The effect of alcohol on the circulation. Alcohol has been used extensively as a vasodilating agent - that is, one that "opens up" and increases the flow of circulation by widening the peripheral blood vessels on the body surfaces and extremities such as in the face, the hands, the legs and the feet. Through this vasodilation the rise in skin temperature after two ounces of whiskey is as great as 9° to 12° Fahrenheit. The florid face of the drinker, the red nose of the tippler, and the traditional method of "warming up" with a "few good ones under the belt" are well-known to all of us.
New drugs have been introduced for vasodilatation in the treatment of arteriosclerosis and atherosclerosis of the legs and feet and Buerger's disease, and I have prescribed many of them. These diseases often give rise in many individuals to severe pain or crippling effects (even gangrene) of the legs and feet, particularly if complicated by other illnesses such as diabetes or simply by advancing years. In my experience, none of these new drugs has matched the physiological effects on the peripheral circulation that alcohol gives. I have seen and helpfully treated with alcohol many sufferers from arteriosclerosis of the legs who were unable to walk and at times faced gangrene and amputation of the toes or feet. However, to be effective the alcohol must be given judiciously at frequent intervals, in the correct amounts and in combination with other vitamin and dietary supplements. This must be done in a manner best judged only by the physician, because of the frequently delicate balance in which the peripheral circulation is maintained. This varies from person to person. The factor of alcoholic addiction must be constantly kept in mind by physician, patient, and family. The needs of each individual case should be determined by the doctor and judged accordingly.
Alcohol can be used to improve circulation. Like many other doctors, I have found the use of alcohol in moderation to be an excellent means of improving the circulation. One patient of mine, Mr. J., is a 48-year-old successful advertising executive who is subject to an unusual amount of tension and harassment in his business. Mr. J. was getting severe attacks of angina (chest pain from poor circulation in the coronary arteries) every time he had lunch and supper. It was apparent that he had to eat in order to live, and yet he was afraid to eat for fear of dying-the anginal pain was so severe. After a loss of over 30 lbs. and a problem of underweight, 1 urged Mr. J. to take one brandy or whiskey before each meal and to have 2 glasses of wine at lunch and supper. This man had always been a teetotaler; he had a particular aversion to alcohol due to a childhood broken home caused by a drunken father. After much personal persuasion and great trepidations, Mr. J. tried the new "treatment." Miraculously, the pain disappeared. Normal weight was restored and a great change took place in Mr. J.'s personality. Clearly the alcohol had become an effective "tranquillizer." He was now much at ease, ate his food in a relaxed manner and enjoyed it, and the anginal pain had disappeared. This clearly showed how nervous tension blocks normal digestion and thus places a severe strain on the heart. One of my earliest series of experiments to demonstrate this occurred some 20 years ago. I called for a group of volunteers among my heart patients. Five of them volunteered for the experiment - two men and three women of courage and with interest in medical science. After two years of constant experimentation, I devised a series of balloons that could be swallowed and blown up in the stomach. At the same time, I constructed the balloons (made from ordinary toy balloons) so that I could measure and control the pressure in the stomach and record the movements of the stomach walls. In addition, I arranged matters so that I could simultaneously record the heart action by electrocardiograms.
For the first time it was possible to simulate indigestion and examine its effects on the heart. To my great surprise, I was able to measure all kinds of bad effects on the heart from distention in the stomach, a very common daily occurrence with many individuals. But to my consternation, in one of my volunteers, the effects on the heart distention were so dramatic that the heart suddenly stopped beating, and the patient fainted - as I almost did! We revived him quickly by releasing the "gas pressure" in the stomach, and of course the heart immediately resumed its normal beating. What a dramatic way to show how acute indigestion can and does kill a person! Fortunately, when the American Medical Association published the results of my research in its Journal, it stimulated further research in this field, such as that which showed how gallbladder conditions will also provoke heart symptoms and heart attacks. But even after reviving my courageous volunteer patient, a reviving drink of brandy did much to relax and improve his circulation - and mine too!
Moderation is the key. Now all this does not mean that I advocate "tippling" or addiction to alcohol. Alcohol should always be taken with discretion and in moderation. In most cases, "the man who is a drinker before 40 is either sick or a fool." And the man who doesn't take a drink after 40 may become either sick or foolish! There were many pathologists who believed that alcohol acted as a "solvent" in the arteries against cholesterol and the fatty deposits that make for arteriosclerosis and atherosclerosis. But to get the proper amount of alcohol in the blood stream to induce this ideal state would require a continuous alcohol bath in the arteries, or a "pickling" process, that not only would dissolve the cholesterol in the arteries, but would surely dissolve the liver first. This we see in the unfortunate victims of cirrhosis of the liver associated with alcoholism! So with alcohol, as with so many other things, follow the ancient Greek advice: "All things in moderation!"
Does alcohol in any way benefit the coronary arteries? Finally, we come to the possible benefits of alcohol on the coronary arteries. It was formerly thought that alcohol was beneficial in dilating the coronary arteries and that all patients with heart disease should drink alcohol regularly. Many patients found from experience that they had less heart pain, as from angina, if they took alcohol before and during meals and in between, as often as feasible. Repeated and recent research has found that these results (from drinking moderate amounts of alcoholic beverages) in relieving chest pains due to heart conditions such as coronary artery disease, are not due to any improvement or dilation in the coronary circulation of the heart. The relief and improvement in pain was found to be due to two things: 1) the analgesic or "narcotic" pain-alleviating effect of alcohol which raises the threshold at which pain is felt, and 2) the ability of alcohol to allay worry and anxiety and induce psychic as well as physical relaxation. This also tends to raise the threshold of pain tolerance. The analgesic quality of alcohol has an element of risk involved. Some heart patients may overexert or strain their hearts while under the influence of the alcohol, since it may have removed Nature's warning signal - pain! One of my patients, Mr. N., when he first consulted me regarding his anginal pains following his coronary attack, insisted that a few highballs before his lunch and his supper diminished the number and severity of his attacks of angina. His wife, who accompanied him to my office, turned to me and said, "But Doctor, I keep telling Jim that ever since he started taking these highballs, he falls asleep after his meals, and is quite groggy even when he awakens from his *naps* And since he loves to smoke his pipe right after meals, he has already set himself on fire several times when falling asleep! I really think he gets 'drugged* after his highballs. Don't you?"
Mrs. N. puts her finger precisely on the diagnostic spot. Mr. N., it was true, felt less pain after his drinks. But in Mrs. N.'s words, it was an abnormal or 'drugged' kind of relief. It came as a result of the narcotic action of alcohol in deadening his pain, and stupefying his senses. It actually did nothing in any way to improve or relieve the strain on his heart.
Alcohol can relax tension in heart cases. On the whole, however, I find that alcohol, when used wisely, is helpful to most heart cases and is an excellent way to relax the tension that many heart patients consciously or unconsciously experience.
