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Cornell University 
 Library 
 
 The original of tinis book is in 
 the Cornell University Library. 
 
 There are no known copyright restrictions in 
 the United States on the use of the text. 
 
 http://www.archive.org/details/cu31924030306272 
 
SHALL WE DRINK WINE? 
 
 A PHYSICIAN'S STUDY 
 
 OF 
 
 THE ALCOHOL QUESTION 
 
 BY 
 
 Dr. Jno. Madden 
 
 Professor of PHYsroLOGV in The Wisconsin College of 
 Physicians and Surgeons 
 
 The more concentrated the alcoholic liquor invested, the more intense the infiam- 
 matioit of tissue. At the same time an equal quantity of the potable alcohols 
 will sooner exhibit their characteristic symptoms if largely diluted with water," 
 
 — Dujardin-Beaumet^ and Audtge. 
 
 " Nothing, from the physician s standpoint, is falser than to think that the evil 
 influence of alcohol is lessened through the increased substitution of beer for the 
 stronger alcoholic drinks," — Dr, Adolph von Struempell, 
 
 MILWAUKEE 
 
 PRESS OF OWEN & WEIHBRECHT CO. 
 1899 
 
^'^Qb«^'3> 
 
 Copyrighted by the Author. 
 1899. 
 
 /^M. 
 
PREFACE. 
 
 In the preparation of this essay, the writer acknowledges no 
 motive but to discover the truth, and to put it in such form that it 
 might be comprehended by the ordinary reader. As to the facts herein 
 set forth, they are the result of the laborious, painstaking investiga- 
 tions of capable, conscientious, dispassionate men, and they rest upon 
 the sound basis of experimental evidence. As to what may be the 
 degree of perspicuity in which they are set forth, the reader must 
 judge. 
 
 As to the importance of the alcohol question, there can be only 
 one opinion. How long can we continue to increase the per capita 
 consumption of alcohol at the rate of seventy per cent, every twenty 
 years before it becomes evident to the slowest of comprehension that 
 something must be done to save civilized races from annihilation ? 
 The writer believes, too, that it is the province of the physician more 
 than the moralist, more than the philanthropist, and certainly as much 
 as the statesman, to do what he may for the suppression of alcohol. 
 This essay is, therefore, written certainly as much for the physician 
 as for the intelligent layman. 
 
 In closing, the writer wishes to acknowledge the encouragement he 
 has received from members of the medical profession, and especially 
 the courtesy of Dr. A. Smith of Baden, who kindly permitted the use 
 of much material from his valuable work. 
 
 jno. madden. 
 
 32 & 33 Sentinel Building, 
 Milwaukee, May 3, 1899. 
 
CONTENTS. 
 
 Pagt. 
 
 I. HISTORICAL, 9 
 
 11. THE CONSTITUENTS OF ALCOHOLIC BEVERAGES, 29 
 
 III. THE FOOD VALUE OF ALCOHOLIC BEVERAGES, . 38 
 
 IV. ALCOHOL AS A STIMULANT, 48 
 
 V. THE EFFECTS OF ALCOHOL UPON DIGESTION AND 
 
 ASSIMILATION, . 66 
 
 VI. THE GENERAL PATHOLOGY OF ALCOHOLISM, 74 
 
 VII. ALCOHOLIC HEART DISEASES, 83 
 
 VIII. ALCOHOLIC IRRITATION OF OTHER ORGANS, 89 
 
 IX. EFFECTS OF ALCOHOL UPON NERVE TISSUE, 91 
 
 X. THE INFLUENCE OF ALCOHOL UPON EMBRYONIC 
 
 TISSUE AND HEREDITY, . . 102 
 
CONTENTS— CONTINUED. 
 
 Page. 
 XI. ALCOHOL AS A FACTOR IN THE PRODUCTION OF 
 
 INSANITY, . 117 
 
 XII. THE ATTITUDE OF THE MEDICAL PROFESSION 
 
 TOWARD ALCOHOL, . 128 
 
 XIII. WHO BECOME DRUNKARDS AND WHY ? 139 
 
 XIV. WHAT IS INEBRIETY? . 141 
 XV. INTERMITTENT OR PERIODIC INEBRIETY, 144 
 
 XVI. CONSTANT OR HABITUAL INEBRIETY, 151 
 
 XVII. POPULAR FALLACIES REGARDING ALCOHOLIC BEVER- 
 AGES, . 158 
 
 XVlll. SHALL THE PHYSICIAN CEASE TO PRESCRIBE ALCOHOL? 174 
 
 XIX. EFFECTS OF ALCOHOL UPON CIVILIZATION, . 176 
 
 XX. WHAT IS THE BEST MEANS OF COMBATING THE 
 
 ALCOHOL EVIL ? 202 
 
TO 
 
 DR. N. S. DARLING, 
 
 OF LA PORTE, INDIANA, 
 
 whose abstemious, active, useful life is crowned, in age, by 
 
 a vigourous body and mind, this essay is 
 
 affectionately dedicated. 
 
SHALL WE DRINK WINE? 
 
 A PHYSICIAN'S STUDY OF 
 THE ALCOHOL QUESTION. 
 
 I. 
 
 RtBtortcal. 
 
 The use of beverages containing alcohol is as old as 
 civilization itself. In the countries of the East the mention 
 of wine occurs in their earliest legends, and these give it a 
 sacred character, attributing its origin to the Gods — Dio- 
 nysus in Greece and Osiris in Egypt. The Hebrews cred- 
 ited its discovery to Noah, "The second father of the 
 human race." Frequent mention of it is made in the 
 hterature of the Old Testament, where wine with corn and 
 oil seem to be regarded as the choicest gifts of the soil 
 and the highest achievement of ancient husbandry. Indeed, 
 to produce wine in those times was an evidence of greater 
 social stability than generally prevailed, for those ancient 
 peoples generally lived and moved with their flocks and 
 herds, remaining in one place only long enough to make 
 one crop of corn. Those engaged in viticulture, however, 
 oould not be nomadic but must remain in one place to 
 await the growth of their vineyards and the maturing of 
 their wines. Hence they must have had the power to resist 
 the encroachments of the universally warring tribes in 
 order to have retained their vineyards and wine presses. 
 Thus the making of wine was an index of a more powerful 
 and stable civilization. Indeed, the cultivation of the olive 
 
10 SHALL WE DRINK WINE ? 
 
 and the vine required a so much higher order of civiliza- 
 tion than the raising of herds and corn that the vine and 
 olive became, with these ancient peoples, symbols of refine- 
 ment and culture. 
 
 There is evidence that the art of vvinemaking originated 
 in Armenia and other nearby localities of the East. From 
 thence it spread westward gaining importance with the 
 growth of civilization and commerce; and, while it had no 
 place in the oldest Roman husbandry and was not used in 
 the oldest Roman ritual, in the time of the Republic it had 
 reached an important place in commerce; for it was arti- 
 ficially fostered by laws prohibiting the importation of for- 
 eign wines into Italy. 
 
 Probably scarcely less ancient than the making of wine 
 from the juice of the grape is the making of an alcoholic 
 drink by the fermentation of grains, notably of barley. 
 Many hundred years before the Christian era the Egyptians 
 practiced the art of brewing, afterwards it was done by 
 the Greeks and Romans and ancient Gauls, from which 
 peoples it has been handed down through intermediate 
 generations to the present time. Herodotus writing about 
 450 years B. C. tells us that the Egyptians having no 
 vines made wine from corn. It is probable, however, that 
 the Egyptians were acquainted with the making of wine as 
 well as the art of brewing; for the lands of the Egyptians 
 were fertile and well adapted to raising the vine. Further- 
 more, the grape is mentioned so often liy biblical writers, 
 and was elsewhere so abundant, that the historian may not 
 have been fully acquainted with the productions of that 
 fertile country. Pliny also tells us of the Egyptians mak- 
 ing wine from corn, and to this he gives the name of 
 "Zythum" which is the Greek equivalent for a drink 
 made from barley. Hellanicus, mentioning that wine was 
 introduced at Plinthium, an Egyptian city, says, "From 
 
HISTORICAL. 11 
 
 this source the Egyptians are thought to have derived their 
 love for and use of liquor which they think so necessary 
 for the human bodies that they made a wine from barley." 
 The Greeks who received a great part of their civilization 
 from the Egyptians, obtained from tJiem also their knowl- 
 edge of making alcoholic drinks from artificial fermenta- 
 tion of barley, in short, the process of brewing. Indeed 
 in the writings of Archilocus, the Parian poet, we find 
 that the Greeks of this day were already acquainted with 
 the art of brewing. This was about 70D years B. C. 
 
 Again, from Aeschylus, 470 B. C., Sophocles, 420 B. 
 C, and Theophrastus, 300 B. C, we also learn that the 
 Greeks used a wine made from barley, not only for festive 
 and ceremonial occasions, but also in daily life. There- 
 fore, there is little doubt that the use of beer as a beverage 
 is nearly as ancient as that of wine itself. Xenophon in an 
 account 400 years B. C. in which he speaks of the retreat 
 of the ten thousand Greeks, tells us that the inhabitants 
 of Armenia used a drink made from barley. Dioscorides 
 says that the Galatians also prepared a beverage by fer- 
 menting barley, like the Egyptians. Dioscorides makes 
 mention of two kinds of beer but does not describe them 
 sufficiently to enable a distinction to be made. He says 
 that both were made from barley and that liquors of a 
 similar nature were made in Spain and Britain from wheat. 
 During the life of Tacitus, which was in the first century 
 of the Christian era, in describing manners and customs 
 of the Germans, he says that their usual beverage was beer 
 and, though his description has many imperfections, there 
 can be no doubt that they understood the method of mak- 
 ing barley malt. The Germans not only made beer in 
 abundance, but drank it freely. In Spain beer was used 
 under the name of celia and ceria, and in Gaul under the 
 name of cerevisia (Pliny's natural history, chapter XXII, 
 
12 SHALL WE DRINK WINE ? 
 
 page 82). Speaking further of the use of intoxicating 
 drinks, PHny says, "The natives who inhabit the west of 
 Europe have a Hquor by which they intoxicate themselves 
 made from corn and water. The manner of making this 
 hquid is somewhat dififerent in Gaul, Spain and other coun- 
 tries, and it is called by different names, but its nature and 
 properties are everywhere the same. The people in Spain 
 particularly brew this liquor so well that it will keep good a 
 long time. So exquisite is the cunning of mankind in 
 gratifying their vicious appetites that they thus invent 
 a method to make water itself produce intoxication." 
 
 The Romans are supposed to have introduced the art 
 of malting into Britain. It is evident from Virgil that 
 barley was known to the Romans for he speaks of it in 
 the plural form, "Hordea." Pliny tells of the Hordearii 
 Gladiatores, a kind of fencer, whose chief food was barley. 
 The ordinary beverage of a soldier under Caesar was 
 vinegar and beer. The former was very strong and was 
 drunk diluted with water when on the march. Beer being 
 so easily produced with an agricultural people with whom 
 corn was plenty, and so suitable to the climate, it soon 
 became a natural beverage. Before this time ordinary 
 drinks of the ancient Britains were water, milk, and mead. 
 The latter was a fermented drink made from honey. After 
 the Romans were driven out from Britain the Saxons in- 
 vaded the island, subdued its people, and from them 
 learned the art of brewing. Various other savage peoples 
 have made and are making beverages by malting different 
 kinds of grain, or by fermenting natural fluids which con- 
 tain sugar. Thus the Kaffir races of South Africa have, 
 from remote ages made, and are still making, a beer by 
 malting the seed of a variety of Millet (Sorghum Vulgare). 
 Natives of Nubia, Abyssinia and other parts of Africa 
 also make an intoxicating drink by treating the seeds of 
 
HISTORICAL. 13 
 
 the Poa, a kind of grass. Beverages have also been made 
 from the juice of the palm, cactus, the sap of the maple, 
 spruce fir, birch, and ash, the juice of the aloe and many 
 other fluids. Indeed, there seems to be scarcely any sub- 
 stance yielding a juice containing sugar that has not been 
 made to produce an alcoholic beverage by some primitive 
 people to whom it was easily accessible. 
 
 *One of the most interesting subjects in medicine 
 is the narcotic addiction of savage or semi-savage peoples. 
 The making of alcoholic beverages preceded the white 
 man's invasion of the countries of both hemispheres. The 
 Indians of the Americas, the negroes of many parts of 
 Africa, especially equatorial Africa, and the Malays of the 
 islands of the Pacific, all had native beverages made by 
 subjecting the sugar laden juices of certain plants, or a 
 watery mixture of certain malted grains, to alcoholic fer- 
 mentation. 
 
 In Central America and Peru Atolle and Chicha were 
 made by malting maize flour, and in Mexico Pulque was 
 made from the agave and also from the cocoa bean. An- 
 other drink called Chocolatl was made from the ripe cocoa- 
 bean, which was first ground into a fine flour or meal. 
 Next this drink was also fermented, we have reason to 
 believe, for we read that the jugs of Chocolatl "with the 
 froth still on them were never lacking when Montezuma 
 made a meal." 
 
 The Chicha of the Peruvians, which may also have 
 been used by the Mexicans, was made like beer from 
 malted Indian corn. Narcotic herbs were sometimes 
 added to it, after which it was called Sora, and the drinking 
 of it was forbidden to many classes, especially the nobles 
 and warriors. Drunkenness among the peoples of the old 
 American Empires was widespread. Some Spanish writers 
 
 *See Prof. Friedrlch Ratzel's " Voelkerkunde." or "History of Mankind." 
 
14 SHALL WE DRINK WINE? 
 
 attribute their early downfall to this cause, Peru especially. 
 The Peruvians are said to have made themselves drunk 
 with Chicha before entering battle with their enemies, but 
 that instead of bringing victory brought demoralization. 
 The early missionaries saw the evils wrought by Chicha in 
 Peru and Pulque in Mexico and Yucatan and did what 
 was possible to restrict their use. Finally the use of 
 Pulque at the festivals of the gods was prohibited by law. 
 The Peruvians celebrated a festival of the summer solstice 
 during which even natives of low birth were permitted to 
 get drunk on this maize beer, and "the days during which 
 the festival lasted seem not to have been surpassed in wild 
 debauchery by what took place in the temples of Ash- 
 taroth and Hathor." The corn beer was made by the 
 virgins of the sun, and was a noble offering. The first 
 offering was made to the rising sun himself, and carried 
 into his temple by pipes; "then the Inca drank to his 
 ancestors, to the mummies in whom the sun-god had been 
 incarnate, and lastly it was put at the disposal of the 
 people." 
 
 The forest Indians of Central and South America also 
 had their intoxicating drinks even before the discovery 
 of America. These they made of Indian corn, cassava 
 bread, the fruits of palms, and bananas. Still there were 
 a great many tribes, especially in the southern part of 
 South America, which drank only water and chewed the 
 juicy stalks of plants. In Guiana pieces of cassava are 
 put into a vessel and boiling water poured over them. 
 When it is cooled, women chew it and stir it until it 
 reaches the consistence of a thick porridge. It is then 
 put into a long trough made from the stem of a hollow 
 tree and water added, when it is allowed to ferment, the 
 ptyalin of the saliva contributing to this result. When 
 fermentation takes place it is strained through a reed 
 
HISTORICAL. 15 
 
 sieve and bottled in gourds. The process is like that of 
 preparing Kava in Oceania, and the finished drink is 
 called Paiwari. It is yellowish brown in color and tastes 
 like sour beer. In contains sufficient quantity of alcohol 
 to intoxicate, and the Indian who attends a Paiwari feast 
 is pretty sure to get drunk. The ordinary drink of the 
 villages is unfermented Paiwari. A good deal of cere- 
 mony attends the preparation of Paiwari, as is the case 
 with Kava in Oceania. Sugar-cane wine and another 
 intoxicating fluid from a mixture of sweet potatoes and 
 molasses are made by these people. In the latter fer- 
 mentation is set up by the addition of chewed grains of 
 maize, the latter acting as a yeast. 
 
 The inhabitants of the mountain regions of Colombia 
 and Ecuador make a drink from fermentated watery solu- 
 tions of raw sugar, which they call Guarapo. To this 
 they add the juice of a small aromatic citron, giving the 
 mixture a flavor not unlike that of lemonade. It is also 
 drunk before fermentation sets in; it is then called 
 "regular" to distinguish it from the other, which is called 
 "bravo." A similar drink is made by chewing pieces of 
 sugar-cane and spitting them into a calabash, and bot- 
 tling the juice in a gourd, where it is allowed to ferment. 
 The drink thus prepared is strongly alcoholic and intoxi- 
 cating in small quantities. 
 
 Though the great tribes of central and northern North 
 America had the sap of the sugar maple, birch, and 
 sugar pine, and though they made quantities of sugar 
 and were fond of it, they do not seem to have stumbled 
 upon the process of fermentation. Not because they dis- 
 hked alcohol, surely; for the Indian has always suffered 
 great demoralization when he permitted his appetite to be 
 gratified with the white man's intoxicants. Neither is 
 there any evidence that the tribes inhabiting the cold 
 
16 SHALL WE DRINK WINE? 
 
 regions of the southern part of South America have any 
 alcoholic liquors. 
 
 Nearly all the negro tribes made an intoxicating drink 
 of some kind, beer made from millet or Indian corn 
 being the most common. They not only made the 
 beverages but drank them to excess. Drunkenness among 
 them was quite general, according to Wissmann, who 
 advised travelers who intended to transact business with 
 them to see them in the morning before the great daily 
 drunk began. Beer of this kind was made both north 
 and south of the equator, while in the equatorial regions 
 there was an abundance of palm and banana wine. The 
 Hottentots were an exception, and had no native alcoholic 
 drink. 
 
 Among the Australians, the inhabitants of New South 
 Wales made a drink from honey by a process of fer- 
 mentation; but this seems to be the only native alcoholic 
 drink among the people of the island. 
 
 The natives of the Samoan and other Pacific islands 
 make fermented drinks from starch bearing plants and 
 the juice of the palm. The Malays largely use a wine 
 made from the palm and also a slightly alcoholic drink 
 made from malted rice and the fermented juice of sugar- 
 cane. The Chinwans of Formosa brew a beer from rice 
 or millet, fermentation being set up by rice meal which 
 has been chewed by an old woman. In Borneo and 
 Sumatra, however, the staple drinks are cocoa-nut milk 
 and watei. 
 
 That alcoholic excesses prevailed among the people 
 of the earliest civilizations, history furnishes abundant 
 evidence. The history of later times contains much that 
 is more definite concerning the demoralization wrought 
 by the immoderate consumption of alcohol ; and no people, 
 
HISTORICAL. 17 
 
 perhaps, suffered so much in this respect as the Germans. 
 
 Of drunkenness among Germans in the early centuries 
 much has been written. "In order to still their hunger," 
 wrote Tacitvis, "the Germans need no fine preparations, 
 nor do they care for delicacies. In their drinking, on 
 the contrary, they do not show the same moderation. 
 Should one undertake to satisfy their love for drink and 
 furnish as much as they desire, he would find it easier 
 to conquer them through their vice than by the sword." 
 Also Venantius Fortunatus, Bishop of Portiers, thus 
 describes a company of drinking gentlemen which he 
 met on a journey to the Rhine and Moselle Country; 
 "Singers sang and accompanied their songs with music 
 on the harp, while around sat the listeners furiously drink- 
 ing from large pitchers of maple wood. They drank each 
 others health or for a wager; and any one who refused 
 to take part in their debauches was considered an ass. 
 One should consider himself lucky," continues the bishop, 
 "to be alive after such a drinking bout." (Kurze Ge- 
 schichte der Trinksitten; Dr. William Bode.) These 
 drank wine and this condition of excessive drinking had 
 then a long time persisted. We read that the German 
 Emperor, before his coronation in Rome, was asked "Wilt 
 thou, with God's help, keep thyself sober?" And only after 
 the question received an affirmative answer did he receive 
 the crown. 
 
 "Clergymen on the one side, and the gentry, judges, 
 and soldiers on the other were often given to drunkenness," 
 says Dr. Bode. The common people drank when they 
 could obtain the means to purchase the intoxicating 
 drinks; but the leisure classes above mentioned were about 
 the only ones who could afford, at this time, the luxury 
 of continuous drunkenness. 
 
 And wine and beer were held in high estimation. It 
 
18 SHALL WE DRINK WINE ? 
 
 is related that Rudolph of Hapsburg, after receiving a 
 drink of beer, much to his Hking, from a burgher of 
 Erfurt, rushed into the street waving the empty mug and 
 shouting "Well in! well in! A good beer is that made 
 by Herr Sifried of Bustade!" ("Wol in! Wol in! Ein gut 
 bier das hat Herr Sifried uf gethan.") To be able to stand 
 a good drunk was regarded as proof of a noble descent. 
 Among the Hohenlohe vassals there was an old German 
 custom requiring any one put to the test to drain the 
 great feudal cup (Lehenbecher), which held a quart of 
 beer, at a single draught, as proof of his fitness to serve 
 the King. A similar custom ruled among the Alvensleben 
 and other feudal peoples. 
 
 Things were scarcely better in the Monasteries, where 
 the monks busied themselves with wine and beer making, 
 in which they became famous. Frequent and excessive 
 drinking was the result. In the French Cloisters matters 
 were just as bad. In the famous correspondence between 
 Abelard and Heloise, the latter complains of the evils of 
 intemperate wine drinking. It pained her to see so much 
 drunkenness and coarseness at the table. She quoted 
 much from the scriptures and from the holy fathers of 
 the church against wine drinking. Especially did she 
 quote St. Benedict who says that wine is not a fit drink 
 for monks. Still she could not think it right to have it 
 completely forbidden to the nuns; because humanity had 
 become so weakened and degenerated that they can no 
 longer reach their ideals without some artificial aid. "It 
 appears," she declared^ "as though the world had grown 
 old and that humanity had lost its original freshness of 
 youth, as though according to the Word, Truth and Love 
 had grown cold, not in many, but in all breasts. Since 
 mankind has changed, the customs regulating human con- 
 duct should be changed or their rudeness moderated." 
 
HISTORICAL. 19 
 
 Abelard agreed with his friend. He thought that the nuns 
 should either abstain entirely or have their wine mixed 
 with water, one part of water with three of wine. Neither 
 would he forbid drinking to satiety or an amount sufficient 
 to satisfy without producing drunkenness; for "it is not 
 satiety which is a sin but intemperance." 
 
 We also learn that in the Celebrated Cloister of St. Gaul 
 in the tenth century, every monk daily received five quarts 
 of beer besides wine in considerable quantity. In North 
 Germany, also, intemperance was a greater evil than in 
 the south. 
 
 Not, however, until the end of the middle ages did 
 the drinking of alcoholic liquors become a national danger 
 in Germany. As important cities arose and developed in 
 North Germany, beer making became a recognized art and 
 breweries sprang up in Einbeck, Braunschweig, Goslar, 
 Hamburg, Merseburg, Luebeck, Danzig, Erfurt, Torgau 
 and other places. There arose, indeed, as Dr. Bode says, a 
 genuine "Beer Cultus" which reached its highest point 
 in the sixteenth centurj'. A learned Dr. Placotomas wrote, 
 in 1575, in Erfurt "Five books in that Godly and noble 
 gift, that sacred and wonderful art of brewing beer 
 philosophically." A few years later there appeared in 
 Vienna a "Wine book" by John Rosch in which the "wine 
 cultus" was held in nearly the same estimation. To drink 
 wine was here held to be a service of God (Gottesdienst). 
 Drinking, revelry, debauchery^ and all manner of coarse- 
 ness reached its highest tide during the period just preced- 
 ing the thirty years' war, at which time the German people 
 were enjoying an era of commercial activity and material 
 progress. One has only to read the satirical lampoons 
 of that time to learn the extent of drunkenness among 
 the leisure classes. Noblemen assailed each other with 
 the vile language of the ox drivers (Ochsenknecht). 
 
20 SHALL WE DRINK WINE ? 
 
 When Duke Henry of Braunschweig' in 1539 called John 
 Frederick of Saxony and other noblemen drunken rascals 
 these replied that undoubtedly they were sinners in that 
 direction, but that Duke Henry himself was even a greater 
 offender for he could be found drunk early in the morn- 
 ing. "I will not excuse the life at court," wrote Luther 
 in 154T. "Unfortunately all Germany is plagued with 
 drunkenness. It is a bad old custom in the German land, 
 which has grown and still continues to increase." The 
 gluttony and drunkenness of that time are vividly 
 described in the works of the Silesian poet, Hans von 
 Schweinichen (1586), who went on a begging and drink- 
 ing journey with Duke Henry XI of Liegnitz, through 
 Germany. "These two Silesians were probably the great- 
 est drunkards in that drtinken century; but they had an 
 abundance of company." 
 
 The sixteenth century has been called "the classical 
 Age of German Inebriety." This, as has already been 
 stated, was due largely to the prosperity of the ruling or 
 leisure classes; but about the beginning of this century we 
 hear, for the first time, complaints of the evils done by 
 the stronger alcoholic drinks. In 1496 we read that the 
 Niirenberg council was compelled to take action against 
 disorders caused by the immoderate use of brandy, by 
 forbidding its purchase on Sundays and holidays, and on 
 working days only a half-penny's worth could be sold to 
 one purchaser. In other places there must have been 
 much drinking of brandy; for we find, for instance, that 
 there were 34 distilleries in Zwickau in the early part of 
 the sixteenth century. At the same time Frankfurt on 
 the Oder had 80 and Zittau had 40. In Berlin brandy 
 was allowed to be sold only in the apothecary shops until 
 
 1574- 
 
 Beer, however, continued to be the great national drink 
 
HISTORICAL. 21 
 
 and it seems to have reached a degree of favor with the 
 common people amounting to almost veneration. Not 
 only was it used as a beverage by all who could afford 
 it, but it was also regarded as a remedy for various 
 diseases. Many kinds were manufactured, not only from 
 barley alone, but with the addition of other materials, and 
 each kind had its peculiar use as a remedy assigned to it. 
 We read, for instance, that rosemary beer was good for 
 melancholia, "Scordien' beer was good for weak eyes, 
 lavender beer "strengthened the head," sage beer "took 
 away the trembling of the knee pan" and strengthened 
 loosened teeth, and beer made from mugwort was good 
 for unfruitful women. Beer was also extraordinarily 
 cheap. For a few pfennigs, one could get all that he 
 could drink. Three and four pfennigs a quart was the 
 price of the best that could be purchased. 
 
 Not only were the German noblemen of this time 
 drunkards, but their wives and daughters drank to excess 
 as well. It is related that Henry IV of France, though 
 certainly not temperate himself, refused to marry a German 
 princess because he did not wish to have a wine cask 
 constantly by his side. Among all the drunkards of that 
 drunken century, Anna of Saxony, daughter of Count 
 ^loritz, was the most notorious. She had the doubtful 
 reputation of being able "to drink all the guests under 
 the table," and finally died of alcoholic insanity. It is 
 related that her marriage with William of Orange in 1561 
 was celebrated by the drinking of 3600 casks of wine and 
 1600 barrels of beer. When Guenther XLI of Schwarz- 
 burg married Duchess Catherine of Arnstadt the wedding 
 was celebrated by drinking the following wines and beers : 
 20 barrels of Malmsey, 25 barrels of Reinfall (a Welsh 
 wine), 25 wagon-loads of Rhine wine, 30 barrels of Frank- 
 fort and Wuerzburg wine, 6 barrels of Necker wine, 228 
 
22 SHALL WE DRINK WINE ? 
 
 barrels of beer. This was for the use of the guests alone; 
 but besides this the servants and peasants received loio 
 pails of "land wine" and 120 barrels of beer with which 
 to drink the health of the happy couple. 
 
 Intemperance ruled all classes and both sexes, says Dr. 
 Bode. The nobility set the worst possible examples. 
 Only a very few of them lived thoughtful sober lives. Of 
 the Saxon and Pommeranian nobles scarcely one was not 
 a drunkard. Horrible things are related of them by 
 Janssen. Count John Frederick of Saxony spent his time 
 in arranging drinking bouts for wagers which often ended 
 in the severe illness or death of several of the bibulous 
 nobles. Count Christian I died of alcoholism. Christian 
 II was also a notorious drunkard. When he visited the 
 Imperial Court in Prague, in 1607, he prided himself that 
 he was not sober a single hour during his visit. A 
 foreigner once declared that his face was the face of a 
 wild beast rather than that of a nobleman. Six or eight 
 hours would sometimes be spent at the table. Now and 
 then the drunken nobleman would make some filthy re- 
 mark, throw the beer from a partly filled glass into the 
 face of a servant or box his ears, or engage in some other 
 form of drunken coarseness. As the court ladies con- 
 stantly sat at the tables during these scenes it is easy to 
 understand that they too drank and got drunk. The 
 Duchess of Braunschweig was said to make a remarkable 
 spectacle of maudlin happiness whenever she sat at the 
 state dinner. 
 
 Citizens, laborers, and farmers emulated the conduct 
 of the gentry whenever possible. The council of Nuern- 
 berg in 1540 provided for a hand wagon to go about the 
 streets and pick up those who had become too drunk to 
 walk; and in 1557 they deplored the fact that so many 
 serious wounds resulted from drunkenness in artizans of 
 both sexes. 
 
HISTORICAL. 23 
 
 In England and other countries at this time drunken- 
 ness was as prevalent as it was in Germany, and affected 
 the same classes of people. The gentry of that time, from 
 the fox hunting country squire to the prime minister, all 
 drank to excess and the lower classes did the same when 
 the opportunity presented. To write of drunkenness in 
 England would, therefore, be to repeat the chapter on 
 drunkenness in Germany for the same time. We have 
 only to read the works of contemporary writers to obtain 
 a correct view of the drink habits of the English people 
 of that time. 
 
 Much has been said about the comparative harmless- 
 ness of wine and beer drinking, and that spirits drinking 
 is responsible for practically all of the evils of temperance. 
 This matter is fully discussed in another place. We can 
 see, however, from history that unlimited drunkenness may 
 result from indulgence in wine and beer. 
 
 There can be no doubt, however, that the introduction 
 of whiskey as a beverage added much to the general de- 
 moralization produced by drunkenness. 
 
 Whiskey probably originated among the Celtic in- 
 habitants of Ireland and Scotland. Its name is a cor- 
 rupted abbreviation of the Celtic Uisage-beatha (Usque- 
 baugh), meaning "water of life." Popularly, distilled spirit 
 was known as Aqua vitae and was used solely as a power- 
 ful medicinal agent. It did not come in general use 
 as a beverage until about the middle of the 17th 
 century ; and the first law of which we have any knowledge 
 for the regulation of its sale was that passed by the town 
 council of Glasgow in August, 1655. This act prescribed 
 certain rules for the sale of "Ail and Aqua vitae." An 
 excise duty was first levied on the "Aqua vitae" consumed 
 in England in 1660, and in 1684 duty was paid on 527,492 
 gallons. 
 
24 SHALL WE DRINK WINE? 
 
 From this time on the consumption of ardent liquors 
 grew with remarkable rapidity. At the end of the century 
 the amount annually consumed reached more than a mil- 
 lion gallons and forty-three years later it reached the 
 incredible quantity of 8,200,000 gallons. With this rapid 
 increase in the imbibition of strong alcoholic liquor, came 
 great public demoralization. The liquor could be pro- 
 duced cheaply and its sale was practically unrestricted. 
 This condition led to the multiplication of gin shops in 
 London during the early part of the i8th century and 
 so keen was competition that it is said keepers of these 
 places put placards in their windows announcing that any- 
 one might get drunk for a penny and that "Clean straw 
 in comfortable cellars" would be provided for customers 
 where they might sleep off the effects of the alcoholic 
 narcotism. About this time the London authorities awoke 
 to the necessity of passing laws to curb the destructive 
 tide of debauchery, but the measures adopted (Gin Act 
 1736) were only slightly effectual. Acts were also adopted 
 regulating the traffic in Ireland and Scotland about the 
 same time; but here as in England they met with only a 
 small success. Evasions of the penalties imposed by law, 
 by smuggling, dishonest distilling, and the like, were 
 incidents in the whiskey traffic then as they are now. 
 
 Comparing the drunkenness of the early centuries with 
 that of recent times, it will be seen that there is less of 
 brutal excess among the people in the higher and more 
 responsible stations of lite now than there was in the pre- 
 ceding three or four centuries. Not, perhaps, due to the 
 fact that there is less alcohol consumed by these classes 
 of society so much as to the influence on civilization which 
 has softened the manners of all classes and given to all 
 a much greater measure of self-restraint. What the per 
 capita consumption of any of the European countries was, 
 
HISTORICAL. 25 
 
 until very recent times, we have no means of knowing. 
 It is probable, however, that in none of them was it as 
 great as it is at the present time. The great mass of 
 people were too poor to indulge, excepting on festive 
 occasions, while at the present time some form of alcoholic 
 drink is part of the daily diet of nearly all the laboring 
 classes of Europe and America. 
 
 With primitive peoples the intoxicating effects of alco- 
 holic drink must have been a deep mystery because of an 
 inability to connect cause with effect. Unknown forces 
 were ascribed to a spirit origin, to the gods, good or 
 evil, according to their beneficent or harmful effects on 
 man. With the Greeks wine found its apotheosis in 
 Bacchus (Dionysus) the son of Jupiter. "He represents 
 not only the intoxicating power of wine, but its social and 
 beneficient influence likewise; so that he is viewed as a 
 promoter of civilization, and a law-giver and lover of 
 peace" (Bulfinch's Mythology p. 113). But the evil 
 wrought by wine was recognized, even at this early day, 
 no less than the apparent good; for did not the Princes of 
 Greece undertake to prevent the introduction of Bacchus 
 worship into their country "because of the disorders and 
 madness it brought with it?" And did not Pentheus, King 
 of Thebes, forbid Bacchanalian rites being performed 
 within his kingdom, even going so far as to order the 
 death of Bacchus? 
 
 This bit of mythology curiously reflects a division of 
 public opinion as to the value of wine and its evils which 
 persist, if we substitute all alcoholic drinks for wine, to the 
 present day. This Grecian Apotheosis of wine is a part 
 of our present heritage. Through all of the intervening 
 centuries the industries concerned in the production of 
 alcoholic beverages have grown and flourished with the 
 
26 SHALL WE DRINK WINE ? 
 
 growth of civilization. The drinking of wine has been 
 regarded by all peoples as a proper mode of expressing 
 the greatest human happiness. Is a child safely born to 
 us, is a beloved daughter happily married, has a wanderer 
 returned, is an enemy defeated, or has the Goddess of 
 Fortune smiled upon us? Then let us be happy and give 
 appropriate expression to that happiness by sitting down 
 with our friends and drinking wine. Not by primitive 
 peoples alone has it been deified. Great men of all times 
 and nations have dedicated to it some of the best products 
 of their minds. It has a high place in song and story. The 
 hterature of all peoples give it a place in a social organism 
 made up of all such elements as make life complete and 
 desirable. It figures in the profound solemnities of church 
 rituals. It has been regarded as a food for the tender 
 years of infancy, a staff for the tottering steps of age, an 
 elixir vitae for those impoverished by disease, and a 
 blessed nepenthe to soothe away the hours of grief or 
 mental irritation. And ale has a literature all its own. 
 For more than a thousand years the people of great 
 nations have beheved that ale gives health, manHness and 
 strength; and the great masses of the common people, 
 the nation's sinews in peace and war, have made it the 
 one indespensible article of their dietaries. The god of 
 beer, too, found a materialization in the person of 
 Gambrinus, Jean Primus, or John The First of Brabant, 
 the stout Flemish duke who is said to have invented 
 lager beer. 
 
 Ardent spirits being of more recent date are not sur- 
 rounded by the mysteries which surround wine and ale 
 and have no god in any mythology; but many generations 
 of physicians and influential laymen have given to the 
 strong alcoholic drink an undeserved reputation for doing 
 good. For many generations has it been used to stimulate 
 
HISTORICAL. 27 
 
 a flagging heart, promote sleep, relieve pain, increase the 
 vital capacity and protect the body from the cold of winter 
 and heat of summer. Indeed, the giving of ardent spirits 
 has, until very recent years, formed part of the routine 
 treatment of nearly all classes of diseases. 
 
 Let anyone consider these things and he will under- 
 stand why alcoholic beverages claim vested rights. They 
 are a part of our civilization. Like a degenerate member 
 of an imperial house ruling an unwilling people their 
 evils are patent but they have hereditary rights. They 
 have that authority which arises from an uninterrupted 
 reign of many generations^ they have social, political and 
 religious prestige; and more than all, they have the 
 prestige which arises from the ready command of un- 
 countable millions of material wealth. Furthermore, the 
 opinion prevails with nearly all intelligent people that used 
 in moderation they are not only not harmful but beneficial 
 in their action, and are only to be deprecated when used 
 in excess. 
 
 Of drunkenness in modern times we know, un- 
 fortunately, too much. In our own country the per capita 
 consumption of alcohol is increasing in an alarming de- 
 gree. Statistics from the great nations of Europe show a 
 like or still greater increase. Statistics for 1896 show 
 that ninety million gallons of absolute alcohol was con- 
 sumed in the beverages drunk by the inhabitants of the 
 United States during that year. Furthermore, the average 
 per capita consumption of alcohol during the decade pre- 
 ceding i8g6 was seventy per cent, greater than that for 
 the decade 1875-86. 
 
 This increase in alcohol consumption has been 
 attended, pari passu, by an increase in crimes, deeds of 
 violence, murder, suicide, manslaughter, and assault, while 
 the number of insane to each hundred thousand in- 
 
28 SHALL WE DRINK WINE ? 
 
 habitants shows a like increase; for ninety million gal- 
 lons of alcohol can destroy an enormous amount of 
 healthy brain tissue. Something more effective than is 
 now in force must be inaugurated to stem the tide of gen- 
 eral demoralization or we shall be overwhelmed. Surely, 
 however, the magnificent intelligence and practical com- 
 mon sense of the American people make them equal to 
 dealing with this problem once their attention is sufficiently 
 aroused to the dangers threatened by alcohol. 
 
n. 
 
 Zht Constituents of HlcoboUc Beverages. 
 
 The alcoholic beverages commonly drunk are wine, 
 spirits (whiskey, brandy, rum and gin), and beer. Wine 
 is produced by subjecting grape juice to alcohol fermenta- 
 tion, during which process the sugar in the grape juice is 
 changed into alcohol and carbonic acid. The amount of al- 
 cohol in any wine will depend, therefore, upon the amount 
 of sugar in the grape from which it is made. Wines made 
 from grapes rich in sugar contain more alcohol than those 
 made from grapes which contain a less amount of sugar. 
 There is a limit, however, to the amount of alcohol that 
 may be produced by this species of fermentation; for the 
 process will not go on after the alcohol reaches 15-20 per 
 cent, of the fluid. After wines are put in wooden casks, 
 however, they become richer in alcohol, for a part of their 
 watery contents pass through the wood and evaporate. 
 They are also artificially "fortified" by the addition of 
 alcohol. Some wines are not allowed to ferment to their 
 fullest extent; they, therefore, contain a proportionately 
 small amount of alcohol and large amount of sugar. 
 
 The following table from Dr. Weiss (Der Alkohol, 
 Seine Wirkung und Sein Wesen) shows the average per- 
 centage of alcohol in the different European wines: 
 
 Rhine Wine 6-16 
 
 Mosel Wine - 8-13 to 15-25 
 
 Red Bordeaux 6-13 
 
 White Bordeaux 11-19 
 
30 SHALL WE DRINK WINE ? 
 
 Hungary Wine 9-15 
 
 Italian Wine 14-19 
 
 Red Burgundy 7-14 
 
 White Burgundy 9-12 
 
 GreeVc Wine 13-18 
 
 Port Wine 16-23 
 
 Sherry 16-25 
 
 Madeira 16-22 
 
 Cape Wine 18-23 
 
 The amount of sugar in different wines varies very 
 much. In some all the sugar has been changed into alco- 
 hol and carbon dioxid while in others, like sweet catawba, 
 the amount of sugar may rise as high as thirty per cent. 
 
 The principal acid of wine is tartaric acid, a constant 
 constituent of the grape. Next in importance is tannic 
 acid from the grape skins, especially in red wine. Acetic 
 acid, an oxidation product from alcohol and succinic acid. 
 Carbon dioxid results in considerable quantity from fer- 
 mentation in some varieties of grape; but sometimes it is 
 added as an artificial substance. Wine also contains oe- 
 nanthic acid, which is a substance peculiar to wine and 
 arises during the process of sugar fermentation. Wine also 
 contains oenanthic ether which imparts to it its peculiar 
 odor; but the "bouquet" is not due to this substance, ac- 
 cording to Weiss, but to a number of ether like substances 
 which are developed at the same time by peculiar kinds of 
 sugar fermentation. 
 
 The inorganic substances in wine are potassium, sodi- 
 um, calcium, sulphates and phosphates with traces of iron 
 and chlorine, the proportion of each being dependent upon 
 the character of the soil in which the grape was grown. 
 Thus in Mosel, wine which is made from grapes grown on 
 a soil of slate clay, may be found acetate of magnesia, alu- 
 minium chlorate, and other substances peculiar to that par- 
 ticular district. The total amount of inorganic matter var- 
 ies from .1% to .3%. 
 
THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 31 
 
 The proportion of alcohol, sugar, acid and water 
 varies very much with different wines. Sometimes any one 
 or more of these substances are added to those already in 
 the wine to make it contain the properties usually found in 
 a particular kind of wine. 
 
 Wine is much adulterated, the principal material used 
 for this purpose being alcohol. Sometimes the alcohol 
 used for this is impure, containing not only ethyl alcohol 
 but also the heavier and much more poisonous alcohols, 
 propyl, butyl and amyl. Unadulterated wine contains only 
 the least poisonous ethyl alcohol. Various substances are 
 added, also, for the purpose of coloring. Most of these 
 are harmless; but fuchsin, often used for the purpose of 
 coloring red wine, contains arsenic and may do much 
 damage. The extent of this sophistication in Europe may 
 be judged from the fact that the island of Medeira pro- 
 duces only about 30,000 barrels of wine annually, yet 
 50,000 barrels of Madeira wine are yearly exported to the 
 United States alone. Our domestic wines are probably 
 not adulterated to the extent that the foreign wines are. 
 The abundance of grapes have made wines so cheap that 
 adulterations would not be profitable. 
 
 Aside from wine from grape juice a great deal of alco- 
 holic drink is produced from other fruits of various kinds. 
 Apple, pear and orange cider, and wines from currants, 
 gooseberries and other small fruits. In pear and apple cider 
 the tartaric acid of the grape is represented by malic acid. 
 In other respects ciders and fruit wines do not differ from 
 those made from grapes. 
 
 All distilled spirits were formerly produced from wine. 
 The brandy of commerce is still produced in that way and 
 much is manufactured in the countries of Southern Eu- 
 rope, France, Spain and Portugal, and in the great wine 
 districts of America, especially in California. It contains 
 
32 SHALL WE DRINK WINE ? 
 
 from 50% to 60% of alcohol, and the volatile substances, 
 oenanetic ether and the like, found in wine. An artificial 
 brandy is made from a 70% alcohol to which has been 
 added oenanthic ether resulting from the oxidation of palm 
 oil by distillation with potassium chromate and concen- 
 trated sulphuric acid. Brandy is also artificially made by 
 the simple addition of oenanthic ether to alcohol diluted, or 
 by distilling wine lees after adding acetic and nitrious ether. 
 Rum is made from sugar cane and molasses, alcohol 
 arising from fermentation as in the case of wine, and formic 
 acid resulting as a by-product. After fermentation the 
 fluid is subjected to a process of distillation, the formic 
 acid passing over with the alcohol. Rum contains from 
 60% to 70% of alcohol. It is artificially made by adding 
 essence of rum, containing butyric ether, acetic, nitric, and 
 formic acid, to dilute alcohol. Arac is made from rice by 
 fermentation and distillation. Besides alcohol its chief in- 
 gredients are formic and butyric acid. Corn, rye, pota- 
 toes and other starch producing materials are used in the 
 manufacture of whiskey. Each substance gives rise to a 
 whiikey having its own peculiar character which depends 
 upon the ether and volatile oils which develop during the 
 process of fermentation. Whiskey contains from 30% to 
 60% of ethyl alcohol and a small quantity of the heavier 
 alcohols. After remaining a long time in barrels these lat- 
 ter are said to have been removed by oxidation. This, 
 however, has not yet been demonstrated, and is probably 
 not true. Potato whiskey, much of which is manufactured 
 and drunk in Germany, Ireland and other countries of Eu- 
 rope, is said to contain a relatively larger amount of fusel 
 oil than that made from any other substance. Amyl alco- 
 hol, one of the fusel oil group, is much more poisonous 
 bulk for bulk than ethyl alcohol, the relation which they 
 bear to each other, being according to Dujardin-Beau- 
 metz and Audige, 8 to 1.7. 
 
THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 33 
 
 The lethal dose of the various alcohols per kilogram of 
 animal weight according to these investigations is as fol- 
 lows: Ethyl alcohol 8 grams^ propyl alcohol 3.8 grams, 
 butyl alcohol 2 grams and amyl alcohol 1.4 to 1.7 grams. 
 It should not be forgotten, however, that the effects of the 
 heavier alcohols differ in no way from those resulting from 
 the ingestion of ethyl alcohol; the difference is one of de- 
 gree not of kind. According to Strassman, also, (Experi- 
 mentelle Untersuchungen zur Lehre von Chronische Al- 
 koholismus) the amount of fusel oil is not more than from 
 .3% to .5% of the amount of ethyl alcohol; in other words, 
 an amount of fusel oil sufficient to make a 40% whiskey 
 equal to one of 41 or 42%. Mobius and Weiss, however, 
 regard amyl alcohol as being much more poisonous than 
 indicated by Strassman, the latter declaring that a half 
 grain is sufficient to produce narcosis and muscular weak- 
 ness in an adult. Besides amyl alcohol there results from 
 the oxidation of fusel oil valerianic acid and valerianic 
 aldehyde. 
 
 Many other kinds of distilled liquors are made, some 
 of which contain the volatile oils of different plants. All 
 are no doubt more or less injurious; one, absinthe, es- 
 pecially so. This is made by distilling wormwood (Artemi- 
 sia absinithium) with alcohol. In contains 60-80% of alco- 
 hol with the essential oil of the wormwood and is espe- 
 cially poisonous to the nervous system, being productive 
 of attacks which cannot be differentiated from epilepsy. 
 France is the home of absinthe, but the dissipated dwellers 
 of all large cities of America and Europe have among them 
 a considerable number of absinthe drinkers. 
 
 Adulterations of spirituous liquors are not infrequent. 
 Most of these, however, are in the form of coloring matter, 
 sandal wood, turmeric and caramel, which are harmless; 
 not, however, so harmless are coloring matters from ani- 
 
34 SHALL WE DRINK WINE? 
 
 line and naphthalene which are also used for this purpose ; 
 and we have also heard of picric acid being used to color 
 whiskey which was drunk by men subject to military duty 
 to give them a jaundiced appearance so that they might be 
 rejected by the military examiner. This substance as well 
 as copper sulphate which is sometimes used to produce the 
 green color of absinthe are both dangerous poisons. 
 
 By far the most widely consumed and most highly 
 estimated alcoholic drink is beer. It is supposed to be 
 made of germinating barley; but wheat, oats, rice and In- 
 dian corn are largely used in its production. The process 
 of germinating produces a substance called diastase which 
 has the power of changing starch into sugar, the latter be- 
 ing further changed into alcohol and carbon dioxid by 
 fermentation as in the case of wine. Hops are added to 
 the fluid before fermentation begins. From the malted 
 grain is obtained dextrin, sugar, various salts and albumi- 
 noid bodies. The hops contain resin, tannic acid, a bitter 
 substance called lupulin and volatile oil. Resin and tannic 
 acid derived from the hops precipitate, in part at least, the 
 albuminoid substances from the grains while the lupulin 
 and hop oil remain in solution. 
 
 Beer, then, which is made from malt and hops alone, 
 contains water, extractive matter, starch, gums, sugar, dex- 
 trine and albumens, alcohol, carbon dioxid, with a small 
 amount of succinnic, lactic and acetic acids; salts, chiefly 
 the alkaline phosphates and sulphates, pottassium carbon- 
 ate, chloride of sodium and silicic acid. Aside from these 
 at times beer contains a small quantity of yeast and fat. 
 
 More substances are used in the adulterations of beer 
 than of any other alcoholic beverage, some of which are 
 harmless and some the opposite. Unmalted grain, the 
 husks of which have been soaked in lye, is sometimes 
 added to save the expense of malt. From this beer 
 
THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 35 
 
 acquires a peculiar bitter taste. Potatoes are mixed with 
 the malt giving rise to fusel oil. Potato starch, dextrin, 
 couch grass roots, carrots, beets and Hcorice are all said to 
 be used to increase the profits of the brewer. Glycerine is 
 also added as a preservative; but it destroys, according to 
 Weiss, "double the quantity of malt extract." A small 
 quantity of glycerine is a natural constituent of beer, but 
 only .02 to .09%. It arises from the splitting up of sugar 
 into glycerine and succinic acid. Glycerine, as is well 
 known, in considerable quantity and taken for some time 
 leads to serious disturbance of the digestive organs and 
 the kidneys. 
 
 Substitutions for hops are of much greater variety, and 
 as a rule more injurious than substitutions for malt. Any 
 thing which will yield tannic acid in abundance may be 
 used, the tannic acid taking the place of the ethereal oil and 
 resin of the hop. For this purpose hemp is commonly 
 used. This substance is well known to medical men as a 
 peculiar intoxicant, giving to the subject pleasant hal- 
 lucinations at first, and later producing narcosis. It is 
 known as "hasheesh" among some eastern peoples. The 
 use of hemp as a beer adulterant is not only attested by 
 writers on the subject; but I have had this information 
 verified by a brewer. The bitter principal of the hop is 
 also frequently represented by such substances as orange 
 peelings, wormwood, coriander, cardamon, mace, Salvacea 
 clara, Ribes nigra, Ruta graveolens; but these are prob- 
 ably never, with the exception of wormwood, used in quan- 
 tity sufficient to produce harm. Not so harmless, how- 
 ever, are other bitters used for the same purpose, such as 
 gentian, catechu and quassia which with long use bring 
 about serious disturbances of the digestive functions. Still 
 more injurious are some of the materials which are said to 
 be used for the purpose of adulterating certain foreign ales. 
 
36 SHALL WE DRINK WINE ? 
 
 They are Solanum dulcamara (bitter sweet), one of the 
 night shades, its leaves and berries, taxas baccatus, bark, 
 leaves and berries. Datura stramonium (a night shade) the 
 entire plant, white hellebore, the leaves and root, Colchicum 
 autumnale, all parts of which are highly poisonous, and 
 even opium. The above is certainly a formidable list of 
 violent narcotic poisons which should be used only under 
 the careful supervision of a physician. Strychnine produc- 
 ing plants, Strychnos nux vomica, Strychnos Ignatii, and 
 Strychnos colubrina, are also used to impart the bitter taste 
 to beer in the absence of a sufficient quantity of hops. All 
 the members of the Strychnos family are very poisonous 
 and extremely bitter. To the above really formidable 
 poisons may be added, as occasional adulterations of beer 
 and ale, colocynth, aloes, and picrotoxin, all dangerous 
 poisons. 
 
 For coloring purposes the materials used are generally 
 harmless. They are caramel, scorched malt, and extract 
 of chicory. For the purpose of clarifying, however, sul- 
 phuric acid and alum are sometimes used, both of which 
 are injurious to the stomach. Also through various ma- 
 nipulations before it leaves the brewery beer may receive 
 an addition of alkali, yeast, sugar or alcohol; the latter not 
 always free from a suspicion of fusel oil. 
 
 In spite of the fact, however, that so much material is 
 used in the adulteration of alcohoHc beverages, some of 
 which is fatally poisonous in small doses, alcohol is the 
 poison which inflicts by far the greatest amount of damage 
 upon the organism. 
 
 It is highly probable that many of these injurious sub- 
 stances, by acting upon the digestive organs and nervous 
 system, contribute to the general break down ; but the most 
 destructive changes such as interstitial inflammations, de- 
 generations and the like, to which so many deaths are due, 
 are clearly the result of alcoholic irritation. 
 
THE CONSTITUENTS OF ALCOHOLIC BEVERAGES. 37 
 
 Malt liquors contain, according to Weiss, the follow 
 ing percentages of alcohol: 
 
 Munich beer, 4 varieties, an average of 4.3 
 
 Culmbacher lager beer 4.5 
 
 Porter 5.5-7 
 
 Ale 6.5 
 
 Vienna beer 4.0 
 
 Berlin and Thuringen beer 3.0 
 
 French beer 4.0 
 
 Pilsen beer 3.5 
 
 The average of American beers is probably about 4% 
 of alcohol. 
 
 The amount of sugar in different beer varies very 
 much, from 3 to 8.5 or 9%. The writer has found the 
 German beers much richer in sugar than are those made 
 in America. 
 
III. 
 
 •Che food Taluc of HlcohoUc Beverages. 
 
 The most important food substance found in alcoholic 
 beverages are sugar and dextrine. Sugar occurs in all the 
 sweet wines in varying quantity and sugar and dextrine in 
 malt liquors. The only other substance which can be re- 
 garded as a real food, found in sufficient quantity to de- 
 serve notice, is the group of albuminoid bodies derived 
 from the malted grain and found only in malt liquors. 
 Aside from these two groups of substances alcohol is the 
 only material in the ordinary alcoholic beverages in suffi- 
 cient quantity to be of importance as a food. 
 
 That alcohol is a food is asserted on every hand but 
 still lacks confirmation. From the time that Liebig made 
 his celebrated classification of foods until the appearance 
 of a memoir by MM. Lallemand, Duroy, and Perrin, it 
 was believed that ingested alcohol was totally consumed 
 in the body, giving rise to vital energy. The investigation 
 disclosed in this memoir showed that alcohol escapes from 
 the body unchanged. Not only did they find that alcohol 
 escapes unchanged, but that the products of alcohol com- 
 bustion, carbonic, acetic, oxalic acid, aldehyde and the like, 
 are not increased by alcohol ingestion. 
 
 In more recent times Bodlander (Die Ausscheidung 
 aufgenommenen Weingeistes aus der Koerper, Pfluegers 
 Archi., XXXII, P. 399 et seq.) expressed the opinion, as 
 the result of his investigations, that about 90% of any 
 moderate amount of ingested alcohol was oxidized in the 
 
THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 39 
 
 body to carbon dioxid and water and that the rest, about 
 io%, is eliminated as such or as oxidized products of al- 
 cohol, through the lungs, skin, and kidneys. These results 
 were afterwards corrected by Strassman (Untersuchungen 
 ueber den Naehrwert und die Ausscheidung des Alcohols, 
 Pfluegers Archi., XLIX, P. 315 et seq.). It was held by 
 both that alcohol like every other carbohydrate should be 
 regarded as a "respiratory food," that its oxidation within 
 the body just like the oxidation of all other carbohydrats 
 gave a definite number of caloric units and kept up the 
 bodily temperature. In other words it was held that the 
 kind of carbohydrate ingested was of no importance so 
 long as its oxidation yielded the sufficient number of heat 
 units to perform the necessary physiological work and 
 keep up the bodily temperature. The fallacy of this meth- 
 od of reasoning is pointed out by Dr. August Smith (Die 
 Alkoholfrage, P. 12 et seq.) who shows that as a matter of 
 fact the most superficial observation will prove that it 
 makes a great deal of difference whether alcohol or a like 
 quantity of sugar is ingested, and that this difference is due 
 to the difference in oxidation. Dr. Smith's observations 
 upon this subject are so important that they are given here 
 in substance. 
 
 Certain pure chemical observations which have been 
 confirmed by physiological researches, but which have been 
 neglected or overlooked in the literature of alcohol, com- 
 pel a new interpretation of the action of alcohol within the 
 living body. 
 
 Alcohol should be regarded as a respiratory poison, if 
 the expression can be allowed, because it interferes with 
 the interchange of the gases of the entire body by disturb- 
 ing the normal life processes of the individual cells. This 
 disturbance is produced by the affinity of alcohol for oxy- 
 gen, on the one side, and its extreme diffusibility on the 
 other. 
 
40 SHALL WE DRINK WINE? 
 
 In a general way we must assume that a normal con- 
 servation of the bodily temperature must be preceded by 
 an equable oxidation process in such a manner that the 
 material for consumption through a proper supply of oxy- 
 gen shall be submitted to a properly regulated gradual oxi- 
 dation, somewhat after the manner of a modern heating 
 stove, the fuel of which when thrown in is not immediately 
 burned; but, by an intelligently arranged draft, is made to 
 do service for a definite time. The sort of coal which is 
 appropriate for the stove's system may be regarded, in a 
 certain degree, as the nutritious material of the stove, while 
 other oxidizable material would produce neither warmth 
 nor explosive force. 
 
 Without further argument we may assume that for 
 heating our bodies a certain kind of carbohydrate is appro- 
 priate, that kind which would make no claim upon nor have 
 no need for a greater supply of oxygen than that which is 
 furnished by the normal process of respiration, both for 
 the purpose of oxidizing the food material and removing 
 the carbon gas. 
 
 A superficial consideration will show us that alcohol as 
 a "respiratory food" does not answer the purpose of the 
 first demand. We have, moreover, sufficient reason for 
 holding that a double injury is inflicted by the oxidation of 
 alcohol in the body: First, because the increased demand 
 for oxygen cannot be supplied through normal respiration 
 and, second, that as a result of the increase in carbon 
 dioxid, resulting from the rapid oxidation of alcohol, the 
 carbon dioxid cannot be promptly removed through ex- 
 piration. We have, therefore, to reckon with an active 
 and a passive kind of poisoning. The first arises from the 
 fact that alcohol leaves the stomach in an extraordinarily 
 short time, making a demand for an immediate large 
 amount of oxygen which the normal respiratory processes 
 cannot furnish. 
 
THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 41 
 
 The alcohol is, therefore, in part eliminated unchanged, 
 but, for some time after its absorption, it must remain in 
 contact with the tissues, awaiting a supply of oxygen or a 
 removal to some organ through which it may be elimi- 
 nated. The respiratory organs make an effort to supply the 
 increased demand for oxygen, for the experiments of 
 Zuntz (Beitrag zur Kenntn. d. Wirkung des Weingeistes 
 auf. d. Respirationsproz. d. Menschen; Zeitsch. d. Med. 
 1887,5.1.) show that there is a reflex increase in the amount 
 of air inspired amounting to 9% and by Geppart (Die Ein- 
 wirkung d. Alk. auf d. Gaswechsel d. Menschen, Archiv. f. 
 exp. Path. u. Pharm. 1887 Bd. XXII, P. 368.) the in- 
 crease was found to be 7%. In spite of this reflex in- 
 crease^ however, the experiments of Wolffer have shown 
 that the supply of oxygen is still insufficient to meet the 
 increased demand, whenever alcohol is introduced into the 
 animal organism. In alcoholized rabbits^ with which Wolf- 
 fer experimented, in spite of the fact that the gasometer 
 showed they were obtaining a larger supply of oxygen 
 than when other carbohydrate food was given, the respir- 
 atory quotient remained relatively higher, approaching or 
 passing unity. Thus, for alcohol, the respiration quotient 
 (i. e. for every CH combination there is a constant rela- 
 tion between the excreted carbon dioxid and the in- 
 spired oxygen) is exactly two-thirds (C2H30+6o=2C02 
 3H2O), therefore the increase in the output of carbon 
 dioxid is to be explained in two ways: First, that other 
 carbohydrate of a higher respiratory quotient are oxidized 
 with the alcohol, and this is the explanation accepted by 
 Wolffer, in spite of the fact that his experiments were 
 carried out with rabbits which had fasted for a long time, 
 or, and this certainly seems the most probable explanation, 
 the alcohol not finding a sufficient supply for oxidation in 
 the circulating oxygen, must, from every tissue with which 
 
42 SHALL WE DRINK WINE? 
 
 it comes in contact, take up the oxygen which is necessary 
 to the cell in carrying out its functions. 
 
 The affinity of alcohol for oxygen explains the cell de- 
 generation which is found in cases of acute fatal alcoholic 
 poisoning. This degeneration is seen in nearly every or- 
 gan of the body, but is particularly typical in the cells of the 
 absorption vessels, especially those of the liver (Hankel, 
 Vergiftung d. einmal, Genuss d. Alk. Vierteljahrschrift ger. 
 Med. N. F. XXXVIII, I, P. 15, et seq.). So also have 
 Nissl and Dehio shown this kind of cell degeneration at- 
 tending alcohol poisoning, especially in the cells of the 
 brain. 
 
 We see, therefore, that while the oxidation of alcohol 
 within the body may give rise to a certain amount of heat, 
 the circumstances attending its oxidation remove from it 
 all claims as a food material. Still more shall we be justi- 
 fied in denying it food properties when we remember that 
 the increased bodily temperature lasts for only a single mo- 
 ment. Within two or three minutes after its ingestion 
 paralysis of the peripheral nerve endings cause a dilatation 
 of the surface blood vessels, giving rise to increased heat 
 radiation; so that though the total amount of bodily heat 
 may for a short time be increased, the increase in heat 
 radiation more than compensates for the increased pro- 
 duction, so that the actual temperature of the body is 
 lowered after the imbibition of even very small quantities 
 of alcohol. 
 
 The amount of alcohol which may be oxidized within 
 the body certainly must be small even under the most fa- 
 vorable circumstances ; for, no matter how small the quan- 
 tity taken, some of it is eliminated unchanged. Nor is 
 there any definite evidence that the ingestion of alcohol is 
 followed by an increase in the elimination of incompletely 
 oxidized products of alcohol, such as acetic and oxalic 
 acids. 
 
THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 43 
 
 Nor is the increase in carbon dioxid excretion by any 
 means constant. The narcotic effects of alcohol upon the 
 respiratory center soon decreases its irritability to such an 
 extent that it no longer responds to the irritation of an in- 
 creased amount of carbon, and the respirations become 
 slower and shallower, further contributing to the general 
 embarrassment of the vital functions. The reason why so 
 many investigators have arrived at different results or why 
 the same investigator has arrived at different results al dif- 
 ferent times, is probably due to the amount of alcohol 
 given in the experiments. Naturally, we would expect an 
 increase in the excretion of carbon dioxid when an amount 
 of alcohol insufficient to narcotize the respiration center 
 had been given, and a decrease in carbon dioxid excretion 
 when a greater amount had been exhibited. 
 
 Dr. Adolph Fick, the celebrated professor of physi- 
 ology in Wurzburg, gives the following estimate of alcohol 
 as a food (Die Alkoholfrage, P. 5 et seq.). 
 
 "The oxidation of proper food material, albuminoids, 
 fats, and sugar, has not for its principal object the genera- 
 tion of heat; but the maintenance of the functions of the 
 muscles, the nerves, and the gland cells, in short, the activ- 
 ity of the entire tissues of the body. The animal organ- 
 ism is, in this respect, to be compared with a steam engine. 
 If it is to do work it must be furnished with a definite sort 
 of fuel put in a certain place through which mechanical 
 power is generated; and at the same time, heat developed. 
 Certainly alcohol cannot be regarded as an efficacious food 
 for muscles, nerve cells, and the like. Not even in a nar- 
 row sense can it take the place of a force generating food 
 stuff. It might be supposed that the heat generated by the 
 oxidation of alcohol would be of value to the organic 
 household, outside of the question of organic activity, in 
 keeping up the bodily temperature in the colder surround- 
 
44 SHALL WE DRINK WINE? 
 
 ing medium. This, however, is not correct, and for two 
 good reasons: First, alcohol greatly increases heat radi- 
 ation by dilating the blood vessels of the skin, which be- 
 comes reddened through this increased blood supply. This 
 gives rise to the deceptive subjective feeling of warmth, but 
 according to physical laws the warm skin gives out more 
 heat into the colder surrounding atmosphere, and the 
 bodily temperature, according to abundant experimental 
 proof, is actually lowered by the ingestion of alcohol. 
 Secondly, the oft repeated statement that alcohol, when in- 
 gested, being much more easily oxidized than the tissues 
 of the body, is burned up while the body tissues are spared. 
 But this has not only been shown to be not true, but ex- 
 periment has shown that alcohol actually hastens bodily 
 tissue waste. 
 
 Although the oxidation of alcohol in comparison with 
 the oxidation of true food materials in the animal organism 
 is not yet completely cleared up, it is certain that alcohol in 
 moderation cannot be counted as a proper food material. 
 All the pleasant sensation of physical and mental strength 
 brought forth by moderate doses of alcohol are deceptive 
 and depend upon paralysis of the critical judgment and 
 upon the momentary blunting of the sensation of fatigue." 
 
 The oft repeated statement that alcohol prevents nitro- 
 genous tissue waste is by no means proven. Miura (Zeit- 
 schrift f. Klin. Medicin, 1892, vol. XX, P. 137.) in a series 
 of elaborate experiments, referred to by Professor Pick, 
 arrived at diametrically opposite results. He brought 
 himself into a condition of what is known to physiologists 
 as "nitrogenous equilibrium," that is he took just enough of 
 a mixed food to keep him at a definite weight. Then he 
 omitted from his diet a certain part of the carbohydrate 
 food, and substituted an equal (isodynamic) amount of al- 
 cohol. The alcohol, however, did not give the expected 
 
THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 45 
 
 protection; for there was proteid loss from the body, show- 
 ing that the alcohol did not act as a food. He then re- 
 sumed his old diet until a nitrogenous equilibrium was 
 again established and again left out from his diet the same 
 part of the carbohydrate material but did not substitute al- 
 cohol. During this period it was found that less proteid 
 was lost from the body than during the time that alcohol 
 was also taken, thus showing that instead of protecting the 
 bodily tissues against waste by its oxidation, it exercised a 
 directly injurious efifect on proteid consumption. 
 
 Dr. Diakonoff of St. Petersburg (Wratch, 1889) carried 
 out some experiments to show the effects of alcohol upon 
 febrile patients which are of interest in view of the oft re- 
 peated statement that alcohol is a valuable auxiliary food, 
 especially in typhoid fever. Of the seven patients subjected 
 to experiment, six had typhoid fever and one exudative 
 pleurisy. Five were moderate drinkers and two were to- 
 tal abstainers. The alcohol was given in the form of 40% 
 vodka, in amount about one and three-fifths ounces of ab- 
 solute alcohol daily. No other medicines were adminis- 
 tered and the food was limited to white bread and milk. 
 
 He found that alcohol invariably lowers the assimila- 
 tion of nitrogenous food and that there was no difference 
 in this respect between the habituated and non-habituated 
 patients. This interference with proteid assimilation was 
 manifested by a largely increased amount of undigested 
 albumen in the faeces, and unoxidized products in both the 
 faeces and urine. 
 
 It has been shown, moreover, by Bunge (Lehrbuch der 
 phys. und path. Chemie., Leipzig, 1889, P. 348 et seq.) that 
 the carbohydrates are the chief source of muscular 
 strength ; and Mosso (Infleuenza dello zucchero sul lavoro 
 dei muscoli-Ugolino Mosso and Luigi Paoletti) has dem- 
 onstrated the stimulating effects of an easily absorbed so- 
 
46 SHALL WE DRINK WINE? 
 
 lution of sugar upon muscular contractions. Certainly if 
 alcohol has anything of food value in common with other 
 carbohydrates its efifects upon muscular contraction should 
 be like those of sugar, in kind if not in degree. On the 
 contrary, however, the experiments of Dr. Frey (Ueber 
 den einfluss des Alkohols auf die Muskelermueding) show 
 conclusively that the total capabiHty of the muscle is very 
 much lessened by the ingestion of even small quantities 
 (two and one-half to five grams) of alcohol. 
 
 In the light of the foregoing definite experimentation 
 and observation the reiterated statements so widely preva- 
 lent in authoritative medical literature that alcohol fur- 
 nishes an easily oxidizable food which makes it of value 
 whenever immediate vital force is desired or to prevent tis- 
 .^ue waste in disease, should be at once and for all time dis- 
 carded as untrue. 
 
 Returning to the subject of the food value of alcoholic 
 beverages as a whole, the spirituous liquors may be elim- 
 inated at once as having no value; because they contain 
 practically nothing but alcohol and water. Some wines 
 contain sugar, varying in this respect from two or three 
 per cent, to twenty-five per cent, or more. No one, how- 
 ever, will ever buy a bottle of the sweetest wine for its 
 food value as long as bread may be had for five cents a 
 loaf and sugar for six cents a pound. 
 
 We hear a great deal about the food value of beer and 
 other malt liquors. Much is said of the highly nutritious 
 "extractive" substances found in malted grain and held in 
 solution in beer and ale. Many persons who make or echo 
 those encomiums on beer forget, or never learned, that 
 good bread possesses all those extractives. Moreover, 
 beer as a food compared with bread is extraordinarily dear. 
 In Germany where the best beer can be bought at the rate 
 of four liters or a little over one gallon for one mark (24 
 
THE FOOD VALUE OF ALCOHOLIC BEVERAGES. 47 
 
 cents), Struempell estimates that it costs about eight times 
 as much as would be asked for an amount of bread con- 
 taining an equal amount of nutrition, and that the differ- 
 ence is still greater in comparison with potatoes, peas, 
 beans or other vegetables. He estimates that four liters 
 of beer contain 240 grams of carbohydrate food and scarce- 
 ly ^2 grams of albuminoid material, while bread purchased 
 for one mark contains 2,000 grams of carbohydrate and 
 250 grams of albuminoid food. In America bread can be 
 bought as cheaply as in Germany, but beer costs the Amer- 
 ican consumer probably twice as much; so the American 
 laboring man pays about twenty times as much for the 
 food he obtains in beer as that which he obtains in his 
 bread. Moreover, German beer is much richer in sugar 
 and other extractive matter than that made in our own 
 country, and is probably not adulterated to the same ex- 
 tent; for all beers made for domestic consumption in Ger- 
 many are subjected to an examination by a state chemist, 
 penalties being imposed upon the manufacturer if his prod- 
 uct is not up to a certain standard, while in America no 
 such system is in force. We may, therefore, without fur- 
 ther consideration, decline to regard alcoholic beverages 
 as foods. 
 
IV. 
 Hlcobol aa a Stimulant. 
 
 From time immemorial alcohol has been used as a 
 stimulant. The term stimulant has been rather loosely ap- 
 plied; but it is supposed to mean a substance which in- 
 creases mental and physical capacity to perform work, to 
 enhance, in short, the value of all vital functions, espe- 
 cially those of the heart. Exhaustion results from the lack 
 of suitable food to renew the worn out tissues or from ex- 
 cessive work on the part of the exhausted organ, more tis- 
 sue being consumed than can be supplied. An easily di- 
 gested and assimilated food, with rest, are the prime stimu- 
 lants when the heart's power is unimpaired through or- 
 ganic disease. Any remedy increasing the systolic power 
 of the heart without increasing its frequency is the best 
 stimulant when that organ alone is responsible for the ex- 
 haustion. In order to make plain all sources of exhaustion 
 the fact that the heart's action is often notably depressed by 
 a multitude of nervous reflexes must not be forgotten. One 
 of the most common is that observed in the condition 
 known as shock, resulting from severe injury, pain, or 
 overwhelming mental impressions. In these conditions 
 whatever will lessen the sensibility of the nervous system, 
 will act as a stimulant. Here morphine and other nar- 
 cotics act as stimulants by removing the reflex irritation 
 which depresses the heart's action. 
 
 If the above propositions are well founded, and they 
 seem to be, the value of alcohol as a stimulant may be de- 
 
ALCOHOL AS A STIMULANT. 49 
 
 termined by comparing its physiological effects with the 
 requirements of a stimulant above indicated. 
 
 So many observers have noted a temporary increase in 
 the force and frequency of the heart beat after the ingestion 
 of moderate doses of alcohol, that the correctness of these 
 observations cannot be doubted. The period over which 
 alcohol exercises a stimulating effect upon the heart, is, 
 however, very short; for, as has been shown by Smith 
 (Loc. Cit.), it lasts only until the superficial blood vessels 
 are dilated by the paralyzing effects of alcohol upon the 
 paripheral nerves. The effects of alcohol upon the ex- 
 hausted or fatigued heart muscle may be better understood 
 after studying the effects of alcohol upon muscular work 
 in general. 
 
 Exact experimentation to determine in what manner 
 and to What degree muscular contraction is influenced by 
 alcohol was first carried outj so far as I am aware, by Dr. 
 Herman Frey, in Professor Sahli's medical clinic in Bern. 
 His report was published in a pamphlet in 1896 under the 
 title of "Ueber den Einfluss des Alkohols auf die Muskel- 
 ermiidung." Mosso's "Ergograph" was used to register 
 the amount of work done, from the time the contractions 
 began until they ceased from muscular exhaustion, was es- 
 timated in kilogram meters. Experiments were made 
 with the muscle in a fresh condition after a long period of 
 rest, and after it had been fatigued by repeated contractions. 
 Alcohol was given in the form of cherry brandy, cognac, 
 wine, beer and diluted alcohol, the cognac and cherry 
 brandy being also diluted, and in amount equal to from 
 one and one-fourth to two and one-half drachms of abso- 
 lute alcohol. 
 
 Upon the unfatigued muscle these small doses of alco- 
 hol, with only two exceptions, m one, that of a hysterical 
 man, decreased muscular capability. Not only were the 
 
50 SHALL WE DRINK WINE? 
 
 individual contractions weaker under the influence of alco- 
 hol, but the total amount of work performed before the 
 muscle became exhausted was much less when alcohol was 
 ingested. For instance, in one case the total work without 
 alcohol was 4.66 kilogram meters ; but, under the same cir- 
 cumstances, twenty minutes after drinking a little over a 
 half pint of beer, the total amount of work was only 2.66 
 Kilogram meters. In a second case the total work per- 
 formed by the muscles tested was 4. 11 and 4.8 kilogram 
 meters in two tests, while a third test made ten minutes 
 after the ingestion of a little over a pint of beer, showed a 
 total efficiency of only 2.63 kg. meters. A third 
 subject gave 4.79 and 4.58 kg. meters respectively 
 in two tests without alcohol, and only 2.02 kg. 
 meters in a test made fifteen minutes after drinking about 
 a half pint of beer. Several other subjects gave similar 
 results. In one case the total amount of work was in- 
 creased from 5.95 to 6.35 kg. meters to 8.6 kg. 
 meters ten minutes after the ingestion of a half pint of beer. 
 The author thinks, however, that this subject, as well as 
 the hysterical patient, was influenced by suggestion. The 
 results were the same whether brandy, wine, beer or di- 
 luted alcohol was exhibited. 
 
 A peculiar fact was to be noted during the experiments 
 which explains the almost universal belief among alcohol 
 drinking laymen, and among medical men as well, that al- 
 cohol gives strength. In spite of the fact that the maxi- 
 mum contractions were weaker and the muscles became 
 fatigued sooner under the influence of alcohol, the subject 
 lifted the weight without as much conscious efifort after 
 taking the alcohol as before. In the case of the author 
 himself this difference was so marked that he was obliged 
 to examine the apparatus to see whether some of the 
 weight had not been removed, so much easier did he find 
 
ALCOHOL AS A STIMULANT. 51 
 
 the work after drinking a small quantity of alcohol, at the 
 same time he was actually doing, less than before the al- 
 cohol was ingested. 
 
 From these experiments, therefore, the author draws 
 the following conclusions: 
 
 1. Alcohol has an injurious effect upon the unfatigued 
 muscle, in that it essentially decreases the amount of work 
 the muscle is capable of doing. 
 
 2. The feeHng of fatigue is abolished by alcohol and, 
 for this reason, the labor seems to be lighter. 
 
 The subjects of Dr. Frey's experiments seem to have 
 all been men accustomed to a moderate amount of alco- 
 holic drink daily. He remarks, however, that in his own 
 case the effects of alcohol in decreasing muscular capabil- 
 ity were most marked after six weeks of total abstinence 
 from all kinds of alcoholic drink. 
 
 To determine the effects of alcohol upon fatigued mus- 
 cle, experiments were carried out in the following manner : 
 A series of contractions were inaugurated in each of which 
 the muscle was completely exhausted, and the time between 
 each series was so short (from one to three or five minutes) 
 that the muscle was not completely rested before the be- 
 ginning of the next series. The contractions thus produced, 
 in a short time, a condition of complete exhaustion, finally 
 rendering the muscle unable to respond to the stimulus at 
 the end of the short period of rest. 
 
 When complete exhaustion was thus brought about 
 the exhibition of the same small quantity of alcohol as was 
 given in the experiments with non-fatigued muscle, en- 
 abled the muscle to make renewed effort. The total 
 amount of work which the muscle could accomplish, af- 
 ter the subject had ingested the alcohol, was estimated by 
 the author to be equal to the amount done before complete 
 
52 SHALL WE DRINK WINE ? 
 
 exhaustion by the non-alcoholized muscle; but in no case 
 did the individual contraction after alcohol ing-estion rise as 
 high as they did in the absence of the alcohol. For in- 
 stance, in one case the work accomplished before complete 
 exhaustion equaled 3.35 kg. meters, when 15 grams of 
 cognac were given. The muscle then accomplished 3.6 
 kg. meters before the occurrence of complete exhaustion. 
 Similar results were attained in other cases. As a rule, 
 however, the amount of work accomplished after alcohol 
 ingestion was less than before. 
 
 It is to be noted here as a matter of much importance 
 that massage had a similar influence nearly as great as that 
 shown by alcohol, and the same exhibition of renewed con- 
 tractile power followed the ingestion of 20 grams of sugar 
 in watery solution. For instance, the total labor of a mus- 
 cle before exhaustion equaled 1.95 kg. meters and 
 after two minutes' massage was stimulated to renewed ef- 
 fort equaling 1.68 kg. meters. Similarly a case is 
 recorded by Dr. Frey in which the total amount of muscu- 
 lar work before complete fatigue equaled 2.85 kg. 
 meters, when 20 grams of sugar brought about renewed 
 efforts, in which 2.55 kg. meters of work was accom- 
 plished by the same muscle before complete exhaustion 
 again occurred. 
 
 By what means then does alcohol bring about renewed 
 activity in the fatigued muscle? Not as a food certainly, 
 or it would not have the injurious effects on non-fatigued 
 muscle shown in the first series of experiments. Or if it 
 has a food value, that is entirely smothered by its narcotic 
 effects. According to Bunge (Loc. Cit.) the carbohy- 
 drates are the chief source of muscular strength. We 
 would expect, therefore, that an exhausted muscle would 
 be stimulated to renewed activity by the absorption of 
 sugar. The effect of massage is not so clear. It might 
 
ALCOHOL AS A STIMULANT. 53 
 
 operate by increasing the circulation and thus enable the 
 muscle to get rid of irritating waste products, and probably 
 does act in that way. 
 
 Alcohol, however, has the power to both irritate and 
 narcotize. Does it, then, affect the fatigued muscle by 
 goading it to renewed efforts simply as a chemical irritant, 
 or does it make further contraction possible by neutraliz- 
 ing the effects of tissue metabolism which are known to 
 produce fatigue or, furthermore, does the small amotmt of 
 alcohol given in these experiments of Dr. Frey lower, for 
 a time, the rate of tissue metabolism, while it hastens the 
 departure of waste products by peripheral dilatation of the 
 blood vessels? None of these questions can be answered 
 at the present time. 
 
 As to whether the fatigued muscle thus temporarily 
 aroused by alcohol was thereby rendered incapable of per- 
 forming the normal work of the unfatigued muscle, after 
 the same period of rest, was not determined by Dr. Frey. 
 He states merely that the alcohol seemed to have no dele- 
 terious effects. 
 
 Experiments were carried out with the electric current 
 as an irritant, giving the same results as when contraction 
 was voluntary. 
 
 It is entirely reasonable to suppose that alcohol affects 
 the fatigued heart as much as it does muscles of the volun- 
 tary system, either by inhibiting the results of fatigue by 
 peripheral narcosis, if the term may be allowed, or by spur- 
 ring it on to renewed efforts simply as an irritant. That 
 alcohol affects the heart directly and not through the cen- 
 tral nervous system has been pointed out by Dr. David 
 Cerna (Therapeutic Gazette, April, May and June, 1894). 
 That alcohol stimulates by inhibiting the effects of fatigue 
 irritation, is indicated by the experiments of Dr. H. C. 
 Wood (Medical News, Vol. 57, p. 126) with alcohol in 
 
54 SHALL WE DRINK WINE ? 
 
 chloroform and ether narcosis. His statements are as fol- 
 lows: 
 
 "Of all drugs that which I think is usually most relied 
 upon by clinicians as a cardiac stimulant in anaesthesia, as 
 in other cases of heart failure, is alcohol. The chemical 
 and physiological relation of alcohol to ether and chloro- 
 form are, however, so close that many years ago I became 
 very doubtful of the value of this drug as a stimulant to a 
 heart depressed by anaesthesia. 
 
 These doubts continually grew stronger from what I 
 saw and read as to the effects of the administration of al- 
 cohol during anaesthesia, and were finally changed into 
 conviction by the experiments of R. Dubois (Progres 
 Medical, 1883), who found that in the animal to which al- 
 cohol has been freely given, much less chloroform is re- 
 quired than in the normal animal, to anaesthetize or to 
 kill; or, in other words, that alcohol intensifies the influ- 
 ences of chloroform and lessens the fatal dose. 
 
 "In my own experiments with alcohol an 80 per cent, 
 fluid was used, diluted with water. The amount injected 
 into the jugular vein varied in the different experiments 
 from 5 to 20 c.c. ; and in no case have I been able to detect 
 any increase in the size of the pulse or in the arterial pres- 
 sure, produced by alcohol, when the heart was failing dur- 
 ing advanced chloroform anaesthesia. On the other hand, 
 on several occasions the larger amounts of alcohol 
 apparently greatly increased the rapidity of the fall of the 
 arterial pressure, and aided materially in extinguishing the 
 pulse rate." 
 
 We might interpret these results by saying that, with a 
 heart already narcotized, stimulation by abolishing fatigue 
 irritation is not possible as it has already been abolished, 
 and that the narcotic effects of alcohol would be manifest 
 only in increasing the profundity of existing narcosis. 
 
ALCOHOL AS A STIMULANT. 55 
 
 The beneficial effects to be observed from the giving of 
 alcohol in conditions of shock, depend but very little, it is 
 probable, upon its direct stimulation of the heart. The 
 condition itself is brought about by some overwhelming 
 impression made upon the central nervous system. Great 
 joy, fear or other emotion is well known as a cause of fatal 
 shock. On the other hand profound shock arises from 
 purely physical causes, like the destruction of large sensory 
 areas by extensive burns or the severing of the nerve 
 trunks supplying these areas in high amputations of the 
 lower limbs. In section of the optic nerve during enuclea- 
 tion there is a momentary profound shock during which 
 the pulse disappears at the wrist. The amount of alcohol 
 found necessary to bring about a reaction in these cases is 
 much more than that which is found sufficient to raise 
 arterial pressure. Those who have employed whiskey or 
 brandy for this purpose will recall that two or three or more 
 ounces may be given a patient before signs of reaction 
 become manifest. It would seem, certainly, that the nar- 
 cotizing effect of these large doses would have much more 
 to do with relieving shock by rendering the nervous sys- 
 tem unimpressionable than by stimulating the action of 
 the heart directly. Opium and other narcotics promptly 
 increase the action of the heart in the same way. 
 
 An abundance of experience under widely differing cir- 
 cumstances of climate, involving equatorial and polar ex- 
 tremes of temperature, have unanimously shown that the 
 hardships of exploration^ military campaigning, hunting, 
 and all other adventures of like nature are not only in no 
 way lightened by alcoholic ingestion but that dependence 
 upon this so called "stimulant" has always been attended 
 by disaster whenever the greatest physical efforts were to 
 be put forth. 
 
 Experience in the army of the United States has shown, 
 
56 SHALL WE DRINK WINE? 
 
 according to Dr. Frank H. Hamilton, that the habitual use 
 of no amount of alcoholic liquor by healthy men is to be 
 advised under any circumstances. No exception should 
 be made whatever for extreme heat or cold, rain or shine, 
 nor whether the soldier had been accustomed to drink be- 
 fore entering the army. Even the moderate drinking of 
 alcoholic liquor has been shown to be so injurious to those 
 who are subjected to the hardships of life, in an arctic cli- 
 mate, that shipmasters, in the last ten or fifteen years, have 
 absolutely forbidden the use of any kind of spirits to the 
 crews of ships coming in polar waters. Nansen ascribed 
 his successful journey across Greenland on snowshoes to 
 the fact that he and his companions had not a drop of al- 
 cohol with them. The same holds good, but probably in 
 a lesser measure, for tropical climates as has been shown 
 by the experience of the British Army in East India. 
 Moreover Karl Peters had a similar experience in East 
 Africa. He says, in his work upon the German Emin 
 Pascha Expedition, p. 268: "In Baringo the last bottle 
 of cognac was destroyed. After this we had coffee, tea 
 and cocoa to drink, and it may also be said that our 
 health became excellent." 
 
 Certainly the proper test for a muscular stimulant is its 
 use in just the hardships above enumerated. FaiHng to 
 meet those requirements and indeed adding physical 
 demoralization to the hardships already incurred, where 
 is the ground for saying that alcohol is a muscular 
 stimulant? 
 
 That alcohol promotes a "flow of ideas" is a postulate 
 held by the majority of medical men. In the absence of 
 definite proof to the contrary it is easy to understand that 
 an increased flow of words might be mistaken for an actual 
 gain in thought. By no investigators, as far as I know, has 
 this matter been so thoroughly studied as by Kraeplin (Der 
 
ALCOHOL AS A STIMULANT. 57 
 
 Physolog. Versuch in der Psychiatric, Leipzig, 1895 and 
 Ueber die Beeinflussung einfacher phychischer Vorgaenge 
 dnrch einige Arzneimittel, Jena, 1892). The results of 
 Kraeplin have been summarized by Dr. August Smith 
 (Loc. Lit.) as follows: 
 
 "The action of alcohol upon mental processes, the re- 
 sults of which are so evident in acute alcoholic intoxication 
 or dn.mkenness, as well as in the later stages of chronic al- 
 coholic poisoning, deserve especial consideration. Kraep- 
 lin was the first to make the study of psychic processes of 
 value in practical medicine, especially in psychiatric. This 
 he did after the method of Wundt, and we have him and 
 his school to thank for a series of valuable conclusions as 
 to the action of special poisons upon the psychic domain. 
 
 "Especially have we a series of his observations regard- 
 ing alcohol poisoning which give us a very good under- 
 standing of the complicated processes involved, although a 
 final determination of the same is not yet reached. The 
 difficulty of arriving at definite conclusions is based upon 
 the essential difference in the manner in which moderate 
 quantities of alcohol affect the intellectual and motor 
 centers. 
 
 "It has been proven experimentally that all the intel- 
 lectual functions examined suffer a marked depression 
 after the ingestion of small, moderate and large doses of 
 alcohol, and that this depression makes its appearance im- 
 mediately after the alcohol has been ingested, as a rule. 
 In a few cases there appeared to be a short period of in- 
 creased activity; but in these cases the amount of alcohol 
 given was so small that this fact cannot be said to have 
 been established. At the same time that the intellectual 
 functions were depressed there was an increased activity in 
 the motor functions which was followed, after a short time, 
 by depression. Different psychic functions, in which mo- 
 
58 SHALL WE DRINK WINE? 
 
 tor actively played a role indicated these double effects very 
 beautifully. When, for example, in the case of associa- 
 tions in which the reaction periods become shorter, that is 
 the quantity of the associations increased, while their char- 
 acter became entirely different. Instead of the inner as- 
 sociations the outer ruled, instead of ideas connected in 
 their logical relations, word memory and tune, rhyme and 
 assonance became more prominent as is seen in cases of 
 dementia in the human subject. 'More words but fewer 
 ideas.' " 
 
 Kraeplin speaks of the results of his psycho-physical 
 experiments in the effects of acute alcoholic intoxication 
 and their relation to what is already known of the subject 
 as follows : 
 
 "Let us ag-ain cast a look upon the completed picture of 
 alcohol intoxication which we have attempted to develop 
 by our experiments, and there can scarcely be any doubt 
 that it possesses the same features which have become so 
 well known to all of us through daily experience. The ex- 
 periments give us the same appearances, though in a 
 milder degree, which we observe in the brutality of the se- 
 vere acute alcoholic poisoning. The difficulty of compre- 
 hension seen in the subjects of our experiments corre- 
 ponds with the inability of the drunkard to follow the 
 course of events in his immediate vicinity, and to properly 
 conduct himself in relation to the same. This difficulty in 
 arousing his attention exists in all degrees up to the point 
 where there is complete insensibility resulting from blunt- 
 ing of all the organs of sense. In the retardation of the 
 associative processes we again see the depression of his in- 
 tellectual functions, the abolition of discriminative power 
 which makes it impossible for him to impart or receive an 
 idea, the lack of which makes it impossible for him to tell 
 whether the idea is his own jniclgment or that of another, 
 
ALCOHOL AS A STIMULANT. 59 
 
 the poverty of clear estimation and insight into the range 
 of his words and acts. The quahtative changes of the 
 associations are signalized to us by the superficiality of the 
 thought range, the tendency to stereotyped and trivial 
 phrases, to empty jests, to foolish repetitions, sometimes 
 in a foreign language. 
 
