} ' '
Gt.Brit. Board of .edaoation.
SChe hygiene of food ina drink.
London, 19 20 •
tf-r,, ."v/s jfr. i j ' ir fv y yi r- w*ts*r *> ? -m ii fJfHY **
k
8^
f4
"i givt theft Books
1 for the founding of a. College in, this Colony"
e
YAUE °WMP/iEI&Slir
- ILMBMIEF .
I
r.
1 1
TRANSFERRED TO
YALE MEDICAL LIBRARY
BOARD OF EDUCATION.
THE
HYGIENE OF POOD AND DRINK.
A Syllabus of Lessons,; for use in Schools, and Notes
for the Assistance of Teachers.
LONDON:
PUBLISHED BY HIS MAJESTY'S STATIONERY OFFICE.
To be purchased through any Bookseller or directly from
H.M. STATIONERY OFFICE at the following addresses:
Imperial House, Kingsway, London, W.C. 2, and 28, Abingdon Street, London, S.W. 1;
37 Peter Street, Manchester; l, St. Andrew's Crescent, Cardiff;
23, Forth Street, Edinburgh;
or from E. PONSONBY, Ltd., 116, Grafton Street Dublin.
1920.
Price 2d. Net.
2
THE HYGIENE OF FOOD AND DRINK.
A Syllabus of Lessons for use in Schools.
PREFATORY NOTE.
1. A "Temperance" Syllabus was first issued by the Board
of Education in 1909 and was subsequently reprinted without
substantial alteration in 1916. In view of the advance in the
knowledge of the subject since that date, it is considered that
the present time is opportune for a complete revision, relating,
the Syllabus generally to the Hygiene of Food and Drink,
including alcohol. In addition, a section has been added on
the misuse or abuse of food and its results. In this section an
attempt has been made to provide the teacher with some
practical notes on which he will be able to base his instruction
on the effects of under-feeding, of over-feeding, and of wrong
feeding. The question of the misuse of food and its abuse is
not less important than the question of the abuse of alcohol, and
there is little doubt that the- two subjects should be dealt with
in a proper and well balanced relation. Sections III. and IV.
are interdependent. Section II. has been based on the con¬
clusions of the Advisory Committee on Alcohol of the Central
Control Board.*
2. The Board have not hitherto recommended that " Tem¬
perance" should be regarded as a separate and distinct subject
of the curriculum, but that it should form a part of the general
instruction given to children from time to time on the art of
healthful living. The Board, however, consider that, in view
of the more important and comprehensive character of this
Syllabus, Local Education Authorities should take such steps as
are practicable to give it an appropriate place in the curriculum
of the schools for which they are responsible, whether the
instruction is given by members of the ordinary school staff or
by specially appointed teachers of Hygiene. Less formal
instruction should still continue to be given at appropriate
times, and opportunities for such instruction will be found to
arise incidentally in connection with a variety of subjects ; in
* See " Alcohol: Its Action on the Human Organism " (published by
His Majesty's Stationery Office, 1920, price Is. to be obtained direct from
Imperial House, Kingsway, or through any bookseller). It is strongly
recommended that this Report should be read by everyone engaged in
teaching the subject of " Temperance."
Prefatory Note.
3
the Science course ; in the History lesson in connection with
the social life of the people ; in the Geography lesson when the
influence of climate is being explained ; or, perhaps, during
the periods of rest in the course of the Physical Exercises, or in
connection with organised games or " training " for sports, &c.
3. Though it is considered useful and appropriate to take
every suitable opportunity of presenting the subject of Tem¬
perance to children, the teacher should be constantly on his
guard against making categorical statements or drawing
inferences that are not supported by facts fully substantiated
by present scientific knowledge. It is, of course, important
that the teaching given should be acceptable and interesting to
the pupils. But since the subject is peculiarly apt to be
coloured by personal predilections and prejudices, the accom¬
panying Syllabus has been framed as a " model" for the
guidance of teachers, whether members of a School Staff or
otherwise, and the Board of Education are of opinion that, in
the absence of exceptional circumstances, special care should be
taken to follow the lines of the Syllabus.
4. The statement of facts now made has been prepared after
much consideration and is accepted by leading physiologists.
The Notes on the Syllabus are intended for the information
and guidance of teachers and not for mere reproduction to the
children. Every attempt should be made to avoid the use of
technical terms and the practice of building a lesson round
them should be rigidly excluded. The lesson should take the
form, of a simple, practical and, above all, a sincere talk to the
children. The appeal should be to their common sense and not
to their emotions or their fears, and therefore emphasis should
be laid not so much on the dangers arising from the non-
observance of the laws of health as on the fitness and well-being
which follows their observance.
5. It is perhaps hardly necessary to state that the one idea
that should dominate any1" Temperance" teaching is the
paramount importance of self-discipline. A healthy life
depends mainly on consistently good habits and the apprecia¬
tion and practice of a few simple and direct laws of health.
The inculcation of such principles is, in the case of children,
almost entirely a question of sound training. The wise teacher
will lose no opportunity of impressing upon his scholars the
vital importance of habits of self-control and it will be his
constant aim to afford plain, simple and satisfying reasons which
the child will understand and appreciate.
6. The more advanced pupils may usefully be instructed as
to the positive risks and dangers of any form of excess ; and,
conversely, the far-reaching advantages of self-control should
be emphasised, not only from a moral point of view, but from
the point of view of practical expediency and personal comfort.
While such teaching should be forceful and incisive, the advice
A (36)11649 Wt 10610—908 7500 7/20 E & S A 2
4
Prefatory Note.
or injunctions given should be based upon the broad facts of
common experience. The general findings of trained observers
as to the effect of alcohol on mental and physical work may also
appropriately be discussed ; but the results of laboratory
experiments or pathological investigations are not, per se, of
primary value for this purpose. They may sometimes be found
useful in illustrating the teaching of Hygiene to advanced
students but can have little real meaning to children. Finally,
and above all, the subject should be dealt with in a dispassionate
manner and should be made to appeal to the child's reasoning
capacity and to his common sense.
Whitehall, London, S.W.,
July, 1920.
SYLLABUS.
Section I.
THE USES OF FOOD AND DRINK.
1. What things do we eat?
2. The different kinds of food.
(а) Bodv-bnilding foods, including meat and fish; milk,
cheese and eggs ; pulse foods, such as peas, beans
and lentils.
(б) Energy and warmth-producing foods, including fat
(butter, margarine, dripping, cream), foods com¬
posed principally of starch (potatoes, rice, tapioca).
(c) Rurifying foods, such as vegetables and fruits, valu¬
able for the salts, acids and vitamines they contain.
Water in food.
3. What is the use of our food ? Why food is necessary.
(а) Food is necessary for the growth of the body.
(б) Food should prevent the body from becoming thin
and wearing away. It repairs waste.
(c) It is from food that we get our strength and power
to work.
(d) It is by our food that the body is kept warm.
(ie) The working of the mind depends upon the condition
of the body. If the body is not properly fed the
mind will not work so well.
4. The special usefulness of the different kinds of food.
5. Why people eat various kinds of food, and why they are
wise to do so.
6. Things which people eat and drink for pleasure. Sweets,
cakes, tea, coffee and cocoa. The value of each. Why
people drink tea and coffee.
A 11649
6
The Hygiene of Food and Drink :
Section II.
ALCOHOL.
1. Beer, wines, and spirits are not useful in the ways in which
our ordinary food, and such things as cocoa and milk,
are useful. People often do themselves great harm by
taking beer, wine, and spirits.
The chief reason for this is that these beverages
contain Alcohol and little or no real food substance.
2. What is Alcohol ?
3. Some characteristics and uses of " pure " Alcohol.
4. The proportion of Alcohol in beer, wine, and spirits.
It is not possible to drink Alcohol undiluted, because
of the direct inj ury and pain it would produce.
The harmful effects of Alcohol are weakened, though
not destroyed, when it is mixed with water and other
things, as in alcoholic beverages.
