COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX641 27206 RC565 .AL5 1900 Alcohol, a dangerous /.. h>:aith. Digitized by tine Internet Arciiive in 2010 witii funding from Open Knowledge Commons http://www.archive,org/details/alcoholdangerousOOalle A Book You Ought to Read. Alcohol, a Dangerous and Unnecessary Medicine. By Mrs. Martha M. Allen. 435 pages, f 1.25, postpaid. The Journal of the ADierican Medical Association says of it: "Without the scientific pretensions of the Report of the Committee of Fifty, it is probable that this book is far more influential and that its genaral conclusions are more acceptable to the medical profession. * * * The book is excellent, and -worthy of respectful consideration by phgsi^jgtns. " ■^ vis, Sr., of Chicago, late dean of the Medical Northwestern University, said of the first a rich storehouse of facts most valuable for eference by physicians, and equally valu- ery family." of Inebriety says: "The author has done ) the cause of medicine and reform. We nd this book to ail our readers." ,nent of "It is. ady r vise It ALCOHOL A DANGEROUS AND UNNECESSARY MEDICINE HOW AND WHY What Medical Writers Say BY MRS. MARTHA M. ALLEN Superintendent of the Department of Medical Temperance for the National Woman's Christian Temperance Union 1» Published by the DEPARTMENT OF MEDICAL TEMPERANCE OF THfc NATIONAL WOMAN'S CHRISTIAN TEMPERANCE UNION Marcellus, New York V ) /J DO Copyright, 1900, CONXENTS. Introduction 5 Preface to Second Edition 7 CHAPTER I. History of the Study of Alcohol. Discovery of distillation — First American investigator of effects of alcohol — Medical Declarations — Sir B. W. Richardson's researches — Scientific Temperance In- struction in American Schools — Committee of Fifty. . 9 CHAPTER H. The Woman's Christian Temperance Union in Opposition to Alcohol as Medicine. How the Opposition began — Memorial to International Medical Congress — Origin of Medical Temperance De- partment — Objects of the department — Public agitation against patent medicines originated by the department ■ — Laws of Georgia, Alabama and Kansas on Medical prescription of alcohol 21 CHAPTER HI. Alcohol as a Producer of Disease. Alcohol a poison — Sudden deaths from brandy — Changes in liver, kidneys, heart, blood-vessels and nerves caused by alcohol — Beer and wine as harmful as the stronger drinks — Alcohol causes indigestion — Other diseases caused by alcohol — Deaths from alcoholism in Switzer- land 28 CHAPTER IV. Temperance Hospitals. The London Temperance Hospital — Methods of treat- ment — The Frances E. Willard Temperance Hospital, Chicago — "As a beverage" in the pledge — Address by Miss Frances E. Willard at opening of hospital — The Red Cross Hospital — Clara Barton and non-alcoholic IV CONTENTS. medication — Reports of treatment in Red Cross Hos- pital — Use of Alcohol declining in other hospitals .... 37 CHAPTER V. The Effects of Alcohol Upon tpie Human Body. The body composed of cells — Effect of alcohol on cells — Alcohol and Digestion — Effects on the blood — The heart — The liver — The kidneys — Incipient Bright's dis- ease recovered from by total abstinence — Retards oxi- dation and elimination of waste matters — Lengthens duration of sickness and increases mortality 58 CHAPTER VI. Alcohol as Medicine. Medical use of alcohol a bulwark of the liquor traffic — Alcohol not a Food — Alcohol reduces temperature — Food principle of grains and fruits destroyed by fer- mentation — Alcohol not a Stimulant — Experiments proving this — Alcohol not a tonic — Professor Atwater on Alcohol as Food 96 CHAPTER VH. Alcohol in Pharmacy. Strong tinctures rouse desire for drink in reformed in- ebriates — Glycerine and acetic acid to preserve drugs — Non-alcohol tinctures in use at London Temperance Hospital — Sale of liquor in drug-stores condemned by pharmacists 131 CHAPTER VHL Diseases, and Their Treatment Without Alcohol. Alcoholic Craving — Ansem.ia — Apoplexy — Boils and Car- buncle — Catarrh — Hay-Fever — Colds — Colic — Cholera Cholera Infantum — Consumption — Displacements — De- bility — Diarrhoea — Dysentery — Dyspepsia — Fainting — Fits — Flatulence — Headache — Hemorrhage — Heart Dis- ease — Heart Failure — Insomnia — La Grippe — Measles — Malaria — Neuralgia — Nausea — Pneumonia — Pain After Food — Snake-bite — Rheumatism — Spasms — Shock — Sudden Illness — Sunstroke — Typhoid Fever — Vomit- ing 140 CHAPTER IX. Alcohol and Nursing Mothers. Beer not good for nursing mothers — Helpful diet — Opinions of medical men — Analysis of milk of a CONTENTS. V temperate woman — Of a drinking woman — Advice of Dr. James Edmunds, of the Lying-in Hospital, Lon- don — How to feed the baby — Case of a young mother who used beer — Nathan S- Davis on beer and gin. .. . 234 CHAPTER X. Comparative Death-Rates With and Without THE Use of Alcohol. Fewer deaths in smallpox hospitals without alcohol — 200 cases of scarlet fever without alcohol — Non-alcoholic treatment of fevers with less than 5 per cent, death- rate — Report of cases in English and Scotch hospitals — 340 cases of typhus — London Lancet articles on typhoid — Mercy Hospital, Chicago — Death-rates in pneumonia and typhoid in large hospitals — Sir B. W. Richardson's report of practice , 247 CHAPTER XL Reasons Why Alcohol is Dangerous as Medicine. Researches of Abbott — Vital Resistance lowered by al- cohol — Experiments upon Urinary Toxicity — Effect of alcohol upon the guardian-cells of the bod}^ — Dr. Sims Woodhead on immunit}^ — Delearde's experi- ments at the Pasteur Institute — Dr. A. Pearce Gould on alcohol and cancer — Delirium in illness caused by alcohol 262 CHAPTER XII. Why Doctors Still Prescribe Alcoholics. Public often demand it — Lack of knowledge of true nature of alcohol — Alcohol given undeserved credit for recoveries — Use of alcohol results from custom — Edu- cation of the people in teachings of non-alcoholic phy- sicians necessary — Prescription of alcohol a matter of routine — Two examples 291 CHAPTER XIIL Alcoholic Proprietary or "Patent" Medicines. The Pure Food Law — The guarantee — Newspaper op- position to the law — Headache remedies — Fake testi- monials — Dangers of soothing syrups and morphine cough syrups — Fraud orders issued by Post-Office De- partment — Internal Revenue Department and Patent VI CONTENTS. Medicines — Proprietary "Foods" strongly alcoholic — Alcoholic Cod-Liver Oil preparations — Australia's Royal Commission on Patent Medicines — Committee on Pharmacy analyses — Malt extracts — Coca Wines — Advertising, the strength of the Nostrum business — An effectual remedy 299 CHAPTER XIV. Drugging. Drugs do not cure disease — Nature cures — Opinions of drug medication of prominent physicians — La grippe caused by drug taking — Coal-tar drugs — Quinine — Sir Frederick Treves on disuse of drugs — People demand drugs of physicians — Mothers make drug victims of their children — Habit-producing drugs — Causes of drug-taking — How to be well 335 CHAPTER XV. Testimonies of Physicians Against Alcoholic Medication. No need for substitutes for alcohol — Alcohol hides symp- toms of disease — Responsibility of physicians — Opin- ions of many teachers in medical colleges — Hot milk better than alcohol — Journal of the American Medical Association on researches of Abbott and Laitinen — Resolution against alcohol of West Virginia Medical Society — Dr. Knox Bond on Scarlet Fever — Metchin- koff on white blood-cells — Kassowitz describes his treatment of fevers — Sims Woodhead's opinions — Opinions of German Physicians — Dr. Harvey blames medical profession for careless use of alcohol and opium — Use of Alcohol declining rapidly in medical practice 35^ CHAPTER XVL Recent Researches Upon Alcohol. Experiments of Laitinen — Resistance of blood-cells to disease lowered by alcohol — International Congress on Alcoholism, London, 1909 — Alcohol and Immunity — Effect of Alcohol Drinking on Human Off-spring— - Researches of Kraepelin and Aschaffenberg— Economic losses by reduced work through beer and wine drink- ing — Researches of Dr. Reid Hunt — Mice given alcohol killed by small doses of poison — Difference in effect CONTENTS. Vll of alcohol and starch foods — Chittenden on food theory of alcohol — Researches of Dr. S. P. Beebe — Liver im- paired by alcohol — Dr. Winfield S. Hall's interpretation of the researches of Beebe and Hunt — Oxidation of alcohol by liver a protective action — Researches show that alcohol is a poison, not a food 392 CHAPTER XVH. Miscellaneous. Alcohol Baths — Beverages for the Sick — Tobacco and the E3'esight — Advertised "Cures" for Drunkenness — How to quit drinking — Dr. T, D. Crother's remedy for drink crave — Alcohol and Children — Alcohol Tested — Beer-Drinking Injurious to Health — Drug Drinks — Special Directions for Women — Total Absti- nence and Life Insurance — Opinions of Life Insurance Companies on drinkers as risks 410 INTRODUCTION. This book is the outcome of many years of study. With the exception of a few quotations, none of the material has ever before appeared in any book. The writer has been indebted for years past to many of the physicians mentioned in the following pages for copies of pamphlets and maga- zines, and for newspaper articles, bearing upon the medical study of alcohol. Indeed, had it not been for the kindly counsels and hearty co-operation of physicians, she could never have accomplished all that was laid upon her to do as a state and national superintendent of ^Medical Temperance for the Woman's Christian Temperance Union. She is also under obligation for helps received from the secre- taries of several State Boards of Health, and from eminent chemists and pharmacists. The object of the book is to put into the hands of the people a statement of the views regarding the medical properties of alcohol held by those physicians who make little, or no use of this drug. In most cases their views are given in their own 5 6 INTRODUCTION. language, so that the book is, of necessity, largely a compilation. It is hoped that while the laity may be glad to peruse these pages because of the very useful and interesting information to be obtained from them, the medical profession, also, may be pleased to find, in brief form, the teachings of some of their most distinguished brethren upon a question now fre- quently up for discussion in society meetings. The writer does not presume to set forth her own opinions upon a question which is still a sub- ject of dispute among the members of a learned profession ; she simply culls from the writings of those members of that profession who, having made thorough examination of the claims of alcohol, have decided that this drug, as ordinarily used, is more harmful than beneficial, and that medical practice would be upon a higher plane, were it driven entirely from the pharmacopoeia. PREFACE TO SECOND EDITION. When the first edition of this book was published in 1900. there were only a few leading physicians either in Europe or America who were ready to condemn the medical use of alcohol. Sir Benjamin Ward Richardson, Sims Woodhead, and a few others in England; Forel, Kassowitz and one or two more on the Continent, and Nathan S. Davis, T. D. Crothers and J. H. Kellogg, in America, were about all that could be quoted largely as opposed to alcoholic liquors as remedies in disease. Whisky was then looked upon as necessary in the treatment of consumption and diphtheria. Ten years have brought about a great change. There are many American physicians now willing to admit that the}' have very little or no use for alcoholic liquors as remedial agents, and now, instead of recommending whisk}- for con- sumption anti-tuberculosis literature almost everywhere warns against the use of intoxicating drinks. The use of anti- toxin in diphtheria has driven out whisky treatment in that disease with markedly favorable results. Lender the whisky treatment death-rates ran up to fifty-five and sixty per cent. ; now the diphtheria death-rate is very low. Ten years ago many good authorities still ranked alcohol as a stimu- lant; now, almost all rank it as a depressant. In England, leading physicians and surgeons have spoken so strongly against alcohol in the last few years that the London Times, England's leading newspaper, said : "According to recent developments of scientific opinion, it is not impossible that a belief in the strengthening and supporting qualities of alco- hol will eventually become as obsolete as a belief in witch- craft." 7 8 PREFACE TO SECOND EDITION. So far as the writer can learn from replies sent to her inquiries by teachers of medicine, and by study of text- books on medicine, and articles in good medical journals, alcohol now has only a very limited use in medicine with the great majority of successful physicians. Some recommend wine in diabetes mellitus, saying that it acts less like a poi- son and more like a food in that disease than in any other. Some use alcoholic liquors in fevers as a food "to save the burning of tissue," but an article on "Therapeutics" in the Journal of the American Medical Association, for Novem- ber 6, 1909, page 1564, says that sugar would probably have equal value in such case. The same article says that hot baths, with hot lemonade, and a quickly acting cathartic, will abort a cold without any need of recourse to alcohol. The writer wishes here to make grateful acknowledgment of courtesies received from busy physicians who have aided materially in her work by answering personal letters of in- quiry, also letters published in the Journal of the American Medical Association, by kindness of the editor. Especially would she thank those professors of medicine and superin- tendents of large hospitals, who so courteously aided her in preparing a paper for the International Congress on Alcohol- ism, held in London, July, 1909, to which she was a dele- gate, representing the United States government. A few of the replies received at that time are given in this book. There was not room for all. She wishes also to acknowledge kindness and much help received from pharmacists and druggists in the fight against dangerous patent medicines and drug drinks sold at soda fountains. The Druggists' Circular, of New York, deserves special mention in this connection. It has been necessary to make many changes in this edi- tion because of the changing views on alcohol and the pub- licity on patent medicines. Physicians will find Chapter XVI entirely new, and of great interest. M. M. A. ALCOHOL. CHAPTER I. HISTORY OF THE STUDY OF ALCOHOL. The only intoxicating drinks known to the ancients were wines and beers. That these w^ere used for medicinal as well as beverage purposes is evident from sacred and secular history. About the tenth century of the Christian era, an Arabian alchemist discovered the art of distillation, by which the active principle of fermented liquors could be drawn off and separated. To the spirit thus produced the name alcohol was given. A plausible reason cited for this name is that the Arabian for evil spirit is Al ghole, and the effects of the mysterious liquid upon men suggested demoniacal possession. Medical knowledge at this time was very limited ; there was no accurate way of determining the real nature of the new substance, nor its action upon the human system. It could be judged only by its seeming effects. As these were pleasing, it was supposed that a great medical discovery had been made. The alchemists had been seeking a panacea 9 lO ALCOHOL AS A MEDICINE. for all the ills to which flesh is heir, indeed for something which would enable men even to defy Death, and the subtle new spirit was eagerly pro- claimed as the long-looked-for cure-all, if not the very aqtia vitcB itself. Physicians introduced it to their patients, and were lavish in their praises of its curative powers. The following is quoted from the writings of Theoricus, a prominent German of the sixteenth century, as an example of medical opinion of alcohol in his day : — " It sloweth age, it strengtheneth youth, it helpeth digestion, it cutteth phlegme, it cureth the hydropsia, it healeth the stranguria, it pounces the stone, it expelleth gravel, it keepeth the head from whirling, the teeth from chattering, and the throat from rattling ; it keepeth the weasen from stiffling, the stomach from wambling, and the heart from swelling; it keepeth the hands from shivering, the sinews from shrinking, the veins from crumbling, the bones from aching, and the marrow from soaking." Being a medicine, which very rapidly creates a craving for itself, the demand for it became enormous, and, as time advanced, people began prescribing it for themselves, until its use both as medicine and beverage became almost general. If the medical profession is responsible for the wide-spread belief that alcoholics are of service to mankind both as food and medicine, it should not be forgotten that it is to members of the same profession the world is indebted for the correction of these errors. All down through the centuries there have been physicians who doubted and ALCOHOL AS A MEDICINE. II Opposed its claims to merit. It remained for the medical science of the latter half of the nineteenth century to clearly demonstrate with nicely adjusted chemical apparatus and appliances the wisdom of these doubts. The scientific study of the effects of alcohol upon the human body began about sixty years ago. The first American investigator was Dr. Xathan S. Davis, of Chicago, who was the founder of the American jMedical Association. During the months of May, June, July, September and October, 1848, Dr. Davis published in the Annalist, a monthly medical journal of New York City, a series of articles controverting the universal opinion that alcoholic drinks are warm- ing, strengthening and nourishing. In 1850 he exe- cuted an extensive series of experiments to determine the effects of a diet exclusively carbonaceous (starch), one exclusively nitrogenous (albumen), and alcohol (brandy and wine), on the temperature of the living body; on the quantity of carbonic acid exhaled; and on the circulation of the blood. The results of these investigations were embodied in a paper read before the American Medical Association in May, 1851. They showed that alcohol, instead of increasing animal heat, and promoting nutrition and strength, actually produced directly opposite effects, reduc- ing temperature, the amount of carbonic acid exhaled, and the muscular strength. So opposed were these conclusions to the generally accepted 12 ALCOHO.L AS A MEDICINE. teachings of the day that the Association did not refer the paper to the committee of publication. It was pubb'shed later in the Northwestern Medical and Surgical Jour nal. In 1854 Dr. Davis published one of the most remarkable of the numerous works which have come from his prolific pen ; it was entitled, '' A Lecture on the Effects of Alcoholic Drinks on the Human System, and the Duty of Medical Men in Relation Thereto." This lecture was delivered in Rush Medi- carCoUege, Chicago, on Christmas, 1854. An appendix to the work contained a full account of the series of original experiments which the author had been conducting in relation to the effect of alcohol upon respiration and animal heat, and gave the same conclusions as those presented before the A. M. A. several years previously. These experiments laid the foundation for the scientific study of the physiological effects of alcohol ; and their bearing upon the study of the temperance question can even yet scarcely be appreciated. They were the first experiments which showed conclusively that the effect of alcohol is not that of a stimulant, but the opposite. In 1855 Prof. R. D. Mussey, of Vermont, read an able paper before the American Medical Associa- tion upon "The Effects of Alcohol in Health and Disease," in which he said, " So long as alcohol retains its place among sick patients, so long will there be drunkards." ALCOHOL AS A MEDICINE. 1$ In England as early as 1802, Dr. Beddoes pointed out the dangers attendant upon the social and medical use of intoxicating drinks, laying stress upon " The enfeebling power of small portions of wine regularly drunk." In 1829 Dr. John Cheyne, Physician General to the forces in Ireland said : — • " The benefits which have been supposed from their liberal use in medicine, and especially in those diseases which are vulgarly supposed to depend upon mere weakness, have invested these agents with attributes to which they have no claim, and hence, as we physicians no longer employ them -as we were wont to do, we ought not to rest satisfied with the mere acknowledgment of error, but we ought also to make every retribution in our power for having so long upheld one of the most fatal delusions that ever took possession of the human mind." Dr. Higginbotham, F. R. S., of Nottingham, a keen and able clinical practitioner, abandoned the prescription of alcohol in 1832, saying: — " I have amply tried both ways. I gave alcohol in my prac- tice for twenty years, and have now practiced without it for the last thirty years or more. My experience is, that acute disease is more readily cured without it, and chronic diseases much more manageable, I have not found a single patient injured by the disuse of alcohol, or a constitution requiring it ; indeed, to find either, although I am in my seventy-seventh year, I would walk fifty miles to see such an unnatural phenomenon. If I ordered or allowed alcohol in any form, either as food or as medicine, to a patient, I should certainly do it with a felonious intent." — Ipswich Tracts. No. 346. In 1839 ^^' Julius Jeffreys drew up a medical declaration which was signed by seventy-eight leaders of medicine and surgery. This document 14 ALCOHOL AS A MEDICINE. declared the opinion to be erroneous that wine, beer or spirit was beneficial to health ; that even in the most moderate doses, alcoholic drinks did no good. This, of course, dealt only with the beverage use of alcoholics. In 1847 ^ second declaration was originated, signed by over two thousand of the most eminent physicians and surgeons. This also referred only to liquor as a beverage. In 1871 a third declaration, signed by two hundred and sixty- nine of the leading members of the medical profes- sion was published in the London Times, This declaration was in part as follows : — " As it is believed that the inconsiderate prescription of large quantities of alcoholic liquids by medical men for their patients has given rise, in many instances, to the formation of intemper- ate habits, the undersigned, while unable to abandon the use of alcohol in the treatment of certain cases of disease, are yet of opinion that no medical practitioner should prescribe it with- out a sense of grave responsibility. " They are also of opinion that many people immensely exaggerate the value of alcohol as an article of diet, and they hold that every medical practitioner is bound to exert his utmost influence to inculcate habits of great moderation in the use of alcoholic liquids." In the same year the American Medical Associa- tion passed a resolution that " alcohol should be classed with other powerful drugs, and when pre- scribed medically, it should be done with conscien- tious caution, and a sense of great responsibility." The physicians of New York, Brooklyn and vicinity not long afterward published a declaration ALCOHOL AS A MEDICINE. 15 practically the same as that of the A. M. A., add- ing : " We are of opinion that the use of alco- holic liquor as a beverage is productive of a large amount of physical disease." The publication of these later declarations was the beginning of a marked change in the medical use of alcohol. In England the scientific temperance movement began with Dr. B. W. Richardson, afterwards knighted by Queen Victoria for his great services to humanity as a medical philanthropist. Dr. Richardson's success in bringing before physicians the remarkable medicinal agent known as nitrite of amyl, led to a request from the British Association for the Advancement of Science that he investigate other chemical substances. The result was that several years of study, beginning with 1863, were given to the physiological effects of various alco- hols, ethylic alcohol, which is the active principle in wines, beers and other intoxicating drinks, receiv- ing special attention. The following is taken from his '' Results of Researches on Alcohol " :— " In my hands ethylic alcohol and other bodies of the same g^oup ; viz. methylic, propylic, butylic, and amylic alcohols were tested purely from the physiological point of view. They were tested exclusively as chemical substances apart from any question as to their general use and employment, and free from all bias for or against their influence on mankind for good or for evil. l6 ALCOHOL AS A MEDICINE. " The method of research that was pursued was the same that had been followed in respect to nitrite of amyl, chloroform, ether, and other chemical substances, and it was in the follow- ing order : First, the mode in which living bodies would take up or absorb the substance was considered. This settled, the quantity necessary to produce a decided physiological change was ascertained, and was estimated in relation to the weight of the living body on which the observation was made. After these facts were ascertained the special action of the agent was investigated on the blood, on the motion of the heart, on the respiration, on the minute circulation of the blood, on the digestive organs, on the secreting and excreting organs, on the nervous system and brain, on the animal temperature and on the muscular activity. By these processes of inquiry, each specially carried out, I was enabled to test fairly the action of the different chemical agents that came before me. ***** " The results of these researches were that I learned purely by experimental observation that, in its action on the living body, alcohol deranges the constitution of the blood ; unduly excites the heart and respiration ; paralyzes the minute blood- vessels ; disturbs the regularity of nervous action ; lowers the animal temperature, and lessens the muscular power. " Such, independent of any prejudice of party or influence of sentiment, are the unanswerable teachings of the sternest of all evidences, the evidences of experiment, of natural fact revealed to man by testing of natural phenomena." When Dr. Richardson reported to the Association for the Advancement of Science the results of his researches so at variance with commonly accepted ideas, the Association was as incredulous as the American Medical Association had been in 1851 when Dr. Davis gave a similar report, and Dr. Rich- ardson's paper was returned to him for correction. ALCOHOL AS A MEDICINE. 1/ It should be stated here that Dr. Richardson was not a total abstainer when he began his study of the effects of alcohol, but became an ardent and enthusiastic advocate of total abstinence, and later of non-alcoholic medication, because of what he learned by his experiments with this drug. He was the first to suggest that scientific temperance be taught in the public schools, and he prepared the first text-book ever published for this purpose. In 1874 he delivered his famous ''Cantor Lectures on Alcohol," by request of the Society of Arts. This series of lectures created a sensation, being attended by crowds of people, as it was the first time that any physician of eminence had spoken from experi- mental evidence in favor of total abstinence. The agitation begotten in medical circles by the discussion of Dr. Richardson's researches upon alcohol led to extensive experimenting upon the same line by scientists of England, Continental Europe and America. The efforts of the National Woman's Christian Temperance Union of the United States, led by that intrepid woman, Mrs. Mary H. Hunt, to introduce scientific temperance instruction into public schools gave impetus to the study in this country. The call for text-books caused publishers to request professors in medical colleges to make minute research into the nature and effects of alcohol, that the demands of the new educational law might be met. The bitter opposi- tion to these temperance education laws was a great l8 ALCOHOL AS A MEDICINE. stimulant to the scientific study of alcohol, for it was hoped by many that the teachings regarding the deleterious effects of alcohol might be proved incor- rect. Unfortunately for the lovers of the bibulous, the proof was all the other way ; great medical men could not be bought by distillers or brewers to tell anything but the truth, and the truth of experimental research was all against alcohol. The text-books en- dorsed by Mrs. Hunt and her advisory committee being assailed again and again as containing errone- ous teaching, were finally, in 1897, submitted to an examining committee of medical experts, nearly all of whom were connected with medical colleges. This committee consisted of Dr. N. S. Davis, Sr., of Chi- cago, 111. ; Dr. Leartus Connor, of Detroit, Michigan ; Dr. Henry Q. Marcy, of Boston, Mass. ; Dr. E. E. Montgomery, of Philadelphia, Pa. ; Dr. Henry D. Holton, of Brattleboro, Vt. ; and Dr. George F. Shrady, of New York City. From their reports upon the books the following is culled : — " I find no errors in the teaching of any of them on this subject." " No statement was found at variance with the most reliable studies of especially competent investigators." " I was asked to point out any errors in these books which need correcting. I find no such errors." *' I find their teaching completely in accordance with the facts determined through scientific experimentation and investi- gation." " I find them to be in substantial accord with the results of the latest scientific investigations," ALCOHOL AS A MEDICINE. I9 Dr. Baer, of Berlin, Germany, the foremost Euro- pean specialist on the subject treated in these text- books, has recently subjected the books to rigid examination. He says in his report upon them : — '' On the basis of the examination I have made I can assert that the above mentioned school text-books, (the endorsed physiologies), in respect to their statements regarding alcoholic drinks contain no teachings which are not in harmony with the attitude of strict science." Still the opposers of the text-books were not satis- fied, and a self constituted Committee of Fifty under- took an investigation. Men of unquestioned ability were chosen to make researches, but the result of their investigations was so different from what was looked for, that, with the exception of Professor Atwater's contention for the food value of alcohol, the report of the Committee of Fifty did not stir up much con- troversy. The school text-books deal exclusively with the effects of alcohol used as a beverage ; for obvious reasons this is all they can do. But as intoxicating drinks have been generally supposed to contain great virtue as remedial agents, this phase of their nature and effects has not been overlooked by those pursuing inquiries concerning them. While full agreement has not yet been reached by experts as to the value of alcoholic liquids as medicines, it is noteworthy that some of the most eminent investi- gators w^r^ led to drop alcohol from their pharna^'? 20 ALCOHOL AS A MEDICINE. ceutical outfit, and the remainder to admit that its sphere of usefulness is extremely limited. There are now medical colleges of high standing where students are advised against the use of alco- hol as a remedy ; hospitals are gradually using it less and less, some entirely discarding it ; and many progressive physicians, while saying nothing as to their position upon the alcohol question, yet show their lack of faith in this drug by ignoring it unlesf X)atients or their friends desire it. CHAPTER II. THE WOMANS CHRISTIAN TEMPERANCE UNION IN OPPOSITION TO ALCOHOL AS MEDICINE. When the W. C. T. U. was first organized there was no thought among its members of antagonizing the use of alcohol in medicine. One almost im- mediate result of the organization, however, was that the women began to study the causes of in- ebriety, and prominent among the prevailing influ- ences leading to drunkenness they found the medical use of alcoholics. The early efforts of these women were chiefly in rescue work through Gospel temper- ance meetings, and visitations of jails and poor- houses. By reason of this contact with the effects of inebriety they learned many sad tales of ruined lives, blighted homes and lost souls, through the appetite for strong drink created, or aroused, by alcoholic prescription. They saw, as time passed, thatsome of the drunkards reclaimed through their influence lapsed again into their evil habits because a little beer, or wine, " for the stomach's sake," or some other sake, had been advised them. Some of the workers had this trouble in their own homes, husband, son or other relative enslaved to alcohol through prescription in disease. Is it any wonder 21 22 ALCOHOL AS A MEDICINE. that women of the spirit of the Crusaders, having once had their attention thoroughly aroused to the danger of alcohol in medicine, should begin to ex- amine this stronghold of the enemy to discover, if possible, whether or not, his fortress, the medicine- chest, was impregnable ? Greatly to their joy they found that the medical profession was not a unit in commending alcoholics as remedial agencies, that all along since alcohol came into common use there have been physicians who distrusted, and opposed it. They learned, too, that some of the most dis- tinguished physicians of America and of England were using little or no alcohol in their practice, and that a hospital had been established in London, England, which was clearly demonstrating the su-* periority of nonralcoholic medication by its small death-rate in comparison with hospitals using al- cohol. This knowledge encouraged those possessing it so that they began to refuse alcoholics as remedies in their own households, and rarely did they find physicians unwilling or unable to supply another agent when asked to do so, and thousands of women can now testify to the fact of having recovered from ill health without the wine, beer or brandy they were advised to take. So the W. C. T. U. discovered several good reasons for opposing alcohol in medi- cine. I. Its liability to create or revive an uncontrollable appetite. Z. A considerable number of the leading physician? of ALCOHOL AS A MEDICINE. 