 "The stimulation of the motor reactions is the ultimate 
 source of the sensation of increased strength, and also of all 
 those thoughtless, purposeless, impulsive and violent acts, 
 which has given alcohol such notoriety, not only in the his- 
 tory of foolish and thoughtless acts^ but also in the annals 
 of criminal impulses. It is the source of that lack of self- 
 restraint which is seen in a company of drunken revelers 
 among whom some catch word or some act may be the 
 signal for all such purposeless and thoughtless reactions as 
 foolish talkativeness, shouting, singing, screaming, decla- 
 mation and the like; and corresponds to what our experi- 
 ments showed when the difficulty of thinking had become 
 marked. With this phase of alcoholic intoxication should 
 be pointed out the fact that under its influence all psychic 
 restraint, which is known to us as timidity, embarrassment 
 and confusion, is abolished, that all those countless consid- 
 erations which govern our conduct in our relation with our 
 fellows, in the normal state, lose their power over us. We 
 become courageous, unrestrained, and regardless of conse- 
 quences, we speak without thought, express ourselves un- 
 couthly without troubling ourselves as to the effects of 
 what we say, and tattle our secrets nonchalantly alike to 
 intimate friends or strangers. 
 
 This increased activity in the motor sphere and eu- 
 phoria of the drunkard, Kraeplin ascribes to the subjec- 
 tive feeling of increased strength. 
 
 While Schmeideberg and Bunge look upon this motor 
 excitement as the result of paralysis of the intellectual pow- 
 
60 SHALL WE DRINK WINE? 
 
 ers and would make the lack of judgment in the psychic 
 direction answerable for all the purposeless motor im- 
 pulses, somewhat like that which is seen in excessive ataxic 
 movements of tabes. Kraeplin thinks it is due to the dif- 
 ferent manner in which alcohol afifects the motor and sen- 
 sory centers. 
 
 "We come, therefore, to the conclusion that alcohol, as 
 a matter of fact, affects both sides of our soul-life, but each 
 in a different manner. With large doses the sensory and 
 intellectual as well as the motor functions are quickly 
 paralyzed. Small doses, on the contrary, abolish only the 
 first, while upon the latter domain the paralysis is pre- 
 ceded by a longer or shorter stage of excitement." Kraep- 
 lin also attributes a greater resistance to the motor centers 
 against the power of alcohol poisoning. 
 
 What the euphoria of the drunkard most nearly ap- 
 proaches is erethistic imbecility. In both there is that 
 naive self-glorification with progressive liability toward 
 brutality, so much said by both drunkard and imbecile 
 about what he has seen and experienced, and the same un- 
 shakable confidence in his own powers. In drunkenness 
 there is a lack of the critical powers for which the ex- 
 tinguishment of the judgment is responsible, and I could 
 without further discussion point it out as analogous to the 
 foolish happiness of the weak minded. 
 
 Further, there can be no doubt that different centers of 
 our brain possess different degrees of resistance. If we 
 refer to the beautiful diagrams of Exner, it will be made 
 clear to us, that those lines of action which are first to de- 
 velop in the life history of the individual are for that rea- 
 son the strongest and the least easily disturbed in their re- 
 lation to others. It, therefore, needs no complicated the- 
 orem to demonstrate that the motor centers and those 
 which control purely vegetable processes which serve to 
 
ALCOHOL AS A STIMULANT. 61 
 
 perpetuate the individual and the species, provide for the 
 carrying out of their functions over established routes in 
 quite a different manner from that of those centers the de- 
 velopment of which is the result of social-ethical education 
 which comes with more mature years. And, furthermore, 
 that it is just these last developed social-ethical feelings 
 which are first to suffer a blunting or complete extinguish- 
 ment in chronic alcoholism is a well known fact. 
 
 But something further in this apparent opposition be- 
 tween the intellectual and motor sphere seems to me to de- 
 serve consideration. 
 
 That is the fact that with the cessation of psychic pro- 
 cesses involuntarily the motor functions are set free. Som- 
 mer pointed out at the meeting of naturalists and physi- 
 cians in Vienna in 1894, that in the Westphal phenomenon 
 with the balanced leg, at the moment of the falling of the 
 hammer in Jendressek's grasp a higher level was reached; 
 in other words, that the energy which was applied to the 
 hand grasp, probably because of the expectation effect 
 through the attention being given to the hammer, at the 
 moment the blow was interrupted, involuntarily it was 
 transposed into muscular activity, which caused the leg to 
 be actively raised for quite a long time. 
 
 The remarkable antagonism between morphine and al- 
 cohol poisoning seems to me to be a far reaching support 
 for the presence of a law, also, for the conservation of 
 power in the brain mechanism, where a sudden transmis- 
 sion of a cortical stimulation in some way seems to have 
 an inductive influence upon the sub-cortical centers. As 
 we have seen after the ingestion of alcohol there is an im- 
 mediate blunting of the intellectual processes followed by 
 an increased motor activity ; but, with the ingestion of mor- 
 phine in the abstinent, whatever increased motor activity 
 may be present is diminished and intellectual capacity is in- 
 
62 SHALL WE DRINK WINE? 
 
 creased. We have analogous phenomena in mania, in the 
 excitement of febrile diseases with disturbances of con- 
 sciousness, and others. 
 
 The experiments of Professor Kraeplin in showing" the 
 effects of small quantities of alcohol (one and one-fourth 
 to two and one-half ounces daily, in divided doses) upon 
 the psychic functions are of extreme interest and impor- 
 tance and conclusively demonstrate the injurious effect of 
 alcohol upon the mental functions. It should not be for- 
 gotten that the amount of alcohol used by Kraeplin is just 
 the amount which nearly every medical writer on the sub- 
 ject has declared may be disposed of without injury, or 
 with benefit, by the ordinary adult, daily, if given in divided 
 doses, properly diluted. In this manner it was given by 
 Kraeplin. 
 
 The experiments extended over a period of twenty- 
 seven days. Mental capability was tested in two ways, by 
 problems in addition and by memorizing. The capability 
 for this sort of brain work was first tested without alcohol 
 and as will be seen in the figures, (i and 2) with slight 
 vacillations, there was a daily increase of efficiency. 
 
 The alcohol was then given when, for a few days, the 
 mental capability remained at nearly the same level, then 
 greatly and rapidly decreased, the decrease being much 
 more noticeable in the case of the ability to memorize. 
 After the breaking off of the alcohol there was an imme- 
 diate rise of efficiency which continued for seven days. 
 On the eighth day the exhibition of the alcohol was re- 
 newed and immediately there was a great depression in 
 this form of mental capability. It will be observed by re- 
 ferring to the figures that the depression was much more 
 rapid after the renewal of the alcohol following the seven 
 days of abstinence. It would seem from these experiments 
 that even this so-called small amount of alcohol first par- 
 
FIG. 1. 
 
 Exercises in Addition. 
 
 The blacli spaces represent tiie days upon wliich alcohol was taken, 
 and their height the proficiency which the subject experimented with 
 reached in the two mental processes. Figures to the left indicate number 
 of Tests. 
 
FIG. 2. 
 
 Exercises in Memorizing (Ad. from Dr. Smith). 
 
 The black spaces represent the days upon which alcohol was taken, 
 and their height the proficiency which the subject experimented with 
 reached in the two mental processes. Figures to the left indicate number 
 of Tests. 
 
ALCOHOL AS A STIMULANT. 63 
 
 alyzes the brain protoplasm, rendering it incapable of re- 
 ceiving lasting impressions in a normal degree; and that 
 with continued use, the paralysis is followed by degenera- 
 tion. 
 
 The same experiment was carried out by another in- 
 vestigator for a period of twenty-two days, and though 
 there were individual differences due to various causes the 
 same result was always observed, that is, an important 
 lessening of mental capability during the ingestion of 
 alcohol, and a relatively more rapid decUne in mental 
 cabability upon resuming the alcohol after a seven days' 
 abstinence. 
 
 Another series of experiments were carried out to de- 
 termine the effect of this amount of alcohol upon the length 
 of the period between stimulation and reaction, with the 
 result of showing that this period was always lengthened 
 by the use of alcohol. 
 
 Still more significant were the conclusions arrived at 
 through a series of experiments conducted by Dr. Smith 
 himself (Die Alkoholfrage, P. 30 et seq.). He undertook 
 the task of determining what mental processes were most 
 affected by alcoholic poisoning. For this purpose he fol- 
 lowed the arrangement of Aschaffenberg, which classifies 
 mental processes as follows: 
 
 1. Internal Associations : Co-and subordination, casual 
 dependence associations, predicative determination. 
 
 2. External Associations: Co-existence of time and 
 place, identity, speech reminiscences. 
 
 3. Disconnected Perception Associations: Word-Sup- 
 plementing or completion, tune and rhyme Associations, 
 wholly unintelligible association. It will be observed that 
 the first group of associations have to do with the judg- 
 ment, the grouping together of ideas and drawing con- 
 clusions therefrom ; the second has to do with the memory. 
 
64 SHALL WE DRINK WINE? 
 
 upon recalling matters in logical sequence, while the last 
 is a mere matter of memory without judgment and with- 
 out any logical sequence of events. 
 
 The following diagram shows (Fig. 3) Dr. Smith's 
 method of determining the relative number of associations 
 in each group estimated on a percentage basis. A total 
 of 1,350 Associations was examined and classified. Ex- 
 amining the diagram it will be seen that the internal and 
 external associations are almost equal, while those of the 
 last group are so few as to be of no practical importance, 
 during the period of abstinence from alcohol, 1-5 days. 
 During the period of alcohol ingestion (40 to 80 grams 
 being taken), extending over eleven days, the number of 
 internal associations markedly decreased while the external 
 group increased in the same proportion, and there is a 
 relatively very large increase in the lowest group, those 
 which have to do with disconnected memory associations 
 alone. Again, when the alcohol is withdrawn there is a 
 prompt return towards the normal relative number in 
 each group, while a return to alcohol ingestion quickly 
 decreases the number in the first group and increases the 
 number in the other two. 
 
 A similar result was produced by an attempt to group 
 a number of related ideas in series around a central idea 
 suggested by a single word, or to describe a chain of 
 external events and to name the circumstances relating 
 to them in the order of their occurrences. For instance, 
 when the subject examined abstained from alcohol the 
 word "electricity" suggested a series of ideas like "con- 
 tinuous current," "interrupted current," "alternating cur- 
 rent" and the hke. On the seventh day, the first upon 
 which alcohol was taken (in the same quantity as during 
 the preceding experiments), the ability of the mind to 
 suggest logically connected ideas decreased, and on the 
 
FIG. 3 
 
 No Alcohol. 40-80 erra. Alcohol per day. 
 1-5 day. 6-11 day. 
 
 No Alcohol. 
 
 80,0 grm. Alcohol. 
 
 12-17 day. 18-21 day. 22-25 day. 26-27 day. 
 
 " Internal " Associations 
 
 " External" Associations 
 
 Associations not connected in logical thought, Mi 
 
 (Rhyme, sound, word completion, and unrela- 
 ted associations.) 
 
 No. of Associations examined, 1350. 
 (Adopted from Dr. A. Smith.) 
 
ALCOHOL AS A STIMULANT. 65 
 
 17th and i8th days, nearly every central word suggested, 
 not related ideas or words representing related ideas, but 
 groups of words closely connected by a similarity of 
 sound, (Unterbau, Baumeister, Meisterstiick, Stiickwerck, 
 Werkstatte, Stettenheim). On the 19th day, with a with- 
 drawal of the alcohol on the i8th, system in the associa- 
 tions returned as in the beginning, and a renewal of the 
 alcohol on the 26th and 27th days again brought about 
 the disconnected associations. 
 
 Taking those processes which lead to the formation of 
 logical conclusions as the highest functions of the brain, 
 which they certainly are, while mere word memory or 
 sound memory is the lowest, the injurious effects of 
 alcohol upon the quality of brain products, upon thought, 
 is at once understood. Here is the basis, too, for the pop- 
 ular belief that alcohol "stimulates" mental processes 
 because it brings about an increased fluency in words. 
 It is a practical demonstration of what Kraeplin has 
 already quoted, that acute alcohol poisoning makes "more 
 words but less thought." 
 
 In the presence of the above definite evidence, but one 
 conclusion can be drawn, and that is, the habitual drinker, 
 no matter how moderate he may be, in his own estima- 
 tion, in the use of alcohohc beverages, never reaches the 
 highest possible plane of his physical and mental capabili- 
 ties. Very interesting in this connection is a remark made 
 by Helmholz, the greatest physicist of the Nineteenth 
 Century, in a speech delivered at a celebration of his 
 seventieth birthday. He spoke of the ruin of those minds 
 which might have originated the most brilliant and original 
 thoughts, and closed with the remark that in his own case 
 "the smallest quantity of alcoholic drink seemed utterly 
 to dissipate them." 
 
V. 
 
 "Che effects of Hlcobol apon Digestion and 
 Hssimilation. 
 
 The effects of alcohol upon digestion are two-fold: 
 first, by irritating the mucous surfaces with which it comes 
 in contact; and, secondly, by combining chemically with 
 the digestive ferments, the products of digestion, or even 
 with the tissues themselves. Added to the disturbances 
 resulting from the above mentioned effects are those 
 which arise from alcoholic narcosis. 
 
 The irritating effects of alcohol are manifested locally 
 in the fauces, pharynx, oesophagus, and stomach, by the 
 establishment of a chronic catarrh. The stomach suffers 
 the most, for its lining membrane is the longest in con- 
 tact with the alcohol. Catarrh produced by alcohol may 
 be of all grades of severity from a slight congestion to a 
 breaking down of the tissue. Post-mortem examinations 
 in a subject dead of alcoholism show the mucous mem- 
 brane of the stomach an intense red in color, thickened, 
 with patches of infiltrated blood, and other patches cov- 
 ered with a tenaceous mucous. Indeed, so great is the 
 irritation which may be produced that a suspicion of arsen- 
 ical poisoning is often aroused, which is dissipated only 
 after a chemical examination. 
 
 Not in the stomach alone, but in other parts of the 
 digestive canal there may be intense inflammation. Here 
 as in the stomach there is no limit to the inflammatory ac- 
 tion of alcohol short of actual disintegration. Intense con- 
 
EFFECTS UPON DIGESTION AND ASSIMILATION. 67 
 
 gestion first, the outwandering of leucocytes, dilatation of 
 the terminal vessels with rupture leading to ecchymoses, 
 suppuration and ulceration finally result. In a subject re- 
 cently dead of alcoholism, I have seen multiple submucous 
 abscesses extending nearly the whole length of the small 
 intestine. Mackenzie states (Diseases of the Pharynx, 
 Larynx, and Oesophagus, 1880) that the most cases of 
 chronic catarrh of the throat come from excessive drink- 
 ing of strong alcoholic beverages. Lancereux has seen 
 ulceration of the oesophagus and Bergeret stenosis of that 
 organ in chronic alcoholism. 
 
 Coincident with the anatomical changes brought about 
 by alcoholic irritation are disturbances in the function of 
 digestion. There are pain, nausea, vomiting, distress after 
 eating, general emaciation and mental depression, the 
 degree depending upon the amount of damage which the 
 digestive organs have suffered. 
 
 Chemically alcohol interferes with the normal process 
 of digestion^ by rendering the pepsin inert as long as the 
 alcohol is present, and by precipitating the incompletely 
 digested albuminoid foods. The amount of chemical dis- 
 turbance produced by the imbibition of alcohol depends 
 upon the individual, the vigor of his digestive organs and 
 his custom in regard to alcoholic indulgence on the one 
 hand, and the amount and concentration of the alcoholic 
 liquors ingested on the other. Something definite as to 
 the nature and degree of chemical disturbances which a 
 given amount of alcohol liquor of known concentration 
 may produce was worked out by Blumenau in Koschla- 
 kofFs clinic in 1891 (Wratsch, St. Petersburg). The sub- 
 jects of his experiments were five young men from 
 twenty-two to twenty-four years of age, some of whom 
 were accustomed to the daily use of moderate quantities 
 of alcohol and some total abstainers. One hundred cubic 
 
68 SHALL WE DRINK WINE ? 
 
 centimeters of a twenty-five to fifty per cent solution was 
 administered to each from ten to twenty minutes before a 
 dinner consisting of five to six hundred grams of soup 
 (one pint), a cutlet weighing two and one half to three 
 ounces, and 6 to 8 ounces of white bread. 
 
 It will be seen from the above that the quantity of 
 alcohol given varied from seven-eighths of an ounce to one 
 and three-quarters ounces and that it must have been 
 markedly diluted after reaching the stomach for not much 
 of a pint of soup under ordinary circumstances would 
 be absorbed in ten to twenty minutes. Assuming that 
 only ten ounces of fluid remained in the stomach, the 
 alcohol solution would have a strength of only four to 
 eight per cent. 
 
 The effects of this quantity of alcohol thus administered 
 were as follows: For three hours after the alcohol was 
 ingested there was a very noticeable decrease in digestive 
 activity; the general activity of the gastric juice decreased, 
 liictic acid being practically the only acid present, while 
 hydrochloric acid was almost wholly absent; from four 
 to six hours after the alcohol was taken, digestion became 
 more energetic, the general activity of the juice rose about 
 50% above the normal (from 0.22 to 0.35%), the propor- 
 tion of hydrochloric acid also increased to beyond the 
 normal (.12% to .14%), while, at the same time, lactic 
 acid decreased and finally ceased to be present in sufficient 
 quantity to give any reaction. 
 
 With the increase in acidity the gastric juice acquired 
 an increased digestive power and under alcohol irritation 
 the secretion of the juice was more profuse and lasted for 
 a longer time than in its absence. During the first hours 
 following the alcohol ingestion the amount of pepsin was 
 also noticeably decreased as could be demonstrated by 
 artificial digestion tests. 
 
EFFECTS UPON DIGESTION AND ASSIMILATION. 69 
 
 All the changes above described were more pro- 
 nounced in subjects not accustomed to alcoholic beverages, 
 and strong solutions of alcohol produced more intense 
 changes than weak ones. 
 
 It would seem, from these results, alcohol first paralyzes 
 the peripheral nerve endings in the stomach mucous mem- 
 brane as it does elsewhere, thereby rendering the cells 
 supplied by them capable of secreting neither the normal 
 amount nor kind of gastric juice. After the paralyzing 
 effects have passed away, however, there still remains the 
 irritating effects of the alcohol, and a more than normally 
 energetic secretion of gastric juice takes place. Un- 
 doubtedly the presence of a strong alcoholic liquor in the 
 stomach will retard digestion both by its effects upon 
 pepsin and upon the partly digested albuminoids, pre- 
 cipitating the latter, which must be redissolved before 
 digestion can again go on. These effects are, however, 
 of secondary importance to the effects upon the nerve 
 filaments. Significant, too, is the fact that the retardation 
 was greater in the case of those unused to alcoholic liquor. 
 If it were due solely to chemical causes there should be 
 no difference between the abstinent and those accustomed 
 to alcohol. Furthermore, the activity of the epithelial cells 
 of the stomach was shown to be decreased in Blumenau's 
 experiments from the fact that absorption was also lessened 
 by the ingestion of alcohol. 
 
 The movements of the muscular wall of the stomach 
 were also seen to be decreased in the experiments of 
 Blumenau, which might have been anticipated, as those 
 movements are probably the result of reflex stimulation of 
 the gastric membrane. 
 
 Mohilanski (Medical Chronicle Nov., 1889) found that 
 in those habituated to a moderate amount of alcohol daily, 
 less food was assimilated during the days of abstinence 
 
70 SHALL WE DRINK WINE? 
 
 than during the days upon which alcoholic liquor was 
 ingested. In some cases the difference amounted to as 
 much as 4.22% but averaged only 2.09%. With the 
 habitual abstainer, on the other hand, the powers of 
 assimilation invariably decreased with the ingestion of 
 alcohol when given in quantity of two to five ounces of 
 absolute alcohol in divided doses during the twenty-four 
 hours. 
 
 Mohilanski attributed the increased assimilative power 
 of the stomach after alcoholic ingestion in the habitue class 
 to "an intensified gastric juice which resulted from pro- 
 longed retention of food in the stomach on the one hand 
 and from increased digestive power and secretion of gastric 
 juice on the other." A more probable explanation, how- 
 ever, is that in the habitue class, alcohol, or its irritating 
 or narcotic qualities, from long continued use, becomes a 
 necessity for assimilation as is the case with opium and 
 other narcotics. It is impossible to see why it should 
 not otherwise have the same effects with both the abstinent 
 and habitue classes. He also found that nitrogenous 
 metabolism always decreases. In thirteen of the fifteen 
 persons subjected to experiment there was an average fall 
 of 8.73%, the maximum being 19.42% and the minimum 
 0.14%. This decrease was observable when small doses 
 were taken and was invariable with moderate quantities. 
 No strict parallelism existed, however, between the 
 amount of alcohol ingested and the amount of metabolic 
 decrease. The decrease continued some days after the 
 alcohol was discontinued. The decrease in tissue metabol- 
 ism was attributed by Mohilanski to the action of alcohol 
 inhibiting systemic oxidation, changing the blood pressure, 
 dilating the vessels retarding the circulation, and thus de- 
 pressing bodily temperature. 
 
 All investigators who have studied the subject agree 
 
EFFECTS UPON DIGESTION AND ASSIMILATION. 71 
 
 that alcohol interferes with the oxidation of fatty foods, 
 much more fat being excreted unchanged after alcohol 
 ingestion than during abstinence. As we have already 
 seen alcohol makes such a demand upon the respiration 
 and tissues for oxygen that the normal oxidation in 
 all parts of the system is disturbed. 
 
 It will be noted that the experiments of Mohilanski 
 by showing that alcohol^ in decreasing the output of 
 products resulting from proteid metabolism, seems to act 
 as a conservator of the tissues; and thus warrant a con- 
 clusion opposite to that drawn by Miura. This, however, 
 is not necessarily so. There are two sources from whence 
 the products of tissue metabolism are derived, the food 
 ingested and the tissues themselves. Anything which 
 would interfere with the oxidation of the nitrogenous food, 
 so that it would in part or wholly leave the intestinal canal 
 unchanged, would necessarily decrease the output of pro- 
 teid metabolism, while at the same time the various tissues 
 of the body might suffer as much or more than they would 
 during complete abstinence from alcohol. Practical ex- 
 perience has certainly demonstrated that alcohol alone in 
 no quantity, either large or small, has the power of con- 
 tributing to bodily weight in the shape of subcutaneous fat. 
 
 According to Wilkins (New York Medical Journal, 
 Sept. 22, 1894,) alcohol precipitates ptyalin, forming with 
 it an insoluble combination of the small amount of 
 albuminous matter present. It also neutralizes the fer- 
 mentative power of ptyalin, thus interfering with its physi- 
 ological functions. In the small intestine alcohol especially 
 interferes with the digestion of fats. It does this by 
 coagulating the pancreatic juice, rendering it incapable of 
 emulsifying the fats. This is one of the fruitful causes of 
 fatty degeneration of various organs. The stearin of the 
 fat is dissolved out of the fat globules, being aided by the 
 
72 SHALL WE DRINK WINE? 
 
 duodenal secretions. The remainder of the fat thus be- 
 comes a foreign body in the circulation, and being a com- 
 pound of palmatin .md olein only, does not possess that 
 property by virtue of which it is attracted to the adipose 
 vesicle ; but is deposited in the different organs, even in the 
 ventricles of the heart and great vessels, thus constituting 
 degeneration. 
 
 The glycogenic function of the liver is modified by 
 the excessive use of alcohol, by preventing the rehydration 
 of the alcohol, without its being taken up by the capil- 
 laries and put into circulation. This result is accompHshed 
 by the union of alcohol with water, which cannot be used 
 in any physiological process, the mixture of alcohol pro- 
 ducing a pathological result instead of a physiological one. 
 The oxygen of the blood and water is prevented from 
 uniting with the bilirubin to form biliverdin. Physiologic- 
 ally, therefore, even a small quantity of alcohol is inimical 
 to life. 
 
 Before leaving this subject attention should be called 
 to the fact that in habitual drinkers the vegetative and per- 
 haps all other functions are stimulated by the presence 
 of alcohol. Putting it in another way, and this seems the 
 correct way to express it, with the habitual drinker, the 
 absence of alcohol is attended by a decreased activity in 
 all the physiological functions. This is simply analogous 
 to what is seen in the habitue of any form of narcotic. In 
 one accustomed to taking a considerable daily quantity of 
 opium, its sudden withdrawal is attended by disturbances 
 of every physiological function, sometimes of a gravity 
 dangerous to life. The patient can eat nothing, digest 
 nothing, may indeed be on a condition of physical and 
 mental collapse. A dose of his accustomed narcotic 
 promptly brings about a re-establishment of the, to him, 
 normal order of things. He eats, digests, walks about. 
 
EFFECTS UPON DIGESTION AND ASSIMILATION. 73 
 
 and talks naturally and cheerfully. Not that the physiol- 
 ogical functions can ever be carried out to the highest 
 point of efficiency under the influence of any narcotic; but 
 the narcotic habitue establishes for himself a grade of 
 physiological efficiency, the key-stone of which is the nar- 
 cotic, which, if it be suddenly taken away, allows the whole 
 artificial physiological structure to tumble to the ground. 
 After a time nature readjusts the organism to the absence 
 of the narcotic; but until that readjustment is accom- 
 plished the habitue will show less energy in all his func- 
 tions than during the period of his narcotic ingestion. 
 
 The amount of disturbance following the withdrawal 
 of an accustomed narcotic is, other things being equal, in 
 direct ratio with the amount daily consumed. 
 
 One accustomed to the narcotizing effects of a few 
 ounces of alcohol daily would undoubtedly exhibit a de- 
 creased assimilative power after its withdrawal. In fact 
 just such results as those obtained by Mohilanski ought 
 to be expected. 
 
VI. 
 General pathology of HlcoboUam. 
 
 Tlie key-note of alcohol morbidity is decreased tissue 
 resistance, brought about by alcohol ingestion. The bio- 
 chemistry of alcoholic tissue degradation is not fully under- 
 stood; but it is probably based upon lack of oxidation and 
 other nutritive disturbances. Of disturbances in tissue 
 oxidation by alcohol, which has been so luminously ex- 
 plained by Dr. A. Smith, much has been written; Prout, 
 Edward Smith, Harley, Schmeideberg, Vierordt, and other 
 well known writers having contributed much valuable 
 information upon the subject. More recently J. J. Ridge 
 (Medical Pioneer, Endfield, Eng., 1894,) has discussed the 
 subject in relation to haemaglobin as a carrier of oxygen 
 to the tissues and carbon dioxid away from them. He 
 has shown that under the influence of alcohol the time 
 necessary for the absorption of oxygen by haemoglobin, 
 as well as the time necessary for it to part with its carbon 
 dioxid, is markedly lengthened. Undoubtedly this dis- 
 turbance results, in part at least, from the affinity of 
 alcohol for oxygen; but the irritating and narcotic prop- 
 erties of the poison may have some influence upon the 
 cell life of the corpuscle, directly. Similarly, in all struc- 
 tures of the organism, it is not unlikely that irritation and 
 narcosis play an important role in decreasing resistance, 
 aside from that caused by the interference with oxidation. 
 
 Upon this same subject, Gaule of Zurich (Bulletin 
 Medical, Paris, Aug. 25, 1895,) alluded to the fact that 
 
GENERAL PATHOLOGY OF ALCOHOLISM. 75 
 
 experiments upon elementary organisms had shown that 
 alcohol causes atrophy by removing' the water contained 
 in them, and that the experiments performed in his labora- 
 tory, by Obersohn, show that alcohol has the same destruc- 
 tive influence upon cell protoplasm as is seen in ether 
 and chloroform. 
 
 The decrease of tissue resistance resulting from alco- 
 holic poisoning has been the subject of much investiga- 
 tion in very recent times^ and the information thus obtained 
 is of the utmost interest and importance as explaining 
 the increased severity of bacterial diseases when the sub- 
 ject is a victim of alcoholism. In a series of experiments 
 conducted by A. C. Abbott (Jour. Exper. Med. July, 1894), 
 under the auspices of the "Committee of Fifty," he found 
 that the normal tissue resistance of rabbits against the 
 streptococcus of erysipelas is markedly decreased when 
 the animal has been kept under the influence of alcohol, 
 sufficient to intoxicate slightly, daily for several weeks. A 
 similar, but not so conspicuous, diminution of resisting 
 powers was exhibited against the colon baccillus (bacillus 
 coli communis) under the same conditions. Against the 
 bacterium of pus (staphylococcus pyogenes aureus), there 
 were individual cases showing a decreased resistance when 
 the alcoholized animals were inoculated in various ways. 
 Still it could not be said that there was a marked diflference 
 in this respect between the alcoholized and the non- 
 alcoholized animals, as far as this particular bacterium is 
 concerned. It is particularly interesting and instructive 
 to learn that the results of inoculating the alcoholized 
 rabbits with the germ of erysipelas bore a striking resem- 
 blance to the course of the disease observed in the alcohol- 
 ized human subject. The effects of the erysipelas inocula- 
 tions were not only manifested earlier in the alcoholized 
 animals; but the disease ran a much more violent course. 
 
76 SHALL WE DRINK WINE? 
 
 the abscesses being much deeper and more destructive. 
 Abbott looked for structural changes which might explain 
 the lack of normal tissue resistance, but found nothing in 
 the way of macroscopic change which would throw any 
 light on the subject. He believes that a closer examination 
 might show some abnormality of structure brought about 
 by the alcohol to which the cell owes its diminished power 
 to resist bacterial invasion. 
 
 Such evidence as we have, however, indicates that the 
 change is chemical rather than physical, as is the case in 
 immunity. 
 
 Not only is the vital resistance markedly decreased by 
 alcoholic poisoning; but the intestinal congestion thereby 
 produced favors the outwandering of bacteria found nor- 
 mally in the intestinal canal. An inquiry into this subject 
 was made by Wurtz and Hudelo (Bulletin Medical, Paris, 
 Jan. 30, 1895), who found that intestinal bacteria are driven 
 out during alcoholic coma. Rabbits were intoxicated 
 with ethyl alcohol and killed when a profound state of 
 narcosis was reached. In one-half of the rabbits killed 
 micro-organisms were found in the peritoneum and blood 
 of the portal vein, showing that microbes during alcohol 
 congestion pass through the walls of the intestine and 
 veins, as is the case in certain other poisons, cold, and 
 asphyxia. They believe, therefore, that this diffusion of 
 microbes plays a part in the production of peritonistis and 
 liver troubles of alcoholism. 
 
 Very instructive in this respect is the establishment 
 of an increased vulnerability to the cholera bacillus in sub- 
 jects accustomed to alcoholic indulgence. During the epi- 
 demic of 1848 and 1849 Professor Adams of Glasgow esti- 
 mated that 19.2 per cent, of the abstinent class died with the 
 disease, while of the drinking class 91.2 per cent, of all 
 attacked by the plague succumbed. He would, therefore. 
 
GENERAL PATHOLOGY OF ALCOHOLISM. 77 
 
 put over the door of every dram shop, "Cholera for sale 
 here." During the epidemic it was further observed that 
 most of the new cases of illness occurred immediately 
 after a Sunday or holiday, which was generally spent in 
 drinking. 
 
 Of the highest interest, in judging the worth of Dr. 
 Adams' conclusions, is the result of an investigation made 
 by Dr. Thomas in the Strasburg Clinic, as to the predis- 
 posing role of alcohol in cholera infection (Archiv. f. 
 experim. Path, und Pharm., Bd. XXXIL, Heft i). He 
 showed that alcohol increased the predisposition to cholera 
 sixfold in rabbits, a result which closely corresponded 
 with the observations of Adams on the human subject. 
 Nor was this predisposition due to the gastro-intestinal 
 catarrh inaugurated by the alcohol. A far greater degree 
 of irritation was produced by such substances as Croton 
 oil and cantharides, in other animals, without in any way 
 increasing the predisposition to cholera. Moreover, alco- 
 hol did not lose its predisposing influence, even when 
 solutions were used too diluted to produce any irritation 
 of the stomach or bowels whatsoever. From these experi- 
 ments it was decided that alcohol diminishes the bac- 
 tericidal properties of blood serum, and that a small 
 quantity of alcohol is effective for this purpose. 
 
 When the last cholera epidemic prevailed in Germany, 
 the government sanitary officials advised the drinking of 
 alcoholic liquors as a preventive measure. This advice 
 was based upon the fact that the comma bacillus has not 
 yet been found in concentrated alcoholic solutions. But, 
 as Dr. Smith says, the comma bacillus has not yet been 
 found in concentrated sulphuric acid, nitric acid, 
 hydrochloric acid, nor strong solutions of copper sulphate 
 any more than in rum and cognac, which articles might 
 for just the same reason be recommended as preventives 
 of Asiatic cholera. 
 
78 SHALL WE DRINK WINE ? 
 
 In no direction is the tissue debasement of alcoholism 
 more noticeable than in tuberculosis. The frequent 
 occurrence of tuberculosis in alcoholics was long ago a 
 matter of record. It was spoken of by physicians of the 
 last century and has been confirmed beyond doubt by 
 numerous observers during the past twenty-five years. 
 Lancereaux (Le Bulletin Medical, March 6, 1895,) declares 
 that he has held this opinion for more than thirty years. 
 He could, he says, produce many proofs to support it. 
 The phthisis of drunkards is peculiar. Instead of first 
 involving the front of the left apex, which is the classical 
 site for its commencement, when it results from insufficient 
 aeration or nutrition it attacks the right apex posteriarly, 
 producing lessening of elasticity on percussion. It is also 
 different in its evolution, for the disease generally improves 
 after the first attack, and the patient frequently recovers, 
 if he give up his bad habits and properly nourish himself, 
 even though the disease may have been attended by 
 hemorrhages. This, however, he rarely does. A second 
 and a third attack follows, converting the first attack into 
 an alarming condition due to the dissemination of the 
 tubercles. In some cases this dissemination is general 
 from the beginning; but, even in these cases treatment 
 may meet with success and the process be arrested. In 
 other drunkards tuberculosis simultaneously affects the 
 lungs, meninges of the brain and the peritoneum, quickly 
 causing death. This phenomenon he has often seen in 
 market-porters, coopers, and truckmen. In all cases, he 
 believes, alcohols and essential oils, by diminishing organic 
 combustion and being eliminated by the lungs, create at 
 the same time a general and local predisposition which 
 furnishes a proper field for the growth of tubercle bacilli. 
 
 Lancereaux further contributed (Bulletin Medical, June 
 2.6, 1895,) valuable evidence in support of these views by 
 
GENERAL PATHOLOGY OF ALCOHOLISM. 79 
 
 showing that the increase in tuberculosis is in proportion 
 to the increase in alcoholic consumption. Alcoholism did 
 not become notable in France until after the vines had 
 been destroyed by the phylloxera. At that time pul- 
 monary consumption was met with in men only one half 
 as often as in women. At the present time twice as 
 many men as women are afflicted, because the women of 
 France, as a rule, are not habituated to the use of excessive 
 quantities of alcohol. 
 
 Legrain also (Medical Press & Circular, London, Jan. 
 13, 1894,) speaks of having observed 55 cases of tuber- 
 culosis in 819 descendants of 215 cases of alcoholic 
 parentage. 
 
 T. D. Crothers (Journal of Am. Med. Assn. Apr. 9, 
 1898,) takes the ground that alcoholic inebriety and 
 tuberculosis are allied diseases. He says that in some 
 families the two conditions alternate. Some of the 
 members drink to great excess, then abstain, contract 
 tuberculosis, and die. Others have all the signs of con- 
 sumption when they begin to drink and recover it, but 
 become inebriates afterward, and die suddenly of acute 
 pneumonia or nephritis. Instances of the former class 
 are very common, and in these the course of the disease 
 is very rapid. In the case of the latter class alcohol seems 
 to abort the tuberculosis in some cases while in others it 
 makes the progress of the disease more rapid. 
 
 In his experience with 2,000 cases fully twenty per cent, 
 were associated with tuberculosis; but a much larger per- 
 centage of all cases of alcoholic inebriety die from tuber- 
 culosis, "of which, probably, there was no intimation until 
 the end of life." Close observers know that these cases 
 have a heredity and a great variety of symptoms in com- 
 mon. The phthisical insanities mentioned by Dr. 
 Maudsley, inherit qualities which lead first to inebriety and 
 
80 SHALL WE DRINK WINE? 
 
 later to the development of tuberculosis. Insanity some- 
 times develops in these cases; but is not so frequent as 
 tuberculosis ; and, when it does occur, it is usually traceable 
 to some injury like sunstroke or mental strain. Physical 
 and mental unrest due to inherited degeneracy drive the 
 victim to the narcotic effects of alcohol for relief; but 
 inebriety, producing a still greater degree of degeneracy, 
 prepares the subject for tuberculosis provided degeneracy 
 has not taken on acute forms in other centres leading to 
 inflammation. 
 
 The production of bronchial catarrhs by alcoholic 
 drinking lead in the same way to the invasion of tuber- 
 culosis. Dr. Sharkey in The Journal of the London 
 Pathological Society is quoted as saying that disturbances 
 and lesions of the vagus were such as may come from 
 alcoholism, by lowering the nutrition of the lung, and pre- 
 pare it to become the nidus of the tubercle bacillus. Ref- 
 erence is also made to the exhaustive paper of Dr. Alison 
 (in Archives Generales de Medicine) relative to tuber- 
 culosis in alcoholics. In the study of eighteen hundred 
 cases he reached the positive conclusion that alcohol pre- 
 disposed subjects to tuberculosis both by producing a local 
 irritation and lowering the general vitality. He believes 
 that inebriety and tuberculosis are interchangeable, both 
 following from the same general cause and producing 
 death by the latter before the age of forty. After that age 
 acute inflammations are more common. 
 
 Reference is also made to the writings of Dr. Mays 
 in the Journal of Inebriety for 1889, Dr. Irwell, in "Race 
 Deterioration," Dr. Williams in his work on Pulmonary 
 Consumption, Dr. Clouston of Edinborough and Dr. 
 Payne in "Pathology of Chronic Alcoholism." The 
 evidence given by these writers is corroborative. In all 
 of them the relation of alcoholism and tuberculosis is con- 
 
GENERAL PATHOLOGY OF ALCOHOLISM. 81 
 
 firmed by numerous observations, and the part played by 
 heredity in producing alcoholic inebriates from phthisical 
 parents and consumptives from alcoholic parents is 
 referred to at length. 
 
 To these I could add numerous cases in my own experi- 
 ence, two of them occurring within the past few months. 
 The first was a nervous, erratic man of 36 years of age, 
 possessing a restless energy and given to frequent out- 
 bursts of passionate rage. Has heredity was bad, his 
 father having been an alcoholic, and several brothers and 
 sisters died in infancy. He had been addicted to the use 
 of large quantities of alcoholic liquors, chiefly in the form 
 of strong spirits, but married and gave up alcohol entirely. 
 About this time he had a bronchial catarrh but no evidence 
 of tuberculosis. Soon, however, the characteristic symp- 
 toms developed and he died in a few months of pulmonary 
 consumption. 
 
 The other was a young man of 32. He had been a 
 hard drinker for ten years or more; but finally "graduated" 
 from a local institution for drunkards and became a total 
 abstainer. His health was only fair after this and began 
 to fail in a few months, chiefly because of digestive dis- 
 turbances. This was in September. In January following 
 there was complete infiltration of the right lung, with 
 cavities of the apex. An attack of pneumonia supervened 
 in February, and the already rapid course of the disease 
 was made still more rapid, death occurring on the first of 
 March. What the hereditary influences in this case were, 
 as regards alcohol, I do not know, but there was no history 
 of tuberculosis. 
 
 Several other similar cases occur to me as I write these. 
 In some of them there was a history of heredity alcoholism 
 or consumption or both, while in others pulmonary con- 
 sumption cut short a life the greater part of which had 
 
82 SHALL WE DRINK WINE? 
 
 been spent in alcoholic dissipation. None of these cases, 
 however, as I recall them, present any special features not 
 already mentioned. They would be simply in the nature 
 of corroborative testimony. 
 
VIL 
 HlcohoHc Bcart Diseases. 
 
 In the healthy subject death results from failure of 
 respiration, when a lethal dose of alcohol is taken, through 
 narcosis of the respiratory center of the medulla. Death 
 may result, however, from heart exhaustion due, no doubt, 
 to the irritating effects of alcohol, when large doses are 
 ingested at short intervals, but not sufficient in quantity to 
 produce profound narcosis. This form of alcohol poison- 
 ing is often seen in subjects who tolerate enormous quan- 
 tities of alcohol without being sufficiently narcotized 
 thereby to produce prolonged sleep, death usually occur- 
 ring at the end of a prolonged spree attended by evidence 
 of great nervous excitement. 
 
 There is no doubt that alcohol acts directly upon the 
 heart to produce its irritating effects, and there is good 
 reason for believing that when death results from heart 
 failure due to alcohol it is brought about by the direct 
 poisoning of the heart muscle or its ganglia. I have seen 
 five cases resulting fatally in which no organic change in 
 the heart could be made out during life; and, in two of 
 these, post-mortem examinations showed no changes in 
 the heart muscle sufficient to account for the fatal termina- 
 tion. Yet, in all of these, death was sudden and followed 
 a debauch in which great quantities of alcohol were drunk. 
 Two of these cases, the two upon whom post-mortems were 
 held, are so instructive and seem to so fully confirm the 
 belief that death may result from sheer heart exhaustion 
 
84 SHALL WE DRINK WINE? 
 
 due to the long continued irritant action of alcohol that 
 I shall quote them in full: 
 
 M. J., a man 43 years of age, large, muscular, well 
 nourished, and had never had any serious illness. His 
 social status was good and he held a municipal office of 
 considerable importance. He consulted me in the latter 
 part of November, just after or during a debauch of two 
 or three weeks, during which time he drank large quan- 
 tities of strong liquor. At this time his most marked 
 symptom was a very rapid and feeble pulse, so rapid that 
 it was almost impossible to count it and so feeble that the 
 entire surface of his body was cyanotic. Upon careful 
 examination, no organic change in any of the chest organs 
 could be made out; but there was a moderate amount of 
 albumen in the urine. He did not make a rapid recovery; 
 but about the first of the following March his heart was 
 apparently normal in all respects, albumen disappeared, 
 and he declared he felt as well as he ever did. During 
 the last days of the following May he again began to 
 drink excessively, and continued his excesses for nearly 
 two weeks. I saw him again at this time and he pre- 
 sented a condition identical with that of the preceding 
 autumn. A day or two afterwards, while attempting to 
 sit in a chair, he fell over and expired suddenly. 
 
 Post-mortem examination disclosed the usual irrita- 
 tion due to drunkenness but not in a marked degree; for, 
 at the time of his death, he had had no alcohol for three 
 days. The heart was not dilated. It had, however, a 
 sodden intensely red appearance and a few pigmented 
 points due to the deposition of broken down blood 
 corpuscles. 
 