5. Effect of Alcohol on the brain and nervous system.
6. Effect on the body's strength and power to work.
7. Effect on the power of the body to resist disease.
8. Effect on the digestion of food.
9. Effect on the body temperature.
A Syllabus of Lessons for Use in Schools.
7
Section III.
THE MISUSE AND ABUSE OF FOOD AND ITS
RESULTS.
1. Principles which must be observed if errors of diet are to be
avoided.
Diet should be mixed, varied, sound in quality and
sufficient in quantity ; appetising and digestible.
Necessity for adequate supply of protein, fat, carbo¬
hydrates, salts, vitamines, water. Value of fat in cold
weather. Limited value of dried foodstuffs, preserved
vegetables, tinned meats.
2. The consequences of eating too much.
Object of eating should be to secure (a) health of the
body, (b) development and growth, (c) repair and vital
energy.
Ill-effects of over-eating—pain, headache, sickness,
vomiting ; accumulation of too much fat in the body ;
strain on the action of the muscles, especially of the
heart; overworking of the organs of excretion.
Avoidance of spiced, rich foods.
3. Importance of taking food at fairly regular intervals.
Food taken* between meals interrupts process of
digestion.
4. The consequences of taking food which is unsuitable to the
age or habits of the individual.
Appetite not always a safe guide. Constant eating
of sweets tends to destroy the teeth.
5. Malnutrition.
Caused by insufficient food, unsuitable food, over¬
eating, defective digestion and assimilation.
t). Prevention of diseases due to faulty feeding.
Habits to be avoided.
The Hygiene of Food and Drink.
Section IV.
THE MISUSE AND ABUSE OF ALCOHOL.
1. For different reasons the drinking of alcoholic beverages in
excess is likely to be injurious to all parts of the body,
and renders those who do so less fit and healthy. This
tends to shorten life and also produces mental apathy,
carelessness, and the loss of due control over the muscles.
2. Facts revealed by a study of mortality tables. Comparative
mortality in certain occupations.
3. Facts revealed by a study of the experience of the principal
life offices and friendly societies. Increased expectation
of life among " abstainers."
4. The social effects of drinking to excess are not confined to the
injury done to the body, but also may be followed by
moral injury.
(а) Loss of self-control; loss of freedom; moral
weakness.
(б) Unfitness for work; loss of employment;
pauperism.
(c) Ill-health ; disease ; insanity.
(d) Neglect of duty ; moral degradation ; crime.
5. The wastefulness of the excessive drinking of alcoholic
beverages.
Nation's drink bill.
Waste of money which could be wisely spent or
saved.
The value of thrift.
The ruin of homes; unhappiness, suffering, cruelty
and brutality may result.
The working powers of the people as a whole are
impaired, and so the prosperity of the nation itself is
undermined.
G. Prevention of the evils arising from alcoholic excess—
(а) Total abstinence ;
(б) State action.
Contributory factors ; international competition.
Notes on Syllabus.
9
NOTES ON SYLLABUS#
Section I.
1. What things do we eat.
By questioning the class the teacher will readily ascertain a considerable
number of foods in common use in the homes of the pupils, e.g., meat, fish,
bread, butter, jam, potatoes.
2. The different hinds of food.
Generally speaking, foods are capable of classification into three
categories:—(a) Body-building foods, including meat and fish; milk,
cheese and eggs ; pulse foods, such as peas, beans and lentils. (b) Energy
and warmth-producing foods, including fat (butter, margarine, dripping,
cream), foods composed principally of starch (potatoes, rice, tapioca,
oatmeal), (c) Purifying foods, such_ as vegetables and fruits, valuable
for the salts, acids and vitamines they contain.
The body-building foods are rich in protein, which is essential for the
building up of the tissues of the body. The starchy and sugary foods are
composed chiefly of carbohydrates. The body-building foods, though
composed principally of protein, contain usually also some carbohydrate or
fat, or both, as well as salts ; whilst the energy and warmth-producing foods
may contain, besides starch and sugar, a certain amount of protein and fat.
Water in food.
In addition to solid food the body needs also something liquid. Water
is the best fluid to drink, and man cannot exist without it in some form. If
a plant is not watered, and is thus allowed to become dry, it will wither and
die ; in similar circumstances the human body will also die. Most foods
contain a large proportion of water; and some foods, (e.g., jelly), though
appearing to be quite solid, consist almost wholly of water. All fruits and
vegetables contain it. There is also a considerable quantity in meat. The
amount of water in food, however, is not sufficient to maintain health ; it is
necessary also to drink, so that food may be dissolved and made liquid. The
nourishing part of the food is then in a condition to be absorbed into the
blood, through which medium it is distributed to all parts of the body.
Food without water would be of little or no use to the body, however good
it might be in itself.
Other factors.
In addition to these constituents of a satisfactory dietary, there are
certain accessory food factors known as vitamines which are essential to the
maintenance of good health. Little is known as to their physical and
chemical properties. Three kinds of vitamines have been discovered. They
are all products of the plant world, and when present in animal tissues are
always derived from vegetable food.
One kind is formed in that part of the seed or grain known as the
" embryo " or " germ." When cereal grains are highly milled or polished,
the " germ," and therefore the vitamine, is removed with the bran. Hence
people who feed mainly on bread made from superfine white flour, or
polished rice (as was the case in Japan) often suffer from a painful disease
of the nerves, beriberi. A second kind originates in green leaves, and when
these are eaten by an animal the vitamine is stored in its fat. Thus the fat
in cow's milk contains the vitamine because the cow eats grass. Yegetable
* It is not intended that these Notes should be read to the Class or used in such
> a way as to overload the teaching with detail.
a 5
10
Notes on Syllabus.
fats and margarines made from them do not contain it, and thus are of
inferior nutritive value to butter. This vitamine is necessary for growth
(hence the value of milk and milk products to children) and probably for
the prevention of rickets. A third kind is present in fresh vegetables and
fruits and is essential for the prevention of scurvy.
3. What is the use of our food ? Why food is necessary.
Everything that is eaten is not necessarily " food." To be a real food
it should affect the body in one or more of the following ways :—
(a) Food is necessary for the growth of the body.
It should tend to make the body taller and bigger. Healthy babies and
children should grow bigger and heavier, but they cannot do this unless the
food they eat is converted into bone and muscle. During serious illness
adults become thin, wasted1 and weak ; during convalescence it is necessary
for them to eat nourishing food to restore their bodies to normal weight
and strength.
(b) Food prevents the body from becoming thin and wearing away.
If food is not taken for several hours, hunger is felt. Some part of the
body is continually wearing away and being used up, somewhat as a candle
is used up as it burns or as the parts of an engine wear away with use.
"When hunger is felt it indicates a need of food to replace the part of the
body that has wasted away. The muscles that are used in doing hard work
wear away faster than if they are not required to work, and therefore food
is needed before work to provide the extra energy and after work to repair
the extra waste. If sufficient food is unobtainable, the body gets thin, so
it is evident that food is necessary even if the body is to remain the same
size and weight.
(c) It is from food that we get strength and power to work.
When either body or mind is at work energy is being used up and
sooner or later one gets tired, and has no more power to work effectively.
Thus, besides rest, food is necessary to repair the wastage.
(d) It is by food that the body is kept warm.
As the body is, in normal circumstances, warmer than the air, it is
constantly tending to cool and to lose heat. When food is taken it is
digested and carried by the blood to the tissues where it is stored; the
food material thus incorporated then combines with the oxygen which the
blood also carries. This process is called oxidation or " combustion."
Combustion leads to the formation of heat; so in that slow combustion,
which all living things exhibit, heat is pi-oduced. In this way, the heat
derived from food replaces the heat lost from the surface of the body, and
so maintains a nonnal temperature
(e) The working of the mind depends on the condition of the body.
The mind cannot work well unless the body is properly fed and warmed,
because food serves to strengthen brain as well as body. Just as the body
becomes weak and unable to work if it is not fed, so the bi-ain alsp becomes
less active if it is not noui-ished. Children who are not propei'ly fed cannot
leara their lessons as well as when they are well nourished. It is particularly
important that children should have suitable and sufficient food. Under-
nourishment in childhood may starve not only the body but also the brain,
upon the health, capacity and power of which their life will largely depend.
