Overview of the Evolving Recognition of the Health Effects of Excessive Alcohol Use Over the Past Two Centuries Including the Classic Citations

Abstract

The negative behavioral and social consequences of alcohol ingestion, particularly when done so in excess, have been recognized for thousands of years and have led to various types of prohibition imposed on religious, moral, or social grounds in nearly every society at one time or another. However, the relatively modern era of medicine has only more recently documented and investigated the adverse health effects of excessive alcohol consumption. Although the pathophysiological effects of alcohol on the liver and the brain are more widely recognized and have attracted much of the attention by physicians and scientists, alcohol abuse has a myriad of systemic targets including the lung. In fact, it has been recognized for more than two centuries that alcohol abuse is a major risk factor for pneumonia. More recently, clinical observations have identified that alcoholics are at risk for much poorer outcomes if they develop certain pneumonias such as from Streptococcus pneumoniae. Further, even more recent epidemiological studies have identified that alcohol abuse significantly increases the risk of acute lung injury following acute insults such as sepsis or trauma. This chapter highlights some of the classic observations and discoveries of the relationship between alcohol use and lung disease over the past two centuries and sets the stage for the more detailed analyses and accounts of the current state of our knowledge of specific facets of this relationship in subsequent chapters.