BxMi Pric|5 1 i , Ui-iUM CURES OPINIONS OF AMERICAN AND EUROPEAN PHYSICIANS IN CHINA AS TO THE MEDICAL AND GOVERNMENTAL AID THAT SHOULD BE GIVEN TO THOSE COMPELLED BY ANTI-OPIUM LEGISLATION IN MANY LANDS TO BREAK OFF THE OPIUM HABIT AND TO OTHERS VOLUNTARILY TURNING FROM IT EDITED BY Rev. WILBUR F. CRAFTS, Ph.D. SUPERINTENDENT OF THE INTERNATIONAL REFORM BUREAU, Author of “Intoxicants and Opium in All Times and Lands,” “A Primer of Inter nationalism,” Princeton Lectures on “Practical Christian Sociology,” etc. [Third Abridged Edition.] Dr. David T. Stewart, Superintendent of Elizabeth Blake Hospital, Soochow, in letter to editor: “The subject you are taking up is certainly a very interesting •one, and on its success in a large measure depends the future of this great nation. Take away opium from the Chinese and who can tell what a powerful people they •will be?” INTERNATIONAL REFORM BUREAU, 206 Pennsylvania Avenue, s. e., Washington, D. C. “OPIUM CURES.” [Extracts from pamphlet on “Opium Cures” by Wilbur F. Crafts.] An anti-opium “wave of reform” swept round the world in the quad- reunium 1903 to 1907. In the Philippines, New Zealand, Australia and South Africa the importation of opium was in those years prohibited, and the British Parliament condemned and ordered the “speedy close” of the Indo-Chinese opium trade which emboldened China to close its opium dens. Both Britain and China are moving too slowly because revenue fights at every step the march of righteousness. But the opium traffic is mani- festly doomed. To assure success in the Herculean task of emancipating the Chinese from this vice in China and in the Philippines, President Roose- velt has united all the governments having permanent territorial possessions in eastern Asia, namely, China, Japan, Britain, France, Italy, Holland, and the United States, in an Anti-opium Joint Commission, whose work can hardly fail to extend until the opium traffic joins piracy and slavery in the limbo of crimes against civilization. The recent acts in this drama are recorded in my booklet entitled, “A Primer of Internationalism,” and preceding acts in “Intoxicants and Opium in All Times and Lands.” This pamphlet only aims to bring to China and the Chinese everywhere, and their friends and helpers, the best medical advice as to what should be done by governments and individuals to aid opium users in breaking from the slavery that was thrust upon China, when its law prohibited opium except as a medicine, by what Mr. Gladstone called ‘ ‘the wickedest wars of history,” the opium wars of 1840, 1858 and 1861. The world was ready to forgive and forget those wars when, on May 30, 1906, the British Parliament unanimously voted “that the Indo-Chinese opium trade is morally inde- fensible, and the Government is instructed to bring it to a speedy close.” The Government has not been “speedy” in obeying that mandate, and the Christian citizens of the British Empire, who are demanding that the vote shall be fully and promptly obeyed, should be reenforced by the almost irresistable might of international public opinion, expressing itself through courteous resolutions, not only of missionary and reform societies but also of chambers of commerce, since ‘ ‘the opium traffic is the foe of the honest trade of every nation.” But in this pamphlet we aim to show more especially what action, governmental and medical, is needed in China and wherever the Chinese have spread this deadly drug, to meet the immediate exigency caused by nearly a million people being cut off by legislation from the vice which they were previously allowed to indulge. The writer, being in China when the opium dens were being closed by imperial decree, saw new perils arising from the sale of alleged ‘ ‘opium cures,” all of them containing opium in some form, to be eaten or drunk. He heard there and in the Philippines the plea of merchants and officials interested in holding on to opium revenues so long as possible, that five or ten years would be necessary for opium sots to “taper off.” The Chinese 2 Government, though it had ordered opium dens closed in six months, had spoken of ten years allowance for aged opium sots to accomplish gradual emancipation. On this account he sought from the skilled physicians in the missionary hospitals of China, graduates of the best medical schools of Europe and America, authoritative information on this “tapering off” theory and re- lated matters. Their replies are found in the following pages which we ask philanthro- pists to aid us in sending in Chinese and English to the millions who need this important information. The 'consensus of these replies (with minor variations) is : 1. That the worst opium sots can be cured in a month, while the majority of opium users can stop at once, without harm, as prisoners do, especially if opium prohibition has put them in like case — that they can not get the drug. 2. That whatever slight “tapering” is in rare cases permissible should be done in a hospital or at least through medical prescription, and that it is foolish to suppose any sot, with opium dens accessible, will himself drop the habit by a sliding scale. 3. That like does not cure like in the case of alleged “opium cures” made wholly or in part of opium, and that the sale of all such “cures” should be suppressed. 4. That moral and legal means should be used to prevent the abuse of the exception made in all anti-opium legislation for the use of the drug in prescriptions of qualified physicians. The best suggestion on this point is that only in public hospitals should such prescription be permissible. This should certainly be the law in China and in the Philippines. The writer made careful inquiry as to the treatment of opium sots in the Hong Kong prison. The chief warden said that opium-using prisoners, on being jailed, dramatically protested they ‘ ‘could not live without opium.” The answer would be not denial but seeming postponement. “Tomorrow” to them meant indulgence, but to the keeper it meant treat- ment. On the morrow there would be a yet more dramatic “scene” that might be called, “Dope or die.” The keeper would prove to be a believer in Mark Twain’s motto, “Never put off till tomorrow what you can do day after tomorrow just as well." At last, when the prisoner had discovered he ‘could really live two or three days without dope, but was miserable enough to listen to advice, he would be assured by the keeper that a glass of water would relieve him of his misery. There is nothing an opium fiend so much loathes as water, but he would finally conclude to try the