In the adult, under-nourishment and malnutrition lessen physical and
mental fitness, power of work and l'esistance to disease.
4. The special usefulness of the different kinds of food.
The several kinds of food referred to above are all required by the body,
and each kind is of use in its own pai-ticular way. For instance, meat, fish
Notes on Syllabus.
11
and eggs help the body to gro w, to become strong and able to work ; to
make nrnscle and supply energy and strength. Cheese and milk are useful
in the same way. Foods containing sugar, starch and fat enable the body
to work and (especially in the case of fat) warm it; but they do not supply
the materials needed for its growth and repair. Fat in food is for a time
stored in the body, and so produces that condition of plumpness which, if
not excessive, gives a feeling of comfort. Fat is a readily combustible food,
and when burnt it generates a relatively large amount of heat. It thus
forms a reserve which is burnt off when the fuel supplied is inadequate to
the demand. Consequently thinness is an early sign of insufficient intake of
food. In addition to these foods, it is well to eat fruits and green vegetables,
because they, too, help to keep the body healthy. Milk is the type of a
" complete " food, and in order to lay the foundation of sound nutrition in
infancy an abundant supply of fresh pure milk is essential. It forms for
infants a complete diet in itself, the solid part consisting of nearly equal
proportions of body-building material (casein), fat (cream), and milk-sugar,
with small quantities of a large variety of salts. As children pass from
infancy, and are able to take other foods, milk should still form a consider¬
able part of their diet. The purer and richer it is, of course, the more
nourishing it is; but for these older childreu even skimmed milk, when it
can be obtained fresh and pure, is an excellent body-building food, and may
be used with advantage in making milk puddings, &c. But skimmed milk
should not be given to infants in any form ; they should have whole milk
only, even if it is necessary to dilute it before use.
Milk is a fluid which readily becomes contaminated. As it leaves a
healthy cow it is free from germs. It is, however, often exposed to dust and
dirt at the time of milking, on its way to or at the dairy or milkshop and in
the home of the consumer. The bacteria which gain access to the milk are
mainly (a) those producing fermentation, (b) those found in sewage, (c) those
associated with diseases such as tuberculosis, typhoid fever, diphtheria, and
epidemic diarrhoea.
To secure a supply of pure milk it is necessary (i) for the cows to be
healthy, amid clean surroundings, and free from tuberculosis; (ii) for strict
cleanliness to be observed at the time of milking; (iii) for the temperature
of the milk to be kept low (by the use of the refrigerator when necessary,
and (iv) for protection to be afforded on its way to the consumer against
all contamination by dust or dirt. Similarly in the home every care should
be taken to protect the milk and to keep it cool. Whenever there is doubt
as to the purity of the milk, it should either be boiled or heated to about
180° Fahrenheit for ten to fifteen minutes. The latter is usually sufficient
for all practical purposes and makes less alteration than boiling in the com¬
position of the milk. The best brands of condensed milk and dried milk
are pure, wholesome and nutritious, but lacking in a certain vital quality,
owing mainly to the destruction of vitamines in the process of preparation.
Many infants and young children suffer from the lack of sufficient pure
milk, whether mothers' milk or cows' milk. This lack is at the root of
much of the malnutrition in infancy, is closely associated with the production
of rickets, and leads to lack of stamina which renders the child less able to
withstand the onset of disease or, when attacked, to recover from infectious
or other diseases. For these reasons a much larger supply of good pure
milk than is at present given to infants and young children is necessary.
5. Why people eat various hinds of food and why they are wise to do so.
It is not good to attempt to live on one kind of food alone. If, for
example, only bread and butter is eaten, though there is plenty of starch
and fat, it would be necessary to consume a large quantity in order to
obtain enough of the body-building substance, protein. Meat furnishes a
great deal of protein but no starch. Again, if fresh vegetables or fruit are
not included in the diet, illness results for the reason that a sufficiency of
vitamines, salts and acids is lacking. It is best to eat a little of a good
many different kinds of food.
A 6
12
Notes on Syllabus.
6. Things which people eat and drink for pleasure.
Besides the food that people eat for their good there are many things
which they eat merely because they are pleasant to the palate. Children,
for instance, like sweets and cakes, which contain sugar and other pleasant
things that are good if not eaten to excess. Sweets eaten between meals
tend to spoil the appetite for the other more nourishing food which the
body needs.
People also drink things because they like them, e.g., tea, coffee, and
cocoa. Neither tea nor coffee is a real food ; the only food in tea as it is
drunk in this country, is the milk and sugar that is put into it. The
difference between milk, for example, and tea lies in the fact that milk gives
the body power and strength, whereas tea only stimulates the body to put
forth and use the strength it has gained from real food If people drink
these things when they are tired, they feel for a short time fresher and more
able to work. This is due to substances contained in tea and coffee which
temporarily increase the capacity for muscular and mental -work. Thus
fatigue is in some degree diminished and not merely obscured; but if tea
and coffee are taken too frequently, especially for the purpose of freshening
up the body when it is tired, they may be harmful. When the body is tired
it does not need stimulants so much as rest and food.
Tea should be freshly made and should not be strong. If it is left to
stand long after it has been made (unless the tea has been poured off the
leaves into another vessel), it soon begins to taste bitter; this is because
" tannin " has been dissolved out of the tea-leaves. Besides making the
tea taste bitter, the tannin is injurious to the body tissues; it hinders the
assimilation of food, sometimes causes indigestion, and may do harm in
other ways. Tea should be drunk, therefore, soon after it is made. Tea
and coffee are not good for children; they should have milk or cocoa,
because they are less stimulating and contain more food substance.
Notes on Syllabus.
13
Section II.
1. Beer, Wine, Spirits.
There has often been much controversy as to the food value of alcohol.
It has already been shown that there are the three main classes of foods
and the respective services which each renders to the maintenance of a
healthy body have been indicated, viz., that the proteins supply the material
for the repair of tissue waste, while carbohydrates and fats provide the
necessary fuel for the supply of energy. In considering the food value of
alcohol, however, this point requires further explanation. Besides making
use of protein for tissue growth and the repair of tissue waste, the body is
able to transform some of it also into carbohydrate and thus utilise it as
a source of energy. But the supply of an adequate quantity of carbohydrate
and fat renders this conversion of protein unnecessary; they act, that is to
say, as protein savers.
Further, besides furnishing fuel for energy, food can be stored in the
body for future use. Carbohydrate is stored mainly in the liver and
muscles, but it may be transformed by the body into fat and stored in that
form. Alcohol can be utilised by the body as a fuel, and it can act also
as a protein saver. It cannot, however, be altered or stored by the body in
any way for future requirements, but circulates in the blood for some 15-24
hours, during which period it is very slowly burnt. Thus it is seen, that if
taken in large amounts or if taken in moderate amounts too frequently,
alcohol exerts a more or less constant action on all the body tissues.
In a measure, then, alcohol is rightly classed as a food in that it is able,
by helping to supply the immediate requirements of the body, to prevent
some depletion of the reserve, but for practical everyday purposes alcoholic
beverages cannot be regarded as a source of nourishment. Many people
suppose that beer is a real food, and they drink it partly because they think
it makes them more able to work. It is true that it contains a certain
amount of nourishment, There is, for example, a litt'e sugar and there is
a small quantity of the food substance found in meat. To obtain enough
food from beer for it to be of serious consequence as a source of energjq
however, it would be necessary to take an extremely large quantity, and rhe
good that might be done by the nourishing part of the beer would be more
than counter-balanced by the harm done by the alcohol contained in so
large a quantity. This is one important reason for not taking beer as a
food. Another is the expense, for even if no harm were done by the amount
of beer which it would be necessary to drink, the cost of such a meal would
be far greater than the cost of an equal amount of nourishment taken in the
form of ordinary food. For these two reasons, therefore, beer cannot be
considered to be one of the " foods " which the body requires. Moreover,
alcoholic beverages do not, as a rule, quench thirst as water and tea do; in
fact, thirst may be created and increased instead of being satisfied.