23 America and of Great Britain discard it from their list of remedies, considering it harmful rather than helpful. 3. The lessened mortality consequent upon its entire disuse demonstrated by the London Temperance Hospital. 4. By their own experience they knew that alcohol is not necessary to the restoration of health, nor to the upbuilding of strength. The first active work touching the medical use of alcohol was a memorial from the National W. C. T. U. to the International Medical Congress of 1876, which met in Washington, D. C. This memorial was suggested by Miss Frances E. Willard, and co- operated in by the National Temperance Society. It asked for a deliverance from the Congress upon alcohol as a food and as a medicine. The Congress was divided into sections for the more thorough discussion of the various topics. Upon the program was a paper on " The Therapeu- tic Value of Alcohol as Food, and as a Medicine," by Ezra M. Hunt, M. D., delegate from the New Jersey Medical Society. This paper was read before the " Section on Medicine," and, after earnest dis- cussion, the conclusions of the author were adopted '' quite unanimously " as the sentiments of the Sec- tion on Medicine. As such they were reported for acceptance to the General Congress, and by it ordered to be transmitted as a reply to the memori- alists. The report was published in full by the National Temperance Society, and may be obtained from it 24 ALCOHOL AS A MEDICINE. in paper binding for twenty-five cents. As it makes a book of 137 pages the conclusions only will be quoted here. They are as follows : — 1. " Alcohol is not shown to have a definite food value by any of the usual methods of chemical analysis or physiological inves- tigation. 2. " Its use as a medicine is chiefly that of a cardiac stimulant, and often admits of substitution. 3. " As a medicine it is not well fitted for self-prescription by the laity, and the medical profession is not accountable for such administration, or for the enormous evil arising therefrom. 4. " The purity of alcoholic liquors is in general not as well assured as that of articles used for medicine should be. The various mixtures when used as medicine should have definite and known composition, and should not be interchanged pro- miscuously." It is matter for sincere regret that this deliverance was not, in some way, brought prominently before every physician in the land. There are, doubtless, thousands of physicians who never heard of it, and, consequently have never been influenced by it to doubt the utility of the popular brandy bottle. In 1883 Mrs. Mary Towne Burt, President of New York State W. C. T. U., in her annual address, suggested that a department of work be created to endeavor to induce physicians to not prescribe alcohol, unless in such cases as allowed of the use of no other agent. Mrs. (Rev.) J. Butler, of Fairport, was the first superintendent of this department, which was named, " Influencing Physicians to not Prescribe Alcoholics as Medicines." The National W. ALCOHOL AS A MEDICINE. 25 C. T. U. adopted the department in 1883, but soon dropped it. In 1895 it was reinstated and Mrs. Mar- tha M. Allen, New York's superintendent, was made national superintendent. In 1905 the name of the department was changed from Non-Alcoholic IMedica- tion, which it had borne for fifteen years, to Medical Temperance. The objects of this department of work are: 1. To inform the public of the objections to the medical use of alcoholic drinks now held by many suc- cessful physicians. 2. To show the dangers in the home-prescription of alcohol and other powerful drugs. 3. To expose fraudulent and dangerous proprietary and "patent" medicines and liquid ''foods," the main ingredients of which are alcohol and morphine. 4. To use persuasion with pubhshers of newspapers and magazines against fraudulent medical advertis- ing. Also to seek legislation which shall hinder such advertising. 5. To endeavor to win the attention of physicians who prescribe alcoholic liquors to the teachings of great leaders in their profession who have abandoned such practice. 6. To bring to the attention of nurses the same teachings, and to seek their co-operation in education against the self-prescription of alcohol. 7. To work for legislation which shall correct the evils of the whisky drug-store, the whisky-prescrib- ing doctor, and the dangerous ''patent'^ iMedicine. 8. To gather the opinions upon alcohol of well- 26 ALCOHOL AS A MEDICINE. known physicians who do not use it, and publish them. This department originated the pubHc agitation against injurious and fraudulent "patent" medicines which later was so ably carried on by Collier's Weekly, and the Ladies' Home Journal. That its early work in this direction was not better known to the general public was due to the fact that religious as well as secular papers were reaping large revenues from the advertising of these nostrums, and consequently re- fused to publish anything which might injure the trade. Indeed, in accepting some of this advertising, newspaper managers had to sign a contract that they would not publish any reading matter opposed to the nostrum business. The Christian Advocate of New York city deserves special mention for having published in 1898 two arti- cles written by Mrs. Allen under the caption, "The Danger and Harmfulness of Patent Medicines." These were in the fall of that year published in pamphlet form, and a copy sent to every local W. C. T. U. in the United States for study. Tens of thou- sands of copies of this and other leaflets on that theme were distributed within a few years, some local unions placing them in every home in their community. Med- ical journals took note of this work and commended it highly. When Mr. Bok began his campaign of edu- cation in the Ladies' Home Journal, for which he de- serves lasting gratitude, the American Druggist said he was "bowing to the clamor of the W. C. T. U." This department which began in weakness, and was for years regarded as fanatical even by many mem- ALCOHOL AS A MEDICINE. 2/ bers of the W. C. T. U. has entered upon an era of victories. The National Pure Food Law requires the percentage of alcohol in patent medicines, and the pres- ence of different dangerous drugs, to be stated upon the label. The prohibition law of Georgia forbids physicians to prescribe alcoholic beverages, absolute alcohol only being permitted. Kansas has amended her law so that whisky drug-stores are eliminated. If physicians prescribe alcohol the law forbids charge for it. Alabama forbids the sale of liquor for every- thing but the communion. The Internal Revenue De- partment has examined a large number of "patent" medicines and has listed them as intoxicating bever- ages. Two state medical societies and some county societies in 1908 passed resolutions to discourage the medical use of alcoholic liquors. Two national socie- ties of druggists and pharmacists in 1908 passed reso- lutions against whiskey drug-stores. These are some of the results of Medical Temper- ance agitation. Much more may be expected in the next decade if the work is as faithfully "and fearlessly carried on as in the past. This book contains much of the teachings of the de- partment of Medical Temperance. When these views are generally accepted the liquor-problem will be well- nigh solved. CHAPTER III. ALCOHOL AS A PRODUCER OF DISEASE. That alcohol is a poison is attested by all chemists and other scientific men ; taken undiluted it destroys the vitality of the tissues of the body with which it comes in contact as readily as creosote, or pure carbolic acid. The term intoxicating applied to beverages containing it refers to its poisonous nature, the word being derived from the Greek toxicon, which signifies a bozv or an arrow ; the barbarians poisoned their arrows, hence, toxicum in Latin was used to signify poison ; from this comes the English term toxicology, which is the science treating of poisons. Druggists in selling proof spirits usually label the bottle, "Poison." Apart from the testimony of science in regard to its poisonous nature, it is commonly known that large doses of brandy or whisky will speedily cause death, particularly in those unaccustomed to their use. The newspapers frequently contain items regarding the death of children who have had access to whisky, and drunk freely of it. Cases are reported, too, of men, habituated to drink, who after tossing off several glasses of brandy at the bar of a saloon have suddenly dropped dead. 28 ALCOHOL AS A MEDICINE. 29 Dr. Mussey says : — " A poison is that substance, in whatever form it may be, which, when applied to a living surface, disconcerts and dis- turbs life's healthy movements. It is altogether distinct from substances which are in their nature nutritious. It is not capable of being converted into food, and becoming a part of the hving organs. We all know that proper food is wrought into our bodies ; the action of animal life occasions a constant waste, and new matter has to be taken in, which, after digestion, is carried into the blood, and then changed ; but poison is incapable of this. It may indeed be mixed with nutritious sub- stances, but if it goes into the blood, it is thrown off as soon as the system can accomplish its deliverance, if it has not been too far enfeebled by the influence of the poison. Such a poison is alcohol — such in all its forms mix it with what you may." Dr. Nathan S. Davis said in an address given in 1891:— " When largely diluted with water, as it is in all the varieties of fermented and distilled liquids, and taken into the stomach, it is rapidly imbibed, or taken up by the capillary vessels and carried into the venous blood, without having undergone any digestion or change in the stomach. With the blood it is carried to ever^^ part, and made to penetrate every tissue of the living body, where it has been detected by proper chemical tests as unchanged alcohol, until it has been removed through the natural process of elimination, or lost its identity by molecular combination with the albuminous elements of the blood and tissues, for which it has a strong affinity. "The most varied and painstaking experiments 9^ chemists and physiologists, both in this country and Europe, have shown conclusivelv that the presence of alcohol in the blood dimin- ishes the amount of oxygen taken up through the air-cells of the lungs ; retards the molecular and metabolic changes of both 30 ALCOHOL AS A MEDICINE. nutrition and waste throughout the system and diminishes the sensibility and action of the nervous structures in direct propor- tion to the quantity of alcohol present. By its stronger affinity for water and albumen, with which it readily unites in all pro- portions, it so alters the hemaglobin of the blood as to lessen its power to take the oxygen from the air-cells of the lungs and carry it as oxyhemaglobia to all the tissues of the body ; and by the same affinity it retards all atomic or molecular changes in the muscular, secretory and nervous structures ; and in the same ratio it diminishes the elimination of carbon-dioxide, phos- phates, heat and nerve force. In other words, its presence diminishes all the physical phenomena of life. " I say, then, that from the facts hitherto adduced, whether from accurate experimental investigations in different countries, from the pathological results developed in the most scientific societies, from the most reliable statistics of sickness and mor- tality, as influenced by occupations and social habits, or from the life insurance records kept on a uniform basis through periods of ten, twenty, thirty or even forty years, it is clearly shown that alcohol when taken into the human system not only acts upon the nervous system, perverting its sensibility, and, if increased in quantity, causing intoxication or insensibil- ity, but it also, even in small quantities, lessens the oxygena- tion and decarbonization of the blood and retards the molecular changes in the structures of the body. When these effects are continued through months and years, as in the most temperate class of drinkers, they lead to per7nanent structural changes, most profuinently in the liver, kidneys, stomach, heart, blood- vessels and nerve structures, and lessen the natural duratio7t of life in the aggregate fro?n ten to fifteen years. Conse- quently there is no greater, nor more destructive error existing in the public mind than the belief that the use of fermented and distilled drinks does no harm so long as they do not in- toxicate. " Another popular error is the opinion that the substitution ALCOHOL AS A MEDICINE. 3 1 of the different varieties of beer and wine in the place of dis- tilled liquors promotes temperance, and lessens the evil effects of alcohol on the health and morals of those v^ho use them. Accurate investigations show that beer and wine drinkers gen- erally consume more alcohol per man than the spirit drinkers ; and while they are not as often intoxicated, they suffer fully as much from diseases and premature death as do those who use distilled spirits. Again, the beer drinker drinks more nearly every day, and thereby keeps some alcohol in his blood more constantly; while a large percentage of spirit drinkers drink only periodically, leaving considerable intervals of abstinence, during which the tissues regain nearly their natural condition. The more constant and persistent is the presence of alcohol in the blood and the tissues, even in moderate quantity, the more certainly does it lead to perverted and degenerative changes in the tissues, efiding in renal (kidney) and hepatic (liver) dropsies, cardiac (heart) failures, gout^ apoplexy and pa- ralysis y Sir B. W. Richardson says : — " Alcohol produces many diseases ; and it constantly hap- pens that persons die of diseases which have their origin solely in the drinking of alcohol, w^hile the cause itself is never for a moment suspected. A man may say quite truthfully that he never was 'tipsy in the whole course of his life; and yet it is quite possible that such a man may die of disease caused by the alcohol he has taken, and by no other cause whatever. This is one of the most dreadful evils of alcohol, that it kills insidiously, as if it were doing no harm, or as if it were doing good, while it is destroying life. Another great evil of it is that it assails so many different parts of the body. It hardly seems credible at first sight that the same agent can give rise to the many different kinds of diseases it does give rise to. In fact, the universality of its action has blinded even learned men as to its potency for destruction. 32 ALCOHOL AS A MEDICINE. " Step by step, however, we have now discovered that its modes of action are all very simple, and are all the same in character ; and that the differences that have been and are seen in different persons under its influence are due mainly to the organs, or organ, which first give way under it. Thus, if the stomach gives way first, we say that the person has indigestion or dyspepsia, or failure of the stomach ; if the brain gives way first, we say the person has paralysis, or apoplexy, or brain dis- ease ; if the liver gives way first, we say the man has liver dis- ease, and so on. " All persons who indulge much in any form of alcoholic drink are troubled with indigestion. When they wake in the morning they find their mouth dry, their tongue coated, and their appetite bad. In course of time they become confirmed * dyspeptics,' and as many of them find a temporary relief from the distress at the stomach, and the deficient appetite from which they suffer by taking more liquor, they increase the quan- tity taken, and so make matters much worse. ***** "There are a great number of diseases caused by alcohol, some of which are known by terms that do not convey to the mind what really has been the cause of the diseases." They are : {a) Diseases of the brain and nervous system : indicated by such names as apoplexy, epilepsy, pa- ralysis, vertigo, softening of the brain, delirium tre- mens, loss of memory and that general failure of the mental power called dementia. (B) Diseases of the lungs: one form of consumption, congestion and subsequent bronchitis, [c) Diseases of the heart : irregular beat, feebleness of the muscular walls, dila- tion, disease of the valves, id) Diseases of the blood : scurvy, dropsy, separation of fibrine. {e) Diseases of the stomach : feebleness of the stomach and indi- ALCOHOL AS A MEDICINE. 33 gestion, flatulency, irritation and sometimes inflam- mation. (/) Diseases of the bowels : relaxation or purging, irritation, {g) Diseases of the liver: con- gestion, hardening and shrinking cirrhosis. (Ji) Diseases of the kidneys : change of structure into fatty or waxy-like condition and other changes lead- ing to dropsy. (/) Diseases of the muscles : fatty changes in the muscles, by which they lose their power for proper active contraction. (/) Diseases of the membranes of the body : thickening and loss of elasticity, by which the parts wrapped up in the membrane are impaired for use, and premature decay is induced. But it constantly happens that when deaths from these diseases are recorded and alcohol has been the primary cause, some other cause is believed to have been at work. While drinking parents by virtue of a strong con- stitution sometimes escape the penalty of their bibulous habit, it is not uncommon to see their children suffering from some disease or nervous weakness such as is caused by alcohol, ** the sins of the father being visited upon the children." Erasmus Darwin says upon this point : — " It is remarkable that all the diseases from drinking spiritu- ous or fermented liquors are liable to become hereditary, even to the third generation, gradually increasing, if the cause be contmued, till the family become extinct." Prof. Christison, of Edinburgh, in answer to in- 34 ALCOHOL AS A MEDICINE. quiries from the Massachusetts State Board of Health, says of general diseases due to alcohol : — " I recognize certain diseases which originate in the vice of drunkenness alone, which are delirium tremens, cirrhosis of the liver, many cases of Bright's disease of the kidneys, and dipso- mania, or insane drunkenness. " Then I recognize many other diseases in regard to which excess in alcoholics acts as a powerful predisposing cause, such as gout, gravel, aneurism, paralysis, apoplexy, epilepsy, cystitis, premature incontinence of urine, erysipelas, spreading cellular inflammation, tendency of wounds and sores to gangrene, in- abihty of the constitution to resist the attacks of epidemics. I have had a fearful amount of experience of continued fever in our infirmary during many epidemics, and in all my experience I have only once known an intemperate man of forty and up- wards to recover." Professor Christlson also claims that three-fourths, or even four-fifths, of Bright's disease in Scotland is produced by alcohol. Dr. C. Murchison, in speaking of alcohol as a pre- ventive of disease, says : — " There is no greater error than to imagine that a liberal •allowance of alcoholic liquids fortifies the system against con- tagious diseases." In a paper read before the Royal Medical and Chirurgical Society, Oct. 22, 1872, Dr. W. Dickin- son gave the following conclusions : — • " Alcohol causes fatty infiltration and fibrous encroachments ; it engenders tubercles ; encourages suppuration, and retards heahng ; it produces untimely atheroma (a form of fatty degen- eration of the inner coats of the arteries), invites hemorrhage, ALCOHOL AS A MEDICINE. 35 and anticipates old age. The most constant fatty changes, re- placement by oil of the material of epithelial cells and muscular fibres, though probably nearly universal, is most noticeable in the liver, the heart and the kidneys. Drink causes tuberculo- sis, which is evident not only in the lungs, but in every amena- able organ." Dr. William Hargreaves says : — • " Brandy is not a prophylactic. To the temperate it is an active, exciting cause. It is well known that a single act of intemperance during the prevalence of cholera, will often pro- duce a fatal attack. The sense of warmth and irritation (called stimulation) produced by alcoholic liquors, has led to the erroneous notion that they may prevent cholera. But the contrary we have seen is the truth, for the effects of alcoholics are to reduce the temperature of the body, and instead of stimulating, they narcotize, and reduce the life-forces, and predispose the system to all kinds of disease." The following testimonies are culled from the writings of eminent physicians : — Sir Andrew Clark, rvl. D., F. R. C. P., London, Physician in Ordinary to the Queen, Senior Physician at the London Hospital : " As I looked at the hospital wards to-day, and saw that seven out of ten owed their diseases to alcohol, I could but lament that the teaching about this question is not more direct, more decisive and more home-thrusting. ***** Can I say to you any words stronger than these of the terrible effects of alcohol } When I think of this I am disposed to give up my profession, and go forth upon a holy crusade, preaching to all men — Beware of this e7iemy of the race." Sir William Gull, F. R. S. (late Physician to her Majesty) : " I should say, from my experience, that alcohol is the most destructive agent that we are aware of in this country. I would like to say that a very large number of people in society 36 ALCOHOL AS A MEDICINE. are dying day by day, poisoned by alcohol, but not supposed to be poisoned by it." Dr. Abernethy : " If people will leave off drinking alcohol, live plainly, and take very little medicine they will find that many disorders will be relieved by this treatment alone." Dr. Forel, of the University of Zurich, Switzerland : " Life is considerably shortened by the use of alcohol in large quanti- ties. But a moderate consumption of the ^ame also shortens life by an average of five to six years. This is consistently and unequivocally seen in the statistics kept for thirty years by English insurance companies, with special sections for ab- stainers. They give a large discount, and still make more profit, as not nearly so many deaths occur as might be expected under the usual calculations. According to federal statistics in the fifteen largest towns of Switzerland, over ten per cent, of the men over twenty years of age die solely, or partly of alco- holism." Dr. J. H. Kellogg, Battle Creek, Mich. : " Every organ feels the effect of the abuse through indulgence in alcohol, and no function is left undisturbed. By degrees, disordered function, through long continuance of the disturbance, induces tissue change. The most common form of organic or structural disease due to alcohol is fatty degeneration, which may effect almost every organ in the body. ***** No class of persons are so subject to nervous diseases due to degeneration of nerves and nerve-centres as drinkers. Partial or general paralysis, locomotor ataxia, epilepsy and a host of other nervous disorders, are directly traceable to the use of alcohol." One of the visiting physicians of Bellevue Hos- pital, New^ York, states that at least two-thirds of all the diseases treated there originated in drink. Dr. W. A. Hammond : " It is of all causes most prolific in exciting derangements of the brain, the spinal cord, and the nerves," CHAPTER IV. TEMPERANCE HOSPITALS. THE LONDON TEMPERANCE HOSPITAL. In 1865 Dr. S. Nicholls, medical officer of the Longford Poor-law Union, published a report of the results of non-alcoholic treatment of disease as practiced by him for sixteen years in the institutions under his control. The figures for 1865 were : — ADMITTED. RECOVKRED. DIED. Fever, 142 135 7 Scarlatina, 33 30 3 Small-pox, 48 47 I Measles, 8 8 231 220 II The treatment was altogether without wines, spirits or alcohol in a7iy form. The death-rate reported by Dr. Nicholls was so small that some of the more observing and pro- gressive physicians were led by it to begin similar experiments in the disuse of alcohol in other hospi- tals. Among these was Dr. James Edmunds, senior physician at the Lying-in Hospital, London. The experiments continued a year with a reduced death" V 38 ALCOHOL AS A MEDICINE. rate among both mothers and children. But the great brewers of London, who contributed largely to the support of this hospital raised such a storm of opposition to the discontinuance of alcoholic liquors that the experiments had to be abandoned. The establishment of a temperance hospital was now suggested, and in October, 1873, ^ temporary- institution was opened in Gower Street, accommoda- ting only seventeen in-patients at one time. Later a fine site w^as secured on Hampstead Road, and in 1881 the east wing and centre were opened by the Lord Mayor of London. In 1885 the west wing was finished, and the opening ceremonies conducted by the Bishop of London. At the time of the launching of this enterprise, wine and spirits were literally " poured into " sick persons, with frightful results. Death-rates were enormous. The success of the Temperance Hospi- tal has no doubt had much to do in modifying this abuse. Its death-rate, on an average, has been only 6 per cent, throughout the years since its beginning. This is lower than that of any other general hospi- tal in London, and certainly proves conclusively that alcohol is not necessary in the treatment of disease. The physicians connected with it have been men of eminence in the profession, such as Dr. James Edmunds, Dr. J. J. Ridge and Sir B. W. Richardson. The visiting staff is not compelled to pledge dis- use of alcohol, but is required to report if it is used. ALCOHOL AS A MEDICINE. 39 During all these years it has been given only seven- teen times, then almost entirely in surgical cases, and in nearly all of these a fatal result proved it to be useless. The patients who are restored to health leave without having had aroused or im- planted in them a desire for alcoholic liquors, neither have they been taught to regard them as valuable aids to the recovery of health and strength. On the contrary, there have been many who have come in, suffering from this delusion, who have had it thoroughly dispelled, both by their own experi- ence and the experience of their fellow patients. Sir B. W. Richardson took charge of this hospital from 1892 until his death in 1897. In his report in 1893 he said : — " I remember quite well when according to custom, I should have prescribed alcohol in all those cases that were not actually inflammatory (speaking of diseases of the alimentary system) ; but I never remember having seen such quick and sound recoveries as those which have followed the non-alcoholic method." The following selection showing points of prac- tice in this hospital is taken from the same report : " For medicinal purposes, we are as free as possible from all complexity. We use glycerine for making what may be called our tinctures, and in my chnique I am introducing a series of ' waters ' — aqua ferri, aqua chloroformi, aqua opii, aqua quinae, and so on — to form the menstruums of other active drugs when they are called for. I also follow the plan of having the medi- cines administered with a free quantity of water, and with as accurate a dosage as can be obtained, for I agree with Mr. 40 ALCOHOL AS A MEDICINE. Spender's original proposition that the administration of medi- cines in comparatively small and frequent doses is more effective and useful than the more common plan of large doses given at long intervals. " I treat many cases by inhalation, and for this end I use oxygen in a new and, I hope, efficient manner. I make oxygen gas a medium for carrying other volatile substances that admit of being inhaled with it. The mode is very simple, ***** In the pneumonic and bronchial cases the treatment has been of the simple and sustaining kind. The medicines that have been given during the acute febrile stages have been chiefly liquor ammoniae acetatis and carbonate of ammonia in small and frequently repeated doses. The patients have all been well and carefully fed on the milk and middle diet until con- valescence was declared. In some of the more extreme in- stances, where there was fear of collapse from separation of fibrine in the heart or pulmonary artery, ammonia has been given freely according to the method I have for so many years inculcated. I have also in cases of depression under which fibrinous separation is so easily developed, lighted on a mode of administering ammonia which combines feeding with the medicine. I direct that a three or five-grain tabloid of bicar- bonate of ammonia shall be dissolved in a cup of coffee or of coffee with milk, and be taken by the patient in that man- ner. The coffee can be sweetened with sugar if that is desired by the patient, and the ammonia can be so administered with- out any objectionable taste to the beverage. After what is called the crisis in acute pneumonia, I administer very little medicine of any kind ; I trust rather to careful feeding with an occasional alterative or expectorant, as may be required. *****! am satisfied that no aid I could have derived from alcoholic stimulants, as they are called, could have bettered my results. I feel sure any candid medical brother who will have the steady courage to put aside many old and unproven, though much-practiced, methods, based only on unquestioning and ALCOHOL AS A MEDICINE. 4I unquestioned experience, and to move into these new fields of observation and experience, will, in the end, find no fault with me for leaving a track which, though it be beaten very firmly and be very wide and smooth to traverse, may not, after all, be the surest and soundest path to the golden gate of cure." THE FRANCES E. WILLARD NATIONAL TEMPERANCE HOSPITAL. This hospital is situated at 343-349 South Lincoln Street, Chicago, in a handsome and well-equipped building. It is connected with a medical school. The history of its origin is best told in the words of the woman to whom the conception of such an institution first came, Dr. Alary Weeks Burnett, for several years the physician in charge: — " In the fall of 1883 there came to a few of us the thought that there was a point of weakness in the temperance pledge. It reads, ' We promise to abstain from all liquors — as a bever- age.' We had found in many instances in reform work that pledging to abstain from liquor ' as a beverage,' and leaving the victim to the unlimited use of it in physicians' prescriptions, was simply a skirmish with the devil's outposts, that the con- flict, based upon these grounds, was short, and defeat almost sure ; and the great fact remained that the innermost recesses of evil force and power were by this pledge still left unassailed. We found that this power of evil had largely entered the homes of our land through the family physicians, and that willingly or not, the physicians were being used to bring in even our inno- cent children as recruits to this unrighteous warfare. " Now, how could we hope to eliminate those three little words ' as a beverage ' from our pledge .'