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[00:00:00.080 – 00:00:03.740] Talk to you about today is alcohol itself.

[00:00:03.740 – 00:00:11.280] You know, you hear rumors that alcohol has something to do with alcoholism, and as time goes on, and alcohol occurs in many other forms.

[00:00:11.280 – 00:00:17.170] Like, uh, today, for instance, uh, we have it probably in at least 100 different forms.

[00:00:17.170 – 00:00:19.220] It can cause the same cirrhosis of the liver.

[00:00:19.220 – 00:00:20.900] It can cause the same brain damage.

[00:00:20.900 – 00:00:22.340] It can cause the same withdrawal.

[00:00:22.340 – 00:00:26.720] Yet many of these forms you wouldn’t recognize, and certainly they aren’t beverage alcohol.

[00:00:26.720 – 00:00:30.520] So the family of chemicals that we’re talking about has become far greater.

[00:00:30.520 – 00:00:40.850] Uh, unfortunately, the family itself is, uh, uh, a little bit complicated, and certainly anyone who has a disease that goes by the name of alcoholism,

[00:00:40.850 – 00:00:46.660] uh, should have some fundamental knowledge as to, uh, what alcohol has to do with creating this disorder.

[00:00:46.660 – 00:00:56.740] Now, frankly, the things I’m going to talk about today are what alcohol does to simple laboratory animals, to human volunteers who can be encouraged to drink this

[00:00:56.740 – 00:01:00.280] much, and certainly has nothing specifically to do with alcohol.

[00:01:00.280 – 00:01:03.400] So we’re going to talk today about what alcohol can do to anyone.

[00:01:03.400 – 00:01:13.620] Now, we’ve had a great deal of difficulty with alcohol for probably as long as we’ve known about it, and I could guess that probably this is, amounts to the last 8,000 years,

[00:01:13.620 – 00:01:23.780] simply because the earliest reference that I can find to anybody being worried about their consumption of alcohol goes back to a copy of the Egyptian Book of the Dead,

[00:01:23.780 – 00:01:32.280] which was taken out of a pyramid, uh, uh, and it was the custom in the days of the old pharaohs to be buried with a confession of your good deeds.

[00:01:32.280 – 00:01:38.300] And depending on how good this confession was depended on how, uh, uh, effectively you crossed to the hereafter.

[00:01:38.300 – 00:01:49.020] Well, this book said that this, uh, man had, uh, defended the, uh, meek and had fed the hungry and clothed the naked, and, uh, the one thing that it said quite conspicuously

[00:01:49.020 – 00:01:50.880] was he had never been intoxicated.

[00:01:50.880 – 00:01:58.660] So as far back as this period of time, which would date it back to 6,000 years BC, man has been worried about being snockered.

[00:01:58.660 – 00:02:08.419] So, uh, alcohol and its consumption has represented sort of a double, uh, idea, a double concept to us for probably as long as we’ve known about it.

[00:02:08.419 – 00:02:18.440] Now, frankly, uh, uh, I think the ancient Greeks had the best way or one of the clearest ways of looking at it because they actually had a double deity to represent

[00:02:18.440 – 00:02:18.840] one.

[00:02:18.840 – 00:02:28.930] They had a fellow by the name of Dionysus who, uh, dashed around with a horn of plenty on his shoulder and all the goodies were rolling out of it, and he represented those things that are good that

[00:02:28.930 – 00:02:32.640] come from the vineyards and from agriculture in general.

[00:02:32.640 – 00:02:42.660] But he was always followed by a companion deity who probably represents the patron saint of the alcoholic called Silenus, who was half man, half goat, had a shrunken

[00:02:42.660 – 00:02:52.660] head, a drunken leer, a big old potbelly with his liver down to his navel and all the accessory blood vessels opening, indicating that he obviously had very far advanced cirrhosis of the

[00:02:52.660 – 00:02:53.240] liver.

[00:02:53.240 – 00:02:56.880] And little old Silenus was the butt of every drunk joke that the Greeks told.

[00:02:56.880 – 00:02:59.380] So, uh, frankly, things haven’t changed too much.

[00:02:59.380 – 00:03:08.980] But certainly, the Greeks, as far back as many hundreds of years BC, recognized that alcohol was capable of creating both good and evil on the face of the Earth.

[00:03:08.980 – 00:03:19.520] So we’ve always regarded it with, uh, sort of double, uh, standards and with, uh, a great deal of apprehension and misunderstanding simply because alcohol has been, uh, uh, represented

[00:03:19.520 – 00:03:22.740] a very difficult thing for us as mankind to deal with.

[00:03:22.740 – 00:03:32.760] Now, if, for instance, you were to ask me to describe what was in the last alcoholic beverage that you consumed, I would be totally unable to

[00:03:32.760 – 00:03:33.120] tell you.

[00:03:33.120 – 00:03:37.920] Uh, frankly, we to this day don’t know what’s in alcoholic beverages.

[00:03:37.920 – 00:03:48.000] I was involved in a research project about 20 years ago where, uh, we were trying to determine the chemical makeup of the old Southern Comfort kind of beverages, brandies

[00:03:48.000 – 00:03:48.720] and liqueurs.

[00:03:48.720 – 00:03:58.820] Uh, we stopped at 1,500 different chemical compounds, and we still had jar, jars of, uh, gray goop and brown goop and so forth that we hadn’t even bothered to begin

[00:03:58.820 – 00:03:59.820] to analyze yet.

[00:03:59.820 – 00:04:06.520] So frankly, I can tell you that there’s more than 1,500 different chemical compounds in a Southern Comfort kind of beverage.

[00:04:06.520 – 00:04:14.329] Now, this means that some of them were, gave it its color, some of it gave it its flavor, but oddly enough, there were some in there that had antibiotic properties.

[00:04:14.329 – 00:04:19.320] There were some in there that had properties very much like the medicines we use to treat peptic ulcers with.

[00:04:19.320 – 00:04:25.880] Uh, so that there are a great number of chemicals that have activity, uh, in these particular kind of beverages.

[00:04:25.880 – 00:04:26.860] Now, there’s a Dr.

[00:04:26.860 – 00:04:36.969] Silverman in California who’s devoted most of his adult life to studying domestic wines, and about every 10 years, he publishes a new book, and the last book had

[00:04:36.969 – 00:04:42.700] better than 3,800 different chemical compounds that he’s isolated from the various domestic wines.

[00:04:42.700 – 00:04:47.540] So this, this means that we have many things now that indicate that Grandma was correct.

[00:04:47.540 – 00:04:50.860] There are antibiotic, uh, uh, properties to certain wines.

[00:04:50.860 – 00:05:01.180] Of course, you have to drink 14 or 15 gallons, which means that the antibiotic properties are, are, uh, somewhat negligible because by the time you drank that much, you wouldn’t notice the infection you were trying to treat anyway.

[00:05:01.180 – 00:05:06.340] So, uh, but there are active ingredients in, in, uh, all alcoholic beverages.

[00:05:06.340 – 00:05:09.080] In fact, one of them gave us a great deal of difficulty.

[00:05:09.080 – 00:05:17.780] When we began to study the heart disease that goes along with alcoholism, we discovered something that we had ab- absolutely no explanation for at all.

[00:05:17.780 – 00:05:27.940] That in alcoholic cardiomyopathy, which means the direct damage of the heart muscle due to the consumption of alcohol, it was the beer drinker who died earliest and with the most

[00:05:27.940 – 00:05:29.320] severe form of this disease.

[00:05:29.320 – 00:05:39.340] And we said, “Well, now that doesn’t make any sense because that’s the beverage that has a rather low alcohol content.” But frankly, as we began to research further, we found out that beer contains a mineral

[00:05:39.340 – 00:05:47.820] called cobalt, and cobalt in conjunction with alcohol produces the most devastating heart changes that we know caused by any kind of alcoholic beverage.

[00:05:47.820 – 00:05:55.060] So it really is quite important that we, uh, understand the makeup of alcoholic beverages, and yet we are still incapable of doing this.

[00:05:55.060 – 00:06:05.196] So when we talk about the beverages we consume, we have to, uh, accept the fact that these are still great unknowns, and there’s a great deal more that we need to know about them But even

[00:06:05.196 – 00:06:10.816] when we get to talking about alcohol itself, uh, we find that this isn’t a terribly simple subject.

[00:06:10.816 – 00:06:18.356] Uh, alcohol is made up of certain chemical elements that in and of themselves are relatively harmless.

[00:06:18.356 – 00:06:28.356] One is carbon, which is the lead in a lead pencil, and with a little heat and coal, it becomes, uh, things like oil and coal, and a little more heat and coal and, uh, and,

[00:06:28.356 – 00:06:30.796] and pressure, it becomes things like diamonds.

[00:06:30.796 – 00:06:34.196] Fourteen percent of yours and my body’s made up of carbon.

[00:06:34.196 – 00:06:40.476] Every foodstuff that we take into our system contains carbon, so it’s certainly not a harmful element in and of itself.

[00:06:40.476 – 00:06:50.756] Now, the next thing that we find in alcohol is oxygen, and oxygen is what you see around hospital corridors in those little green tanks with a mask

[00:06:50.756 – 00:06:51.256] attached.