Children and young people should not drink beer, wine or spirits of
any kind. Children do not, as a rule, like the taste of alcohol; in fact,
wide experience proves that " alcohol is seldom any temptation to the
" young, but nevertheless, the habit may be acquired and become a temp-
" tation later."* When in health, the body does not need alcohol, whereas
it is always possible that various evils may arise as a consequence of
drinking beverages containing it. If alcohol is used regularly, " drinking "
habits may not infrequently result, for a mere knowledge of the dangers of
alcohol is not a sufficient safeguard.
* Life and Labour of the People in London, by Right Hon. Charles Booth
(Macmillan), 7s. 6d. Final volume, page 64, 1903.
a 11649 a 7
14
Notes on Syllabus.
2. What is Alcohol / *
The term alcohol is applied by chemists to a variety of substances
- having a certain type of chemical constitution, but in the ordinaxy use of
the term it is restricted to what is called " ethylic" alcohol, which is the
constituent of all alcohol drinks and is produced by the fermenting action
of yeast upon sugar. Thus wine is produced by the fermentation of the
sugar in the juice of the grape, cider by the fermentation of that in the
apple. The alcohol in beer is produced by the fermentation of malt-sugar,
which is produced in the process of brewing, from the action of a ferment
on the starch in the barley grain.
During the process of fermentation other " alcohols " and similar sub¬
stances are produced, which give rise in the main to the characteristic
flavours of the different kind6 of wines and spirits ; but it is the ordinary or
" ethylic" alcohol which is responsible for the effects produced by the
drinking of alcoholic liquors.
3. Some C liar act eristics and Uses of Pure Alcohol.
Pure alcohol is colourless and looks like water, but it has a peculiar
smell; also, unlike water, it has not the power to quench thirst. It will
burn; hence brandy and whisky, which eontain a great deal, will readily
take fire.
Alcohol has a greal attraction for water, and if substances containing
water are soaked in alcohol, they lose this water and become dry and hard.
Alcohol is also able to absorb water from the tissues of the body, and this
explains why alcoholic drinks tend to make a man more rather than less
thirsty. When the body loses water, whatever the cause of this loss may
be, thirst is created and a renewal of the supply of water is necessary. For
this reason alcoholic beverages make one thii-sty.
These properties of alcohol make it very useful in certain arts and
manufactures, and for some industrial purposes. As a fuel, for example,
it may be used for spirit lamps or to drive motors. The chemist uses it
to prepare and purify drugs and other compounds. It is employed to dry
and harden substances ; many ai*ticles and museum specimens are preserved
in spirit; and since it is difficult to freeze alcohol, it is used instead of
mercury in thermometer's when it is desired to register very low
1 emperatures.
4. Proportion of Alcohol in Beer, Wine and Spirits.
It is not possible to drink pure alcohol, because it causes a hot painful
feeling in the mouth, throat and stomach, and also produces direct injury.
Therefore it can only be taken when diluted and made weaker by mixing it
with water or other liquids less harmful than alcohol.
Beer, wine and spirits all contain alcohol. There is some in beer, more
in most wines, and a great deal in spirits. (It is for this reason that
although beer will not burn, brandy will.) The percentage of alcohol by
volume in some of the commoner alcoholic beverages may be stated as
follows :—
Lager beer contains about 4-5 per cent.
Bottled beer „ „ 5-7 „ „
Claret, hock, &c. contain about 9-10 per cent.
Poi-t contains about 17-23 per cent.
"1 Gin contains about 37 per cent.
ffepiiits ryy^Lty l „ 40-50 per cent.
J Brandy J
* The matter contained in this section is based upon the official publication,
Alcohol: its Action on the Human Organism, 1920. H.M. Stationery Office.
Price Is.
f The percentage of alcohol in spirits has been reduced under the Defence of the
Realm Act Regulations.
Notes on Syllabus.
15
Some of the " medicated wines," sold by chemists and others, contain a
large percentage of alcohol, and, for this reason, harm may be done by their
use as "tonics."
5. Effect of Alcohol on the Brain and Nervous System.
Contrary to popular opinion, the effect of alcohol on the nervous system
is to depress rather than to stimulate its functions. The apparently
stimulating action, as shown by the stage of excitement through which the
drinker may pass, is due to its depressing action upon the highest and latest
developed part of the brain, namely, that which is associated with the
exercise of the intellect and of the will,, The emotions released from proper
control are left free play to respond to the immediate environment in which
the drinker finds himself, and this as a rule is of a convivial character. The
emotional characteristics are the oldest established ; they have their seat in
certain lower parts of the brain which are developed early in the animal
scale.
Next in order of development come the nerve centres associated with
the sensory and skilled motor functions, and latest of all is developed that
part of the brain connected with the higher intellectual faculties. Thus,
the action of alcohol is to depress the functions of the brain from above
downwards in the reverse order of their development in the individual and
in the race.
Among these successive steps the following may be noted :—
(i) Blunting of self-criticism.—Self-criticism represents the latest
developed of the intellectual functions. When it is blunted, actions are
indulged in or remarks made which are not consistent with the usual
character of the individual. The resulting effects of this blunting are
various to an almost unlimited degree; but certain of them are particularly
characteristic of • the action of alcohol, and emerge with considerable
regularity in carefully conducted tests and experiments. Among these may
be cited:—
(a) uncritical self-satisfaction of the individual with his work and
actions ;
(b) disregard of occurrences and conditions normally requiring
caution of act and word ;
(c) trespass of rules and conventions previously respected;
(d) impaired appreciation of the passage of time;
(e) talkativeness;
(/) an argumentative frame of mind; quarrelsomeness.
(ii) Interference with the performance of skilled movement. This is
indicated by clumsiness of behaviour, by the slurring of words.
(iii) The blunting of the senses—of hearing, taste, touch, and vision.
(iv) The display of the primary emotions. Anger may be displayed at
one moment, and affection at another; similarly with boisterousness and
depression, laughter, and tears.
(v) The failure to respond to external stimulation and the eventual lapse
into a heavy sleep. At each successive stage in the process of intoxication,
it will thus be seen that the action of alcohol is chiefly narcotic.
This narcotic action has been aptly summarised by the Alcohol
Committee of the Liquor Control Board in their review of the existing
state of scientific knowledge regarding the action of alcohol on the human
organism* : —
" A further conclusion of capital importance which emerges with equal
clearness is that the action of alcohol on the nervous system is essentially
sedative, and—with the possible exception of its direct influence on the
respiratory centre—is not truly stimulant. The popular belief in the
stimulating properties of alcohol, as regards nervous and other functions,
2 Alcohol : Its Action on the Human Organism, H.M. Stationery Office, 1920,
Price Is.
L6
Notes on Syllabus.
seems to be of purely subjective origin and illusory; it is in the main, if not
wholly, an effect of the narcotic influence of the drug, for, as we have seen,
it dulls the drinker's perception of unpleasant conditions in himself and his
surroundings, and may make him feel better, more efficient and stronger
than he really is. Effects which are apparently of a different character—
effects such as the increased loquacity and freer gesticulation produced by
alcohol—which are usually interpreted by the drinker, if not by those about
him, as evidences of stimulation, are really narcotic effects; they result
from the removal of the control exercised by the higher nervous centres, a
control which enables the individual to weigh his words and acts, and
renders him self-critical and solicitous as to the impression he is making on
other people. The removal of this control and the decrease of critical self-
consciousness are, in fact, the most constant and characteristic effects of
alcohol, whether in the moderate dose which diminishes restraint and imparts
courage to the diffident speaker or in the excessive dose which gives rise to
the verbose diffuseness of drunkenness."