* " In some way we must bring about an arrest of thought in the minds of 100,000 men and women physicians whose medi- 42 ALCOHOL AS A MEDICINE. cal education warranted them in supposing that they knew that of alcohol which justified them in its full and free use in medi- cal practice. Nothing short of a great national object lesson could ever convict and convert this broad constituency through which the power of darkness is doing his deadliest work. " In January, 1884, four of us met and organized under the name of the National Temperance Hospital. To have our sick properly cared for in our hospital we found that we should be obliged to train our own nurses. The nurse who has always been accustomed to administering alcohol under the physician's prescription at all times and under all circumstances, and to ad- ministering it herself at her own discretion if the physician is not at hand, is a terror to the temperance physician. So we in- cluded in our charter a Training School for Nurses. It is now open, and we expect, as the years go by, to send out armed with our training school diplomas, grand, noble women and men thoroughly trained in true temperance methods for reliev- ing the sick. " Our organization lived on paper, and was sustained in pur- pose by prayer and planning for two years. In September, 1885, Mr. R. G, Peters, of Manistee, Michigan, signified to us his intention to give ^50,000 toward our buildings whenever we had satisfactorily materialized. About the same time a good old gentleman in Michigan placed in his will for us $2,500. The dear man is still living, and we hope will live many years. Even the money when it comes can never be of greater service to us than was the knowledge at that time that the Lord was our leader and was raising up helpers in the work. "In January, 1886, we found, according to the law under which our charter was obtained, that we must commence active operations at once, or obtain a new charter. After a blessed season of prayer and counseling together in the board meeting held January 29, there being present only the members of the board at that time, Mrs. Plumb offered to advance $3,500, if necessary, toward the expenses for the first year. We accepted ALCOHOL AS A MEDICINE. 43 it with great thankfulness, rented a building the 15th of March, 1886, and formally opened the National Temperance Hospital on the 4th of May, 1886. " In April, 1886, we took a firm stand upon the alcohol ques- tion, and decided to eliminate it entirely from our list of thera- peutics, as we had become convinced that there were better and more reliable remedies as stimulants and tonics. "In September, 1886, at our annual meeting, we reaffirmed this decision, and we now have the following as one of the arti- cles of our constitution : 'All medicines used in the hospital must be prepared without alcohol, and all physicians accepting positions on the medical staff of the hospital or dispensary must pledge themselves not to administer alcohol in any form to any patient in hospital or dispensary, nor to call in counsel for such patients any physician who will advise the use of alcohol. " Any physician of pure character, and in good standing, who is a total abstainer from liquor and tobacco can, by subscribing to this pledge, become a member of our physicians' association, and if so desired, be placed upon the visiting and consulting staff of the hospital. " The cases treated in the hospital include many of the seri- ous medical and surgical maladies. In no case has any parti- cle of alcohol been used, and the usual inflammatory secondary symptoms resulting when alcohol is used have been entirely avoided. " Our course of building-up treatment is, we believe, unique in hospital practice. It consists of treatment by massage, heat, rest, passive exercise, etc. together with proper medication and a thoroughly nutritious diet adapted to the individual needs of the patient. "To alleviate, and, if possible, cure disease, is the design of all hospital treatment. In our hospital we seek to gain this re- sult by means which the highest science of the day approves, and in addition to this we have especially at heart the advance- 44 ALCOHOL AS A MEDICINE. ment of the temperance reform. There are, we believe, thou* sands of temperance adherents, who do not yet fully apprehend the importance of this hospital to the permanent extension and progress of temperance principles. Although prohibition as a principle has been accepted by many, yet in its practical appii- catio7t in the home in serious illness, it is still feared by the im- mense majority of even our strongest prohibitionists. We are organized upon the basis 7io alcohol in fnedicine, and we are preparing to demonstrate fully and scientifically, so he who runs may read, that as in health, so in disease and accident, alcohol in any form works to the hindrance and injury of the vital forces, and prevents the establishment and advancement of health processes in the system." At the opening of the hospital, May 4, 1886, Miss Frances E. Willard, the president of the National W. C. T. U., gave the following address : — " Nothing is changeless except change. The conservatives of one epoch are the madmen of the next, even as the radicals of to-day would have been the lunatics of yesterday. To prove this, just imagine the founders of this hospital declaring to my great-grandfather that because he had taken a cold was no rea- son why he should take a toddy ; and per contra, imagine my great-grandfather's doctor marching into our presence here and now, with saddle-bags on arm, and after treating us each to a glass of grog for our stomach's sake, giving us a scientific disquisition on the sovereign virtues of the blue pill, and inform- ing us that bleeding, cupping and starvation were the surest methods of cure ! " That the story of Evolution is true I am by no means certain, but that ' We, Us, and Company,' are ' evoluting ' with elec- tric speed ourselves it is useless to deny. This very hospital is the latest mile-stone on the highway of progress in the Ameri- can temperance reform. The conditions that have made its ALCOHOL AS A MEDICINE. 45 existence possible have developed in this country within about twelve years. " Public opinion, that mightiest of magicians, has within that time been educated up to this level and has said in its omnipo- tence : ' Hospital, be ! ' and, behold, the hospital zs. "When I joined the ranks of temperance workers in 1874, a thought so adventurous as that alcoholics in relation to medi- cine were a curse and not a blessing had never lodged within my cranium. But, as in duty bound, I studied the subject from the practical, which is the nineteenth century standpoint. " I investigated the cause of inebriety, and found the medical use of alcoholic stimulants a prominent factor in this horrible result ; I sought for expert testimony, and found Dr. N. S. Davis, ex-President American Medical Association, saying ' that in bis ample clinical practice he had for over thirty years tested the medical uses of alcoholics, and had found no case of disease and no emergency arisi7ig from accident that he could not treat more successficlly tvithout any form of fermented or distilled liquors tha7i with' ; found Dr. James R. Nichols^ of Boston, so long editor of The fournal of Chemistry, declaring as his deliberate scientific opinion that the entire banishment of these liqifors ' would not deprive us of a single one of the indis- pensable agents which modern civilization demands' ; found Dr. Green, of Boston, saying before the physicians of that city that it is upon the members of the medical profession and the excep- tional laws which it has always demanded, that the whole liquor fraternity depends more than upon anything else to screen it from opprobrium and just punishment for the evils it entails, and that after thirty years of professional experience he felt assured that alcoholic stimulants are not required as medi- cines, and that many, if not a majority of the best physicians, now believe them to be worse than ttseless. Meanwhile I learned that across the sea such great physicians as Dr. Benja- min Ward Richardson, St Andrew Clark, Sir Henry Thompson and Sir William Gull held views v/hich for their latitude were 4^ ALCOHOL AS A MEDICINE. almost equally radical ; and Dr. James Edmunds, founder of the London Temperance Hospital had demonstrated publicly and on a grand scale the more excellent way, his hospital having 4| per cent, fewer deaths than any other in London, taking the same run of cases, and that the Royal Infirmary at Manchester reported the medicinal use of alcohol fallen off Sy per cent, in recent years, with a decrease in its death-rate of over one-third. Besides all this, and independent of any such investigation, the * intuitions ' of our most earnest women were leading them out of the wilderness. As is their custom, they determined to put this matter to the test of that ' experience which one experi- ences when he experiences his own experience,' and a whole body of divinity upon the advantages of non-alcoholic treatment could be furnished from their evidence. I was not able person- ally to pursue this method, my own condition of good health having become chronic. Away back in 1875, in executive committee, one of our leading officers was stricken with ajigina pectoris. A physician was promptly summoned. ' Give her brandy,' he said, and insisted so stoutly upon it as vital to her recovery that we should probably have sent for it, but the dear woman gasped out faintly, ' I can die, but I can't touch brandy.' She is alive and flourishing to-day. Another national officer absolutely refused whis-ky for a violent attack of a very different character, the physician telling her that she could not live through the night without it ; but she is still an active worker — a living witness that doctors are not infallible. Instances like these have multiplied by hundreds and thousands in our Woman's Christian Unions and Bands of Hope. * No, mamma I can't touch liquor; I've signed the pledge,' is a protest ' familiar as household words.' Meanwhile, I beg you to con- template something else that has happened. Behold, our own beloved beverage itself, ' Sparkling and bright. In its liquid light,' has come grandly to our rescue in this crusade against alcohol AI.COHOI. AS A MEDICINE. 47 in the sick room. Water has become a favorite — nay, even a fashionable — medicine ! The most conservative physicians freely prescribe it in the very cases where some form of al- cohol was the specific so long. To be sure, they give it hot, but we do not object to that, since 'water hot ne'er made a sot,' and it cures dyspepsia and all forms of indigestion as whisky never did, but only made believe to ; while its ex- ternal use as a fomentation is banishing alcohol even for old folks' 'rheumatiz' where, as a remedy, it would be likely to make its final stand. "Farewell, thou cloven-foot. Alcohol ! Thou canst no longer hide away in the home-like old camphor bottle, paregoric bot- tle, peppermint bottle or Jamaica-ginger bottle ; and a tender good-by, Mrs. Winslow's Soothing Syrup, for be it known to you that the wonderful discovery stumbled over for six thou- sand years has in our day been made, namely, that hot water will soothe the baby's stomach-aches and the grown people's pains, and drive out a cold when all else fails. Jubilate! Clear out the cupboard and top shelf of the closet now that the sideboard has gone. Let great Nature have a glance to 'mother up' humanit}^ with the medicine, as well as the beverage, brewed in Heaven." THE RED CROSS HOSPITAL. A philanthropic young woman, Miss Bettina A. Hofker, entered Alount Sinai Training School for Nurses in 1891. Her desire was to fit herself as a nurse for the poor. After her graduation in 1893, she met Mrs. Charles A. Raymond, a benevolent lady, who offered her pecuniary assistance in her work. Miss Hofker suggested that she would like to institute a Red Cross Hospital and Training School for Nurses. Mrs. Raymond succeeded in in- teresting others in the proposition. The name of 4^ ALCOHOL AS A MEDICINE. Red Cross however could not be used without permission of the officers of the society bearing that name, but after consultation with Miss Barton, permission was granted. Several years previous to this, Dr. A. Monse Lesser, Dr. Thomas McNichoU and Dr. Gottlieb Steger had opened a small hospital under the name of St. John's Institute. This was now amalgamated with the Red Cross, and Dr. George F. Shrady and Dr. T. Gaillard Thomas, two of New York's leading physicians, were requested to act as consulting physicians. The hospital does not confine itself to service in its building alone, but sends its workers wherever called, to mansion or tenement. The *' Sisters " are trained for field service or for any national calamity such as floods, earthq'uakes, forest fires, epidemics, etc. When neither war nor calamities require their presence, they devote themselves to the service of the needy poor, or wait upon the rich, if called. The heroic service rendered by the surgeons and nurses from this hospital in the Cuban War, brought their work into great prominence. At the suggestion of Miss Barton, the medical department of the hospital was commissoned to treat diseases without the use of alcoholic liquids. Dr. Lesser, the executive surgeon, is a German, and of German education, having received his med- ical education in the Universities of Berlin and Leipsic. In a conversation with a press represent- ative, Dr. Lesser said some time ago : — ALCOHOL AS A MEDICINE. 4g " We have been convinced that the use of alcohol can be entirely eliminated from our medical practice, and this has been practically accomplished at the Red Cross Hospital. We find that where stimulants are required, such remedies as caffeine, nitro-glycerine and kolafra take the place of alcohol, and are even more satisfactory. The main use of alcohol is to stimulate the action of the heart in various ailments. The blood is thus forced to the remote parts of the system, and poisonous sub- stances carried away. But, besides serving this good purpose, the drug tears down and ultimately destroys the cellular tissues of the body. A relapse is certain to follow the application. The drugs that I have mentioned serve exactly the same purpose without the disastrous results. We are proving this every day at the Red Cross Hospital. " Only a few days ago a boy was brought in, apparently at the point of death. He was put into bed and watched by the nurse. After a little ammonia had been given to him as a stimulant, he unconsciously expressed himself to the effect that it was not the same as they gave him in another place, and gradually when it dawned upon him that no alcohol was administered by the Red Cross, he said, ' Gin has allers made me better.' The doctor in charge, who already suspected that the boy was pretending illness for the sake of the drink, was not surprised an hour or two afterwards to learn that he had demanded his clothes, dressed himself, and left the hospital most ungratefully, but apparently quite well." Dr. George F. Shrady, one of the consulting phy- sicians, is famous as having been in attendance upon both President Garfield and President Grant. He is the editor of the Medical Record^ one of the most important medical journals published in America. While not a non-alcoholic physician, he says of the medical use of intoxicants :— 50 ALCOHOL AS A MEDICINE. " There is altogether too much looseness among physicians in prescribing alcohol. It is a dangerous drug. There is much more alcohol used by physicians than is necessary, and it does great harm. Whisky is not a preventive ; it prevents no dis- ease whatever, contrary to a current notion. Another thing, we physicians get .blamed wrongfully in many cases. People who want to drink, and do drink, often lay it on to the physician who prescribed it. * * * * * I think that in most cases where alcohol is now used, other drugs with which we are familiar could be used with far better effect, and with no harm- ful results." Dr. Steger, another physician of the staff, says : — " I don't use alcohol at all in my practice. I used to use it, but my observation has been that other drugs do the same work without the harmful results. Alcohol over-stimulates the heart, and tears down the cellular tissues of the system, besides causing other deleterious effects. The use of alcohol is simply a superstition among physicians. They have used it so long that they think they always must. J am not a total abstainer, but that only shows that I take better care of my patients than I do of myself. It is not good for a healthy man to drink, but sometimes folks like myself do things which had better be left undone. I have seen patients in hospitals made absolutely drunk by their physicians." The following interesting items in. regard to practice in this hospital are culled from the report of 1897: — " Temperature was never reduced by active drugs known as antipyretics. " Water was allowed freely after all kinds of surgical oper' ations and in fevers. ■' Alcohol was never used as an internal medicine. ALCOHOL AS A MEDICINE. 5 1 " The free use of water in saline solutions directly injected into the tissues was found of great service. Quarts have been injected that way with most satisfactory results. " Antipyretics were altogether discarded as it is well known that their action diminishes the tone of the heart. Artificial reduction of temperature only deludes one into the belief that the drug has improved the condition of the patient, while in reality, it has no beneficial influence on the disease, and has reduced the vital resistance of the patient. In no case has high temperature harmed a patient and there was every evidence that in some instances a high temperature was preferable to a low one. " Special attention has been given to the use of alcohol in disease, not with any desire to approve or disapprove it, but solely for the purpose of discovering the truth, for nothing seems of greater public interest from a medical standpoint than the truth regarding a subject for which so many virtues are claimed on the one hand, and so many destructive elements proven on the other. ***** "We criticise the treatment of no institution, antagonize no school of medicine, claim no unusual or peculiar scientific virtue, but what we do maintain and insist upon is this ; that the human body may be ever so afflicted, ever so reduced, the heart ever so feeble, and the spark of life ever so dim, the conscientious student of medicine can secure as good results without as with administration of antipyretics, sparkling wines, beers or liquors. " Experience teaches that true science does not antagonize nature. In surgical cases, in septicemia, in pneumonia, or in any of the fevers, water freely administered has proven to be a real source of comfort, and an aid to recovery. It is amazing how favorably diseases terminate under this beneficent bever- age. The withholding of food does not retard, but rather hastens convalescence. 52 ALCOHOL AS A MEDICINE. " In the conduct of our Red Cross patients, irrespective of their condition when admitted, it can be truly said that after treatment began, dehrium has not been witnessed in a single instance, and as our hospital reports indicate, our mortality has been unusually small. " Alcohol has not figured as a life-saver in our institution. Cases of extreme collapse following major operations, cases of pneumonia, where the pulse ranged from i6o to 220, patients suffering from pernicious anaemia, septicaemia, pyaemia, cholera infantum and typhoid fever, some of whom when first seen were in the worst stages of delirium and collapse have without alcohol regained consciousness, overcome delirium and made excellent recoveries. " The following cases very forcibly illustrate the results of non-alcoholic treatment : — " Case No. i. A child, aged nine months, under treatment for six days for pneumonia, came under our notice on the seventh day. The temperature was 106 5-10; pulse was 220; respirations 90. Whisky, which had been given previously to the extent of two ounces daily, was stopped. Carbonate of ammonia, caffeine salicylate, nitro-glycerine and i-io of a drop of aconite were given internally ; camphorated lard applied externally ; with the result that on the ninth day temperature stood 99 ; pulse loo ; respiration 20. The child made a complete recovery. " Case No. 2. L. was a child aged eight months, suffering from a very violent attack of entero-colitis. For three weeks previous to coming under our notice the patient received brandy, stimulating foods and alkaline mixtures. Fearfully emaciated, temperature 106, feeble pulse 182, frequent bloody discharges from the bowels, numbering as much as thirty in a day and constant vomiting, the child was considered beyond hope. Under these circumstances, and at this time we first ^gw her. Brandy and all foods were stopped ; bowel flushings ALCOHOL AS A MEDICINE. 53 were given, 1-12 of a drop of tincture of aconite was adminis- tered every half hour and salicylate of caffeine every two hours. In twenty-four hours the temperature was 105 and the pulse 160. In two days, temperature was 102 and the pulse 140. In one week, temperature was 99 5-10, pulse no. In three weeks, the patient was discharged cured. " Case No. 3. Mrs. C, aged forty-three, who had been under treatment for seven weeks for metorrhagia, nietortes and peri- tonitis came under our notice. Brandy which had been previ- ously given in large quantities had proved of no avail and the patient was considered beyond recovery. We found her com- pletely prostrated, temperature 102, pulse 170, and unconscious. The heart very weak and irregular. The brandy was discon- tinued, salicylate of caffeine and nitrate of strychnia were given with the result that in a short time the patient was con- valescent and finally recovered. "Each case in our hospital is an additional proof that whether found in wines, spirits or beers, alcohol can claim no right as an indispensable medicine." Dr. Lesser, who was Surgeon-General of the American Red Cross in the Cuban War said after his return from his first visit to Cuba that four out of six of his patients, to whom he allowed liquor to be given as a concession to the popular idea that it was necessary, died ; while subsequently in treating absolutely without alcohol sixty-three similar cases, only one died, and he upon the day on which he was received at the hospital. ALCOHOL IN OTHER HOSPITALS. In the spring of 1909 a circular letter was sent to some of the best Known hospitals throughout the coun- 54 ALCOHOI. AS A MEDICINE. try asking if the use of alcoholic liquors had decreased in those institutions during the past ten years. From the replies received the following statements are taken : — Cook County Hospital, Chicago, sent figures for two years only, 1907, and 1908. With 28,932 patients treated in 1907, the bill for wines and liquors amounted to only $719.40. In 1908 with 31,202 patients the bill for liquors amounted to $970.65. This makes a per capita expenditure for liquors for 1907 of .024 cents, and for 1908 a per capita expenditure of .031 cents. The per capita expenditure for liquors during the same years in Bellevue and Allied Hospitals of New York city, with from 30,000 to 40,000 patients treated was .0246 and .029. Two or three cents as the yearly per capita expenditure for alcoholic liquors in the two largest hospitals in America is striking evi- dence that the physicians practicing there have not large faith in whisky, or other alcoholic liquors as remedial agents. Long Island, N. Y., State Hospital: — "We are not using more than half the amount of alcohol we used ten years ago." Manhattan State Hospital, Ward's Island, New York City: — "Our patient population has averaged nearly 4,500 the last four years, and we have had about 750 employees, many of whom are prescribed for by institution physicians. The per capita cost of distilled liquors for the last fiscal year was .0273 at this hos- pital." Milwaukee City Hospital: — "No alcoholic liquors ALCOHOL AS A MEDICINE. 55 are used to any extent in this hospital, or prescribed by the staff. I know of no move against such use of Hquors, but venture the assertion that the physicians believe they have more reliable agents at their com- mand for most cases." Pennsylvania Hospital, Philadelphia: — ''We are now using about one-third the amount of liquor that was used in the Pennsylvania Hospital ten years ago." The Presbyterian Hospital of Philadelphia sent fig- ures for the years from 1900 to 1908. Those for 1900 show the cost of liquors to be $774.20 and for 1908 only $331.48. The number of patients was not given. Grady Hospital, Atlanta, Georgia: — "That less liquor is now used than formerly is a fact well known to all connected with the institution." Garfield Memorial, Washington, D. C., sent figures for ten years. For 1899 the cost of liquors was $490.08, with a steady decrease to 1908 when the cost was $274.58. Number of patients in 1899 was 1,171 ; in 1908, 1,898 patients. The per capita for 1908 was .144 cents. University Hospital, Ann Arbor, Michigan : — ''Very little alcohol is prescribed in this hospital." Maine General Hospital, Portland: — "Compara- tively speaking, we use but little alcohol for the reason that we now have many remedies which, especially for continued use, are superior to alcohol, which twenty years ago we did not have. For the conditions or emergencies in which we think alcohol has a value it is used when required or deemed be&t." 56 AI^COHOL AS A MEDICINE. Buffalo, New York, State Hospital sent figures for six years which include cost of alcohol used in the manufacture of pharmaceutical preparations, which, of course, makes a very decided difference. Per capita for 1903 was 22 cents ; for 1908 it was 18 cents. Buffalo, New York, General Hospital : — "The use of alcohol as a drug in this hospital has diminished about one-third in the past ten years, but I wish to add in this connection that the use of all drugs has diminished in this hospital, and to the best of my knowledge in other institutions of a like character. The use of the microscope, and other studies have advanced the science of medicine the same as all other branches of learning, and other methods are coming to be used beside the use of drugs." Mount Sinai, New York City: — 'The use of alco- holic beverages here for medical purposes is the excep- tion rather than the rule. The majority of our cases are surgical cases, and in these alcoholic liquors are rarely prescribed for any purpose whatsoever." Massachusetts Homeopathic Hospital, Boston, sent figures for five years. For 1904 the cost of alcoholic liquors was $197.69 with 3,720 patients ; for 1908, the cost was $69.82 with 4,543 patients. The per capita cost for the five years is as follows: 1904, cost .0531 cents; 1905, cost .0474; 1906, cost .034; 1907, cost .0171 ; 1908, cost .0153. In the Boston Medical and Surgical Journal of April 15, 1909, Dr. Richard C. Cabot gave a table show- ing the decrease in the use of alcoholic liquors, and of Other drugs in Massachusetts General Hospital, Boston, ALCOHOL AS A MEDICINE. 57 The following is his table : Ale and Beer Wines and liquors. Total for alcoholic drinks, Total for other medicines Number of patients. Cost of alcohol per patient. Cost of medicine per patient. Ale and beer, Wines and liquors. Total for alcoholic drinks, $1,026.00 $1,335.00 $445.00 $738.00 $813.00 Total for other medicines, $7,815.00 $9,162-00 $7,018.00 $5,981.00 $5,492.00 1898 1899 1900 1901 1902 $759.00 $793.00 $1,062.00 $723.00 $605.00 1,563.00 2,209.00 $3,002.00 1.348.00 $2,410.00 1,063.00 799.00 $2,321.00 $1,786.00 $1,404.00 $8,424.00 $10,013.00 $10,132.00 $9,168.00 $9,772.00 5,005 5,203 5,012 5,495 5,342 $0.46 $0.57 $0.48 $0.32 $0.26 1.68 1.92 2.02 1.66 1.88 1903 1904 1905 1906 1907 $338.00 $431.00 S301.00 $192.00 $203.00 688.00 904.00 144.00 546.00 610 00 Number of patients. 5,429 5,709 5,531 5,513 5,966 Cost of alcohol per patient. $0.19 $0.23 $0.09 $0.13 $0.13 Cost of medicine per patient, 1.43 1.60 1.26 1.08 0.92 Dr. Cabot says: — "Since there has been no fall in the price of stimulants or medicine, the diminished expenditure corresponds to a dimi- nution in the number of doses of medicine and stimulants, and indicates a rapid and striking change of view among the members of the staff of the hospital, especially in the past five years, when it has become generally known that alcohol is not a stimulant but a narcotic and that drugs can cure only about half a dozen of the diseases against which we are contending. "There has been during this period no increase in the pro- portion of surgical cases among the whole number treated, so that the decreased use of miedicines and alcoholic bever- ages has not resulted from an increased resort to surgical remedies. On the other hand, there has been a great in- crease in the utilization of baths (hydrotherapeutics), of massage, of mechanical treatment and of psychical treatment, all of which accounts no doubt for part of the falling off in the use of alcohol and drugs." CHAPTER V. THE EFFECTS OF ALCOHOL UPON THE HUMAN BODY. The body is made up mainly of cells, fibres and fluids. The cell is the most important structure in the living body. Life resides in the cell, and every animal may be considered a mass of cells, each of which is alive, and each of which has its own work to accomplish in the building up of the body. The matter which forms the mass of a cell is called protoplasm, or bioplasm. It resembles somewhat the white of a raw egg, which is almost pure albumen. Cells make up the body, and do its work. Some are employed to construct the skeleton, others are used to form the organs which move the body ; liver-cells secrete bile, and the cells in the kidneys separate poisonous matters from the blood in order that they may be expelled from the system. These cells, composing the mass of the body, being very delicate, are easily acted upon by sub- stances coming into contact with them. If sub- stances other than natural foods or drinks are introduced into the body, the cells are injuriously affected. Alcohol is especially injurious to cells, " retarding the changes in their interior, hindering 58 ALCOHOL AS A MEDICINE. 59 their appropriation of food, and elimination of waste matters, and therefore preventing their proper development and growth." "Bioplasm is living matter; it is structureless, semi-fluid, transparent and colorless. It is the only matter that can grow, move, divide itself and multiply, the only matter that can take up pabulum (food) and convert it into its own substance ; and is the only matter that can be nourished. The bioplasm in the cell gets its nourishment by drawing in of the pabulum through the cell wall, and in that w^ay building up the formed material while it is being disintegrated on the outer surface. This proc- ess is continually being carried on, and is what is meant by nutrition. Disintegration of the formed material is as essential as the building up of it. All organic structure is the result of change taking place in bioplasm. These small cell-like bio- plasts are the workmen of the organism. All wounds are repaired by them, all fractures are united, and all diseased tis- sues brought back to their normal and healthy condition, unless there is not vitality enough to overcome disease, or they have been injured or killed by poisonous material. The body is kept in repair by this living matter, and all the functions of the body are but the result of its action. We may examine, watch and study bioplasm under the microscope ; we see it take up pabu- lum and convert that which is adapted to itself into its own sub- stance, while all other substances are rejected. We take a solution of what we call a stimulant and immerse the bioplasm in it, and we find that it increases its activity, m.oves faster, takes up more pabulum, and divides more rapidly than in the unstim- ulated condition. We next add an astringent, and it begins to move more slowly, and soon contracts into a spherical shape and remains contracted, or may move slowly to a limited ex- tent, depending on the strength of the solution. We next take a relaxant, and gradually the living matter begins to spread in all directions, in a laxy-like manner, and becomes so thin as to 6o ALCOHOL AS A MEDICINE. be almost undiscernible, and takes up very little, if any, pabu- lum. If sufficiently relaxed or astringed, the movements may entirely cease so as to appear lifeless, but when a stimulant is again added the same result is obtained as before — it begins to move, and acts as vigorous as ever, which shows that it was not injured in the least by the agents used. Alcohol is called a stimulant. We take a weak solution of alcohol and try it in the same way ; but we find that almost instantly the living matter contracts into a ball-like mass. Now, we may through ignor- ance suppose that alcohol acts as an astringent, and so we try to stimulate it with the same harmless agent before used, but no impression is made on it ; it does not move ; it is dead mat- ter. These are demonstrable facts, and lie at the foundation of physiology, pathology and the practice of medicine. Alcohol destroys the very life force that alone keeps the body in repair. For a more simple experiment as to the action of alcohol, take the white of an egg (which consists of albumen, and is very similar to bioplasm), put it into alcohol, and notice it turn white, coagulate and harden. The same experiment can be made with blood with the same result — killing the blood bio- plasts. Raw meat will turn white and harden in alcohol. Al- cohol acts the same on food in the stomach as it does on the same substances before introduced into the stomach, and acts just the same on blood and all the living tissues in the system as out of it ; and this alone is enough to condemn its use as a medicine." From Alcohol, Is It a Medicine? by W. F. Pech- uman, M. D., of Detroit, Michigan. ALCOHOL AND STOMACH DIGESTION. The nitrogenous portions of the food are the only ones digested in the stomach. The oily and fatty, as well as the starchy portions, are digested in the small intestines. Very little was known about digestion until 1833, ALCOHOL AS A MEDICINE. 