarette. Some of the nicotine in the smoke is absorbed by the mucous membrane of the mouth. Some more is absorbed by the lungs. How harmful is this very small amount of a definite poison?

There is no question but that many people become ill the first time they smoke tobacco, which may be accepted as evidence that tobacco is poisonous. The fact that the body soon acquires a certain amount of tolerance to the toxic sub-stances is by no means proof that they are no longer toxic. So many pathological conditions have been laid at tobacco's door by honest doctors, only to be taken away again by equally honest doctors, that it would be futile to enumerate them.

There are, however, cases on record in which smoking to excess has appeared to favor development of disease of the blood vessels and stomach, chronic bronchitis, optic neuritis, insomnia and other disorders. Many of the disturbances induced by excessive smoking tend to clear up when the use of tobacco is discontinued. Because of possible intoxication of the child, nursing mothers should avoid smoking; or if they must smoke, the less the better.

Unbiased scientists have tried to determine the harmfulness of smoking. The opinion of a large share of medical experts can still be summarized in the statements of Dr. Walter L. Mendenhall, research pharmacologist, in the Harvard Health Talk on Tobacco (Harvard University Press, 1930):

"Is tobacco harmful? This can be very satisfactorily answered to everyone . . . by saying, 'No and Yes.' If a man or woman uses tobacco in moderation, he or she may live as long, be as happy and free from disease as a neighbor who does not indulge. If a man or a woman uses tobacco in excess, he or she may suffer disorders or may die sooner than a neighbor who does not indulge."

In certain diseases of the blood vessels, heart, stomach and intestines, smoking must be absolutely discontinued or strictly limited.

So-called denicotinized cigarettes, for which it is claimed that the "nicotine is out," actually contain only one-half to one-third less nicotine than ordinary cigarettes. They are more expensive than ordinary cigarettes and are not worth buying for the slightly reduced nicotine content.

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