[00:06:51.256 – 00:06:56.696] And oxygen is not only harmless, but it’s actually an essential and vital part to our survival.

[00:06:56.696 – 00:06:59.216] Again, every foodstuff we have contains oxygen.

[00:06:59.216 – 00:07:04.676] Uh, a significant part of our body is made up of oxygen, so it’s nothing foreign to us at all.

[00:07:04.676 – 00:07:14.956] Now, finally, alcohol contains hydrogen, and hydrogen, uh, for a while was the kinda thing that we used to fill up circus balloons and dirigibles

[00:07:14.956 – 00:07:18.356] and so forth, and as such was relatively harmless.

[00:07:18.356 – 00:07:26.376] But since World War II, some idiots determined a way of making a bomb out of it, so it’s relatively more harmful than it used to be.

[00:07:26.376 – 00:07:36.576] Now, the only other thing we really need to know about, uh, the makeup of alcohol is that if we take two hydrogens and an oxygen and put them together, we have plain old drinking water.

[00:07:36.576 – 00:07:46.616] Now, the simplest alcohol that we can safely consume has two carbons linked in a chain, a half a drop of water on the end, a few hydrogens hitched up around

[00:07:46.616 – 00:07:51.636] the edges to sort of balance things off, and this is our good old friend ethyl alcohol.

[00:07:51.636 – 00:07:57.736] Now, ounce per ounce, this is probably the easiest, uh, form of alcohol for our body to process.

[00:07:57.736 – 00:07:58.796] It can be burned whole.

[00:07:58.796 – 00:08:09.076] Uh, it’s so light that when we distill a mixed beverage over, this is the alcohol that goes over the most easily, so it really represents the major alcohol

[00:08:09.076 – 00:08:14.096] content of any beverage, but it’s in almost pure state in those beverages that we distill.

[00:08:14.096 – 00:08:21.536] So vodka, whiskey, gin, uh, contains about 99% of its alcohol content is ethyl alcohol.

[00:08:21.536 – 00:08:31.536] Now, as we go down the line and get to those beverages that are half-fermented and half-distilled, we start to pile up a few alcohols that have three and four carbons in

[00:08:31.536 – 00:08:39.176] a chain, and this is what we’d find in the Southern Comfort kind of beverages, beer, ale, brandies, liqueurs, and so forth.

[00:08:39.176 – 00:08:48.336] And the only problem is that if you, uh, uh, accumulate, uh, a considerable quantity of this, uh, that it has to be split once in the liver in order to be burned.

[00:08:48.336 – 00:08:58.376] Now, again, in beer, ale, uh, brandies, and liqueurs, the major portion of the alcohol content is still, still ethyl alcohol, and what’s left

[00:08:58.376 – 00:09:02.956] over are these more complex kinds of alcohols that have to take a little longer to process.

[00:09:02.956 – 00:09:13.156] Now, if we get down to the distilled beverages, we have alcohols that maybe have four and five and six carbons in a chain, and these have to be broken a couple of times

[00:09:13.156 – 00:09:14.376] to be processed in the liver.

[00:09:14.376 – 00:09:23.996] Now, again, in the average bottle of wine, there’s probably not more than a half a teaspoon of this kind of alcohol compared to probably a couple, three shot glasses of ethyl alcohol.

[00:09:23.996 – 00:09:33.996] But very frankly, if you get into the kind of consumption of wine that, uh, occasionally occurs in people who end up at Brighton Hospital, you get to the point where that half a teaspoon gets up

[00:09:33.996 – 00:09:38.496] to a tablespoon or two a day, and then we run into some rather interesting kinds of things.

[00:09:38.496 – 00:09:42.716] In fact, there’s certain wines that are quite rich in these kinds of alcohols.

[00:09:42.716 – 00:09:47.716] They happen to be the Rhine wines, the bright, uh, the, uh, light, dry wines like champagne.

[00:09:47.716 – 00:09:55.336] And every now and then, you run into somebody that’ll tell you a story like I’m about to relate, and you can believe that it probably actually did occur.

[00:09:55.336 – 00:10:04.516] Now, this is the person who goes out and really ties into a lot of, uh, a, a heavy alcohol, rich kind of alcohol like champagne.

[00:10:04.516 – 00:10:09.636] And after putting away three, four, five, six bottles, they go home, and the liver’s like the rest of us.

[00:10:09.636 – 00:10:12.636] It likes to process the easy thing first, so it starts here.

[00:10:12.636 – 00:10:22.896] And by the time it’s burned off the ethyl alcohol in that quantity of champagne, the body consumes water in the process of burning alcohol, so the individual has become

[00:10:22.896 – 00:10:24.115] somewhat dehydrated.

[00:10:24.115 – 00:10:31.836] Therefore, the bloodstream can’t support transporting foreign material, and the body has to do something with these alcohols that are left over.

[00:10:31.836 – 00:10:34.856] Well, what it does is simply stuff it out in the stored body fat.

[00:10:34.856 – 00:10:42.256] Now, the next morning, the person wakes up bright-eyed and bushy-tailed, absolutely stone-cold sober, but terribly thirsty.

[00:10:42.256 – 00:10:47.016] You know, the 7th Cavalry has marched through their mouth out the Sahara Desert, dropping off bales of hay as they went.

[00:10:47.016 – 00:10:55.976] So he goes into the bathroom, or she does, has a couple of glasses of bright, sparkling, pure, clear drinking water, re-expands the blood volume.

[00:10:55.976 – 00:11:06.216] Now that the blood can transport foreign material, out of the stored body fat comes our friend, and they’ve got a free ride until 10 o’clock or noon that day and, uh, uh, with no explanation

[00:11:06.216 – 00:11:06.936] other than this.

[00:11:06.936 – 00:11:11.476] And it can be somewhat of a frightening experience if it happens without any, uh, warning.

[00:11:11.476 – 00:11:20.496] But this also gives you some idea of how long some of these more complex alcohols, if you succeed in getting a significant quantity into your system, are going to stay around.

[00:11:20.496 – 00:11:25.156] Now, this is the family of alcohols that are safe for human consumption.

[00:11:25.156 – 00:11:35.336] Now, this doesn’t mean that there aren’t several hundred more alcohols around, uh, that are not safe for human consumption, and below this line, we lump them all into a group

[00:11:35.336 – 00:11:45.336] that we call fusel oils, simply because our ancestors really determined through trial and error and many deaths that it was safer to use those to heat the house or

[00:11:45.336 – 00:11:47.076] light your lamps than it was to drink.

[00:11:47.076 – 00:11:57.176] Because these being a very light three-in-one oil type of material can go through the gut membrane and into the bloodstream, but since they can’t be dissolved, they simply stay there

[00:11:57.196 – 00:12:06.296] the rest of the individual’s life, and if you’ve accumulated enough so that it amounts to an ounce or two, that won’t be too long because you simply go ahead and die the alcoholic death whether you drink or not.

[00:12:06.296 – 00:12:12.328] Now, this is the kind of problems we used to run into when people used to drink things that weren’t meant for human consumption.

[00:12:12.328 – 00:12:22.568] Our good old friends Sterno and, uh, paint thinners and so forth, uh, because they weren’t designed to be consumed by human beings, uh, usually had a great amount of fusel oil.

[00:12:22.568 – 00:12:32.648] And if you, uh, wanna know what fusel oil smells like, simply open the top of one of these five-gallon GI cans that’s migrated down, you know, tax-free from the Tennessee hills, and you’ll have the

[00:12:32.648 – 00:12:34.708] characteristic smell of fusel oil.

[00:12:34.708 – 00:12:43.007] And taste it, and that rough, harsh taste of Mountain Dew, uh, or the rough, harsh taste of any rough whiskey is due to its fusel oil content.

[00:12:43.007 – 00:12:53.088] Now, frankly, most people in this day and age where you can buy a bottle of soda pop wine for 10 cents less than you can buy Sterno are really drinking the things that are up here meant

[00:12:53.088 – 00:12:59.268] for human consumption, so we’re not really bothered with fusel oil as much as we were 10 and 15 and 20 years ago.

[00:12:59.268 – 00:13:07.308] Now, fusel oil has been known to us as a deadly poison for so long that it’s really affected our way of handling alcoholic beverages.

[00:13:07.308 – 00:13:14.448] Have you ever wondered why the neck on a fifth of whiskey is shaped in its characteristic fashion, narrow at the top of the bottle and narrow again at the top?

[00:13:14.448 – 00:13:24.868] Well, that derives from the Old West when the most skilled bartenders, the fusel oil would seep up and float on top of the regular alcohol in the neck of the bottle, and the best bartenders

[00:13:24.868 – 00:13:33.268] could empty that neck without losing any of the good stuff, uh, uh, in one glunk down the sink and get rid of the poisonous part, and that left the rest for easy consumption.

[00:13:33.268 – 00:13:40.228] Of course, an individual who was in a hurry could always use that narrow spot to break the bottle, and he had a handy container to drink the rest.

[00:13:40.228 – 00:13:46.528] Now, it also, uh, has dictated how we store, uh, uh, normally, uh, manufactured wines.