6l when Dr. Beaumont published the results of his investigations upon the stomach of Alexis St. Martin. St. Martin received a severe wound in the left side from a shot-gun. The wound in healing left an opening into the stomach about f of an inch in diameter, closed on the inside by a flap of mucous membrane. Through this opening the interior of the stomach could be thoroughly exam- ined. Dr. Beaumont made hundreds of observations upon this young man, who was in his home several years. He says : — " In a feverish condition, from whatever cause, obstructed perspiration, excite7nent by alcoholic liquors, overloading the stomach with food, fear, anger or whatever depresses or dis- turbs the nervous system, the lining of the stomach becomes somewhat red and dry, at other times pale and moist, and loses its smooth and healthy appearance, the secretions become vitiated, greatly diminished or entirely suppressed." One day after giving St. Martin a good whole- some dinner, digestion of which was going on in regular order, Dr. Beaumont gave him a glass of gin. The digestive process was at once arrested, and did not begin again until after the absorption of the spirit, after which it was slowly renewed, and tardily finished. Gluzinski made some conclusive experiments with a syphon. He drew off the contents of the stomach at various times with and without liquor. He concluded that alcohol entirely suspends the transformation of food while it remains in the stomach. 62 ALCOHOL AS A MEDICINE. Dr. Figg, of Edinburgh, fed two dogs with roast mutton; to one of them he gave i^ ounces of spirit. Three hours later he killed both dogs. The dog without liquor had digested the mutton ; the other had not digested his at all. Similar experiments have been made repeatedly with like result. The elements of our food which the stomach can digest depend upon the pepsin of the gastric juice for their transformation. Alcohol diminishes the secretions of the gastric juice, unless given in very- minute quantities, and kills and precipitates its pepsin. It also coagulates both albumen and fibrine, converting them into a solid substance, thus rendering them unfit for the action of the solvent principles of the gastric juice. Hence, any considerable quantity of alcohol taken into the stomach must for the time retard the function of digestion. Many experiments have been made with gastric juice in vials, one, having alcohol added, the other, not having alcohol. The meat in the vials without alcohol, in time dissolved till it bore the appearance of soup ; in the vials to which alcohol was added the meat remained practically unchanged. In the latter a deposit of pepsin was found at the bottom, the alcohol having precipitated it. Dr. Henry Munroe, of England, one of the experimenters in this line of research, says : — " Alcohol, even in a diluted form, has the peculiar power of interfering with the ordinary process of digestion. ALCOHOL AS A MEDICINE. 63 " As long as alcohol remains in the stomach in any degree of concentration, the process of digestion is arrested, and is not continued until enough gastric juice is thrown out to overcome its efiects."—Trac/s Physiology, page 90. In The Human Body, Dr. Newell Martin says : — " A vast number of persons suffer from alcoholic dyspepsia without knowing its cause; people who were never drunk in their lives and consider themselves very temperate. Abstinence from alcohol, the cause of the trouble, is the true remedy." Sir B. W. Richardson : — " The common idea that alcohol acts as an aid to digestion is without foundation. Experiments on the artificial digestion of food, in which the natural process is closely imitated, show that the presence of alcohol in the solvents employed interferes with and weakens the efficacy of the solvents. It is also one of the most definite of facts that persons who indulge even in what is called the moderate use of alcohol suffer often from dyspepsia from this cause alone. In fact, it leads to the symp- toms w^hich, under the varied names of biliousness, nervous- ness, lassitude and indigestion, are so well and extensively known. "From the paralysis of the minute blood-vessels which is induced by alcohol, there occurs, when alcohol is introduced into the stomach, injection of the vessels and redness of the mucous lining of the stomach. This is attended by the sub- jective feeling of a warmth or glow within the body, and according to some, with an increased secretion of the gastric fluids. It is urged by the advocates of alcohol that this action of alcohol on the stomach is a reason for its employment as an aid to digestion, especially when the digestive powers are feeble. At best this argument suggests only an artificial aid, which it cannot be sound practice to make permanent in place of the natural process of digestion. In truth, the artificial 64 ALCOHOL AS A MEDICINE. stimulation, if it be resorted to even moderately, is in time deleterious. It excites a morbid habitual craving, and in the end leads to weakened contractile power of the vessels of the stomach, to consequent deficiency of control of those vessels over the current of blood, to organic impairment of function, and to confirmed indigestion. Lastly, it is a matter of experi- ence with me, that in nine cases out of ten, the sense of the necessity, on which so much is urged, is removed in the readiest manner, by the simple plan of total abstinence, with- out any other remedy or method." \n Medicinal Drinking, by John Kirk, M. D., this passage occurs : — " Especially in the matter of support, it is essential to our inquiry to examine fully into alcoholic influence on the change by which food introduced into the stomach becomes capable of passing into the circulation and constituent elements of the living frame. It may be best to suppose a case for illustration. Here, then, is a child of, say, six or seven years of age. This child is of the slenderer sex and has been brought into a state of extreme weakness as the consequence of fever. The fury of the disease is expended, but it has, as nearly as may be, extin- guished life. The medical man's one hope for saving this child is now concentrated in what he fancies to be ' support.' Beef-tea, arrowroot and port wine are prescribed. Let it be kept in mind that the pure wine of the grape is discarded in favor of alcoholic wine. Our question is. What effect will the alcohol in this wine have on that process by which the food is to prove really nourishing, and so to be that support which is the only hope for this child } Will it help her ? or will it so hinder the necessary change in the food as to kill her, unless she has sufficient strength left to get above its influence? These are surely important questions. Neither of them can be set at rest by the fact that she recovers ; for she 7nay have strength enough, as many have had, to survive even a serious error in her treatment. I ALCOHOL AS A MEDICINE. 65 " What light, then, does true science throw on these important questions ? All who know anything on the subject are aware that alcohol, instead of dissolving food, or aiding in its dissolu- tion, is one of the most powerful agents in preventing that dissolution. On what principle, then, is it possible that its being mixed with the materials of food, in this case, can aid in their dissolution, so that they may more easily be changed into the fresh blood required to sustain and recover life in this child ? " He then refers to the experiments with gastric juice in vials, and proceeds : — " Here, then, is indisputable evidence that alcohol effectually preve7its that process which is known as digestion, and which is essential to food's being of any use to support life in man. On what principle can the physician explain his introduction of it into the stomach of a child whose thread of life is attenuated to the slenderest hair ? " We urge the chemical truth that the alcohol, given to pro- mote support, is of such a nature as to prevent that which would nourish, from effecting the end so much to be desired, and for which true food is adapted." The pure, unfermented juice of the grape, free from chemical preservatives, is now used by many- physicians where the miserable concoction of drugs and alcohol, known as port wine, was once con- sidered essential. Unfermented grape juice con- tains all the nutriment of the grape, without any of the poison, alcohol. After being opened it should be kept in a cool place, or it will ferment and pro- duce alcohol. Fruit juices are very grateful to a fever patient, and should not be withheld as they are in so many cases. Dr. J. H. Kellogg, and other 66 ALCOHOL AS A MEDICINE. non-alcoholic physicians, recommend them highly. They are better than milk, as milk frequently pro- duces " feverishness," while fruit juices allay it. For those who think beer or ale an incentive to appetite. Dr. N. S. Davis, and others, recommend an infusion of hops, made fresh each day. It is the bitter which promotes appetite, not the alcohol. For the sake of the little bitter in beer, it is not wise to vitiate the tone of the stomach with the alcohol it contains, and which is its active principle. Many mothers have become drunkards, secret drunkards, possibly, through the use of beer as a fancied aid to digestion. Multitudes of men suffer untold horrors from dyspepsia, caused by the beer which they mistakenly suppose to be a friend to their stomach. EFFECTS OF ALCOHOL UPON THE BLOOD. " The blood is a thick, opaque fluid, varying in color in different parts of the body from a bright scarlet to a dark purple, or even almost black." If a drop of blood be placed under a microscope, im- mense numbers of small bodies will be seen. These are called blood-globules, or corpuscles, or discs. There are both red, and white or colorless, corpus- cles. Each red corpuscle is soft and jelly-like. Its chief constituent, besides water, is a substance called hemoglobin, which has the power of combin- ing with oxygen when in a place where that gas is plentiful, and of giving it off again in a region ALCOHOL AS A MEDICINE. 6/ where oxygen is absent, or present only in small quantity. Hence, as the blood flows through the lungs, which are constantly supplied with fresh air, its corpuscles take up oxygen, which, as it flows on, is carried by them to distant parts of the body where oxygen is deficient, and there given up to the tissues. This oxygen-carrying is the function of the red corpuscles. i Hemoglobin, as the coloring-matter of the blood is called, is dark purplish-red in color ; combined with oxygen it is bright *' scarlet red." Accord- ingly, the blood which flows to the lungs after giv- ing up its oxygen is dark red in color, its dark color being due to the impurities it contains ; and that which, having received a fresh supply of oxy- gen, flows away from the lungs is bright scarlet — having been cleansed of its impurities. The bright red blood is called arterial, and the dark red verious. The work assigned to the blood in the economy of the human system is : first, to pick up nutriment in its course through the walls of the alimentary canal, and oxygen, as it flows through the lungs, and convey these to all other parts of the body. Second, to act as a sort of sewage stream that drains off waste matter, and to carry this to the organs of excretion by which waste is expelled from the body. " The blood is the great circulating market of the body, in which all the things that are wanted by all parts, by the mus- cles, the brain, the skin, the lungs, liver and kidneys, are 68 ALCOHOL AS A MEDICINE. bought and sold. What the muscles want they buy from the blood ; what they have done with, they sell back to the blood ; and so with every other organ and part. As long as life lasts this buying and selling is forever going on, and this is why the blood is forever on the move, sweeping restlessly from place to place, bringing to each part the thing it wants, and carrying away those with which it has done. When the blood ceases to move, the market is blocked, the buying and selling cease, and all the organs die, starved for lack of the things they want, choked by the abundance of things for which they have no longer any need." — Foster. This is one way of saying that the processes of repair and waste are constantly going on in the body. Every action of the body, every impulse of the mind uses up some cell-matter, which must then be passed from the body as waste. This is called tissue disintegration. New cells to repair tissue waste are built up from the nutriment which the blood carries from the alimentary canal after the process of food digestion is accomplished. This is called tissue construction, or the process of assimilation. Technically, these are the metabolic, or destructive and constructive processes. Both are essential to health and life. Any substance taken into the body, which will interfere with these processes of nutrition and waste is inimical to health, and in time of disease, dangerous to life. Alcohol is such a substance. The cells and tissues of the body which are touched by alcohol are more or less hardened and injured by it, hence are less perfectly nourished ALCOHOL AS A MEDICINE. 69 than they are when alcohol is not present in the blood. Even a teaspoonful of alcohol to a ^ gallon of water hinders natural growth. If liquor is given to puppies it keeps them small. Young growing- cells are most affected by it, because they are most tender. There are growing-cells in adults as well as in children, for people are growing and changing all through their lives. Hence, when alcohol is administered in sickness the cells are hindered in the full performance of their function of taking up food for the building up of tissue, and as a consequence, the patient's body is really robbed of nutriment by the agent which is supposed to be " keeping up his strength." Truly, " Wine is a mocker^ strong drink is raging, and who- soever is deceived thereby is not wise." That alcohol interferes with the passage of waste matter from the body is generally conceded. In- deed this is claimed by the advocates of its me- dicinal use as one of its virtues ; the fact that less waste passes from the body being urged as evidence that there is less waste, that in some way alcohol preserves tissue from being used up in the natural way. Those who speak thus seem to think that they know better than the Creator how the body should be treated. He made the body so that in health, work, waste and repair should be equal to one another. Dr. Ezra M. Hunt says in Alcohol as a Food and as a Medicine : — 70 ALCOHOL AS A MEDICINE. " We believe that any one who will candidly review the claims put forth for alcohol, in that it delays in any of these hypothetical ways, tissue-change, will conclude that it has no such power in a salutary sense, and that it is unwarrantably assumed that to retard tissue metamorphosis (change) is equivalent to tissue nutrition." Dr. N. S. Davis says: — " It seems hardly possible that men of eminent attainments in the profession should so far forget one of the most funda- mental and universally recognized laws of organic life as to pro- mulgate the fallacy here stated. The fundamental law to which we refer is, that all vital phenomena are accompanied by, and dependent upon, molecular or atomic changes ; and what- ever retards these retards the phenomena of life ; whatever sus- pends these suspends hfe. Hence, to say that an agent which retards tissue metamorphosis is in any sense a food, is simply to pervert and misapply terms." Non-alcoholic physicians unite in declaring that the retention of waste matter in the system, caused by alcohol, invites disease, and tends to inflamma- tory action ; and in illness retards, and frequently prevents, recovery, for the germs of disease remain longer in the body than they would were it not for the delay in the passage of effete matter. Alcohol not only hinders the blood in its work of tissue nutrition ; it also prevents the full oxidation of the blood in the lungs. " In order that a steam engine may work and keep warm it is not merely necessary that it have plenty of coal, but it must also have a draft of air through its furnace. Chemistry teaches us that the burning in this case consists in the combination of a gas called oxygen, taken from the air, with other things in the ALCOHOL AS A MEDICINE. 7 1 coals ; when this combination takes place a great deal of heat is given off. The same thing is true of our bodies ; in order that food matters may be burnt in them and enable us to work and keep warm, they must be supplied with oxygen ; this they get from the air by breathing. We all know that if his supply of air be cut off a man will die in a few minutes. His food is no use to him unless he gets oxygen from the air to combine with it ; while he usually has stored up in his body an excess of food matters which will keep him alive for some time if he gets a supply of oxygen, he has not stored up in him any re- serve, or, if any, but a very small one, of oxygen, and so he dies very rapidly if his breathing be prevented. In ordinary lan- guage we do not call oxygen a food, but restrict that name to the solids and liquids which we swallow ; but inasmuch as it is a material which we must take from the external universe into our bodies in order to keep us alive, oxygen is really a food as much as any of the other substances which we take into our bodies from outside, in order to keep them alive and at work. Suffocation, as death from deficient air supply is named, is really death from oxygen-starvation." — Martin's Human Body, Much of the food taken into the body is burned to supply energy and heat. This burning is called oxidation. When food is burned, or oxidized, either in the body, or out of it, three things are produced, carbon dioxide {carbonic acid gas), water and ashes. These are waste matters, and must be ex- pelled from the body, or they will clog up the vari- ous organs, as the ashes and smoke of an engine would soon put its fire out if they were allowed to accumulate in the furnace. It is the duty of the lungs to pass the carbon dioxide out to the air. With every breath exhaled, this poison gas, gen- erated in the body through the oxidation of food, 72 ALCOHOL AS A MEDICINE. passes from the system. With every breath inhaled the hfe-giving oxygen is taken into the body ; pro- viding that the person is not in a close room from which the fresh air is excluded. Any substance taken into the body which inter- feres with the reception of oxygen into the blood, and with the giving off of carbon dioxide from the same is a dangerous substance. Alcohol is such a substance. It has already been stated that it is the duty of the little red corpuscles in the blood to take up oxygen in the lungs, and carry it to every part of the body, and upon the return passage to the lungs to convey the debris, or used-up material, from the tissues, called carbon dioxide gas. A little vapor and ammonia accompany this gas. The action of alcohol upon these little corpuscles, or carriers of the blood, is to somewhat harden and shrivel them, so that they are unable to take up and carry as much oxygen as they can when no injurious sub- stance is present in the blood. In consequence of this, the blood can never be so pure when alcohol is present, as it may be in the absence of this agent. The following is taken from The Temperance Lesson Book, by B. W. Richardson, M. D. : — " When the blood in the veins is floating toward the right side of the heart, which communicates with the lungs, it carries with it the carbonic acid {carbon dioxide), and, as I have found by experiment, a great part of this gas is condensed in these little bodies, the corpuscles. Arrived at the lungs, the blood ALCOHOL AS A MEDICINE. 73 comes into such contact with the air we breathe, that the oxygen gas in the air is freely absorbed by the httle corpuscles, while the carbonic acid is given up into the air-passages of the lungs, and is thrown off with every breath we throw out. In this process the blood changes in color. It comes into the lungs of a dark color ; it goes out of them a bright red.* * * * * The parts of the blood on which alcohol acts injuriously are the corpuscles and the fibrine. The red corpuscles are most dis- tinctly affected. They undergo a peculiar process of shrink- ing from extraction of water from them. They also lose some of their power to absorb oxygen from the air. In confirmed spirit-drinkers the face and hands are often seen of dark mottled color, and in very bad specimens of the kind, the face is sometimes seen to be quite dark. This is because the blood cannot take up the vital air in the natural degree. ***** " If anything whatever interferes with the proper reception of oxygen by the blood, the blood is not properly oxidized, the animal warmth is not sufficiently maintained, and life is reduced in activity. If for a brief interval of time the process of breath- ing is stopped in a living person, we see quickly developed the signs of difficulty, and we say the person is being suffocated. We observe that the face becomes dark, the lips blue, the surface cold. Should the process of arrest or stoppage of the breathing be long continued the person will become uncon- scious, will stagger and fall, and should relief not be at hand, he will in a very few minutes die. " I found by experiment that in presence of alcohol in blood the process of absorption of oxygen was directly checked, and that even so minute a quantity as one part of alcohol in five hundred of blood proved an obstacle to the perfect reception of oxygen by the blood. The corpuscles are reduced in size, when large quantities of alcohol are taken, and become irregu- lar in shape." Dr. J. J. Ridge says in Addresses on the Physio- logical A ction of A Icohol : — 74 ALCOHOL AS A MEDICINE. " It has been found by experiment that, when alcohol is taken, less carbonic acid comes away in the breath than when it is not. This is partly because the blood-corpuscles cannot carry so much, and partly because so much is not produced, because there is less oxygen to join with the food and produce it. Just as burning paper smokes when it does not get enough oxygen, so other things are formed and get into the blood when there is not enough oxygen to make carbonic acid. These things make the blood impure, and cause extra work and trouble to get rid of them. This is why persons who drink alcohol are more liable to have gout and other diseases, than total abstainers." Dr. Alfred Carpenter, formerly president of the Council of the British Medical Association, says in Alcoholic Drinks : — " A blood corpuscle cannot come into direct contact with an atom of alcohol, without the function of the former being spoiled, and not only is it spoiled, but the effete matter which it has within its capsule cannot be exchanged for the necessary oxygen. The breath of the drunken man does not give out the.quantity of carbonic acid which that of the healthy man does, and the ammoniacal compounds are in a great measure absent. Some of the carbon and effete nitrogenous matter is kept back. The retention of these poisonous matters within the body is highly injurious. Let the drinker suffer from any wound or injury and this effete matter in his blood is ready at a moment's notice to prepare and set up actions called inflammatory or erysipelatous, or some other kind ; by means of which too often the drinker is hurried into eternity, although, perhaps, he may have been regarded as a perfectly sober man, and have never been drunk in his hfe." In the light of these scientific facts, what can appear more utterly foolish than the swallowing of ALCOHOL AS A MEDICINE. 75 alcoholic patent medicines which are widely adver- tised as " Blood Purifiers " ? That they will ren- der the blood impure is only too evident in the light of scientific truth. Dr. Nathan S. Davis has written much in dis- approval of the use of alcohol in fevers, pneumonia and diphtheria, putting stress upon the fact that these diseases, of themselves, interfere with the reception of oxygen into the blood, and hence the use of all remedies that notably diminish the internal distribution of oxygen, or impair the cor- puscles of the blood, should be avoided. Not only is alcohol of such a nature, but all the coal-tar series of antipyretics also. Since the internal dis- tribution of oxygen, and the processes of tissue change are essential to the repair of the body, and alcohol hinders the blood in the full performance of its duties in these respects, it certainly seems clear that those physicians, who are extremely cautious in the use of this drug, or who do not use it at all, are more likely to be successful in saving their patients than are those who use it freely. Death-rates, with and without alcohol, show conclu- sively the superiority of the latter treatment. ALCOHOL AND THE HEART. The organs of circulation are the heart and the blood-vessels. The blood-vessels are of three kinds, arteries, capillaries and veins. The arteries carry blood from the heart to the capillaries ; the veins 'jS ALCOHOL AS A MEDICINE. collect it from the capillaries and return it to the heart. There are two distinct sets of blood-vessels in the body, both connected with the heart ; one set carries blood to, through and from the lungs, the other guides its flow through all the remaining organs ; the former are known as the pulmonary^ the latter as the systemic blood-vessels. The smallest arteries pass into the capillaries, which have very thin walls, and form very close net- works in nearly all parts of the body ; their immense number compensating for their small size. It is while flowing in these delicate tubes that the blood does its nutritive work, the arteries being merely supply-tubes for the capillaries, through whose delicate walls liquid containing nourishment exudes from the blood to bathe the various tissues. The quantity of blood in any part of the body at any given time is dependent upon certain relations which exist between the blood-vessels and the nerv- ous system. The walls of the arteries are abun- dantly supplied with involuntary muscular fibres, which have the power of contraction and relaxation. This power of contraction and relaxation is con- trolled by certain nerves called vasomotor nerves, because they cause or control motion in the vessels to which they are attached. When arteries supply- ing blood to any particular part of the body con- tract, the supply of blood to that part will be di- minished in proportion to the amount of contraction. If the nervous control be altogether withdrawn, the ALCOHOL AS A MEDICINE. 7/ arterial walls will completely relax, and the amount of blood in the part affected will be increased corre- spondingly. Alcohol, even in moderate doses, paralyzes the vasomotor nerves which control the minute blood- vessels, thus allowing these vessels to become dilated with the flowing blood. " With the disturbance of power in the extreme vessels, more disturbance is set up in other organs, and the first organ that shares in it is the heart. With each beat of the heart a certain degree of resistance is offered by the vessels when their nerv- ous supply is perfect, and the stroke of the heart is moderate in respect both to tension and to time. But when the vessels are rendered relaxed, the resistance is removed, the heart begins to run quicker like a clock from which the pendulum has been removed, and the heart-stroke is greatly increased in frequency. It is easy to account in this manner for the quickened heart and pulse which accompany the first stage of deranged action from alcohol." — Richardson. Dr. Parkes of England, assisted by Count Wollowicz, conducted inquiries upon the effects of alcohol upon the heart, with a young and healthy man. At first they made accurate count of the heart beats during periods when the young man drank water only ; then of the beats during succes- sive periods in which alcohol was taken in increasing quantities. Thus step by step they measured the precise action of alcohol on the heart, and thereby the precise primary influence induced by alcohoL Their results are stated by themselves as follows : — " The average number of beats of the heart in 24 hour§ ((a$ 7B ALCOHOL AS A MEDICINE. calculated from eight observations made in 14 hours), during the first, or water period, was 106,000 ; in the earlier alcoholic period it was 127,000, or about 21,000 more ; and in the later period it was 131,000, or 25,000 more. " The highest of the daily means of the pulse observed during the first, or water period, was 77.5 ; but on this day two obser- vations are deficient. The next highest daily mean was Tj beats. " If, instead of the mean of the eight days, or 73.57, we com- pare the mean of this one day ; viz. 'j'j beats per minute, with the alcoholic days, so as to be sure not to over-estimate the action of the alcohol, we find : — ■ "On the 9th day, with one fluid ounce of alcohol, the heart beat 4,300 times more. " On the loth day, with two fluid ounces, 8,172 times more. " On the nth day, with four fluid ounces, 12,960 times more. " On the 1 2th day, with six fluid ounces, 20,672 times more. " On the 13th day, with eight fluid ounces, 23,904 times more. " On the 14th day, with eight fluid ounces, 25,488 times more. " But as there was ephemeral fever on the 12th day, it is right to make a deduction, and to estimate the number of beats in that day as midway between the nth and 13th days, or 18,432. Adopting this, the mean daily excess of beats during the alco- holic days was 14,492, or an increase of rather more than 13 per cent. " The first day of alcohol gave an excess of 4 per cent., and the last of 23 per cent. ; and the mean of these two gives almost the same percentage of excess as the mean of the six days. " Admitting that each beat of the heart was as strong duri'ng the alcoholic period as in the water period (and it was really more powerful), the heart on the last two days of alcohol was doing one- fifth more work. ALCOHOL AS A MEDICINE. 