 The second case, W. G. G., male, 29 years old, a 
 traveling salesman in easy financial circumstances. He 
 drank periodically, going on a spree for from one to three 
 
ALCOHOLIC HEART DISEASES. „ 85 
 
 weeks, and then totally abstaining for six months or more. 
 Twice I treated him for the disorders following acute alco- 
 holism, mostly disorders of the nervous system, once for 
 incipient delirium tremens. About six months preceding 
 the attack which terminated fatally, and about one month 
 after a characteristic excess, he complained of some heart 
 disturbance. An examination, however, disclosed no or- 
 ganic trouble, but the pulse was rapid, 90 to 100, and fee- 
 ble. According to instructions, he returned twice more for 
 examination and advice. A noticeable improvement upon 
 his second visit was followed by a complete return to 
 the normal state upon his third visit. The debauch which 
 ended in his death was like many that had preceded it 
 excepting that it had not continued so long, being volun- 
 tarily cut short by the patient himself because of extreme 
 palpitation of the heart. For four or five days after the 
 withdrawal of the alcohol he ate but little, was weak and 
 cyanosed, and had a feeble pulse running from 98 to 130 
 per minute. About eleven o'clock on the morning of the 
 sixth day of abstinence, while sitting on the edge of his 
 bed in the act of putting on his shoes he fell over, and 
 expired in a few moments. 
 
 Post-mortem examination was held twenty-four hours 
 after death. There was some irritation of the mucous 
 membrane of the intestinal tract with a few petechial spots 
 near the cardiac end of the stomach. The heart showed 
 no organic change beyond what might be considered a 
 lack of normal firmness of its muscle. An examination of 
 the brain was not permitted. 
 
 Of the three other cases in which death could appar- 
 ently be traced to direct exhaustion of the heart by the 
 irritant action of alcohol, one was a periodic drinker who 
 died suddenly forty-eight hours after the ingestion of the 
 last alcohol, one was a chronic alcoholic who died soon 
 
86 SHALL WE DRINK WINE ? 
 
 after an attack of excessive palpitation without organic 
 trouble that could be detected by examination, and the 
 third, a moderate drinker with periodical excess, died on 
 the first day of an attack of pneumonia, presumably of 
 heart exhaustion. Of this group the first two were under 
 forty and the last one 52 years of age. 
 
 Undoubtedly the usual cause of death from heart dis- 
 ease in subjects of chronic alcoholism is some organic 
 change produced by the long continued action of the poi- 
 son. Fatty degeneration and dilatation with consequent 
 valvular insufficiency probably are the usual changes; but, 
 in the absence of any of these, direct heart exhaustion must 
 be regarded as the cause of a fatal issue. The lack of 
 nutrition is also an important element in contributing to 
 this species of heart failure. Drunkards, especially peri- 
 odic drunkards, in their excesses rarely take even a mod- 
 erate amount of nourishment. Sometimes they will go 
 for days or a week practically without food. With some, 
 too, alcohol produces a species of mania, during which 
 very little sleep is taken. This lack of food, lack of rest, 
 and all the destructive disturbances incident to the inges- 
 tion of large quantities of alcohol must contribute pow- 
 erfully to the fatal issue of heart exhaustion of alcoholism. 
 Parkes and Wollowicz, in their classical work on alco- 
 hol, called attention to the fact that four ounces of alcohol 
 ingested in the course of twenty-four hours causes an ad- 
 ditional labor, on the part of the heart, of 12,960 pulsations; 
 and they express the opinion that so much additional labor 
 on the part of the heart, amounting to about one-eighth 
 of the normal work, must speedily lead to exhaustion 
 of that organ. This view, however, is untenable. 
 Mere stimulation of the heart leads to hypertrophy of the 
 muscle which may be compensatory as when the circula- 
 tion is obstructed, or necessary to meet the requirements 
 
ALCOHOLIC HEART DISEASES. 87 
 
 of severe physical labor. In either case the hypertrophy 
 is not pathological but necessary for a new order of things. 
 In other words the heart exhaustion of alcoholism is not 
 the result of an increased amount of work which it is called 
 upon to perform; but to the degenerative changes in the 
 heart muscle, nerves or gangHa brought about by the direct 
 poisonous efifects of the alcohol. Hypertrophy of the 
 heart in chronic alcoholism is frequently observed; but it 
 may have arisen from co-existent cirrhosis of the liver 
 and kidneys. Another cause of drunkards cardiac hyper- 
 trophy, to which not much attention has been given, results 
 from the increased labor the heart is called upon to per- 
 form by reason of the enormous quantity of water which 
 is introduced into the circulation of wine and, especially, 
 beer drinkers. The water in two or three quarts of wine 
 in addition to the usual fluids drunk at meal times must 
 add to the intra- vascular pressure in a marked degree. 
 In beer drunkards, who consume from two to sixteen 
 quarts of beer every twenty-four hours, the labor of the 
 heart in ridding the distended circulatory system of this 
 enormous surplus of fluid, must be sufficient to lead to 
 hypertrophy, or in cases in which the hypertrophy is insuf- 
 ficient to meet the increased demands made upon the 
 heart, dilatation must result. As a matter of fact, enlarge- 
 ment of the heart is very common, according to Struem- 
 pell, in Bayreuth, Munich, and other beer cities of Ger- 
 many, an observation confirmed by other German phy- 
 sicians. 
 
 But the increased amount of fluid within the circulatory 
 organs is not alone sufficient to produce the changes seen 
 in the hearts of beer drinkers. The excess of carbohy- 
 drate food material which a beer drinker takes into his 
 circulation with five or ten quarts of beer cannot be 
 appropriated, but remains in the circulation, increasing 
 
88 SHALL WE DRINK WINE? 
 
 the Specific gravity of the blood, thus adding another fac- 
 tor to the hindrance of circulation. The increased sup- 
 ply of carbohydrate food aids, moreover, in the production 
 of fatty degeneration which, as we have seen, results 
 from alcohol interfering with the normal evolution of fat 
 digestion and assimilation. 
 
vni. 
 
 HlcoboUc Irritation of Other Organe. 
 
 If we do not lose sight of the fact that alcohol is an irri- 
 tant and as such gives rise to conditions identical with 
 those attending an ordinary inflammation, we shall find 
 it easy to understand the destructive changes produced 
 in the various tissues by long contact with alcohol. 
 Wherever it comes it produces a dilatation of the blood 
 vessels and an outwandering of the leucocytes. These 
 are finally organized into connective tissue to take the 
 place of the more highly organized tissue which it dis- 
 places, or, by contraction, deprives the normal tissue of 
 its proper supply of blood, thereby causing it to atrophy. 
 
 In the kidney alcoholic irritation is manifested by an 
 increase in the elements of its cortical substance at first, 
 followed by contraction and decrease in the bulk of the 
 entire organ. The uriniferous tubes are destroyed partly 
 by this subsequent contraction, but chiefly by the direct 
 action of alcohol upon the epithelial cells themselves. 
 The longer the poisonous influence of the alcohol is 
 exerted over the organ, the more likely will be the kidney 
 to exhibit cortical change; but the greater the quantity 
 of alcohol consumed, other things being equal, the more 
 the epithelium is likely to suffer. Another form of alcoholic 
 nephritis has been pointed out by Strumpell, the so-called 
 acute nephritis of alcoholism, in which there is a sudden 
 breaking down of great areas of epithelium. This seems 
 to result from a cumulative effect of chronic alcoholic 
 intoxication. 
 
 89 
 
90 SHALL WE DRINK WINE? 
 
 In the liver and probably in the spleen and pancreas, 
 although not much attention seems to have been given 
 these latter organs in alcoholism, there is an increase in 
 connective tissue of the cortical substance with a destruc- 
 tion of the epithelial cells. In the liver the interlobular 
 connective tissue contract, giving rise to prominences 
 on its surface, characteristic of alcoholic inflammation, 
 a condition known as "hob-nail" liver. 
 
0)c effects of Hlcobol on the Nerve I^issue. 
 
 Of all tissues of the body those which enter into the 
 structure of the nervous system are the most profoundly 
 affected by alcohol. Here, as elsewhere, alcoholic degen- 
 eration is characterized by two classes of changes: A 
 destruction of cell protoplasm and an increase in con- 
 nective tissue elements; but, as has been shown by Gaule 
 of Zurich, those cells which are the most highly differ- 
 entiated, which are called upon to perform the most com- 
 plex functions, suffer the most and are the earliest to be 
 affected, brain and other nerve cells are more profoundly 
 injured than those of any other part of the body. 
 
 This destruction of the cell protoplasm is shown in 
 the shrunken, flattened convolutions of the brain of an 
 alcoholic subject, and a microscopic examination discloses 
 an atrophy not only of the cells but also of the nerve 
 fibers. There is a great proportional increase in con- 
 nective tissue, and a part of the cell atrophy may be due 
 to consequent pressure by the connective tissue upon 
 the cells. According to Bevan Lewis (Text-book of Men- 
 tal Diseases, 1889,) the vessels which pass into the brain 
 cortex are enlarged, and their coats in an advanced state 
 of inflammatory and fatty change. There is a prolifer- 
 ation of the adventitious sheath nuclei, the protoplasm 
 of which is undergoing fatty degeneration. A great 
 number of scavenger cells pervades the external region 
 of the peripheral zone of the cortex lying immediately 
 
92 SHALL WE DRINK WINE? 
 
 behind the pia, "their branching processes forming a 
 dense matting which converts the outermost fourth into 
 a closely netted substance of minute meshes." These 
 scavenger cells are in greatest number where the vessels 
 pass downward through the cortical layers, resembling 
 the connective tissue increase along Glisson's capsule in 
 alcoholic inflammation of the liver. The deepest layer 
 of cells in the brain cortex are the most affected, the 
 upper, beyond the fifth, are sometimes apparently not 
 invaded. The motor area is that chiefly involved. In 
 the lowest layer, the spindle-cell formation, the scavenger 
 cells are sometimes so great in number as to conceal the 
 spindle-cells from view, the nerve elements being preyed 
 upon by the scavengers. In the spinal cord there are 
 similar changes, but particularly in the walls of the blood 
 vessels, some of the smallest vessels being entirely oc- 
 cluded by the increase in their muscular walls. 
 
 In recent years much has been done in working out 
 the characteristic nerve changes of acute and chronic 
 alcoholism. The researches of Jackimoff (Bulletin of An- 
 thropology, Paris, 1890,) showed in puppies and dogs 
 which had for a long time been fed on diluted alcohol, 
 characteristic changes. In animals which died of intox- 
 ication the brain was congested and infiltrated with new 
 connective tissue cells. The cells of the grey matter of 
 the spinal cord, especially of the anterior cornua, showed 
 intense disintegration, exhibiting many vacuoles, gran- 
 ules and indistinct nuclei. These changes were found also 
 in the medulla oblongata but in a less degree. 
 
 Berkley in a paper entided "The Action of Ethyl Al- 
 cohol on the Cortical Nerve Cells" (American Journal of 
 Insanity, July, 1895, and the Glasgow Medical Journal, 
 Dec, 1895,) records the results of the examination of five 
 rabbits which had been fed with dilute alcohol for periods 
 
THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 93 
 
 varying from six months to a year, and which had nearly 
 all died in convulsions. In the vascular wall there were 
 only slight changes, principally a slight increase in the 
 nuclei of the intermediary vessels, some thickening of the 
 walls, some crystals of haematoidin in the surrounding 
 lymph spaces, with a definite dilatation of the lymph 
 spaces surrounding the blood channels and an occasional 
 small hemorrhage due to rupture of a blood vessel. The 
 greatest changes were found in the nucleoli. They were 
 much enlarged, roughened, and spongy with elongated 
 projections from the surface. A large number of the 
 pyramidal cells had tumefactions of varying size on their 
 protoplasmic branches or dendrons. These tumefactions 
 commenced, apparently, on the outer end of the dendron 
 and were accompanied by a disappearance of the latter 
 buds of the dendritic processes. In the cells of Purk- 
 injie of the cerebellum the same alterations but more pro- 
 nounced were observed. The structure of the axis cyl- 
 inders was normal. The structures of the neuroglia were 
 also invaded. 
 
 From the fact that the arterial changes observed were 
 so insignificant. Dr. Berkley thinks that the changes pro- 
 duced could not be the result of lack of nutrition, but 
 must be charged to the direct irritative action of the alco- 
 hol on the cell protoplasm. 
 
 The observations of Jackimoff and Berkley are con- 
 firmed by other investigations. Recently Hoch (Amer- 
 ican Journal of Insanity, Vol. LIV., P. 600 et seq.) re- 
 ported the cell changes in a man recently dead of delirium 
 tremens. These changes he found were uniform. The 
 cell substance which ordinarily takes the stain for obser- 
 vation is lost and that which ordinarily is not suscepti- 
 ble to staining takes the coloring matter instead. The 
 cells have a mottled appearance. The nuclear wall is 
 
94 SHALL WE DRINK WINE ? 
 
 uncommonly distinct and the nucleus contains numerous 
 sharp granules which are often seen distributed in the 
 net-work. The nucleolus is not enlarged but may show 
 light areas. The next change, a greater disturbance or 
 destruction of the cell, shows the nucleus lighter, the 
 nucleus wall less distinct and more irregular in its outline, 
 the nuclear net-work loses its sharpness and the nucleolus 
 becomes paler and in some instances distinctly smaller. 
 In the last stage the nucleus becomes very pale, either 
 small or very large, often very ragged in its outlines, the 
 nuclear membrane being indicated only by dots, the con- 
 tents being indistinct and speckled with numerous gran- 
 ules. The nucleolus is either of normal size or very small, 
 very pale, or it may be entirely absent, this being the 
 most common occurrence. These changes are most prom- 
 inent in the deepest layer (the fifth) and least pronounced 
 in the second layer of cells. The dendritic processes far 
 away from the cell assume a crumbled appearance. 
 
 In the neuroglia there are large white spaces around 
 the nuclei, the cell body is visible in parts, often having 
 granules in it^ the pigment is often well seen, the chromatin 
 is present in coarser granules than normal, and there is 
 an increase in the neuroglia nuclei. Besides we have in 
 the first layer well marked spider cells. 
 
 The vessels frequently present no abnormality, some 
 stand out prominently, partly on account of the neuroglia 
 nuclei of the surrounding tissue. The vessel walls are un- 
 altered. 
 
 What chemical changes are undergone during the 
 process of cell degeneration is not known. There can be 
 no doubt, however, that they are as important as the 
 structural changes would seem to indicate. 
 
 Commensurate with the physical changes shown by 
 the microscope are the changes in nerve function in all 
 
THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 95 
 
 parts of the nervous system. These are first to be noticed 
 in the psychic domain, and the ethical side of the alco- 
 holic's character is the first to exhibit the deterioration. 
 These are almost imperceptible at first and take the form 
 of simple irritability. Trifles annoy him. Petty displeas- 
 ing incidents which would have passed unnoticed in his 
 normal condition now call forth expressions of anger 
 out of all proportion to the importance of the incident. 
 The alcoholic himself recognizes this unfavorable change 
 in his disposition; but, instead of giving up the drink 
 which causes it, he seeks relief in the narcotism afforded 
 him by increased potations. While in this condition he 
 is apt to regret his impatience. He seeks out those friends 
 to whom his irritability may have given offense and apol- 
 ogizes with profuse and often maudlin volubility. 
 
 Later he grows suspicious of those around him, thinks 
 that he is neglected by his friends and that he is not ac- 
 corded a just measure of gratitude for favors he may 
 have done them, and is liable to attach a great deal of 
 importance to a trifling act of this kind done by him. If 
 his friends notice the change in him and warn him that 
 he is injuring himself with drink, instead of giving due 
 heed to the advice, he is liable to consider this an infringe- 
 ment on his personal liberty, an unwarranted interference 
 with his private affairs, and he will resent it to the extent 
 of putting a friend of a score of years on the list of his 
 enemies. 
 
 The moral sense suffers enfeeblement and deteriora- 
 tion. He who was once so punctilious in the matter of 
 meeting his daily obligations becomes evasive and neg- 
 lectful. That nice discrimination with which he formerly 
 met and promptly attended to the various complicated 
 questions of social and business ethics is lost, and 
 his mind is seen to be of a distinctly coarser fiber. 
 
96 SHALL WE DRINK WINE? 
 
 Sense of dignity, of honor, of moral obligations, of per- 
 sonal conduct, no longer move him as formerly. He 
 thinks only of escaping from them, for the weakened 
 brain cells are no longer capable of attending to such 
 things without infinite labor which the will power of the 
 alcoholic is no longer able to command. The ego be- 
 comes prominent, but it is an ego of very inferior order. 
 He talks much of himself — ^what he is, what he can do, 
 and is anxious to gain the ear of anyone who will listen 
 to his long rambling imbecile narrations of which he is 
 himself always the hero. 
 
 Oftentimes the character of the inebriate is so com- 
 pletely the opposite of that of the same man when sober 
 that one marvels at the possibility of both dwelling in the 
 same individual. A man of affairs upon whose shoulders 
 rests the responsibility of successfully directing an in- 
 vested capital of hundreds of thousands of dollars, does 
 it with an insight and comprehensive grasp of detail 
 worthy the brain of a field marshal. He is an important 
 social factor, too, and his influence is felt along scores 
 of complicated lines of beneficial action. At home he is 
 a loving husband and father, and abroad he is a gentle- 
 man of modest unaffected manners so brilliant and genial 
 that it is a pleasure to be in his society. In his personal 
 habits he is strictly correct, and he carries himself with 
 the confident air of one who is a complete master of him- 
 self and affairs. Let this same man be drunk on alcohol 
 every day for a year, and the degenerative changes in the 
 brain cells make him a being so much lower in the scale 
 of social evolution that he might be regarded as belong- 
 ing to another and infinitely lower race of men. He has 
 not only lost his power to direct great business ventures, 
 but he has no desire to do anything of the kind. All of his 
 ambitions are now represented by an intense desire to 
 
THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 97 
 
 get sufficient alcohol wherewith to relieve the physical 
 and mental anguish induced by even a short abstinence. 
 Friends have long since been forgotten, and family ties 
 probably broken by neglect or even hatred on the drunk- 
 ard's part. His conversation is now the maudlin obscen- 
 ity of the bar-room, and his associates are the fallen men 
 and women who live by the petty crimes committed in 
 theirs, the lowest stratum of any kind of human society. 
 His personal appearance has suffered no less than his 
 character, and his unkempt, neglected, shuffling figure 
 and repulsive expression are a fitting index of the brain 
 degeneration produced by the long contact of its cells with 
 alcohol. 
 
 Finally the alcoholic reaches the condition of real in- 
 sanity. He is emotional in a morbid degree, intensely 
 self-conscious, fault-finding, perverse, intolerable of con- 
 tradiction, and easily aroused to violent passion. He 
 may, on the other hand, become indiflferent to his sur- 
 roundings, falling into a condition of stupidity from which 
 nothing, for the time, will rouse him, or he may fall into 
 a condition of simple imbecility. 
 
 It is a well-known fact that the will power is early and 
 profoundly affected in alcoholism. The subject loses the 
 power to control his own actions and he is willing to be 
 led by very slight influences. Recognizing his duties, he 
 finds it impossible to perform them, impossible to reach 
 and carry out any plan of action requiring vigorous 
 thinking. The indifference with which he regards his 
 daily duties, with an inability to perform them, gives rise 
 to a distaste for all the occupations in which he was 
 formerly engaged. 
 
 Last to fail, as a rule, is intellectual power. It may 
 show itself after prolonged excessive indulgence, even 
 after the body is become a wreck. Sometimes it is, in a 
 
98 SHALL WE DRINK WINE? 
 
 fitful way, present to the last. Failure of the intellect is 
 generally first observed as a loss in power to quickly 
 grasp an idea, a loss of vivacity, an evidence that all men- 
 tal processes are performed more slowly and laboriously. 
 The drunkard is indifferent to all social and other ques- 
 tions which give interest to the lives and intercourse of 
 the healthy. His conversation is broken and his ideas 
 fragmentary. Finally the memory fails in a marked de- 
 gree, and he soon reaches a stage of mental degeneration 
 which renders him unfit for any useful calling. 
 
 The above sketch touches only a small part of the 
 phenomena due to the continued use of large quantities 
 of alcohol. Organic changes in the viscera, the digestive 
 tract, liver, heart and other organs complicate in a thou- 
 sand ways mere nerve degeneration, giving the disease 
 picture an almost kaleidoscopic aspect; moreover, there 
 are hereditary influences at work which are aroused by 
 indulgence in alcohol and contribute their part in modi- 
 fying the surface play of alcoholic degeneration. 
 
 Of disturbances relating to the special senses, hal- 
 lucinations of sight are common, hallucinations of hear- 
 ing sometimes present, as are also those of smell and 
 taste. Of sensation, anesthesia or hyperesthesia may be 
 present, as well as abnormal sensations of heat or cold. 
 Amblyopia is common, probably from the degeneration 
 of the cortical cells. 
 
 Disturbances of motion in chronic alcohoHsm is com- 
 mon, and may assume a variety of forms and different 
 grades of severity from slight ataxia with numbness to 
 almost or quite complete paralysis. In my experience 
 the lower limbs are oftener affected than the upper, and 
 the feet the most usual site both of sensation and motion 
 anomalies. The arthrodynia described many years ago 
 (New England Journal of Medicine and Surgery, 1822,) by 
 
THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 99 
 
 James Jackson, is prominent in many cases. The pains 
 are persistent and at times excruciating, accompanied by 
 a feeling of numbness which causes the patient much 
 anxiety. Progressive atrophy of the muscles, especially 
 of the extensors, takes place, causing a contraction of 
 the flexors to such a degree that from this and the paralysis 
 the patient may be entir ;ly crippled. Many other writers 
 have noticed these changes since Jackson wrote of them, 
 notably Lancereaux, Huss, Wilks and Dreschfeld. 
 
 A typical but mild case of alcoholic paralysis is now 
 under my care, and I cannot do better than give a com- 
 plete history of the course of the disease as exhibited in 
 him. This man is now forty years of age, and up to 
 eighteen months ago had been addicted to periodic alco- 
 holic excesses ever since he was seventeen years old. 
 With increasing years his excesses increased until about 
 three years ago, at which time he "took a course" in a 
 commercial institution for inebriates. For a year after- 
 wards he drank no alcoholic liquor excepting an oc- 
 casional glass of beer. He felt well at this time and at- 
 tended to his duties as bookkeeper in a lumber yard for 
 several months, and was able to do his work well and 
 without unusual fatigue. He then began to drink large 
 quantities of whisky and brandy, his daily average for 
 a period of seven or eight months being a quart or more. 
 He is able to tell exactly how much he drank, for he 
 bought the liquor by the gallon. 
 
 He came under my care, in the present instance, only 
 two months ago; I cannot, therefore, speak accurately of 
 his condition just after he ceased taking this enormous 
 quantity of alcohol. From what he says, however, I judge 
 that his present condition of ataxia or paralysis is as it 
 was at that time only in a less degree. The parts involved 
 are the right knee and foot and to a less degree the right 
 
100 SHALL WE DRINK WINE? 
 
 shoulder. He has had almost continuous pain and sore- 
 ness of the right knee extending down the leg to the foot, 
 associated with a feeling of numbness and formication in 
 sole of the foot. He is troubled a great deal by a sense 
 of insecurity of the affected member. If he happens to 
 step with the heel upon a projecting knot or other prom- 
 inence in the way, his knee is liable to give way and cause 
 him to fall. The sensation as he describes it is like that 
 one experiences when he attempts to walk when his foot 
 is asleep. The shoulder is not so painful as the knee, 
 and the hand shows none of the anomalies of the foot. 
 The muscles are not apparently atrophied. He complains 
 of uneasiness in the region of the right cerebellar lobe, 
 accompanied by a dull ache; and, when he looks upward, 
 he has a sensation of dizziness and inability to retain his 
 equilibrium, indicating a possible degeneration of a cell 
 area in the cerebellum. 
 
 Two other cases similar to this case occurred in my 
 experience a few years ago. In one paralysis was bilateral, 
 almost complete, and affected only the lower extremities. 
 In the other only one lower extremity was affected and 
 here the pain and anesthesia were more prominent than 
 the paralysis. A peculiarity of the first case cited is the 
 long continued persistence of the ataxic symptoms after 
 the alcohol is given up; for in all the other cases which 
 I have observed the withdrawal of the alcohol was attended 
 by rapid progress toward recovery. 
 
 Degenerative changes in the peripheral nerve filaments 
 have been described by Leudet, Dreschfeld, Lancereaux, 
 Dejerine and others. Huss was unable to find any 
 changes in the five cases dead of alcoholic paralysis. 
 
 Where the peripheral nerve filaments suffer degen- 
 erative changes it is difficult to say how much is due to 
 direct alcoholic irritation and how much to lack of nutri- 
 
THE EFFECTS OF ALCOHOL ON NERVE TISSUE. 101 
 
 tion. The recent researches of Hoch (Loc. Cit.) showed 
 that while the nerve cell might be profoundly degener- 
 ated the axis cylinder was apparently unchanged. Rea- 
 soning from this, we might conclude that the peripheral 
 nerves may not be directly affected by alcohol. 
 
 The evil effects of alcohol upon the rapidly develop- 
 ing tissue cells of the entire organism in childhood deserve 
 special attention. Here, protoplasm activity, as is the 
 case in embryonic tissue and the nervous tissue of the 
 adult, invites alcoholic destruction; therefore small quan- 
 tities of the poison have a relatively greater influence than 
 upon the organism of the adult. 
 
 Excepting among the most vicious classes in the over- 
 crowded tenement districts in our large centers of popu- 
 lation, the stronger alcoholic liquors are seldom given 
 to children as a beverage. Among foreign born parents, 
 however, a not inconsiderable quantity of alcohol in the 
 form of beer and wine is daily given to children from a 
 few months of age upwards. 
 
 As a remedy, however, the ever present brandy bottle 
 has been a panacea in the ordinary household for all kinds 
 of slight digestive troubles incident to childhood, even 
 children in the cradle having a little lime-water and brandy 
 put in their nursing bottles to correct "acidity" and give 
 strength to the little victim of mal-nutrition. This form 
 of domestic medication, having the authority of medical 
 books and medical men, may go on for weeks and months, 
 and the seemingly small daily quantity may do an incal- 
 culable amount of harm to the already weakened tissues 
 of the tiny patient. Demme cites (Einfluss des Alkohols 
 auf den Organismus des Kindes, P. 48, et seq.) two cases 
 of real alcoholic sclerosis of the liver in boys, four and a 
 half and eight years of age respectively, the first of which 
 was given whisky for colic, and the latter received it as 
 
102 SHALL WE DRINK WINE ? 
 
 a stimulating tonic. Both cases, of course, terminated 
 fatally. Many cases of lack of mental development from 
 the same cause, are mentioned by the same author; and 
 of particular interest are several cases of epilepsy, typical 
 in all respects, the origin of which could be directly traced 
 to the poisonous influence of alcohol upon the impres- 
 sionable tissues of childhood. Cases of epileptic attacks, 
 eclampsia, chorea, and many other nervous disturbances, 
 mild and severe, directly resulting from the exhibition of 
 alcohol in the early years of life, might be cited. 
 
 Other writers in recent years have raised a warning 
 voice against the administration of alcohol to children, 
 and especially against allowing them to drink any kind 
 of alcoholic beverage. Professor Nothnagel (Verhand- 
 lungen des VII. Congresses fur innere Medicin, Wies- 
 baden, 1 888, P. 137,) characterized the giving of wine at 
 the table to children of three or four years of age as "a 
 cancer of our age." 
 
X. 
 
 Cbc Influence of Hlcohol dpon embryonic 'Ctssue 
 and Rcrcdity. 
 
 The action of alcohol upon the rapidly growing cells 
 of the embryo is undoubtedly more destructive than upon 
 mature tissue, if we are permitted to reason from analogy. 
 It is easy to understand that the protoplasm of cells which 
 display great activity, even if that activity is only vegetative 
 in character, must be in a condition of great physiological 
 irritability, needing only a comparatively weak stimulus 
 to push it beyond the limits of normal activity to cell 
 destruction. We may compare the irritant action of al- 
 cohol with the ordinary irritation seen in inflammatory 
 processes, in which irritation may be only sufficient to 
 stimulate an increase in new tissue, or the process may be 
 so energetic that the tissue is broken down, as is seen 
 in the ordinary process of suppuration. The embryonic 
 cell already possessing a high degree of the same irrita- 
 bility which results from all inflammatory processes, it 
 needs only a comparatively small amount of stimulation 
 to accomplish its destruction. Moreover, the narcotic 
 effects of alcohol must play an important part in hinder- 
 ing the normal course of the biochemical processes nec- 
 essary to physiological cell integrity. 
 
 In the work of Dr. Wilkins (Loc. Cit.) the adminis- 
 tration of alcohol was supplemented by fifty-one post- 
 mortem examinations, from which he concludes that the 
 cell walls enclosing the germinal matter are dissolved, the 
 
104 SHALL WE DRINK WINE ? 
 
 albumen not in combination coagulated, the red blood 
 corpuscles are deprived of their constituents, which mingle 
 with the liquor sanguinis, leaving them shrunken and 
 wrinkled, and the organizing ability of the protoplasm 
 is modified. The result is to fill up the connective spaces 
 with foreign compounds favoring the growth of tumors 
 and neoplasms. Chemical selective power is either im- 
 paired or completely destroyed, rendering wounds dif- 
 ficult to heal. Two conditions cause this. In the first 
 place, although there is an abundant proliferation of pure 
 germinal matter, it cannot be organized because of the 
 degeneration above mentioned, but proceeds to further 
 degeneration into pus cells because of the continued irri- 
 tation. Secondly, metabolic life is suspended because the 
 ganglions are deprived of phosphorus and protagon by 
 the direct solvent action of alcohol. Thus the neuro- 
 dynamia in the grey matter is not properly organized, 
 the enlarged soft parts disintegrate and neoplasm forms 
 in the wounds, while the broken bones receive no osteo- 
 blasts to repair damage. 
 
 Fere reported a series of very interesting experiments 
 Qournal of Anatomy and Physiology, Paris, March and 
 April, 1895,) in which he undertook to demonstrate the 
 effects of direct contact with alcohol with the bird embryo. 
 For this purpose he dosed a number of hens' eggs with 
 small quantities of alcohol before placing them in position 
 for incubation. Several living chickens were hatched out 
 at the end of twenty-one days, but the most of them were 
 not ready, at the end of that time, to leave the shell because 
 of insufficient development, a large yolk being still re- 
 tained. Some were killed by the alcohol, and those which 
 were not could not leave the shell before the twenty-third 
 day. Of peculiar interest was the fact that many of the 
 young birds presented various anomalies and monstrosi- 
 
INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 105 
 
 ties, such as deficiencies of the abdominal wall, double 
 terminal phalanges and nails, crossed beaks and the like. 
 One of the birds was an epileptic and all might be regarded 
 as alcoholic degenerates. 
 
 Fere's experiments also show that alcohol vapors ar- 
 rest the development of the embyro in the egg of the 
 fowl, and he believes that these results prove that the same 
 obtains in the case of alcoholism in the human subject. 
 
 That the progeny of lower animals show the degen- 
 erating effects of alcoholic parents is a matter which is 
 engaging the attention of some experimental physiolo- 
 gists at the present time. Of great interest in this con- 
 nection are the experiments conducted by Professor C. F. 
 Hodge of Clark University. The subjects of his experi- 
 ments were two pairs of Cocker spaniels, healthy and 
 of the same age, the males being brothers and the females 
 sisters of distantly related parentage. One pair received 
 a daily supply of alcohol, but not sufficient in quantity 
 to noticeably intoxicate. The other pair received the 
 same kind and quantity of food but no alcohol. Nine 
 litters of puppies were born to each pair, those of alco- 
 holic parentage numbering 20 and those of non-alcoholic 
 parentage 16. Of those born of the alcoholized parents 
 6 were born dead and 8 had some sort of malformation, 
 only 4 being healthy. To the non-alcoholic parents i was 
 born dead, and only i was malformed, the remaining 15 
 being perfectly healthy. In other words, only 20% of 
 the progeny of the alcoholized parents were healthy, while 
 93.8% of the progeny of the non-alcoholic parents were 
 healthy in all respects. This result agrees very closely 
 with the results of Demme's ten alcoholic and ten sober 
 families. 
 
 Reasoning from the destructive influences of alcohol 
 upon protoplasm in general and upon the extremely active 
 
106 SHALL WE DRINK WINE ? 
 
 protoplasm of the embryo particularly, we are prepared 
 to understand the evils which may be transmitted by the 
 alcoholic parent to his offspring, long ago recognized by 
 obsendng medical men. So many observations of this 
 kind have been made that anything like a complete rec- 
 ord of them would consume much more space than may 
 be given to that subject in this work. More than twenty- 
 five years ago Alexander Bain, the psychologist, expressed 
 a belief, as the result of evidence he was able to collect, 
 that no child conceived While either parent was in a con- 
 dition of alcoholic intoxication could be perfectly sound 
 mentally and physically. This is, no doubt, an extreme 
 view, for we must admit the force of modifying circum- 
 stances, such as other hereditary influences in the parents 
 aside from alcohoHsm, the amount of damage done to the 
 tissues at the time conception took place, and whether 
 both parents were alcoholic habitues. In short, the 
 actual amount of damage done to parental tissue as a 
 whole by the continued use of alcohol ought to be an in- 
 dex of the amount of deviation from the normal standard 
 of health exhibited by the child. It ought not to be for- 
 gotten that the heritage of alcoholic degeneracy usually 
 descends through only one parent, the father; the mother, 
 in America at least, being almost always free from ac- 
 quired alcoholic taint. There should be, therefore, in cases 
 in which the mother is sober and herself free from hered- 
 itary taint some chance of producing normal, healthy prog- 
 eny. As a matter of fact, instances of the kind are common 
 in the experience of every one who has taken the trouble 
 to make the necessary observations and investigations. 
 Many instances might be recalled of strong, sound, force- 
 ful, mature young men and women who are the sons 
 and daughters of drunken fathers. As to whether alco- 
 holic degeneracy may leave the next generation unmo- 
 
INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 107 
 
 lested and reappear in the second or third, no definite 
 observations, so far as I am aware, have yet been made. 
 The difficulties attending the collection of statistics of this 
 nature are necessarily so many and so great that no val- 
 uable conclusion could be arrived at. 
 
 Wilson of Kansas City (New York Medical Journal, 
 Sept. 22, 1894,) thinks that if conception takes place at 
 the time when one or both parents are in a condition of 
 alcoholic intoxication or have been in that state for a 
 time sufficient to cause a deficiency in the nerve centers 
 there will be a corresponding deficiency in the child. 
 Not that all the children of alcoholics are weak-minded 
 or idiots; but, when the conditions exist as stated above, 
 a weak mind or idiocy is the result. 
 
 Haushalter of Nancy gives an interesting case of alco- 
 holic degeneracy exhibited in the offspring of a chronic 
 drunkard (Revue Medical, Paris, July lo, 1894). The 
 father is forty years old and shows all the outward signs 
 of an excessive habitual consumer of alcohol. The 
 mother of about the same age looks worn and many years 
 older; she, however, never had any specific disease. The 
 first male child was born dead. The fourth, seven and 
 a half years old, was brought to the hospital in a wretched 
 state. Although fully developed, strong, and robust at 
 birth, he is now pale, emaciated, and with a dry scaly skin. 
 The child is addicted to vicious habits, silent, morose, and 
 terrified, crying upon the slightest occasion. Haushalter 
 expressed his belief that the deplorable moral and phys- 
 ical degeneration is due to the fact that the child is 
 "the last born of an alcoholic father." 
 
 Personally I have come in contact with many cases 
 of inherited degeneracy from an alcoholic father as strik- 
 ing as this cited by Haushalter. Space will permit a 
 description of only a few and I select four famiUes well 
 
108 SHALL WE DRINK WINE ? 
 
 known to me as fairly representative cases of inherited 
 alcoholic degeneracy. 
 
 First family: Father a drunkard for twelve years. 
 No hereditary taint in father as far as could be ascer- 
 tained. Two sisters and one brother sober and useful 
 members of society. Drank to excess from time of his 
 marriage until fourth child was born excepting an inter- 
 val of about two years. Cessation of drink during this 
 period was due to removal into an isolated settlement 
 where intoxicating drinks could not be procured without 
 much difficulty. 
 
 First child female, well developed and healthy in early 
 childhood. Later became nervous and anaemic and had 
 two attacks of chorea before puberty. With appearance 
 of puberty asthma developed accompanied with various 
 psychic disturbances, periodical nervous excitement, hys- 
 teria and melancholia. 
 
 Second child, male, was a typical degenerate mentally. 
 Given to attacks of violent passion and rage, cruel to ani- 
 mals and children whose weakness made it safe for him 
 to bully them, intractable at home and at school, with the 
 appearance of manhood he committed some punishable 
 offense and was obliged to seek safety in flight, from 
 which time he passed from under my observation. So 
 far as I know he was not addicted to alcoholic drink at 
 the time of his escape. 
 
 Third child, female, still born. 
 
 Fourth child, male, fairly well developed and in good 
 health. When last seen he was seventeen years of age 
 and his steady going habits were often the subject of 
 remark by his degenerate elder brother. It is interesting 
 to note that this child was born less than six months after 
 his father again began his alcoholic excesses, which ter- 
 minated fatally in three years. 
 
INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 109 
 
 The fifth child, born two years after the fourth and 
 while the father was in a condition bordering on alcoholic 
 imbecility, was an interesting study. He was under ob- 
 servation from the time he was eight years of age until 
 his fifteenth year. As a child he was well nourished and 
 healthy in appearance, but walked with the uncertain 
 gait of a mildly choreic subject. This incoordination 
 afifected the muscles of the upper extremities, though in 
 a less degree, and the child's speech was halting and 
 stammering. At school he was timid, lacking self-con- 
 fidence in his classes and seeking the constant compan- 
 ionship and protection of his more robust elder brother. 
 He learned rapidly and was very faithful to his school 
 work; with increasing years the incoordinated movements 
 became less marked, possibly from greater efforts to con- 
 trol them, but when last seen they were still to be noticed, 
 especially when he was excited. 
 
 Second family: Father and mother of good heredity, 
 have seven children. The first four, born while the father 
 was sober and prosperous, are in good health and have 
 had no disease except the ordinary diseases of childhood. 
 After the birth of the fourth child the father became a 
 drunkard, since which time three children have been born, 
 not one of which exhibits the strength of any of the first 
 four. All are nervous, have nutritive disturbances, and 
 the youngest exhibits signs of hydrocephalus. 
 
 Third family: Father a drunkard, heredity un- 
 known, has no alcoholic excesses, but drinks a small 
 quantity of beer occasionally. Mother at the time of her 
 marriage to present husband had one healthy female 
 child. Two children resulted from the second union, 
 both male; one appears to be in a normal condition of 
 health, but the younger one is idiotic and has recently 
 been sent to a home for the feeble-minded. 
 
110 SHALL WE DRINK WINE? 
 
 Fourth family: Heredity of mother unknown, hered- 
 ity of father good. Mother's habits good, but father has 
 been a drunkard ever since his marriage and before. 
 Two children have been bom to them, both of whom 
 exhibit trophic disturbances in a marked degree. The 
 elder child is one of the most restless and irritable I have 
 ever seen, and exhibits frequent excessive emotional 
 storms, is of poor color, emaciated, sleeps poorly, and in 
 many other ways shows profound nervous disturbance. 
 The other child is a victim of mal-nutrition amounting 
 to marasmus, and has been beset by adenoid vegetations of 
 naso-pharynx and larynx which twice rapidly reappeared 
 after their removal from the pharynx. So conspicuous 
 were the trophic changes in the case that a colleague dis- 
 cussed with me the probability of an existing specific 
 taint, but we could find absolutely no evidence to war- 
 rant that conclusion. 
 
 That there is an hereditary alcoholic degeneracy mani- 
 fested by an abnormal desire for alcoholic drink without 
 serious physical or mental disturbances seems to be sup- 
 ported by good evidence. A case in point is that of a prom- 
 inent and intelligent man of affairs, under my care at vari- 
 ous times for alcoholic excesses, who finally died of alco- 
 holic cirrhosis of the liver. He gave a very detailed account 
 of the alcoholic family of which he was a member, for 
 three generations. His paternal grandparents were both 
 drunkards and all his paternal uncles and aunts, with 
 the exception of one of the latter, drank to excess. In 
 his immediate family, the father and two brothers were 
 drunkards, while a brother and a sister only were sober. 
 He declared to me also that his little children, girls six 
 and nine years old respectively, at that time, had already 
 exhibited the consuming desire for strong drink which 
 had characterized so many members of his family. He 
 
INFLUENCE UPON EA^BRYONIC TISSUE AND HEREDITY. Ill 
 
 described his own desire for drink as absolutely uncon- 
 trollable. His excesses were periodic at first, and when 
 the desire seized him absolutely nothing but the fact that 
 to secure drink was a physical impossibility would pre- 
 vent him from satisfying his morbid appetite. 
 
 Another case of transmitted morbid appetite without 
 other disturbance mental or physical was that of a young 
 man whose mother drank large quantities of brandy dur- 
 ing his intra-uterine life. This woman was of good par- 
 entage and surroundings and had never taken any alco- 
 holic drink of any importance until her first pregnancy. 
 At this time her desire for alcohol assumed the form of 
 a morbid longing characteristic of her condition. Her 
 husband was absorbed by his business affairs and she 
 was left to gratify her morbid appetite at will. This she 
 did until her son was born, after which she had no further 
 desire for alcohol. Excepting an indefinite history of 
 "nervousness" the boy exhibited no abnormal tendencies 
 until the age of puberty was reached. At this time he 
 evinced an intense liking for all kinds of liquors, and in 
 early manhod became a confirmed sot. When last seen 
 by me he had reached a condition of idiocy, and I learned 
 of his death soon afterward. 
 
 Of statistical evidence showing the blighting effects of 
 alcoholism in the parents upon the offspring, that recently 
 reported by Legrain is most instructive (Medical Press 
 and Circular, London, Jan. 13, 1894). This report in- 
 cludes vital statistics of 215 alcoholic families represented 
 by 819 descendants. Of this number 16 were born dead, 
 ■^"j were born prematurely, there were 121 premature 
 deaths, generally attended by convulsions, 55 cases of 
 tuberculosis, 38 cases of marked physical debility, and 145 
 cases of mental derangement. Of the remainder, "a large 
 number were epileptics, hysterics, idots, etc." These ob- 
 
112 SHALL WE DRINK WINE ? 
 
 servations were made in France and the author attributes 
 the rapid depopulation of that country to the great increase 
 in alcohol consumption, or, rather, he considers this as of 
 prime importance as a cause of the depopulation of France. 
 Hitherto the French have been regarded as a sober peo- 
 ple, but they deserve that reputation no longer, for in 1892 
 they consumed nearly 40,000,000 gallons of alcohol. In 
 1789 France was the most thickly populated country in 
 Europe, representing 27 per cent, of the entire European 
 inhabitants. To-day she represents only 12 per cent., 
 the excessive death rate being infantile. During the ten 
 years preceding 1894, 42,000 children were still-born and 
 240,000 children between the ages of one and five have 
 died annually. Apart from other causes contributing to 
 this result, great prominence is, by general consent, given 
 to alcohol. This has been occasioned largely by the in- 
 creasing manufacture of wine charged with impure alcohol. 
 
 Legrain emphasizes the fact that drunkenness is a 
 fertile cause of unhealthy issue. The simple condition of 
 drunkenness at the time of conception is sufficient to cause 
 mental and physical inferiority in the offspring. This 
 degeneration in the children of alcohoHcs may result even 
 though neither parent may be actually under the influ- 
 ence of alcohol at the time of procreation. 
 
 Forel is convinced that chronic alcohol poisoning in 
 the parents is transmitted to the offspring in the form of 
 various mental and physical anomalies (Medical Pioneer, 
 Endfield, Eng., Nov., 1893). The heritage may descend 
 in the form of an irresistible craving for alcohol, physical 
 debasement, mental disease, idiocy, and a multitude of 
 other disturbances. Hereditary craving for alcoholic 
 drink may exist when neither parent drank from any other 
 motive than that of sociability. He found, too, that these 
 abnormal descendants bear alcoholic liquors badly and 
 are easily intoxicated. 
 
INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 113 
 
 Vigillis of Italy (ibid.), discussing the heritage of 
 criminals, says that 32 per cent, of all criminals have 
 criminal tendencies as a direct inheritance from their par- 
 ents, and that alcohohsm in the ancestry is a most fruit- 
 ful cause of criminal tendencies. Corre of the French 
 military service (Quarterly Journal of Inebriety, Jan., 
 1894,) believes that 40 per cent, of crime and reprehen- 
 sible conduct comes from inherited alcoholic degenera- 
 tion from inebriate parents. 
 