6. Effect of Alcohol on the Body's Strength and Power to Work.
The drinking of beer, wine, and spirits tends to weaken the muscles of
the heart and of the body generally, and so diminishes the power and
capacity to work. Experiments were made by Dr. Edmund Parkes, F.R.S.,
with two gangs of soldiers doing equally hard muscular work (mowing), one
gang alternately taking beer during the work and the other not. In every
case it was shown that, although men taking beer might for a short time
gain on the others, they soon dropped behind, and at the end of the day the
total work accomplished by them was less than that done by those who had
no alcohol. In the South African war it was observed by Sir Frederick
Treves, who was with the column which relieved Lady smith, that soldiers
who drank much alcohol were the first to fall out on a long march, and were
less fitted to overcome hardships and fatigue than those who either did not
drink alcohol, or took it in very moderate amount.* Athletes, when training
for racing, boxing, or other sports, usually avoid alcohol because they know
the harmful effect it may have upon their strength and endurance. On
the Great Northern Railway there was a celebrated gang of navvies who
did more work in a day than any other gang on the line, and always left off
work an hour or an hour and a-half earlier than any other men. Every
navvy in this powerful gang was a teetotaler f Muscular fatigue following
severe exertion is far less readily recovered from if alcohol is taken during
the work or exertion, and the recuperative powers of those who regularly
take too much to drink are greatly lessened. Broadly, therefore, it may be
said that experience shows that men engaged in very hard manual labour
do their work more easily, in all respects, without alcohol.+
In reporting on the health of men employed in very heavy trades, the
Health of Munition Workers Committee stated, in regard to certain steel
smelters :—" A few of the workers are abstainers from alcohol in any form.
" These latter are usually the most reliable men, When the supply of
" drink was restricted by the closing of the public-houses in the district, a
" great improvement in the health and the time-keeping of the workmen
" was noticed and was admitted by the men."§
In the final report of the Health of Munition Workers Committee, the
various factors leading to the production of accidents are discussed, and an
example is given of a fuse factory where the number of accidents among
* It has never been the custom in the British Army to include alcohol in the
ration ; but an issue of rum is made under conditions of stress and exposure to bad
weather, on medical recommendation, and with the sanction of the General Officer
Commanding.
f Work and Wages, Brassey (Longmans, price 5s,), 1894.
J For many instances and particulars under this heading, see A Manual oj
Practical Hygiene (Churchill), by the late Edmund A. Parkes, M.D., F.R.S. (Section
dealing with Alcoholic Beverages).
§ Industrial Efficiency and I<atigue, 1917 (Cd. 8511), p. 100. (Price Is. 3d.)
Notes on Syllabus.
17
the night-shift workers fell rapidly after the restriction of alcoholic
consumption.*
In a Return, furnished to the House of Commons in April 1915, on the
causes of the alarming incidence of bad time-keeping in ship-building,
munitions, and transport areas, the following statement is made :—
" The evidence is really overwhelming that the main cause of this
alarming loss of time is the ' lure of drink.' The employers say so
most emphatically; the Admiralty have received elaborate reports
emphasising the same conclusion in the case of ship-building, repairs,
munitions of war, and transport. The Home Office reports are to the
same effect, and the detailed figures summarised above are, in them¬
selves, strong evidence that drink is the cause. A section of each class
of workmen keep perfectly good time throughout the week, and therefore
the cause is not one which is common to all the workmen, or due
to any general industrial condition. The worst time is generally kept
after wages are paid, and at the beginning of the following week. "When
absence from work occurs the workman is usually absent for several days
together. Staleness and fatigue, no doubt, must arise from working during
long hours over an extended period, but inasmuch as half the men are not
in fact working for more than 45 hours a week, the cause must be found
elsewhere. The testimony of observers in each district is that drink is by
far the most important factor."
7. Effect of Alcohol on the Power of the Body to resist Disease.
Alcohol lowers the resistance of the body to disease, that is to say, a
person who habitually drinks alcoholic beverages is more likely to contract
illness than one who does not. The devitalising of the tissues produced by
chronic alcoholic poisoning lowers the defences of the body against the
invasion of germs, and consequently the body is rendered more liable to
develop, and less able to throw off, diseases dependent on microbial
invasion such as pneumonia, tuberculosis, septicaemia (blood-poisoning), &c.
Then again, wounds, sores, and cuts heal less readily in a person who takes
beer and spirits than in one who does not, and such a person is more likely
to suffer from blood-poisoning.
8. Effect of Alcohol on the Digestion of Food.
Alcohol increases the flow of gastric juice, which is also modified in
composition, containing a very small quantity of the digestive ferment,
pepsin. Small amounts have little marked action on the movements of the
stomach, or on the chemical process of digestion, nor do they appear to
exercise an appreciable influence on the absorption of digested foodstuffs.
Alcohol taken in excess, however, leads to chronic inflammation of the
stomach and bowel, the digestive functions of the stomach are interfered
with, food is not absorbed into the blood as freely as it usually is, and the
general nutrition therefore suffers. Alcohol, when taken in such quantities,
also tends to destroy the natural appetite, and the wholesome sensations of
hunger which are an aid to good digestion; less food is therefore taken into
the body, and this, together with defective absorption, serves to bring about
a condition of under-nourishment. Further harmful results are produced by
the absorption of certain by-products of digestion which would not other¬
wise get into the blood-stream. One result of this is to produce chronic
inflammation of the liver leading to destruction of its cells and consequent
interference with its functions.
9. Effect of Alcohol on the Body Temperature.
It is important to distinguish between the surface temperature and the
deep temperature. The former is usually lower than the latter, and it is
also subject to much variation. The deep temperature remains in health
almost constant, and this is indeed an essential condition of health.
* Industrial Health and Efficiency, 1918 (Cd. 9065), p. 66. (Price 2s.)
18
Notes on Syllabus.
There are two processes, the generation of heat and the loss of heat, in
constant action. Heat is being continually produced as a result of the
chemical changes taking place in the body, and it is as continually being
lost owing to the fact that the body is usually warmer than the air which
surrounds it.
The due regulation of these two processes is maintained by a nei-vous
centre in the brain known as the heat-regulating centre. The function of
this centre is to protect the body against a fall of the deep temperature.
This it does in the main through regulation of the amount of blood circula¬
ting through the skin. Immediately the deep temperature becomes liable
to fall through exposure to cold the blood vessels of the skin are contracted,
less blood flows through the skin, and correspondingly more through the
deeper tissues and organs, while the heat which would have been lost by
evaporation from the surface of the skin is available for maintaining the
deep temperature. " Shivering " helps to this end also. It is produced by
uncontrollable contraction of the muscles which results in an increased pro¬
duction of heat; and itself leads to various forms of voluntary muscular
activity.
This process of regulation of the body temperature is affected by alcohol
in two ways. First, it produces a general flushing of the surface of the skin
through its action in leading to the dilatation of the blood vessels of the
skin, and to that extent it causes a fall in the deep temperature; and,
secondly, by relieving the unpleasant sensation of feeling cold, it prevents
the warning, to which this feeling would otherwise have given rise, from
reaching the heat-regulating centre, and consequently the involuntary and
voluntary muscular responses to that warning fail to be evoked. Alcohol
accordingly leads to a fall of the deep temperature. Moderate doses of
alcohol, taken to relieve a temporary feeling of cold, do not, of course,
seriously affect the deep temperature; but, taken before or during severe
exposure to cold, are dangerous. Many Arctic explorers have not permitted
alcohol to be taken as a beverage by members of their expeditions, partly
because it causes this loss of heat, which is especially serious in cold
climates, and partly because it diminishes the muscular strength and the
capacity for endurance. A man drinking much alcohol in a very cold
climate is likely to suffer severely, or even die, from the cold because of
the heat that is lost from the body on account of the alcohol. Persons
frozen to death, at any rate in this country, have often died because they
were intoxicated when exposed to the cold.* On the other hand, as a
restorative after severe exposure to cold, it may, when suitable hot appli¬
cations are available to prevent the escape of heat from the skin, prove of
value in promoting the circulation of the blood. Alcohol has also been
found to predispose to sunstroke.
* Food and the Principles of Dietetics, by Robert Hutchison, M.I). (Arnold
price 18*., 1919, p. 348.
Notes on Syllabus.
19
Section III.