79 " Adopting the lowest estimate which has been given of the daily work of the heart ; viz. as equal to 12.2 tons Ufted one foot, the heart during the alcoholic period, did daily work in excess equal to lifting 15.8 tons one foot, and in the last two days did extra work to the amount of 24 tons lifted as far. " The period of rest for the heart was shortened, though, per- haps, not to such an extent as would be inferred from the number of beats, for each contraction was sooner over. The heart, on the fifth and sixth days after alcohol was left off, and, apparently at the time when the last traces of alcohol were eliminated, showed in the sphygmographic tracing signs of unusual feebleness ; and, perhaps, in consequence of this, when the brandy quickened the heart again, the tracings showed a more rapid contraction of the ventricles, but less power than in the alcoholic period. The brandy acted, in fact, on a heart whose nutrition had not been perfectly restored." Richardson quotes these experiments of Parkes and Wollowicz as if he agrees with them that in- creased heart-beat must of necessity mean increased work done by the heart. Dr. Nathan S. Davis, Dr. Newell Martin, Dr. A. B. Palmer, and some other investigators, show conclusively that mere increased frequency of beat above the natural standard is no evidence of increased force or efficiency in the cir- culation. " The more frequent beats under the influence of alcohol con- stitute no exception to the general rule, for while the heart beats more frequently, its influence on the vasomotor nerves causes dilatation of the peripheral and systemic blood-vessels, as proved by the pulse-line written by the sphygmograph, which more than counterbalances the supposed increased action of the heart. The truth is, that under the influence of alcohol in the blood the systolic action of the heart loses in sustained force in 80 ALCOHOL AS A MEDICINE. direct proportion to its increase in frequency, until, by simply increasing the proportion of alcohol, the heart stops in diastole, as perfectly paralyzed as are the coats of the smaller vessels throughout the system. This was clearly demonstrated by the experiments of Professor Martin of Johns Hopkins University, to determine the effects of different proportions of alcohol on the action of the heart of the dog ; and those of Drs. Sidney Ringer and H. Sainsbury, to determine the relative strength of different alcohols as indicated by their influence on the heart of the frog. Professor Martin states that blood containing I per cent, by volume of absolute alcohol, almost invariably dimin- ishes, within a minute, the work done by the heart." (This estimate would equal In an adult man an amount equal to the absolute alcohol in two or three ounces of whisky or brandy.) " These investigations of Professor Martin, being directly corroborated by those of Drs. Ringer and Sainsbury, complete the series of demonstrations needed to show the actual effects of alcohol on the cardiac, as well as on the vasomotor, and also on the direct contractability of the muscular structure, when supplied with blood containing all gradations in the rela- tive proportion of alcohol, leaving no longer any basis for the idea, popular both in and out of the profession, that alcohol in any of its forms is capable of increasing, even temporarily the force or efficiency of the heart's action." — Dr. N. S. Davis in Ijijluence of Alcohol On the Human System. The following letter will be of great interest to all students of the physiological effects of alcohol : — "Chicago, III., March 3, 1899. "To Mrs. Martha M. Allen, " Syracuse, N. Y., "Madam: Your letter asking my attention to %^- apparent contradiction of authorities concerning the work don^ by the heart when influenced by alcohol was received yesterday. ALCOHOL AS A MEDICINE. 8l " The explanation is not difficult. It depends entirely on the different views of what constitutes the work of the heart. " One class of investigators, led by the original and valuable experiments of Parkes and Wollowicz base their estimate of the heart's work entirely on the tuinibe?' of times it co7itracts or beats per viiniite. Thus Dr. Parkes, finding that moderate doses of alcohol increased the number of contractions of the heart from three to six beats per minute more than natural, readily estimated the number of additional contractions that would occur in twenty-four hours, and thereby demonstrated a large amount of increased work done by the heart under the influence of alcohol. All writers who speak of ' stimulating ' or increasing the action of the heart by alcohol follow this method of measuring the amount of work done. They generally add that it is like applying ' the whip to a tired horse.' " The other class of investigators who claim that alcohol di- minishes the actual work done by the heart base their estimates on the amount of blood the heart passes through its cavities into the arteries in a given time. This is the physiological function of the heart ; i. e. to aid in circulating the blood. Professor Martin's experiments were admirably contrived to determine, not how frequently the heart beat, but the amount of blood it delivered per minute under the influence of alcohol and without alcohol. " He, and all others who take this basis of work, found that alcohol in any dose diminished the efficiency of the heart in cir- culating the blood in direct ratio to the quantity taken. " My own original experiments, made fifty years ago, uni- formly showed that alcohol quickly increased the number of heart beats per minute, but at the same time diminished the efficiency of the circulation generally. Every experienced prac- titioner knows that the weaker the hea.7't becomes, the faster it beats. Consequently, the number of times the heart contracts per minute is no measure of the efficiency of its work in circula- 82 ALCOHOL AS A MEDICINE. ting the blood. Indeed the mechanism of the heart is such that there must be sufficient time between each of its con- tractions for its cavities to fill, or it is made to contract on an insufficient supply, and the efficiency of the circulation is di- minished. " Yours respectfully, " N. S. Davis." The International Medical Congress of 1876 adopted as its reply to the Memorial of the National Temperance Society, and of the National Woman's Christian Temperance Union respecting ''Alcohol as a Food and as a Medicine," the paper by Dr. Ezra M. Hunt, one conclusion of which was, '' Its use as a medicine is chiefly that of a cardiac stim- ulant." As experiments conducted since that time show that it is not a cardiac stimulant, but a direct car- diac paralyzant, what excuse is there for using it as a medicine now? " Whenever the heart is compelled to more rapid contraction than is natural, it has less time to rest. Although it seems to be constantly at work, it really rests more than half the time, so that, although the periods of relaxation are very short, they are so numerous that the aggregate amount of rest in a day is very great. Now, if the rapidity of the contractions is increased materially and continuously, although the aggregate amount of time for rest may be the same as before, yet the waste caused by the contractions is greater, while the time for rest after each one is shorter. This lack of rest produces exhaustion of the heart-muscle, ending in partial change of the muscular tissue into fat. The heart then becomes flabby and weak and its walls become thinner, a condition known to physicians as a ALCOHOL AS A MEDiCINE. 83 ' fatty heart,' often resulting in sudden deatii." — Tracy s Physi- ology, page 158. Dr. T. D. Crothers, of Hartford, Conn., has made many observations with the sphygmograph to learn the effects of alcohol upon the heart. He says : — " On general principles, and clinically, the increased activity and subsequent diminution of the heart's action brings no medicinal aid or strength to combat disease. This is simply a reckless waste of force for which there is no compensation. Without any question or doubt the increased heart's action, extending over a long period, is dangerous. " The medicinal damage done by alcohol does not fall ex- clusively upon the heart, although this organ may show it more permanently than others." — Transactions of Second Annual Meeti7ig of A. M. T. A. Dr. I. N. Quimby, of Jersey City, N. J., in an address before the American Medical Temperance Association, after describing two clinical cases which ended in death, made the following statement : — " There was nothing so strange about the death of these two patients, although they both died unexpectedly to the physician and their friends, but the declaration I am about to make may be somewhat new and startling, namely : That neither of these patients, in my candid judgment, died from the effect of disease, but rather from vasomotor paralysis of the heart, superinduced by the administration of the alcohol, which brought on a sudden and unexpected collapse and death." Alcohol causes fatty deg*eneration of the heart and other muscular structures. Old age also causes these degenerations, hence alcohol is said to produce premature aging of the body. 84 ALCOHOL AS A MEDICINE. " In fatty degeneration the cells and fibres of the body be- come more or less changed into fat. If a muscular fibre under- goes fatty degeneration, the particles of which it is made dis- appear one by one, and particles of oil or fatty matter take their place, so that the degree or amount of degeneration varies according to the extent to which this change has gone on. When the fibres of which a muscle is composed have become thus altered by fatty degeneration they become softer accord- ing to the amount of it ; they are more easily torn and may even tear across when the muscle is being used during life. The more a muscle is thus degenerated the weaker it is, be- cause it contains less muscular substance and more fat. Not only do the heart and other voluntary muscles thus degenerate, but those of the arteries also. " Fatty degeneration is promoted by alcohol because alcohol prevents the proper removal of fat, which has been seen to accumulate in the blood ; alcohol prevents the proper oxidation or burning up of waste matters ; growing cells which are affected by the chemical influence of alcohol are not quite natural or healthy, so are more liable to degeneration ; alcohol hinders the proper removal of waste matter from individual cells and tissues." — Dr. J. J. Ridge, London. Dr. Newell Martin says in T/ie Human Body : — " Although fatty degeneration of the heart may occur from other causes, alcoholic indulgence is the most frequent one. Fatty liver or fatty heart is rarely if ever curable ; either will ultimately cause death." Dr. Ridge says these degenerations occur in the tissues of thin people as well as in those of stout persons. In thin people they are usually in the fibres only, not between them. It is because of this degeneration of the heart and other muscles caused by alcohol that athletes in ALCOHOL AS A MEDICINE. 8$ training need to be so very careful to avoid the use of beer and other intoxicating drinks. Diseases sucli as fevers, diphtheria, and pneu- monia which interfere with the reception, and inter- nal distribution of oxygen, favor granular and fatty degeneration of the heart and other structures of the body. Hence non-alcoholic physicians urge that alcohol and such other drugs, as have like action in hindering full oxidation of the blood, and causing fatty degenerations should be studiously avoided. These physicians attribute many of the deaths from heart-failure in such diseases to the combined action of the disease and the alcohol in exhausting the heart, and weakening its structure. Comparative death-rates with and without alcohol sJioiv conclusively the superiority of tJie latter treat- ment, EFFECTS OF ALCOHOL UPON THE LIVER. The liver is a very large organ, the largest and heaviest in the body, weighing in a healthy adult from three to four pounds. It secretes the bile. Its cells also store up, " in the form of a kind of animal starch called glycogen," excess of starchy or sugary food absorbed from the intestine during the digestion of a meal. This it gradually doles out to the blood for general use by the organs of the body until the next meal is eaten. Dr. William Hargreaves says : — " The office of the liver is to take up new substances having 86 ALCOHOL AS A MEDICINE. not yet become blood, as well as the portions of integrated matter that can be worked over, and brought again into use. It is in fact the economist of the system. It excretes bile, and liver-sugar, and reviews the blood. When the liver is disor- dered the whole body is more or less deranged and the proper nutrition of its parts arrested." Dr. Alfred Carpenter says : — " The liver has to do several things ; a considerable part of its duty is to purify the blood from debris (waste matter), to filter out some things, to break up and alter others, and to expel them from the body in the form of bile. There are certain dis- eases in which the liver suddenly declines to do any more work. Acute atrophy of the liver is the name of this condition, and when it arises death rapidly results from suppression of the se- cretion of bile. It brings about a state of things called acholia; the patient is actually poisoned by the non-removal of those in- gredients from the blood which it is the duty of the liver to re- move. This corresponds in effect to the condition which alco- hol can bring about by slow degrees." The liver is the first important organ, next to the stomach and bov^els, to receive the poisonous in- fluence of alcohol. " If alcohol is used habitually, though only in small quantities at a time, the liver may become the seat of serious changes. There may be a great increase of fat deposited m the cells, producing what is called ' fatty liver,' or it may lead to a great increase of connective tissue (membrane) between the cells, and surrounding the blood-vessels. This newly-developed con- nective tissue gradually contracts, and in so domg crushes the cells and obstructs the blood-vessels, making the organ much smaller than natural, and causing the surface to be covered with little projecting knobs, consisting of portions of liver-tissue that have been less compressed than the part that separates ALCOHOL AS A MEDICINE. 87 them. The pressure upon the Hver-cells and the destruction of many of them, prevents the proper formation of bile and liver- sugar. The contraction of the newly-developed tissue, by ob- structing the blood-vessels, interferes with the circulation. Malt liquors seem to produce fatty degeneration, while the stronger liquors cause the development of connective tissue." — Tracy s Physiology. Speaking of diseases of the liver, Dr. Trotter said in his Essay on Drunkenness : — " The chronic species is not a painful disease ; it is slow in its progress, and frequently gives no alarm, till some incurable affection is the consequence. Hence, the fallacy and danger of judging merely by the feelings of the beneficial effects of the use of intoxicating drinks ; for the liver and stomach may be seriously diseased, while a man imagines himself in moderate health." Hardening of the liver, or '' hob-nailed " liver, is said to be the result, largely, of taking liquor upon an empty stomach. Dr. E. Chenery, of Boston, in his excellent book, Facts for the JMillions, tells of a patient of his who was well up to the evening be- fore, when he went out and drank with some com- panions, taking the liquor on an empty stomach. That night, vomiting and pain in the right side came on, with high fever. Headache began and in- creased, followed by delirium and a general jaun- diced condition. He died as a result. The disease was acute inflammation of the liver, brought on by the one broadside of alcohol poured " point blank " into the organ. Dr. Chenery says further on in the same book : — ■ 88 ALCOHOL AS A MEDICINE. " There is another disorder of a very serious nature which science is now laying at the doors of the liver — diabetes mellitus, or sugar in the urine. Till quite recently, this formidable af- fection has been regarded as having its seat in the kidneys ; and it is so classified in medical writings. Later researches, however, show that the sugar has been formed in the economy before it reaches the kidneys, and that these organs act only as strainers with respect to it, removing it from the blood as they remove salt and various other substances. In seeking for the fountain-head of diabetic sugar, it is found that the liver is the great glycogenic, or sugar-originating factory of the body. In an ordinary state of health this substance is produced in just the proper amount for the uses for which it is intended, so that it is all disposed of in the organism, and does not pass off by the kidneys. If any cause interrupts the processes by which the sugar is consumed, while its manufacture goes on normally, there will come to be an over-supply of sugar in the blood, which, when it reaches 3 parts to 1,000 of the blood, will begin to pass off by the kidneys and appear in the urine. On the other hand, if an undue amount of it is formed, the consumption remaining normal, it will also accumulate in the circulation, and be eliminated by the kidneys. In either case we have diabetes, the sugar irritating and diseasing the kidneys as it passes." Dr. Harley, of the Royal Society of London, has made the subject of alcohol and diabetes, matter for considerable study. He says a small quantity only of alcohol injected into the portal (liver) circulation of healthy animals will cause diabetic urine. "If any one doubt the truth of the assertion that alcohol causes diabetes, let him select a case of that form of the disease arising from excessive formation, and after having carefully esti- mated the daily amount of sugar eliminated by the patient, allow him to drink a few glasses of wine, and watch the result. ALCOHOL AS A MEDICINE. Sq He will soon find the ingestion of the liquor is followed by an increase of sugar. If alcoholics increase the amount of sac- charine matter in the urine of the diabetic, we can easily under- stand how their excessive use may induce the disease in individuals pred/sposec/ to it." — Dr. Harley. Some physicians claim that in jaundice and cer- tain other biHous disorders even medicines prepared in alcohol are decidedly prejudicial and aggravating. Dr. J. H. Kellogg, and other writers draw atten- tion to the effects of alcohol in hindering the liver in its duty of destroying the toxic substances gen- erated within the system of a sick person by the specific microbes to which the disease owes its origin, saying that the activity of the liver in de- stroying these poisons is one of the physiologic processes which stand between the patient and death. The more this question is studied the more ap- parent is it that, other things being equal, the sick person who is cared for by a non-alcoholic phy- sician has a much better chance of recovery than the one dosed by "a brandy doctor." EFFECTS OF ALCOHOL UPON THE KIDNEYS. " The kidneys, being the chief organs for the excretion of nitrogen waste, are among the most important organs of the body. Any defect in their healthy activity leads to serious in- terference with the working of many organs, due to the accu- mulation in the body of nitrogenous waste products. If both kidneys be cut out of ,an animal, it dies in a few hours from blood-poisoning, due to the accumulation of waste poisonous 90 ALCOHOL AS A MEDICINE. substances which the kidneys should have got rid of. Serious kidney-disease amounts to pretty much the same thing as cut- ting out the organs, since they are of httle use if not healthy. It i-s always fatal if not checked, and often kills in a short time. The things which most frequently cause kidney disease are un- due exposure to cold, and indulgence in alcoholic drinks." — Martin's Human Body. " The kidneys are supplied with arterial blood, which, having given up water, urea, salt, and certain other substances, either secreted or simply strained from it, returns to the kidneys nearly as bright and fresh as when it entered them. While the lungs are concerned in removing carbonic acid — the ashes of the furnace — it is the peculiar province of the kidneys to remove the products of the wear and tear of the bodily machinery — the wasted nerve and muscle — in the form of urea, or other crystal- lizable substances, the presence of which in the economy for any considerable time is attended with disastrous results. " Now, nature has put these organs, charged with so impor- tant work, as far away as possible from any source of irritation. Could alcohol get as direct access to them as to the liver, there is no doubt that their function would be destroyed almost at once, since the change in arterial blood by alcohol is much more extensive and damaging than that wrought in such venous blood as the liver receives from the portal veins. Thus while the liver takes the alcohol immediately from the alimentary canal, the kidneys receive it only after it has passed through the liver, the heart, the lungs, and the heart again ; by which time much of it has escaped, while the remainder has been greatly diluted by the blood of the general circulation ; yet com- ing to the kidneys even so considerably diluted, it has power to congest, irritate, and excite them to the excretion of an unusual amount of the watery elements of the urine, as if to wash the irritant away. " But it is only the watery element that is increased, not the ALCOHOL AS A MEDICINE. 9 1 urea, which is the substance representing the waste of vital action, and is a poison to the system ; this it is the special office of the kidneys to remove. Not only does alcohol not increase its elimination, but actually lessens the discharge. And should the irritation of the spirit continue, or be augmented in force, inflammation would follow, and the excretion of urea nearly or entirely cease and life be in the greatest jeopardy. Relief or death then must speedily follow." — Dr. E. Chenery, of Bos- ton, in Alcohol Inside Out. "Alcohol causes kidney-disease in several ways. In the first place it unduly excites the activity of the organs. Next, by impeding oxidation it interferes wath the proper preparation of nitrogen wastes : they are brought to the kidneys in an unfit state for removal, and injure those organs. Third, when more than a small quantity of alcohol is taken, some of it is passed out of the body unchanged, through the kidneys, and injures their substance. The kidney-disease most commonly pro- duced by alcohol is one kind of " Bright's disease," so called from the physician who first described it. The connective tissue of the organ grows in excess, and the true excreting kidney-substance dwindles away. At last the organ becomes quite unable to do its work, and death results. " The three most common causes of Bright's disease are an acute illness, as scarlet fever, of which it is a frequent result ; sudden exposure to cold w^hen warm (this often drives blood in excessive quantity from the skin to internal organs, and leads to kidney-disease) ; and the habitual drinking of alcoholic liquids." — Dr. Newell Martin in The Huma7i Body. " Every physician knows or should know, that the quantity and quality of the effete, or waste, material separated from the blood by the kidneys and voided in the urine, is such as to render a knowledge of the action of any remedy or drink on the function of these organs, of the greatest importance in the treatment of all diseases, and especially those of an acute febrile character. As was long since demonstrated by clinical obser- 92 ALCOHOL AS A MEDICINE. vation, and more recently by patient and accurate experiments by Bouchard and others, the amount of toxic, or poisonous, material naturally separated from the blood by the kidneys and passed out in the urine is so great that if wholly retained by failure of the kidneys to act for two or three days, speedy death ensues. Equally familiar to every observing physician is the fact that in all the acute febrile and inflammatory diseases, not only is the quantity of the urine secreted generally dimin- ished, but its quality or constituency is also changed to a greater degree than even its quantity. Thus, some of the more important constituents are increased, others diminished, and often new or foreign elements are found present, all resulting from the disordered metabolic processes taking place through- out the system during the progress of these diseases. " It is, therefore, hardly necessary to remind the physician that it is of the greatest importance to know as correctly as possible both the direct and the indirect influence of every medicine or drink on the action of the kidneys and all other eliminating organs and structures, lest he unwittingly allow the use of such as may not only retard the elimination of the specific causes of disease, but also favor auto-intoxication by retarding the elimination of the natural elements of excretion. " That the presence of alcohol in the living system positively lessens the reception and internal distribution of oxygen, and consequently retards the oxidation processes of disassimilation by which the various products for excretion are perfected and their elimination facilitated, is so fully demonstrated, both by observation and experiment, as no longer to admit of doubt. " As nearly all the toxic elements of urine are the results of these oxidation processes, the presence of alcohol in the system could hardly fail to interfere with them in a notable degree. " The direct and somewhat extensive series of experiments instituted by Glazer. as published in the Deut, Med. Woch- ensck., Leipsic, Oct. 22, 1891, demonstrated this, as shown by the following conclusions : ' Alcohol, in even relatively moder- ALCOHOL AS A MEDICINE. 93 ate quantities, irritates the kidneys, so that the exudation of leu- cocytes and the formation of cylindrical casts may occur. It also produces an unusual amount of uric acid crystals and oxa- lates, due to the modified tissue changes produced by the alcohol. The effect of a single act of over-indulgence in alcohol does not last more than thirty-six hours, but it is cumulative under con- tinued use.' "Dr. Chittenden kept several dogs under the influence of alcohol eight or ten days, and found it to increase the amount of uric acid in their urine more than loo per cent, above the normal proportion. "Mohilansky, house-physician to Manassein's clinic, in the conclusions drawn from his interesting experiments on fifteen young men to determine the effects of alcohol on the metabolic processes generally, stated that ' it does not possess any diu- retic action ; but rather tends to inhibit the elimination of water by the kidneys.' It is further stated that this result is owing to the coincident effect of diminished systemic oxidation and of blood pressure. " On the other hand, several observers have reported that the flow of urine was increased by the use of alcohol. From as full an examination of the subject as I have been able to make, it appears that the diverse results obtained have depended upon the previous habits of those experimented on, and the widely varying quantities of w^ater drank with the alcohol. When the alcohol is taken with large quantities of water, as is usual with those who use beer and fermented drinks generally, the total amount of urine passed is usually increased, but not more than is found to result from taking the same quantity of water with- out any alcohol. When alcoholic drinks are taken by those already habituated to its use, it has less marked effect on the quantity and quality of the urine than when taken by those who had previously been total abstainers. This was illustrated by the experiments of Mohilansky on the fifteen men, some of whom 94 ALCOHOL AS A MEDICINE. were habitual drinkers, some occasional drinkers, and others total abstainers. When all were subjected to the same diet and drinks, with alcohol, in two the daily amount of urine voided re- mained unaltered, in five it was increased seven per cent., and in eight it decreased twelve per cent. But whatever may be the va- riations in the mere quantity of urine voided under the influence of alcohol, the alterations in quality pretty uniformly show an increase in the products of imperfect internal metamorphosis or oxidation, such as uric acid, oxalates, casts, leucocytes, albumen and potassium, with less of the normal products, as urea and salts of sodium. " During the past year I have met with three cases in which the regular daily use of alcoholic drinks for several months, in quantities not sufficient to produce intoxication, had so altered the blood, and the renal function, that the urine contained both casts and albumen, and some degree of oedema was observable in the face and extremities. These changes were so marked as to justify a diagnosis of incipient nephritis, or Bright's disease. Yet after totally abstaining from the use of alcoholic drinks and remedies, and taking such vasomotor tonics as strychnine and digitalis, with a regulated diet and fresh air, they com- pletely recovered. "When it is remembered that in diphtheria, pneumonia and typhoid fever, the acute diseases in which a large part of the profession administer most freely alcoholic remedies, the func- tion of the kidney is altered in almost the same direction as are found to take place under the influence of alcohol, it should certainly cause every practitioner to pause and critically review the pathological basis on which he has been prescribing. An anaesthetic, like alcohol, may certainly render a patient with diphtheria, pneumonia or typhoid fever more quiet, and cause him to say he feels better, but if it at the same time diminishes the internal distribution of oxygen, retards the oxidation and elimination of waste and toxic products through the kidneys and lungs, and lessens vasomotor force, it cannot fail to pro- ALCOHOL AS A MEDICINE. 95 tract'the duration of disease, and increase the ratio of mortal- ity."— Dr. N. S. Davis, A. M. T. A. Quarterly, April, 1894. Dr. J. H. Kellogg, by a series of carefully executed experiments, conclusively demonstrated that alcohol hinders the elimination of poisonous matter by the kidneys. This property of alcohol is one of the objections which he sees to its use as a medicine. He says : — " Water applied externally stimulates elimination by the pores of the skin, and employed freely internally by water drinking, and enemas to be retained for absorption, aids liver and kidney activity. If the patient dies it is because his liver and kidneys have failed to destroy and eliminate the poisons generated with sufficient rapidity to prevent their producing fatal mischief in the body." CHAPTKR VI. AI^COHOIv AS A MKDICINE. Although nearly all of the foremost scientific in- vestigators of the effects of alcohol upon the body have lost faith in the old views of the usefulness of alcoholic liquors as remedial agencies a considerable proportion of the medical profession do not seem yet to have learned how to treat disease without re- course to the alcohol therapy. This is largely due to the fact that the new thought has not yet crystallized to any large extent in the medical text-books, and also to the widely variant views held by professors of medicine. The medical use of alcohol has been, and still is, the great bulwark of the liquor traffic. The user of alcoholics as beverages always excuses himself, if hard pressed by abstainers, upon the ground that they must be of service or doctors would not recom- mend them so frequently. In all prohibitory amendment, and no-license campaigns, the cry of " Useful as Medicine " has been the hardest for temperance workers to meet, for they have felt that they had to admit the statement as true, know- ing nothing to the contrary. Indeed, thousands of those who advocate the prohibition of the sale of 96 ALCOHOL AS A MEDICINE. 9/ liquor as a beverage, use alcohol in some form quite freely as medicine, and are as determined and earnest in defence of their favorite " tipple " as any old toper could well be. Many use it in the guise of cordials, tonics, bitters, restoratives and the thousand and one nostrums guaranteed to cure all ills to which human flesh is heir. The wide-spread belief in the necessity and efficacy of alcoholics as remedies is the greatest hindrance to the success of the temperance cause. It is impossible to convince the mass of the people that what is life-giving as medicine can be death- dealing as beverage. The two stand, or fall, together. Hence there is no more important ques- tion ;before the medical profession, and the people generally, than that of the action of alcohol in dis- ease, and, as a goodly number of the most dis- tinguished and successful physicians of Europe and America declare it to be harmful rather than helpful, it behooves thoughtful people to care- fully study the reasons they assign for holding such an opinion. Certainly it is true that if physi- cians and people would all adopt the views of the advocates of non-alcoholic medication the temper- ance problem would be solved, and the greatest source of disease, crime, pauperism, insanity and misery would be driven from the face of the earth. To understand the arguments advanced in favor of non-alcoholic medication it is needful to make some study of the effects of alcohol upon the 98 ALCOHOL AS A MEDICINE. body, and of the purposes for which alcoholics are prescribed medically. A Icohol is used in sickness as a food^ when solid foods cannot be assimilated^ " to support " or sustain, the vitality ; it is used as a stimulant, a tonic, a sedative or narcotic, an anti-spasmodic, an antiseptic and antipyretic ; it is used in combination with other drugs, in tinctures and hi phar'}nacy. It is not wonderful that the people esteem it above all other drugs, for none other is so variously and so generally employed. Those who discard it as a remedy teach that only in human delusions is it a food or a stimulant, and for the other uses to which it is put, outside of pharmacy, there are different agents which may be more satisfactorily employed, IS ALCOHOL FOOD ? So well agreed are all the scientific investigators that alcohol has no appreciable food value that it would seem foolish to spend time upon a discussion of alcohol as food were it not that the idea of its "supporting the vitality" in disease, in some mysterious way is deeply rooted in the professional, as well as the popular mind. Foods are substa?ices which, when taken into the body, undergo change by the process of digestion ; they give strength and heat and force ; they build up the tissues of the body, and make blood ; and they induce healthy, normal action of all the bodily functions. ALCOHOL AS A MEDICINE. 