[00:13:46.528 – 00:13:55.788] We store wines on their side to allow the fusel oil, the toenail clippings, and the grapevine leavings to all collect in a, uh, glob of gunk up in a corner.

[00:13:55.788 – 00:14:00.427] And then if you pour it carefully, you don’t get these things into your glass, and everything is fine.

[00:14:00.427 – 00:14:03.848] Now, this leaves us with one alcohol yet to discuss.

[00:14:03.848 – 00:14:12.968] Now, it’s actually, to the alcoholic, would be an absolute dream because it only has one carbon, which means that if you drank an ounce, you could get twice as drunk.

[00:14:12.968 – 00:14:17.448] And since it has to combine with itself to burn in the liver, you’d sober up in half the time.

[00:14:17.448 – 00:14:19.268] Except it does have one drawback.

[00:14:19.268 – 00:14:29.568] Instead of the alcohols combining over here on the carbon, they combine over here on the oxygen, producing a chemical called formaldehyde or embalming fluid, which tickles

[00:14:29.568 – 00:14:32.208] the nerves going to your eyes, producing total blindness.

[00:14:32.208 – 00:14:36.028] So we don’t recommend wood alcohol at Brighton Hospital either.

[00:14:36.028 – 00:14:41.988] So there’s a very narrow range of alcohols that, uh, uh, human beings expose themselves to.

[00:14:41.988 – 00:14:45.568] Now, let’s examine alcohol as a food.

[00:14:45.568 – 00:14:55.728] Now, as long as consumption of alcohol is kept down to under an ounce of alcohol per hour in 150-pound person, a person lighter

[00:14:55.728 – 00:14:57.808] than that can’t quite get by with an ounce.

[00:14:57.808 – 00:15:01.588] A person heavier than that might get by with a little bit more than an ounce.

[00:15:01.588 – 00:15:11.628] The alcohol goes to the liver and is transformed from alcohol into acetone, which is what’s used to, uh, dissolve plastics

[00:15:11.628 – 00:15:13.288] and airplane glue and so forth.

[00:15:13.288 – 00:15:20.328] And then that acetone is converted into vinegar, which is what the body finally processes.

[00:15:20.328 – 00:15:29.648] Now, Antabuse simply blocks this second reaction, and we simply begin to accumulate large quantities of acetone, which is known to be somewhat hazardous to your health.

[00:15:29.648 – 00:15:35.008] And you get, uh, violently ill, hot and cold flushes, nausea and vomiting, and so forth.

[00:15:35.008 – 00:15:37.388] And this is what gives the Antabuse reaction.

[00:15:37.388 – 00:15:42.288] It requires that alcohol be in the picture, uh, to provide the source of acetone.

[00:15:42.288 – 00:15:52.368] Now, I have heard some rumors in the halls as I’ve been wandering around that there are one or two of you in the audience here who have been known to drink a little more than an ounce of alcohol per

[00:15:52.368 – 00:15:54.688] hour for 150 pounds of body weight.

[00:15:54.688 – 00:15:57.908] So I think we have to legitimately discuss what happens here.

[00:15:57.908 – 00:16:06.848] Well, as soon as you’ve done this, you’ve exceeded the body’s physiological limit for alcohol, and you have to call in the auxiliary, uh, uh, power.

[00:16:06.848 – 00:16:16.988] And this means that we start using a chemical buzz saw to try and increase our breakdown of alcohol that’s run by the dye pigments that give the liver its

[00:16:16.988 – 00:16:18.788] vital brown kind of color.

[00:16:18.788 – 00:16:29.348] Now, what we do with the alcohol when we break it up is we send it over to a boiler in the liver, a chemical boiler, in two carbon chunks,

[00:16:29.348 – 00:16:35.968] stuff it in the boiler, and it gets consumed in a chemical fire that produces calories or units of energy.

[00:16:35.968 – 00:16:43.248] And these calories drive a chemical generator in the liver, which turns out power to run everything in the liver.

[00:16:43.248 – 00:16:47.628] So this generator begins to demand more and more and more of the power output.

[00:16:47.628 – 00:16:56.808] Now, when the reaction is all done, we get, through the chimney here, carbon dioxide that leaves by way of the lungs.

[00:16:56.808 – 00:17:02.768] And over on this side, leaving by way of the kidneys, we get a little tiny bit of water that’s used up.

[00:17:02.768 – 00:17:05.458] And, uh, that’s where everything goes.

[00:17:05.458 – 00:17:15.548] Now, as we begin to consume more and more alcohol, uh, over and above the ounce per hour that nature has equipped us to handle, more and more of the energy output

[00:17:15.548 – 00:17:25.788] of this generator has to go to recharge these pigments in our liver, which are very much like the hemoglobin in our blood, and our body demands top priority to recharging those particular

[00:17:25.788 – 00:17:26.348] chemicals.

[00:17:26.348 – 00:17:36.368] Well, as we go up to, oh, heaven forbid, two ounces per hour or three ounces per hour, uh, we start running into a little bit of trouble because now we don’t have enough energy resources left

[00:17:36.368 – 00:17:42.268] over from the consumption of the alcohol to handle all the other minor things that might need to be going on in the liver.

[00:17:42.268 – 00:17:47.498] Now, what you’re going to get, and, and remember, I’m not talking about the alcoholic, I’m talking about normal-

[00:17:47.627 – 00:17:56.867] Human beings and normal laboratory animals, that it even may be more dangerous to eat while one’s drinking than it would be to go on a total starvation kind of diet.

[00:17:56.867 – 00:18:00.167] Because one of the things that suffers is what we do to sugar.

[00:18:00.167 – 00:18:10.267] Now, we need this energy source down here to put sugar into storage, or to un-store it, or to convert

[00:18:10.267 – 00:18:14.346] it into brain sugar, or to convert it into muscle sugar.

[00:18:14.346 – 00:18:24.507] Now, some of you have had the experience of coming into a place like Brighton Hospital and waking up the next day with a mild headache, like somebody’s playing the anvil

[00:18:24.507 – 00:18:26.867] chorus on an empty oil drum inside of your head.

[00:18:26.867 – 00:18:37.047] But after all, if your brain had been starved from whatever period of time you drank for enough sugar to operate the brain efficiently, and at the same time was starved for oxygen during

[00:18:37.047 – 00:18:41.207] that entire period, your brain would be making all kinds of undulations, too.

[00:18:41.207 – 00:18:45.907] Now, some of you have awakened and, you know, really couldn’t find a comfortable place to put your legs.

[00:18:45.907 – 00:18:49.727] You had cramps back here, and cramps in your leg, and cramps in your shoulder.

[00:18:49.727 – 00:18:59.927] But again, that’s just the muscles complaining because for whatever period of time you were drinking more than an ounce of alcohol per hour, those muscles were being malnourished so far as having enough sugar

[00:18:59.927 – 00:19:03.507] to operate properly and were being starved for oxygen at the same time.

[00:19:03.507 – 00:19:13.527] Have you ever wondered why somebody could be drinking for five or six weeks, come in here into the hospital with cracks at the corner of their mouth that look like they had, they had nothing to eat for, uh, the

[00:19:13.527 – 00:19:14.417] whole six weeks?

[00:19:14.417 – 00:19:17.047] They’re suffering from obvious vitamin deficiencies.

[00:19:17.047 – 00:19:22.487] They’re suffering from obvious symptoms of malnutrition and still have the same generous proportions that I do?

[00:19:22.487 – 00:19:32.547] Simply because it’s possible, with this particular thing going on in the liver, to starve to death in the midst of plenty, so to speak, because you can’t un-store body fat, you

[00:19:32.547 – 00:19:41.007] can’t store body fat, and most people, while they’re drinking more than an ounce of alcohol per hour, don’t gain or lose weight simply because it’s totally impossible.

[00:19:41.007 – 00:19:51.227] Now, I get kind of a chuckle when I read in, you know, some of the major medical m- journals, like the Reader’s Digest and Time and Newsweek, about alcohol diets, where you have a high booze, high protein

[00:19:51.227 – 00:19:52.207] kind of diet.

[00:19:52.207 – 00:20:02.347] And, you know, if you kind of lean a little heavy on that booze, like more than an ounce per hour, it’s going to be totally impossible to change your body weight one way or the other simply because this reaction’s going to be blocked.

[00:20:02.347 – 00:20:12.917] Now, there’s one other little observation I should toss in here quickly before we leave sugar, and that’s simply the fact that most of us in the treatment of alcoholism know an awful lot of old alcoholics,

[00:20:12.917 – 00:20:21.867] and we know an awful lot of old diabetics, but we don’t know an awful lot of old alcoholic diabetics simply because too many accidents can happen.

[00:20:21.867 – 00:20:26.367] When the liver is operating in this fashion, sugar can’t be stored.

[00:20:26.367 – 00:20:36.387] The blood sugar goes so high that sugar is forced to an abnormal route, goes down and produces all kinds of toxic products, very much related to acetone, and the individual be- can

[00:20:36.387 – 00:20:39.247] become very ill and still have a normal blood sugar.

