Committee on Problems of Alcohol: A Report of Its Activities From 1949 to 1955, the Research Work It Has Supported and the Place of This Work in the Field of Alcoholism (1956)

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-17- • It should be noted that the work of Dr. Diethelm's group has been done on privately hospitalized chronic alcoholics whose intellectual and educa- tional levels were far above the average for the general population. Dr. Bleuler contrasted his findings in the fifty patients of the Payne-Whitney group with those he had obtained on Swiss alcoholics with a considerably dif- ferent, generally Ipwer middle class;, tedkjj^Qugd,-.-\' •.^^\; •r:•i: :. *.....'.'.-r .; ;•• ••••;• k•0 ••• ". , . .M :;•;•? .i.::-'*"^'. '''.._''.• ;-:i .., t;:'' 'tK.--':-''v1-' . In the last section of the teook,' Dr. Bafnett described in an interesting manner the use and abuse of alcohol in New york.'a Chinatowiij, giving a good deal of background information: on Chinese cvilture and its interactions with .^American• oultute. ' Of especial!interest was the Chinese use of drinking.as a competitive phenomenon, at banquete'and parties., at•which they would 'try to get others drunk without becoming HBO themselves. A number of drinking "games" were used' to achieve this end. The man .who. withdrew from this competition was not ridiculed, but would' admit by implication that he could not hold his liquor as well as his challenger. However, the man who became intoxicated would be subjected to considerable disgrace and.r/ididule from,thegroup, ( . -.. • • "* f'f».';**;* :*".'.'' i •"•'•'•' * ' , The Cantonese culture placed a far greater stigma on drunkenness than did the American culture, with apparent resultant reduction In the incidence of chronic alcoholism* The Cantonese clannishness and their strong need to conceal anything so disgraceful as alcoholism from outside eyes made any-valid estimate of the real prevalence of chronic .alcoholism impossible, however, «.I:-.:••«•'*'• •\t'...".. ..ft.i -.•-•' '..,"'•'•:•:.. •' •'•'M'!i: :i''.'.v..•..>!*• \tfll>-COMPLICATIONS OF CHRONJC ALCOHOLISM '.'.•. ..,,, .r : " . . .'..••..•' ,: • •'; • - ';• :' . -., .' •.•-.T --1 • • : . .' .. . . • ; ; ' . : ; ..•.'.• j . » X *' ; * • ..,. Ur. S; tfellov of. IthetState Itoiversity of,New:•iork at:^rra6use has been studying the causation of one of the most important complications of chronic alcoholism, cirrhosis of the liver. It had been generally assumed .in recent years that all the complications of chronic alopholism - cirrhosis of the • liver, delirium tremenap. nerve paralyses, et cetera - ware due to the vitamin deficiencies so oomuionly found'in chronic alcoholics. This concept.has recently been shaken in the case of delirium tremens by the work of Dr. H. Isbell (17) of the Drug Addiction Research Unit at Lexington, Kentucky, who has demon- • strated that ddllrivjm tremens oo\ild occur in fvplunteer subjects'^ who have been kept on a constant high level of alcohol consumption, when the alcohol was withdrawn. This could occur despite'thb fact that these subjects were, kept on high doses of vitamins throughout the entire ..experiment. ' '.^ / .' *.! :'•;-•' Dr. Mall6v (27) has .been currently studying in rats the effects''' of. ^alco- hol substituted calorie for calorie for some of the carbohydrate in their standard diet. He lias found that these alcohol-fed rats would develop fatty livers (which is believed but not proven to be the beginning stage of cir- ., rhosis of the liver) on diets which should be quite adequate in all necessary vitamins. A deficiency in-.-choline, a vitamin-like substance, would also pro- duce fatty liver. Ch^line appears to be neceissary ffor the proper metabolism of fat*. It may be, as', suggested by Dr. Westerfeld of our Committee^ that . alcohol is metabolized .in many ways more like a fat than like a carbohydrate and may therefore increase the amount of choiine needed by the body.. This hypothesis is partially confirmed by Drl Ijfallbv's finding that this action of alcohol in producing a fatty liver in the rat could l;e counteracted by giving, large supplementary doses of choiine, • r?! t; . • .••.;• ••:"• '.' i . ; .r • . . ,i • '..'*'*•