remedy. The water would serve as an emetic. A very foul stomach would be cleaned out, and a hot bath and long sleep would complete the cure. Only in very rare instances is the prison hospital resorted to, and then only for a brief period. The opjium sot usually takes up his prison task as quickly and works as steadily as other prisoners. This prison record shows the possibility of an immediate break without injury. Surely government should by drastic 3 prohibition give opium sots out of jail an equal chance for swift emancipa- tion, and provide also for prevention by making it impossible to get opium outside of a hospital. There is another peril that all friends of China should provide against, namely, that the beer saloon shall take the place of the abolished opium dens. China has been a prohibition country since the fourth century, except as foreign trade and treaties have broken down its customs and laws both as to intoxicants and opium. ‘ ‘Young China,” aping the follies of the West in its blind effort to be “progressive,” thinks it can prove itself so by doing three things: whistling, smoking cigarettes, and drinking beer. We have therefore included in this pamphlet, which we hope may be trans- lated into Chinese and circulated wherever the Chinese dwell, “Scientific Testimony on Beer.”* In the fight against beer we must probably rely upon educational rather than legislational action. In every missionary school in China at least — if possible in Government schools and colleges — and also by posters such as are used for like purpose in French and British cities, the warnings of science against beer should swiftly be made known. En Route, April ii, 1908. WTlbur F. Crafts. ALCOHOLISM AND PHYSICAL DEGENERACY. [The strongest sentences in French and British Municipal posters have been combined by the International Reform Bureau’s Council for New South Wales. His Grace the Archbishop. of Sydney, Chairman, in the above poster, which is recommended for adoption by mayors, city councils, boards of health, and boards of education in all lands.] From Proceedings French Supervising Council of Public Aid, 1902 Report by Prof. Debove Dean of the. Faculty of Medicine. Alcoholism is the chronic poisoning which results from the habitual use of alcohol, even when the latter would not produce drunkenness. It is an error to say that alcohol is necessary to workmen who engage in fatiguing labour; that it gives heart to work, or that it repairs strength. The artificial excitation which it produces gives place very quickly to nervous depression and feebleness. The habit of drinking entails disaffection from the family, forgetfulness of all duties to society distaste for work, misery, theft and crime. It leads at the least to the hospital, for alcohol engenders the most varied maladies; paralysis, lunacy, disease of the stomach and liver, dropsy. It is one of the most frequent causes of tuberculosis. Finally, it complicates and aggravates all acute maladies. Typhoid fever, pneumonia, erysipelas, which would be mild in the case of a sober man quickly carry off the alcoholic drinker. The hygenic faults of parents fall upon their children. If the latter survive the first months they are threatened with idiocy or epilepsy, or, still worse, they are carried off a little later by tuberculosis, meningitis or phthisis. For the health of the individual, for the existence of the family, for the future of the nation, alcohol is one of the most terrible scoirrges. [Five paragraphs above are from posters put up by French city governments to check national decay that has led to deaths exceeding births. What follows is from British Parliamentary Report on Physical Deterioration, prompted by failure of a majority of candidates for enlistment in British Army to pass physical examinations. In consequence, British city governments post these extracts as a warning, not only in Great Britain as a cure but also in athletic Australia as a preventive. For one or other of these reasons such a warning should be posted in every city and town of the world, and read in the schools.] The continued use of alcohol, whether in form of beer, wine or spirits, even though not to the extent of drunkenness, often leads to chronic poisoning Of 61,215 people the average deaths per year by insurance tables will be i,ooo. Of 61,215 liquor sellers, the death average is 1,642. Of 61,215 Rechabites (abstainers) the death average is 560. Sir Frederick Treves, Physician to King Edward, declares that alcohol is an insiduous poison, and should be subject to the same strict limitation as opium, morphia or strychnine and that its supposed stimulating effects are delusive. Respectfully submitted for consideration of citizens by Mayor. *See p. 13!. 4 Medical opinions came in response to following circular of inquiry; MEMORANDUM FROM INTERNATIONAL REFORM BUREAU, 206 Pennsylvania Ave., s. e., Washington, D. C., U. S. A. Please send your opinion as a Medical Missionary in China to our Bu- reau, at above address, to be presented with a few others to President Roosevelt, who has just secured appointment of a Joint Commission for cooperative international action in suppression of the vicious uses of the opium in eastern Asia. The danger is that those interested in opium revenue will again plead, as they have done successfully in many cases of previous ineffective legislation, that ‘ ‘opium users would be killed if opium dens were suddenly closed,” and that legislatively and medicinally a long ‘ ‘tapering off” period of ten years or five or three should be allowed. Acting Gov. May of Hong Kong, tells me his prison positively disproves this, as no bad results follow an instantaneous breaking off at the time of arrest. Such men do their job at once and as regularly as other prisoners. The United States Congress allowed three years, terminating Mar. ist. 1908, for “tapering off” in the Philippines.* H. E. Viceroy Yuan Shih kai accompanies his sudden closing of opium dens in North China with the opening of a special opium hospital adjoining his Yamen, where I saw the recovering victims examined by Dr. Peck, all doing well and about ready to be dismissed after short treatment. The authoritative word will be that of the medical missionary, and we shall welcome your opinion — 1. Whether opium users need a long period for ‘ ‘tapering off”. 2. Whether this should be provided by continuing opium dens or by hospital treatment. 