 C. H. Hughes of St. Louis (Alienist and Neurologist, 
 Jan., 1894,) recalls Morel's table of alcoholic neuropathic 
 degeneration extending through four generations as fol- 
 lows: 
 
 FIRST GENERATION: Immorality, alcoholic ex- 
 cesses, brutal degradation. 
 
 SECOND GENERATION: Hereditary drunken- 
 ness, maniacal attacks, and general paralysis. 
 
 THIRD GENERATION: Sobriety, hypochondria, 
 lypemia, maniacal attacks, and general paralysis. 
 
 FOURTH GENERATION: Feeble intelligence, 
 stupidity, first attacks of mania at sixteen, transmission 
 of complete idiocy, and probably extinction of family. 
 
 More recently Legrain presented in the British Med- 
 ical Journal a great many observations which, when tabu- 
 lated, lead him to draw the following conclusions : 
 
 (i) Double parental alcoholism creates an irresisti- 
 ble tendency to drinking in children. 
 
 (2) Parental absinthe drinking seems to directly 
 transmit epilepsy to the offspring. 
 
 (3) Parental combination of absinthe drinking and 
 epilepsy is a common cause of epilepsy in children. 
 
 Fuerer of Heidelberg (Bulletin Medical, Paris, Aug. 
 25, 1895,) expresses the doctrine that the generative cells 
 of the drunkard are alcoholized and that the offspring are. 
 
114 SHALL WE DRINK WINE? 
 
 for that reason, frequently degenerates: psychopathies, 
 idiots, or rachitics. He makes a distinction between those 
 cases in which there is only an inherited desire for drink 
 and those in which there is some inherited organic fault. 
 He admits, however, that one form may coexist with or 
 engender the other, both being the result of real degen- 
 eration. He thinks it absurd to think that an evolution- 
 ary adaptation of the human kind to alcohol will ever be 
 brought about, insuring it immunity against alcoholic 
 poisoning. Facts prove the contrary. The intoxication 
 of the male and female germs weakens the resisting force 
 against alcohol in the descendants instead of strengthen- 
 ing it. It is impossible for an evolutionary adaptation to 
 narcotic poisons to take place. 
 
 Speaking of the influence of alcoholism in producing 
 degenerative offspring, Crothers (Journal of American 
 Medical Association, April 9, 1898,) remarks that heredity 
 has in these cases left the person a low and defective vital- 
 ity, feeble powers of resistance, and inability to adjust 
 himself to his surroundings. These conditions of weak- 
 ness and degeneration diminish the power of resistance 
 against inflammatory disease, and also make narcotism by 
 alcohol fascinating because the subject thus acquires a 
 feeling of strength and his physical and mental distress 
 are at the same time relieved and deadened; moreover, 
 the families of inebriates and consumptives are often very 
 numerous. Where the degradation of the parents is un- 
 mistakablCj the number of children is often very large, 
 confirming the oft noted fact that just before extinction 
 of the race a supreme effort is made to perpetuate the 
 seed and save it from obliteration. While the inebriate 
 families are often large, they die young. If they live 
 through childhood, they carry with them into maturity 
 defects which soon cause their extinction. Several cases 
 
INFLUENCE UPON EMBRYONIC TISSUE AND HEREDITY. 115 
 
 illustrating this are cited. Two degenerate members of 
 a famous family in New York united, both of whom were 
 moderate drinkers. Thirteen children were born, five 
 of whom died in infancy, and eight reached the age of 
 maturity. Three of this number were drunkards and 
 died of tuberculosis, one died of acute pneumonia, one 
 became demented, and two died with some low fever asso- 
 ciated with rheumatism. The one still living has been 
 eccentric and feeble-minded all his life. Not one of the 
 descendants of these people is living. Of another family, 
 three of the nine members came for treatment for inebriety, 
 one relapsed and became insane, the second was killed by 
 accident, the third is a low drunkard. Two of the remain- 
 ing children died of tuberculosis, one is an eccentric re- 
 former with extreme zeal, but little wisdom, and one is 
 a paranoiac single woman. The parents were healthy 
 drinking people, without business, who died in middle 
 life of some acute disease. 
 
 Degenerate families of this kind are by no means 
 uncommon, especially in older sections of the country. 
 They appear in the two extremes of great fecundity or 
 barrenness. When a general history shows that the family 
 is degenerating, growing weaker in appearance and con- 
 duct retrograding, tuberculosis and inebriety with hys- 
 teria, eccentricity, rheumatism, and a variety of nerve 
 diseases are almost sure to follow. Members of such 
 families are sometimes brilliant and precocious. A son 
 of one of these dying families took high honors at col- 
 lege and entered upon a brilliant professional career, in 
 which he became eminent; but two years later he became 
 an inebriate and died of tuberculosis. His inherited de- 
 generation had been masked by his display of vigor and 
 precocious brilliancy. 
 
 Baer has pointed out that in sections of the country 
 given to excessive drink there is a smaller percentage 
 
116 SHALL WE DRINK WINE? 
 
 of young men fit for military duty than is to be found 
 in those parts in which the people are temperate, and 
 Gyllenskiold says that since the full benefit derived from 
 the recently enacted laws regulating the sale of intoxicants 
 in Sweden has become apparent, there is a smaller num- 
 ber unfit for military service because of physical weak- 
 ness and low stature, than before these laws were enacted. 
 
 In an address delivered in 1874 by the Director of the 
 Council of the Canton of Bern in regard to the manage- 
 ment of a model distillery, the evil done by this institu- 
 tion was described in the following words: "In our Can- 
 ton, without any difference in age or sex, the consumers 
 of spirits have so largely increased that it furnishes an 
 explanation as to why the large, strong, fresh, fine figures 
 are becoming more rare, why the recruit transports con- 
 tain so many small, bent, prematurely old individuals 
 with expressionless, yellow, stupid faces, and why the 
 number of acquired and not congenital nervous diseases 
 is increasing." (From Demme's Einfluss des Alkohols 
 auf den Organismus des Kindes, Pp-^35 and 36.). 
 
 In Demme's comparison of ten families of drunkards 
 with ten families whose members were temperate their 
 life histories disclosed the following facts: Of the ten 
 drunken families there were 57 direct descendants. 25 
 of these died in their first year of insufficient vitaHty, 6 
 were idiots, 5 were dwarfs, 5 epileptics, i choreic and 
 idiotic, and 5 had hydrocephalus, hare-lip, and club foot. 
 Two of the young men were epileptic and had inherited 
 alcoholism. Only 17.5 per cent, had ordinary good 
 health in childhood. Of the temperate families there were 
 61 direct descendants. Only 5 died in infancy of con- 
 genital lack of vitality, four had curable nervous diseases, 
 and two more had some congenital defect. 81.5 per cent. 
 were mentally and physically sound in childhood and 
 vouth. 
 
XI. 
 
 Hlcobol as a factor in the production of 
 Insanity. 
 
 From the evidence cited above the conviction that 
 alcohol is an important causative factor in the produc- 
 tion of insanity cannot be avoided. It is extremely dif- 
 ficult, however^ in the vast majority of individual cases, 
 to determine exactly how much of the disturbance may 
 be charged to alcohol, either directly or indirectly, and 
 how much to other causes near or remote. In order to 
 reach anything like a correct conclusion, a history of 
 the direct and collateral family ties of each person, for 
 at least three generations, would be absolutely necessary, 
 and this should be supplemented by a minute personal 
 history from infancy until the onset of the mental dis- 
 turbance. While the latter may sometimes be approxi- 
 mately or quite complete, the former is rarely or never 
 complete enough to be of definite value for the purpose 
 of fixing alcoholic responsibility. Furthermore, recog- 
 nizing the difficulty of obtaining such ancestory statistics, 
 superintendents of hospitals for the insane have probably 
 paid little attention to the matter, and there are available 
 no records of even the small number of cases the histories 
 of which might have been obtained with a valuable degree 
 of completeness. 
 
 One of the foremost statisticians in the United States 
 (Dr. Frederick Wines) writes me that he has no statistics 
 on the subject; and those he has seen were not trust- 
 
118 SHALL WE DRINK WINE ? 
 
 worthy. Another writes me that he is now collecting 
 evidence of this kind, but that it will be many months 
 before it is analyzed. From a letter received from a third 
 I quote the following paragraph: "We have very little 
 literature on the subject. During the last year in this 
 institution there were 409 admissions. Fifty-four cases 
 were recorded as intemperate. There were probably 15 
 cases in which this was not given as a cause that I per- 
 sonally know to have been intemperate, and I have no 
 doubt that there are others in which the use of alcohol 
 was an etiological feature and was not set forth in the 
 examination papers" (Dr. W. A. Gordon, Northern Hos- 
 pital for the Insane, Wis.). In letters from several 
 other superintendents of insane hospitals, no statistics of 
 the kind are available. Of course the mere fact that an 
 insane person had been addicted to alcohol in excessive 
 quantities is of small importance in determining the cause 
 of his insanity unless he could prove a good inheritance 
 and sound health up to the time of his alcoholic excesses ; 
 for, as we have seen, alcoholism may be an effect as well 
 as a cause of central nervous disturbance. 
 
 A committee is now engaged in collecting statistics 
 upon alcoholism and insanity, but statistical evidence of 
 this kind is of slow growth, and many years must elapse 
 before it can assume a definiteness and proportion suffi- 
 cient to make it of value. The most complete statistics 
 on the subject of alcoholism are those collected by the 
 authority of the state of Massachusetts for the year end- 
 ing with August 1st, 1895 (Twenty-sixth Annual Re- 
 port of the Bureau of Statistics of Labor). There were 
 confined in state institutions for the insane 1,836 persons, 
 974 of whom were males and 862 females. In point of 
 age, only 78 were under twenty years. The decade hav- 
 ing the greatest number was that between thirty and forty. 
 
ALCOHOL IN THE PRODUCTION OF INSANITY. 119 
 
 there being 457 of that period. The next greatest num- 
 ber occurred between twenty and thirty — ^405, while 372 
 occurred between the ages of forty and fifty, 235 being 
 fifty and sixty, 254 between sixty and eighty, while only 
 30 were beyond eighty years of age. 
 
 Of the whole number of insane (1836) 311 were said 
 to be excessive drinkers before the occurrence of insan- 
 ity^ 360 were moderate drinkers, while 677 were total 
 abstainers. The habits of the remaining 488 with regard 
 to alcoholic indulgence could not be ascertained. It will 
 be seen, therefore, that 16.94 per cent, of the insane were 
 excessive drinkers, 19.6 per cent, were moderate drinkers, 
 and 35.87 per cent, were total abstainers, while from 26.58 
 per cent, of the whole number no information upon this 
 point could be obtained. 
 
 Subtracting those cases of whom no information could 
 be obtained regarding habits of alcoholic indulgence, there 
 remained 1,348 whose habits were known, 699 of whom 
 were males and 649 females. Of these known cases, 35.48 
 per cent, of the males were excessive drinkers and 26.32 
 were total abstainers; while of the females 10.02 per cent, 
 were excessive drinkers and 75.96 per cent, total abstain- 
 ers. 
 
 Information regarding the habits of the parents as to 
 indulgence in alcoholic beverages could not be obtained 
 in 939 or 51.14 per cent, of the cases. In 616 cases, 
 comprising 316 males and 300 females, one or both par- 
 ents were intemperate, while in 281 cases, 128 males and 
 153 females, one or both parents were total abstainers. 
 
 As to whether the inmates' insanity was directly due 
 to the excessive use of alcoholic beverages, in 330 instances 
 no. information could be obtained. Of the remainder, 
 in 383 cases, including 296 males and 97 females, replies 
 were obtained showing that insanity was directly due to 
 
120 SHALL WE DRINK WINE? 
 
 alcoholic excess. In 1,123 cases, including 479 males 
 and 644 females, the insanity waa said not to be due to 
 excessive alcohol consumption. Therefore, expressed in 
 percentages, the point as to whether the lunatic was made 
 insane by alcohoHc poisoning was not ascertained in 17.97 
 per cent of the cases; insanity was the result of alcoholic 
 poisoning in 20.86 per cent, of the cases, and it was not 
 the result in 61.77 P^i" cent, of the cases. 
 
 Going into the question as to whether the intemperate 
 habits of one or both parents led to the insanity of the 
 lunatic, produced the following results: In 1895 cases no 
 information could be obtained, in 20 cases the repljf was 
 "yes," and in 921 cases the reply was "no," that is, no 
 information could be obtained in 48.75 per cent, of the 
 cases, the negative rephes were 50.16 per cent., and the 
 affirmative replies 1.09 per cent, of the whole number, 6 
 of which were males and 14 females. In 184 cases 
 insanity was attributed to intemperate habits in the grand- 
 parents, in 170 cases the grandparents were said to be 
 temperate, and in the remainder of the cases, 1,482, no 
 information regarding the habits of the grandparents in 
 this respect could be ascertained. 
 
 This question was also asked: "Did the intemperate 
 habits of others (neither parents nor grandparents) lead 
 to the insanity of the person considered?" In 123 cases 
 the reply was "yes," in 757 it was "no," and in 956 cases 
 no information could be elicited. 
 
 Analyzing the above statistics, it will be seen that of 
 the whole number of insane patients whose habits could 
 be learned 35.48 per cent, of the males and 10.02 per 
 cent, of the females were excessive drinkers. But exces- 
 sive drinking might not have been the cause of the insan- 
 ity, it might rather be the result of some neurosis. Fur- 
 ther on, however, we learn that out of a total of 1,506 
 
ALCOHOL IN THE PRODUCTION OF INSANITY. 121 
 
 cases alcohol was held to be the direct cause of the insan- 
 ity in 383 cases, 296 of which were males and 87 females. 
 As had already been stated, the habits of only 699 males 
 as to their indulgence in alcohol could be learned, and 
 296 attributed their insanity to alcohol directly. Thus we 
 have 42.5 per cent, of all the males whose habits in this 
 respect could be ascertained made insane by alcoholic 
 poisoning. Of the 649 females whose habits in this respect 
 are known only 87, or 10.86 per cent., were made insane 
 by direct alcoholic poisoning. 
 
 Of the evidence which these statistics contain, that 
 relating to heredity shows that i.og per cent, of those 
 from whom information on the point could be obtained 
 attributed their insanity to parental intemperance, and 
 123, or 6 per cent, of all concerning whom grandparental 
 influence could be ascertained attributed their insanity to 
 that cause. 
 
 Taking for granted that the cases concerning which 
 the direct or ancestral influence of alcohol could not be 
 ascertained would show the same percentages as those in 
 which it was ascertained, we would have a total of prob- 
 ably about 45 per cent, of all the cases of insanity in this 
 group chargeable either directly or indirectly to alcohol. 
 This method of drawing conclusions, however, should 
 not be permitted. 
 
 A further fault of the above statistics is the fact that 
 many of the cases may have been influenced in several 
 ways by alcohol, directly, through parental or grand- 
 parental or collateral relatives' intemperance. All such 
 cases would be counted in each class, and be considered 
 as not one insane patient but as many as there are classes. 
 Statistics of this kind are not valuable. 
 
 Insanity statistics in the United States are not reliable. 
 The census report for 1880, for instance, showed the fol- 
 
122 SHALL WE DRINK WINE? 
 
 lowing number of insane person for every 100,000 inhab- 
 itants: Foreign white 398.8, native white 161. 9, and 
 negroes 91.2 respectively, while the census report for 
 1890 showed 387.0 foreign white, 140.5 native white, and 
 88.6 colored insane to each 100,000 inhabitants. The 
 total number of insane reported for 1880 was 91,959, while 
 the total number of insane reported in the census returns 
 of 1890 was 106,485, showing that in the decade the 
 number of insane persons increased a trifle more than 
 15 per cent. But the population increased 24 per cent, 
 in the same time. In 1896, however, the National Con- 
 ference of Charities and Corrections reported 145,000 
 insane persons in the United States, an increase of nearly 
 }jy per cent, in six years. The only conclusion to be 
 drawn is that the statistics of the United States census 
 reports are of no value in showing whether insanity has 
 increased or decreased. It is generally beheved, how- 
 ever, that insanity is increasing, and this increase is shown 
 in statistics for localities. Whether insanity is increas- 
 ing in the same ratio as the per capita consumption of 
 alcohol we have no means of knowing. 
 
 Something more definite regarding this matter has 
 been obtained in Europe. In the German Empire alone 
 in 1877 there were 4,272 patients undergoing treatment 
 for alcohoHc insanity in pubHc institutions. In 1885 this 
 number has increased to 10,360, an increase out of all 
 proportion to the increase in population (Die Gefahren 
 des Alkoholgenusses, Dr. Servus). 
 
 According to the statistics of Baer there were, in the 
 years 1878 and 1879, 4,013 male lunatics in the Ger- 
 man insane asylums, the insanity of 1,088, or 27 per cent, 
 of whom could be traced directly to the influence of alco- 
 hol. Of these 690 suffered with delirium tremens. If 
 we reckon with these the patients who were treated in 
 
ALCOHOL IN THE PRODUCTION OF INSANITY. 123 
 
 private institutions, the total of alcoholic insane amounts 
 to 2,016 yearly. Furthermore, in the years 1878 and 
 1879, the yearly number of patients suffering from the 
 extremes! forms of alcoholic disease in institutions the 
 statistics of which were open to inspection, amounted to 
 5,212. In those )rears there died from alcoholic poison- 
 ing 1,993 persons yearly. In the year 1885 there were 
 11,974 such patients in Germany, with a correspondingly 
 high mortality. Considering, again, the Swiss statistics, 
 it was found that of the 366 deaths from alcohol occurring 
 in 1 89 1, 187 belonged to the laboring classes, and 179 
 were men in the easier circumstances of life. 
 
 Of special interest is the fact that the increase in the 
 number of lunatics in the asylums of Germany was very 
 rapid after the middle of the present century, at which 
 time the manufacture of whisky from potatoes was begun. 
 In France also were the effects of this new industry very 
 apparent. In the Bicetre, according to Baer, from 1806 
 to 181 1, the number of male lunatics whose insanity could 
 be ascribed to alcohol was only 11.7 per cent, of the 
 whole number. In 1855 it had slightly increased, but 
 still was only 12.78 per cent., but in 1865 it had increased 
 to the astonishing figure of 25.24 per cent, of the whole 
 number. 
 
 In Charanton the proportion of alcoholic lunatics from 
 1826 to 1835, according to Esquirol, was 8 per cent; Lage- 
 rose estimated the proportion at 24 per cent, in 1857, and 
 by Marsaing it was estimated to average 27.87 per cent, 
 during 1865 and 1870. 
 
 In Austria, according to the best of evidence, since 
 the beginning of the fiftieth year of this century there has 
 been an average yearly increase of 2 per cent, in cases 
 of insanity, and these increasing recruits are said by Gaus- 
 ter to come exclusively from the ranks of alcohol drink- 
 
124 SHALL WE DRINK WINE? 
 
 ers. What this increase means will be better understood 
 when it is known that every ten years a new asylum cap- 
 able of accommodating 600 patients must be erected, and 
 that 2,000 more apply each year for treatment than applied 
 forty years ago. At the time when this report was ob- 
 tained about 40 per cent, of all the cases of insanity affect- 
 ing males could be ascribed to alcoholic excesses. 
 
 Recent statistics upon this point in Germany are not 
 accessible. The last obtainable showed that 27 per cent, 
 of the male and 3.2 per cent, of the female lunacy patients 
 became such through excessive alcohol consumption. In 
 institutions which lie near large centers of population the 
 percentage of alcoholic insane is considerably greater. 
 Statistics from Prussia especially show a rapid increase 
 in the number of insane. In 1852 to 1854 there were 
 only 3,631, but the number had increased to 8,481 in 
 1870 fo 1872, an increase out of all proportion to the 
 increase in population. 
 
 "Ill another place I have already stated what seems to 
 nic of the utmost importance, that we in Germany are so uni- 
 versally accustomed to look upon alcoholism as the normal 
 condition, the basis, in a certain degree, of the normal phys- 
 iological man, that our physicians need the strongest kind 
 of hint (with many, even an attack of delirium tremens is 
 not sufficient) to lead them to the thought that the illness is 
 the result of chronic alcohol poisoning" (Dr. August Smith, 
 Die Alkoholfrage, P. 74).* 
 
 *"In anderem Orte, habe Ich erwaehnt, was mir zu 
 wiederholen wichtig scheint, das wir in Deutschland im 
 allgemeinen so sehr gewoehnt sind, den chronischen Alko- 
 liolismus als Normalzustand, die Grundlage gewisser- 
 massen des physiologischen Menschen anzusehen, das es 
 bei unseren Aerzten schon der aller kraeftigsten Hin- 
 weise bedarf (ein Delirium Tremens geniigt manchen dazu 
 
ALCOHOL IN THE PRODUCTION OF INSANITY. 125 
 
 noch iiicht) um bei einer Erkrankung nur den Gedanken 
 einer Alkoholvergiftung aufkommen zu lassen." 
 
 Some significant statistics came from the Dalldorf 
 Asylum (Mansfield Holmes in Medical Pioneer, Aug., 
 1895), where, out of a total of 1,234 patients confined, 450 
 were children. Rust, the physician in charge of the 
 asylum, considered the large percentage of insane children 
 due to the fact that habitual drinking was the rule and 
 not the exception. Investigations by the local authorities 
 show that alcohol may produce insanity by acting as an 
 exciting cause, or it might produce an hereditary insanity 
 by transmitted debasement in children in the form of pre- 
 disposition. Rust thinks periodical excessive drinking 
 more likely to produce insanity in tlie subject himself, 
 but that habitual constant drinking is more apt to breed 
 hereditary insanity in the offspring, and that bad heredity 
 as a determining cause of inseinity played a most important 
 part with the patients in this institution. H. Piper, one 
 of its physicians, stated that up to 1882, at which time he 
 began his observations, the total number of reliable cases 
 then collected in the German statistics was 1,287; of this 
 number 860, or 66 per cent., were traced to hereditary 
 causes and the balance, 427, or 33 per cent., to acquired 
 causes. This is a proportion of two cases of heredity to 
 one of acquirement. Of 416 cases collected by himself 
 during the twelve years following 1882, 310, or 75 per 
 cent., were traced directly to hereditary causes, and 25 
 per cent, to acquired causes : a ratio in favor of hereditary 
 causes of three to one. 
 
 Undoubtedly, however, many cases of insanity due to 
 alcoholism are the result of children of tender years ingest- 
 ing large quantities of alcoholic liquors, rather than to 
 inherited tendencies alone. I have seen in the city 01 
 Berlin children from five years of age upwards given free 
 
126 SHALL WE DRINK WINE ? 
 
 quantities of strong wine and beer, the effects of which 
 must have been seriously deleterious; and Moreaux oi 
 Tours, France (Annales Medico-psychologiques), con- 
 siders alcoholism^ so prevalent in children, only partly due 
 to hereditary influence. Drunkenness in these cases is 
 sometimes seen at a very early age, and when there is a 
 hereditary predisposition a small amount of alcohol is 
 sufficient to produce intoxication. He found in alcoholic 
 children marked evidence of evil dispositions leading to 
 criminal tendencies. The continental custom of giving 
 young children wine is a powerful factor in bringing about 
 this state of affairs, while some responsibility rests with 
 the indiscriminate prescribing of alcoholic medicines bj 
 physicians. He had seen delirium tremens in childreii 
 four or five years of age, brought about, as in adult life, 
 by the sudden stopping of alcohol with children who were 
 habitual drinkers. 
 
 More recently Jakubowitsch (British Medical Journal) 
 reported increasing drunkenness among the children of 
 Russia, where vodka, an acrid drink containing from 40 
 to 50 per cent, of alcohol, is the national beverage. He 
 also tells of children four or five years of age having had 
 delirium tremens. Parents there, he says, often thought- 
 lessly give their children spirituous liquors to improve the 
 color of their cheeks, make their eyes sparkle, or induce 
 sleep. He also discusses the influence of alcoholism in 
 the parents in producing hereditary defects in the children, 
 and cites cases similar to those already given in another 
 part of this work in which children begotten while the 
 parents were sober were healthy and intelligent, while 
 others conceived when the same parents were intoxicated 
 showed marked cases of physical and mental degenera- 
 tion. Among the least progressive peoples of France, 
 especially those of Brittany, children are, at a very tender 
 
ALCOHOL IN THE PRODUCTION OF INSANITY. 127 
 
 age, habituated to the daily use of spirits. In Great 
 Britain and in our own country, though in a less degree, 
 in large centers of crowded and vicious population the 
 use of drink among children of a tender age prevails to 
 an alarming extent, and the consequent physical defective- 
 ness and moral degradation lead to habits of viciousness 
 and immorality shocking in the last degree. 
 
 It would be no easy task, therefore, in cases of insanitj 
 among children due to alcoholism to determine how much 
 of the disturbance may be due to the direct effect of 
 alcohol and how much to hereditary effects where both, 
 as is very frequently the case, operate as determining 
 causes. 
 
xn. 
 
 JZhi Httitudc of the Medical profession Coward 
 Hlcobol. 
 
 About the value of alcoholic beverages in the normal 
 condition of health there is only one medical opinion, and 
 that is that they are entirely unnecessary and therefore 
 do no good. In America at least a small number of 
 physicians would probably express the opinion that "mod- 
 erate drinking is not harmful/'' perhaps the same number 
 would hold that any amount of alcohol in health is harm- 
 ful, while the great majority are probably influenced by 
 their surroundings and have no fixed opinions upon the 
 subject. 
 
 As to the value of alcohol in disease, medical opinion 
 is again divided. There are many physicians, and the 
 number is growing, who believe that while alcohol has 
 some value in diseased conditions this value is very limited, 
 and that it performs no duties as a curative agent which 
 could not be better and more safely performed by some 
 other agent. A much larger number, however, especially 
 those who were educated on the continent of Europe, still 
 cling to the traditions of medical practice and prescribe 
 alcoholic beverages in various diseased conditions, espe- 
 cially such as indicated a lowered vitality, lack of appetite 
 and strength. I say this is done as a matter of routine prac- 
 tice, for I believe that the majority of physicians who do 
 this have not given the subject any particular attention, but 
 are bound by the authority of precedent. Among men 
 
THE ATTITUDE OF THE MEDICAL PROFESSION. 129 
 
 who have to deal with nervous diseases and with insanity, 
 at least here in America, alcohol as a therapeutic agent 
 has no place. 
 
 Certainly no other remedy for the treatment of disease 
 has been as extensively used as alcohol in the form of 
 some alcoholic beverage. Its use received a great impetus 
 about the end of the eighteenth century in England from 
 the teachings of that time, which would see the causes 
 of all diseases in a condition of "sthenia," or "asthenia," 
 according to whether the surface play indicated increasea 
 activity of the heart and "plethora" or the lack of them. 
 For the former bleeding, emesis, and catharsis were the 
 prime remedies, while for the latter nothing found so 
 much favor as alcohol. 
 
 The first half of the present century was completely 
 under the influence of those teachings. Todd and his 
 pupils treated all inflammatory diseases, especially typhoid 
 fever, with enormous quantities of alcoholic liquor. It 
 was not an unusual thing at this time for a patient ill with 
 typhoid fever to receive two or three bottles of strong 
 red wine, port, or burgundy, besides a considerable quan- 
 tity of champagne and cognac, as much as a quart of 
 the latter often being given within the course of twenty- 
 four hours. 
 
 Todd and his school were followed by the greatest 
 lights of the profession in both Europe and America. 
 Trousseau, Moneret, and Terrier in France advised a 
 free administration of alcohol in typhoid fever. Soulie 
 treated all his cases of typhoid, whether mild or severe, 
 with rum in doses of 60 to 80 grams (Bullet, de Thera- 
 peutique, 1870), and Bouvier was conspicuous in his 
 advocacy of the administration of strong wines in typhoid 
 fever. In Germany Liebermeister, Riegel, and Juergen- 
 sen used large quantities of alcohol in treating typhoid 
 
130 SHALL WE DRINK WINE? 
 
 fever and the so-called "asthenic" inflammations of the 
 lungs. Daret and Breisky gave the same treatment for 
 puerperal fever; Leyden, for gangrene of the lung, and 
 Volk, for the treatment of erysipelas. It was held by all 
 of these eminent men that alcohol within proper bounds 
 and where there was no definite contraindication was of 
 the utmost importance in relieving the prostration incident 
 to all of those exhausting diseases, and that during the 
 course of the fevers alcohol would not intoxicate. 
 
 European medical opinion was very naturally reflected 
 in America. Here medical writers of twenty-five years 
 ago, or even of a more recent date, almost uniformly 
 advised the administration of alcohol in all inflammatory 
 diseases attended by great exhaustion. There were some 
 prominent dissenters from the generally accepted creed, 
 but they were few in number compared with those who 
 clung to alcohol as a stimulant. Indeed, within the past 
 few years, if a physician were advised to "stimulate'' his 
 patient he would take that advice to mean that his patient 
 should receive alcohol in the form of strong spirits. 
 Recent developments in chemistry and biology, especially 
 in the chemistry and biology of bacterial diseases, are 
 forcibly bringing to the notice of the profession the errors 
 of past teachings as to the stimulating value of alcohol. 
 
 There are a few medical men who openly espouse the 
 cause of alcohol, not only as a valuable remedy in disease, 
 but as having increased the sum total of human happiness. 
 Some of these men have given reasons for the faith that 
 is in them, while others have been content to merely 
 express their opinions. The number of these men, how- 
 ever, is small compared with those who hold opposing 
 views. It will be instructive to examine the views thus 
 set forth in order to learn the evidence upon which they 
 rest. 
 
THE ATTITUDE OF THE MEDICAL PROFESSION. 131 
 
 Mortimer Granville has said: "Drunkenness is in no 
 other sense the consequence of drinking than the destruc- 
 tion of a house by fire is the consequence of having a 
 cooking range on the premises. The moment appears 
 opportune for a little plain speaking and I trust that this 
 may be permitted in one of those who seeks to convert 
 the public mind — that alcohol in all its forms is needless 
 to the healthy and only of questionable value to the sick — 
 to those who hold that it is far better that the healthy 
 should be moderate drinkers than abstainers, and that the 
 great value of alcohol in the treatment, and I will go 
 farther and say, in the prevention of disease, should be 
 clearly recognized. I am perfectly well aware that in 
 professing this strong belief that abstinence from the use 
 of wine or beer is a worse evil than occasional abuse of 
 these intoxicants — I use this form of expression advisedly 
 — I am placing myself in antagonism to the majority of 
 medical writers on this subject, but I am so thoroughly 
 convinced of the accuracy of this view after years of 
 study and observation of the subject, in its professional 
 and social aspects, that I should be lacking in moral 
 courage if I hesitated to express myself decidedly. I 
 sincerely believe that incalculable harm has been done 
 to the human organism with its functions, which we are 
 wont to classify as mental and physical, by the spread of 
 teetotal views and practices. There is less stamina in the 
 life of the average Englishman now than there was fifty 
 years ago. He may live a little longer, but he is not so 
 well able to resist the invading germs of disease, or to 
 recover from the depleting effects of such invasion, as he 
 was when good wine and sound ale was an integral part 
 of his daily diet. He has lost some, if not much, of the 
 practical advantage due to the diminution of preventable 
 maladies by improved sanitation, because he has allowed 
 
132 SHALL WE DRINK WINE? 
 
 his organic life to fall to a grade lower in vital energy 
 than that which previously protected him against perils 
 greater than those that now beset him. Asylum physicians 
 go their rounds and notice that a very large proportion of 
 those who became insane previously drank to excess; but 
 if the bulk of the general practitioners outside of the 
 asylums were asked what proportion of those who 
 habitually drank became insane — which is a very different 
 matter — the evidence that drink plays an important part 
 in the production of insanity would be found to fall to 
 the ground. I doubt whether, of the great bulk of general 
 practitioners who have the opportunity of collecting infor- 
 mation upon this subject, any large number could com- 
 pile twenty cases falling under their individual observation 
 of persons who habitually drank freely and became insane. 
 It is needless to the point to tell us that of insane persons 
 many once drank. We want to know the proportion of 
 persons who drink that is passing into the class of lunatics. 
 So far as I have been able to ascertain, this portion is so 
 small as to be insignificant. Meanwhile, a calm and 
 grave survey of the statistical and facts will show that not 
 a few terrible diseases, such as consumption, cancer, 
 specific maladies of low type — for example, diphtheria, the 
 worst forms of gout, nervous troubles, and a host of minor 
 ailments — have for their cause asthenic conditions of vital 
 force in the organism which render it, as a whole, weak 
 in the presence of its enemies, and, as to its constituent 
 parts, prone to the degradation of organic types of life, 
 and have developed and extended their ravages since the 
 substitution of table waters for the sound (malt and hop 
 and grape) fermented beverages has sprung into fashion 
 at the instance of temperance advocates. These are grave 
 assertions to make, and I am not insensible to the respons- 
 ibility which attaches to the physician daring to make 
 
THE ATTITUDE OF THE MEDICAL PROFESSION. 133 
 
 them; but I am persuaded that the time has come when 
 those who do not share the views it is fashionable to 
 profess ought to declare themselves." 
 
 It is not necessary to point out the many errors in 
 the views of the above writer. Here are a group of bold 
 assertions without any evidence to support them, except 
 the casual observations of the writer, not one of which 
 but is abundantly refuted by exact methods of observa- 
 tion and investigation, the results of which have already 
 been fully set forth in this work. 
 
 When the attention of the great Charcot was called 
 to Tolstoi's article on alcoholism, he replied (British 
 Medical Journal, July, 1891): "I am compelled to admit 
 that I do not find the article of Tolstoi very able. It is 
 exaggerated, and, therefore, false. Alcohol and tobacco 
 are injurious, but they can be used in moderation. There 
 are numerous examples of this. Moreover, before alcohol 
 and tobacco there came into the world abominable things. 
 Indeed, since their introduction civilization has rather 
 softened. Must one say, then, that alcohol and tobacco 
 are immoral forces? In everything I hate extreme posi- 
 tions. I believe in common sense, and I do not see that 
 the position of Tolstoi conforms to its dictates." 
 
 There is always a disposition to attach importance to 
 the opinions of great men without regard to the basis 
 upon which they are founded. The mere fact that some 
 one in authority has promulgated the opinion is sufficient 
 to give it weight without regard to its intrinsic value. 
 Because "civilization has softened" (if there was any 
 civilization before the introduction of alcoholic beverages) 
 since the introduction of alcohol and tobacco, how does 
 that prove the value of these narcotics unless they can 
 be connected as cause and effect? Such methods of 
 reasoning are childish. 
 
134 SHALL WE DRINK WINE? 
 
 Another example of this specious mode of reasoning 
 is found in an article by Dr. S. S. Herrick (Journal of the 
 Am. Med. Assn., Feb. 19, 1898): "This alleged de- 
 generacy has been going on ever since Noah planted the 
 vine and got drunk on its products, on coming out of the 
 ark, yet within the period of profane history the span of 
 human life has doubled and is increasing. France, Spain, 
 and Italy are producing annually, according to different 
 estimates, fifteen to forty gallons of wine per capita, most 
 of which is consumed at home, and this has continued 
 for centuries; the output of wine and beer in Austro- 
 Hungary is about fifteen gallons annually per capita, and 
 in the German Empire double this amount. On the alco- 
 holic basis, degeneracy in the latter progresses twice as 
 fast as in the former. In these European countries chil- 
 dren drink fermented liquors from the time they are 
 weaned, and follow the habit all their lives. Inasmuch as 
 human Hfe is steadily lengthening, popular education ex- 
 tending, and military power growing, the present writer 
 fails to see proofs of degeneracy." 
 
 Arguments of this kind will convince no logical mind. 
 Why did not Dr. Herrick use his own statistics to draw 
 another conclusion? He has said that the consumption 
 of wine, per capita, in France, Spain, and Italy is nearly 
 three times that of Austro-Hungary, and one and a half 
 times that of the German Empire: therefore, should we 
 not look for a greater amount of degeneracy in the Latin 
 countries than in either Austria or Germany? If this 
 writer really believes in his own method of reasoning, he 
 should have reached the conclusion that the degeneracy 
 of France, Spain, and Italy, recognized by all intelHgent 
 people, is really due to their excessive use of alcoholic 
 beverages. He should not have been content to point 
 out that Germany is no more degenerate than Austro- 
 
THE ATTITUDE OF THE MEDICAL PROFESSION. 135 
 
 Hungary, though the former does consume twice as much 
 alcohoHc liquor as the latter. As to his statement that 
 the children of these countries "drink fermented liquors 
 from the time they are weaned and follow the habit all 
 their lives," enough has already been said of the deplor- 
 able results of this reprehensible habit, yet the statement 
 is made by this writer to carry the impression that no 
 evil results follow. If he fails to see proofs of degeneracy 
 it must be from the fact that he has not examined the 
 evidence. It is absurd to take a few general facts, ignore 
 the rest, and then draw sweeping conclusions. I cannot 
 leave this article of Dr. Herrick's without calling attention 
 to another example of his most fallacious reasoning. He 
 calls attention to the fact that "the native populations of 
 Old and New Mexico, having been subjected to small- 
 pox with little or no modification by vaccination for three 
 and a half centuries, have acquired a great tolerance" 
 and that "the races of tropical America have become 
 tolerant of yellow fever that total immunity is claimed for 
 them by some writers," therefore, we must conclude, peo- 
 ple long accustomed to alcohol and other narcotics will 
 also get a degree of immunity which will make alcohol 
 harmless. But alcohol does not and cannot give such 
 immunity. It is so different in its nature from the poisons 
 of small-pox and yellow fever, so different in the biochemic 
 changes which it produces in the body, that any attempt 
 to compare the two indicates an absurd lack of knowledge 
 of immunity processes. 
 
 In a comprehensive work on dietetics (Practical 
 Dietetics, W. Oilman Thompson, M. D., 1896,) the sub- 
 ject of alcohol is treated at considerable length. The 
 author excuses a full presentation of the subject upon 
 the plea that it would be too long for the limits of his 
 book, hence we do not know upon what evidence he bases 
 
136 SHALL WE DRINK WINE? 
 
 his conclusions, which are as follows: "The problem 
 whether the world as a whole is better or worse for the 
 existence of alcohol, aside from all ethical questions, and 
 viewed merely from a scientific standpoint of the influence 
 of alcohol upon mortality, is difficult of solution; for, to 
 offset the numerous cases of fatal alcoholism and still 
 larger number of cases of diseases which would not 
 presumably be fatal without the existing condition of 
 chronic alcoholic poisoning of the system, are very many 
 cases among both infants and adults in which life is un- 
 doubtedly saved by the prompt resort to this food and 
 stimulant and its energetic use. So long as man is 
 exposed to hardships and conditions arising from im- 
 proper and deficient food supply, as well as the numerous 
 infectious diseases to which he is heir, alcohol must still 
 be regarded as a blessing rather than a curse; for there 
 is no form of stimulant and food combined, or stimulant 
 alone, which, taken all in all, can be so completely relied 
 upon in cases of emergency. Alcohol when taken alone 
 will prolong life beyond the period at which it terminates 
 from starvation." 
 
 From the above conclusions one who has knowledge 
 of all the evidence must wholly dissent. They are in direct 
 opposition to the great mass of experimental truths which 
 have resulted from the most laborious, painstaking, and 
 exact methods known to science, and which have been fully 
 discussed in this work. There can be no hesitancy in 
 making a choice between the loose generalizations and 
 guesses founded upon unsupported statements, and the 
 knowledge actually gained by experimental research. 
 
 There is still another class of physicians who for 
 cHnical reasons alone have discarded alcohol as a thera- 
 peutic agent. These are busy, practical men, good 
 observers and quick to take advantage of any remedy, 
 
THE ATTITUDE OF THE MEDICAL PROFESSION. 137 
 
 the value of which is apparent, without taking the time 
 to inquire very closely into the reasons for the good 
 results exhibited. These men, I find, are almost a unit 
 against the giving of alcohol in diseased conditions except- 
 ing where the patient happens to be an alcoholic habitue 
 and its withdrawal would be attended by serious nervous 
 disturbances. 
 
 One physician of this class, who has enjoyed a large 
 general practice for more than twenty-five years, in 
 answer to my question, declared that he had not prescribed 
 an alcoholic beverage for more than ten years, and his 
 reason was that he had never observed any good to 
 result therefrom. A surgeon who is a teacher of anatomy, 
 and who also is surgeon of a railway company, in which 
 capacity he has to deal with many acute injuries attended 
 by pain, loss of blood, and shock, answered the same ques- 
 tion by saying that he not only did not use alcohol in 
 dealing with these cases, but neglected no occasion to 
 caution the railway employes against taking spirits in case 
 of their own injury or giving it to their fellows under the 
 same conditions. His observations had led him to believe 
 that nervous disturbances were prolonged and intensified 
 in those cases in which alcohol had been freely given, 
 which was often done before he could reach the patient. 
 A physician of ripe age and many years experience with 
 hundreds of old men in a Soldiers' National Home said 
 that alcohol is the worst enemy of the veterans under his 
 charge. Not only do the majority of fatal issues resulting 
 from some inflammatory diseases take place immediately 
 after an alcoholic excess, but he has seen no diseased con- 
 dition improve under the administration of spirits in either 
 small or large quantities. The men who totally abstain 
 are better nourished, freer from disease, and carry their 
 years more lightly than those who take alcohol in any 
 
138 SHALL WE DRINK WINE ? 
 
 quantity. Many of the inmates are alcoholic inebriates. 
 They demand their accustomed drink and get it. It is 
 possible that some of these would die sooner if it were 
 suddenly withdrawn, therefore, in these cases, alcohol 
 probably prolongs life. Nearly all of this class have 
 organic diseases directly traceable to the long continued 
 use of alcohol. 
 
XIII. 
 5Clbo Become Drutihardd and dhy? 
 
 That the great majority of drunkards become such 
 through the influence of social environment cannot for a 
 moment be doubted. To drink and ask the companion- 
 ship of others in drinking alcoholic beverages is the first 
 lesson in the primary school that develops the confirmed 
 drunkard, and to drink and ask others to drink is and 
 always has been so much an integral part of social func- 
 tions of a large part of our people that time and observance 
 have elected them to the position of at least quasi-social 
 duties. The ease with which intoxicating drinks may be 
 obtained wherever there is any considerable aggregation 
 of people makes the practice of this social custom quite 
 universal. It would be absurd to deny that the social 
 status of indulgence in alcoholic beverages does more to 
 make drunkards than all the other causes combined, for 
 the sanest of individuals, beginning to drink through the 
 influences of social environment, may become as hopeless 
 a drunkard as any defective member of society. So subtle 
 are the processes of the narcotics, of which alcohol is one, 
 in creating a need on the part of the nervous system for 
 a repetition of the same drug, that the habitue becomes 
 such before he is aware; and his chance to regain his 
 former mental and physical condition, other things being 
 equal, is in exact ratio to the amount of damage he has 
 sustained from alcoholic poisoning. 
 
 To show how great is the influence of social drinking 
 
140 SHALL WE DRINK WINE ? 
 
 in the production of drunkards one has only to recall the 
 fact that the vast majority of drunkards are of the male 
 sex. Here in America, where the drinking of alcoholic 
 intoxicants does not prevail among the women as a whole, 
 the ratio of male to female drunkards is certainly as great 
 as one hundred to one, and probably much greater. 
 Assuming that heredity is as influential in producing 
 female as male alcoholic degenerates, which, according 
 to laws of heredity, must be true, the preponderance of 
 male drunkards over those of the female sex must be 
 attributed to the increased opportunity for alcoholic in- 
 dulgence enjoyed by the male. Nor can there be any 
 reasonable doubt that many male defectives, the victims 
 of a neuropathic heritage from alcoholism or any other 
 parental cause, would become useful and reasonably happy 
 members of society could their enforced abstinence from 
 alcohol be assured, but these are almost always the un- 
 fortunate victims of social drinking. The pleasing effects 
 of alcoholic narcotism once experienced, the habit of alco- 
 holic excess is soon formed; and the will power, always 
 insufficient, is still further weakened until resistance is 
 no longer possible and the degenerate abandons himself 
 to the bestiality of satisfying his vicious appetite. 
 