1 Principles which must be observed if errors of diet are to be avoided.
It is common knowledge that man's diet should be mixed, varied, sound
in quality and sufficient in quantity, consumed at fairly regular intervals,
and appetising and digestible. It should contain an adequate supply of
protein, fat, carbohydrate, inorganic salts and water—and these substances
are represented in greater or less degree in the common articles of diet,
meat, milk, bread, sugar, starch, rice, oatmeal, &c. Fat and carbohydrate
can replace one another in a diet, but the body digests and deals best with
a certain proportion of each. Fat, however, yields weight for weight more
than twice as much energy as carbohydrate, and so in cold climates and
cold weather more fat is naturally eaten.
Further, as has been pointed out above, in addition to these necessary
constituents certain unidentified living principles, known as accessory
food factors or " vitamines," must be present in the diet to ensure health
and nutrition. These bodies are contained in peas, beans, eggs, animal fats,
milk, butter, cod-liver oil, green vegetables, potatoes, fruits, lemon .juice,
and so on. If a chemically ideal and model food be prepared in the
laboratory with the proper amounts of each essential constituent, and then
it be sterilized, dried or otherwise " preserved," it may be deprived of some
or all of its vital principles. Hence, dried foodstuffs, preserved vegetables
and tinned meats, though possessing some practical advantages, are
reduced in value as complete foods. They become auxiliary only, for they
are deprived in some measure of their vital elements.
2. The Consequences of eating too much.
If we eat more food than is necessary to secure—
(a) the health of the body ;
(b) proper development and growth; and
(c) repair and vital energy ;
we may do our bodies lasting harm. The taking of food ought to make us
fit and ready for more work; when a meal induces an inclination to abstain
from work, when it causes a feeling of " heaviness," ineffectiveness and
desire for inaction and rest, it has failed in its purpose.
If the digestive organs are able to avoid the immediate ill effects of
over eating (for example, pain in the stomach, headache, sickness, vomiting)
the body usually becomes too fat. It is of course a good thing to have a
moderate store of fat in the body, but it is a bad thing to have an excessive
amount. Superfluous fat impedes the action of the muscles, and especially
the action of the great muscular pump, the heart. Moreover, the organs of
excretion, the kidneys, are overworked in their effort to dispose of such
waste products as are not burned away into carbonic acid gas, and these
organs so tend prematurely to wear out.
If, on the other hand, the digestive organs rebel at once against the
excessive work put upon them, the immediate result is indigestion, flatulence,
and constipation. Subsequently less of the food taken is absorbed than
would have been the case had rules of temperance been observed. Para¬
doxical as it may sound, under nourishment may readily be produced by
over-eating, appetite fails and to stimulate it spiced, dainty, luscious, and
easily digested foods are craved. Over-fed children may be recognised by
their heavy, pasty faces ; they have a tendency to headache, constipation,
irritability, and general lethargy.
These evils are produced even when the excessive quantities of food
consumed are in themselves wholesome, but the evils are exaggerated, when
the food is not of a satisfactory character.
20
Notes on Syllabus.
Many people suppose that expensive foods are more nutritious than
cheaper ones, and will stint themselves to provide these supposed delicacies
for weakly children. In point of fact many of such expensive foods
(e.g., oysters, asparagus, caviare, &c.) are physiologically inferior to those
costing much less; some of them possess hardly any nutritional value at
all. The value of a food should, by no means, be measured by its cost or
" tastiness." The golden rule of dietary is temperance in quantity, plainness
in quality.
3. The importance of taking food at fairly regular intervals.
Some part of the digestion of food begins at once in the mouth (affecting
the starch), and this process is continued in the stomach for some time ;
then other digestive action begins (the conversion of the nitrogen-containing
or protein food), the other changes are arrested and the contents of the
stomach are moistened and kneaded into a smooth semi-fluid consistency.
Then the entrance between the stomach and the small intestine opens and
the food passes on to undergo further changes.
If shortly before this process is complete (say, an hour or two after a
meal), some sweet biscuits or cakes, for instance, are eaten, the digestion of
their starch hinders the passage onwards of the food already in the stomach
and the process of digestion is delayed. The taking of food between meals
is frequently the cause of chronic illness.
4. The Consequences of taking Food which is unsuitable to the age or habits of
the Individual.
A food good for one period of life may be quite unsuitable at a later age;
for example, milk is an ideal food for young children, but it is not a suitable
staple diet for the adult. Conversely, foods which are good for the adult
are not necessarily suitable for children. Babies should not be given meat
and gravy ; and strong tea and coffee are not good for children at any age.
The appetites of civilised people and even of children are not always safe
guides. Children should not be allowed to eat everything they like ; buns,
sweets, cakes, lemonade, ginger beer, &c., should not be substituted for
bread, butter and milk. Soft starchy foods, allowed to accumulate about
the teeth, are one of the principal causes of decay. Sound teeth are an
all-important factor in the maintenance of health.
Beverages like ginger beer and lemonade impede the work of digestion
in the stomach and have a negligible food value. Sugar is a valuable food,
but the constant eating of sweets is bad, not only for the reasons given
above, but also because it tends to damage the teeth. The reason for this
is that if sweets are constantly being eaten, the mouth is seldom free from
a solution of sugar, which is a food peculiarly favourable to the multiplication
of the germs which destroy the teeth.
5. Malnutrition.
The factors which operate to cause malnutrition are numerous, and the
subject is a complex one. It is not enough that the body be supplied with
food of any sort, that of itself will not suffice. There must be the proper
proportion of nutrients, sufficient proteid to meet the demand for nitrogen,
sufficient carbohydrate and fat to yield heat and energy. There must be
sufficient solids, vitamines, vegetable acids and water, and there must be a
sufficiency also in regard to quantity,
Over and above this provision there must be healthy activity of those
physiological processes which have to do with mastication and preparation,-
with absorption, assimilation, metabolism and excretion. Healthy and
complete nutrition is something more than mere feeding, mere filling of
the stomach.
We must therefore take a wide and comprehensive view of nutrition,
which must be estimated not only in terms of bulk and weight, but of the
ratio stature to weight, of the general appearance and " substance " of the
body and of its carriage and bearing; of the firmness of the tissues ; of
the presence of subcutaneous fat; of the condition and process of develop-
Notes on Syllabus.
21
ment of the muscular system; of the condition of the skin and the redness
of the mucous membranes; of the nervous and muscular systems as
expressed in listlessness or alertness, apathy or keenness; of the condition
of the various systems of the body; and of the relative balance and
co-ordination of the functions and powers of digestion, absorption, assimila¬
tion of food, and of the excretion of waste products. In brief, it may be
said that malnutrition is usually due to one of four causes :—
(i) Shortage of food.
(ii) Unsuitable food;
(iii) The result of excessive intake of food ;
(iv) Lack of digestive power.
The first and second can often be remedied by an elementary knowledge of
the value of different kinds of food; the third, by self-control; and the
fourth, by toning up the system by leading an hygienic life, by an apprecia¬
tion of the value of fresh air, and by physical exercise and games.
6. The Prevention of Diseases due to Faulty Feeding.
"More than one-half of the chronic complaints which embitter the
" middle and latter part of life," said Sir Henry Thompson, the surgeon,
" is due to avoidable eiTors in diet." One cause of error is lack of knowledge
in the choice of good and evil in regard to food—its selection, nutritive
value, preparation and consumption. But there are other aspects of the
dietetic habit which have a large share in the production of disease:
(a) irregularity of meals and the consumption of food or drink in between
them ; (b) the unvaried monotony of the average dietary; (c) the failure to
masticate food owing to defective teeth or the habit of bolting food;
(d) drinking too much -with meals ; (e) bad teeth ; (/) chronic constipation;
(g) swallowing air at the time of eating; and (h) the abuse of tea, spices
and alcoholic beverages, These seem to be trivial matters, but it is out of
the smaller habits and neglectfulness of men and women that disease is
bora. Again, there are the group of deficiency diseases, rickets, scurvy,
beri-beri, due in part to ignorance in dietetics. Perhaps the most serious
of these four types of disease in this country is rickets, partly because of its
prevalence in many of our great cities, partly because of the life-long
deformities which it may create, and partly because it lowers the process of
resistance to disease in childhood. Its cause is twofold: absence or
deficiency of certain accessory foods in the presence of excess of carbo¬
hydrates ; and lack of fresh air, sunlight and exercise. It is thus an almost
typical " nutritional" disease. It is usually preventable by a careful and
well-informed mother.
