Tests were made with sour and sweet wines, beer, brandy, and pure alcohol (diluted). The taking of alcoholic beverages with meals is a habit with many people. It is claimed by many people that a glass of wine, beer, or some mixture of alcohol taken before meals increases the appetite (and possibly the hunger). The writer is neither a total abstainer nor a habitual user of alcoholic beverages. But it is his experience , that a glass of beer taken at mealtime seems to awaken or increase J appetite. This effect is rather immediate and therefore not due solely to the absorption of the alcohol. Pavlov has recorded an instance from his own experience where a drink of wine seemed to j initiate the sensation of hunger the very minute the wine reached j the stomach. From inquiries as extensive as opportunities have permitted we are inclined to believe that this apparent augmentation of hunger or appetite by alcoholic beverages is rather a common experience. In view of this fact, we expected to find that these alcoholic beverages increased the tonus and the contractions of the empty stomach, since it is the tonus and the contractions of the empty stomach that give rise to the hunger sensation. To our\ surprise the results proved to be the very opposite. Wine, beer, J brandy, and pure alcohol (diluted) introduced directly into the stomach inhibit the hunger contractions and the tonus of the empty stomach instead of increasing them. This is true, whether these fluids are cold or at body temperature. If these alcoholic beverages are greatly diluted with water, a degree of dilution can be reached which has the same action on the empty stomach as equal quantities of water, although the specific beverage is readily detected when the mixture is placed in the mouth. In no instance have we been able to make out any undoubted augmentation of the stomach tonus and hunger contractions after the inhibition period. In other words, alcoholic beverages when introduced directly into the empty stomach in quantities and concentrations that directly affect the tonus and the contractions of the stomach * cause inhibition, and inhibition only. '
The pure alcohol was never used in stronger concentrations than 10 per cent. The brandy was usually diluted one-half with water, while the beer and wines were put in the stomach undiluted.
We have seen that acids in the stomach cause inhibition of the hunger contractions. Pure alcohol also causes inhibition. It is therefore evident that the alcohol and acids are primarily responsible for the inhibition following the introduction of alcoholic beverages into the empty stomach. For the sake of brevity we may designate it as " the alcohol inhibition."
The duration of the alcohol inhibition varies directly with the quantity and concentration of the beverage introduced into the stomach. Thus 50 to 100 c.c of 10 per cent alcohol may inhibit \ ^the hunger contractions for 1 to 2 hours; or if introduced during a period of relative quiescence it delays correspondingly the onset of the next hunger period. Inhibition for 30 to 60 minutes is caused by 200 c.c. of beer. The sour wines on the whole cause greater inhibition than the sweet wines, probably through their acids.
It must be stated that these alcoholic beverages were put into the stomach of Mr. V. and the other subjects, including the author, with their consent and without any protest, resentment, fear, or disgust on their part, which might account for the stomach inhibition. Mr. V. takes wine and beer occasionally. At times he bought his own choice of wine and beer and introduced into the stomach the desired quantities. The effect on the hunger contractions was always the same. We are therefore dealing with a characteristic alcohol and acid inhibition, and not with a masked "psychic" inhibition.
How are these results to be harmonized with the seeming stimulation of the appetite by alcoholic beverages taken by the mouth ?
In the first place, the local inhibitory action of alcoholic beverages in the gastric cavity is so marked and so invariable that we feel confident that this is always the gastric effect of these beverages in man, whether taken normally by the mouth or introduced into the empty stomach without coming in contact with the mouth or esophagus. Alcoholic beverages can therefore not initiate or increase hungery since hunger is caused by the stomach contractions, and these are inhibited by the alcohol. Since most of the alcoholic beverages stimulate the end organs of taste and smell as well as those of general sensibility in the mouth cavity and in the esophagus, it is possible that this stimulation in some way augments or initiates appetite for food. If this is the case, we have the singular condition of alcoholic beverages augmenting appetite and inhibiting hunger at the same time. There can be little doubt that cerebral states, as modified by training and habit, are also factors in this apparent action of alcoholic beverages on appetite. It is certain that the individual's first taste of alcohol, beer, or sour wines does not focus his attention on food and eating.
If alcoholic beverages in the stomach caused as marked inhibition of the stomach movements in digestion as they do in the stomach movements in hunger, even moderate drinking with meals would lead to acute indigestion. As this is not the case, it is evident that alcoholic beverages affect the mechanism of these two types of movements differently.