[00:20:39.247 – 00:20:49.467] There was a sheriff’s deputy on patrol about a year and a half ago in Los Angeles County, and he saw some fella playing billiards with his car off of the curbs down the road, so he thought he was driving

[00:20:49.467 – 00:20:50.807] a little bit erratically.

[00:20:50.807 – 00:20:59.227] Pulled him over and invited him to go downtown, where he promptly blew the breathalyzer up to about .24, uh, which meant that he was four sheets to the wind.

[00:20:59.227 – 00:21:02.607] But he also had in his wallet identification as a diabetic.

[00:21:02.607 – 00:21:13.087] So the deputy drove him over to the local hospital, where he was seen by the pinnacle of the medical staff, the intern on duty, who ran a blood sugar and ran a white count and gave him a thorough physical examination

[00:21:13.087 – 00:21:19.647] and finally told the deputy it was okay to take the man back to jail, where the turnkey found him dead in bed the next morning.

[00:21:19.647 – 00:21:23.367] At the time of his death, his blood sugar was six times normal.

[00:21:23.367 – 00:21:33.627] He had pneumonia in the base of both lungs and a broken leg, so that if someone is not familiar with the problems that can be caused in the body’s metabolism by over-imbibing of alcohol,

[00:21:33.627 – 00:21:44.147] many very fatal mistakes can be made, and the diabetic is more prone to these mistakes than any other group, so that frankly, it becomes extremely difficult at times to get the needed

[00:21:44.147 – 00:21:47.787] or the knowledgeable medical care that they might need with the combined problem.

[00:21:47.787 – 00:21:57.847] So any of you that have a tendency towards diabetes or who are diabetic, you better get rid of the alcoholism because the two together, uh, represent a rather lethal kind of combination.

[00:21:57.847 – 00:22:01.347] All right, now, there are other foods that we take into our system, too.

[00:22:01.347 – 00:22:04.467] For instance, uh, we take protein into our system.

[00:22:04.467 – 00:22:07.527] And we need to do several things with protein.

[00:22:07.527 – 00:22:17.767] We either have to take it over here and manufacture new protein, or we have to break it down, and it breaks down into ammonia, which acts as an anesthetic in the body and is very toxic.

[00:22:17.767 – 00:22:25.787] Uh, but we can combine the mo- ammonia with itself and produce a material called urea, which leaves the body by way of the kidneys over here.

[00:22:25.787 – 00:22:33.107] Unfortunately, we need this energy supply here and down here, which gets us into some trouble, too.

[00:22:33.107 – 00:22:42.867] This means that while one is drinking more than an ounce of alcohol per hour, heaven forbid, you’re unable to manufacture new pus cells to drive off body infections.

[00:22:42.867 – 00:22:48.267] You can’t manufacture immune bodies to drive off body infections or to help you to fight them off either.

[00:22:48.267 – 00:22:58.627] So the longer you go more than an ounce per hour of alcohol, uh, the more like you get the person in the nursing home or the newborn infant who is totally

[00:22:58.627 – 00:23:02.447] and completely susceptible to infections and unable to fight them off.

[00:23:02.447 – 00:23:12.827] So it isn’t any wonder that the most common things we see out in the admitting ward are pneumonias and massive kidney infections and quite serious infections, uh, that may last for a considerable

[00:23:12.827 – 00:23:13.487] period of time.

[00:23:13.487 – 00:23:17.327] Oftentimes, we’ll get people who have actual bone marrow depression.

[00:23:17.327 – 00:23:26.967] They simply can’t manufacture new cells, either red or white, uh, in order to fight off any kind of infection and have a very severe anemia that’s refractive to almost anything.

[00:23:26.967 – 00:23:37.067] Now, on top of that, if we can’t do this, we simply accumulate more and more ammonia in the bloodstream, eventually become very drowsy, go into a deep coma, and if we actually get enough,

[00:23:37.067 – 00:23:43.467] uh, we can go into, uh, respiratory arrest and simply die, uh, of accumulation of ammonia in the bloodstream.

[00:23:43.467 – 00:23:49.447] So again, uh, the consumption of alcohol can create a few minor problems so far as protein is concerned.

[00:23:49.447 – 00:23:54.947] Now, the final thing has to do with the thing that gives this whole liver problem its name.

[00:23:54.947 – 00:23:56.427] We do eat fats.

[00:23:56.427 – 00:24:05.177] And fats are converted into what we call free fatty acids, and then finally into a material called triglycerides.

[00:24:05.177 – 00:24:11.497] Now, triglycerides are very much like sugar, and they can be handled up here.

[00:24:11.497 – 00:24:13.897] Uh, and they’re really not terribly toxic in the body.

[00:24:13.897 – 00:24:20.017] But, you know, a few years back, or quite a few years back now, we used to measure the fatty acids in your bloodstream.

[00:24:20.017 – 00:24:26.957] And one day, Don says, “I don’t know why you’re doing this.” And he showed me a rack of tubes that were waiting up on the windowsill.

[00:24:26.957 – 00:24:34.797] And instead of there being that nice, clear, straw brown blood plasma that should be up above your cells, it was nothing but plain old white dairy cream.

[00:24:34.797 – 00:24:36.657] You could shake it up, and it would whip.

[00:24:36.657 – 00:24:46.817] Uh, and it really meant that, uh, the– after going back and looking at the laboratory results, the average person should have about 150 milligrams percent of free fatty acids in the bloodstream.

[00:24:46.817 – 00:24:56.897] And the average person coming through the door of Brighton Hospital had 1,500 to 3,000 milligrams of f-free fatty acid, uh, uh, in their bloodstream, which simply meant

[00:24:56.897 – 00:25:01.177] that we had a very good explanation for why alcoholics have coronaries and strokes.

[00:25:01.177 – 00:25:10.217] It’s awfully difficult to pump blood around through dairy cream, and they have a c– uh, tendency to sludge up and clump together and cause all kinds of body problems.

[00:25:10.217 – 00:25:15.237] Now, in addition, one of these free fatty acids, uh, can make more trouble than the rest.

[00:25:15.237 – 00:25:17.197] It’s our good old friend cholesterol.

[00:25:17.197 – 00:25:27.197] And when a normal serum cholesterol ought to be about 160, and the average serum cholesterol in the old days used to be about 1,500 milligrams percent,

[00:25:27.197 – 00:25:37.337] then it shouldn’t come as any surprise that alcoholics represent perhaps half of the coronaries and strokes in this country, and usually happen many years earlier than, uh, one would ordinarily

[00:25:37.337 – 00:25:38.117] expect.

[00:25:38.117 – 00:25:48.337] That’s why most life insurance actuaries don’t like insuring alcoholics, even though they’ve been sober for several years, until they’ve been sober for about five years or more, which gives them some

[00:25:48.337 – 00:25:52.436] chance to have the serum cholesterol go back down to normal, if it indeed will.

[00:25:52.436 – 00:25:57.677] So while we’re circulating this dairy cream, we’re also clogging up the liver cells.

[00:25:57.677 – 00:26:07.677] Instead of the liver being a nice, bright red, viable, uh, vigorous, healthy-looking kind of thing, it gets all greasy and swollen, kind of tender to the touch, and this

[00:26:07.677 – 00:26:12.777] is what gives it its name, the acute fatty liver.

[00:26:12.777 – 00:26:15.197] Now, this isn’t cirrhosis of the liver.

[00:26:15.197 – 00:26:25.226] This simply means that by putting alcohol in there at quantities larger than the liver’s equipped to burn it, we simply cause a whole lot of, uh, chemical problems with the liver, and

[00:26:25.226 – 00:26:27.917] all of your liver tests become disastrously changed.

[00:26:27.917 – 00:26:31.997] But without the alcohol, the liver simply goes back to repairing itself.

[00:26:31.997 – 00:26:33.817] It goes back to business as usual.

[00:26:33.817 – 00:26:40.057] And within, oh, six weeks to six months, all of these liver tests, uh, clear up, and things go back to normal.

[00:26:40.057 – 00:26:42.057] Now, this is only part of the story.

[00:26:42.057 – 00:26:49.377] You think if I told any normal person that if they drank more than an ounce of alcohol per hour, uh, they couldn’t store or un-store sugar.

[00:26:49.377 – 00:26:51.517] They wouldn’t nourish their brain or muscles properly.

[00:26:51.517 – 00:26:59.277] They couldn’t make new, uh, proteins to repair body damage, repair a broken leg, repair a laceration of skin, make new cells to fight off infection.

[00:26:59.277 – 00:27:03.737] Uh, and they would accumulate the good old white, uh, tornado ammonia in the bloodstream.

[00:27:03.737 – 00:27:13.777] Besides that, they’d be circulating dairy cream for the whole time they did that, that they would kind of consider that alcohol in quantities more than an ounce per hour would be moderately hazardous to one’s health.

[00:27:13.777 – 00:27:15.957] But this isn’t the whole story either.

[00:27:15.957 – 00:27:18.957] Now, this is a rather complicated boiler over here.

[00:27:18.957 – 00:27:25.117] It has, has its own built-in draft, and this is oxygen that comes from the lungs.

[00:27:25.117 – 00:27:33.097] And it has its own self-starting match, which is manufactured and stored in the pancreas.