3. What action should be taken by Government with reference to alleged opium cures that continue the use of opium in pills or other form.f 4. What safeguards are needed against the abuse of the exceptions allowing opium to be prescribed by physicians. Thanking you in advance for your reply, I am, Yours for a “better world” here and now, Wilbur F. Crafts. En Route from Philippines to Australia, June 2, 1907. *The editor having reported the opium situation to President Roosevelt, the following cablegram was sent from Washington to Manila by the Bureau of Insular Affairs of the War Department on July 20, 1907 : “W. F. Crafts has written intimating some of the internal revenue officials are inclined to recommend postponement of the date within which Congressional opium prohibition to become effective. Secretary of War writes me to cable on no account must any hope be entertained that Congres- sional limitation will be postponed or in any way modified; that a warning ought to be issued immediately calling attention to the coming into operation of prohibitory statute, and that all persons must be prepared to have it strictly enforced.” Accord- ingly prohibition took effect Mar. i, 1908. fThe famous ‘‘Malay Cure” spread.s the average daily dose of opium over a week. The Shanghai Conference of Medical Missionaries in 1907 was unanimously against it. 5 [From “National Righteousness," B. Broomall, Editor.] A WORLD-ENCIRCLING “WAVE” OF ANTI-OPIUM REFORM. JAPAN. “The Opium Law of Japan forbids importation, the possession, and the use of the drug except as a medicine ; and it is kept to the letter in a population of 45 000 , 000 .” Article 159. “Whosoever imports, manufactures, or sells opium, or has in his possession opium with the object of selling it, shall be pvmished with penal servitude for a period not exceeding seven (7) years.” Article 162. ‘ ‘ Every individual who smokes or eats opium shall be ptmished with penal servi- tude for a period not exceeding three (3) years.” — Revised Draft of the New Penal Code of Japan. The quantity of opium used in Japan in a year is 9^ chests. — See the Annual Report of the Central Sanitary Bureau, Tokyo, 1902. [“The preparation and importation of patent medicines is carefully watched and supervised by the Government, in order that the fatal drug may not come into the country that wav.”] NEW ZEALAND. Extracts from an Act to prohibit the Importation or Smoking of Opium. — “It is imlawful for any person to import into the Colony Opium in any form suitable for smoking.” “Every person who commits a breach of this section is liable for each offence to a penalty not exceeding one hundred pounds.” “If any person is found smoking Opium, or permitting or abetting the smoking of Opium, he shall be liable to a penalty not exceeding ten pounds.” AUSTRALIA. The AUSTRALIAN COMMONWEALTH has prohibited the importation of Opium. THE UNITED STATES AND THE PHILIPPINES. The AMERICAN GOVERNMENT has enacted that from the ist of March, 1908, it shall be unlawful to import into the Philippine Islands, Opium, in whatever form, except by the Government. THE UNITED STATES AND CHINA. Between these coimtries the importation of Opium is forbidden by Treaty. RUSSIA AND CHINA. Between these countries the importation of Opium is forbidden by Treaty. BRAZIL AND CHINA. Between these countries the importation of Opium is forbidden by Treaty. CHINA. And now China, alarmed at the awful prevalence of Opium smoking, has resolved to suppress the habit. PRESENT OPIUM POLICY OF GREAT BRITAIN. {Quotations from the correspondence recently presented to Parliament.) “His Majesty’s Government would undertake to limit the quantity of Opium (Bengal and Malwa) exported from India to countries beyond the seas to 61,000 chests in 1908, 56,800 chests in 1909, and 51,700 chests in 1910. It is contended that this limitation of the total export from India will secure the reduction of one-tenth of the Indian Opium imported into China as effectually as a limitation on the basis proposed by China would do. “And the view of the Government of India is that such a standard ought to satisfy the Chinese Government for the present! BUT WHAT IS OPIUM DOING IN CHINA? “Opium is not only robbing the Chinese of millions of money, year by year, but is actually destroying them as a people. It undermines the constitution, ruins the health, and shortens the life of the smoker, destroys every domestic happiness and prosperity, and is gradually effecting the physical, mental and moral deterioration of the nation as a nation. “We have inflicted a terrible wrong on the people of China, and it is our solemn duty to try to undo it by abandoning the trade at once and for ever ourselves, and by giving them every sympathy and aid in our power in their attempt to banish the curse from within their own borders. — Rev. Dr. Griffith John. 6 Opinions of American and European Physicians in China as to THE Best Aid, Medical and Governmental, to be Given to Those Who, Voluntarily, or Under Compulsion, are Giving up the Vicious Uses of Opium. W. H. Park, M. D., Soochow Hospital, Soochow, China, June i8, 1907, American Southern Methodist Mission: [Dr. Wm. Hector Park was born in Georgia, U. S. A., Oct. 27th, 1858, and came to China as medical missionary in 1862. Has always run an opium refuge in connection with his hospital. Compiled the pamphlet, ‘ ‘Opinions of One Hundred Physicians on the Use of Opium in China.” For many years has acted as treasurer of the Anti-Opium League of China.] 1 . Opium users do not need a long time for tapering off. 2. Where necessary it should be accomplished by hospital treatment and not by opium dens. If opium could be absolutely withdrawn from the country, over ninety of the present opium users would need no treatment at all. They might suffer for a few days, but in a short time they would be like new men, and would be a thousand times better off without opium than they can ever be with it. 3. Government should absolutely prohibit the sale of all opium cures containing opium. 