99 Alcohol does none of these. It undergoes no change in the stomach, but is rapidly absorbed and mixed with the blood, and has been discovered hours after its ingestion in the brain, blood and tissues, unchanged alcohol. In many of the experi- ments made with it upon animals, considerable quantities of the amount swallowed were recovered from the excretions of the body, without any change having taken place in its composition. This, of itself, is sufficient evidence to show that it is a substance which the body does not recognize as a food. Foods buildup the tissues of the body. All phys- iologists are agreed that since alcohol contains no nitrogen it cannot be a tissue-forming food ; there is no difference of opinion here. Dr. Lionel Beale, the eminent physiologist, says that alcohol is not a food and does not nourish the tissues. " There is nothing in alcohol with which any part of the body can be nourished." — Cameron's Alanual of Hygietie. " Alcohol contains no nitrogen ; it has none of the qualities of the structure-building foods ; it is incapable of being trans- formed into any of them ; it does not supply caseine, albumen, fibrine or any other of those substances which go to build up the muscles, nerves and other active organs." — Sir B. W. Richardson. " It is not demonstrable that alcohol undergoes conversion into tissue." — Dr. W. A. Hammond. If it is a food why do all writers and experiment- ers exclude it from the diet of children, and why is lOO ALCOHOL AS A MEDICINE. the caution always given people to not take it upon an empty stomach ? Foods are supposed to be particularly suited to an empty stomach. Foods induce healthy, normal action of all the bodily functions. The chapter upon " Diseases Produced by Alco- hol " is evidence that by this test alcohol shows up in its true nature as a poison, and not a food. Alcohol destroys healthy normal action of all the bodily functions, and builds up impure fat, fatty degeneration, instead of strong, firm muscle. Dr. Parkes, one of the most famous of English students of alcohol, says : — " These alcoholic degenerations are certainly not confined to the notoriously intemperate. I have seen them in women ac- customed to take wine in quantities not excessive, and who would have been shocked at the imputation that they were taking too much, although the result proved that for them it was excess." Dr. Ezra M. Hunt, late secretary of New Jersey State Board of Health, remarks : — " The question of excess occurs in sickness as well as in health, and all the more because its determination is so difficult and the evil effects so indisputable. The dividing Hne in medi- cine, even between use and abuse, is so zigzag and invisible that common mortals, in groping for it, generally stumble beyond it, and the delicate perception of medical art too often fails in the recognition." All non-alcoholic writers assert that the continu- ous use of alcohol as a medicine is equally injurious ALCOHOL AS A MEDICINE. lOI to all the bodily functions as the employment of it as a beverage. Calling it medicine does not change its deadly nature, nor does the medical attendant possess any magical power by which a destructive poison may be converted into a restorative agent. Dr. Noble, writing recently to the London Times, said : — " The internal use of alcohol in disease is as injurious as in health." Since foods induce healthy, normal action of all the bodily functions, and alcohol injures every organ of the body in direct proportion to the amount con- sumed, by this test it is proved to not be a food. Foods give strengtJi. Alcohol weakens the body. This has been determined again and again by ex- periments upon gangs of workmen and regiments of soldiers. These experiments always resulted in showing that upon the days when the men were supplied with liquor they could neither use their muscles so powerfully, nor for so long a time, as on the days when they received no alcoholic drink. Of the results of such tests Sir Andrew Clark, late Physician to Queen Victoria, said : — *' It is capable of proof beyond all possibility of question that alcohol not only does not help work but is a serious hinderer of work." So satisfied are generals in the British army of the weakening effect of alcohol that its use is now forbidden to soldiers when any considerable call is 102 ALCOHOL AS A MEDICINE. to be made upon their strength. The latest ex- ample of this was in the recent Soudan campaign under Sir Herbert Kitchener. An order was issued by the War Department that not a drop of intoxi- cating liquor was to be allowed in camp save for hospital use. The army made phenomenal forced marches through the desert, under a burning sun and in a climate famous for its power to kill the unacclimated. It is said that never before was there a British campaign occasioning so little sick- ness and showing so much endurance. Some Greek merchants ran a large consignment of liquors through by the Berber-Suakim route, but Sir Her- bert had them emptied upon the sand of the desert. A reporter telegraphed to England : — " The men are in magnificent condition and in great spirits. They are as hard as nails, and in a recent desert march of fifteen miles, with manoeuvring instead of halts, the whole last- ing for five continuous hours, not a single man fell out ! " This was in decided contrast to the march in the African war some years before when, as they passed through a malarial district, and a dram was served, men fell out by dozens. Dr. Parkes, one of the medical ofificers, prevailed upon the commander-in- chief to not allow any more alcoholic drams while the troops were marching to Kumassi. Experiments in lifting weights have also been tried upon men by careful investigators. In every case it was found that even beer, and very dilute solutions of alcohol, would diminish the height to ALCOHOL AS A MEDICINE. IO3 which the lifted weight could be raised. As an il- lustration of the deceptive power of alcohol upon people under its influence, it is said that persons experimented upon were under the impression, after the drink, that they could do more work, and do it more easily, although the testing-machine showed exactly the contrary to be true. Athletes and their trainers have learned by ex- perience that alcohol does not give strength, but is, in reality, a destroyer of muscular power. No care- ful trainer will allow a candidate for athletic honors to drink even beer, not to speak of stronger liquors. When Sullivan, the once famous pugilist, was de- feated by Corbett, he said in lamenting his lost championship, *' It was the booze did it " ; meaning that he had violated training rules, and used liquor. University teams and crews have proved substan- tially that drinking men are absolutely no good in sports, or upon the water. Football and baseball teams, anxious to excel, are beginning to have a cast-iron temperance pledge for their members. So practical experience of those competing in tests of strength and endurance teach eloquently that alcohol does not give strength, but rather weakens the body, by rendering the muscles flabby. Sandow, the modern Samson, wrote his methods of training in one of the magazines a few years ago, and stated that he used no alcoholic beverages. The ancient Samson was not allowed to taste even wine from birth. I04 ALCOHOL AS A MEDICINE. A question worthy of serious consideration is: how are the sick to be strengthened and ** sup- ported " by drinks which athletes are warned to specially shun as weakening to the body ? Either the sick are mistakenly advised, or the athletes are in error. Which seems the more likely ? Dr. Richardson says in Lectures on Alcohol : — " I would earnestly impress that the systematic administration of alcohol for the purpose of giving and sustaining strength is an entire delusion." In another place he says : — " Never let this be forgotten in thinking of strong drink : that the drink is strong only to destroy ; that it never by any pos- sibility adds strength to those who drink it." Sir William Gull, late physician to the Prince of Wales, said before a Select Committee of the House of Lords on Intemperance : — " There is a great feeling in society that strong wine and other strong drinks give strength. A large number of people have fallen into that error, and fall into it every day." Any unprejudiced person can readily see that ex- perience and experiment unite in testifying that alcohol does not give strength, hence differs rad- ically from most substances commonly classed as foods. Yet millions of dollars are spent annually by deluded people upon supposedly strength-giving drinks, and thousands of the sick are ignorantly, or carelessly, advised to take beer or wine to make them strong and to support them when solid ios^ cannot be assimilated. Truly, " My people is de- stroyed for lack of knowledge." ALCOHOL AS A MEDICINE. 105 Foods give force to the body. Dr. Richardson says : — " We learn in respect to alcohol that the temporary excite- ment is produced at the expense of the animal matter and animal force, and that the ideas of the necessity of resorting to it as a food, to build up the body or to lift up the forces of the body, are ideas as solemnly false as they are widely dis- seminated." Dr. Benjamin Brodie says in Physiological In- quiries : — " Stimulants do not create nerve power ; they merely enable you, as it were, to use up that which is left.'' Dr. E. Smith :— " There is no evidence that it increases nervous influence, while there is much evidence that it lessens nervous power." Dr. Wm. Hargreaves, of Philadelphia : — • " It is sometimes said by the advocates and defenders of alcohol, that by its use force is generated more abundantly. This it certainly cannot do, as it does not furnish anything to feed the blood or to store up nourishment to replenish the expenditure. For by their own theory, the increase of action must cause an increase of wear and tear ; hence alcohol instead of sustaining life or vitality, must cause a direct waste or expenditure of vital forced Dr. Augusta Forel, of Switzerland : — '• All alcoholic liquors are poisons, and especially brain- poisons, and their use shortens life. They cannot therefore be regarded as sources of nourishment or force. They should be resisted as much as opium, morphia, cocaine, hashish and the like." Io6 ALCOHOL AS A MEDICINE. Dr. W. F. Pechuman, of Detroit, in his valuable little treatise, Alcohol — Is it a Medicine ? says clearly : — " When alcohol or any other irritant poison is put into the system, the conservative vital force, recognizing it as an enemy, at once makes an effort through the living matter to rid the system of the offender ; — the heart increases in action and new strength seems to appear. Now, right here is where the great mass of people and a large number of physicians are deluded. They mistake the extra effort of the vital force to preserve the body against harmful agencies for an actual increase in strength as the result of the agent given ; we wonder that they can be so blind as not to see the reaction which invariably occurs soon after the administration of their so-called stimu- lant." Dr. F. R. Lees, of England : — " All poisons lessen vitality and deteriorate the ultimate tissue in which force is reposited. Alcohol is an agent, the sole, perpetual and inevitable effects of which are to avert blood development, to retain waste matter, to irritate mucous and other tissues, to thicken normal juices, to impede diges- tion, to deaden nervous sensibility, to lower animal heat, to kill molecular life, and to waste, through the excitetnent it creates in heart and head, thegra?td controlli7ig forces of the nerves and brain*' If alcohol is a destroyer of bodily force, as any ordinary observer of drinking men can readily see, it is a problem beyond solving, how it is going to give force to, or sustain vitality in, the patient hovering betv^^een life and death. Too often has it been the means of hastening into eternity those who, but for its mistaken use, might have recovered from the illness affecting then. ALCOHOL AS A MEDICINE. 10/ Food gives heat to the body. Alcohol does not, but really robs the body of its natural warmth. This finding of science was re- ceived with the utmost incredulity when first presented to the medical world, but the invention of the clinical thermometer settled it beyond con- troversy. It is now believed by all but a very few of those who have knowledge of the physiological effects of alcohol. While Dr. N. S. Davis, of Chicago, was the first to demonstrate this fact, it was Dr. B. W. Richardson, of England, who succeed- ed in putting it prominently before the attention of physicians. The normal temperature of the human body is a little over 98 degrees by Fahrenheit's thermometer. If the temperature is found to be much above or below 98 degrees the person is considered out of health ; indeed by this condition alone physicians are able to detect serious forms of disease. By the use of the clinical thermometer, placed under the tongue, it is easy to determine what agents acting upon the body will cause the temperature to vary from the natural standard. When alcohol is swal- lowed there is at first a decided feeling of warmth induced ; if the temperature be taken now it will be found that in a person unaccustomed to alcohol the warmth may be raised half a degree ; in one accustomed to alcohol the warmth may be raised a full degree, or even a degree and a half beyond the natural standard. But this warmth is only temporary, and is soon succeeded by chilliness. I08 ALCOHOL AS A MEDICINE. Dr. Richardson says in his Temperance Lesson Book : — " The sense of warmth occtirs in the following way : When the alcohol enters the body, and by the blood-vessels is conveyed to all parts of the body, it reduces the nervous power of the small blood-vessels which are spread out through the whole of the surface of the skin. In their weakened state these vessels are unable duly to resist the course of blood which is coming into them from the heart under its stroke. The result is that an excess of warm blood fresh from the heart is thrown into these fine vessels, which causes the skin to become flushed and red as it is seen to be after wine or other strong drink has been swallowed and sent through the body. So, as there is now more warm blood in the skin than is natural to it, a sense of increased warmth is felt. The skin of the body is the most sensitive of substances and the sense of warmth through, or over the whole surface of the skin is conveyed from it to the brain and nervous centres of the body, by which we are enabled to feel. "The warmth of surface which seems to be imparted by alcohol, only seems to be imparted. Positively the warmth is not imparted by the alcohol, but is set free by it. - In a short time the sense of warmth is succeeded by a feel- in? of slight chilliness. Unless the person is in a very warm room, or has recently partaken of food, the thermometer will now show a decided decrease in temperature, reaching often to a degree. Should the person go out into a cold air, and especially should he go into a cold air while badly supplied with food, the fall of temperature may reach to two degrees below the natural standard of bodily heat. In this state he easily takes cold, and in frosty weather readily contracts congestion of the lungs, and that disease which is known as bronchitis. If the person drinks to drunkenness his temperature will be found to be from two and a half to three degrees below the natural ALCOHOL AS A MEDICINE. IO9 standard. It takes from two to three days, under the most favorable circumstances, for the animal warmth to become steadily re-established after a drunken spree. " The excitement of the mind in the early stages of drunken- ness is not natural ; it is exhaustive of the bodily powers, and exhaustive for no useful purpose whatever. ***** " As nothing has been supplied by the alcohol to keep up the supply of heat the vital energy is rapidly exhausted, and if the person is exposed to cold, the exhaustion becomes extreme, sometimes fatal. All great consumers of alcohol are chillier during winter than are abstainers, and as they labor under the delusion that they must take wine or ale or spirits to keep them warm, they keep on making matters worse by constantly resorting to their enemy for relief." Dr. Newell Martin makes this very clear in his physiology, The Human Body. " Our feeling of being warm depends on the nerves of the skin. We have no nerves which tell us whether heart or myscles or brain, are warmer or cooler. These inside parts are always hotter than the skin, and if blood which has been made hot in them flows in large quantity to the skin, we feel warmer because the skin is heated. As alcoholic drinks make more blood flow through the skin, they often make a man feel warmer. But their actual effect upon the temperature of the whole body is to lower it. The more blood that flows through the skin, the more heat is given off from the body to the air, and the more blood, so cooled, is sent back to the internal organs. The consequence is that alcohol, in proportion to the amount taken, cools the body as a whole, though it may for a time heat the skin." If other evidence that alcohol is not heat-produc- ing in the body were necessary it could be found in the fact that the products of combustion are de- no , ALCOHOL AS A MEDICINE. creased when it is present in the body. The quantity of carbonic acid exhaled by the breath is proportionately diminished with the decline of animal heat. Arctic explorers learned by experience what science discovered by experiment. Dr. Hayes, the explorer, says : — " While fresh animal food, and especially fat, is absolutely essential to the inhabitants and travelers in Arctic countries, alcohol, in almost any shape, is not only completely useless, but positively injurious." Lieutenant Johnson, who accompanied Nansen upon his northern expedition, said, when inter- viewed by a reporter of the London Daily News : — " The common opinion that alcohol becomes in some w^ay a necessity in cold countries is entirely a mistaken one. This has been conclusively proved by the expedition. In making- up his list of the Frains equipments, Nansen did not include any spirits, v^^ith the exception of some spirits of w^ine for lamps and stoves." In the list of stores taken upon the long sledging expedition after leaving the Frant no liquors are mentioned. See Farthest North, by Nansen. The omission of spirits was not because of any " tem- perance fanaticism," but because the experience of former Arctic expeditions had shown clearly that men freeze more readily after partaking of alcohol than when they totally abstain from it. That wine is not a fuel-food was shown conclu- sively in the Franco-Prussian war during the siege ALCOHOL AS A MEDICINE. Ill of Paris. Food was scarce in the French army, and wine was liberally supplied. The men com- plained bitterly of the extreme chilliness which affected them. Dr. Klein, a French staff surgeon, was reported in the Medical Temperance Journal of England, October, 1873, as saying of this:— " We found most decidedly that alcohol was no substitute for bread and meat. We also found that it was no substitute for coals. We of the army had to sleep outside Paris on the frozen ground. We had plenty of alcohol, but it did not make us warm. Let me tell you there is nothing that will make you feel the cold more, nothing which will make you feel the dread- ful sense of hunger more, than alcohol." There is no evidence against alcohol stronger than that which shows it to be not heat-producing, as commonly believed, but a reducer of heat in the body. Indeed, this question of bodily temperature is used in recent times to decide whether a man who has fallen upon the street is troubled by apo- plexy, or influenced by alcoholism. If the clinical thermometor shows the temperature to be above normal, it is apoplexy ; if below normal, it is al- coholism. " Alcohol is clearly proved to not be a fuel-food, for if it were it would enable the body to resist cold, instead of making it colder ; and in the extreme degrees of cold it would go on burning like other fuel-foods, and would maintain, instead of helping to destroy, life." — Richardson's Lesso7i Book. Yet because it creates a glow of warmth in the skin immediately after drinking it, thousands of 112 ALCOHOL AS A MEDICINE. people will discredit all evidence that it is a reducer of bodily heat. Clinical thermometers, and after- sensations of chilliness, are unheeded, for *' Wine is a mocker," and multitudes are willing to be deceived by it. So, also, with the conclusions against it as a strengthening agent ; because it dulls the sense of hunger and of fatigue, those who crave it will de- clare in the face of all scientific testimony that it strengthens them, and takes the place of food. They will cite, too, the cases of people who 'Mived upon whisky " during an illness of greater or less duration. Of the sustaining of life upon alcohol only, Dr. N. S. Davis has said : — ■ " The falsity of all such stories is made apparent by the fact that nineteen-twentieths of all the alcoholic drinks given to the sick are given in connection with sugar, milk, eggs or meat- broths, which furnish the nutriment, and would support the patients better if given with the same perseverance without the alcohol than with it. While we have quite a number of exam- ples of men living on nothing but water forty or fifty days, I have never seen or learned of a well-authenticated case of a man's taking or receiving into his system nothing but alcohol for half of that length of time, without becoming sick with either gastro-duodenitis, nephritis, or delirium tremens." Some of the defenders of the medicinal use of alcohol claim that since it has been shozvn to reduce tissue waste it should be classed as an indirect food, a conserver of tissue. Of this claim, Dr. N. S. Davis says in the Bulletin of the A. M, T. A., November, 1895:- ALCOHOL AS A MEDICINE. II3 " A careful study of the conditions and processes necessary for both tissue building or nutrition, and tissue waste or dis- integration, in all the higher order of animals, will show that neither process can be materially retarded without retarding or preventing the other. Both processes take place only in bioplasm or vitalized matter, supplied with oxygen, water and heat. Neither the assimilation of new material food, nor its use in tissue building can be effected without the presence of free oxygen and nuclein, or corpuscular elements of the blood. And without the presence of the same elements we can have no natural tissue disintegration and removal of the waste. The processes of tissue building and tissue disintegration, are therefore, so intimately related, and dependent upon the same materials and forces, that neither can be hastened or retarded from day to day without influencing the other. When alcohol or any other substance, introduced into the blood, retards the tissue waste, as shown by the diminished amount of excretory products, it must do so by either diminishing the amount of free oxygen in the blood, by impairing the vasomotor and trophic nerve .functions or by direct impairment of the prop- erties of the nuclein or protogen elements of the blood and tissues. The popular idea, both in and out of the profession is_, that the alcohol, by further oxidation in the blood, lessens the amount of oxygen to act on the tissues, and generates heat or * some kind of force.' Those who advocate this theory of saving the tissues by combining the oxygen with alcohol seem to for- get that in doing so they are diverting and using up the only agent, oxygen, capable of combining with, and promoting the elimination of, all natural waste products as well as the various toxic elements causing disease. " But the theor\^ that alcohol directly combines with the oxygen of the blood by which it would be converted into car- bonic acid and water with evolution of heat is completely refuted by the well-known fact that its presence in the blood diminishes both temperature and elimination of carbonic acid 114 ALCOHOL AS A MEDICINE. as already stated. Physiologists of the present day very gener- ally agree that the capacity of the blood to receive oxygen from the lungs, and convey it to the systemic capillaries and various tissues, depends chiefly on its hemoglobin (red coloring matter), protein, or albuminous and saline elements. '• Both experimental and clinical facts in abundance show that alcohol at all ordinary temperatures displays a much stronger affinity for these elements of the blood and tissues, than it does for oxygen. And when present in the blood, it rapidly attracts both water and hemoglobin from the cor- puscular and albuminoid elements of that fluid, and thereby diminishes its reception and distribution of oxygen. We are thus enabled to see clearly how the alcohol diminishes the oxygenation and decarbonization of the blood, and retards all tissue changes both of nutrition and waste without itself under- going oxidation with evolution of heat. Consequently, instead of acting as a shield or conservator of the tissues by simply combining with the oxygen, the alcohol directly impairs the properties and functions of the most highly vitalized elements of the blood itself, and thereby not only retards tissue waste but also equally retards the highest grades of nutrition, and favors only sclerotic, fatty and molecular degenerations, as we see everywhere resulting from its continued use. Can an agent displaying such properties and effects be called a food, either direct or indirect, without a total disregard for the proper meaning of words } " In another place he says : — " This lessening of the elimination of tissue waste is simply an evidence of the accumulation of poisonous substances with- in the body, through the lessened activity of liver and kidneys and the impairment of the blood.'' Dr. Ezra M. Hunt says in Alcohol as Food and as Medicine, page 37 : — ALCOHOL AS A MEDICINE. II5 " It sounds conservative of health to say of a substance that it delays the breaking down of tissue, but the physiologist does not allow a substance which occasions such delay, to possess, because of that, either dietetic or remedial value. To increase weight by prolonged constipation is not a physiological process." Dalton says : — • " The importance of tissue change to the maintenance of life is readily shown by the injurious effects which follow upon its disturbance. If the discharge of the excrementitious substances be in any way impeded or suspended, these substances ac- cumulate either in the blood or tissues, or both. In con- sequence of this retention and accumulation they become poisonous, and rapidly produce a derangement of the vital functions. Their influence is principally exerted upon the nervous system, through which they produce most frequent irritability, disturbance of the special senses, delirium, insensi- bility, coma, and finally, death." The power to retard the passage of waste matter from the system is one of the gravest objections to the use of alcohol in sickness, as the germs of dis- ease are thereby caused to remain longer in the body than they would, were no alcohol or drug of similar action, used. Thus recovery is delayed, if not effectually hindered. The preponderance of scientific evidence is all against alcohol as possessing food qualities. It contains no elements capable of entering into the composition of any part of the body, hence cannot give strength ; it is not a fuel-food as it does not supply heat to the body, but decreases temperature ; and its classification as indirect food because it re- Il6 ALCOHOL AS A MEDICINE. tards the passage of waste matter is shown to be utterly unscientific, as any agent which interferes with the natural processes of assimilation and dis- integration is a dangerous agent, a poison rather than a food. The question naturally arises : — If these drinks are not liquid food, as we have been taught to believe, how is it, since they are made from food, as barley, corn, grapes, potatoes, etc? These drinks are not food, although made from food, because in the process of manufacturing them the food principle is destroyed. The grain is malted to change starch into sugar — loss of food principle begins here — then the malted grain is soaked in water to extract the saccharine matter. When the sugar is all in the water the grain goes to feed cattle or hogs, and the sweetened water is fermented. The fermentation changes the sugar into alcohol. Analyses of beer by eminent chemists show an average of 90 per cent, water, 4 per cent, alcohol, and 6 per cent, malt extract. The malt extract consists of gum, sugar, various acids, salts and hop extract. Starch and sugar are all of these capable of digestion, and the amount of them would be equal to 39 ounces to the barrel of beer. Liebig, the great German chemist, said : — - "If a m^R drinks daily 8 or 10 quarts of the best Bavarian ALCOHOL AS A MEDICINE. 11/ beer, in a year he will have taken into his system the nutritive constituents contained in a 5 pound loaf of bread." Eight quarts a day for a year would be 2,920 quarts, or a little more than 23 barrels. If sold to the consumer at the low rate of five cents a pint, it would cost him $292 ; a high price for as much nour- ishment as in a 5 pound loaf ! Analyses of wine by reliable chemists show that the consumer must pay $500 for the equivalent in nourishment of a 5 pound loaf of bread, wine being higher priced than beer. Wines average 80 per cent, water, about 15 per cent, alcohol, and 5 per cent, residue. This residue is composed of sugar, tar- taric, acetic and carbonic acids, salts of potassium and sodium, tannic acid, and traces of an ethereal substance which gives the peculiar or distinguishing flavor. The only one of these ingredients possess- ing food value is sugar ; this exists chiefly in what are called sweet wines. Yet how many thousands of people spend money they can ill afford for wines and beers to build up the failing strength of some loved one ! A costly delusion, and too often a fatal one ! " Distilled liquors, if unadulterated, contain literally nothing but water and alcohol, except traces of juniper in gin, and the flavor of the fermented material from which they have been dis- tilled." — Influe7ice of Alcohol, by N. S. Davis, M. D. It is the solemn duty of those to whom the people look for instruction in matters of health to unde- ceive the toiling masses as to the food-value of alco^ Il8 ALCOHOL AS A'MEDICINE. holic liquids. Some of the medical profession are faithful in this regard, but too many others are themselves deceived, or care not for the destruction of the people. IS ALCOHOL A STIMULANT? A lady asked her family physician several years ago what he thought of the views of those medical writers who class alcohol as a narcotic, and not a stimulant. He answered with some heat, "Any one who says alcohol is not a stimulant is either a fool or a knave ! " He could not have been aware that some of the most distinguished professors in American medical colleges teach that alcohol is not, properly speaking, a stimulant, but a narcotic. The accepted definition of a stimulant in medical literature is some agent capable of exciting or in- creasing vital activity as a whole, or the natural activity of some one structure or organ. Dr. N. S. Davis has said repeatedly that both clinical and experimental observations show that alcohol directly diminishes the functional activity of all nerve structures, pre-eminently those of res- piration and circulation, thus decreasing the internal distribution of oxygen, which is nature's own special exciter of all vital action. "Consequently it is antagonistic to all true stimulants or remedies capable of increasing vital activity. Instead, therefore, of meriting the name of stimulant, alcohol should be designated and used only as an anaesthetic and sedative, or depressor of vital activity." ALCOHOL AS A MEDICINE. II9 The following is taken from an editorial article in the American Medical Temperance Quarterly for January, 1894: — " Drs. Sidney Ringer and H. Sainsbury in a carefully exe- cuted series of experiments on the isolated heart of the frog, found that all the alcohol when mixed with the blood circulat- ing through the heart, uniformly diminished the action of that organ in direct proportion to the quantity of alcohol used, until complete paralysis was induced. In closing their report in re- gard to the action of different alcohols, they say that ' by their direct action on the cardiac tissue these drugs are clearly paralyzant, and that this appears to be the case from the out- set, no stage of increased force of contraction preceding .' " Professor Martin, while in connection with the Johns Hop- kins University, performed an equally careful series of experi- ments in regard to the action of ethylic, or ordinary alcohol, directly on the cardiac structures of the dog, and with the same results. He makes the following explicit statement of the results obtained by him. ' Blood containing one-fourth per cent, by volume, that is two and a half parts per 1000 of abso- lute alcohol, almost invariably diminishes, within a minute, the work done by the heart ; blood containing one-half per cent, always diminishes it, and may even bring the amount pumped out by the left ventricle to so small a quantity that it is not suffi- cient to supply the coronary arteries.' " In 1883, R. Dubois, by direct experimenting upon animals, found that the presence of alcohol in the blood much intensified the action of chloroform and thereby rendered a much less dose fatal. " Prof. H. C. Wood of the University of Pennsylvania, in an address upon Ansesthesia to the Tenth International Medical Congress, of Berlin, in 1890, said : * In my own experiments with alcohol, an eighty per cent, fluid was used largely diluted with water. The amount injected into the jugular vein varied in the I20 ALCOHOL AS A MEDICINE. 