[00:27:33.097 – 00:27:43.177] And it has an automatic thermostat over here, which is thyroid hormone, which is made in the thyroid gland.

[00:27:43.177 – 00:27:48.017] Now, when we eat a quarter pound of sugar, all of this stuff hits the liver.

[00:27:48.017 – 00:27:50.097] We start to breathe very deeply.

[00:27:50.097 – 00:27:52.437] We start squirting a lot of insulin in there.

[00:27:52.437 – 00:27:59.037] The thyroid turns the thermostat up a couple of notches, and we’re ready to run around the golf course two or three times we’re so full of pep.

[00:27:59.037 – 00:28:00.957] Now, what happens with alcohol?

[00:28:00.957 – 00:28:05.817] Now, uh, we really don’t run into any problem, as I say, at an ounce per hour.

[00:28:05.817 – 00:28:15.957] But, you know, I’ve, I’ve heard rumors that there are actually some people in this hospital who drink more than an ounce of alcohol per hour for more than nine to 11 hours, and then we start running into some rather

[00:28:15.957 – 00:28:16.796] serious troubles.

[00:28:16.796 – 00:28:26.317] Depending on how much you drink over that, uh, nine to 11 hours, at the very time when you want the damper open, you’re starting to get an anesthetic effect in your brain.

[00:28:26.317 – 00:28:32.717] And instead of breathing very deeply, you’re now breathing very shaw– slowly and very shallowly, and you’ve shut the damper.

[00:28:32.717 – 00:28:39.797] At the ar– uh, end of about nine to 11 hours, depending on the health you’re in, you’ve used up all of the available insulin.

[00:28:39.797 – 00:28:42.797] You can’t make any new because it’s a complicated protein.

[00:28:42.797 – 00:28:45.357] So at that time, you throw water on your matches.

[00:28:45.357 – 00:28:49.977] You can’t replace the thyroid hormone you’ve been using, so you bust the thermostat.

[00:28:49.977 – 00:28:58.437] And at the very time that you want the boiler working the best, you shut the damper, busted the d– uh, thermostat, thrown water on your matches, and everything I’m talking about over there gets worse.

[00:28:58.437 – 00:29:08.497] So frankly, I think we have to consider alcohol as a food as somewhat less than the ideal kind of food if one, you know, exceeds the ounce per hour that the body’s equipped

[00:29:08.497 – 00:29:13.297] to handle and, Heaven forbid, drinks more than, you know, eight or nine hours steadily.

[00:29:13.297 – 00:29:23.357] Uh, because then we start getting into all kinds of serious problems that causes the liver to go into collapse and brings about this chemical disease, not, uh, any change in– permanent change in the cells

[00:29:23.357 – 00:29:25.677] at all, that we call the acute fatty liver.

[00:29:25.677 – 00:29:29.777] Now, by and large, most of you have fatty liver.

[00:29:29.777 – 00:29:34.857] I s-see very few people, uh, who come into Brighton, more in recent years.

[00:29:34.857 – 00:29:45.017] And most of the time, we’ll sit down before you’re going home and tell you that this does represent a reversible change, and that within a matter of five or six weeks or five or six

[00:29:45.017 – 00:29:47.277] months, most of these changes will go back to normal.

[00:29:47.277 – 00:29:56.697] Cirrhosis of the liver is a relatively rare disease nowadays, and one has to work a great deal longer and harder to develop this particular form of disease.

[00:29:56.697 – 00:30:00.477] And its complications and its implications are far more great.

[00:30:00.477 – 00:30:02.857] Well, so much for alcohol as a food.

[00:30:02.857 – 00:30:09.667] It doesn’t seem to come up, uh, as being the ideal sort of- This is the other side of the coin.

[00:30:09.667 – 00:30:19.487] Uh, alcohol has really enjoyed a rather funny position in our society for probably as long as we’ve had a society.

[00:30:19.487 – 00:30:22.067] Mankind has used drugs in several ways.

[00:30:22.067 – 00:30:27.087] Uh, the first way was simply as part of our organized religion.

[00:30:27.087 – 00:30:32.007] Uh, we use alcohol in the Judeo-Christian observances.

[00:30:32.007 – 00:30:42.007] Uh, this is probably the safest form of drug use that we know, uh, simply because it’s used in the– under the supervision of people who have very terrifying powers to

[00:30:42.007 – 00:30:43.527] punish here and in the hereafter.

[00:30:43.527 – 00:30:53.607] So for many, many years, you’re probably aware of this, the alcoholic priest could use alcoholic beverages in religious observance without too much hazard to their, uh,

[00:30:53.607 – 00:30:54.647] overall sobriety.

[00:30:54.647 – 00:30:58.667] Uh, the next way we used drugs was simply to kill each other off.

[00:30:58.667 – 00:31:07.347] We, uh, for instance, those of you who are taking belladonna for your ulcers at the present time are taking the derivative of the deadly nightshade plant.

[00:31:07.347 – 00:31:17.407] Those of you who are taking digitalis for your ailing hearts are taking a drug that was used by the famous de’ Medici family to keep the population down in southeastern Italy at about the fifteenth

[00:31:17.407 – 00:31:18.287] century.

[00:31:18.287 – 00:31:28.457] Uh, those of you who have had surgery recently were given a chemical by vein to relax your muscles that we discovered on the tips of the Amazon Indians’ arrows, uh, when we first began to explore

[00:31:28.457 – 00:31:29.867] that particular area.

[00:31:29.867 – 00:31:38.487] Now, finally, we decided by reducing the doses, we could use, uh, these chemical substances as medicines, and we use many of them now to maintain and restore our health.

[00:31:38.487 – 00:31:43.967] Then we started to get so crowded, uh, that we ran into another problem altogether.

[00:31:43.967 – 00:31:54.527] We suddenly found that we couldn’t send everybody to Miami Beach in the wintertime or to, uh, the, the French Riviera, and we suddenly recognized that we needed a easily transported,

[00:31:54.527 – 00:32:01.087] low-cost form of recreation that could be readily wid– or rather widely dispensed, or we were gonna end up killing each other.

[00:32:01.087 – 00:32:11.267] So, uh, we suddenly discovered that certain chemicals had a great deal of recreational value, and therefore, we began to use recreational chemicals or recreational drugs.

[00:32:11.267 – 00:32:18.667] Now, the world’s great civilizations has adopted recreational drugs that fit their aspirations and their lifestyles.

[00:32:18.667 – 00:32:27.807] Now, interestingly enough, the Middle East is where all of the recreational drugs have come from, and they may have ended up just passing off all the bad news in other directions.

[00:32:27.807 – 00:32:37.827] But Western man learned how to make beer from the Canaanites, who taught the Israelites how to make beer, and when the Greeks learned from the Macedonians,

[00:32:37.827 – 00:32:40.087] who learned from a Turkish tribe how to make wine.

[00:32:40.087 – 00:32:43.787] So they gave us alcoholic beverages as our recreational drug.

[00:32:43.787 – 00:32:53.807] And it was natural because we’re sort of the gung-ho, Horatio Alger, uh, become vice president of the corporation by the time we’re 30, uh, make a million dollars by the time we’re 40

[00:32:53.807 – 00:32:59.167] kinda society, and the one thing that we prize more than anything else is sheer, raw, innate aggression.

[00:32:59.167 – 00:33:06.187] Now, frankly, if you don’t believe that alcohol preserves aggression, go into the local tavern at ten o’clock at night and pick a fight.

[00:33:06.187 – 00:33:12.587] And people who can’t even stand up will take you on, uh, simply because that’s the one thing they can still do is compete.

[00:33:12.587 – 00:33:19.547] Now, as time went on, uh, we really felt the need for a more, uh, concentrated form of recreational drug.

[00:33:19.547 – 00:33:27.147] Uh, uh, it was time-consuming and, uh, somewhat difficult at times to get completely blasted three sheets to the wind with what we had.

[00:33:27.147 – 00:33:37.227] So we fought, uh, crusades or, or war during the, uh, uh, uh, the, um, Dark Ages, and we ran into the Middle Easterners

[00:33:37.227 – 00:33:37.667] again.

[00:33:37.667 – 00:33:42.967] And they gave us the process of distillation ostensibly to help us practice better medicine.

[00:33:42.967 – 00:33:44.987] Well, you know what returning GIs are like.

[00:33:44.987 – 00:33:52.227] Uh, the moment an enterprising Scotchman got home, he got together some barley mash, distilled it over once, and gave the world Scotch whiskey.

[00:33:52.227 – 00:34:01.347] Now, not to be outdone, an enterprising Irishman a couple years later distilled over the same barley mash three times and gave the world shamrock green white lightning.

[00:34:01.347 – 00:34:11.227] And since that time, we’ve been distilling corn squeezings, rye, oats, and everything else we could get our hands on, uh, simply to maintain this high-class, high-priced, uh, recreational drug.

[00:34:11.227 – 00:34:21.247] Now, the Middle East is a more slow-paced, introspective, uh, not very achievement-oriented kind of society, and they’ve maintained

[00:34:21.247 – 00:34:24.526] their ties to, uh, the derivatives of the Indian hemp plant.