4. During the present state of medical practice in China, abuse of the exceptions allowing opium to be prescribed by physicians can not be safeguarded. Government should raise the standard of the medical practice and allow only registered medical men to prescribe opium to their patients. This privilege will be abused, though, unless some way can be devised for holding the doctor responsible. President Roosevelt, Washington, D. C., Dear Sir:- I have been asked by Rev. Wilbur F. Crafts to write you as to my opinion of the ‘ ‘tapering off” of opium users in ten years, five years or three or other long periods, from the standpoint of a medical man familiar by reading and practice with opium cases. I do not believe in the tapering off plan. We are supposed to be taper- ing in Soochow now under a notice to close all opium dens in six months, but, though the time is nearly up, the tapering has not yet begun. As a rule, opium smokers never taper off. The tendency is all the other way, and they will smoke their full amount as long as they can get it, if the heavens fall. This is just as true of those who daily smoke a small amount as those who smoke a large. All are sots and time given them to taper off in is just so much time thrown away. The suffering from stopping at once may be rather severe in many cases, but it does not last many days and is not in itself dangerous to life. Chinese patients often ask me to “pull their teeth 5/ow and easy." Imagine how it would feel if I should listen to their appeals. So with the opium 7 habit — it must be eradicated, and the quicker it is pulled out by the roots the better for all parties concerned. Most respectfully yours, W. H. Park. David T. Stuart, M. D., Superintendent, Eli?abeth Blake Hospital, American Presb5derian Mission, South, Soochow, China, June 1 8, 1907: We treat an average of two hundred opium smokers in our hospital a year, and my answers are based on an experience covering eight years in Soochow. 1. From two to three weeks treatment after a sudden breaking off or rather stoppage of opium gives the best results, and the patients suffer very little pain or discomfort during this time. 2. Hospital treatment is the only satisfactory method. Opium dens should all be closed at once. 3. The government should absolutely prohibit the sale of ‘ ‘anti-opium pills” and other “opium cures”. They all contain opium in one form or another and it simply means continuing the use of opium in another form. It is not a cure by any means, and simply dupes the victim and makes him a worse slave to the habit. 4. This is a hard question to answer. Any physician can prescribe opium in any prescription and defend himself by saying the patient needs it. It all depends on the honesty of the physician. The only safeguard I know of is to raise the ethics of the profession and take away the license of any physician found guilty of ordering opium for a patient when he does so simply to satisfy his craving for the drug. The subject you are taking up is certainly a very interesting ONE AND ON ITS SUCCESS IN A LARGE MEASURE DEPENDS THE FUTURE OF THIS GREAT NATION. TaKE AWAY OPIUM FROM THE CHINESE ANDWHO CAN TELL WHAT A POWERFUL PEOPLE THEY WILL BE?” John MacWillie, M. D., St. Peter’s Hospital, American Church Mission Wuchang, Via Hankow, China, June 21, 1907: 1. In my five years active practice in China I have treated most of my breaking off opium cases by the radical method, i. e., by immediate and total deprivation of opium in any form, and the balance of my patients by the gradual method, i. e. by reducing the amount of the alkaloid each day for ten days, when only water is given. The only obstinate case is one at present under my care whom I have treated by the radical method. He has been addicted to the habit for over 20 years and has been under treatment for 15 days. 2. Hospital treatment. 3. Prohibition. 4. Effective safeguard impossible as there is practically no Chinese medical profession and no registration of those who take upon themselves the calling. 8 James L. Maxwell, M. D. Lond., Tainan, Formosa, June 22, 1907, English Presbyterian Mission: 1. The method used should be that of immediately and completely cutting off the supply of the drug. The only exception to this rule is when the habitue of the drug is very seriously ill from some other cause, in which case the opium should be continued till convalescence is established, and then the same rule followed. 2. The answer to this is implied in the answer to the first question. 3. No “opium cures” containing opium or its alkaloids should under any circumstances be allowed to be offered for public sale. 4. No safeguards are needed so long as the word “physician” implies a registered practitioner holding the qualifications of some reputable school. J. G. Meadows, M. D., Wuchow, American Southern Baptist Mission, via Canton, China, June 23, 1907: 1. “A long period for tapering off” is not needed. The cure must be radical and immediate, but opium in some form will very often be required for a few days. The large majority do not need any opium while taking the cure. 2. The treatment will have to be done in hospitals or institutions for the special purpose to make it most effective. Many do break off without any treatment at all. 3. The most radical measures possible should be taken to suppress the sale of opium or its compounds in pill form. It is far more injurious than opium smoking and is at present quite general. 4. Physicians as a class are no better than other men and if business men require safeguards, so do all classes of men. A physician proven to have abused his privilege as a physician to prescribe opium should be prohibited from practising medicine. E. L. Woodward, M. D., H. B. Taylor, M. D., St. James Hospital, Amer- ican Church Mission, Nganking, China, June 24, 1907: 1. The tapering off method is only required when the patient is ex- tremely debilitated. The ordinary case can be broken off immediately and without serious difficulty or any danger if under medical supervision. The tapering off method, whether used for those extremely debilitated or for those attempting to break off the habit without medical supervision and restraint, should not be prolonged beyond about twenty days. 2. By hospital treatment exclusively. 3. To be effective, government action must be rigidly uncompromis- ing and therefore the alleged opium cures that continue the use of opium in pills or other forms should be exposed by government analysis and sup- pressed except when used under medical supervision. 4. The prescribing of opium preparations should be restricted to the duly licensed practitioner, and the abuse of the privilege should be followed by a heavy fine. 9 B. L. Livingstone-Learmonth, M. B., C. M., Edin., Irish Presbyterian Mission Hospital, Hsin Min fu, via N’Chwang, Manchuria, June 25, 1907: 1. Opium users do not need a long period for breaking off. 2. Opium shops would be useless. The breaking off is attended with considerable discomfort and should be undertaken in hospitals where the various symptoms may be treated as they arise. 