Alcoholism

ALCOHOLISM. -

I. MEDICINE

A morbid condition caused by the immoderate use of alcohol or spirituous beverages, in quantities sufficient to produce alcoholic intoxication. Wine is used more commonly (Italy and France), beer (Germany and England), and liqueurs (Scandinavia, Russia, and the U.S.A.); in these beverages ethyl alcohol ranges from 3–4% in beer to 60–70% in liqueurs. The central nervous system is especially affected, initially by an excitatory action, which is soon followed by a paralysing and narcotic one. In acute intoxication, if death does not occur, the damage may resolve; in chronic intoxication, lesions are established that are largely irreversible. Psychically, chronic a. produces the moral and intellectual deterioration of the individual, with characteristic alterations of the personality: weakening of memory, dulling of the moral sense, apathy with a marked reduction in working capacity. Polyneuritis develops (tremors,

ataxia, paralysis); chronic catarrhal conditions of the mucous membranes, especially of the gastric mucosa, with the classic « vomitus matutinus potatorum »; arteriosclerotic lesions; serious alterations in the most important organs of vegetative life: hepatic cirrhosis, renal sclerosis, degeneration of the myocardium, often causing premature death. Apoplexies are frequent (v.).

The most serious neuropsychic form is « delirium tremens » (motor over-excitation accompanied by a state of mental confusion and distressing auditory and visual hallucinations), which may be followed by death (10% of cases) or by a chronic demential state.

The high mortality and morbidity among the descendants of alcoholics is probably connected with the neuropsychic and somatic defects transmitted by the parents.

The most serious forms of chronic a. are caused by the abuse of liqueurs. In the countries most severely affected (England and the U.S.A.), 40% of psychoses and 80% of crimes are caused by alcohol; the offspring of those addicted to liqueurs are more seriously affected: epilepsy and other diseases of the central nervous system are frequent.

In Italy, where a. is less widespread than in other countries, it causes 8% of psychoses, and alcoholism appears as a personal antecedent in 36% of the mentally ill and as a family antecedent in 21%.

As to the question whether the small doses of diluted alcohol used as beverages (wine, beer) are harmful, one can answer with certainty in the negative, provided that the dose is not exceeded (approximately one gram of alcohol per kilogram of body weight in 24 hours).

The sense of euphoria accompanying the ingestion of alcohol conceals the damage caused by intoxication and lends support to the prejudices that recommend the use and abuse of alcoholic beverages. Similarly, its depressive action on intelligence is often masked by the apparent hyper-ideation connected with the tumult of ideas and images that it provokes in the brain, analogously to what occurs with other poisons (belladonna, opium, haschiach); hence the connection between alcoholism and poetic inspiration observed in certain subjects (Swift, Verlaine, Hoffmann).

BBL.: Royal Commission on liquor licensing Laws, Final Report, London 1899; L. Bianchi, Trattato di psichiatria, 2nd ed., Naples n. d.; E. Adami, Farmacologia e farmacoterapia, Milan 1942; U. Cerletti, Santi delle lezioni di malattia nervose e mentali, Rome 1946. Giuseppe de Nino

2. SOCIAL MORALITY

1) The harms of a. Alcohol was defined as the narcotic of consciousness because it alters or destroys the centres of inhibition and reflection. This accounts for the large number (reaching 40 and 50%) of persons rendered insane by a. and for its frequent and extremely close connection with crime, suicide, and industrial accidents. A. also diminishes resistance to disease, is a principal factor in prostitution and poverty, with the squandering of money and abandonment of family life, especially in proletarian milieus. The harms suffered by the individual are transmitted to the offspring: the alienist Mozel formulated a law concerning the descendants of alcoholics over four generations, finding among them the most serious forms of insanity and degeneration. Alcoholic intoxication at conception, during pregnancy, and during breast-feeding is of particular importance, since it gives rise to the greatest number of mental and nervous diseases (hysterics, epileptics, idiots, imbeciles). Statistical evidence includes the high number of military discharges on account of alcoholic heredity and the high number of long-lived persons among the temperate and abstinent. A., as a social disease, is fostered by industrial organization and urbanization, especially among factory workers; it is widely diffused among the prosperous classes of Anglo-Saxon countries.

