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| Sunday, 3 October 2004 |
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Today is World Temperance Day : The need to shun the bottle by Aryadasa Ratnasinghe "Alcohol provokes the desire, but it takes away the performance. Much drink may be an equivocator with lechery." - William Shakespeare The World Temperance Day falls today. In response to the social evils caused by alcoholism, so widespread throughout the world, Temperance Societies were organised in most countries, firstly in the United States and then in the United Kingdom, and later other countries followed suit. An attempt was made to stop the manufacture and sale of alcoholic drinks in the US, authorised by the 18th Amendment to the Constitution (1919) and the Volstead Act (1920). But the prohibition was met with much resistance and generated a large bootlegging industry for the manufacture of illicit liquor (moonshine drinks) sold at cheap rate. Today, in Sri Lanka, 'kasippu' has a ready market, despite the long arms of the law, to cater to the needy. Alcohols are, generally, organic compounds having a hydroxyl function. Alcoholic drinks meant for human consumption contain ethanol (ethyl alcohol), a colourless liquid with a characteristic odour, mostly prepared by the fermentation of sugars. It is well-known for its intoxicating properties. As a challenge to the licit products (arrack, gin, brandy etc), the distillation of illicit brews began to raise its ugly head. Ethyl alcohol is the base for all intoxicating drinks. They fall into three groups, (i) wines, ciders, perry and other drinks in which the alcohol is produced by direct fermentation of their sugars by yeasts, (ii) malt liquors, such as beer and stout, where the starch of grain is converted into sugar by malting, and the sugar is then fermented into alcohol by the action of yeasts, and (iii) spirits distilled from malted liquors or wines. In Sri Lanka, toddy is the base for 'pol' arrack and molasses for 'gal' arrack. The strength of 'proof spirit' is 57 per cent by volume. In an average person, a concentration of alcohol in the blood of 0.15 per cent causes mild intoxication, 0.3 per cent causes definite drunkenness and partial loss of consciousness, and 0.6 per cent endangers life. Periodic bouts of acute alcoholism are called 'dipsomania'. Liquor gives rise to 'Dutch courage' (a factitious courage induced by drinking) to do anything unusual and exceptional. Alcohol cannot be stored in the body, but largely broken down in the liver, and to a lesser extent in the stomach and kidneys. A healthy person is capable of metabolising upto 180g of alcohol per day. In the liver cells, alcohol is converted into acetaldehyde, a highly toxic substance. Increased acetaldehyde production can cause great damage to the liver cells. Established cirrhosis cannot be cured, but its complications can be treated. Kidney failure in cirrhosis occurs due to decrease in the blood circulation to the kidneys. In the context of the liberalised policy of the government in the production, distribution and sale of intoxicants, and the easily available 'kasippu' without quality, it is imperative that people should be made aware of, through press and electronic media, the ill-effects of alcohol, especially on the liver, which is a large, unpaired gland with digestive functions. It secretes bile, facilitates the digestion and absorption of fats, and deals with the newly absorbed products of digestion. Medical hints Liver also manufactures the anticoagulant heparin and other plasma proteins, stores glycogen, fat, iron, copper and the vitamins A, D, E and K, detoxifies harmful substances, and plays a prominent role as a store house of food. Some medical hints are that it is dangerous to consume more than 60g of liquor a day. The interval between one drink and the other should not be short, and intermittent drinking is harmful to the liver. Occasional drinking is harmless (at least twice in a week). Injury to the liver depends on the volume and the duration of consumption. Drinking neat is not advised due to irritation of the throat. Usually, people who drink heavily do not eat much or nothing at all. From a health point of view, it is not a good habit. In the case of cirrhosis, fatty liver is the earliest sign of alcohol abuse. Large fat droplets appear in the liver cells, within a week of alcohol abuse, and the liver becomes enlarged. Loss of appetite, loose motions, retching or to strain as if to vomit, and stomach pain are some of the non-specific symptoms. Following abstinence from alcohol, this condition may resolve itself. Treatment is not necessary, unless advised by a doctor. The next stage of cirrhosis is alcoholic hepatitis (inflammation of the liver). This is a serious condition where medical treatment becomes necessary. The diseased person may develop jaundice, encephalopathy (an altered mental state) gastro-intestinal bleeding and ascites (collection of fluid in the abdominal cavity). Blood sugar level may drop leading to sudden death. With cirrhosis, the functional capacity of the liver is generally compromised. The victim may suffer from enlargement of his parotid glands, testicles atrophy, sexual performance diminishes, memory becomes poor, sleep is disturbed and he may develop hallucinations, tremor and convulsions. The combination of cirrhosis and alcoholic hepatitis is extremely serious and usually fatal. For a cirrhotic patient, complete abstinence from alcohol is the best approach to escape from the lethal disease. Bleeding from the oesophageal varices can be controlled by drugs or endoscopic injection or rubber band ligation. Those patients who vomit blood need urgent hospitalisation, blood transfusions and endoscopy to ascertain the liver damage. For consumption of liquor, the safe limit recommended by the Royal College of Physicians and the British Medical Association in UK is 4 units or less per day or 21 units or less per week. 1 unit equals 8g of alcohol, 10 ml of alcohol, half pint of beer (125 ml), a small glass of wine or a single shot of spirit (25 ml). The alcohol percentage of arrack is 40 per cent. A companion Some people cannot drink liquor alone and they want a companion, but there are others who drink alone, whenever they have the fancy for a drink, regardless of when and where. Some people have become so accustomed to drinks that they suffer from alcoholism or alcoholic toxification. As they get up from the bed in the morning, they must have a light drink to make them steady. They suffer from a nervous disorder that their hands shiver which they are unable to control otherwise. Habitual drinking is the greed for liquor from which they are unable to escape. Then there are the Alcoholics Anonymous who are a self-help group for alcoholics trying to stop drinking. Founded in the US in 1935, it consists of local groups where members (identified by first names only) meet to give each other support. If I remember correct, in Sri Lanka too there is such a group who are in the limelight. The process of distillation of spirituous liquor was not known to the natives of Sri Lanka. As for liquor, they only drank toddy. |
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