3. The government sanitary inspector should have the various pills examined and if they contain opium they should be under the same embargo as the opium of the opium dens. 4. When there is a government diploma necessary for all medical practitioners, it will be time enough to discuss this point. Henry Fowler, London Mission Hospital and Leper Home, Hsiao-kan, via Hankow, Central China, June 29, 1907: 1. My experience is that the majority of opium users suffer no ill effects by breaking the habit suddenly. My own practice is to allow one week. At the end of that time I invariably find that the desire for smoking the drug is gone. The patient remains in hospital for a further period of two weeks to undergo medical treatment. As a rule the patient is enfeebled and requires tonics and a generous diet. I have a little hesitancy when one comes to old men, chronic smokers. I have been disappointed in some cases to find that the sudden giving up of the habit has meant the death of the patient. 2. For this reason I earnestly recommend for such patients Hospital treatment under fully qualified medical men or women. The older the patient the more necessary the medical treatment. I am firmly convinced that the habit can be given up if care is taken in treating the case. The harm results from carelessness. Constant watching of the cardiac and pulmonary apparatus is necessary. 3. I am entirely opposed to the anti-opium pill. Invariably it means that the user is taking an even larger quantity of morphia or opium than previously. I have made a collection of these pills as sold on the street in this city and find that they all contain opium or its derivatives. The government must on no account allow the sale of these pills. 4. In China there are so few qualified Chinese doctors that it would be safe to say that no one but physicians connected with hospital prac- tice SHOULD USE OPIUM AS A MEDICINE. All native drug stores should be fined for stocking or selling it. The greatest offender in this part of China, is Japan. Her medical quacks are to be found all over central China. They derive their greatest fees from these so called “opium cure pills.” If any- thing can be done to protect China from these quacks so much the better. f *Missionaries and others should urge that wherever opium cases are numerous, in China, the Philippines, India, and in large parts of New Zealand, 10 James Menzies, M. D., Hwai Ch’ing fu, Honan, China, July 2, 1907: Canadian Presbyterian Mission. Have been a medical missionary in North China for nearly 12 years in the Province of Honan, and have during that time had considerable experience with patients breaking off the opium habit. 1 . In many cases sudden stopping of opium would mean the death of the user where the habit has become confirmed, unless he were looked after in some hospital. I have, however, even with the worst cases of late stopped their opium at once on entering the hospital, but have carefully looked after them with stimulants till they were able to sleep and digest natural food. In my humble opinion this tapering off business will in most cases mean tapering on instead of tapering off. 2. I would close every opium den in the kingdom at once. While these exist the people will never break off the habit, and those who have broken off will begin again. Proper hospital treatment is, I am sure, far more sane and more likely to be effectual. 3. The government should prohibit the sale of opium cures containing opium. The country is at present being flooded with such. They do not cure the opium craving, but merely substitute the habit of opium eating for opium smoking, and the last end of that man is worse than the first. The government should take a lesson from the experience of the United States and Canada, and prohibit the sale of patent medicines whose FORMULA IS NOT PLAINLY PRINTED ON THE LABEL. Medical missionaries would not abuse the privileges, but unscrupulous native doctors might, and some legislation along that line might be found necessary. Bran V. SomerinTaylor, M. B., (Nearly 29 years medical missionary in China), Hing Hua, Foochow, July 6, 1907: American Church Missionary Society. 1 . Opium users do not need a long period for tapering off. 2. No continuance of opium dens. They simply perpetuate the evil. Sweep them off the face of China. 3. Prohibit all such pills. They are useless and delude the patient. 4. Very difficult to answer. At first sight, it seems that a law pro- hibiting the use of opium or morphine except by physicians in prescriptions would guard against abuse, but until the Chinese register their physicians such a plan is useless, unless they confine the use of opium to foreign quali- fied physicians, which one could hardly ask them to do. The only plan that I can think of is that the Customs keep track of all imported opium or morphia and follow it up as far as possible. Australia, South Africa, Haw'aii and the United States, the administering of opium as a medicine to Chinese should be limited to public hospitals. fHere is a subject on which missionaries and ambassadors in Japan should approach the Mikados’ Government, through the high-minded Foreign Secretary Count Hyashi. The large exportation of hyperdermic syringes from Japan to China (probably to the Philippines also since the prohibition of opium there Mar. i, 1908) should be a subject of courteous but earnest protest. And the promotion of opium using as well as gambling in Korea and Formosa by the Japanese, who vigorously suppress both evils in Japan, should be opposed by the new and almost omnipotent force, in- ternational public opinion. W. F. C. Chas. W. Service, M. D., Canadian Methodist Mission, Kiating via Chung king, China, Aug. i8, 1907: 1. Opium patients do not need a long period for tapering off. Many suffer, more or less, for the first few days, but two or three weeks are usually ample for treatment in hospital. I do not think there is any danger in breaking off suddenly, although most patients are more or less uncomfortable for a few days. 2. Give them from two to four weeks hospital treatment by all means. Many have some concurrent disease which needs treatment. 3. I think the government should forbid the sale and use of all opium in pills or other forms. Most, if not all of the so called opium cures sold on the streets in China and by unlicensed practitioners, drug shops, etc. contain opium in some form and should be prohibited under penalty. 