XIV. 
 ^hat Is Imbncty? 
 
 The term inebriety is rather loosely used, both by the 
 profession and by the laity. In its simple and broader 
 sense it means no more than habitual intoxication. 
 Formerly it meant merely the condition of drunkenness; 
 now it is by common consent applied to those cases which 
 exhibit an overmastering appetite for narcotics in quantity 
 sufficient to intoxicate, together with the gratification of 
 that appetite. When unqualified, alcoholic inebriety is 
 understood. Dr. Norman Kerr has suggested that 
 "inebriety'' be displaced by the term "narcomania," which 
 he defines as "a mania for intoxication by an intoxicant." 
 This gives the term a new aspect, for, according to this 
 definition, a narcomaniac would be an inebriate whether 
 he indulged his abnormal appetite or not. 
 
 Inebriety is called a disease, and the term is modified 
 to suit the special narcotic for which the subject evinces 
 an abnormal appetite. There may, from this point of 
 view, be as many forms of inebriety as there are narcotic 
 drugs capable of producing their forms of intoxication. 
 There is a general belief, upon the part of the laity at least, 
 that the inebriate appetite is selective from tlie beginning, 
 that certain individuals evince an overmastering desire 
 for certain narcotic drugs and that they will be satisfied 
 each only by a particular narcotic. Especially does this 
 view prevail with the public as to alcoholic inebriety, and 
 certain influences which will be discussed later have done 
 much to spread and confirm this view. 
 
142 SHALL WE DRINK WINE? 
 
 In former times drunkenness was considered as always 
 a voluntary and vicious act, and punishment was meted 
 out of various degrees of severity, from fines and imprison- 
 ment to whipping, torture, and death. Indeed, a visit 
 to a police court in any of our larger municipalities on 
 any of the working days of the year will convince the 
 observer that, though the whipping post, the pillory, and 
 the scaffold have been abolished nothing better than fine 
 and imprisonment has yet been discovered as a corrective 
 for public drunkenness. In more recent years, as a result 
 of medical investigation, there has grown up a belief that 
 the drunkard is not always responsible for his acts, that 
 he may be physically and mentally defective, and that he 
 should be treated, not as an offender against the law, but 
 as a sick man who is afflicted with a species of insanity. 
 The public, or at least that part of the public philan- 
 thropically inclined, has seized this idea; but, not pos- 
 sessing that discriminating power which is possessed by 
 medical men, have come to regard all drunkards as 
 afflicted with that disease called inebriety, and to thigk 
 that "its victims are irresponsible." This idea is erroneous 
 and mischievous, but it has been so persistently fostered 
 and so widely disseminated by certain commercial institu- 
 tions that its teachings have had an enormous effect. It 
 is not sufficient to say that medical men know that this 
 teaching is false. The mehods adopted by these institu- 
 tions have made it the most prominent factor in the 
 alcohol question in America during the past eight or ten 
 years, and its influence has been many times that of 
 thoughtful medical men who have stood for the truth. 
 These institutions teach that inebriety is a specific disease. 
 We need not discuss the purposes for which they do so, 
 when we call attention to the fact that a specific cure is 
 offered to all who can afford to pay the price. Neither 
 
WHAT IS INEBRIETY? 143 
 
 is it necessary to call attention to the various sophistries 
 set forth by its supporters to bolster up this syndicated 
 opinion, for the purpose of refuting them. We must not 
 forget, however, in our practical dealings with the alcohol 
 question that the "literary" machinery of this venal institu- 
 tion has probably converted a majority of the laity to its 
 views. 
 
 The statement that inebriety is a disease should not 
 be taken without qualifications. It is generic rather than 
 specific. It is no more a disease than nervousness or 
 dropsy. It is a morbid condition of the nervous sys- 
 tem which craves the intoxicating effects of narcotics. 
 This craving may arise from degenerate conditions result- 
 ing directly from the action of the narcotic upon the 
 subject himself, it may come to him as a congenial 
 fault, or it may be the outgrowth of nervous dis- 
 turbances coming on at any time of life from any cause. 
 In short, anything which makes existence continuously 
 painful tends to produce inebriety by driving the victim 
 to such means as may be most easily available to find 
 relief. There are many examples of a selective appetite 
 manifested in early life, a preference exhibited for a par- 
 ticular form of narcotic, but this appetite very rarely or 
 never becomes evident until the subject has actually 
 experienced the intoxicating effects of the drug of his 
 choice. To show that this is true one has only to recall 
 that alcoholic inebriety very largely preponderates over 
 all other kinds, and that the number of male inebriates 
 is very much in excess of the female. This is due to the 
 fact that the habit of drinking and treating prevails almost 
 exclusively among males, thus giving every oppor- 
 tunity of arousing any latent defect, or, rather, of sug- 
 gesting that alcohol be drunk because it is seen to 
 contribute to the apparent wellbeing of the drinker, who 
 
144 SHALL WE DRINK WINE? 
 
 may be the victim of a latent defect. On the other hand, 
 such occasion for bringing out latent defects does not 
 often come to the female. If they exist they are more 
 likely to be disclosed by the physician's prescription. For 
 this reason, while as alcoholic inebriety among women 
 of respectable standing and habits is very rare, other drug 
 addiction is much more common. Morphine, chloral, 
 bromides, and, more rarely, cocaine habitues are in my 
 experience much more common among the latter than 
 among the former, and their inherent morbidity was 
 almost always aroused, in the first instance, by something 
 prescribed by the family physician. There can scarcely 
 be any doubt that opium inebriety would be the most 
 common form prevailing if preparations of opium pleasing 
 to the taste were sold under the same conditions which 
 now regulate the sale of alcoholic beverages. 
 
 It should be understood, then, that inebriety instead 
 of being a specific disease which always drives its victim 
 to some form of narcotic excess is simply a defect in his 
 nervous organization which makes his condition, his ex- 
 istence, under the influence of some narcotic intoxication 
 more pleasurable or less painful than during abstinence. 
 
 Inebriety arising from nervous defects presents many 
 variations of type and widely dififering degrees both of 
 nervous disturbances and excesses in alcoholic indulgence. 
 It may be periodical or continuous. 
 
XV. 
 
 Intonnittctrt or periodical Inebriety. 
 
 Men, especially young men, who are occasional 
 drinkers sometimes drink to excess. It would be difficult 
 to find one of this class who has not at least once felt the 
 intoxicating effects of alcohol. To some a single ex- 
 perience of the painful after effects of alcoholic poisoning 
 is sufficient to prevent a repeated indulgence, but the 
 number is not large. Here again social influences pre- 
 dominate to make the occasional drunkard. There is 
 an undefined, and generally unspoken sentiment, among 
 boys and young men that a physical tolerance for alcohol 
 is an evidence of mature manhood; and, therefore, that 
 he who is able to drink the greatest amount of the 
 intoxicant at hand without showing signs of complete 
 intoxication is deserving of respect. To have a "weak 
 head" for wine is to invite derision and reproach. In 
 stories of England's country gentlemen, they have been 
 described as "two bottle," "four bottle," or some other 
 number of bottles, men, meaning that they habitually 
 drank that number of bottles of wine, generally port wine, 
 after dinner, and to be a "twelve bottle man" was to excite 
 no little admiration in the rural community. Similarly 
 on the continent of Europe, and especially in Germany, 
 is this sort of manly superiority recognized at the present 
 day. There, as is well known, the students of various 
 universities have their beer drinking contests for the pur- 
 pose of electing a "beer king," the last man or boy to "fall 
 
146 SHALL WE DRINK WINE? 
 
 under the table" from sheer acute alcoholic poisoning 
 being unanimously chosen to wear the royal ermine of 
 King Gambrinus. 
 
 The idea that social superiority attaches to an ability 
 to drink large quantities of alcoholic beverage exists in 
 a still more marked degree with the lower orders of society, 
 while a "weak head" is assailed with a deeper measure 
 of contempt. I have heard many stories of this sort of 
 prowess among the lumbermen of the north, mill hands, 
 and lake sailors, while I have seen poor weaklings intoxi- 
 cated with whisky furnished by their more accomplished 
 fellows in order to be made the butt of rough ridicule. I 
 have known a periodic drunkard to drain an ordinary table 
 tumbler full of raw whisky at a single draught before 
 sitting down to his breakfast, turn to a companion, and 
 say, "Ah, Joe, me boy you will be a dandy when you can 
 do that!" and I have known of a "boss" in a lumber camp 
 who refused to hire a man because "he could stand so 
 little whisky." 
 
 The influence of this sort of public opinion in the 
 production of inebriety cannot be overlooked. Not only 
 is it calculated to rouse all the latent desire for narcotic 
 intoxication, but it may drive the novice, even though it 
 cost him several painful experiences, as is the case in 
 acquiring the tobacco habit, to acquire not only a taste, 
 but an imperative need, on the part of his abused and 
 degenerated ner\'0us system, for alcohoHc narcotism. 
 
 There ma)', therefore, be many occasional or periodical 
 drunkards whose excesses are caused by certain determin- 
 ing influences without the existence of any inherent defect. 
 To apply the terni inebriate to these would be to confuse 
 the subject. They are, as far as may be ascertained by 
 any method of examination, mentally and physically sound 
 before and after their alcoholic excesses. 
 
INTERMITTENT OR PERIODICAL INEBRIETY. 147 
 
 A smaller number of periodical drunkards are true 
 degenerates. Without apparent external cause, in the face 
 of promises and protests to the contrary, against the 
 prayers of those who have the greatest influence over him, 
 and in the face of impending business ruin and personal 
 disgrace, alcoholic excesses are begun and continued until 
 the storm has exhausted itself in a debauch. Then comes 
 a period of deep remorse sometimes leading to suicide. 
 Always there is deep contrition, renewed earnest promises 
 of reform, and a sincere and often successful attempt to 
 repair the damage done to health and character, a period 
 of successful decorous hfe, and again a sudden plunge 
 into alcoholic excesses. "Many men who fall into per- 
 sistent drunkenness are unaware of their neuropathic 
 heritage of unsteady nervous organism bequeathed to 
 them through alcoholic or other depressing influences 
 operating in their ancestors. Not understanding the 
 tyranny of their unstable system, they censure themselves 
 as fools for each bout of drinking, resolving and re- 
 resolving not to do it again, and then go on and do the 
 same unless aided by medical art to overcome the t3'ranny 
 of the degenerated organism" (C. H. Hughes in Alienist 
 and Neurologist, Jan., 1894). 
 
 Several marked cases of this class of inebriate have 
 been under my care or observation at various times. 
 Nearly all belonged to alcohoHc families. One I treated 
 several times for incipient delirium tremens. Twice dur- 
 ing periods of remorse following protracted debauches, 
 while consulting me in my office, the unfortunate man 
 fell upon his knees and with tears streaming from his 
 eyes and hand uplifted, against my protest, made a most 
 solemn oath never again to drink another drop of alcoholic 
 Hquor. Scarcely two months after his last interview with 
 me, I saw him again in the beginning of another drinking 
 
148 SHALL WE DRINK WiNE ? 
 
 bout. He was active, noisy, irritable, grandiloquent, 
 arrogant, and proud. He took it as a serious personal 
 affront when I drew him aside to remind him of the 
 danger of his condition, declaring that he was quite 
 competent to take care of himself without any outside 
 interference. This man had large business interests and 
 possessed more than an average amount of intelligence 
 and business capacity. He was of distinct alcoholic 
 heredity. 
 
 Another case was that of a fairly intelligent man who 
 had periodical attacks of great restlessness, attended by 
 dizziness, slight mental confusion, headache, and sleep- 
 lessness. At the same time an intense desire for liquor 
 possessed him, and he drank excessively for one or two 
 weeks, then suddenly stopped and resumed his daily 
 avocation, which was a minor judicial office. Unlike most 
 inebriates, he consulted me during a sober interval. He 
 fully appreciated his condition, and described it minutely 
 and intelligently. The periods occurred independently of 
 any surrounding circumstances, and varied in frequency 
 from six or eight weeks to three months. The attacks 
 began with mild disturbances, but increased in severity 
 until he was compelled to seek relief in alcohol. He was 
 advised to keep on hand a mixture of chloral, potassium 
 bromide, and tincture of capsicum, and to take it in 
 quantity sufficient to allay his nervousness as soon as it 
 appeared. He was also advised to remain at home for a 
 -day or more, to avoid being irritated by the petty annoy- 
 ances of his office. This simple expedient kept him from 
 alcohol for more than two years. At the end of that time 
 he lapsed once more into his old habit, but the debauch 
 was not severe, and he declared he made it voluntarily 
 to celebrate a local political victory. He was under 
 observation for nearly a year after this, but no knowledge 
 of any further backsliding came to me. 
 
INTERMITTENT OR PERIODICAL INEBRIETY. 149 
 
 Three brothers of this inebriate were known to be 
 drunkards. One of them, however, was a successful 
 business man, who, though he drank at times, still pos- 
 sessed sufficient self-control to prevent his excesses from 
 becoming very conspicuous. Another brother has 
 been a drunkard for many years. He drinks con- 
 tinuously and indulges frequently in conspicuous ex- 
 cesses. The third brother was a typical alcoholic de- 
 generate of the periodic type. I attended him through 
 an attack of alcoholic mania characterized by violence, 
 delusions of persecution, and destructive tendencies 
 — ^homicidal, suicidal, and property. Immediately after 
 recovering from this maniacal attack, when the nor- 
 mal functions were all re-established, he escaped from 
 his room during the absence of his attendant, and returned 
 in a few hours in a maudlin condition of intoxication. He 
 was then locked in a cell and kept until his desire for 
 alcoholic liquor could be controlled. 
 
 The time elapsing between any two successive narcotic 
 debauches varies much with different inebriates and at 
 different times with the same inebriate. In some the 
 nervous tension is always at the same level and needs only 
 the occasion, the presence of favorable circumstances, to 
 insure a narcotic excess. A commercial traveller who 
 had his work arranged so that he would visit a certain 
 town once in three months, and afterward once in six 
 months. Here he had to wait a week before resuming 
 his travels. He invariably seized this occasion for a drink- 
 ing bout, four times a year when occasion permitted it, 
 but only twice a year when the old order of things had 
 been changed. Here, it would seem, the periodicity was 
 determined by the periodicity of his visit to this particular 
 town. 
 
 Examples of this kind are numerous. Many inebriates 
 
150 SHALL WE DRINK WINE? 
 
 are controlled by the presence of a wife, a mother, or a 
 sister, but the absence or death of the relative removes tlie 
 restraining force under which the degenerate may have 
 fretted and silently protested, and he at once plunges into 
 the excesses toward which he was so long inclined. 
 Periodicity may, therefore, be determined by the periodicity 
 of occurrence of favorable circumstances and have the 
 same variations. 
 
 Another kind of periodicity is that which seems to be 
 the result of accumulated nervous irritation. It is as 
 though a successive train of electrical impulses were sent 
 into a Leyden jar, which finally becomes charged and is, 
 electrically speaking, in a condition of unstable equi- 
 librium, exploding when it becomes surcharged. An 
 inebriate of this kind has tolerably regular intervals of 
 dnmkenness, for, no matter what the surroundings may 
 be, to drink is inevitable. 
 
 Still another type is epileptic in character. There may 
 be long intervals of perfectly sane decorous conduct, with- 
 out nervous perturbation of any kind, when the subject 
 is taken by storm and seeks immediate relief in alcoholic 
 or other narcotic intoxication. This type is sometimes seen 
 in women, coinciding with the menstrual function. I have 
 seen a marked example of it in a clergyman's wife who 
 invariably became drunk on port wine with the recurrence 
 of each menstrual period. 
 
 By far the greater number of periodic inebriates, how- 
 ever, are those of unstable mental equilibrium, in a 
 constant state of mental depression and irritation, who 
 suffer from ennui, tedium vitae, whose intercourse with 
 the world is fatiguing, who find no joy in occupation, 
 who are given to introspection, and who find their very 
 existence painful. Losses of any kind, in business or of 
 friends, or anything else which may add to the burden 
 
INTERMITTENT OR PERIODICAL INEBRIETY. 151 
 
 imposed by existing degenerate conditions, may make 
 that burden too painful to be borne, and relief is sought 
 in the nerve deadening effects of narcotic drugs, chiefly 
 in alcohol. 
 
 Many cases of periodic inebriety are difficult of classi- 
 fication. Certain susceptible individuals seem to be 
 markedly affected by atmospheric conditions. Heat, 
 cold, moisture, electrical tension and the like, may develop 
 a latent desire for drink which would have otherwise 
 remained dormant. In certain other cases there seems to 
 be absolutely no cause for occasional bouts of drunkenness 
 but the pleasure of gratifying the physical taste for some 
 form of alcoholic drink. Drunkards of this kind often 
 have their debauches in solitude and consume only a 
 special brand of spirits or wine. Their periods of excess 
 are^ in some cases, at least, far apart. For example, there 
 is the case of a well-known professional man who once a 
 year drank large quantities of a certain brand of whisky. 
 Preparations were always deliberately entered into, a local 
 druggist being asked to have on hand a stated amount 
 of the intoxicant for the occasion, which always took the 
 form of a fishing excursion lasting from one to two weeks. 
 His only companion was a trusted man-servant. During 
 the remainder of the year he abstained from alcoholic 
 beverages absolutely. Another example was that of a 
 wealthy and venerable philanthropist who, every summer, 
 engaged a suite of rooms in a prominent hotel of a distant 
 city, and in the seclusion of his apartments drank enormous 
 quantities of a particular brand of champagne. Ten or 
 twelve days thus spent sufficed to satisfy him for the whole 
 year. Perhaps we may regard these cases as we would 
 cases of simple gluttony^ excesses to gratify a momentary 
 taste, without any craving on the part of the nervous 
 system. 
 
XVI. 
 Non-Intermitting or Constant Inebriety. 
 
 The periodic inebriate or the occasional drunkard may 
 become the constant inebriate. Sometimes inebriety is 
 constant from the beginning, but this is not common. 
 The same causes which produce the one form produce 
 the other. In the writer's experience, the sound man 
 of good heritage who acquires the habit of drinking 
 is more Hkely to become a constant than a periodic 
 inebriate. He creates the necessity for narcotic sedation 
 by his excesses. Some drunkards daily take a sufficient 
 quantity of alcohol to produce a certain state or degree 
 of intoxication for months at a time^ exhibit no periods 
 of irregular conduct, attend to their daily duties with the 
 utmost regularity, and finally die of some acute inflamma- 
 tion or some chronic disease engendered by alcoholic 
 irritation. Many of this class have no history of degenera- 
 tion of any kind. They become the victims of favorable 
 opportunity. They are men of means and leisure, without 
 definite aims in life, to whom normal existence has become 
 dull. Employment may also favor constant drinking. 
 The wine merchant becomes a constant inebriate from 
 drinking his wares with his many customers. So does 
 the distiller and his salesmen; but more particularly do 
 the laborers engaged in the manufacture of alcohohc 
 liquors become drunkards. It is the habit of employes in 
 such places to have a definite amount of the beverage 
 manufactured set apart for each individual daily. The 
 
NON-INTERMITTING OR CONSTANT INEBRIETY. 153 
 
 laborer is very jealous of his "rights" in this respect and 
 I have heard of a strike threatened because of a suggestion 
 on the part of a brewer to reduce this daily allowance of 
 beer. The amount allowed to each workman is probably 
 always sufficient to keep him in a continual state of in- 
 toxication. I have it on good authority tliat some brewers 
 of Germany allow each workman eight liters of beer for 
 his individual consumption (a liter is 2. 113 pints). Esti- 
 mating beer to contain from three to eight per cent, of 
 alcohol, the amount of alcohol consumed daily by each 
 man would be from one to two and two-thirds pints. 
 Whether this custom is universal in America, I cannot 
 say. It is observed, at least, in some breweries, but 
 whether it is observed or not the brewery employe is 
 pretty sure to keep himself saturated with alcohol and 
 exhibit its damaging consequences. A medical friend who 
 has considerable practice among these men declared that 
 many of them "are walking pathological museums." 
 
 Similarly, bartenders, porters, and other servants em- 
 ployed where intoxicating liquors are sold, readily acquire 
 the habit of continuous excessive drinking, without the 
 existence of any abnormal appetite for drink, but simply 
 because the drink is easily accessible. 
 
 Very liable to lead to constant inebriety is the habit 
 of keeping late hours combined with the drinking of 
 alcoholic liquor in quantity to produce slight intoxication. 
 Indulged in, night after night, as is often the case with 
 young men of the store, the bank, or the lawyer's office, 
 they find that the day's work must begin with an aching 
 brain and exhausted body, which may be temporarily 
 relieved by a "bracer" of brandy. When exhaustion thus 
 produced becomes marked, a repetition of the dose at 
 frequent intervals during the day may become imperative 
 to enable the debauchee to do his work, and the way is 
 soon paved to continuous inebriety. 
 
154 SHALL WE DRINK WINE? 
 
 There is a general but ill defined opinion that the con- 
 tinuous inebriate, unlike the periodic inebriate who is the 
 victim of an insane impulse, is somehow personally 
 responsible for his drunkenness, and there is some founda- 
 tion for this opinion. It is not that the voluntary inebriate, 
 if the expression can be allowed, does not become a de- 
 generate and does not suffer from the withdrawal of his 
 habitual narcotic, but that he began his habit of drink a 
 free man, unhampered by any resistless impulse bequeathed 
 to him by degenerate parents or acquired by other means 
 than alcohol. 
 
 As a corollary to the fact that habit alone, without pre- 
 existing degeneracy, may lead to continuous inebriety, 
 is the fact that this sort of inebriate is most readily 
 reformed or cured. If great and permanent damage has 
 not been suffered by any important organ, and he is 
 intelligently supported during the nerve storm, following 
 the withdrawal of alcohol, until he has regained his usual 
 standard of health, he is certainly not so liable to lapse 
 into his old habits as he would be if he had some congenital 
 fault to deal with. Here, again, blame should attach to 
 him should he, after complete recovery, again form habits 
 which would lead to inebriety. 
 
 The amount of damage done by alcohol which may be 
 repaired by patient and judicious treatment cannot be 
 definitely stated. It is not uncommon to meet with cases of 
 complete recovery after evidence of most profound nerve 
 degeneration — partial paralysis, incoordination, pares- 
 thesia, anesthesia, hyperesthesia, marked disturbances of 
 the special senses, and the like. Physicians who have had 
 considerable experience with drunkards will readily recall 
 examples of this kind. 
 
 One such case under my observation for a time ex- 
 hibited signs of most marked degeneration. The muscular 
 
NON-INTERMITTING OR CONSTANT INEBRIETY. 155 
 
 system was atrophied, he suffered intense pain and inco- 
 ordination in the lower extremities, complete anasthesia 
 of one foot, and amaurosis to such an extent that he could 
 not read, nor even oversee the work of his employees (he 
 was a master plumber). A complete withdrawal of alco- 
 holic liquor was followed by prompt improvement, and 
 within eighteen months he had apparently reached his 
 normal condition of health. Nearly seven years have since 
 elapsed, but there has been no recurrence of his old 
 habit. 
 
 Not only under intelligent medical handling may inebri- 
 ates of this class recover, but they sometimes exhibit a sur- 
 prising amount of will power and enter almost single- 
 handed into the struggle against the bestiality to which 
 they have sunk. Generally the determination to reform is 
 the result of some profound impression, fear of speedy 
 death if the habit is continued, a religious revival, a disaster 
 to family or friends for which the drunkard thinks he is to 
 blame, or the dying request of a neglected wife or mother. 
 
 A "homesteader" in a pine forest of northern Wiscon- 
 sin, whose nearest neighbor was several miles away, left 
 his wife, who was about to be confined, to call a physician 
 in a village about ten miles away. On arriving he found 
 that the physician was absent and would not return before 
 two or three hours. He then went to a saloon, of which 
 he had for a long time been a liberal patron, to get his 
 jug filled and await the doctor's arrival. Here alcohol soon 
 made him oblivious of his urgent errand, and not until 
 the next day did he return to his home, where he found 
 both his wife and baby dead. The calamity was sufficient 
 to make him abjure alcohol for sixteen years. 
 
 A young man of good heritage became a constant 
 inebriate through social influences alone. For a period 
 of eight or nine years he had not been free from alcoholic 
 
156 SHALL WE DRINK WINE? 
 
 intoxication for a single day. At the end of this time he 
 had become unfit for any kind of labor. He had the 
 usual symptoms of nerve degeneration, with marked 
 psychic disturbances. For these he called his physician, 
 and asked an opinion as to whether his condition was 
 dangerous to life. He was candidly told that he might 
 die in a short time, and that he certainly would die within 
 two years if he continued his course. With only a very 
 little help from his physician he fought out the battle, and 
 at the end of four or five weeks he could enjoy a normal 
 existence without any narcotic. Eight years have elapsed 
 without a revival of his old habit. 
 
 The history of another young man under the writer's 
 observation is almost identical with the above. The latter, 
 however, drank more alcohol and showed profound nerve 
 degeneration, especially of sight. Fear of losing this im- 
 portant sense started him on the road to reform. He, 
 however, accomplished the result quite singlehanded, re- 
 jecting proffered medical aid. His cure has persisted up 
 to the present, a period of more than five years. A wealthy 
 lumberman had been a drunkard from the age of eighteen. 
 For many years he habitually became intoxicated on 
 Saturday afternoon and continued so until Monday or 
 Tuesday morning. Besides this he drank more or less 
 during the remainder of the week. Four or five years 
 previous to his reformation he became a continuous 
 drunkard, being under the influence of alcohol during his 
 entire waking time. He ceased drinking at the age of for- 
 ty-one, giving as his reason the fact that his wife had 
 never upbraided him for his excesses, and that her christian 
 fortitude, together with an overwhelming sense of the 
 wrong he had done her, compelled him to attempt to re- 
 form, even though the effort should kill him. 
 
 Many other instances of partially or wholly voluntary 
 
NON-INTERMITTING OR CONSTANT INEBRIETY. 157 
 
 reformation might be recalled, but cases of this kind are 
 already familiar to both laymen and medical men. When a 
 considerable number of them are analyzed, it is difficult to 
 escape the conviction that much drunkenness is really vol- 
 untary. 
 
 Here is an appropriate place to point out more fully 
 some facts, the failure on the part of the public to under- 
 stand which, have made imposition by commercial inebriate 
 institutions possible. These people send out broadcast un- 
 qualified assurances that they "cure inebriety,'' assuming, 
 of course, that it is a definite specific disease. Many guar- 
 antee to "cure" it in from four to six weeeks. Their clients 
 are instructed and assured that this method of cure abso- 
 lutely abolishes all desire for alcoholic liquors. Not only 
 this, but the former appetite for strong drink is replaced 
 by deep-rooted and permanent abhorrence for alcoholic in- 
 toxicants. Their proposition may be stated thus: "You 
 have had the specific disease called inebriety. You are now 
 cured. Instead of having an appetite for alcohol, you now 
 have and always will have an aversion, unless you again 
 begin to drink voluntarily. Should you again begin to drink 
 alcoholic beverages, you will again get the disease of which 
 you have been cured." It is unnecessary to point out the 
 puerility of such arguments. I have known a young man 
 just returned from an institution which promulgates this 
 doctrine declare to a group of old convivial friends that 
 even the smell of liquor nauseated him, and that he felt sure 
 that he not only would never but could never again drink 
 spirits, and then die as the result of a drunken debauch four 
 months later. I attended a man for delirium tremens re- 
 sulting from a debauch which began the second day after 
 he left this institution, cured, as he was told. A patient un- 
 der treatment at the present time for syphilis was cured of 
 inebriety in six weeks. A few months afterward he began 
 
158 SHALL WE DRINK WINE? 
 
 his old excesses and for a year or more drank more than 
 ever before taking the cure. He then ceased voluntarily, 
 and for two years has been trying to repair his shattered 
 fortunes. A friend upon whose word the utmost reliance 
 may be placed told that he was an eye witness to the fol- 
 lowing incident : A train bearing several returning "cured" 
 inebriates to a certain city in the west stopped for a time at 
 a way station. Here the returning prodigals met an equal 
 number of the unregenerate on their way to the institu- 
 tion the former had just left; good-fellowship overcame 
 all restrictions and the "cured" and "uncured" got drunk 
 together. 
 
 Many inebriates return to those institutions again and 
 again. A brilliant scholar known to the writer is now un- 
 dergoing his sixth or seventh "cure." Many others are 
 known to have been treated by the same method two, 
 three, four, five, or more times. A few do not fall from 
 grace after taking the treatment once. If a record were 
 kept of all the inebriates thus treated for a period of five 
 years after being discharged as cured, the number which 
 had not relapsed would be found to be very small. In the 
 experience of the writer and, as far as can be learned, that 
 of other physicians, those permanently benefited are almost 
 invariably constant inebriates who become such, not 
 through any inherited or other defect of the nervous or- 
 ganization, but through the habit of social drinking; ine- 
 briates of the periodic type, the victims of a true degener- 
 acy, are rarely, if ever, benefited even for a short time. This 
 result is precisely what ought to be expected when the sub- 
 ject of inebriety is understood. 
 
XVII. 
 
 popular fallacies Regarding Comtnoii Hlcoholic 
 Beverages. 
 
 Perhaps three-fourths of the intelligent people of Amer- 
 ica believe that alcoholic beverages "taken in moderation" 
 are beneficial. A brilliant German woman once said to me, 
 "I use water only to bathe in." She spoke the sentiment of 
 the German people as to the use of water as a beverage, 
 for no German is so poor that he will not spend a few pfen- 
 nigs for beer to drink with any meal excepting breakfast. 
 The Frenchman, though he has recently become some- 
 thing of a beer drinker and has increased his allowance of 
 spirits, still keeps up the traditions of his ancestors in his 
 devotion to wine. Similarly in other European countries 
 water as a beverage is eschewed by all classes of society, 
 and liquors containing alcohol are almost universally sub- 
 stituted, because they are believed to be more beneficial in 
 promoting and maintaining the health. There is a curious 
 popular belief among the majority of uneducated foreign- 
 ers that the drinking of water causes bodily weakness by 
 making the blood "thin," and the physician is sometimes 
 asked if this is not true. 
 
 Spirituous liquors, whiskey, brandy, gin, rum, and oth- 
 ers, containing forty to sixty per cent of alcohol, are popu- 
 larly believed to be stimulating when taken in small quan- 
 tities. As the only active principle they contain (excepting 
 gin) is alcohol, their action is the action of alcohol, and 
 whether alcohol is a stimulant or not has already been 
 
160 SHALL WE DRINK WINE? 
 
 full}' discussed in this work. In the normal man not habitu- 
 ated to the use of narcotic drugs, in spite of the delusive 
 sensation of increased mental and physical power which 
 follows the ingestion of a small drink of spirits, muscle and 
 nerve capacity is, in the sum total, always lessened. This has 
 been conclusively proved by Richardson and others 
 through actual experimentation. 
 
 There is also a popular belief that these strong bever- 
 ages contribute to the physical well-being under conditions 
 of fatigue due to excessive physical exercise, especially if 
 the exercise is taken in a cold and wet atmosphere. A habit 
 prevails extensively, among working-men, of taking a drink 
 of spirits at the close of a hard day's labor, when fatigue is 
 so great as to become painful. Seafaring men, soldiers on 
 a march, sportsmen, and others whose employment makes 
 exposure to the inclemencies of the weather necessary ha- 
 bitually drink spirits to lessen the unpleasantness of expos- 
 ure and make their necessary tasks easier. Here again we 
 meet with the familiar delusion that narcotism is strength. 
 Undoubtedly the sense of fatigue is lessened or abolished, 
 but the chemical conditions causing the fatigue remain the 
 same as they were before the ingestion of the spirits, the 
 sensory nerve endings having simply been narcotized into 
 a temporary quiet. Morphine or any other narcotic pro- 
 duces percisely the same effects. Perhaps alcohol is the 
 least offensive narcotic under these circumstances, but it is 
 a narcotic nevertheless. If exercise is continued after the 
 irritations of fatigue are temporarily lulled to rest, muscle 
 and nerve wear and tear still continue. They are not abol- 
 ished simply because they are not felt. A condition of over 
 fatigue thus results, to recover from which requires a long 
 period of rest; therefore nothing is gained, but there is 
 always a loss due to the temporary derangement of the vital 
 functions by the action of the narcotic. 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 161 
 
 Similarly, while a drink of spirits seems to warm the 
 subject chilled by an unexpected bath in icy waters or a 
 downpour of cold rain, actual investigation by precise 
 methods shows that the bodily temperature is always low- 
 ered when a sufficient quantity of alcohol is taken to affect 
 it at all. 
 
 The stronger alcoholic beverages are popularly be- 
 lieved to increase the bodily weight, to give embonpoint 
 and the color of health. Even some members of the med- 
 ical profession hold this view. A recent writer (Practical 
 Dietetics, Thompson, P. 207) makes the following pecu- 
 liar statement of those who use alcohol: "In the condition 
 of health more food is eaten and more force developed than 
 is actually necessary for the body, and there is constantly 
 a reserve supply of energy on hand which may be used for 
 any extraordinary exertion, and hence the constant use of 
 alcohol as a food or stimulant is both unnecessary and un- 
 advisable." An analysis of this confusing statement would 
 seem to make it mean that the habitual taking of alcohol in 
 the form of spirits leads to an exaggerated condition of nu- 
 trition by stimulating the appetite so that more food is 
 taken than is needed, and that the surplus is stored up in the 
 form of reserved force. The physiological principles which 
 make this impossible in the normal subject have already 
 been discussed. Suffice it here to say that spirituous liquors 
 such as brandy and whiskey have no more power to in- 
 crease the weight of the normal man than have sulphuric 
 ether or chloroform, and that when a drunkard is well 
 nourished or fat he does not confine himself to these 
 alcoholic beverages alone, but drinks others containing 
 food substances. The writer has never yet seen a drunk- 
 ard who drank spirits alone who became fleshy, but the op- 
 posite condition of emaciation always prevailed. Says Dr. 
 Norman Kerr on this point (Alcoholism and Drug Hab- 
 
162 SHALL WE DRINK WINE? 
 
 its) : "Spirits drinkers as a rule are more shrunken in aspect 
 and often grow thinner the longer they continue their deep 
 potations till, in many cases, they are quite emaciated." As 
 to the rosy color of the spirits drinker's face, that is due to 
 the paralysis of the vessel walls leading to permanent dila- 
 tation, especially of the superficial blood vessels of the face. 
 Spirits are commonly taken by one who feels the neces- 
 sity of being braced up to meet a mental ordeal or to tide 
 him over a period of mental perturbation from any cause. 
 Here again it is not the stimulant which relieves, but the 
 narcotic, by making the nervous organism less impression- 
 able to irritating influences. Lastly, spirits are very com- 
 monly taken to ward off infection in the presence of epi- 
 demics of contagious disease. Confidence in the efficacy 
 of strong brandy and whiskey for this purpose is wide 
 spread. No advice of the physician was more common a 
 short time ago than that instructing the throat to be gar- 
 gled with brandy and small quantities of it to be swallowed 
 to ward off an attack of diphtheria. Blood poisoning from 
 an infected wound was also combated with large doses of 
 strong liquor. To-day the physician can demonstrate that 
 infectious diseases are made more formidable by the giv- 
 ing of spirits, but the laity will be a long time learning this 
 important fact. Especially are malt liquors supposed to 
 be of exceptional value in contributing to the physical 
 well-being of man. Beer and ale are supposed to have an 
 important tonic and food value, while the amount of alcohol 
 they contain is looked upon as harmless. The opinion is 
 expressed on every hand that the drinking of beer should 
 be encouraged, because it tends to produce temperance — 
 the more beer that is drunk, the less spirits will there be 
 drunk. Indeed, it is difficult to appreciate to what extent 
 beer is regarded as one of the prime necessaries of life with 
 the people of some European countries and their Amer- 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 165 
 
 ican descendants. With some of these people, not to drink 
 beer is to be considered eccentric, and to doubt its whole- 
 someness and desirability as a beverage is rank heresy, 
 while to publicly oppose it is regarded as a dangerous 
 degree of fanaticism. 
 
 Beer is a mixture of alcohol, sugar and dextrine, car- 
 bonic acid, the bitter principle and some other constituents 
 of the hop, tannic acid derived from the hop or from veg- 
 etable matter used for coloring purposes, and water. The 
 effects of beer are precisely the effects of its constituents if 
 taken separately but simultaneously. The alcohol in beer 
 produces drunkenness just as it does when taken in any 
 other form, and as beer and ale contain from three to twelve 
 per cent of alcohol the amount ingested will depend upon 
 the kind and amount of beer drunk. Four per cent beer 
 may produce unlimited alcoholic intoxication. Massachu- 
 setts passed a law in which an intoxicating liquor was de- 
 fined as one containing four per cent of alcohol or more, 
 but so much drunkenness could be produced by a beer of 
 this strength that the law was afterward amended so as to 
 define an intoxicating liquor as containing alcohol to the 
 extent of one per cent or more. There can be no doubt 
 that many hereditary appetites for alcohol are first aroused 
 by drinking beer. 
 
 There is considerable variation in the amount of sugar 
 contained in different malt liquors. If the sugar and dex- 
 trine be taken together, as they have the same food value, 
 the amount would be found to vary from two and a half to 
 three per cent or more in the heaviest ales and porters. Ex- 
 cepting the very small amount of proteid matter contained 
 in malt liquors, which is so small that it may be disre- 
 garded, sugar alone of all ingredients has a definite food 
 value. There is a popular belief, and it is not confined to 
 the laity exclusively, that malt sugar, which is found in 
 
164 SHALL WE DRINK WINE ? 
 
 malt liquors, is superior to the ordinary sugar of commerce, 
 in being more easily digested and assimilated. There is, 
 however, no foundation for this assumption. Indeed, phys- 
 iologists know that all sugars are changed into the ordi- 
 nary grape sugar of commerce before being finally ab- 
 sorbed and converted into mechanical force. This assump- 
 tion probably had its origin in the belief that diastase ex- 
 isted with malt sugar and aided the digestion of starch. 
 Diastase, however, is killled by the high temperature of the 
 brewing process. 
 
 Sugar is an important and easily assimilated food. 
 Taken in excess of daily need, it is stored up as fat, and to 
 the sugar alone is due the obesity of the beer drinker. In 
 addition to an abundant supply of fat, the beer drinker also 
 develops the ruddy countenance of the spirit drinker, due 
 to the same cause — alcoholic paralysis of the superficial 
 blood vessels. But sugar is not a perfect food. Taken 
 alone it will not support life indefinitely. If taken to the 
 exclusion of a proper amount of nitrogenous food, the 
 subject soon becomes debilitated, and may suffer from 
 fatty degeneration of some important organ. Thus the 
 beer drinker, while he is generally ruddy and in good flesh, 
 may be far from the normal standard of health. With con- 
 tinued excessive drinking of malt liquor, the great accumu- 
 lation of flesh and purple face show even to the unprac- 
 ticed eye evidence of serious disease. I cannot do better 
 than to quote from Dr. Norman Kerr the characteristic 
 appearance of the malt liquor drunkard: "In beer and 
 other malt liquor drunkards the subject at an early stage 
 has a tendency to obesity which, as the disease advances^ 
 becomes more prominent, till he acquires a bloated appear- 
 ance, puffing and blowing with the slightest exertion. The 
 features are heavy and dull, the face red and somewhat of 
 a purple hue, with vascular hypertrophy most conspicuous 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 165 
 
 in the region of the eye and nose, with blotches and an oily 
 glistening surface, conjunctival yellowness (bilious or fatty), 
 moist red eyes. In the early stages the beer drinker 
 may be quick and active, but gradually his gait loses much 
 of its elasticity, he looks sluggish and embarrassed in his 
 movements. Dropsy or syncope or embolism frequently 
 closes the scene in middle life." 
 
 A peculiar demonstration of the fattening power of 
 sugar in a drunkard was recently brought to my notice by 
 a professional friend. He had under his care for some 
 time an inebriate who drank from forty to sixty glasses of 
 whiskey daily, and, not liking the taste of whiskey, he al- 
 ways poured into the glass an equal amount of plain syr- 
 up. This practice he had continued for several years, and 
 when he applied for treatment the flesh hung from nearly 
 all parts of his body in "flabby, yellowish folds," and he 
 was enormously fat. 
 
 Again, the beer drinkers of Germany are almost with- 
 out exception fleshy, while here in America I have seen 
 many beer drinkers decidedly lean ; on examination of sam- 
 ples of imported and domestic beers it is found that the 
 German beers do contain more sugar than the domestic 
 article. In some instances, at least, the difference is as 
 great as three or four to one. 
 
 The carbon dioxide and bitter principles of the hop give 
 to beer much of its pleasant taste, and probably have some 
 influence in the way of increasing the flow of gastric juice. 
 Tannic acid, on the other hand, of which some beers con- 
 tain a considerable quantity, has a deleterious influence on 
 digestion. It is a well-known fact. that this substance has 
 the property of combining with albumen and the various 
 peptones, forming with them insoluble compounds and 
 thereby perventing their proper digestion and assimilation. 
 Dr. Lambert Ott of Philadelphia, speaking of the acute di- 
 
166 SHALL WE DRINK WINE ? 
 
 gestive troubles of beer drinkers, says (Medical News, Jan. 
 6, 1894) "of one hundred cases of this disease (inflamma- 
 tion of the lining membrane of the stomach) seventy-eight 
 occurred in June, July, and August from pouring cold beer 
 into an empty stomach. In fact, the drinking of beer pro- 
 duces the same disturbances that are produced by any liq- 
 uor containing alcohol in the same proportion, with the 
 added trouble that comes of tannic acid and the usual adul- 
 terations that are in beer." In the beers examined by me 
 the amount of tannic acid varied considerably. Certainly 
 there was enough in some of the specimens examined to 
 produce serious disturbance of the digestive processes. 
 
 Of all the alcoholic beverages none are held by the ma- 
 jority of civilized people to have the transcendant virtues 
 of wine. No other food or beverage has commanded so 
 much adulation from all kinds and conditions of men. It 
 occupies so important a place in all the best literatures of 
 the world, in which its desirability, its wholesomeness, its 
 divinity, are the subject of effusive encomium, that to com- 
 pile a catalogue of its votaries' praises would require a 
 much longer time than is vouchsafed to a single human 
 life. Its worship is sincere and deep rooted, and its wor- 
 shippers are among the world's greatest and best men. 
 It is amazing, when one stops to consider the matter, how 
 little foundation there is for the average man's opinion as 
 to the value of wine. Good wine, in his estimation, is al- 
 ways desirable. He may abhor drunkenness, look upon 
 the drinking of spirits as dangerous and demoralizing, 
 regard the drinking of malt liquors with contempt ; and yet 
 he may consider the drinking of a bottle or more of wine 
 each day as a duty Which he owes to his health, his mater- 
 ial success in life, or his social position ; and he is apt to re- 
 gard the contents of his wine cellar as one of his greatest 
 treasures. If he is asked the reason for the value he puts 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 167 
 
 upon his wine, he certainly cannot call attention to its in- 
 trinsic worth, for he is not a chemist nor a physiologist. His 
 answer must be that it cost him a large price per bottle, that 
 it was made at a famous "Chateau" and that the wines from 
 this place are always high priced; that it was part of the 
 contents of a famous wine cellar which was recently sold, or 
 that it is many years old and came to him through the will 
 of his father, grandfather, or some other relative. 
 
 No error, by the way, is more common than that which 
 gives increasing value to wine with increasing age. This 
 value is looked upon as something very real and potent. 
 New wine may be thought unfit to drink. The same wine 
 after ten years is considered good and commands a high 
 price; but let this same wine acquire an age of a hundred 
 years or more, and it now commands a fabulous price and 
 is looked upon as a veritable elixir vitae. One is gravely 
 told even by intelligent men that, no matter in what quan- 
 tity drunk, such wine is never harmful. It will surely pro- 
 duce drunkenness when taken in sufficient quantity, but 
 even drunkenness produced by it leaves no bad after ef- 
 fects. Good wine is supposed to be tonic and stimulating. 
 Red wine is believed to have the power of making "red 
 blood." Good wine is supposed to be always beneficial. 
 When injury is done by wine it is not the wine which is 
 believed to have done the injury, but the suspicion of adul- 
 teration is at once aroused. All the value which the wine 
 possesses may be estimated by considering the substances 
 which enter into its composition. They are water, sugar, 
 tartaric and acetic and a small amount of malic, tannic, 
 and carbonic acids, various salts derived from the grape, 
 like the tartrates of lime and potash, and sulphate of potash 
 and lime, chloride of sodium, potash, and lime. These salts 
 vary in amount from .2 per cent, to .4 per cent. Wine also 
 possesses a peculiar aroma which is known as "bouquet." 
 