2) The Church and the struggle against a. The Church cannot remain indifferent in the face of the physical and spiritual harms of a. Christianity affirms a duty of tempe-

temperance for all the faithful, regardless of the renunciations of ascetics. St. Paul exalts the intoxication produced by the Spirit of God over that produced by wine, and permits Timothy the moderate use of wine as a medicine. Among the pagans, too, there were condemnations of drunkenness and praises of abstinence. The laws of Lycurgus and the ideal laws of Plato and Aristotle prohibited wine to the young. The athlete was required to abstain from sexual intercourse and wine. But paganism could not see the problem in depth, because many of its divinities were devoted to wine, and sacred intoxication was celebrated in the rites of Dionysus and Bacchus. The Church, therefore—ever the teacher of temperance, accustomed to regard wine in the chaste holiness of the rite—found herself in the front line of the struggle against a. The first manifestations of private and state action occurred in non-Catholic countries, because the social phenomenon of a. appeared there before it did in Catholic countries, with the exception of Ireland. To the Irish Capuchin Fr. Theobald Mathew (1790-1850) (v.) is owed the foundation of the League of the Cross, a Catholic temperance society, the fruit and instrument of a remarkable apostolate begun in Ireland (1837) and continued in North America: he received five million pledges of sobriety and organized 90,000 abstainers. The campaign was followed by a 50 per cent decrease in criminal convictions and an 80 per cent decrease in death sentences. From its beginning to the present, the work of Fr. Mathew, which also spread to the United States and England, elicited the cooperation of Daniele O'Connel, Cardinals Manning, McCabre, Newman, Logne, Gibbons, and Vaughan. The importance of the Church’s campaign against alcoholism in the United States was confirmed by resolutions of the Councils of Baltimore (1840 and 1884) and of the Synod of Cincinnati. Catholic Germany had valiant apostles of the struggle against alcoholism from 1843 onward: the priest Seling, Msgr. Egger, and the leader of the Centre, Windthorst. The League of the Cross (for adults) and the Guardian Angel League (for children) flourished exceedingly. Catholic initiatives in Poland, Lithuania, Switzerland, and Belgium were also noteworthy. In France—as in Italy and Spain—the high consumption of wine is linked with the interests of national production, hence the difficulty of the campaign. The French National League against a. federates several associations, including two Catholic ones, the White Cross and the Golden Cross. Protestants have established powerful associations against alcoholism. In North America, the Order of Good Templars (1852), with branches in Europe; in Europe, the Blue Cross, widespread in Switzerland, Germany, Belgium, and France; the Salvation Army also participates in the campaign against alcoholism. Workers’ parties have often joined the campaign against alcoholism. The common basis of all these efforts is educational action (family, school, church, workshop), founded on example (“absolute abstinence from alcoholic beverages is the most effective means of struggle,” as one of the resolutions of the French and Italian anti-alcohol federations states) and supported by vigorous legislative action. To reasons of a moral, hygienic, and social nature, Catholics add the defense of the faith, because a. is closely connected with blasphemy, foul language, and vice.

