Changes in hormonal (insulin, glucagon, cortisol and growth hormone), glucose and FFA levels in blood were studied in four young, normal subjects during, and following, alcohol infusion after 12 hours' fasting. Similar studies were made during and after saline infusions in the same subjects after a comparable period of fasting. At the end of the infusions of alcohol or saline an arginine test was performed in order to compare insular and pituitary responses. The same investigations were performed in another three young, healthy subjects after 36 hours' fasting. A chronic alcoholic suffering from hypoglycemia was studied after a 12 hours' fast when he was first seen and again nine months after alcohol withdrawal. The results are in keeping with the hypothesis that alcohol has a priming effect on islet alpha and beta cells when there is no substrate defect. When glycogen stores are exhausted hypoglycemia ensues. An adrenergic reaction supervenes and consequently FFA, cortisol and glucagon rise to high levels. The growth-hormone response to an arginine stimulus was lower after alcohol than after saline in all subjects. In the chronic alcoholic patient the plasma growth-hormone response was initially very poor to all of the stimuli, but after nine months' alcohol withdrawal pituitary activity had returned to normal.