168 SHALL WE DRINK WINE? 
 
 The amount of alcohol contained in wines varies from 
 three to thirty or more parts by weight. It is thus seen 
 that some wines may do nearly as much damage as whis- 
 key or brandy. Sugar varies from practically none in the 
 dry wines to twentv-five per cent, or more in the sweetest 
 wines. As sugar is the only constituent of wine possessing 
 a food value, the value of wine as a food will depend upon 
 the amount of sugar it contains. It is quite probable that 
 the malic and acetic acid, and perhaps the tartaric, of wine 
 may aid digestion by reinforcing the gastric juice in cases 
 of insufficiency, and therefore promote gastric digestion. 
 
 The bouquet and flavor of wines are due to the devel- 
 opment of certain volatile substances by the reaction of 
 acids upon alcohol. These volatile substances belong to 
 the chemical group known as Ethers. In quantity they 
 are intoxicating, and much more injurious than alcohol, 
 but they exist in such small amounts in wine that they 
 sei"ve merely to give its peculiar odor and taste. The de- 
 velopment of the bouquet to its fullest extent requires a 
 long time, and this alone makes old wine so much pre- 
 ferred by wine drinkers. In all other respects there is abso- 
 lutely no difference between old wine and new. 
 
 Comparing wine with malt liquor, it will be seen that 
 the latter has more nutritive value than the former because 
 it contains the greater amount of sugar. The sweetest 
 wines, it is true, contain more sugar than the average malt 
 beverage, but sweet wines find little favor with wine drink- 
 ers, dry and sour wines being preferred. Champagne con- 
 tains quite a large percentage of sugar, but its cost limits 
 its use to comparatively few. The wine drunkard is not, 
 therefore, liable to present the bloated, pufify, flabby ap- 
 pearance of the malt liquor drunkard. Wine is also lacking 
 in the bitter principle which gives beer a slight tonic value. 
 Wine has no tonic effect beyond that from the food value 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 169 
 
 of its sugar and the slight aid its acids may give to diges- 
 tion, and it "stimulates" or narcotizes according to the 
 amount of alcohol it contains. 
 
 There is a wide-spread belief that all the common alco- 
 holic beverages are more or less adulterated with harmful 
 substances, and that the damage done by them is not so 
 much due to the beverages themselves as to the poisonous 
 drugs used as adulterants. Many persons willingly drink 
 the currant, grape, and other wines made within the pre- 
 cincts of the household who could not be induced to drink 
 the ordinary article of commerce. Indeed, one frequently 
 hears the praises of the domestic article sounded for its 
 wholesomeness and its purity. A few years ago, when one 
 of the Southern States assumed the duties of dispensing 
 liquors to the public, a great deal of opposition to the plan 
 was silenced by the assurances on the part of the Governor 
 and his followers that under state authority the liquor sold 
 would be pure. Also, in other states in which stringent 
 laws were passed to regulate the liquor traffic, provisions 
 were incorporated to prevent the sale of adulterated liq- 
 uors, with the hope of lessening the evils attending their 
 consumption. Those who speak of the prevalence of liquor 
 adulterations, however, rarely make any specific charges as 
 to the material used for adulteration purposes. Now and 
 then one hears of spirits being mixed with "impure alco- 
 hol," fusel oil, and the like. As a matter of fact, however, 
 the ordinary sophistications of spirits are harmless. They 
 are added with the desire of increasing the bulk, and con- 
 sequently the profits of the sale of the liquor. For this 
 purpose the most common adulterants are water, to in- 
 crease the bulk, and caramel or burnt sugar to maintain 
 the proper color; and these not only are not harmful, but 
 render spirituous liquors less irritating by decreasing the 
 amount of alcohol. 
 
170 SHALL WE DRINK WINE? 
 
 While "impure alcohols" are widely spoken of by both 
 physicians and laymen as being used to adulterate liquors, 
 and especially wine, no one has yet pointed out the nature 
 of the impurities. The most common and almost only im- 
 purity met with in ethyl alcohol, the ordinary alcohol of 
 commerce, is water. During the process of fermentation^ 
 however, other alcohols popularly known as fusel oil are 
 also produced. These have a higher specific gravity and a 
 higher boiling point than ethyl alcohol, but some of them 
 generally pass over with the ethyl alcohol during the 
 process of distillation. With the process of time they are 
 supposed to be oxidized into volatile ethers and so 
 removed. New whiskey, therefore, is supposed to be 
 very injurious because of its contained fusel oil, which is 
 regarded as an especially potent poison. As a matter 
 of fact, recent investigations have shown that there is 
 no warrant for concluding that these heavier alcohols 
 are removed by the process of "aging" of spirituous 
 liquors, and while they are shown to be more irritating 
 than ethyl alcohol, they are by no means as poison- 
 ous as they are popularly supposed to be. Recently an 
 English chemist, A. H. Allen, in experiments made on 
 himself, has shown that much larger quantities of fusel oil 
 than any whiskey could contain are borne without any 
 apparent deleterious effect, and a friend of tlie chemist 
 took a large dose of it without serious after effects. 
 
 Many wines are undoubtedly "fortified" by the addition 
 of alcohol, but the alcohol thus used is probably not im- 
 pure in the sense of being made more harmful. Popularly, 
 also, wines are believed to be colored with haematoxylin 
 and their roughness increased by the addition of alum. No 
 authentic evidence, however, has yet been produced to 
 show that this custom is at all common. 
 
 As to the adulteration of beers, a great deal has been 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 171 
 
 said, and probably with some foundation. Glucose is said to 
 be added to save the expense of using malt, but even if this 
 is true it proves nothing to the detriment of beer, for glu- 
 cose has the same food value as malt sugar and its products 
 of fermentation are the same. Thewriter has it on good author- 
 ity that large amounts of the leaves of some plant or plants 
 are used for the purpose of coloring beer, and some of the 
 beers certainly contain more tannic acid than could be 
 given to them by the usual amount of hops used in brew- 
 ing. The conclusion arrived at is that the surplus of tannic 
 acid comes from the material used for coloring. Various 
 substances are also said to be used to check fermentation, 
 among them salicylic acid, boracic acid, and formaldehyde. 
 If these latter drugs are used their use is not general, or 
 they are used in very small quantities. The writer did not 
 find them in the beer examined. Tannic acid, however, as 
 has already been pointed out, may exist in quantity suffi- 
 cient to cause serious digestive disturbances. 
 
 A recent French writer, Mr. Joffroy, attaches a good 
 deal of importance to the effects of the by-products of alco- 
 holic fermentation, and decljires that they play an impor- 
 tant part in determining the pathology of chronic alcohol- 
 ism (Revue Scientifique, Jan. 15, 1898). He calls atten- 
 tion to the fact that many commercial beverages also con- 
 tain additions to the ordinary products of fermentation, 
 as absinthe, anisette, vermuth, bitters, and the Hke; that 
 brandy contains other alcohols than ethyl, aldehydes, and 
 acetic ether. He also calls attention to the various vola- 
 tile substances and salts found in wine and malt liquor, 
 and argues that those as well as the alcohol must play an 
 important part in producing diseased conditions. There 
 cannot be any doubt that absinthe produces conditions pe- 
 culiar to itself, and it is likely that aromatics like anise are 
 added to various made beverages in quantity sufficiently 
 
172 SHALL WE DRINK WINE? 
 
 large to produce notable effects; but he has produced no 
 evidence to show that the ordinary spirits and wine of com- 
 merce contain any of the natural by-products of fermenta- 
 tion in quantity sufficient to cause definite pathological 
 conditions. 
 
 In conclusion it must be said that the popular belief in 
 harmful adulterants of common alcoholic beverages is not 
 warranted by any evidence which has thus far been 
 brought to light, and that alcohol alone must be respon- 
 sible for the damage done by them. 
 
 We often hear the remark made that man in his natural 
 state needs alcohol, that there is something lacking in his 
 makeup which alcohol supplies, that he needs a stimulant 
 and that alcohol is the universal natural stimulant. To 
 support this argument the fact that nearly all primitive 
 peoples make beverages containing more or less alcohol is 
 pointed out, and that they readily become fascinated with 
 the effects of the white man's alcoholic beverages when 
 accessible. It would be interesting to know the origin of 
 the alcoholic drinks of each savage people. That they were 
 the result of accident in the first instance can readily be 
 conceived. Savage peoples are noted for their fondness 
 for sugar and sweets of all kinds. What wonder that they 
 should, in their search for vegetable foods, undertake to 
 save up the sweetest juices of various plants for future use, 
 and what wonder that alcoholic fermentation should result 
 therefrom, especially in a tropical or semi-tropical climate? 
 Drinking the juice thus alcoholized, the savage then as to- 
 day found it pleasing in its effects ; and he would have to 
 be very low in the scale of intelligence if he would not take 
 the hint and purposely bring about the result which the 
 accident suggested. So here, as it always has been, the 
 appetite did not compel the discovery or invention of the 
 alcoholic beverage; but the beverage created the appetite 
 
FALLACIES REGARDING ALCOHOLIC BEVERAGES. 173 
 
 It is interesting in this connection to note that neither the 
 Fuegians nor the Eskimos had any alcoholic beverages 
 when discovered by the whites, and do not have any now 
 excepting what they get from traders. There are no plants 
 indigenous to their countries which yield juices rich in 
 sugar, like those of the sugar-cane and the palm. Neither 
 is there any evidence that the great tribes of the central and 
 northern parts of North America understood the art of 
 making alcoholic beverages, of which they are so fond. 
 They had the sap of the sugar maple from which they made 
 sugar, also the sap of the birch and the sugar pine. As the 
 sap from all of them can be gotten only in the early spring, 
 when the snow is still deep on the ground, it is quite likely 
 that the lack of sufificiet warmth to produce fermentation 
 prevented the North American Indian from discovering 
 the secret of alcoholic fermentation. 
 
 But primitive peoples have exhibited a "natural" ap- 
 petite not only for alcohol but for many other forms of nar- 
 cotic — tobacco, hasheesh, opium, coca erythoxilin, kola, 
 and a variety of other vegetable substances having the 
 power to produce pleasing intoxication. There can be 
 scarcely any doubt that the narcotic taking of savages when 
 it is not attended by religious rites is induced by that de- 
 sire for blissful oblivion of the hard conditions of life which 
 makes the civilized brother drown his sorrows in the wine- 
 cup. 
 
xvm. 
 
 Shall the physician Cease to pwscribc 
 Hlcohol. 
 
 There is no doubt that alcohol as a remedial agent 
 might be forever banished from the physician's armamen- 
 tarium of drugs without in any way lessening his efficiency 
 in combating disease. Indeed, his hands would be 
 strengthened thereby, for now he relies upon the fictitious 
 food and stimulant value of alcohol to the exclusion of 
 safer and infinitely better remedies. This is not mere the- 
 ory. It is confirmed by no less an authority than Benja- 
 min Ward Richardson, one of the acutest observers and 
 most philosophic and original physicians of the century. 
 
 In 1892, fifteen years after he had virtually retired from 
 hospital practice, he was invited to become physician to 
 the London Temperance Hospital, where he was left free 
 to prescribe alcohol medicinally in all cases and at all times 
 that he might see fit. This gave him the opportunity which 
 he had long wished for to treat various diseases without 
 alcohol in any quantity or form. In his own words, he de- 
 clares this invitation "was so much to my taste, and the 
 mode in which it came so handsomely conceived, that I 
 could not help availing myself of it." Here he treated two 
 hundred successive cases of serious diseases extending 
 over a wide range in variety and affecting persons of dif- 
 ferent social conditions, without using a drop of alcohol 
 in a single case. Instead of the ordinary alcoholic tinc- 
 tures he used glycerine and certain prepared waters as 
 
SHALL THE PHYSICIAN CEASE TO PRESCRIBE ALCOHOL? 175 
 
 menstrua for the solution of active drugs. These waters 
 were aqua opii, aqua ferri, aqua chloroformi, and others. 
 His results were all that could be desired. Certainly they 
 could not have been made better by the use of alcohol in 
 any way. 
 
 But many other physicians before and since the ex- 
 perience of Dr. Richardson have treated diseases of all 
 kinds without the use of alcohol, and their reports surely 
 do not indicate that any thing was lost by leaving it out of 
 the list of drugs exhibited. 
 
 The narcotic effects of alcohol should make it of value 
 in selected cases. A small quantity of it well diluted, at 
 bedtime, has a decided and pleasing hypnotic effect with 
 certain nervous individuals troubled by insomnia, but the 
 liability of contracting a habit under such circumstances is 
 very great — so great that the thoughtful physician would 
 be very sure of his patient before subjecting him to the se- 
 ductive influences of so pleasing a remedy. If the sale of 
 alcohol were surrounded by the same safeguards that sur- 
 round the sale of other powerful narcotic poisons, the dan- 
 ger would be much lessened, but it is the most easily pro- 
 curable of all merchandise. Some form of hypnotic less 
 palatable and less easily procured should take the place of 
 alcohol. The method of prescribing alcohol, too, is open to 
 serious objections. Instead of receiving a prescription in- 
 structing a druggist to furnish a solution containing a def- 
 inite percentage of alcohol and directing that a definite 
 dose be taken at stated times, the patient is instructed to 
 buy a case of wine, beer, or spirits, as the case may be, and 
 use it as a beverage. Certainly this method is responsible 
 for the making of many drunkards. 
 
 As a remedy for the relief of pain alcohol is so inferior 
 to many other standard drugs that its use for this purpose 
 need not be considered. No objection should be offered 
 
176 SHALL WE DRINK WINE? 
 
 to the use of alcohol as a solvent for powerful drugs. For 
 this purpose no other substance is so well adapted, for not 
 only are nearly all vegetable substances freely soluble in 
 this menstruumj but it serves the important purpose of pre- 
 venting drug deterioration by fermentation, and the small 
 amount of alcohol used in making tinctures, or added for 
 the purpose of preservation, need excite no apprehension. 
 
XIX. 
 ■Che effects of Hlcohol on Civtlizatton. 
 
 When a physiological chemist wishes to ascertain the 
 probable amount of damage done by any poison which has 
 been introduced into the circulation of an animal, he must 
 first know the potency of the poison and the amount of tis- 
 sue to be affected. To make the matter more explicit, he 
 must know, for instance, how many grains of the drug are 
 necessary per kilogram of animal weight to produce a fatal 
 issue. He must know, moreover, how much damage is 
 done and to what organs by a quantity not large enough to 
 kill. This he learns by experimentation, by producing vari- 
 ous degrees of toxicity extending over various periods of 
 time, finally killing the animal experimented upon and sub- 
 jecting its tissues to a searching examination. The toxic 
 action of alcohol on the human tissues is unfortunately al- 
 ready too well known, but in order to arrive at a probable 
 estimate of the total damage done to the population as a 
 whole, we must know how much of the poison is consumed, 
 and by how many individuals. 
 
 One of the most persistently reiterated statements in 
 medical literature is that two fluid ounces of alcohol may 
 be "burned up" in the body if taken at intervals, in small 
 doses, during a day of twenty-four hours. This would 
 equal one grain of absolute alcohol to one kilogram of 
 weight in a man of one hundred and fifty pounds weight, 
 an amount which Dujuardin-Baumetz found could be 
 
178 SHALL WE DRINK WINE? 
 
 given to pigs "without being followed by any pathologic 
 changes." Anstie put the amount one-sixth less. As a 
 matter of fact, however, there is no reason for thinking 
 that two ounces of alcohol ingested daily might not produce 
 serious disturbances in susceptible individuals, but, as it 
 seems to be accepted by the medical profession as a truth, 
 it may be used as a basis of estimation in this place. 
 
 For the total amount of alcohol consumed in any year 
 we may consult the industrial statistics of the United States 
 government. Here it is found that the total consumption 
 of alcoholic beverages, domestic and imported, were for 
 the year 1896 as follows: 
 
 Spirits 71,051,967 gallons 
 
 Wines 18,701,406 gallons 
 
 Malt Liquors 1,080,626,164 gallons 
 
 Estimating the spirits to contain 53% of alcohol, the 
 wine an average of 15%, and the malt liquors an average 
 of 4%, we get the following amounts of alcohol consumed 
 in that year as follows: 
 
 In the spirits 37,657,542 gallons 
 
 In the wine 2,805,211 gallons 
 
 In the malt liquors 48,628,177 gallons 
 
 Total 89,090,930 gallons 
 
 Taking the population of the country in 1896 in round 
 numbers at seventy millions, the per capita consumption of 
 absolute alcohol for that year would equal 1.27 gallons. 
 
 But what percentage of the total population must be 
 charged with drinking this enormous quantity of alcohol? 
 That question is not easily answered. Here in America 
 women and children rarely drink alcoholic beverages. 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 179 
 
 They may therefore be eliminated as consumers of 
 alcohol. Of the adult males, taking the urban and 
 rural population together, one-half, probably, drink more 
 or less of some kind of alcoholic drink. Estimating the 
 adult males as one-fifth of the total population, or twenty 
 per cent, this would give ten per cent of the total popula- 
 tion as alcohol consumers. A medical man with whom 
 this subject was discussed, thought this estimate too low — 
 in his opinion, fifteen to twenty per cent of the total popu- 
 laion would be nearer the truth. Certainly, however, the 
 number of all occasional and constant drinkers of alcoholic 
 liquors cannot be greater than twenty per cent, or one out 
 of every five, of the total population. 
 
 If ten per cent of the total population drink all the 
 alcohol consumed in the ordinary beverages, this would 
 give to each individual 12.7 gallons per annum, or 1625.6 
 ounces, a daily quantity of 4.45 ounces or more than twice 
 as much as the maximum quantity which is said to be 
 eliminated from the human body without damage. 
 
 Taking the large percentage as representing the alco- 
 hol consumers, one out of every five of the total popula- 
 tion, the daily amount of alcohol, 2.224 ounces, would still 
 exceed the safe maximum. This method of reasoning, 
 however, does little more than hint at the destructive possi- 
 bilities of alcohol. As a matter of fact, there is nothing 
 even approximating this equal distribution of alcohol 
 among all those who indulge in any degree in alcoholic 
 beverages. It would, probably, be very near the truth 
 to say that three per cent of the population consume at 
 least sixty per cent of the total amount of alcohol con- 
 sumed, and that two and a quarter millions of our peo- 
 ple, mostly adult males, are being rapidly destroyed by its 
 poisonous effects, and that this destruction is going on 
 constantly. To this should be added, probably, at least 
 
180 SHALL WE DRINK WINE? 
 
 half as large a number of victims of hereditary alcoholic 
 degeneration. 
 
 The latent capabilities of this ninety million gallons of 
 alcohol consumed in the beverages of seventy million peo- 
 ple during the year 1896 can be better illustrated by show- 
 ing how many adult lives could be destroyed by that 
 amount of the poison.* 
 
 Considering one pint of the absolute alcohol the aver- 
 age lethal dose (it is probably much less than that), there 
 would be enough in the ninety million gallons to furnish 
 ten and a half fatal doses to each individual within the 
 borders of our country. But one pint is a lethal dose for 
 an adult. A much less quantity would suffice to destroy 
 the life of a child. There was, therefore, enough alcohol 
 drank every two or three weeks during that year to destroy 
 the entire population if it had been taken within an hour. 
 There is a general belief that the consumption of alcohol 
 is decreasing. This belief is based upon the fact that the 
 per capita consumption of spirits shows a slight decrease 
 when compared with that of ten and twenty years ago. 
 As a matter of fact, however, the rapid increase in the 
 quantity of malt liquors consumed makes a steady increase 
 in the total alcoholic consumption. The following table 
 shows the nature and extent of that increase by comparing 
 the consumption of 1886 and 1876. As the change in the 
 per capita consumption of wine during these years was 
 very slight, it will not be considered. In the three years 
 mentioned there was the following per capita consumption 
 of alcohol: 
 
 *The lethal dose of alcohol seems to have received but little attention from medical 
 men. Kayser. quoted by Demme (Einfiuss des Alkohols auf den Organismus des 
 KIndes, P. 13^, reported the death of a three-year-old child following: the ingestion of 
 75 grams (2.3 ounces) of undiluted alcohol. A fatal issue followed the drinking of 
 330 grams ^10.3 ounces) by an adult. 
 
 Demme believes that smaller doses than these would probably cause death at these 
 periods of life. 
 
THE EFFECTS OF ALCOHOL UPON CIVILIZATION. 181 
 
 1876 — Spirits 1.33 gallons, 92.88 ounces alcohol 
 
 Malt liquors. 6.83 gallons, 34.97 ounces alcohol 
 
 Total 8.16 gallons, 127.85 ounces alcohol 
 
 1886 — Spirits 1.26 gallons, 85.45 ounces alcohol 
 
 Malt Hquors. 11.20 gallons, 57.34 ounces alcohol 
 
 Total 12.46 gallons, 142.79 ounces alcohol 
 
 1896 — Spirits 1. 00 gallons, 67.84 ounces alcohol 
 
 Malt liquors. 15.16 gallons, 77.62 ounces alcohol 
 
 Total 16.16 gallons^ 14546 ounces alcohol 
 
 Comparing the per capita consumption of 1876 and 
 1886, there is an increase of a little more than 11. 5 per cent 
 in the total alcohol consumption, while a comparison of 
 1886 with 1896 gives an increase of something less than 
 2 per cent. It will thus be seen that the per capita con- 
 sumption of absolute alcohol has increased about 14 per 
 cent in twenty years. Taking the average yearly per 
 capita consumption of the two decades, the showing is 
 much less favorable. The former shows an average per 
 capita consumption of spirits amounting to 1.306 gallons 
 and the latter 1.336 gallons, an increase instead of a de- 
 crease, of .03 gallon. The increase in the average per 
 capita consumption of malt liquors during the same time 
 was enormous. During the decade 1876-85 it was only 
 8.57 gallons, while in the decade 1886-95 it was 13.82. 
 Thus the per capita consumption of absolute alcohol aver- 
 aged about 70 per cent more for the years of the second 
 decade than for the years of the first decade. During this 
 same time the per capita consumption of wine averaged, 
 for the first decade, .465 gallon, and for the second, .459 
 gallon annually, a decrease of only .006 gallon in the 
 second decade. From these figures it will be seen that, 
 while we still continue to drink our spirits and wine in 
 practically the same amount that we did twenty years ago. 
 
182 SHALL WE DRINK WINE ? 
 
 we have enormously increased our annual supply of inalt 
 liquors, so those who think that the rapid increase in 
 beer consumption is lessening the drink evil are laboring 
 under a delusion. 
 
 No doubt this enormous increase in the consumption 
 of malt liquor is due to the old and carefully fostered error 
 that beer is a harmless beverage, and that if beer could be 
 substituted for potable liquids containing a larger percen- 
 tage of alcohol, the cause of temperance would be prac- 
 tically won. It is difficult to say how old tliis fraud may 
 be. Away back in the colonial days of New England the 
 brewing industry was fostered and encouraged by a law 
 exempting from taxes and giving a prize to any brewer 
 who should produce more than five hundred barrels of 
 beer annually. In some parts of New England the sale 
 of light alcoholic drinks is still favored by the law, requir- 
 ing a much smaller license fee from saloons in which beer, 
 wine, and cider only are sold. In Boston prior to 1886 
 a license of $250 was required from sellers of these bev- 
 erages, "it having been urged that it was in the interest 
 of temperance to encourage the use of malt liquors and 
 thereby decrease the consumption of distilled spirits" (The 
 Liquor Problem, by the Committee of Fifty, P. 198). So 
 we find on every hand not only laymen but physicians 
 urging the encouraging of beer drinking as a temperance 
 measure. A recent article by a medical man (Journal of 
 the Am. Med. Assn., Feb. 19, 1898) contains the follow- 
 ing statement: "In the writer's judgment it would be wise 
 for the government to put upon the manufacture of spirits 
 used as a beverage the highest excise duties compatible 
 with collection, a moderate excise on fermented liquors 
 derived from grain and hops, and to encourage the pro- 
 duction of light table wines by leaving them free." 
 
 For the refutation of this error, as in the case of all 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 183 
 
 popular errors on medical subjects, we need only go to 
 those men whose opinions are based upon exact methods 
 of investigation. Kerr, quoting Dujardin-Baumetz and 
 Audige, says (Alcoholism and Drug Habits) "the more 
 concentrated the alcoholic liquor ingested the more intense 
 the inflammation of tissue. At the same time an equal 
 quantity of the potable alcohols will sooner exhibit their char- 
 acteristic symptoms if largely diluted with water. All alco- 
 hols are poisons. All alcoholic influence is the same in 
 kind, varying only in degree. The common belief that 
 there is no wine or beer, but only spirituous, inebriety is 
 an error. Of the inebriates treated at the Dalrymple 
 Home in England, eight per cent have been wine or beer 
 drinkers." 
 
 Says one of Germany's most eminent physicians in a 
 recently published pamphlet (Dr. Adolph von Struempell, 
 Ueber die Alkoholfrage vom aertztlichen Standpunkt aus, 
 1898) "when we see year after year a not insignificant 
 number of respected men, skillful in their calling, sicken 
 and die when sickness and death certainly are chiefly or 
 exclusively due to the supposedly innocent habit of drink- 
 ing from two to three liters of beer daily, should it not be 
 the earnest care of the physician to call attention to this 
 dangerous habit?" Says the same author again (Loc. Cit., 
 P. 15) "Nothing is from the physician's standpoint more 
 false than to think that the evil influence of alcohol is 
 lessened through the increased substitution of beer for the 
 stronger alcoholic drinks." It is under the deceptive mask 
 of a pleasant tasting and nutritious beverage, as beer, that 
 alcohol finds its way into circles otherwise completely 
 closed to it. 
 
 Certainly another important fact cannot be too often 
 reiterated. That is, that an overwhelming majority of all 
 inebriates or drunkards begin their downward career with 
 
184 SHALL WE DRINK WINE? 
 
 beer and wine tippling. As a rule, the stronger alcoholic 
 liquors are regularly indulged in only after a necessity or 
 desire for alcoholic narcotism has been produced by the 
 drinking of beverages containing smaller percentages of 
 alcohol. When this stage in the tippler's career is reached, 
 he no longer seeks to quench his thirst with a beverage, 
 but to supply the demands of a depraved nervous system 
 with its accustomed poison. 
 
 Let no one, then, be cajoled into beheving that the 
 drinking of beer should be encouraged as a temperance 
 measure; for not only has the enormous increase in the per 
 capita consumption of beer not lessened that of spirituous 
 liquors, but, even should the former totally displace the 
 latter, nothing would be gained unless the total per capita 
 consumption of alcohol should be decreased. In short, we 
 shall gain nothing for the welfare and advancement of 
 civilization by substituting beer drunkards for whiskey 
 drunkards. 
 
 From an economic point of view the drink habit is 
 ruinously expensive. Taking again the amount of alco- 
 holic beverages consumed in the year 1896 we find the fol- 
 lowing probable amount paid by the consumer: 
 
 Spirits — 71,051,967 gallons at .50 per pint. . $284,207,868 
 Wines — 18,701,406 gallons at .50 per quart. 37,402,812 
 Malt liquors — 1,080,626,164 gal. .10 per pint 944,500,931 
 
 Total $1,266,111,611 
 
 This estimate is probably too low. Sold over the bar 
 of the saloonkeeper, the average drink of spirits is perhaps 
 not more than one and a half ounces, which sells at an 
 average price of ten cents. This would make a pint sell 
 for something more than a dollar, making no allowance 
 for the almost universal adulteration with water after it 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 185 
 
 reaches the hands of the saloonkeeper. Much beer and 
 wine, as well as spirits, is bought in bulk by the customer 
 at figures lower than those given here, but there is to offset 
 this the higher price paid in the public houses where the 
 greater part of these beverages is consumed. Taken alto- 
 gether, the total amount spent by the customers cannot 
 be less than that here indicated; 1,266 millions of dol- 
 lars is an enormous sum of money. It is about equal to 
 one-half of the nation's greatest public debt. It is one 
 and a quarter times the indemnity paid to Germany by 
 France at the close of the Franco-Prussian war. It is 
 more than one-half the total money now in circulation in 
 the United States. So great is the amount of wealth rep- 
 resented by these figures that it would have sufficed to 
 pay more than one-half the wages of all tlie factory em- 
 ployes of the United States in the year 1890. And what 
 does the consumer get for this sum of money? A very 
 small amount of food material mixed with a relatively 
 large amount of poison. The food material, if it were 
 separated from the other ingredients, would be dear at 
 one-twentieth of that which was paid for the beverages, 
 but, as a matter of fact, its value, small as it was, was 
 entirely destroyed by the admixture of the poison. *We 
 are now engaged in a costly war with Spain. Our ex- 
 penses may amount to anywhere from six hundred to a 
 thousand million dollars before it is ended. Economical 
 citizens mention this great sum and groan at the pros- 
 pective burden of taxation. But by this war we shall 
 gain honor, respect, and a magnificent national solidarity, 
 which will make those millions a profitable investment, and 
 the burden of investment will rest lightly uj>on the 
 shoulders of a prosperous and happy people. Let us 
 
 *This was written in the summer of 1898. As a matter of fact our expenses in the 
 war with Spain were oniy about one-fifth of the amount paid for alcohol beverages in 
 1896, and we have gained aii the advantages mentioned here, and more. 
 
186 SHALL WE DRINK WINE ? 
 
 rather turn our attention to twice that great number of 
 millions, which is a self-imposed burden upon the 
 shoulders of a few millions of people and brings no return 
 but poverty, misery, sickness, and death. 
 
 Of peculiar interest is the fact that three-fourths of the 
 total amount spent for alcoholic beverages went for malt 
 liquor, nearly all of which was domestic beer. This 
 means, of course, that the workingman paid the largest 
 part of this enormous saloon bill, for he is by far the 
 most important consumer of beer. For this purpose he 
 spends a considerable part of his income. Here in Amer- 
 ica, among the workingmen of cities at least, it cannot be 
 less than ten per cent. Perhaps fifteen or sixteen per 
 cent would be nearer the truth. Of the amount thus spent 
 in Germany, Von Struempell says (Die Alkoholfrage, P. 5) 
 "I have through thorough inquiry very often convinced 
 myself that the laborer who receives three marks daily for 
 his services spends fifty pfennigs for beer for his own use, 
 that is, about one-sixth of his entire income." With us 
 wages are higher and the necessities of life cheaper, con- 
 sequently there is an incentive to spend more for beer. 
 Certainly an amount is thus spent sufficient, if it were 
 invested in dividend paying life insurance or some other 
 form of accumulating investment, to guard against all the 
 ordinary exigencies of misfortune and prevent the work- 
 ingman and his children from ever becoming public 
 charges. 
 
 But human lives and money are not the only forms of 
 wealth which are sacrificed to alcohol. The amount of 
 human effort which is dissipated in the production, dis- 
 tribution, and consumption of alcoholic beverages is sim- 
 ply incalculable, and it is as absolutely thrown away as 
 though the individuals who manufacture and distribute 
 them and those who spend their time in drinking them 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 187 
 
 and waiting for the paralyzing effects of alcohol to be dis- 
 sipated were members of a standing army quartered upon 
 the people. Alcoholic beverages possess no economic 
 value aside from the small amount of food material found 
 in malt liquors and wines. It should be remembered, 
 however, that the grain and fruit used in the production 
 of these has many times the value of the manufactured 
 articles, while that used in making distilled liquors is a 
 total loss as food for human beings. 
 
 The size of this army, which were better idle, is not 
 easily estimated. The census of 1890 gives 50,000 as the 
 number engaged in brewing alone. Probably there are 
 at least as many more engaged in the manufacture of 
 distilled spirits and wine. How many are directly engaged 
 in the liquor traffic? As no statistics are at hand, the 
 number can only be estimated. If there is one saloon for 
 every five hundred inhabitants (and this estimate is not 
 too high) we have about 140,000 saloons, the care of 
 which occupies the whole time of at least 200,000 men. 
 But beside the saloonkeeper there are others engaged in 
 the liquor traffic, wholesalers, traveling salesmen, and the 
 like, to the extent of at least 30,000 men. By far the great- 
 est loss of time, however, is that suffered by the consumer, 
 and it is more difficult to estimate. An interesting attempt 
 in this direction was made by the Committee of Fifty last 
 year in Boston. Here 606 saloons received in the aggre- 
 gate 226,752 visits daily. Suppose that each visit con- 
 sumed ten minutes of time. Then there was spent in the 
 saloons of Boston 37,792 hours each day, equal to the 
 idleness of 3,779 men, allowing ten hours for a working 
 day. Boston has a population of about a half million. 
 At the same rate of time expenditure, the whole United 
 States has an army of over 500,000, nearly all adult males, 
 spending all their time in drinking alcoholic beverages. 
 
188 SHALL WE DRINK WINE? 
 
 It may be objected that much of this time is given outside 
 of working hours. This is true, but it should also be 
 remembered that the mere time spent in drinking is not 
 the only factor of loss, perhaps not even the most im- 
 portant one. There still remains to be considered the 
 time actually lost by incapacity for labor, brought about 
 not only by acute alcoholic poisoning, but also by the 
 scores of physical ailments thus engendered, which lessen 
 or completely destroy the productive capabilities of the 
 drinkers, and these would, without doubt, much more 
 than offset the time spent outside of working hours. 
 
 To sum up, then, the army devoted to the interests of 
 alcoholic beverages is made up as follows: 
 
 Manufacturers 100,000 
 
 Wholesalers and traveling salesmen 30,000 
 
 Retailers 200,000 
 
 Drinkers 500,000 
 
 Total 830,000 
 
 This estimate, then, gives us an army approximating 
 a million men who contribute nothing of economic value 
 to the nation and who are supported by the productive in- 
 dustries, a number equal to about six per cent of the 
 adult male population. 
 
 But the expense does not stop here. There is still to 
 be considered the enormously costly machinery of legal 
 procedure made necessary by the increase in crime which 
 is directly traceable to brain deterioration resulting from 
 alcoholic intoxication, asylums for dependent children, 
 pauper institutions, insane asylums, and prisons, all of 
 which are so largely recruited from the ranks of drunk- 
 ards and their descendants, making altogether an expense 
 which must consume the product of many hundred thou- 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 189 
 
 sand individuals. Would it be too much to say that at 
 least ten per cent of our industrial efforts are completely 
 neutralized by the pernicious habit of alcohol drinking? 
 
 The increase in alcohol consumption in European 
 countries is a matter of grave importance. In Germany 
 for the years 1872 to 1875 there was an average per 
 capita consumption of 67.3 liters of beer and 8.6 liters of 
 spirits. This amount increased in the next five years un- 
 til in 1881 the consumption of beer was 87.6 and of 
 spirits 9.2 liters per capita. In Prussia alone in 1872, 57.4 
 liters of beer and 12. liters of spirits was the per capita 
 consumption. In 1875 the amount had risen to 60.3 
 liters of beer and 14.9 liters of spirits per capita. The 
 increase in the number of saloons has kept even pace with 
 the increase in consumption (August Smith, Die Alkohol- 
 frage, P. 107). The per capita consumption of alcoholic 
 beverages for all the German Empire in 1896 was accord- 
 ing to Bade as follows: Beer 108.5 liters, spirits 13.2, 
 and wine 6.44 hters. A liter is 2. 113 pints. Estimating 
 a liter at one quart, the per capita consumption in gallons 
 would be, approximately, beer 27.1 gallons, spirits 3.3 
 gallons, and wine 1.61 gallons, more than twice as great 
 as the per capita consumption in America, estimated as 
 absolute alcohol. 
 
 The amount of illness and death for which alcohol is 
 responsible is well set forth in statistics gathered by Dr. 
 Smith. In Switzerland, during the last few years, the 
 name and cause of the disease producing death in every 
 case is given on a death card filled out by the attending 
 physician, without giving the name of the patient. From 
 these, tolerably correct reports of the percentage of deaths 
 from alcohol have been obtained. The result of these 
 statistics for the years 1891 and 1892, for the fifteen largest 
 cities of Switzerland give the following: Of all males 
 
190 SHALL WE DRINK WINE? 
 
 of 20 years of age or over dying in 1891, 10.7 per cent 
 and in 1892, 10.8 per cent, died of alcohol poisoning. In 
 the same years the percentage of females dying from the 
 same cause was 1.7 and 2 per cent, respectively. 
 
 Because of the similar ways of living, and especially 
 of the rapid increase in spirits consumption in the prov- 
 inces of Posen and Schlesien, the result in Germany, 
 thinks Smith, is at least as bad as that in Switzerland, 
 and probably the death rate is higher. That is, every ninth 
 individual in Germany dies of alcohoUc poisoning. 
 
 If it be objected that these statistics are insuiificient and 
 that the number of deaths from alcoholism in these two 
 years was accidental and not to be considered the average 
 for any considerable time, attention is called for further 
 proof to the mortality statistics, against which these objec- 
 tions cannot be urged, of certain life insurance companies. 
 In some English insurance companies the total abstainers 
 are put in a separate class and receive more favorable 
 rates than the moderate drinkers. Here it has been 
 found that the death rate of the total abstainers is about 
 30 per cent less than that of those who are classed as 
 occasional or moderate drinkers. Taking the statistics 
 of the "United Kingdom Temperance and General Provi- 
 dent Institution" in the years 1886 to 1891 : 
 
 Unclassified Abstinence Class 
 
 Estimated deaths 7,763 5,i77 
 
 Actual deaths 7,459 3,663 
 
 That is, the actual number of deaths in the occasional 
 drinkers was 97.33% of the expectation, while the actual 
 number in the abstinence class was only 70.75% of the 
 expectation. 
 
 Still more convincing is the showing of the statistics 
 for 1884 to 1889 of the "Scepter," the clients of which are. 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 191 
 
 mostly ministers of the gospel and members of various 
 religious orders, which is as follows: 
 
 Unclassified Abstinence Class 
 
 Expected deaths 569 240 
 
 Actual deaths 434 143 
 
 Here the actual deaths of the first class were 76.27% 
 of the expectation, and of the second class only 57.42%. 
 
 In the year 1893, in the former company, the deaths 
 reached 100, 85% of the expectation, in the unclassified, 
 while among the abstinence class it was only 71.62% of 
 the expectation. In the latter company the results cor- 
 respond with those of the former. In consequence of the 
 favorable showing in the death rate of the total abstainers 
 these companies give them a discount of 8 or 10% on 
 their premiums, and notwithstanding this discrimination 
 they are better risks than the unclassified. 
 
 Returning to the mortality statistics of Switzerland 
 as exhibited by the death cards already referred to, the 
 influence of alcohol is as perceptible as in those of the 
 insurance companies. Taking the mortality of all males 
 over twenty years of age by twenty year periods and 
 comparing the number of deaths from alcohol with the 
 whole number, the following table is the result: 
 
 Total Deaths. Deaths from Alcohol. 
 
 1891 3499 366 
 
 1892 3343 361 
 
 Ages 20-39 40-59 Over 60 20-39 40-59 Over 60 
 
 1891 27 °U 36.3% 36.7% 29.2% 50 % 20.6% 
 
 1892 25.5% 38.3% 36.3% 22.7% 55.7% 21.67o 
 
 Analyzing the above table, it will be seen that while 
 the first group shows practically the same percentage of 
 mortality in deaths from alcohol as is shown in the total 
 number of deaths, in the second group the percentage 
 
192 SHALL WE DRINK WINE ? 
 
 of mortality in the subjects of alcoholism is enormously 
 increased. This is undoubtedly due to the fact that the 
 first period is given to preparing a way, through degen- 
 eration processes, for rapid dissolution after the fortieth 
 year, from tuberculosis and other masked diseases. Thus 
 at the very time of life when the man is of greatest value 
 to his family and to the state he is destroyed by a system 
 of chronic alcoholic suicide. 
 
 The influence of moderate drinking in the production 
 of increased morbidity is well illustrated by the statistics 
 collected by Carpenter relating to British soldiers in the 
 Indian service. Observations were made upon 17,354 
 moderate drinkers and 9,340 abstinent soldiers. Of the 
 former group one out of every 7.28 men was sent to the 
 hospital, but of the latter group only one out of every 14.47. 
 Still more favorable to the abstinence group are the sta- 
 tistics considering the average number of days spent in 
 the hospital. The average number of sick days of every 
 hundred moderate drinkers was 10.20, while the average 
 of tlie abstainers was 3.64 sick days for every hundred. 
 
 The experience of certEiin benefit associations in Eng- 
 land gives very similar results. In three of these (Mutual 
 Experience Rural Towns and City Districts, Mutual Ex- 
 perience Rural Districts, and Foresters), in the five years, 
 1884 to 1889, for each laborer, there were 26.20, 24.68, 
 and 27.66 weeks of illness, an average of 26.18 weeks 
 while at the same time in the "Sons of Temperance," 
 which receives only total abstainers, the number of weeks 
 of illness for every member was only 7.48, less than one- 
 third of the others. 
 
 Here we have a remarkably close agreement between 
 statistics taken from widely separated communities and 
 under very different circumstances, and from them it 
 would appear that two-thirds of the total amount of illness 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 193 
 
 is to be ascribed to alcohol alone. Moreover, it is evident, 
 and practical experience long ago established, that alco- 
 holic indulgence is able to make otherwise trifling illness 
 serious, short illness long, and cause a fatal issue in seri- 
 ous cases which might otherwise have recovered. 
 
 Another way in which civilization is affected by alco- 
 hol is the amount of crime for which it is directly respon- 
 sible. To adequately discuss the relationship of alcohol- 
 ism and crime would require much more space than can 
 be given to it in a work of this kind. Nothing more will 
 be done here, therefore, than to indicate the probable per- 
 centage of criminal acts for which alcohol is directly re- 
 sponsible. Statistics on this subject should not be taken 
 too implicitly. As information regarding previous habits 
 of the criminal generally come from the crminal himself, 
 they are not always trustworthy. With a view of obtain- 
 ing a light sentence or an early pardon, the prisoner is 
 liable to hide much of the truth regarding his habits, and 
 put himself in as favorable a light as possible before the 
 public. On the other hand, the criminal often seeks to 
 excuse his conduct by untruthfully asserting that he was 
 drunk at the time the crime was committed. 
 
 Some statistics may be produced, however, which 
 fairly show how much crime may be directly attributed to 
 alcohol drinking, both in America and Europe. The 
 most complete statistics yet compiled in America upon 
 this subject are those embraced in the Twenty-sixth Annual 
 Report of the Bureau of Statistics of Labor of Massa- 
 chusetts, for the year ending August 20, 1895. During 
 this time there were accomplished, within the state, 26,672 
 convictions, 17,573 of which were for drunkenness alone, 
 and 650 for drunkenness united with other crimes. Elim- 
 inating the convictions for drunkeness and for drunkenness 
 with other crimes, there remain 8,449 convictions for other 
 
194 SHALL WE DRINK WINE? 
 
 crimes to be investigated. Of this number, from nine 
 only was no information obtained as to whether the con- 
 vict was under the influence of liquor at the time the 
 crime was committed. Of the remaining 8,440, an affirm- 
 ative answer was given in 3,640 cases, and in 4,791 cases 
 the convict replied that he was not under the influence 
 of alcohol at the time that the crime was committed. In 
 other words, out of the total number of convictions 68.73% 
 were directly due to drunkenness or to drunkenness with 
 other crimes, and 81.97% of the criminal convictions were 
 for criminal acts committed while the convict was under 
 the influence of alcohol, leaving only 18.03% oi all the 
 convictions not directly traceable to alcoholic intoxication. 
 Examining the convictions for crimes against persons 
 we obtain the following results: For murder and man- 
 slaughter there were 21 convictions, and 12 of the offenses, 
 or 57%, were committed while the convict was under the 
 influence of alcohol; 61 cases of assault with a weapon, 
 31 of which were due to alcohol; 69 cases of assault upon 
 an officer, with 36 due to alcoholic intoxication; 12 cases 
 of felonious assault, 3 of which were committed under 
 the influence of alcohol; and 1,652 cases of assault and 
 battery, of which 985 were influenced by alcoholic intoxi- 
 cation. For robbery there were 46 convictions, 38 of 
 which were committed by men under the influence of 
 Uquor. It will thus be seen that about 50% of the cases 
 of serious assault, 67% of the cases of assault and bat- 
 tery, and 82% of the cases of conviction for highway rob- 
 bery, were for offenses committed while the criminal was 
 under the influence of alcoholic intoxication. Of crimes 
 against property, 1,137 persons out of a total number of 
 2,107 convicted of larceny, or nearly 54%, were under 
 the influence of alcoholic drink at the time the offense 
 was committed, and of incendiarism and malicious mis- 
 
FIG. 4.. 
 