22
Notes on Syllabus.
Section IY.
(1) For different reasons the drinking of alcoholic beverages in excess is likely
to be injurious to all parts of the body.
If alcohol is taken habitually in excess some of its effects (set out in
Section II.) become permanent, and the character of the individual is
modified. The general intelligence, the will power, the understanding, the
ability to think and to reason well and clearly, are injured and weakened.
The judgment becomes less accurate and balanced ; the memory becomes
bad; the power of voluntary attention is enfeebled, and the power of
calculation retarded. Thus mental activity generally is reduced and the
work that is done becomes increasingly inaccurate, careless and untrust¬
worthy.
Then, further, the feelings and sensations are blunted and the proper
control of the brain over the muscles is weakened. As one result of this
loss of control, accidents, such as falls, or factory mishaps with machinery,
may occur. Skilled movements requiring delicacy of touch and precision in
execution are affected adversely by even small doses of alcohol. Observa¬
tions made by Dr. Aschaffenburg on the work of compositors (which is
skilled work requiring an active brain) led him to conclude that when
alcohol was taken before the work and by men accustomed to its use, fewer
letters were set up than when no alcohol was given, although the men
themselves were under the impression that the alcohol caused them to work
better and more rapidly.* The trembling shaky hand of those who take
too much alcohol is characteristic of this loss of control by the brain, and
this is especially detrimental to the man who earns his living by skilled
manual work requiring deftness of touch. Detailed investigations have
been made into the effects of moderate doses of alcohol on neuro-muscular
co-ordination and particularly on the accuracy and speed of typewriting. It
was shown that " [the] reaction was invariably in the direction of diminished
" control of the muscles, as was shown in the number of typing and adding-
•' machine mistakes, by diminished typing speed and by increased error in
" pricking a target, "f
The habitual excessive use of alcohol leads also to permanent mental
disorder, as shown principally by failure of memory, failure to control the
emotions, and a general weakening of will power. Comparatively rarely,
probably, does it produce what is ordinarily recognised as insanity, but it
has a strong tendency to render active forms of insanity, that might
otherwise have remained latent and unsuspected. Furthermore, since
sufferers from insanity are liable to become rapidly addicted to excessive
drinking, intemperance can sometimes be regarded as a symptom of
insanity.
A person who frequently takes much alcohol becomes less fit and healthy,
partly owing to its cumulative effect. Neither his muscles nor his brain
are capable of as much exertion as those of a person who abstains or is
strictly temperate, and the quantity and quality of the work that is done
invariably show more or less marked deterioration.
The health of such a man tends to become worse as the effects of the
alcohol on the different parts of the body become more pronounced. He
will probably suffer from digestive troubles and malnutrition or from some
of the various illnesses to which habitual drinkers are particularly liable.
This naturally tends to shorten his life, which is also threatened by accidents
of all kinds to which his mental apathy, carelessness and the loss of due
control over his muscles expose him
* Alcohol and.the Human Body, by Sir Victor Horsley, C.R., F.R.S., and Mary
D. Sturge, M.D. (Macmillan, price 3«.j, 1920, p. 79.
f The Influence of Alcohol on Manual Work and A euro-muscular Co-ordination,
Medical Research Committee Report (H.M. Stationery Office, price 2*.), 1919, No. 31,
page 57.
Notes on Syllabus.
23
(2) Facts revealed by a study of Mortality Tables.
Men and women who are occupied in the manufacture or sale of alcoholic
beverages, and are therefore constantly liable to the temptation to drink
them in excess, do not live so long as the average healthy man, and the
mortality among them is even higher than in many of the so-called
Dangerous Trades.
This is well exemplified by the following Table, furnished by the
Registrar-General, which gives the average relative mortality, expressed in
the form of a ratio, among occupied and retired males (25-65 years of age)
from alcoholism and diseases of the liver, in various trades, during two
periods of 3 years each (1900-02 and 1910-12).
The figures are based on medical certificates as to the cause of death,
and cannot, therefore, do more than given an approximate estimate of the
relative mortality from all causes and from alcoholism. Diseases of the
liver are included because they are so often closely connected with excessive
indulgence in alcoholic beverages.*
Occupation.
All Causes.
Alcoholism and
Diseases of the Liver.
1900-02.
1910-12.
1900-02.
1910-12.
Occupied Males.
100
100
100
100
Coachman, cabman -
115
117
135
126
Costermonger -----
200
191
230
226
Coalheaver
122
121
109
91
Fishmonger
101
95
174
165
Musician ------
126
122
193
170
Dock labourer
148
143
167
187
Chimney sweep
134
128
186
243
Butcher ------
114
112
219
243
Brewer
139
129
279
270
Inn-servant
188
148
419
322
Inn-keeper -
177
160
726
791
It will be understood in reading this Table that the number 100
represents 100 deaths in a given population of occupied and retired males in
all trades and professions, (a) from all causes, and (b) from alcoholism and
diseases of the liver; while the numbers below, in each column, give the
relative mortality from all causes, and from alcoholism and diseases of the
liver, among occupied and retired males in certain special occupations.
That is to say, that if we so choose a standard population that at the rate of
mortality experienced by all occupied and retired males 100 deaths would
have occurred, application to this population of the death rates at different
ages, for coachmen would yield 126 deaths, the brewers' rates would produce
270 deaths and so on. The figures given are, therefore, not death-rates, nor
do they represent, of course, the actual number of deaths taking place in the
years stated; but they give the relative magnitude of the mortality from all
causes, and from alcoholism and diseases of the liver, among persons
engaged in different occupations, demonstrating the relatively high mortality
from alcoholism in certain trades as compared with what may be thought of
as the standard mortality for occupied and retired males of all trades and
professions.
* For farther information as to " Industrial Drinking," consult Alcoholism by
W.C. Sullivan, M.D. (Nisbet, price 5s.), 1906, Chap. YI.
24
Notes on Syllabus.
(3) Facts revealed by a study of the experience of the principal Life Offices
and Friendly Societies.
The following Table shows the Expectation of Life (that is, the average
future duration of life dated from the age in question)—(a) in the general
population of England and Wales based on the experience of 1901-10,
(b) in persons insured in a large number of the principal Life Offices based
on the experience of 1863-93, and (c) in various Friendly Societies and the
United Kingdom Temperance and General Provident Institution. It will
be seen how much more favourable is the Expectation of Life in persons
abstaining from the use of alcoholic beverages :—
Age.
General
Expectation of
Total Male
Population in
England and
Wales based on
Experience of
1901-10
(Regis t.rar-
General).
General
Expectation based
on the Experience
of Persons insured
in a large Number
of the Principal
Life Offices in
Great Britain in
Years L861 -91
(Institute of
Actuaries).
Man¬
chester
Unity of
Odd¬
fellows
(Non-
abstainers
largely)
based on
Experience
of 1S93-97.
Eoresters
(Non-
abstainers
largely).
Rechab¬
ites
(Ab¬
stainers).
United Kingdom
Temperance and
General
Provident
Institution based
on Experience
pf1811-190L
(Abstainers).