4. a. Allow only qualified physicians to prescribe. This rules out quacks and allself-constituted physicians, including Chinese doctors, except such as hold diplomas from schools of scientific medicine. h. Allow only accredited and licensed drug stores to handle it. c. Allow such drug stores to sell it only as above mentioned quali- physicians prescribes it. d. Have rigid inspection of such drug stores. e. Allow no import of opium or morphine except by qualified physi- cians and licensed drug stores. Would the importation into China of patent medicines, cigarettes and spirituous liquors be in line with the work of the International Reform Bureau? These are some of the greatest menaces to China. There is no doubt about the latter two. As for the first, the patent medicine vendors are going to find here a very lucrative field for the exploitation of their wares. The Chinese are great medicine users and even now are spending no small sum in buying foreign patent medicines and proprietary mixtures of doubt- ful worth. As years pass increasing millions of dollars will be wasted or worse than wasted. All sorts of inert and harmful preparations will be foisted upon the millions of this land and only the makers and vendors will be gainers. 16 [For reason of inserting this document see closing paragraph of Introduction.] Scientific Testimony on Beer. From Speech by Senator J. H. Gallinger, M. Opinions of Leading Physicians. The alarming growth of the use of beer among our people, and the spreading de- lusion among many who consider them- selves temperate and sober, that the encour- agement of beer drinking is an effective way of promoting the cause of temperance and of aiding to stamp out the demon rum, impelled the Toledo Blade to send a repre- sentative to a number of the leading physi- cians of Toledo to obtain their opinions as to the real damage which indulgence in malt liquors does the victim of that form of intemperance. Every one is not only a gentleman of the highest personal character, but is a physi- cian whose professional abilities have been severely tested, and received the stamp of the highest indorsement by the public and their professional brethren. More skilful physicians are not to be found anywhere. Vv" e have not selected those of known tem- perance principles. What they say of beer is not colored by any feeling for or against temperance, but is the cold, bare experience of men of science who know whereof they speak. A Beer Drinking City. Toledo is essentially a beer drinking city. The German population is very large. Five of the largest breweries in the country are here. Probably more beer is drank, in pro- portion to the population, than in any other city in the United States. The practice of these physicians is, therefore, largely among beer drinkers, and they have had abundant opportunities to know exactly its bearings on health and disease. Every one bears testimony that no man can drink beer safely, that it is an injury to any one who uses it in any quantity, and that its effect on the general health of the country has been even worse than that of whiskey. The indictment they with one accord present against beer drinking is simply terrible. The devilfish crushing a man in his long, winding arms, and sucking his blood from his mangled body, is not so frightful an assailant as this deadly but insidious en- D., Congressioaal Recerd, January 9, 1901. emy, which fastens itself upon its victim, and daily beecrmes more and more the wretched mreo’s master, and finally drag- ging him to his grave at a time when other men are in their prime of mental and bodily vigor. Beer Kills Quicker Than Other Liquor. Dr. S. H. Burgen, a practitioner 35 years, 28 in Toledo, says : “I think beer kills quicker than any other liquor. My atten- tion was first called to its insidious effects, when I began examining for life insur- ance. I passed as unusually good risks five Germans — ^young business men — who seemed in the best health, and to have superb constitutions. In a few years I was amazed to see the whole five drop off, one after another, with what ought to have heen mild and easily curable diseases. On comparing my experience with that of other physicians I found they were all hav- ing similar luck with confirmed beer drink- ers, and my practice since has heaped con- firmation on confirmation. “The first organ to be attacked is the kidneys ; the liver soon sympathizes, and then comes, most frequently, dropsy or Bright’s disease, both certain to end fatally. Any physician, who cares to take the time, will tell you that among the dreadful re- sults of beer drinking are lockjaw and ery- sipelas, and that the beer drinker seems incapable of recovering from mild dis- orders and injuries not usually regarded of a grave character. Pneumonia, pleurisy, fevers, etc., seem to have a first mortgage on him, which they foreclose remorselessly at an early opportunity. Beer Worse Than Whiskey. “The beer drinker 5 s much worse off than the whiskey drinker, who seems to have more elasticity and reserve power. He will even have delirium tremens ; but after the fit is gone you will sometimes find good material to work upon. Good management may bring him around all right. But when a beer drinker gets into trouble it seems almost as if you have to recreate the man before you can do any- thing for him. I have talked this for years, and have had abundance of living and dead instances around me to support my opinions.” 1 Beer Drinking Shortens Life. Dr. S. S. Lungren, a leading homeo- pathic physician and surgeon, has prac- ticed in Toledo 25 years: “It is difficult to find any part of the confirmed beer drinker’s machinery that is doing its work as it should. This is why their life cords snap off like glass rods when disease or accident gives them a little blow. Beer drinking shortens life. This is not a mere opinion ; it is a well settled, recognized fact. Physicians and insurance companies accept this as unquestionably as any other undisputed fact of science. The great English physicians decide that the heart’s action is increased 13 per cent, in its efforts to throw off alcohol introduced into the circulation. The result is easily figured out. The natural pulse-beat is, say, 76 per minute. If we multiply this by 60 minutes in an hour, and 24 hours in a day, and add 13 per cent., we find that the heart has been compelled to do an extra work during that time in throwing off the burden of a few drinks (4.8 ounces of alcohol) equal to 15.5 tons lifted one foot high.” Life Insurance Companies. “The life insurance companies make a business of estimating men’s lives, and can only make money by making correct esti- mates of whatever influences life. Here is a table they use in calculating how long a normal, healthy man will probably live after a given age: Age. Expectancy. Age. Expectancy. 