Review of: Etiology of Chronic Alcoholism. Edited by Oskar Diethelm, M.D. (Pp. 229+x. 50s.) Springfield, Illinois: Charles C. Thomas. Oxford: Blackwell Scientific Publications. 1955.
British Medical Journal, 8 December 1956, p. 1352.
With a foreword in rather general terms by Dr. Diethelm as editor, this book consists essentially of the accounts of four pieces of research-clinical, biochemical, genetical, and anthropological. Of these by far the most interesting is the biochemical. The clinical investigation, by Dr. M. J. Sherfey, shows no more than that the great majority of chronic alcoholics suffer from no well-defined and discrete psychiatric syndrome, though schizophrenics, manic-depressives, and others may be included in their number. The predominant abnormality is that of a psychoneurotic or psychopathic personality, so various in its forms that it defies any attempt at unified description.
The genetical investigation, in the expert hands of Professor Manfred Bleuler, showed marked similarities in findings in parallel series in New York and Zurich. There was no excess of major abnormalities, such as psychoses, in the other members of the families of these patients, though there was an excess of alcoholism. About a quarter of the patients themselves, Professor Bleuler thought, showed evidence of endocrinological abnormalities such as a tendency to hyperthyroidism. In a high proportion home backgrounds were disturbed and relationships with parents unsatisfactory. As parental attitudes are classified as "too strong," "too weak," "too distant," "ambitendent," or "overaccepting," it will cause little surprise that few parents could pass the high standard of normality set.
The anthropological study, by Dr. M. L. Barnett, is an interesting demonstration that the Chinese of New York's Chinatown are remarkably free from alcoholism. This is true even of the young, and is attributed to the persistence of " the fundamental expectations and obligations of Kwangtung culture," even though it is surrounded by the American way of life.
In the biochemical section Dr. Fleetwood demonstrates, by their effect on such preparations as rabbit duodenum, the occurrence of a nonadrenaline-like "anxiety substance," a cholinergic-like " tension substance," and a "resentment substance" in the blood of alcoholic and other psychiatric patients subjected to the appropriate emotions. The "tension substance" disappeared in alcoholics after the ingestion of alcohol, and was reduced in others. The "resentment substance,"which was higher in alcoholics than in others, was also significantly reduced after the administration of alcohol.