20
43-0
43 2
43*8
43-1
48-8
46-9
25
38-9
39-1
39-6
39 0
443
43-0
30
34-8
35 • 1
35-4
34-8
39-7
38-8
35
30-8
31-2
31-4
30-7
35-1
34-6
40
27-0
27-4
27-4
26-7
30-6
30-3
45
233
23*7
23-6
22-8
26-1
26-1
50
19-8
20-1
19-9
19-1
21*8
22-0
55
16-5
16-7
16-4
—'
17-7
18-1
60
13-5
13-6
13-3
—
13-8
14-6
The first column of this Table gives the Expectation of Life of the
general population whether insured or not. For instance, a person out of
the general population at the age of 20 will live on the average 43 years
more. The second column gives the Expectation of Life of a large number
of insured persons chiefly of a social status above the wage-earning classes,
and it will be seen that it is somewhat larger at each age, even though it
relates to the period 1863-1893, when mortality was considerably higher
generally than in 1901-10. With these may be compared the experience of
the two great Friendly Societies (Oddfellows and Foresters), of whom a
high proportion are non-abstainers, and the experience of the Rechabites'
Society consisting only of abstainers. The last column gives the experience
of abstaining persons chiefly of small means or who are insured for small
sums. Comparing the last two columns with the first four columns, it will
be noted that the abstainers show a greater Expectation of Life than any
of the other groups at each age and in all cases.
Further, it has been ascertained by the Registrar-General that in
respect of the years 1900-02, of 61,215 men between the ages of 25 and 65
in the community, 1,000 die in one year, but of 61,215 publicans, 1,642 die
in one year, while of 61,215 Rechabites (abstainers) 560 die in one year.
(From the Inter-Departmental Committee on Physical Deterioration,
Vol. iii., Appendix XVI., p. 64, Section II.)
The general policy among Insurance Offices of late years has been to
give somewhat more favourable terms to total abstainers, as it has been
recognised that such persons are on the whole likely to live longer than
non-abstainers. On the other hand, the Prudential Life Company in 1874
charged an additional premium of 15s. per cent, on the lives of "beer-shop
keepers, licensed victuallers, and their servants." A few years later this
extra premium was raised to 21s., and in 1896 to 21. on whole life assurances
as a result of a careful examination of the death-rate prevailing among
Notes on Syllabus.
25
persons following these occupations and assured with the Company. It is
the general practice of Accident Insurance Companies also to allow to total
abstainers a reduction of premium, varying from 5 to 10 per cent.
(4) The social effects of drinking to excess are not confined to the injury done
to the body, but also may be followed by moral injury to the individual
himself and great harm to others.
The man who drinks to excess, even if he is never intoxicated, degenerates
in character and capacity. He becomes unfit to work, and in many cases
unemployable. Diligence and application become distasteful to him. Ill
health, and not unfrequently disease, follows such excess, and he becomes
pauperised and even a burden on his family, and to the State. Even
moderate drinking may, in certain circumstances, impair the full development
of a man's mental capacity. Thus the drinker may suffer socially, physi¬
cally, mentally, and morally. Further, a person who is intemperate in one
way is likely to be intemperate in other ways ; the loss of self-control in one
respect indicates a predisposition to moral weakness in other directions also.
Sexual immorality is often dependent on alcoholic intemperance. Moreover,
a person who takes too much alcohol becomes unfit for a good\day's work,
and is among the first to be discharged when employment slackens.
Intemperance, therefore, tends to pauperism. The association of alcoholic
excess with crime is well known; the effects produced in the home and
family life are disastrous.
The children of drunken parents start life with many disadvantages.
With their physical health and energy below the average, they lack tbe care,
nourishment and protection which all children require if they are to grow up
well and strong; they are accustomed to squalor, poverty, and a low
standard of comfort, and therefore often have no desire or ambition to
aspire to better things, and, being thus badly equipped from the outset
both in mind and body, their chances of leading happy and useful lives are
greatly* lessened.*
" The use of these things" (beer, wine, or spirits), says Sir Michael
Foster, " has brought no end of misery into the world. If we could take
" away from the world all the ill-health, all the poverty, all the wretched-
" ness, all the cruelty, all the crime which has been brought about by
" drinking too much wine, beer, or spirits, and the like, how much happier,
" wealthier, and brighter the world would be."f
(5) The wastefulness of the excessive drinking of alcoholic beverages.
Large sums of money are often spent even by poor people on drink.
In the financial year 1919-20, it was estimated that the total expenditure
on intoxicating liquors in the United Kingdom was 410,000,000Z. This
gives an average expenditure per head [i.e., per adult of 21 years and
upwards) of 13Z. 15s. This includes, of course, many individuals who
spend nothing on alcohol. Speaking broadly, it may be said that about
two-thirds of the total sum [i.e., about 270,000,000Z. was spent by the
working classes.£ In 1918 it was estimated*} that the average earnings of a
family of 4• 57 "men" (that is, the family contained persons of different
ages, husband, wife, and children, but their food requirements were the
same as those of 4'57 grown men) were 75s. 5cZ., and that the cost of food
alone was 10s. per " man " per week. So that 45s. 9d. of the income must
be spent on food. If now (expenditure rate of 13Z. 15s.) 5s. per person be
* It may here be added that, subject to certain exceptions, persons are forbidden
by law (Children Act, 1908, §§ 119-120) to give to any child under the age of five
any intoxicating liquor, and the admission of children under 14 to the bars of public-
houses is forbidden.
f Simple Lessons on Health for the Use of the Young, p. 82.
% See also The Temperance Problem and Social Reform, by Joseph Rowntree and
Arthur Sherwell (Hodder and Stoughton), 1901, Popular Edition, Chap. 1, p. 15.
§ See Report of The Working Classes Cost of Living Committee (Cd. 8980), 1918.
Also Greenwood, Hodson, and Tebb, Proc. Roy. Soc. B., Yol 91, 1919, p. 81.
26
Notes on Syllabus.
spent on drink there will be, say, 8s. only left for rent, fuel, clothes. &c.
There must, therefore, he a saving somewhere, and as the rent cannot be
reduced, it probably means that less will be spent on food and other neces¬
saries. So that quite apart from the direct effects of the drink on the
individual, the family will be under-nourished and insufficiently clothed.
No one can be healthy or efficient who is deprived of the actual necessaries
of life.
The evils of drinking too much are not limited to the man himself and
his family. He may also influence others to follow his bad example, and the
harm done by one man may thus be widespread. " One degraded or ill-
" conducted worker will demoralise a whole family; one disorderly family
" inexplicably lowers the conduct of a whole street; the low-caste life of a
" single street spreads its evil influence over the entire quarter; and the
" slum quarter .... subtly deteriorates the standard of health,
" morality and public spirit of the whole city."*
We must, therefore, consider the effects of intemperate habits on the
nation as well as on the individual. Money spent by the nation on drink
must be reckoned as money which is largely wasted, because .there is no
proper return for it. The expenditure of £400,000,000 or more in a year is
a drain on the resources of the nation and the direct cause of not a little
national poverty.
(6) Prevention of the Evils arising from Alcoholic Excess.
Whilst these facts demonstrate the grave evils which may arise from the
drinking of alcoholic beverages to excess—and it must be remembered
that unsober nations have to compete with sober nations—they do not prove
that the moderate use of such articles always does harm, though it is
obvious that for many persons the only certain way of avoiding all risk is
to abstain altogether from the consumption of alcohol. Some States have
for this reason sought to prohibit the consumption of alcohol; others have
sought to restrict its use by law or regulation (temporarily or permanently).
During the European war, restrictions were introduced into most areas of
Great Britain with the result that there was a remarkable decline in
(a) convictions for drunkenness (by 85 per cent.);
(b) cases of delirium tremens ;
(c) deaths from alcoholism, f
Thus the remedy for the evils of alcoholic excess rests partly with the
individual and partly with the State Further, both in the individual and
in the community the habit of consuming alcohol is influenced by a great
variety of factors (faulty nutrition, bad housing, overcrowding, unsatisfac¬
tory industrial conditions, inadequate facilities for healthful recreation,
urbanisation, etc.). Thus the remedy is likewise complex and may consist
of a variety of social and political operations.
* The case for the Factory Acts (Grant Richards), 1901, by Mrs. Sidney Webb, p. 48.
f See also Fourth Report of the Liquor Control Board (H.M. Stationery Office,
price 3^.) 1918.
Printed under the authority of His Majesty's Stationery Office
By Eyre and Spottiswoode, Ltd., East Harding Street, E.C. 4,
Printers to the King's most Excellent Majesty.