20 years.. .41.5 years 50 years.. .20.2 years 30 years.. .34.4 years 60 years.. .13.8 years 40 years.. .28.3 years 65 years.. .11 years “Now they expect a man otherwise healthy, who is addicted to beer, will have his life shortened from 40 to 60 per cent. For instance, if he is 20 years old and does not drink beer, he may reasonably expect to reach the age of 61. If he is a beer drinker, he will probably not live to be over 40 or 45, and so on.” Beer Drinking and Longevity. The President of the Connecticut Mutual Life Insurance Company — one of the old- est in the country — has for years been in- vestigating the relation of beer drinking to longevity ; or otherwise, whether beer drinkers are desirable risks to a life insur- ance company. He declared, as the result of a series of observations carried on among a selected group of persons who were habitual drink- ers of beer, that although for two or three years there was nothing remarkable, yet presently death began to strike, and then the mortality became astounding and uni- form in its manifestations. Ihere was no mistaking it; the history was almost in- variable ; robust, apparent health, full muscles, a fair outside, increasing weight, florid faces ; then a touch of cold or a sniff of malaria, and instantly some acute dis- ease, with almost invariable typhoid symp- toms, was in violent action, and ten days or less ended it. It was as if the system had been kept fair on the outside, while within it was eaten to a shell, and at the first touch of disease there was utter col- lapse, every fiber was poisoned and weak. And this in its main features, varying in degree, has been his observation in beer drinking everywhere. It is peculiarly de- ceptive at first ; it is thoroughly destructive at the last. Beer Drinkers Unpromising Patients. Dr. J. T. Woods: “That confirmed beer drinkers are especially unpromising pa- tients, all practical surgeons agree.” Dr. S. S. Lungren : “Alcohol invites at- tacks of disease, and makes recovery from any attack or injury difficult.” Dr. C. A. Kirkley : “Sickness is always more fatal in beer drinkers, and serious accidents are usually fatal to them.” Dr. S. H. Burgen : “Beer drinkers are absolutely the most dangerous class of sub- jects a surgeon can operate on. Insignifi- cant scratches are liable to develop a long train of dangerous troubles. Sometimes delirium tremens results from a small hurt. It is dangerous for a beer drinker to even cut his finger. All surgeons hesitate to perform operations on a beer drinker that they would undertake with the greatest confidence on anyone else.” “A Little Circle of Doctors.” Dr. S. S. Thorne : “If you could drop into a little circle of doctors, when they are having a quiet, professional chat, you would hear enough in a few minutes to terrify you as to the work of beer. One will say, ‘What’s become of So-and-So? I haven’t seen him around lately?’ ‘Oh, he’s dead.’ ‘Dead ! What was the mat- ter?’ ‘Beer.’ Another will say, ‘I’ve just come from Blank’s. I am afraid its about my last call on him, poor fellow.’ ‘What’s the trouble?’ ‘On, he’s been a regular beer drinker for years.’ A third will remark how has just gone out like a candle in a draft of wind. ‘Beer’ is the reason given. And so on, till half a dozen physi- cians have mentioned fifty recent cases where apparently strong, hearty men, at a time of life when they should be in their prime, have suddenly dropped into the grave. To say they are habitual beer drinkers is sufficient explanation to any physician.” 2 Beer Drinking Produces Rheumatism. Dr. W. T. Ridenour: “Beer drinking produces rheumatism by producing chronic congestion and ultimately degeneration of the liver, thus interfering with its function by which the food is elaborated and fitted for the sustenance of the body.” Dr. S. H. Burgen : “All beer drinkers have rheumatism, more or less, and no one can recover from it as long as he drinks beer. Notice how a beer drinker walks about stiff on his heels, without any of the natural elasticity and spring from the toes and ball of the foot that a healthy man should have. That is because the beer in- creases the lithia deposits about the smaller joints.” Beer Cripples the Liver. Dr. S. H. Burgen: “The first effect on the liver is to congest and enlarge it. Then follows a low grade of inflammation and subsequent contraction of the capsules, producing ‘hob-nailed’ or drunkard’s liver, the surface covered with little lumps that look like nail heads on the soles of shoes. This develops dropsy. The congestion of the liver clogs up all the springs of the body, and makes all sorts of exertion as difficult and labored as it would be to run a clock, the wheels of which were covered with dirt and gum.” Liable to Die of Pneumonia, Dr. W. T. Ridenour: “Beer drinkers are peculiarly liable to die of pneumonia. Their vital power, their power of resist- ance, is so lowered that they are liable to drop off from any form_ of acute disease, such as fevers, pneumonia, etc. As a rule when a beer drinker takes the pneumonia, he dies. “My first patient was a saloon keeper, as fine a looking man physically as I had ever seen — tall, well built, about thirty-five, with clear eyes, florid complexion, muscles well developed. He had an attack of pneu- monia in the lower lobe of the right lung, a simple, well-defined case, which I re- garded very hopefully. Doctors are confi- dent of saving nineteen out of twenty such cases. I told my partner so in the even- ing. To my surprise he said quietly, ‘He’ll die.’ I asked what made him think so. Tie is a beer drinker,’ he answered. My patient began to recover from the attack on the lower lobe. Suddenly the disease lighted up in the middle lobe. Finally it attacked the other lung, and my patient succumbed.” Dropsy Induced by Beer Drinking. Dr. M. H. Parmalee, physician and sur- geon twelve years in Toledo, says: “The majority of saloon keepers die from dropsy, arising from kidney and liver diseases, in- duced by beer drinking. My experience has been that saloon keepers and men working around breweries are very liable to these diseases. When one of those ap- parently stalwart, beery fellows is attacked by a disorder that would not be regarded as at all dangerous in a person of ordinary constitution, or even a delicate, weakly child or woman, he is liable to drop off like an over-ripe apple from a tree. You are never sure of him a minute. He may not be dangerously sick today, and tomorrow be in his shroud. Most physicians, like myself, dread being called upon to take charge of a sick man who is an habitual beer drinker. The form of Bright’s dis- ease known as the swollen