[00:34:24.526 – 00:34:33.307] And you know, a Buddhist monk running down a jungle path, uh, chewing on his goat’s milk and marijuana isn’t gonna get into a great deal of trouble unless a tiger jumps out and eats him up.

[00:34:33.307 – 00:34:35.407] And if he’s chewing enough fast enough, he isn’t gonna mind.

[00:34:35.407 – 00:34:43.507] But you take that same Buddhist monk and put him on I-94 at four-thirty in the afternoon coming out of Detroit, and he’s in serious trouble.

[00:34:43.507 – 00:34:53.707] So, uh, uh, one of the problems we’ve been encountering in recent years is recreational drugs in settings, uh, that weren’t totally appropriate to the use of that particular recreational drug.

[00:34:53.707 – 00:35:00.127] Well, alcohol has been our recreational drug for nigh on to probably as long as we’ve had a civilization.

[00:35:00.127 – 00:35:05.107] And because of it, we’ve been able to and willing to make very major allowances for it.

[00:35:05.107 – 00:35:13.237] Uh, for instance, we’ll sacrifice thirty-five to forty thousand people on the highways this year, maybe half that number on the waterways, airways, and in our factories.

[00:35:13.237 – 00:35:19.727] We’re going to cripple and maim another eight hundred thousand this year predictably simply to keep our recreational drug in our midst.

[00:35:19.727 – 00:35:24.827] So, uh, we make a great number of allowances for alcohol because it is our recreational drug.

[00:35:24.827 – 00:35:30.187] And perhaps we should, because without it, we’d probably all end up killing each other anyway.

[00:35:30.187 – 00:35:33.947] So, uh, it does serve a relatively useful purpose in our society.

[00:35:35.138 – 00:35:41.438] Now, I sort of alluded to the fact that alcohol is not alone in the drugs that can cause alcoholism anymore.

[00:35:41.438 – 00:35:51.318] It belongs to a group of drugs called the sedative hypnotics, which means they slow you down or they put you to sleep, and this includes the hospital anesthetics.

[00:35:51.318 – 00:36:01.398] And for many years, we’ve had some difficulties with people going into a surgical operation, getting an anesthetic, and then going promptly into DTs even though

[00:36:01.398 – 00:36:05.408] they’ve been sober four or five years, uh, the day after they’ve had the anesthetic.

[00:36:05.408 – 00:36:15.698] In fact, a very noted British surgeon described this in the 1940s, and it was his own students that discovered that these were practicing professional indoor drinkers who were displaying these symptoms.

[00:36:15.698 – 00:36:25.868] Uh, even in a medical center of the magnitude of the one in Ann Arbor, I got called in because a woman who had been on Antabuse for two years had had a gallbladder operation and was behaving

[00:36:25.868 – 00:36:27.298] kind of funny after the surgery.

[00:36:27.298 – 00:36:29.698] Well, obviously, she was going into DTs.

[00:36:29.698 – 00:36:39.737] And when I looked at the chart and found out that she had had equivalent to 30 sleeping capsules to get her ready for the anesthetic and then four and a half hours of an anesthetic continuously after

[00:36:39.738 – 00:36:49.738] that and calculated it out to be equivalent to about two gallons of booze over a six-hour period of time, it’s not any wonder that she did a little shaking, a little talking to herself when she came down off of,

[00:36:49.738 – 00:36:51.177] uh, this degree of anesthesia.

[00:36:51.177 – 00:37:01.418] So those who are, uh, uh, uh, uh, able to develop the kind of tolerance that’s going to demonstrate withdrawal, I’d strongly encourage you to, uh, don’t be frank

[00:37:01.418 – 00:37:02.058] with your surgeon.

[00:37:02.058 – 00:37:02.858] He could care less.

[00:37:02.858 – 00:37:04.958] He probably hasn’t even heard the term alcoholism.

[00:37:04.958 – 00:37:14.978] But do be kind of frank with your anesthesiologist, and most of them know how to manal– uh, handle this, uh, very capably and very skillfully if they’re given a head start at least so that

[00:37:14.978 – 00:37:15.738] they can expect it.

[00:37:15.738 – 00:37:23.118] Now, the next things we run into are our old friend alcohol and not-so-old friend formaldehyde.

[00:37:23.118 – 00:37:33.258] Uh, and, uh, finally, we get down to where, you know, it got inappropriate for Granny to be rocking on the front seat of the, uh, home with booze on her breath, so, uh, and we couldn’t give her morphine

[00:37:33.258 – 00:37:35.198] anymore because they passed the Harrison Act.

[00:37:35.198 – 00:37:39.058] So some enterprising German came up with a drug called phenobarbital.

[00:37:39.058 – 00:37:49.258] And we suddenly then had the barbiturates, which include phenobarbital, Nembutal, Seconal, Carbitol, Tuinal, and a whole nother Heinz 57 variety

[00:37:49.258 – 00:37:58.638] of barbiturates, which are now mixed in with stomach medicine, headache medicine, allergy medicine, and so forth, to the point where it’s very difficult not to have some exposure to this group of drugs.

[00:37:58.638 – 00:38:08.778] Now, finally, if life wasn’t complicated enough, uh, people started to learn that you could get a bad habit from barbiturates and that some people had convulsions and delirium

[00:38:08.778 – 00:38:09.478] tremens from them.

[00:38:09.478 – 00:38:19.798] So we certainly didn’t want to give people any more barbiturates, so we came up with a whole Heinz 57 variety of drugs called minor tranquilizers, Librium, Valium,

[00:38:19.798 – 00:38:27.998] Vistaril, Equanil, Miltown, Serax, and so forth, a whole, uh, uh, gamut of them which do exactly the same thing as phenobarbital.

[00:38:27.998 – 00:38:38.088] In fact, one of the kids at the training school came up behind me one day and says, “Doc, do you know what Excedrin Headache number 101 is?” And I said, “No, Charlie, I didn’t.” Well, he says, “That’s the shakes I’m getting today from taking the other

[00:38:38.088 – 00:38:42.838] 100 yesterday.” Now, you can buy these over the counter, and he sure was going into a pretty serious withdrawal.

[00:38:42.838 – 00:38:48.698] Uh, we’ve had even graduate physicians in Brighton Hospital who said, “You know, it’s perfectly okay.

[00:38:48.698 – 00:38:51.518] I don’t get sick when I take my Librium.” Certainly they don’t.

[00:38:51.518 – 00:38:52.398] They don’t have to drink.

[00:38:52.398 – 00:38:54.078] They’re not gonna go through withdrawal.

[00:38:54.078 – 00:39:04.358] And I think one of the basic things that you can remember is if a drug is effective during alcohol withdrawal, then that drug is chemically equivalent to alcohol because if it doesn’t lower your blood pressure,

[00:39:04.358 – 00:39:12.158] if it doesn’t slow down your pulse, if it doesn’t get you to sleep, uh, then it’s probably not, uh, uh, it’s not an alcohol equivalent, and that’s all we’re doing.

[00:39:12.158 – 00:39:19.178] So frankly, if it works during withdrawal, I’d stay away from it like the poison it is, uh, when one gets out of the withdrawal situation.

[00:39:19.178 – 00:39:19.818] Okay.

[00:39:19.818 – 00:39:21.238] Now, what do all of these drugs do?

[00:39:21.238 – 00:39:25.918] Well, they’re primarily sedatives or anesthetics.

[00:39:25.918 – 00:39:35.998] And if we sort of draw a picture of the brain here, front of the brain up there, back of the brain over here, the fold that sits over the ears there, uh, the

[00:39:35.998 – 00:39:42.598] only real difference between all of the members of this family are how we get them into the system and how rapidly we can get them out of the system.

[00:39:42.598 – 00:39:46.858] For instance, ether, which is up here, we inhale into our lungs.

[00:39:46.858 – 00:39:54.158] It goes through a membrane about the size of this stage, goes right into the blood vessels on the way to the brain, and the effect is almost immediate.

[00:39:54.158 – 00:39:58.338] If we want to get rid of it, we simply give the bloodstream the choice to taking up oxygen.

[00:39:58.338 – 00:40:01.958] It throws the ether back out in the lungs, and we exhale it from the body.

[00:40:01.958 – 00:40:06.238] And we can get all of the effects of total anesthesia in a matter of one or two minutes.

[00:40:06.238 – 00:40:09.038] With alcohol, we gotta go the slow route.

[00:40:09.038 – 00:40:10.818] We have to put it into our stomach.

[00:40:10.818 – 00:40:13.118] It gets absorbed after it leaves the stomach.

[00:40:13.118 – 00:40:14.858] From there, it goes to the liver.

[00:40:14.858 – 00:40:17.158] Uh, from there, it gets pumped to the heart.

[00:40:17.158 – 00:40:19.358] From there, it gets pumped to every part of the body.

[00:40:19.358 – 00:40:24.828] And we have to be as drunk in our big toe as we are in the brain to get an, uh, an anesthetic effect from alcohol.

[00:40:24.828 – 00:40:34.738] Now, to get rid of it, we have to run it through that chemical funnel in the liver, and we can only burn about an ounce of alcohol per hour and, and with really a great deal of damage, maybe an ounce and a half per hour.