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 pressure produced by alcohol, when the heart was failing during advanced chloroform anaesthesia. On the other hand, on several occasions, the larger amounts of alcohol apparently greatly increased the rapidity of the fall of arterial pressure, and aided materially in extinguishing the pulse.' " Sir Henry Thompson says : ' That alcohol is an anaesthetic and paralyzant is a fact too well established to be questioned or contradicted.' '' Dr. J. J. Ridge, of London, has published elaborate tables, showing that even small doses of alcohol, averaging one table- spoonful of spirits — not quite half a wineglass of claret or champagne, and not quite a quarter of a pint of ale — impair vision, feeling, and sensibility to weight, without the subject's being conscious of any alteration. Dr. Scougal, of New York, has repeated and confirmed these experiments, and also demon- strated that the hearing was similarly affected. " Drs. Nichol and Mossop, of Edinburgh, conducted a series of experiments on each other, examining the eye by means of the ophthalmoscope while the system was under the influence of Various drugs. They found that the nerves controlling the delicate blood-vessels of the retina were paralyzed by a dose of about a tablespoonful of brandy. "Dr. T. D. Crothers, of Hartford, Conn., has deduced some valuable facts from his experiments with the sphygmograph, upon the action of the heart. He has found by repeated ex- periments that while alcohol apparently increases the force and volume of the heart's action, the irregular tracings of the sphyg- mograph show that the real vital force is diminished, and hence its apparent stimulating power is deceptive." — Extract from the Annual Address before the Medical Temperance Association at San Francisco, Cal, June 8, 1894, by Dr. I. N, Quimby, of Jersey City, N. J. ALCOHOL AS A MEDICINE. 121 Dr. J. 11. Kellogg, of Battle Creek, Mich., has made extensive experiments as to the effects of alcohol. In summing up the results of these he says : — " It would seem that no further evidence could be required that alcohol is a narcotic and an anaesthetic, rather than a stimulant, and that its use as a supporting and tonic remedy is a practice without foundation in either scientific theor)' or natural clinical experience." Sir B. \V. Richardson at a medical breakfast in London in 1895, stated that though alcohol produced an increase in the motion of the heart it was ulti- mately weaker in its action, so he resolved to give up using such an agent. Dr. A. B. Palmer of the University of Michigan prepared a ^' Report " upon alcohol in 1885 for the Michigan State Medical Society in which he cited experiments showing that the opinion that alcohol stimulates the heart by an increase of real force, is an error. It creates a flutter, but decreases power. " Increased frequency of pulsation is often the strongest evi- dence of diminished power — as the fluttering pulse of extreme weakness." He classes alcohol with chloroform. " If chloroform is a narcotic, alcohol is a narcotic. If chloro- form is an anaesthetic, alcohol is an anesthetic. If one is essentially a depressing agent, so is the other. Their strong resemblance no one can question. The chief difference is that the alcoholic narcosis is longer continued, and its secondary effects are more severe." 122 ALCOHOL AS A MEDICINE. In closing his summary of the changes in scientific knowledge of this drug he says : — " We said it was a direct heart exciter. We now know it is a direct heart depressor. We said, and nearly all the text-books still say, it is a direct cardiac stimulant. We know from most conclusive experiments it is a'direct cardiac paralyzant." The following is taken from one of the many ex- cellent papers upon alcohol written by that Nestor among physicians, Dr. N. S. Davis : — " Alcoholics are very generally prescribed in that weakness of the heart sometimes met with in low forms of fever and in the advanced stage of other acute diseases. It is claimed that these agents are capable of strengthening and sustaining the action of the heart under the circumstances just named, and also under the first depressing influence of severe shock. " There is nothing in the ascertained physiological action of alcohol on the human system, as developed by a wide range of experimental investigation, to sustain this claim. I have used the sphygmograph and every other available means for testing experimentally the effects of alcohol upon the action of the heart and blood-vessels generally, but have failed in every in- stance to get proof of any increased force of cardiac action. " The first and very transient effect is generally increased frequency of beat, followed immediately by dilatation of the peripheral vessels from impaired vasomotor sensibility, and the same unsteady or wavy sphygmographic tracing as is given in typhoid fever, and which is usually regarded as evidence of cardiac debility. Turning from the field of experimentation to the sick-room, my search for evidences of the power of alcohol to sustain the force of the heart, or in any way to strengthen the patient has been equally unsuccessful. I was educated and entered upon the practice of medicine at a time when alcoholic drinks were universally regarded as stimulating and ALCOHOL AS A MEDICINE. I23 heat-producing, and commenced their use without prejudice or preconceived notions. But the first ten years of direct clinical or practical observation satisfied me fully of the incorrectness of those views, and very nearly banished the use of these agents from my list of remedies. While it is true that during the last thirty years I have not prescribed for internal use the aggregate amount of one quart of any kind of fermented or distilled drinks, either in private or hospital practice, yet I have continued to have abundant opportunity for observing the effects of these agents as given by others with whom I have been in council ; and simple truth compels me to say that I have never yet seen a case in which the use of alcoholic drinks either increased the force of the heart's action or strengthened the patient beyond the first thirty minutes after it was swal- lowed. >is * * Hs * " Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of patient and friends something must be done. A little wine or brandy is given, and, as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither vi^ine nor brandy had been used." In the Medical Pioneer of November, 1895, Prof. E. MacDowel Cosgrave, Professor of Biology, Royal College of Surgeons in Ireland, says : — " The result of all recent investigation is to show that the use of alcohol when a stimulant effect is desired, is an error ; and that, from first to last alcohol acts as a narcotic." Dr. Edmunds, of London, said in an address given in Manchester: — " By giving alcohol as a stimulant in exhausting diseases, I believe we always do as we should in giving a dose of opium 124 ALCOHOL AS A MEDICINE. and brandy and water to comfort a half suffocated patient ; i. e., increase his danger. If that be so, we reduce alcohol not only from the position of food medicine, but we reduce it from the position of a goad ; and we say that the supposititious stimu- lating or goading influence of alcohol is a mere delusion ; that in fact alcohol always lessens the power of the patients, and always damages their chance of recovery, when it is a question of their getting through exhausting diseases." Many more such quotations might be adduced. Enough are given to show that the popular use of alcohol, when a stimulant is required, is considered a grave error by those who have most thoroughly studied the effects of this drug. ALCOHOL AS A TONIC. Dr. J. J. Ridge, of London, says : — " The action of alcohol in relaxing unstriped muscular fibre, which entitles it to be called an anti-spasmodic, robs it of all claim to give tone. The sense of exhilaration which follows small doses of alcohol has been mistaken for real strength and increase of vitality. It is well known that relaxation of the blood-vessels throughout the body is one of the first effects of alcohol. The arteries of the retina have been observed to dilate after very small doses of alcohol. The diminution of tone is well seen in the tracings of the pulse under the influ- ence of alcohol. If one needs a tonic, therefore, alcohol is one of the things to be shunned altogether. " But alcoholic beverages contain other things beside alcohol. Beer contains infusion of hops, or other bitter stomachics. Some wines contain tannin. These ingredients, by creating or stimulating the appetite, increase the strength and vital power in certain cases. But we have a large number of drugs which ALCOHOL AS A MEDICINE. 1 25 will do the same without the disadvantages arising from the presence of alcohol, and, if the flavor be objected to, many of them can be taken in the form of coated pills. " The external use of cold, either by a dripping sheet, cold sponging, or a shower-bath, according to the power of reaction, is a valuable means of giving real tone. " Wine is frequently prescribed for those young persons who are growing rapidly, and whose strength does not seem to keep pace with their growth. It is important to know that alcohol is not desirable in such circumstances. There is often found in such cases a defective appetite, perhaps even sub-acute gastric catarrh, which may be due to imperfect mastication through bad teeth, or aggravated by it. There are other causes, such as late hours, bad habits, improper food or irregular meals. In such cases those means must be resorted to which are so effectual in improving the condition and strengthening the heart of athletes. Regular and regulated meals, exercise in the fresh air, a good amount of rest and sleep — these wull do more than anything else to invigorate the bodily health." Dr. N. S. Davis says : — " Although I was taught, like all others, to use alcohol as a tonic when patients were sick, to hasten their recovery and pro- mote their strength, yet it did not take me very long to find out that here and there was one already a teetotaler who would not take wine long, nor any kind of alcoholic drink unless prescribed, just as castor-oil, dose by dose, but who, when he got beyond the necessity of having it as a medicine, took no more. What was the comparison ? I\Iy patients who refused, or did not take akohol, got strong quicker and had less tendency to relapse than those who continued its use. Here was the first step in progress, and consequently I came soon to cease the recom- mending it merely to hasten recovery of strength. As a tonic, I found it of no value." 126 ALCOHOL AS A MEDICINE. Dn James Miller, of Edinburgh, says in Alcohol^ Its Place and Power, written many years ago : — " It may be well here to correct an important error, yet very current, in regard to the medicinal use of alcohol. People regard it as a simple and common tonic ; and are ready to accept its supposed help as such in every form of weakness and general disorder of health. But it is ordinarily, no true tonic." Dr. Ernest Hart, editor of the British Medical Journal, stated some years ago at a meeting of the British Medical Temperance Association that " the medical profession were nearly all agreed that alco- hol is neither a food nor a tonic." Many drunkards have been made, especially among women, by the delusion that alcohol has tonic effect. As a sample of these sad cases the following is given, taken from a recent number of The National Advocate : — " There is in the jail at Elizabeth, N. J., a woman who was arrested while participating in wild drunken orgies with a gang of tramps in the woods near the town. She appears nothing but a besotted hag, but was only a short time ago a dutiful wife of a respectable man, and the mother of three beautiful children. Her father, who is said to be living in a village in New York §tate, is a highly respected minister of the Methodist Episcopal Church. Her children are in an asylum, and her husband is a wanderer in the West. The cause of her ruin was beer, pre- scribed for her by the family physician as a tonic. At first she refused to take it, having always been a teetotaler, but per- suaded to obey the physician, she soon acquired a taste for the drink that speedily developed into the overmastering appetite, which has brought her and hers to this sad condition." ALCOHOL AS A MEDICINE. 12/ ALCOHOL AS A SEDATIVE. Dr. J. J. Ridge says in \^\^ Medical Pioneer y April, 1893:- " Alcohol, chiefly in the form of spirits, is often given to pro- cure sleep and to relieve pain, such as that of neuralgia, dyspepsia, colic and diarrhoea. It is as a sedative that alcohol is so insidious and seductive in cases of chronic disease, as, if frequently resorted to, the drink craving is almost certainly developed. Hence the importance in many cases of rather bearing the ills we have than of flying to others that we know not of. It is clear that other narcotics, such as opium, morphia, chorodyne, chloral, are open to the same objection, and the victims of these drugs are terribly numerous. ***** In many instances some form of dyspepsia is the cause of the sleeplessness, palpitation or other uneasy feehng for which a sedative is desired, and when this is cured the symptoms vanish." A prominent minister in a large American city was afflicted with insomnia a few years ago, and, after trying various remedies, was advised by a physician to try whisky '^ night-caps." He became a hopeless drunkard. A young medical student in New York appealed to one of his professors for aid in overcoming aggravated insomnia. The professor advised whisky and morphine ! The advice led to the ruin of the young man. ALCOHOL AS AN ANTIPYRETIC. " By the power of alcohol to retard the evolution of heat in retarding molecular changes in the tissues, the liquids contain- ing it may be used as antipyretics when the temperature is too high, and to retard the processes of waste when these are too rapid. But the antipyretic influence of alcohol is so feeble in 128 ALCOHOL AS A MEDICINE. comparison with the proper application of water to the surface, or with the internal administration of sulphate of quinia, sali- cylic acid, digitalis, etc. that no one thinks of using it for anti- pyretic purposes." — Dr. N. S. Davis in Principles and Prac- tice of Medicine. PROFESSOR ATWATER'S CONCLUSIONS UPON ALCOHOL AS A FUEL-FOOD. In 1899 a decided sensation was caused by the an- nouncement that Prof. Atwater, of Middletown, Conn., had proved that alcohol is a fuel-food equal in value to carbohydrates and fats. The study later of Prof. Atwater's report of his investigations led to prolonged discussions among medical men interested in the alcohol question, and his theory that alcohol is a food because it is oxidized in the body was vigor- ously opposed by many scientists of high standing. Professor Abel, of Johns Hopkins University, Balti- more, an investigator of alcohol who worked with the Committee of Fifty, said on this point : — "Oxidizability cannot be made the measure of usefulness in regard to this substance." Professor Gruber, president of the Royal Institute of Hygiene, Munich, said: — "Does alcohol truly deserve to be called a food substance? Obviously, only such substances can be called food material, or be employed for food, as, like albumen, fat, and sugar, exert non-poisonous influence in the amounts in which they reach the blood and must circulate in it in order to nour- ish* * * * Although alcohol contributes energy it dimin- ishes working ability. We are not able to find that its en- ergy is turned to account for nerve and muscle work. Very small amounts, whose food value is insignificant, show an in- jurious effect upon the nervous system." ALCOHOL AS A MEDICINK. 129 Sir Victor Horsley, the well-known London surgeon, said : — "We know that alcohol lowers the temperature of the body. It can only do that by dimmishing the activity of the vital processes. It also diminishes very greatly the power of the muscles, and it diminishes the intellectual power of the nerv- ous system. To call an agent that causes such diminution of activity throughout the whole body a food is ridiculous." An editorial in the Journal of the Amcrcian Medical Association said : "The fallacy of the reasoning which would place alcohol among the foods is very apparent when we put it in the form of a syllogism : All foods are oxidized in the body ; alcohol is oxidized in the body ; therefore alcohol is food. As logically we might say: 'All birds are bilaterally sym- metrical ; the earthworm is bilaterally symmetrical ; there- fore the earthworm is a bird.' Oxidation within the body is simply one of several important properties of food, as bi- lateral symmetry is one of several important characteristics of a bird." Schaf er's Physiology says : — "It cannot be doubted that any small production of energy resulting from the oxidation of alcohol is more than coun- terbalanced by its deleterious influences as a drug upon the tissue elements, and especially upon those of the nervous system." The Bulletin of the A. M. T. A. for July, 1899, contained an article upon Prof. Atwater by Dr. J. H. Kellogg, from which the following is taken : — " Starch, sugar and fats become foods or fuels only through their assimilation. Abundant physiological evidence attests that no substance can act as a food, or as a true source of energy, unless it has first entered into the composition of the body. It 130 ALCOHOL AS A MEDICINE. must be assimilated. The forces manifested by the body, the muscular forces, or nervous energy, are the result of the break- ing down of organized structure into simpler forms. For example, in the case of nervous energy, material from w^hich nerve energy is derived is stored up in the nerve cell, and can be seen with the microscope in the form of minute granules, which disappear as the cell energy is expended, leaving the cell blank and shriveled when in a state of extreme fatigue from overwork. The same is essentially true of the muscle cell. The source of muscular energy is glycogen, an organized sub- stance which becomes a part of the muscle tissue in a well- nourished muscle in a state of rest. " Experiments have clearly shown that fat, sugar and starch must all alike be converted into the form of glycogen and enter into the muscle structure before they can become a source of energy. " Professor Atwater tells us that alcohol can not form tissue, hence the query is pertinent, How can it be a source of vital energy ? The body does not burn food as a stove does fuel. Food can be called fuel only in a highly figurative sense. The oxidation of food in the body does not take place directly. Food is assimilated, becoming a part of the tissue. Oxygen is also assimilated, entering into the composition of the tissue along with the food elements under the action of special organic ferments brought into play by nervous impulses re- ceived from the central ganglia. "The molecules of these residual tissues which form the storehouse of energy in the body are rearranged in simpler forms, thereby giving up a portion of the energy which holds them together in the state in which they exist in the tissues, and this energy thus set free appears as muscle force, mental activity, glandular work and various other forms of functional activity." CHAPTER VII. ALCOHOL IN PHARMACY. In th.Q Journal of the America?t Medical Associa- tion for November 13, 1897, Dr. T. D. Crothers, editor of the Journal of Inebriety, says in a paper upon " Concealed Alcohol in Drugs " : — " A very important question has been repeatedly raised, and answered differently by persons who claim to have some expert knowledge. The question is, can strong tinctures of common drugs be given in all cases with safety ; tinctures of the various bitters w^hich contain from 10 to 40 per cent, of alcohol, and are used very freely by neurotic and debilitated persons } It is asserted with the most positive convictions that such tinctures are more sought for the narcotic effect of the alcohol than for the drugs themselves. " In my experience a large number of inebriates who are restored, relapse from the use of these tinctures given for their medicinal effects. ***** " The question is asked, how much alcohol can be used as a solvent in drugs without adding a new force more potent than that which is brought out by the alcohol ? Opinions of experts differ. One writer thinks 10 per cent, of alcohol in any drug will, if given any length of time, develop the physiologic effect of alcohol in addition to that of the drug. An English writer says that in some cases a 5 per cent, tincture is dangerous from the alcohol which it contains. " There is some doubt expressed by many authorities as to 131 132 ALCOHOL AS A MEDICINE. the potency of a drug which is covered up in a strong tincture. It is clear that the value of a drug is not enhanced, and it is certain that a new force-producing, or exploding agency, has been added to the body. " In experience, any drug which contains alcohol can not be given to persons who have previously used it without rousing up the old desire for drink, or at least producing a degree of irrita- tion and excitement that clearly comes from this source. It is also the experience of persons who are very susceptible to alco- hol, that any strong tincture is followed by headache and other symptoms that refer to disturbed nerve centres. " In many studies I have been surprised at the- increased ac- tion of drugs when given in other forms than the tincture. Gum and powdered opium, have far more pronounced narcotic action than the tincture. Yet the tincture is followed by a more rapid narcotism, but of shorter duration, and attended with more nerve disturbance at the onset. " I am convinced that a more exact knowledge of the physio- logic action of alcohol on the organism will show that its use in drugs as tinctures is dangerous and will be abandoned. " There are many reasons for believing that its use in pro- prietary drugs will be punished in the future under what is called the poison act." Dr. J. J. Ridge published in May, 1893, in the Medical Pioneer, the foUow^ing statement of the pharmacy of the London Temperance Hospital : — " When the Temperance Hospital was first opened, it became a question of practical importance, what should be done with regard to the alcohol so largely employed as a vehicle and drug excipient. Not that the principle of the treatment of disease without the ordinary administration of alcoholic beverages pre- cludes the employment of alcoholic tinctures, but it was felt that in such a test case as this it was important to obviate the objec- ALCOHOL AS A MEDICINE. 133 tion that while withholding alcohol as a beverage, it was given in the medicine. As a matter of fact, it is surprising, when one looks into it, how much alcohol is often given merely as a vehi- cle for other drugs, and without the special action of alcohol being required or desired. In prescriptions which are to be seen in many text-books, it is not uncommon to find from one to two or three, or even four drachms of rectified spirit in the form of tinctures or spirits. This is very undesirable. If alco- hol is needed it should be given in proper measured dose. But if it is not indicated, then it is not well to administer it in this indirect manner. " Experiments were therefore made, partly at the hospital and specially by Messrs. Southall Bros. & Barclay, of Birming- ham, with the result that new non-alcoholic tinctures were made replacing the following alcoholic tinctures and wines : — Tinct. Aloes. " Arnicas. " Aurantii. •' Belladonnse. " Buchu. " Calumb^. " Camph. Co. " Capsici. " Cascarillse. " Catechu, " Chiratse. " Cinchonse Co. Flav. " Cinnamomse. " Colchici Sem. " Conii. " Digitalis. •' Ferri Acet. " Ferri Perchlor. " Gentiani Co, Tinct. Hyosciami. " Kino. " Kramerise. *' Limonis. " Lobelice. " Nucis Vomicse. " Opii. " Quassiae. " Rhei. " Scillae, " Serpentariae. " Stramonii, " Valerianae. " " Ammon. Vin. Aloes. " Colchici Rad. Sim. " Ipecac. " Opii. " Rhei. 134 ALCOHOL AS A MEDICINE. " These were made by extracting the principles of the drugs in the usual way except that instead of alcohol a mixture of glycerine and water was used in the proportion of one-fourth to one-third part of glycerine, and about five per cent, of acetic acid. These made very elegant preparations, and in the major- ity of cases appeared to have just the same, and just as great physiological action. Subsequently the ordinary tinctures were distilled, and the extracts thus obtained dissolved in the above menstruum, as far as was possible, in most cases the residuum being found to be inert. " Gum resins and essential oils were found to be insoluble in this menstruum, and hence such drugs have been given in the form of pill, powder or mixture. Such tinctures are those of assafoetida, benzoin, cannabis indica, cantharides, castor, cubebs, lavender, myrrh, pyrethrum, sumbul, tolu and ginger. Out of 62 tinctures it was found that 46 made good preparations, and 16 did not. " These were employed for several years. But for some time past, somewhat more reliable preparations have been made for us which contain all the constituents of the alcoholic tinctures without the alcohol. They are for the most part made by tak- ing standardized tinctures, mixing with them sugar of milk, and distilling off the alcohol. The alcoholic extract remains behind in a finely divided condition mingled with sugar of milk. This is broken up, pulverized and compressed into tabloids of a definite dose, which can be taken either in that form or rubbed up and dissolved or suspended in gum water. " The following have been made up in this form : aconite, belladonna, camph. co.. cannabis indica, capsicum, cinchon. co., and cinchon. simpl, digitalis, gelseminum, hyosciamus, nux vomica, opium, strophanthus, ginger and Warburg. Other tinc- tures will be gradually added to this list. " As external liniments those^ommonly used are the linimen- tum terebinthinae and the linimentum terebinthinas aceticum. ALCOHOL AS A MEDICINE. 1 35 which do not contain alcohol. A strong solution of iodine is made with iodide of potassium. " The spiritus ammoniae aromaticus is made without the spirit, the aromatic oils being emulsionized by means of rubbing up with fine sand, but most of these subsequently rise to the sur- face. The spiritus etheris nitrosi is impossible without alcohol, but nitrite of amyl, and nitrites of potash or soda can be substi- tuted. The spiritus chloroformi is replaced by aqua chloroformi, or as a sweetening agent by solution of saccharin. Thus a favor- ite expectorant mixture contains carbonate of ammonia five grains, acetum ipecac, ten minims, and solution of saccharin in each dose. " As a special stimulant a subcutaneous injection of a drachm of pure ether has been given in a few cases : in others digitalis, or caffeine or ammonia in some form, such as the carbonate dissolved in a cup of hot coffee ; or hot solution of Liebig's extract, or rectal injections of hot water." It may be objected by some that glycerine be- longs to the family of alcohols, hence hospitals using glycerine tinctures are not, strictly speaking, non-alcoholic. To this the answer is, that while glycerine certainly is classed in the family of alco- hols, it is of a very different nature from ethyl alcohol, which is used for beverage purposes. Ethyl alcohol, the alcohol in all intoxicating bever- ages in common use, and the alcohol generally used in medicine, creates a fatal craving for itself, and is injurious to the body. Glycerine does not create any craving for itself, and has not been demonstrated to have injurious properties, and is not used for beverage purposes. At the annual meeting of the New York State 136 ALCOHOL AS A MEDICINE. Medical Society, held in New York City, in October, 1898, a discussion was held upon the use of alcohol as medicine. Dr. E. R. Squibb, a leading pharma- cist of Brooklyn, stated that during the last two or three years much had been accomplished in retiring alcohol as a menstruum for exhausting drugs. Of the other menstrua experimented with up to the present time, that which had given the best results was acetic acid, in various strengths. It had been discovered that a ten per cent, solution of acetic acid was almost universal in its exhausting powers. There were now in use in veterinary practice, and in some hospitals, extracts made with acetic acid. They were made according to the requirements of the pharmacopoeia, except that acetic acid was substituted for alcohol. Acetic acid, when used with alkaloids gives the physician some advantages in prescribing, owing to there being fewer incom- patibles. In small doses, the percentage of acetic acid in the extract is so small as to be hardly appreciable, and when larger doses are required, the acetic acid can be neutralized by the addition of potash or soda. Dr. Noble said, in article to London Times'h&iort referred to : — "Modern science has shown that those drugs which are soluble in alcohol only, are, in all probability, more hurtful than useful." The following from Dr. Jas. R. Nichols, editor Boston Journal of Chemistry^ is too good to be ALCOHOL AS A MEDICINE. I37 omitted, although it should be familiar to temper- ance students : — " The facetious Dr. Holmes has said, that if the contents of our drug-stores were taken out upon the ocean and thrown overboard, it would be better for the human race, but worse for the fishes. This statement may be a little sweeping ; but it is true that all the showy bottles in drug-stores which contain alcoholic decoctions and tinctures might be submerged in the ocean, and invalids would suffer no detriment. Since the active alkaloidal and resinoidal principles of roots, barks and gums have been isolated and put in better and more convenient forms, there is no longer need of alcoholic tinctures and elixirs. Laudanum, which is a tincture of opium, might be banished from the shelves of every apothecary, as it is not needed. It is now known that the valuable narcotic and hypnotic principles of opium are contained in certain crystalline bodies, which can be isolated, and used in minute and convenient forms, and that they can be held in aqueous solutions. Alcohol is no longer needed to hold the active principles of opium, Peruvian bark or other indispensable drugs. As regards the vegetable tonics so called, the best among them is the columbo (Radix columbo) and this readily yields its bitter principle to water, as does quassia, gentian, senna, rhubarb and most other valuable sub- stances. A careful survey of the contents of a well-appointed modern pharmacy leads to the conclusion that there is no one indispensable medicinal preparation which requires alcohol as a free constituent. " The catalogue of modern remedies is almost endless, and many of them hold alcohol in some form ; but every intelligent physician knows that 90 per cent, of these alleged remedies have little or no intrinsic value. The nostrums of the quack, the bitters, elixirs, cordials, extracts, etc. nearly all contain al- cohol, and this is the ingredient which aids their sale. The whole unclean list might, withj advantage to mankind, be thrown to the fishes. 