In this volume, the third of our series, the emphasis has shifted from
the theoretical and experimental to the more clinical and practical
aspects of alcoholism. Where, in the earlier volumes, more attention was
directed to animal than human studies, in this volume, almost all
material deals with the human condition. The clinical manifestations of
alcoholism may be divided into two major aspects, that of the disease
itself and that of its complications. This separation is to some extent
artificial since, in a sense, the natural history of the disease is a
function of the development of certain complicating mechanisms. These
mechanisms in turn either become part and parcel of the underlying
condition -alcoholism-or give rise to a new set of clinical variables
characterized as "medical complications. " At this point, the dichotomy
becomes real. The disease alcoholism tends to be seen as a distinct
psychosocial entity and to be treated with psychosocial techniques. The
"medical complications" are more clearly envisioned as being within the
legitimate domain of medical practice and are treated by physicians who
often tend to ignore the underlying alcoholism. The "patient" is
sometimes lost in between. The major thrust of this volume is an attempt
to describe the mechanisms of alcoholism as they are now known, in such
a way as to establish a continuum between the disease alcoholism and its
"medical complications.