or large white kidney is much more freauent among beer drinkers than any other class of people.” Insanity Caused by Beer Drinking. Dr. S. S. Lungren: “The brain and its membranes suffer severely, and after irri- ta.tion and inflammation comes dullness and stupidity. There is no question in my mind that many brain diseases and cases of insanity are caused by excessive beer drinking.” Dr. C. A. Kirkley: “Under its influence the mental powers are more inactive than the physical. There is hardly a single cause that operates more powerfully in the production of insanity; and not only that, but it excites the action of other causes that may be present.” Bright’s Disease Due to Beer. Dr. W. T. Ridenour: “I have no doubt the rapid spread of Bright’s disease is largely due to beer drinking. I have al- ways believed that Bayard Taylor fell a victim to the German beer that he praised so highly. He died of Bright’s disease at 50, when he should have lived, with his constitution, to a ripe old age. He went just as beer drinkers are going all the time and everywhere.” Dr. C. A. Kirkley : “I believe that forty- nine out of fifty cases of chronic Bright’s disease are directly produced by it. I have never met with a case in which the patient has not been intemperate to a greater or less degree. The proportion may be too high, but that is certainly my experience. Mr. Christian, a celebrated author, states that three-fourths to four-fifths of the cases met with in Edinburgh were in hab- itual drunkards.” 3 An Artificial Prop. Dr. C. A. Kirkley, in constant practice in Toledo IS years, says: “I do not be- lieve the healthy organism needs an arti- ficial prop to sustain it. Depression below the standard of health always follows just in proportion as the system is stimulated above that standard. Every physician is familiar with cases in which nervous wear and tear in an active life has been kept up by stimulants without apparent loss of power for years. Bodily and mental vigor, however, suddenly fail. The repeated ap- plication of the stimulus that the exertion might be prolonged has really expended the power of the nervous system, and prepared him for more complete prostration. The temporary advantage was purchased at a great cost. The greater the expenditure of nervous power by the use of stimulants, the more complete the exhaustion.” Children of Drunkards — Idiots, Dr. C. A. Kirkley: “Plutarch says, ‘One drunkard begets another;’ and Aris- totle, ‘Drunken women bring forth chil- dren like unto themselves.’ A report was made to the legislature of Massachusetts, I think by Dr. Howe, on idiocy. He had learned the habits of the parents of 300 idiots, and 145, nearly._half, are reported as known to be habitual drunkards, showing the enfeebled constitution of the children of drunkards. I have in mind an instance where children born to the mother, begot- ten when the father was intoxicated, all died within eight months of birth. They wou’d have recovered, had they not had the enfeebled constitution inherited from their intemperate father. Instances are re- corded where both parents were intoxi- cated at the time of conception, and the result was an idiot. There is not a doubt but that inebriety not only makes more destructive whatever taint may exist, but irrjpairs the health and natural vigor for remote generations.” “A Crop of Lunatics.” Dr, A. McFarland : “That ‘the iniquities of the lathers are visited upon the child- dren;’ that ‘the fathers have eaten souf grapes and the children’s teeth are set on edge,’ are truths that no Scripture is needed to teach. In other words, he who sins through physical excess does not do half the harm to himself that he does to the inheritors of his blood. The penalty must be paid as sure as there is seed time and harvest. “It is your stout old hero, who goes to bed every night with liquor enough under his belt to fuddle the brains of a half dozen ordinary men, and yet lives out his three-score and ten, that will be found at the head of the stock that pour into the world, generation after generation, such a crop of lunatics, epileptics, eccentrics, and inebriates as we often see. The impunity with which one so constituted will violate all physical law gets its set-off in a suc- ceeding generation, when the great harvest begins.” Only One Safe Course. Dr. J. T. Woods: “That beer is foreign to nature’s demand is plainly evident. The whole organism at once sets about its re- moval. Every channel through which it can be got rid of is brought into play, and does not cease till the last trace is gone. Reaching a certain end depends only on the frequency of the repetition. The whole is made up of the parts ; every drink counts one. These ‘ones’ added together make the wreck; to secure this result it is only necessary to make the single numbers suf- ficient. Each leaves its footprints in one way or another ; and the idea that, because you stop before you stagger, the system takes no note of the damaging material you put into it is a ruinous delusion.” Dr. S. H. Burgen : “I have told you the frozen truth — cold, calm, scientific facts, such as the profession everywhere recog- nizes as absolute truths. I do not regard beer drinking as safe for any one. It is a dangerous, aggressive evil that no one can tamper with with any safety to himself. There is only one safe course, and that is to let it alone entirely.” Vie invite those who appreciate the danger that beer and cigarettes and opram pills will be substituted for recently prohibited ooium smoking by the hundred millions of Chinese in China and the Philippines and the British colonies, to contribute generoi^- ly for the free circulation of these medical testimonies on opium and beer among the Chinese everywhere and for the promotion of the kindred crusade, already well begun by seventeen great governments, to protect uncivilized and newly civilized ra^s against the white man’s rum and opium. Let us “seize the hour” when the British Govern- ment has just closed the opium dens in Hong Kong and Ceylon, and when President Roosevelt has called a Conference of nations for Shanghai, Jan. i, 1909, to consign the opium traffic to companionship with piracy and slavery in the limbo of crimes against civilization. A few thousand of this document have been printed at the personal cost of the compiler, who must look to others to whom a few samples are sent to aid in giving the large circulation in English and Chinese that the interests of philanthropy and missions require. Address: The International Reform Bureau, 206 Penn’a Av., s. e., Washington, D. C. 4