[00:40:34.738 – 00:40:40.978] So the effects there are far, far slower, probably four to five hundred times slower than, uh, ether.

[00:40:40.978 – 00:40:50.958] So many of the changes I’m going to talk about are visible with a slow anesthetic like alcohol and are not visible with a very rapid one like ether or, uh, its cousins.

[00:40:50.958 – 00:41:00.918] Now, some of the changes we see have to do with this front part of the brain where we receive the impulses from our fingers, from our eyes, from our ears, from our tongue.

[00:41:00.918 – 00:41:08.598] And we sort of look them over and check them out in the memory to see if we’ve seen anything like that before and then finally make up our mind as to what to do about it.

[00:41:08.598 – 00:41:13.978] So this area sort of controls our behavior, uh, particularly our instinctual behavior.

[00:41:13.978 – 00:41:22.318] Now, most of us, uh, develop certain guidelines or certain reference points, uh, as we become older in sort of an onion skin-sided kind of fashion.

[00:41:22.318 – 00:41:32.338] You know, we start at the beginning in the crib And all we can do there is kick and scream and holler and shake the bars, and somebody’s gonna come along and change our diaper and give us a nice warm,

[00:41:32.338 – 00:41:34.218] uh, bottle of milk to drink.

[00:41:34.218 – 00:41:43.658] But at the age of two and a half, if we lay down on the floor and kick and scream and holler, somebody’s gonna come along and give us a very painful sensation on our butt because we’re now having a temper tantrum.

[00:41:43.658 – 00:41:49.078] And at this particular point, we know we have to give up this and develop some new way of getting what we want.

[00:41:49.078 – 00:41:51.758] Well, at two and a half, you develop the direct approach.

[00:41:51.758 – 00:41:53.538] I want my sister’s sand pail.

[00:41:53.538 – 00:41:56.178] I go over and give her a belt and a kisser, grab it, and run like mad.

[00:41:56.178 – 00:42:04.158] Now, that’s cute until a kindergarten teacher discovers that she’s got 30 people like this around, and she discusses the matter with them in the cloakroom.

[00:42:04.158 – 00:42:09.198] Uh, and after a certain amount of pain and suffering, uh, uh, you adopt another way of getting what you want.

[00:42:09.198 – 00:42:18.498] And at this particular point, it usually boils down to the bug, nag, plead, plead, get underfoot, and, uh, finally wear the adults down so they give you what you want.

[00:42:18.498 – 00:42:28.718] But now again, this is usually resolved in our early teens out behind the pup tent at the Boy Scout outing, uh, or behind the cabin in a Girl Scout outing, and oftentimes

[00:42:28.718 – 00:42:31.158] is followed by a couple of bloody noses and so forth.

[00:42:31.158 – 00:42:37.498] But at this particular point, we developed a method of, you know, coming up with plausible reasons for getting what we want.

[00:42:37.498 – 00:42:47.598] Of course, by this time, we’ve also gotten into adolescence, and this is a terrible period of life because now we have to adjust to the fact that four, uh, that the, uh, Detroit is going to put

[00:42:47.598 – 00:42:50.458] 400 horsepower under a hood not to be used.

[00:42:50.458 – 00:43:00.458] So we have a few experiences of leaving 200 feet of rubber in the road, uh, uh, going around the corner on two wheels and running into one of these unreasonable uniformed fellas, gives us

[00:43:00.458 – 00:43:09.428] a piece of cardboard that we take home, and Dad disappears through the ceiling, and we walk and get huge blisters on our feet and eventually decide to go 30 miles an hour in a 30-mile-an-hour zone.

[00:43:09.428 – 00:43:19.618] Now, at the same time, we have to adjust to the opposite sex, and all of a sudden, you gals have got to quit beating us at football and tennis and swimming and so forth, and we have to make all kinds of critical adjustments

[00:43:19.618 – 00:43:21.758] as males to, uh, for the same sort of thing.

[00:43:21.758 – 00:43:30.658] And then just beyond that, we get into all those complicated things like getting engaged and married and working for people and so forth, and life really gets terribly confused after that.

[00:43:30.658 – 00:43:40.758] Well, now let’s examine what a perfectly normal, healthy, uh, since I’m more familiar with it, young male of about 21 who’s been married for about eight or nine months has just gone off

[00:43:40.758 – 00:43:41.198] to a party.

[00:43:41.198 – 00:43:44.578] Not an alcoholic, probably, probably never will be an alcoholic.

[00:43:44.578 – 00:43:45.758] Has one drink.

[00:43:45.758 – 00:43:48.998] And here he is, stone-cold sober.

[00:43:48.998 – 00:43:51.638] His blood alcohol is about .02.

[00:43:51.638 – 00:43:52.878] He can walk a straight line.

[00:43:52.878 – 00:43:56.258] He has no evidence of intoxication at all, but what dissolves off?

[00:43:56.258 – 00:43:57.058] His marriage vows.

[00:43:57.058 – 00:43:58.358] He becomes swinger of the evening.

[00:43:58.358 – 00:44:03.778] Now, his wife is sitting over there in the corner trying to decide whether to give it to him with a rolling pin or the skillet.

[00:44:03.778 – 00:44:06.217] Now, this makes him nervous, so he has another drink.

[00:44:06.217 – 00:44:09.538] Now, this puts his blood alcohol level up to .04.

[00:44:09.538 – 00:44:10.958] He can still walk a straight line.

[00:44:10.958 – 00:44:13.528] He can still st- uh, talk without falling over his tongue.

[00:44:13.528 – 00:44:23.578] Has every bit of evidence of being, uh, stone-cold sober, which gets him evenly, into even more trouble because now his wife, who’s already mad at him, becomes a buddy instead of a sweetheart.

[00:44:23.578 – 00:44:30.198] He tosses her coat in her, uh, in her face, goes out and pulls the car out in front of the stairs, you know, in front of the house, and leans on the horn.

[00:44:30.198 – 00:44:31.718] Now, her problem is solved.

[00:44:31.718 – 00:44:35.898] He’s gonna get it both with the skillet and the rolling pin ’cause he still looks stone-cold sober.

[00:44:35.898 – 00:44:42.118] Well, this makes him nervous, so he comes in and he has another drink, and now his blood alcohol level is .07.

[00:44:42.118 – 00:44:47.298] And he now becomes a 16-year-old, 200 feet of rubber, squeals around the corner.

[00:44:47.298 – 00:44:51.967] Along comes this unreasonable fellow and gives him a ticket for, uh, reckless driving of all things.

[00:44:51.967 – 00:44:58.078] In fact, the more we look at this, the more we’re quite sure that this kind of driving re- represents driving while impaired.

[00:44:58.078 – 00:45:06.198] Well, that sours his evening, so he goes back to the party, has another drink, you know, to, just, uh, for the road, and that puts him up to .10.

[00:45:06.198 – 00:45:08.338] Now he is legally intoxicated.

[00:45:08.338 – 00:45:18.358] He can still walk a straight line and do pretty well, but at this particular point, and you’ve run into him, he’s down to the nagging, wheedling, pleading kind of individual, and nobody really wants to be around

[00:45:18.358 – 00:45:19.038] him very much.

[00:45:19.038 – 00:45:23.158] So that prompts him to go back and get another drink, where he’s now up to .12.

[00:45:23.158 – 00:45:33.158] And, uh, a lot of you have run into this kind of person, you know, uh, with the fists flying and, uh, uh, uh, uh, really kinda hard to get along with, very hostile, very direct,

[00:45:33.158 – 00:45:35.717] uh, and, uh, and ready to take on everybody.

[00:45:35.717 – 00:45:41.958] Now, if you can encourage him to have another drink, things will be a little bit better because now the blood alcohol level will go up a little bit more.

[00:45:41.958 – 00:45:52.198] And any of you that are cocktail party watchers, look around the next time you go, and there’s gonna be somebody sitting over there in the corner in the crib, shaking their rattle, waiting for somebody to come over there and,

[00:45:52.198 – 00:45:54.217] uh, give them a nice warm bottle of milk.

[00:45:54.217 – 00:45:59.778] Uh, they’re gonna be having a good cry, waiting for somebody to come over and change their diaper so their bottom won’t bother them for months.

[00:45:59.778 – 00:46:03.358] Now, this is actually what gave the American Indian such a bad name.

[00:46:03.358 – 00:46:06.398] You know, they really can drink most of us under the table.

[00:46:06.398 – 00:46:12.578] In fact, alcoholism of the real two-fisted kind is one of the major problems on the Indian reservation.

[00:46:12.578 – 00:46:22.858] But in the old days, they signed a peace treaty, came into the settlements, had one glass of whiskey, and lo and behold, the treaty dissolves off, and they were running around town giving people haircuts.

[00:46:22.858 – 00:46:27.278] And, uh, and they got a very bad name so far as being able to handle alcohol.

[00:46:27.278 – 00:46:31.358] Well, while those things are going on, we also have changes back here.

[00:46:31.358 – 00:46:34.798] Now, the first thing that goes is the ability to learn anything new.

[00:46:34.798 – 00:46:39.898] So they say, “Well, why don’t you go over and pick George and Mary up?” “Certainly, I’ll go over and pick up George and Mary.