3) A. in Italy and the campaign against alcoholism. Italy is among the countries where consumption of the most harmful alcoholic beverages is lowest, while wine is consumed there to the greatest extent, although it is the least harmful of alcoholic drinks. Awareness of the social dangers of a. emerged in Italy during the early years of the twentieth century. The attempts at an anti-alcoholic organization made by Dr. Clerici in Turin (1861) and by the Temperance Patronage in Milan (1882) were short-lived, though significant. An effective movement began in Florence with the periodical Bene sociale (1898) and the foundation of the Italian Anti-Alcoholic Federation at the National Congress against a., held in Venice in 1904. The initiative, neutral in character, received considerable support from the clergy and the laity. Catholic initiatives followed: the struggle against a. was one of the mainstays of the movement for public morality promoted in Turin (1899) by Prof. R. Bettazzi, who later founded (1912) the New Crusade—Italian Catholic Association against a.—which enjoyed rapid success and produced effective initiatives: good popular publications (G. Masi, A. Portaluppi, A. Giacomelli), a pastoral letter by Msgr. Marenco, bishop of Massa Carrara (1915), the establishment of groups of abstainers, young people, and priests, on the model of the young German Catholics, and of the Union of Sober Priests, established in Belgium under the patronage of Cardinal Mercier. A decree of Pius X (21 May 1914) granted indulgences to those enrolled in “societies known as societies of temperance, of abstinence from alcoholic beverages.” As for the guiding principles of action against a., they are summarized in the following declaration adopted by the national federations of France and Italy: a) Wine and beer are neither necessary nor useful to the healthy individual. Distilled beverages are always harmful. b) For the normal adult, the maximum daily quantity of wine, consumed exclusively with meals, does not exceed half a liter. c) Wine and alcoholic beverages are to be forbidden to children, adolescents, pregnant women, nursing mothers, and neuropaths. d) Absolute abstinence from alcoholic beverages is the most effective means of struggle against a.

5) Legislative provisions against a. It is unanimously recognized that the struggle against a. is strengthened first and foremost by spiritual and social means—education and a higher standard of living for the worker in the home and the workshop—which must, however, be supplemented by legislative action. The experience of a century and a half (the first legislative measures against a. in the United States date from 1868) has tested various measures, among which we recall: a) punishment of drunkards; b) internment of alcoholics; c) prohibition of giving alcoholic beverages to minors and drunkards; d) restrictions on their sale (in the number of outlets, in opening hours, etc.); e) the right to sell granted only to temperance societies; f) authorization for municipalities and autonomous public bodies to issue provisions against a.; g) the imposition of heavy taxes on production, manufacture, and sale; h) a state monopoly on manufacture and sale; i) prohibition of the trade and sale of absinthe and alcoholic beverages; l) anti-alcoholic instruction in schools, and measures against intemperate civil servants and workers.

Italian legislation—which made its first systematic statement in this field with the law of 19 June 1913—coordinated in the Consolidated Text of the Public Security Laws (18 June 1931) the various provisions governing the sale of alcoholic beverages. The Penal Code of 1930 contains relevant provisions in arts. 686-91 (Contraventions concerning the prevention of alcoholism and offenses committed in a state of drunkenness).

Of particular significance are the provisions against a. contained in the Law for the Protection and Assistance of Motherhood and Infancy.

6) A. in the colonies and in Africa. A. in colonial territories, and especially in Africa, gives rise to a serious social problem—analogous to that of narcotics—which concerns the Christian missions. The devastation caused by a. among peoples of color led to international measures agreed upon in the General Act of Berlin (29 February 1883) and in the General Act and Declaration of Brussels (2 July 1890). Against the infamous trade of rapacious speculators, import duties and prohibitions or restrictions on alcoholic beverages were established. These measures were strengthened by the international conventions of Saint-Germain (10 September 1909), in which Italy also participated. They are moreover connected with international action against slavery.

Per l'azione contro l'a.: I. Doogan, Manual of Temperance (Roman Cath. Temperance Society), Calcutta 1897; A. Bertillon, L'alcoolisme et les moyens de le combattre, Parigi 1904; A. Giacomelli, Il gran nemico, Treviso 1908; J. Witte, Die Alkoholfrage in religiöser Beleuchtung, Bonn 1910; A. Portaluppi, In faccia alla rovina, Legnano 1912; A. Cobelli, I pubblici esercizi nei provvedimenti per combattere l'a., Milano 1914; G. Masi, Fu bene l'alcool?, Torino 1914; A. Junod, L'alcoolisme chez les noirs africains, Ginevra 1930; A. Jamalio, s. V. in Nuovo Dip. Ital., I, Torino 1937, pp. 302-306. Egilberto Martire