 RELATION OF DRUNKENNESS TO CRIME. 
 Penitentiaries for Men. 
 
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 ages. 
 
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 Drunl<enness. 
 
 Intermittent 
 Druntcards. 
 
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 Drunkards. 
 
 NOTE— Tlie blactc column represents the total percentage of 
 crime caused by drunkenness. The other two columns represent 
 the relaine amount of alcoholic crime committed by the intermittent 
 and habitual drunkard respectively. 
 
FIG. 5. 
 
 Houses of Correction for Men. 
 
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 ages. 
 
 Crime Caused by 
 Drunkenness. 
 
 Intermittent 
 Drunkards. 
 
 Habitual 
 Drunkards. 
 
 NOTE — The black column represents the ioial percentage of 
 crime caused by drunkenness. The other two columns represent 
 the relative amount of alcoholic crime committed by the intermittent 
 and habitual drunkard respectively. 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 195 
 
 chief, 33% and 66% respectively were to be attributed to 
 alcoholic intoxication. 
 
 On the other hand, crimes against the authority of the 
 state, like fraud, embezzlement, selling liquor without a 
 license^ counterfeiting, polygamy — crimes unaccompanied 
 by personal violence — were not committed as a rule by 
 drunkards, the percentages being 7, 28, 14, o and 26 re- 
 spectively. 
 
 Very similar were the results obtained by Baer and 
 reported at an international prison congress in 1874. The 
 report covered 120 prisons and houses of correction which 
 contained 32,837 male convicts. Of this number, 13,706 
 attributed their criminal career directly to the influence 
 of alcohol. Two classes of penal institutions were inves- 
 tigated — jails, houses of correction, and similar prisons, 
 and penitentiaries — and a separate report made for each 
 class. The convicts were classified according to the 
 nature of the crime committed, and, furthermore, divided 
 into occasional and habitual drunkards. The following 
 tables (Figs. 4 and 5) arranged by Dr. August Smith of 
 Baden (Die Alkoholfrage, P. 9) show at a glance the per- 
 centage of drunken criminals as compared with the whole 
 number in each class of criminal offenses, and also the 
 relative number of occasional and habitual drunkards 
 among the convicts addicted to alcoholic intoxication. Of 
 the 13,706 convicts given to alcoholic excesses, 7,262 were 
 periodic or occasional drunkards, while 6,437 were habitual 
 drunkards. 
 
 It will be seen from Dr. Smith's table that 46.1% of 
 the cases of murder and 63.2% of the cases of man- 
 slaughter were influenced by alcoholic intoxication, giv- 
 ing an average of 54.1% for the total homicides, differing 
 only by 3% from the result obtained in Massachusetts. 
 Further comparison between the two groups of statistics 
 shows a like similarity throughout. Take, for instance. 
 
196 SHALL WE DRINK WINE? 
 
 assault with intent to kill or do great bodily harm, assault 
 and battery, and robbery and highway robbery. The 
 Massachusetts statistics give 50%, 67%, and 82%, while 
 Dr. Smith's tables give 50.8%, 68.4% (63.4% in table 
 I and 74.5 in table II), and 68.8% respectively, as having 
 been directly caused by alcoholic intoxication. A com- 
 parison of all the other crimes in the two groups of sta- 
 tistics show very closely approximating results. It 
 should not be forgotten, however, that the Massachusetts 
 statistics are based upon the question as to whether the 
 convict was under the influence of alcohol at the time the 
 offense was committed, while those collected by Baer are 
 based upon the convict's drinking habits as a whole, with- 
 out regard to his condition at the particular time the crime 
 was actually committed. This fact is sufficient to account 
 for the differences in percentages of those crimes which 
 are not accompanied by violence. Crimes like embezzle- 
 ment, fraud, and counterfeiting have been initiated by 
 necessity arising from the wastefulness of drinking habits, 
 but the crimes themselves could scarcely be successfully 
 carried out by one under the influence of alcohol. 
 
 An important part is played in criminal statistics by 
 the occasional or periodic drunkard. In all deeds of vio- 
 lence he has won a bad eminence, and his moral degen- 
 eration, his insensibility to public decency and morality, 
 is scarcely less marked. It is seen from Baer's statistics 
 that of all the deeds of violence for which alcohol can be 
 held directly responsible the occasional drunkard com- 
 mitted 58.6% of the homicides, 60.9% of the attempts to 
 kill, 72.7% and 81.4% of the assaults with injury, 89% of 
 the cases of resistance to the state's authority, 94.2% of 
 breach of domestic peace, and 73.3% of the offenses 
 against public morals. Indeed, the statistics show just 
 what ought to be expected, and just what is happening 
 
FIG. 6. 
 
 Table showing the relative number of crimes against persons on 
 the different days of the week, and on the nights of Tuesday to Friday 
 inclusive, for which conviction was secured in the court of Judge Lang 
 (adopted from A. Smith's " Die Alkoholfrage"). 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 197 
 
 in the daily experience of all peoples who drink alcoholic 
 beverages — namely, that a sudden access of alcoholic 
 intoxication produces a species of mania characterized, 
 usually, by homicidal tendencies. Moreover, if statistics 
 were collected concerning the crimes of habitual drunk- 
 ards, they would certainly show that most of them were 
 also brought about by the same kind of mania due to an 
 imbibition of an increased quantity of alcohol. 
 
 An interesting investigation showing the connection 
 of alcoholism and crime was made by Judge Lang of 
 Zurich in 1890. The statistics collected by him showed 
 that acts of violence against persons and property were 
 committed mostly between Saturday evening and Monday 
 evening, and that this increase was coincident with an 
 increase in alcohoHc consumption. The following dia- 
 gram (Fig. 6) shows the relative proportion of cases of 
 assault with bodily injury for the different days of the 
 week, and for Tuesday, Wednesday, Thursday, and Fri- 
 day nights. Of 141 convictions for this offense, only 
 41 were committed "on the 208 days of the year on which, 
 according to a ruling custom, less is drunk" than during 
 other times. The other 100 offenses were committed on 
 the 157 days upon which an increased amount of alcohol 
 was consumed, and of the 41 convictions above men- 
 tioned, 25 were for offenses committed in or near a saloon 
 at night, while in only 16 cases was there no evidence 
 that alcohol had anything to do with the crime. 
 
 Said Lord Coleridge of England: "If the English 
 people could be made temperate nine-tenths of the Eng- 
 lish prisons could be closed." 
 
 Said Dr. Krohne, director of penal institutions in Ger- 
 many, in a public address delivered a few years ago: "Of 
 crimes against life and limb, assault, assault with bodily 
 injury, manslaughter, and attempts to commit murder 
 
198 SHALL WE DRINK WINE ? 
 
 nearly the entire number is chargeable to drunkenness. 
 Crimes against property are almost without exception the 
 result of necessity, and in 80% of the cases the necessity 
 which led to the crime is the result of drunkenness. 
 Crimes against morality are almost exclusively caused by 
 alcoholic beverages. This has been my experience in a 
 service of twenty years in Oldenburg, Schleswig-Holstein, 
 Hesse, and Brandenburg. Seventy per cent of all deeds 
 of violence against property rights are, more or less, the 
 result of alcohol drinking. Two years ago I received a 
 visit from a friend who had just served as a juryman in 
 Wuerzburg, and he remarked that it was a significant 
 fact that every crime which had been tried during his 
 service was the result, direct or indirect, of alcoholic intox- 
 ication." 
 
 Think, too, the extent to which the habit of alcoholic 
 intoxication prevents the highest realization of physical 
 and mental capability and the nation's loss arising there- 
 from. Said a recent well-known writer on economic sub- 
 jects (Walter A. WyckofT in "The Workers") : 
 
 "Men .... who have risen by force of ambi- 
 tion and sheer development of manual skill to good posi- 
 tion in the factory and have there stood still, their con- 
 genital qualities incapable, presumably of higher efficiency. 
 But sadder far than theirs is the case of men who are 
 often best endowed with native cleverness and aptitude, 
 who rise quickly in the scale of promotion, and who might 
 rise far higher than they do but for the cause of careless 
 living. They know no interest in their work nor pleas- 
 ure in its doing. To them it is the sordid drudgery by 
 which they gain the means of gratifying their real pur- 
 pose and desires. With sullen perseverance they endure 
 the torment of labor, with pay day in view and then Sat- 
 urday night and Sunday spend all in their mad revels in 
 what they call life." 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 199 
 
 But over and above all, and far more important than 
 all the material losses chargeable to the universal imbibi- 
 tion of beverages poisoned with alcohol, has been the 
 effect wfhich alcohol has had upon the ethics of civilization, 
 upon the ideals and conduct of man in his intercourse 
 with his fellows. These alcohol has immeasurably low- 
 ered. All classes and phases of society have suffered 
 thereby. In the family, where the breadwinner should 
 also give love and protection to the weak members of 
 society and carefully train them in the duties and respon- 
 sibilities of adult life, it causes brutality, neglect, and a 
 never ending round of untold squalor and misery. The 
 sum total of human suffering caused by drunken parents 
 is immeasurable. Certainly it is more than that arising 
 from all other causes combined. The army of individuals 
 reared under such circumstances are savages real as any 
 with which our soldiers on the frontier ever had to deal; 
 but they are savages of a lower type than those. They 
 are constantly at war with the better interests of human- 
 ity as exemplified in a progressive, civilized society, for 
 they respect neither personal nor property rights. 
 
 Not through drunkenness alone, as that term is popu- 
 larly understood, but also through "moderate drinking" 
 is the average moral tone, the average capability for exer- 
 cising the subtlest mental processes through which fine 
 distinctions of right and wrong conduct are determined, 
 immeasurably lowered. The human brain, through 
 countless centuries of evolutionary progress has acquired 
 a fineness of texture, a sensitiveness to external impres- 
 sions and a corresponding swiftness of function, which 
 make it the most powerful and at the same time the most 
 easily injured of all animal organs. It is just upon this 
 fineness of brain texture that civilization depends for the 
 carrying out of her highest aims and purposes, for tlie 
 
200 SHALL WE DRINK WINE? 
 
 solution of the manifold and complicated problems which 
 social progress is bringing forth on every hand; and it 
 is this same fineness of brain texture that is destroyed 
 or rendered impossible of development under the influ- 
 ence of even "moderate"' quantities of alcohol daily in- 
 gested. 
 
 To the individual no less than to the state are the irri- 
 tating and stupefying effects of alcohol an irreparable loss. 
 The same degree of brain development which makes the 
 citizen's voice and conduct of such value to the state also 
 renders him capable of enjoying the greatest degree of 
 human happiness, a healthy enjoyment of the purely phys- 
 ical pleasures of life and that exquisite happiness bom of 
 a healthy contemplation of the subtleties of natural phe- 
 nomena, of the development of human progress as ex- 
 hibited in history, the intricacies of mechanical problems, 
 or any other department of human knowledge which may 
 especially engage his attention. All of these are a mental 
 Terra Incognita to the man who daily takes his measure 
 of alcohohc beverage, even though it may never be suffi- 
 cient to make him noticeably drunk. Civilization, more- 
 over, suffers immeasurable loss through the corrupting 
 influence of the liquor traffic upon the affairs of govern- 
 ment. So widespread and intricate is its contamination 
 in this respect that nearly every great municipality in our 
 country has been compelled to recognize it as a power, 
 and protect it in its destmctive and corrupting business. 
 In many instances it has succeeded in getting entire con- 
 trol of the affairs of government, and these cases have 
 always been attended by retrogression and disaster to 
 human progress. 
 
 Alcohol exerts its corrupting influence beyond those 
 who drink it. Its evils act as examples to corrupt the 
 impressionable of all classes. The saloon attracts not 
 
THE EFFECTS OF ALCOHOL ON CIVILIZATION. 201 
 
 only those who are inclined to drink, but all kinds and 
 grades of evildoers. It is as truly the pest spot for the 
 development of crime as is the sewage contaminated well 
 the source of typhoid fever. Is a murder, a highway rob- 
 bery, a burglary, to be committed, it is almost always 
 planned in a private room of a saloon. So are the num- 
 berless petty crimes by organized gangs of human vultures 
 who prey upon the industrious public. 
 
 In short, the universal consumption of these alco- 
 holic poisons render impossible the realization of civiliza- 
 tion's highest ideals. It does this because it destroys a 
 vast number of useful lives, renders many more physically 
 incompetent through disease, destroys an immense amount 
 of valuable brain matter annually, increases insanity, incurs 
 the expense of supporting a vast army of non-producers, 
 immeasurably increases crime, brings unhappiness, pov- 
 erty, and misery to millions, and causes a corrupt admin- 
 istration of the affairs of government. I firmly believe 
 that we have in this great country of ours a system of 
 government, natural resources, and a people of the kind to 
 give to the world in fifty years, if the production and 
 importation of alcoholic beverages were absolutely pro- 
 hibited, a people that for beauty, strength, virtue, mate- 
 rial wealth, and happiness would equal the fondest dreams 
 of a Millennium. 
 
XX. 
 
 Slbat is the Best Method of Dealing with the 
 HlcoboUc Question. 
 
 It is not the purpose of this work to give even a brief 
 history of the various temperance and prohibition move- 
 ments which have been inaugurated from time to time, 
 both in Europe and in America, to abate the evils of alco- 
 holic poisoning. All of the movements have received 
 altention by other writers; and especially have the legis- 
 lative aspects of the liquor problem in America received 
 adequate treatment in a carefully prepared volume by Dr. 
 F. H. Wines and Mr. John Koven, of the "Committee of 
 Fifty" (The Liquor Problem in Its Legislative Aspects, 
 by F. H. Wines and John Koven, 1897). The general 
 statement may be made that all temperance movements, 
 whether lay, religious, or legislative, have accomplished 
 some good; but sometimes the amount of good accom- 
 plished has been very small compared with the efforts put 
 forth; and it has oftentimes seemed that the same amount 
 of effort applied in a different direction might have been 
 productive of greater results. 
 
 Particularly interesting and instructive has been the 
 inauguration of legislative prohibition and governmental 
 control of the liquor traffic, by giving the state the sole 
 right of dispensing alcoholic liquors. The history of all 
 legislative prohibition shows that while the real prohi- 
 bition which the law sought to attain has never yet actually 
 been accomplished, the enactment of all prohibitory laws 
 
BEST METHOD OF SUPPRESSING ALCOHOL. 203 
 
 has been attended by some measure of good, the amount 
 being in exact ratio with the fidelity with which the laws 
 were enforced. Where public opinion has been in favor 
 of their enforcement a practical degree of prohibition has 
 been attained; but public opinion is unstable, and the 
 community which is earnest in its desire for a total supres- 
 sion of the liquor trafific this year may not be of the same 
 opinion next year; so the prohibitory laws are contra- 
 vened with impunity and fall into disrepute. In many 
 communities in which the state has assumed the functions 
 of the Hquor dispenser a notable improvement in public 
 morals has resulted. This improvement has been due to 
 the fact that the cupidity of the saloonkeeper, who seeks 
 by every means in his power to sell as much as possible, 
 is removed, liquor being dispensed only in a certain quan- 
 tity and not at all to any one who has the reputation of 
 being a drunkard. Moreover, the officials in charge of 
 the state dispensaries, having no interest in the sale of the 
 liquor, and their terms of office depending upon the fidelity 
 with which the laws regulating the sale are carried out, they 
 attend strictly and faithfully to all the legal details which 
 rob the traffic as far as possible of its evil influences. 
 Moreover, the state dispensary system has decreased the 
 number of saloons, in some communities entirely abolish- 
 ing them, decreasing in the same degree their corrupting 
 influences; and the one dispensary which has displaced 
 the many saloons is a model of decency compared with 
 the average saloon. The dispensary, too, does a great 
 deal for abstinence in making social drinking impossible. 
 The man who patronizes the dispensary gets the poison 
 for his own consumption, so that only one person is 
 injured thereby. If he patronizes a saloon, the chances 
 are many to one that his social instincts would cause at 
 least another person to indulge who would not have done 
 
204 SHALL WE DRINK WINE ? 
 
 SO Otherwise. It is likely, too, that the moral teachings 
 of the dispensary may be of value to boys and young men. 
 An institution around which the state has fixed so many 
 limitations must appeal to the intelligence of the average 
 youth as being an evil. Certainly alcohol under such 
 restrictions has none of the charm which attends its sale 
 in the midst of gay company, with games and music, and 
 surrounded by the expensive lavishness of fine furniture, 
 cut glass, and the other attractions which give to the liquor 
 traffic its greatest fascination, and an appearcince of well 
 being and cleanliness which it little deserves. 
 
 The value of the dispensary system in comparison with 
 laws totally prohibiting all traffic in alcoholic beverages 
 is well illustrated in the experience of Sweden with the 
 well-known "Gothenburg system." The system was 
 named from the town in which it was first inaugurated, in 
 1871. The beneficial effects of this method of dealing 
 with the alcohol question are seen in the results obtained. 
 In 1 89 1 there were only 304 places in the entire country 
 where spirits could be bought, that is, one place to every 
 6,600 inhabitants; and the per capita consumption of abso- 
 lute alcohol fell from the enormous quantity of 8 liters, or 
 over two gallons, to 1.8 liters. In 1890, however, a new law 
 was passed which was much more stringent in its opera- 
 tions than the one it superseded. It completely abolished 
 the still existing small private sale of liquor, and almost 
 suppressed the sale of spirits in the entire country; for- 
 bade among other things all sale of liquor from one o'clock 
 Saturday afternoon until eight o'clock Monday morning, 
 and on all other days of the week before eight o'clock in 
 the morning. Moreover, it gave local option to the 
 cities, the inhabitants having the power to decide by bal- 
 lot whether they would continue under the state dispensary 
 system or have total prohibition. All persons, whether 
 
BEST METHOD OF SUPPRESSING ALCOHOL. 205 
 
 male or female, over twenty-five years of age were enti- 
 tled to vote on the question. In fourteen cities the result 
 was for total prohibition, the women by the earnestness 
 with which they carried on the campaign contributing 
 much to the result. 
 
 The experiment of prohibition in Sweden has, how- 
 ever, not been a success. No sooner did it become impos- 
 sible to purchase spirits openly than was an illicit trade 
 begun; in spite of the efforts of the authorities, those who 
 wished to purchase alcoholic liquors found some way of 
 doing so. Liquors were surreptitiously brought into the 
 territory from which they had by popular voice been 
 expelled and small stills were erected in many places for 
 their manufacture. Indeed, the demorahzation engen- 
 dered by the unlawful traffic has been so great that many 
 cities which had voted for prohibition have returned or 
 contemplate returning to the restricted traffic under the 
 dispensary system. 
 
 It will thus be seen that attempts to entirely suppress 
 all trade in spirituous Hquors has been attended by the 
 same results in Sweden as those with which we are famil- 
 iar in America. 
 
 Perhaps the greatest hindrance to the total suppression 
 of commercial traffic in alcoholic liquors is the power of 
 the invested capital engaged in their production. At the 
 present time over four hundred million dollars are in- 
 vested in the breweries of the United States alone. Cer- 
 tainly as much more is engaged in the production of 
 spirits and wine. Add to this the value of the land which 
 is constantly engaged in supplying grain and fruit as raw 
 material to the beverage manufacturing establishments and 
 the amout of capital engaged, directly or indirectly, must 
 be considerably more than one thousand million dollars. 
 The value of the annual product of the breweries, based 
 
206 SHALL WE DRINK WINE ? 
 
 on the estimates for 1895, is not less than two hundred 
 million dollars, and of spirits and wine not less than one 
 hundred million dollars' worth are sold annually. Thus 
 the products of the breweries, distilleries, and wine presses 
 for 1895 had a wholesale value of more than three hundred 
 million dollars, while tlie combined value of the wheat and 
 com crops of that year was only two hundred thirty-seven 
 million dollars. 
 
 Moreover, the capital invested in the production of 
 alcoholic beverages is more active and aggressive than 
 that interested in the carrying on of any other enterprise. 
 Not only do individual brewers and distillers have to meet 
 the ordinary competition of others in the same business, 
 but they constantly keep at work some political force 
 such as will enable them to influence legislation favorable 
 to their cause. The extent of the brewers' influence in 
 some municipalities probably outweighs the combined 
 influence of the rest of the citizens. Certainly it is sufifi- 
 cient to determine the direction of alcohol legislation. 
 Speaking of this state of affairs in the city of St. Louis the 
 authors of "The Liquor Problem in Its Legislative As- 
 pects" make the following statement (Pp. 331 and 332): 
 "The multiplication of dram shops is largely due to the 
 business rivalry between breweries, of which St. Louis has 
 twent\-five or thirty, some of them among the largest in 
 the United States, if not in the world. Three-fourths at 
 least of the saloons are indirectly owned and operated by 
 the breweries, which advance the license tax and collect 
 it in installments by charging eight dollars a barrel for 
 beer instead of six." In the city of Boston a similar state 
 of afifairs exists. Quoting from the same book (P. 192) 
 we find that: "The small liquor shop keepers were 
 controlled by their bondsmen, largely brewers and whole- 
 sale dealers, and readily did the bidding of the latter for 
 
BEST METHOD OF SUPPRESSING ALCOHOL. 207 
 
 the protection enjoyed or from necessity. In fact, the 
 liquor power at this time was virtually a few men's power. 
 In 1894, for instance, twenty-five wholesale dealers were 
 sureties for 1,030 saloonkeepers. Three brewers were on 
 328 bonds, another was on 112, others on from 8 to log 
 each. Twenty-five men thus had assumed a monied lia- 
 bility of $2,660,000, some of them a liability in excess of 
 the value of their property." 
 
 In Chicago, Milwaukee, and other large centers of 
 population the influence of the brewer, distiller, and whole- 
 saler is similarly exerted. 
 
 It is seen, therefore, that the enormous capital con- 
 cerned in manufacturing alcoholic beverages exerts its 
 whole influence along such lines as will tend to promote 
 the sale of its products and prevent interference on the 
 part of municipal authorities by keeping an army of de- 
 pendents which efficiently checks all projected unfavorable 
 legislation. 
 
 To meet and overcome the aggressive energy of the 
 makers and dispensers of alcoholic liquors, needs first of 
 all a proper education on the part of the people. Some- 
 thing of the kind is now going on with the children in 
 the pubHc schools, and undoubtedly much good is being 
 accomplished thereby; but the system has many faults. 
 The nature of the information thus imparted is often inac- 
 curate and exaggerated. Recently a so-called "health 
 primer'" was brought to the writer's notice, which exempli- 
 fied this faulty teaching. It was a "popular" treatise on 
 physiology, inaccurate in its statements, unattractive in its 
 style of expression, and the subject of alcohol was dragged 
 in at the end of each lesson, in an absurd attempt to 
 "point a moral or adorn a tale." Yet this method had the 
 approval of a professor of medicine in one of our largest 
 Universities, and was adopted in the schools of one of our 
 
208 SHALL WE DRINK WINE? 
 
 wealthiest and most populous states through the influence 
 of the superintendent of public instruction. 
 
 The child who would carry home to a beer-drinking 
 father the statement that "beer changes the inside coat of 
 the stomach into leather" would be liable to have all the 
 useful information he might acquire at school regarding 
 the bad effects of alcohol neutralized by the superior wis- 
 dom of the father. Indeed, I have before me now sev- 
 eral letters written by irate fathers to teachers of public 
 schools, in which these anti-alcohol teachings have been 
 resented with much warmth, going so far even as personal 
 abuse of the teacher. Let the truth be told about alcohol 
 and alcoholic beverages to those children whom we would 
 teach to avoid them, and no generous nature will, in ma- 
 ture years, resent the teachings of his childhood and 
 discard it all as false. 
 
 But the education of the children alone is not sufficient. 
 Some form of popular education should be inaugurated. 
 In England scientific subjects were popularized and 
 knowledge concerning them imparted by lecture. Work- 
 ingmen's clubs listened with dehght to popular lectures 
 on scientific subjects given by Huxley, Tyndal, Darwin, 
 Herbert Spencer, and others; and though there never 
 can be another Huxley, Tyndal, nor Darwin, every com- 
 munity of a few thousand inhabitants has one or more 
 persons capable of. treating the subject of alcohol from a 
 scientific standpoint and at the same time making it in- 
 teresting and easily understood. Let the subject be 
 taught experimentally, as far as possible, demonstrating 
 the falsity of the belief that alcohol gives strength or that 
 beer is a valuable food, or that any of the alcoholic bev- 
 erages have a tonic value. Surely the intelligent work- 
 ingman who now spends from ten to twenty-five per cent 
 of his daily wages for beer because he believes that beer 
 
BEST METHOD OF SUPPRESSING ALCOHOL. 209 
 
 has a high food value would not spend the pittance which 
 is so sorely needed by his family if he were convinced that 
 in buying beer he is paying from ten to twenty times what 
 he would have to pay for the same food in the form of 
 bread. Nor would he end his substantial midday meal 
 with a large glass of raw whiskey, as I have frequently 
 seen him do, if he knew that he was thereby diminishing 
 his strength and decreasing his digestive powers in a 
 notable degree. Much of this kind of education should 
 come from the medical profession. No thoughtful med- 
 ical man will prescribe a drug so potent for evil as alcohol 
 without being first assured that it meet the indications 
 for which it is prescribed. He should not say to his 
 patient "get a case of beer" or "get a case of wine" or 
 spirits any more than he would say "get a pound of opium" 
 or chloroform or chloral or any other dangerous narcotic. 
 Let him know the truth about alcohol and prescribe it 
 as he would any other narcotic of its class, warning his 
 patient against its dangers and explaining to him the pop- 
 ular errors regarding alcoholic beverages which have found 
 credence and have passed uncontradicted from time 
 immemorial. Let him tell the wealthy owner of a val- 
 uable winecellar who is the victim of Bright's disease or 
 the father of an imbecile child or inebriate son that his 
 cherished winecellar is responsible for all his misfortune. 
 It is nonsense to deny that thousands of useful, brilliant 
 professional men and business men are yearly cut off in 
 the very prime of their prosperity and usefulness by some 
 disease engendered by a habit of daily alcohol imbibition, 
 and who go to their graves not knowing the origin of 
 their illness. The physician sees and knows (or should 
 know), but he is silent. He may adopt the old English 
 phrase and call it "high living"; but it is alcoholic degen- 
 eration. 
 
210 SHALL WE DRINK WINE ? 
 
 Temperance advocates are wont to base their argu- 
 ments on moral or moral-ethical grounds, neglecting the 
 purely scientific side of the argument. The wisdom of 
 this method is doubtful. Undoubtedly alcoholic excess 
 is immoral and contravenes man"s ethical relations to his 
 fellows ; but it should be remembered that the social-ethical 
 sense is first to be destroyed in alcohohc degeneration. 
 To undertake to rouse the drunkard, therefore, by point- 
 ing out the sufferings of others which his conduct entails 
 is not so liable to succeed as would the conviction that his 
 excesses must speedily end in death. 
 
 While education of the people as to the exact nature 
 and value of all alcoholic beverages may do much to bring 
 about a total suppression of the liquor traffic, it alone 
 will not be sufficient to do so. A multitude of people 
 would drink and get drank, even if they knew that alcohol 
 possessed no value beyond its intoxicating effects and that 
 the drinking thereof might be followed by dangerous or 
 fatal disease. Great evils, too, are protected and propa- 
 gated by the very inertia of custom and precedent. The 
 e\ils of slavery were recognized at the time of the adoption 
 of the constitution and measures taken to suppress the 
 importation of slaves after 1808; but more than a half- 
 centur}' later a bloody and costly war was necessary to 
 destroy that hideous institution. Traffic in alcoholic liquors 
 will be tolerated for the same reason — the indisposition 
 of the great mass of influential conservative citizens to 
 interfere with established institutions — long after the 
 people are educated to their worthlessness and dangers. 
 
 The whole tide of public opinion must be changed. 
 At the present time, in the average community, while there 
 may be several shades of opinion as to the value of the 
 different alcoholic liquors, nowhere is it considered posi- 
 tively immoral nor even reprehensible to partake of any 
 
BEST METHOD OF SUPPRESSING ALCOHOL. 211 
 
 form of alcohol drink "in moderation." The average 
 public opinion looks upon it as a matter of course every- 
 where excepting in comparatively unimportant localities, 
 and these are treated by most people with a considerable 
 measure of contempt. It is curious to note the different 
 standards of morality which individuals make for them- 
 selves in their different treatment of the alcohol question. 
 There are certain men who have their liquors shipped to 
 their residences who would feel degraded if seen drinking 
 in a saloon. Others will drink a home-made wine contain- 
 ing fifteen or twenty per cent of alcohol, who would look 
 upon a bottle of five or six per cent wine from the wine 
 merchant with abhorrence. A multitude of similar idio- 
 syncrasies may be discovered with little trouble. There is, 
 it is true, an undercurrent of feeling that the drinking of 
 liquors, especially the stronger alcoholic liquors, is not 
 entirely creditable. I have before me an advertisement 
 for a whiskey, which I clipped, by the way, from a church 
 paper, in which the would-be purchaser is assured that 
 "we ship in plain packages — no- marks to indicate contents 
 (which will avoid possible comment)." The same desire 
 not to be caught in the act of drinking accounts for the 
 curtains always drawn and the screened bars of the saloon. 
 But this tacit understanding that the drinking of alcoholic 
 beverages is an evil has come to be regarded, like all the 
 other evils of alcohol consumption, as a matter of course. It 
 seems to have very little influence in the direction of cre- 
 ating a pubHc opinion sufficiently strong to inaugurate 
 a movement for suppressing the evil. 
 
 Our code of morals, however, will not permit us to 
 regard the taking of opium with the same degree of 
 equanimity. As has been elsewhere remarked, if anyone 
 should enter into the business of dispensing pleasant tast- 
 ing beverages having morphine, cocaine, hasheesh, or 
 
212 SHALL WE DRINK WINE ? 
 
 some Other narcotic than alcohol, for their active princi- 
 ple, how outraged the community would be, and if severe 
 punishment were meted out to the originator of the enter- 
 prise, it would be greeted with universal approval. The 
 man, too, who habitually visits an "opium den" is shunned 
 by his fellows and talked about with superstitious horror. 
 This same man might go to an "alcohol den" a score of 
 times every day without losing his reputation as a gentle- 
 man, or the regard of his fellow men. This is simply 
 because we are accustomed to seeing men indulge in 
 alcoholic instead of other narcotic beverages. Let there 
 be created a public opinion against the indulgence in all 
 forms of narcotics, alcohol included, such as that which 
 now exists against the indulgence in opium, and the liquor 
 traffic will easily be abolished. 
 
 Of greatest influence in perpetuating the custom of 
 drinking alcoholic beverages is the important part which 
 they play in the social intercourse of modern society, and 
 especially in the everyday exchange of civilities between 
 men of all kinds of business and all professions. To be 
 invited to partake of some kind of alcoholic drink imme- 
 diately opens the way to business negotiations, brushing 
 away at once that reserve which makes the meeting of 
 strangers more or less unpleasant, and opening up the 
 way to a more intimate friendship. Moreover, custom 
 has made the offering of a glass of wine one of the first 
 duties of domestic hospitality with a vast majority of civ- 
 ilized people. Indeed, this custom, through centuries of 
 recognition by the world's most enlightened people, has 
 become so essentially a part of our civilization that it will 
 be the most difficult to abolish of all the causes which pro- 
 mote alcohol drinking. It would seem that something of 
 the kind is an absolute necessity. Yet what is there that 
 can be made to take the place of alcoholic beverages which 
 
BEST METHOD FOR SUPPRESSING ALCOHOL. 213 
 
 will be more acceptable? Undoubtedly coffee houses and 
 other places where non-alcoholic drinks may be had, read- 
 ing and lectures rooms and others in which games may be 
 played are doing much to supply the medium of social 
 intercourse, but a g^eat deal of energy must be expended 
 before they are made to totally supplant the saloon and 
 winecellar. High license and all other restrictive legisla- 
 tion which public opinion will allow to be adequately 
 carried out should be earnestly supported until such time 
 as alcohol for human consumption will be found only on 
 the shelves of the apothecary and will be dispensed only 
 upon the physician's prescription and only in such cases as 
 call for sedative or narcotic treatment. 
 
 As to the treatment of drunkenness, inebriety, and all 
 pathological conditions arising from irritating effects of 
 alcohol, each case is a separate problem and requires the 
 intelligent handling of the skilled physician. Removal 
 of patient from his surroundings, withdrawal of alcohol, 
 support to the functions of nutrition, sedation for the nerv- 
 ous system, until such time as the normal physiological 
 processes are re-established, with proper protection against 
 associations or nerve storms which would lead to renew- 
 ing the habit, are the chief considerations. 
 
INDKX. 
 
 A 
 
 Page. 
 
 Abstinence and Expectations in Life Insurance 192 
 
 Adulterations of Alcoholic Beverages, Popular Belief in 169-171 
 
 Adulterations of Wine 31 
 
 Adulterations of Beer 33-34 
 
 Adulterations of Spirits 34-36 
 
 Aggressiveness of Liquor Traffic 205 
 
 Alcoholic Excess Among Ancient Germans 17-20 
 
 Alcoholic Excess Among Germans in Middle Ages 20-25 
 
 Alcoholic Excess In England 24-25 
 
 Alcoholic Excess Present Day 25 
 
 Alcohol, Oxidation in the Body 31 et seq. 
 
 Alcohol, Elimination of 41 
 
 Alcohol, Affinity for Oxygen 42 
 
 Alcohol Not a Carbohydrate Food.. 43-44 
 
 Alcohol in U. S. Army 56 
 
 Alcohol in Morbidity and Mortality in Switzerland 191 
 
 Ancient History of Wine Making 9 
 
 Ancient History of Beer Making 10-11 
 
 Assimilation, Effects of Alcohol upon 70 
 
 Austria, Alcoholic Insanity in 123-124 
 
 B 
 
 Beer, Adulterations of 34-36 
 
 Beer, Amount of Alcohol in 34 
 
 Beer, Constituents of 34 
 
 Beer, Contains no Diastase 164 
 
 Beer Drinking and Inebriety - --- - 184 
 
 Beer Drunkard, Appearance of 164 
 
 Beer, Evils of Drinking 183 
 
 Beer Compared with Bread, Food Value of 46-47 
 
 Beer, German contains more Sugar than American 164 
 
 Beer, Material used for Coloring 36 
 
 Beer Making Among Germans, Growth of 19 
 
 215 
 
216 INDEX— CONTINUED. 
 
 Page. 
 
 Beer, Popular Estimation of 163 
 
 Beer Produces Unlimited Drunkenness 163 
 
 Beer, Stomach Troubles Produced by 166 
 
 Beer, Why It increases Bodily Weight 163-164 
 
 Belief That Alcohol is a Natural Stimulant 172 
 
 Boquet of Wine, What? 168 
 
 Brewing Among Ancient Central Americans 14-15 
 
 Brewing Among Ancient Egyptians 10 
 
 Brewing Among Ancient Greeks 11 
 
 Brewing Among Ancient Mexicans 12 
 
 Brewing Among Polynesians 17 
 
 Brewing Among Romans 12 
 
 Brewing Among South Americans - 15-16 
 
 c 
 
 Careless Prescribing of Alcohol - 175 
 
 Character, Effects of Alcohol Upon 95 at seq. 
 
 Children, Effects of Alcohol Upon 101-102 
 
 Chemical Effects of Alcohol on Digestion 67 
 
 Cholera, Susceptibility Increased by Alcohol - 67-72 
 
 Commercial Inebriate Cures 157-158 
 
 Consumption of Alcohol in Europe 189 
 
 Corruption of Municipal Affairs by Alcohol 200-201 
 
 Crime, Relation to Alcoholism 193 et seq. 
 
 Crime, Committed by "Occasional Drunkards" 195 
 
 Crime, Committed by "Constant Drunkards" 195-197 
 
 Crime, Amount for which Alcohol is Responsible 197-198 
 
 Crime, Days of Week upon which Committed 197 
 
 D 
 
 Degeneration of Nerve Cells, Alcoholic 93-94 
 
 Digestion, Effects of Alcohol upon 66 et seq. 
 
 Diseases, Alcohol in Treatment of 129 
 
 Dispensaries, Government 202 
 
 Drunkards, Reasons for More Males 140 
 
 Drunkards, Social Influences in Making 139 
 
 Drunkards, Who Become 139-140 
 
 Drunkenness Among Germans in the XVI Century 20-25 
 
 Drunkenness in England in XVIII Century 23-24 
 
 Drunkenness, A Bar to Progress 198 
 
 Drunkenness, A Cause of Human Misery 198 
 
INDEX— CONTINUED. 217 
 
 E 
 
 Page. 
 
 Education Concerning Alcohol, Popular 208 
 
 Elimination of Alcohol 42^ 
 
 Embryo, Effects of Alcohol Upon 104-108 
 
 Excretion of Oxidized Products of Alcohol 43 
 
 Exhaustion, Heart, In Alcoholism 83-86 
 
 Ethics of Opium and Alcohol Indulgence 213 
 
 Families, Alcoholic, Soon Run Out II5 
 
 Fatigue, Effects of Alcohol Upon 160 
 
 Fermentation, By-Products of I7I 
 
 Food Value of Beer vs. Bread 46-47 
 
 France, Alcoholic Insanity in 111-112 
 
 France, Increase of Alcoholic Consumption in 123 
 
 G 
 
 Gambrinus, Origin of 26 
 
 Gas, Exchange Affected by Alcohol 74 
 
 Germany, Alcoholic Insanity in 122-123 
 
 Germany, Prevalence of Alcoholic Poisoning in 124 
 
 Glycogenic Functions Affected by Alcohol 72 
 
 Gothenburg System _ 204-205 
 
 H 
 
 Habitual Drinkers and Total Abstainers, Different Effects of 
 
 Alcohol upon 72-73 
 
 Heart Diseases of Alcoholism 83 et seq. 
 
 Heart Exhaustion of Alcoholism 83-86 
 
 Heart in Alcoholism, Chronic Diseases of 86 
 
 Heart Dilatation 87-88 
 
 Heredity, Influence of Alcohol upon 103-116 
 
 Home Drinking, Ethics of 211 
 
 Hops, Substitutes For 35 
 
 I 
 
 Illness Due to Alcohol, Amount of 189-190 
 
 Inebriety, What ? 141 
 
 Inebriety, Constant 152 
 
 Inebriety, Constant, Causes of 152 
 
 Inebriety, Former Punishment For 142 
 
218 INDEX — CONTINUED. 
 
 Page. 
 
 Inebriety, Periodic --- 145-151 
 
 Inebriety, Popular Interpretation of - 142 
 
 Inebriety, Real and Pseudo 143-144 
 
 Inebriate, Constant Not Always a Degenerate 154 
 
 Inebriates, Alcoholic Degeneracy of 108-111 
 
 Inebriates, Criminal Tendencies of 113 
 
 Immunity Against Alcoholic Poisoning 114 
 
 Insanity, Alcoholic .. 117-127 
 
 Insanity, Alcoholic, Statistics of 117-122 
 
 Insanity, Alcoholic, in Massachusetts 119-121 
 
 Insanity, Alcoholic, in Germany 122-123 
 
 Insanity, Alcoholic, in France _ _ 123 
 
 Insanity, Alcoholic, in Austria - 123-124 
 
 Insanity, Alcoholic, Among German Children 125-126 
 
 K 
 
 Kidney, Alcoholic Diseases of.-- 89 
 
 Liquor Traffic, Aggressiveness ot - 205 
 
 Liquor Traffic, Suppression of - 202 
 
 Liquor Traffic, Loss Entailed by .- 187-188 
 
 Liquor Traffic, Power of - 205-206 
 
 Liver, Alcoholic Diseases of 90 
 
 Loss to State Through Drunkenness 200 
 
 M 
 
 Malt in Beer, Substitutes For - - 34-35 
 
 Malt Liquors and Wine, Comparative Effects of 168 
 
 Malt Liquors, Increase in Consumption of 182 
 
 Medicine, Alcohol as a 174 
 
 Mental Processes, Effects of Alcohol Upon 57 et seq. 
 
 Metabolism, Effects of Alcohol Upon 71 
 
 Moderate Drinking, Bar to Highest Happiness 198 
 
 Money Spent for Alcoholic Drinks 184-186 
 
 Morel's Table of Alcoholic Degeneration 113 
 
 Motor Disturbances of Alcoholism 98-99 
 
 Mortality, Alcoholic, in Switzerland 191-192 
 
 Morbidity, Alcoholic, in English Army 192 
 
 Municipal Affairs and Alcohol 200-201 
 
 Muscular Contractions Affected by Alcohol 49 et seq. 
 
INDEX— CONTINUED. 219 
 
 Page. 
 
 Muscular Movements of Stomach Affected by Alcohol 69 
 
 N 
 
 Narcotic, Alcohol an Inferior 175-176 
 
 Nerve Cells in Alcoholism, Degeneration of 93-94 
 
 Nerve Tissue, Effects of Alcohol upon 91-94 
 
 o 
 
 Opium and Alcoholic Indulgence, Ethics of _ 212 
 
 Oxygen, Affinity of Alcohol for _ _ 42 
 
 Paralysis in Alcoholism 99-100 
 
 Periodic Drunkards 145-151 
 
 Peripheral Nerves in Alcoholism, Degeneration of 100 
 
 Peripheral Nerves of Stomach, Effects of Alcohol upon 69 
 
 Physicians Duty to Public in the Use of Alcohol 209 
 
 Per Capita Consumption of Alcohol 178, 189 
 
 Popular Errors about Alcoholic Beverages _ 159 at seq. 
 
 Popular Estimate of Wine 166 
 
 Popular Belief in Adulterations _ 169-171 
 
 Popular Education about Alcohol _ 211-212 
 
 Physicians and The Value of Alcohol ._ 128-138 
 
 Physicians and The Use of Alcohol 50 years Ago 129 
 
 Physicians, Recent Opinions Favorable to Alcohol 131-136 
 
 Proteid Metabolism, Affected by Alcohol 71 
 
 Ptyalin, Effects of Alcohol Upon - 71 
 
 Prohibition, Difficulty of Obtaining 203 
 
 R 
 
 Reformation of Drunkards, Accidental 155-156 
 
 Resistance, Tissue, Decreased by Alcohol 75 
 
 Russia, Drunkenness Among Children of 126 
 
 s 
 
 Saloon, Evil Influences of 201 
 
 Saloon, Substitutes for - 213 
 
 Schools, Temperance Taught in 207 
 
 Social Drinking in Producing Inebriety, Effects of 145-146 
 
 Special Senses in Alcohol, Disturbances of 98 
 
 Spirits, Adulterations of -. 33-34 
 
 Spirits, Constituents of 31-33 
 
220 INDEX— CONTINUED. 
 
 Page. 
 
 Spirits, Materials to Color 33 
 
 Stimulant, What it is 48 
 
 Stimulant, Alcohol not, in Chloroform Narcosis - 54 
 
 Stimulates, How Alcohol - 55 et seq. 
 
 State by Drunkenness, Loss to 200 
 
 Stomach, Effects of Alcohol Upon -- 66-69 
 
 Stomach Troubles Produced by Beer 166 
 
 Sugar Compared with Alcohol, Food Value of 46 
 
 Suppression of Liquor Traffic 202 
 
 Switzerland, Mortality Statistics of....- 191 
 
 Temperance Taught in Schools 207 
 
 Temperature, Effects of Alcohol upon 161 
 
 Temperance Hospital, London 174 
 
 Tissue Resistance Decreased by Alcohol 75 et seq. 
 
 Tissue, How Broken Down by Alcohol 103 
 
 Toxicity of Alcohol 177 
 
 Tuberculosis and Alcoholism 78 et seq. 
 
 w 
 
 Wine Drinking Among Early Germans 17 
 
 Wine Making, Origin of 10 
 
 Wine, Constituents of 29-31 
 
 Wine, Adulterations of 31 
 
 Wine, Materials Used in Coloring 31 
 
 Wine, Old, Popular Estimation of 166