[00:46:39.898 – 00:46:50.028] Where do they live?” And all of a sudden you see him turning around at the door saying, “Where was that I was going anyway?” Well, we’ll write it down on a piece of paper, which you slip in your pocket and forget where you put it, and sooner

[00:46:50.028 – 00:46:57.298] or later you’re calling back from the corner drugstore, and somebody has to go and get George and Mary and go and get you because the two are never gonna get together.

[00:46:57.298 – 00:47:02.058] Now, with a little bit more alcohol, we start to forget what we’ve just done.

[00:47:02.058 – 00:47:10.558] And I’m sure that a lot of us in this room have had the experience of going back and picking up our rubbers, our galoshes, our fountain pens, our overcoat, our scarf.

[00:47:10.558 – 00:47:16.678] We’ve left a trail all the way across town of everything that we’ve laid down simply because we couldn’t remember to pick it up.

[00:47:16.678 – 00:47:26.888] Now, it gets more interesting from this point on because now you may lose, with another glass and getting your blood alcohol up around point, uh, zero seven, uh, your last couple of years,

[00:47:26.888 – 00:47:37.478] which makes it rather interesting, you know, if you’ve moved to a new address and you’re found trying to get into the old place, or you’re out in the parking lot trying to start somebody else’s car that looks like the one that you’ve just replaced.

[00:47:37.478 – 00:47:41.898] Uh, and as time goes on, memory just gets worse and worse and worse until it’s totally no use.

[00:47:41.898 – 00:47:44.818] Well, nature isn’t gonna let this sort of thing go by.

[00:47:44.818 – 00:47:52.554] What it does is it affects the- center in here, which has to do with coordinating the motion of the arms and the legs.

[00:47:52.554 – 00:48:01.114] Now, this doesn’t work out too well because the blood supply, because it’s richer up here than it is down here, affects the legs first.

[00:48:01.114 – 00:48:10.714] So at about the time when your judgment isn’t any good and your memory isn’t any good, your knees become rubbery, and you sit down in one place, and that does at least give you some protection.

[00:48:10.714 – 00:48:18.954] But the arms and the mouth are still working, so you can call and have the stuff brought over, and you can continue the whole process of anesthesia.

[00:48:18.954 – 00:48:24.054] Now, as the evening wears on, you probably notice how unpopular the bar stools get.

[00:48:24.054 – 00:48:28.514] People want something that will support their back so they can slowly sink in the west.

[00:48:28.514 – 00:48:37.034] Now, the next part of the anesthetic now reaches that that has to do with the arms, but we do have dedicated two-fisters who can do it for a while.

[00:48:37.034 – 00:48:45.274] Finally, the neck becomes involved, and your head goes over on your hands on the table, and the sleep center becomes involved, and we now become totally anesthetized.

[00:48:45.274 – 00:48:52.213] Now, again, alcohol produces these changes over a period of time.

[00:48:52.213 – 00:48:53.594] It takes many, many hours.

[00:48:53.594 – 00:49:03.714] So we’ve abandoned it medically, uh, as an unsafe anesthetic and really consider alcohol, by everything that we know about it, to be anywhere from four to five

[00:49:03.714 – 00:49:06.004] hundred times more dangerous than medical ether.

[00:49:06.004 – 00:49:16.174] But let’s examine what our many thousands of years, uh, of association with alcohol as a recreational drug have done to the way we handle this particularly, uh, dangerous

[00:49:16.174 – 00:49:17.064] kind of anesthetic.

[00:49:17.064 – 00:49:23.954] If I were to invite you over to my house a couple of weeks ago for an ether anesthetic, you would have all said, “Doc, don’t bother me.

[00:49:23.954 – 00:49:27.654] I’ll call you,” and I wouldn’t have had any problem parking the cars at all.

[00:49:27.654 – 00:49:37.764] Of course, if I’d invited you over to, for a free, uh, blowout with free booze and food, we’d have had cars parked as far as you could see in either direction from my house, and that’s because of our

[00:49:37.764 – 00:49:42.014] long eight thousand year association with alcohol as our recreational drug.

[00:49:42.014 – 00:49:52.034] Now let’s examine, for instance, how most of you have been taught, and properly so, to deal with an anesthetic that’s four to five hundred times less dangerous than

[00:49:52.034 – 00:49:52.494] alcohol.

[00:49:52.494 – 00:49:57.694] When you go into a hospital and somebody says anesthetic, you expect the following things to happen.

[00:49:57.694 – 00:50:02.014] First of all, you expect to have a complete and total physical examination.

[00:50:02.014 – 00:50:02.794] Why?

[00:50:02.794 – 00:50:11.054] Because during an anesthetic, you are totally helpless against infection, and you could go in with a simple cold and come out with an overwhelming and fatal pneumonia.

[00:50:11.054 – 00:50:16.383] Or you could go in with a simple kidney infection and come out with an overwhelming and fatal, uh, fatal kidney infection.

[00:50:16.383 – 00:50:26.564] On top of that, uh, you know, you, uh, don’t feel a whole lot of pain during an anesthetic, and you might have a heart attack or a stroke or something like that, not get the warning signals,

[00:50:26.564 – 00:50:30.134] get up and move around too rapidly, and that can prove to be fatal as well.

[00:50:30.134 – 00:50:39.014] So you want to know that your heart’s in good condition, that your lungs are in good condition, that you don’t have any infections before you get into one of these dangerous medical anesthetics.

[00:50:39.014 – 00:50:47.374] Now, the next thing you want is the most qualified anesthesiologist you can find because this is the person who’s going to be living your life for you while you’re unconscious.

[00:50:47.374 – 00:50:50.044] This is the person that tells the surgeon, “You better hurry up.

[00:50:50.044 – 00:50:55.114] You’re running out of things to fight stress with.” This is the one that tells the resident he better get his elbows out of your ribs.

[00:50:55.114 – 00:50:55.794] He’s gonna break them.

[00:50:55.794 – 00:51:01.603] So this is the person you’re really relying on to, uh, live your life for you for the time that you’re unconscious.

[00:51:01.603 – 00:51:10.744] Now, because we don’t even trust these qualified anesthesiologists, we have them in what we call a nearly fail-safe environment, almost like one of the space shots.

[00:51:10.744 – 00:51:14.894] Everything that goes into that operating room is checked, double-checked, and triple-checked.

[00:51:14.894 – 00:51:22.674] Every bit of the conditions under which you’re going to get the, uh, anesthetic, all of the machinery is checked and double-checked by several people.

[00:51:22.674 – 00:51:30.474] Now, after the anesthetic, you expect to go to what you call a recovery room, where there’s one nurse taking care of no more than two people.

[00:51:30.474 – 00:51:40.534] Now, here we’re, uh, going to protect you if we can against, uh, swallowing your tongue, suffocating, uh, having an epileptic seizure, rolling off the bed and breaking your neck, or all these

[00:51:40.534 – 00:51:43.774] things that an unconscious person can have befall them.

[00:51:43.774 – 00:51:52.914] Then before you go home, you expect to be checked again medically to make sure that you haven’t developed pneumonia, that you haven’t had a heart attack, that you’ve recovered completely.

[00:51:52.914 – 00:51:58.574] And these are the kinds of things that all of us expect to have done with a dangerous medical anesthetic like ether.

[00:51:58.574 – 00:52:04.413] And if they don’t happen, we really have more or less a right to sue for malpractice and negligence.

[00:52:04.413 – 00:52:11.034] Yet, you know, there isn’t one of you in this room who could convince me that you went out and had a physical examination before you went on that last bender.

[00:52:11.034 – 00:52:19.894] And Louie the bartender might be the world’s best solver of the world’s problems, but he sure doesn’t come up as the most qualified, uh, anesthesiologist that I know of.

[00:52:19.894 – 00:52:26.274] My bedroom or a hotel or a motel room doesn’t come up as the most fail-safe environment that I can think of.

[00:52:26.274 – 00:52:35.134] And unless you end up in a place like Brighton Hospital, you don’t even get a routine physical and recovery room care, let alone follow-up medical care until you’ve completely recovered.

[00:52:35.134 – 00:52:44.394] So because alcohol has been a recommended and accepted recreational drug for better than nine thousand years, we throw all the cautions to the wind.

[00:52:44.394 – 00:52:54.574] We treat it as though it were a Saturday afternoon picnic, when in reality, as a drug, it is four to five hundred times more dangerous than the medical anesthetics that we all fear so much.

[00:52:54.574 – 00:53:05.404] So I think we can sum this whole thing up by saying that ether as an alcohol, uh, alcohol, ether as a food or a drug comes up w- somewhat short, uh, on the, uh, uh,

[00:53:05.404 – 00:53:06.434] uh, whole scale.

[00:53:06.434 – 00:53:16.444] And we would have to say very honestly that in quantities more than an ounce about, uh, uh, per hour, in periods of time longer than one hour, that in normal, healthy human beings,

[00:53:16.444 – 00:53:19.154] alcohol can be somewhat hazardous to your health.

[00:53:19.154 – 00:53:22.374] And with that, uh, comment, we’re ready to adjourn for chow.

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