Medicine: Alcohol and Pneumonia

Early in this century Sir William Osier, patron saint of modern medicine, discovered that nearly 53% of pneumonia fatalities occurred among drunkards. Two years ago young Dr. Kenneth LeRoy Pickrell of Johns Hopkins Hospital, stimulated by Osier’s statistics, set out to learn the exact manner in which alcohol lowered resistance. Last week, after a score of different experiments on 175 rabbits, he reported in the Johns Hopkins Hospital Bulletin the first satisfactory explanation for this important pathological phenomenon.

All his experiments followed the same basic pattern: one group of rabbits was immunized with Type I antipneumococcus serum,* then half the group was stupefied with large doses of ethyl alcohol (or ether) that kept them under from three to 30 hours. Then the entire group received injections of Type I pneumococci. A second group of control animals was not immunized, but half that group was intoxicated and all were injected with the virulent germs, either in the flank or the lung.

Results: 1) The intoxicated or anesthetized rabbits, both immunized and non-immunized, showed no swelling or pus (indications of the activity of the body’s defense mechanisms) in the infected organs, and all died. 2) The non-intoxicated, immunized rabbits developed typical swelling and pus, which killed all bacteria within nine hours, and all got well. But even though inflammation developed after the intoxicated animals recovered from their drunken stupor, it did not save any of them if bacteria had run rampant even for so short a period as three hours. Dr. Pickrell did not determine the minimal amount of alcohol which would inhibit the body’s defense mechanisms.

More significant than these findings, however, were microscopic examinations of cells of freshly killed and newly dead rabbits. Ordinarily the leucocytes (white blood cells) which circulate aimlessly through the body, flow with great rapidity to a site of infection, where they envelop and absorb the invading bacteria. No leucocytes gathered to defend the intoxicated rabbits. Contrary to common medicalbelief, said Dr. Pickrell, alcohol does not paralyze the defensive leucocytes. Rather it prevents the blood vessels from dilating and makestheir walls impermeable, thus trapping the leucocytes and preventing their migration.

In conclusion Dr. Pickrell offered the following warning to doctors and drinkers: “If bacteria are aspirated (inhaled) into the lungs during alcoholic intoxication or … anesthesia, they will grow uninhibitedby the defenses of the body during the entire period of unconsciousness . . . regardless of the amount of immunity possessed bythe body. . . . They may easily become so numerous that inflammation developing after recovery of consciousness may be unable to overcome them.” Whether the popular habit of killing a cold with whiskey contributes to the pneumonia toll he did not say. Nor did he imply that the phrase “alcoholic intoxication” meant anything less than “dead drunk.”

*There are 32 types of pneumococci. Serums exist for all of them.