The effect of alcohol on the renal excretion of water and electrolyte.

That the ingestion of alcohol-containing beverages provokes an increased flow of urine was no doubt a matter of common observation even before Shakespeare commented upon it (1). However, the diuretic effect of alcohol is dismissed in recent textbooks (2, 3) with the statement that the increase in urinary output is largely due to the quantity of fluid imbibed with the alcohol. Although Simanowsky (4) in 1886 reported that a liter of beer provoked a greater diuretic response than a similar quantity of water, Raphael failed to confirm this a decade later (5). The matter then rested until 1910 when Mendel and Hilditch (6) administered a standardized daily diet to two volunteers and following several days of observation gave 16 ml. of 95 per cent alcohol with each meal and also at 10:30 a.m., 3:30 p.m. and 10:00 p.m., in each instance the alcohol being mixed with milk or water. There was no greater urine output on the alcohol than the control days. However, Miles (7) clearly demonstrated in 1922 that a single dose of 27.5 gm. of alcohol in 100 ml. of fluid definitely increased the flow of urine and similar observations are recorded in a number of studies reviewed in 1940 by Bruger (8). The diuresis has in general been ascribed to a direct action of alcohol on the kidney or its circulation. In 1938 Nicholson and Taylor (9) performed the first experiments in which excretion of electrolyte was studied in detail. They employed 136 to 161 gm. of alcohol ingested during a period of eight hours. The authors state that during the