138 ALCOHOL AS A MEDICINE. " The chemist, more particularly the pharmaceutical chemist, may inquire how he is to conduct his processes without alcohol. It is from the pharmaceutical laboratory we derive some of the most important substances used in medicines and the arts. Among them may be named ether, chloroform and chloral hy- drate, three of the most indispensable agents known to science, and the employment of alcohol is essential to their production. Alcohol is a laboratory product ; it is a chemical agent which belongs to the laboratory ; it is the handmaid of the chemist, and, so long as it exists, should be retained within the walls of the laboratory. In the manufacture of most of the important products in which alcohol is either directly or indirectly used, its production may be made simultaneous with the production of the agent desired. In the manufacture of ether and chloro- form, the apparatus for alcohol may be made a part of the de- vices from which the ultimate agents, ether and chloroform, result. Fermentation and distillation may be conducted at one end, and the anaesthetics received at the other. It is true that in a chemical laboratory alcohol is an agent very convenient in a thousand ways. But, if it were banished utterly, what would result? There are other methods of fabricating the useful products named, and many others, without the use of alcohol, but the processes would be rather inconvenient and more costly. The banishment of alcohol would not deprive us of a single one of the indispensable agents which modern civilization demands, and neither would chemical science be retarded by its loss. " It must be remembered that modern science has given us glycerine, naptha, bisulphide of carbon, pyroligneous products, carbolic acid and a hundred other agents which are capable of taking the place of alcohol in a very large number of appliances and processes." The sale of liquor in drug-stores is beginning to be deplored by the more respectable pharmacists. At the annual meeting of the Massachusetts State ALCOHOL AS A MEDICINE. I39 Pharmacists' Association in 1895 the president said in his address : — " One thing that every pharmacist, who has the best interests of his calling at heart, must bear in mind is that the liquor part of their business is being, and must be, slowly crowded out. Public sentiment has changed greatly in the last few years, and instead of all being classed alike, the line has been sharply drawn, and the stores that sell the least amount of liquor that they possibly can are gaining the confidence and esteem of the public, and consequently their business is growing from year to year, while the others are losing ground and dropping lower and lower." The Evening Record of Boston contained the fol- lowing in its issue of March 7, 1896: — " The number of flagrant offences on the part of druggists in certain no-license towns — offences not only against the liquor laws, but also against the laws of decency and humanity — brought before the board of pharmacy, would appall the public if they were known. The Looker-On has seen the record of several of these druggists as transcribed from the police courts and they are very black records. One druggist after selling liquor over and over again to one customer, and several times getting him completely intoxicated, finally deposited him one night in a snowbank, in a state of frozen stupor, where he would have frozen to death had not the wife of the druggist's clerk threatened to complain to the police unless he was rescued. " The story is told of one of the druggists of a neighboring no-license town. A man came in and asked for a pint of whisky. He was asked what he wanted it for. His reply was that he wanted it to soak some roots in. He got it, and as he went out he dryly remarked, ' I should have told you that it was the roots of me tongue that I want to soak.' " CHAPTER VIII. DISEASES, AND THEIR TREATMENT WITHOUT ALCOHOL. The question, " What shall I take instead of wine, beer or brandy?" is frequently asked by those who have been trained to think some form of alcohol really necessary to the cure of disease, but, who, from principle would prefer other agents, if they knew of any equal in effect. This chapter deals somewhat with the answer to that question. Alcoholic Craving : — The craving for alcohol may be present for a time after a person has com- menced to abstain from all beverages containing it. Or, it may occur periodically, as a sort of irresistible impulse. For the periodical craving Dr. Higgin- botham, of England, recommends that a half drachm of ipecacuanha be taken so as to produce full vomit- ing. He says the desire for intoxicating drinks will be immediately removed. The craving is caused by vitiated secretions of the stomach ; the vomiting removes these. Dr. Higginbotham says : — " If a patient can be persuaded to follow the emetic plan for a few times when the periodical attacks come on, he will be effectually cured." Some men in trying to abstain have found the 140 ALCOHOL AS A MEDICINE. I4I use of fresh fruit, especially apples, very helpful. Nourishing and digestible food should be taken somewhat frequently. A cup of hot milk or hot coffee taken at the right moment has saved some. Anemia: — In this complaint there is a defi- ciency of the red corpuscles of the blood. It may be the result of some fever or exhausting illness; it may accompany dyspepsia, and is then due to im- perfect digestion and assimilation of the food. The poverty of the blood produces shortness of breath, and often palpitation of the heart also, especially on a little exertion. There is generally more or less weariness, languor and debility, some- times also giddiness, sickness, fainting and neuralgia. " In the treatment of anaemia, port wine and other alcoholic liquors are worse than useless." — Dr. J. J. Ridge, London. " The common prescription of wine or some form of spirits for states of general exhaustion and anaemia, is a serious mistake. It assumes that the temporary increase in the action of the heart is renewed vigor, and that some power is added to the failing energies. This theory rests solely on the statement of the patient that he feels better. In reality the exhaustion is intensi- fied, though covered up.'' — Medical Pioneer. " Deficiency of nutrition, of light and of pure air may be mentioned as common causes of anemia. ***** It is evident that the first step in the treatment of this disease is to remove the cause. If the cause is dyspepsia, this must receive attention ; if intestinal parasites, they must be dislodged ; if prolonged nursing, nursing must be interdicted ; if too little food, a larger quantity of nourishing, wholesome food must be employed. Such simple and easily digested foods as eggs, poached or boiled, boiled milk, kumyzoon, good buttermilk, 142 ALCOHOL AS A MEDICINE. puree of peas, beans or lentils, boiled rice, well-cooked gruels and other preparations of grains are suitable. Beef tea and extracts are worthless. ***** " A careful course of physical training is essential to securing perfect recovery in cases of chronic anaemia due to indigestion, or any other serious disturbance of the nutritive processes." — Dr. J. H. Kellogg. Appetite, Loss of : — " There is often disinclination for food because it is not required. Many cannot eat much break- fast, because they have had a hearty supper. Or having had both a hearty breakfast and luncheon, they feel but little desire for a dinner of four or five courses. Generally the stomach is right and the habits wrong. What is to be done then, for such lack of appetite } Simply go without food until appetite comes. " When ale or beer is taken regularly with meals the stomach learns to expect them, and the food is not relished without them. The appetizing power of beer and bitter ales is chiefly due to the hop or other bitter ingredients which they contain. When it seems necessary to assist the appetite temporarily, a small quantity of simple infusion of hops may be taken. " Sometimes appetite fails because of exhaustion of body and mind. This may be nature's warning against overwork, and cannot be neglected with impunity. Life will inevitably be shortened if it is found necessary to rely upon the aid of alcohol in any form in order to do a day's work. " Bouillon, or beef soup, at the beginning of a meal are in centives to appetite. Change of scene, and life in the open air are the very best aids to appetite, when aids are really re- quired." Apoplexy : — " There is a popular idea that whenever a per- son is taken ill with giddiness, fainting or insensibility, brandy i should be at once procured and poured down his throat. Nothing can be more dangerous in apoplexy. This disease is] ALCOHOL AS A MEDICINE. I43 due to the bursting of some blood-vessel in the head, and the poured-out blood presses on the brain and leads to more or less insensibility. If fainting occurs, it may possibly save the patient's life, because then the blood-vessels contract, and the flow of blood ceases immediately ; time is thus given for the ruptured blood-vessel to became sealed up by a clot, which will prevent further loss of blood. If brandy is given, there is, first, great risk of choking the patient : if that danger is escaped and the brandy is swallowed and absorbed, the vessels become relaxed and the heart recovers its force; hence the ruptured vessel, if not sufficiently sealed by clot, may be started again, and fatal hemorrhage result. " The only treat7}ient which unskilled hands can adopt is to lay the patient on his back on the floor or sofa with the head and shoulders somewhat raised ; to loosen all the dress round the neck and body ; to apply cold to the head and hot flannels or a hot bottle to the feet and hands, or to soak them in hot mustard and water, and to gently rub the arms and legs." — Dr. J. J. Ridge. Dr. Alfred Smee, surgeon to the Bank of Eng- land, says : — " Give nothing by the mouth. Apply a stream of cold water to the head. If the feet are cold apply warm cloths. If relief is not soon obtained, apply hot fomentations to the abdomen, keeping the head erect." Bed-Sores : — Some object to using alcohol even as an outward application. Dr. Ridge recommends that when a patient is confined to bed the parts pressed on be well washed every day with strong salt and water or alum water, and carefully dried. Glycerine of Ta7i7iin may then be applied. If any redness appears, especially \.i any dusky patch is 144 ALCOHOL AS A MEDICINE. formed, collodion may be applied with a brush, and all pressure should be taken off the part by a circu- lar air-pillow or by a cushion ; or small bran or sand-bags may 'be made and carefully arranged. If the skin is broken, zinc or 7'esin ointment may be applied. Some recommend finely powdered iodoform sprinkled over the surface of the sore. Boils and Carbuncle : — " In many cases these troubles result from an overloaded condition of the system, which is the result of taking too much food, or some error in diet. The boils are an effort of nature to be rid of offending matter. In some cases they are due to the use of impure water, or the presence of sewer gas in the house. In others, overwork, or other debilitating causes, may have produced the state of the digestive organs which usually causes the boils. Carbuncle is, essentially, an extensive boil. " Apply iodine early or a piece of belladonna plaster. The diet should be plain and unstimulating, condiments being avoided and plenty of fresh vegetables taken, if possible. Fresh-air, exercise and proper rest should be obtained, and late hours avoided, " Medical advice is requisite in carbuncle. The popular notion that port wine is absolutely necessary is both erroneous and mischievous." — Ridge. Catarrh : — Among the causes are repeated colds ; errors in diet, especially excess in the use of fats and sugar, and an inactive state of the liver. Cut off from your bill of fare all salted foods, avoid fats and condiments ; drink freely of pure water ; live in the open-air and sunshine as much as ALCOHOL AS A MEDICINE. I45 possible, taking much out-door exercise. Take a cold sponge or towel bath every morning, beginning at the face and finishing by plunging the feet into a foot-tub. Follow with vigorous rubbing with a crash or Turkish towel. Those subject to sore throat should hold the head over a basin of cold water and lave the neck with the water for about two minutes. The writer was formerly subject to frequent sore throats, but has had none for over two years, as she believes, because of the adoption of this measure, together with the towel bath every morning, summer and winter. Care should be taken to avoid exposure to draughts, or any other means which will produce lia- bility to cold. Care in diet, good ventilation and the morning cold bath are essential if a radical cure is de- sired. Local measures, while giving relief, will not remove the predisposing causes. Dr. Kellogg rec- ommends saline solutions in the form of the nasal douche, a teaspoonful of salt to a pint of soft water, adding twenty to thirty drops of carbolic acid, if there is offensive odor, as a relief measure. Sleeping in a poorly ventilated room is said to be one cause of catarrh. Hay Fever is a form of catarrh. The vapor bath is recommended as very helpful in this trouble. Nature Cure says that two vapor baths and a two or three days' fast will cure any case of hay fever. The use of pork and other clogging foods should be 146 ALCOHOL AS A MEDICINE. avoided by those afflicted with this trouble. The bowels should be kept in good condition. If con- stipated, the use of prunes, figs, grapes, apples and other such fruits will be very beneficial ; walking, and massage of the bowels, being added if the fruits are not sufHcient. No one able to walk should depend upon drugs to relieve a constipated condi- tion. Colds : — "If the bowels are constipated, the skin over- burdened and clogged with bilious matter, and the lungs weak, it is as easy to take cold as to roll off a log. If, on the con- trary, the lungs are well developed, and the respiratory power large, providing abundant oxygen to keep bright the internal fires, the colon clean, the skin daily washed, and the system hardened by the cold bath, taking cold is next to impossible. " The first remedial agent for a cold should be a copious enema. Then open the pores of the skin by a hot bath ; take a glass of hot lemonade and go to bed." — The New Hygiene. Chills: — For chill, take a hot foot and hand bath, with mustard in the water, y^ pound to a gallon ; then go to bed in a well ventilated room. Drink freely of hot lemonade or hot water. Ca- tarrh, colds and hay fever may all be effectually re- lieved by hot baths. Relief may be gained also from inhaling the vapor from pine needles or hem- lock leaves. Put them in a bowl, pour boiling water over them, hold the face down over the bowl, the head being covered, and inhale the vapor well up into the nostrils and head. A few drops of hemlock oil in the hot water will do as well. Coughs and Hoarseness : — Boil flaxseed in i ALCOHOL AS A MEDICINE. I47 pint water, strain, add two teaspoons honey, I ounce rock candy, and juice 3 lemons. Drink hot. Also ; roast a lemon till hot, cut, and squeeze on 3 ounces powdered sugar. Colic : — This may arise from cold, or from error in diet. If the latter it is desirable to induce vomiting. For the pain, apply hot flannels or fomentations ; drink hot water. In severe cases, sprinkle a little turpentine on flannel, wrung from hot water, and apply to abdomen. Colic resulting from the accumulation of fecal matter should be treated with hot enemas until relieved. A hot hip-bath is sometimes necessary to relief. The colic of children and infants should never be treated with alcoholics. In infants it generally arises from excessive or improper feeding ; care should be taken that the milk provided them is not sour. In severe cases the babe should be immersed in warm water, keeping the head above water, of course. This is also the best remedy in convul- sions. The hot bath, with a copious enema of warm water, has saved the lives of many babes. For adults, hot water, with a pinch of red pepper added, will do all that brandy can do, and more. Cholera : — Brandy has been considered by many a really necessary medicine in cholera. The follow- ing is a discussion upon Alcohol in Cholera which was held at the annual rneeting of the British 148 ALCOHOL AS A MEDICINE. Medical Temperance Association, in May, 1893, and is taken from the Medical Pioneer of June, 1893 : — " Dr. Richardson opened a discussion on Cholera in relation to Alcohol. He said he would bring forward five points on the subject. 1. The negligence among the people at large produced by alcohol in the presence of a cholera epidemic. There was no doubt on the part of any who had seen an epidemic of cholera as to the mischief done by alcohol, apart from its action as a remedy. People rush to the public houses and take it to ward off the danger, or to relieve them when they begin to feel ill, and the result is very bad morally. He had seen this in differ- ent epidemics. Or people got in spirits to face the danger, and many became intoxicated and less able to resist. 2. Its misuse by those affected. It was often given to cheer them up and remove their fear and nervousness. In his opinion it invariably produced mischief. 3. He was unable to find any physiological reason for giving it. There was a constant drain of fluid, causing spasms and cramp, both of the muscles and blood-vessels, and difficult cir- culation through the lungs. Spasm may be relaxed by alcohol, but, on the other hand, alcohol is exceedingly greedy of water, and so increases the flux. But it also reduces animal tempera- ture, which is a strong feature of cholera, so much so that he could almost diagnose cholera blindfold in the stage of collapse, by the icy coldness. 4. Its uselessness as a remedy during the acute stage. He had seen a great deal of cholera and never saw alcohol do any good whatever. There was a temporary glow which passed away in a few minutes, and then the evil it does in other ways was brought out. Water was far better, even if cold. The College of Physicians had given some instructions and ordered great care in the administration of alcohol ; this was not far enough, but good as far as it went. The recoveries were best ALCOHOL AS A MEDICINE. I49 where the treatment was simplest, such as external warmth with plenty of diluents. He had given creasote largely. 5. Its injuriousness during the stage of reaction. The reac- tive fever following collapse caused a great number of deaths. In this stage alcohol was absolutely poisonous. He could re- call many such cases in which he had given alcohol through ignorance, and always with disaster. " Brigade-Surgeon Pringle said that when he went out to India he thought alcohol was something to stand by, but he had soon found out his mistake ; he had himself suffered from it. He could confirm what Dr. Richardson had said as to the demoralization produced by alcohol to which men resort to keep up their spirits, and men seized under these circumstances were in the greatest danger. Nature effects a cure in many cases with- out assistance, and often with wonderful rapidity. People ap- parently dead and about to be buried, he had known to get up and recover. When alcohol is given during collapse there is often no absorption until reaction occurs, and then the quantity accumulated speedily produces intoxication. It was the same with opium ; he had found pills unchanged in the stomach for hours. He recommended hot drinks ; he had tried every kind of medicine and had little faith in it. The nursing was very important, and it was important that the nurses should abstain. " Dr. Morton said it was easy to see that on physiological grounds alone, alcohol, with its strong affinity for water and its tendency to lower temperature, could not be a useful drug in the treatment of cholera collapse, and with its powers of par- alyzing vascular inhibition and checking elimination of effete matter, could not be otherwise than harmful in the stage of re- action. As these conclusions were corroborated by practical experience he did not think members would hesitate to banish it from their equipment against cholera. " Dr. Ridge said it should be remembered that Doyen had made experiments on guinea-pigs and had found they were proof against cholera, unless they had previously had a dose of I50 ALCOHOL AS A MEDICINE. alcohol. This explained why drunkards and hard drinkers were so much more liable to have cholera, and have it badly as all observers declared to be the case. Another reason might be that small quantities of alcohol, such as would be found cir- culating in the blood, favored the growth and multiplication of bacteria, certainly those of decomposition, and probably those of cholera. Hence, other things being equal, the abstainer had a great advantage. " Dr. Norman Kerr said that he had observed both in America and Glasgow that not only notorious drunkards but free drinkers suffered; abstainers were less liable unless they took contaminated water, and the less liquid taken the less chance of taking cholera ; beer-drinkers often took more than abstain- ers. The alcohol-drinker uses up more water from his blood and so has less to flush out the system. Alcohol, given to a patient, disguised his condition so that he might seem better though really worse. Hence it is better and safer not to give any. The doctors and nurses ought to be abstainers. A doc- tor after dinner was more likely to take a roseate view of a case, looking at it through an alcoholic pair of spectacles. Al- cohol was not really a stimulant, but a depressant, and this is a very depressing disease ; it was important to have our vital re- sisting power as vigorous as possible. Hot water both relaxes and stimulates, and the whole cry of the sufferer is for water. Many persons who died in cholera did not die of the disease^ but of the drugs such as alcohol and opium. Acid drinks should be given, as the bacilli could not live in acid mixtures. Cholera might come, but he believed we were better prepared to meet it and to treat it. " Surgeon-General Francis sent a communication which was read by the Honorable Secretary. He said : ' Having had many opportunities of treating cholera in various parts of India and amongst all classes, I have no hesitation in affirming that alcohol in any shape is one of the very worst remedies. Life is, so to speak, paralyzed, and we give a remedy which, appar- ALCOHOL AS A MEDICINE. 151 ently stimulating, is in reality a paralyzer and therefore mis- chievous ; the death-rate might be considerably reduced pro- vided alcohol were rigidly excluded.' " Dr. Norman Kerr in a valuable paper upon Cholera says : — • " The first thing is to get rid of the poison. How ? By as- sisting it out ; but alcohol keeps it in by blocking the doors, just as the doors were blocked in the terrible calamity at Sun- derland not long ago. The alcohol makes the heart and circu- lation labor more. Alcohol not only retains the cholera poison, but retards the action of the heart. Brandy and opium used to be employed, but the records show that if the object had been to make cholera as fatal as possible, that object was achieved by the indiscriminate administration of brandy and opium. Better leave the victim alone, and his chances of recovery will be greater than if he have a thousand doctors, and as many nurses, administering to him brandy and opium. Alcohol is especially dangerous in the third stage, that of reactive fever, because it adds to the fever. Then, alcohol is not only unsafe in the three stages of genuine cholera, but especially unsafe in the premonitory diarrhoea stage, which gives nearly every one warning before they are attacked by genuine cholera. Brandy is taken simply because it puts away the pain. If there are only the pain and slight diarrhoea, speaking medically, it is all right, but if there is anything behind the pain, it is all wrong.' After the alcohol, the mischief is going on, only the patient does not know it, and valuable time is lost. All the alcohol does is to deaden sensation. ***** Here I can thoroughly recom- mend ice and iced water. I have always treated cholera patients with these. Let them drink iced water to their hearts' content ; they can never drink too much ; and this opinion is fortified by that of Professor Maclean, of Netley. There is no need of a substitute for brandy in cholera, because in ordinary circum- stances in that disease the action of a stimulant is bad. Flush- 152 ALCOHOL AS A MEDICINE. ing of the blood is required, and water will do it. Milk will not do it, because it is too thick — nothing but pure, cold water, all the better if iced." In 1893 Dr. Ernest Hart, editor of the British Medical Journal, read an able paper upon Cholera before the American Medical Association. His argument was that the introduction of such a sub- stance as alcohol, itself being a product of germ ac- tion, into a system already suffering from the toxic influence of a ptomaine, could not be otherwise than pernicious. Cholera Morbus :— Dr. Kellogg says : " The stomach should be washed by means of the stomach-tube when possible. A large hot enema should be given after each evacuation of the bowels. The addition of tannin, one drachm to a quart of water, is serviceable. When the vomited matter no longer shows signs of food, efforts should be made to stop the vomit- ing. Give the patient bits of ice the size of a bean to swallow every few minutes. At the same time apply hot fomentations over the stomach and bowels. If the patient suffer much from cramp, put him into a warm bath. The first food taken should be farinaceous. Oatmeal gruel, well boiled and strained, is useful." Cholera Infantum : — " Iced water may be given in very small quantities every few minutes. Give the stomach entire rest for at least twenty-four hours. There will be no suffering for want of food as long as the stomach is in such a condition. Withhold milk until nature has had time to rid the alimentary canal of the poison-producing germs. White of ^g536; cost of liquors §80.00 ; per cent, of deaths from all causes, 5.7. The cost of liquors is only .004 for each patient. This shows a decided ad- vance in the disuse of alcohol, when so very little is used in a great hospital, with so large a number of patients. Dr. A. L. Loomis, in the treatmemt of 600 typhus fever cases on Blackwell's Island in 1864, excluded alcoholics, with the result of reducing the mortality rate to only six per cent, whereas it had previously been twenty-two per cent., in Bellevue Hospital from which the patients had been removed. In Battle Creek Sanitarium no alcohol is used in any disease, simply because the management be- lieve better results are obtained by the use of other agencies. In the October, (1893) number of the America7i Medical Temperance Quarterly now Bulle- tin of the A. M. T. A., Dr. J. H. Kellogg gives statistics of deaths from various diseases in the Bat- tle Creek Sanitarium. The total of these statistics is as follows : la grippe, 827 cases, 4 deaths — or two per cent. ; scarlet fever, 83 cases, 2 deaths — less than three per cent. ; 333 cases of typhoid fever, 9 deaths — or 2.7 per cent. ; 82 cases of pneumonia, 4 deaths — or 4.9 per cent. These exceptional results are not attributed solely to the non-use of alcohol. The nursing and surroundings were of the best. But these results certainly show that the use of 256 ALCOHOL AS A MEDICINE. alcohol as a remedy in acute diseases is not neces- sary, and that patients have a much better chance for life, other things being equal, where alcohol is not used than where it is. Dr. Kellogg says of the surgical cases : — " In a hospital of 100 beds, connected with the institution, more than 2,000 surgical cases have been treated, to whom alco- hol has never been administered except in connection with chloroform anaesthesia ; my uniform custom being to adminis- ter an ounce of brandy or whisky five minutes before beginning the administration of the anassthetic, when chloroform is used. " The surgical cases include more than 300 cases of ovariotomy, and over 300 other cases involving the peritoneal cavity, such as operations for strangulated hernia, the radical cure of hernia, etc. The statistics of death and recoveries are certainly as good as can be produced by any hospital in the world, dealing with the same class of cases. The total mortality from the operation of ovariotomy, including nearly 300 cases, is less than three per cent., and for the last few years, in which the antisep- tic measures have been perfected, the record is still better, showing a succession of 172 cases of laparotomy for the re- moval of ovarian tumors, or diseased uterus and ovaries, with- out a death. These cases include a number of hyterectomies, and many cases so desperate that those who trust in alcohol as a heart stimulant, and as a means of supporting the vital ener- gies, would certainly have considered it necessary to resort to the use of this drug. Nevertheless, it was not administered in a single case, and I have seen no reason to regret its non-use in a single instance." Dr. T. D. Crothers, of Hartford, Conn., tells the following: — " In a large hospital a study of the mortality of pneumonia indicated a greater fatality at intervals of six months. There ALCOHOL AS A MEDICINE. 25/ were five per cent, more deaths during periods of two months at a time, twice during the year. This extended back for two years, and was finally narrowed down to the service of an emi- nent physician who gave spirits freely in all cases of pneumonia from their entrance to the hospital. The other visiting physi- cians gave very little spirits, and only in the later stages. The physician was skeptical of these statistics, but finally consented to test them by giving up spirits practically in all cases of pneu- monia. This was continued for a year, and the mortality went back to the average statistics. That physician has abandoned alcohol as a food and a medicine, only in very limited degree. He writes, ' My stupidity in accepting theories and statements of others, concerning spirits, which I could have tested person- ally, is a source of deep sorrow, and I do not know but it could be called criminal. I certainly feel that punishment would be just." Brandy has been considered the great necessity in cholera, yet the use of it and other alcoholics are known to expose people to greater danger when this disease prevails. T\i^ Bulletin of the A. M. T. A. is authority for the following : — "During the epidemic of 1832, Dr. Bronson said : ' In Mon- treal 1,000 persons have died of chofera, only two of whom were teetotalers.' A Montreal paper said : ' Not a drunkard who has been attacked has recovered from the disease, and al- most all the victims have been at least moderate drinkers.' " In Albany, N. Y., the same year, cholera carried off 366 per- sons above sixteen years of age, all but four of whom belonged to the drinking classes. Packer, Prentice & Co., large furriers in Albany, employed 400 persons, none of whom used ardent spirits, and there were only two cases of cholera among them. Mr. Delevan, a contractor, said : ' I was engaged at the time in 258 ALCOHOL AS A MEDICINE. erecting a large block of buildings. The laborers were much alarmed, and were on the point of abandoning the work. They were advised to stay and give up strong drink. They all re- mained, and all quit the use of strong drink except one, and he fell a victim to the disease.' He says also : ' I had a gang of diggers in a clay bank, to whom the same proposition was made ; they all agreed to it, and not one died. On the opposite side of the same clay bank were other diggers who continued their regular rations of whisky, and one third of them died.' " In New York City there were 204 cases in the park, only six of whom were temperate, and these recovered, while 1 22 of the others died. In many parts of the city the saloon keepers saw and acknowledged the terrible connection between their busi- ness and the spread of the disease, and, becoming alarmed for their own safety, shut up their saloons and fled, saying : ' The way from the saloon to hell is too short.' " In Washington the Board of Health was so impressed with the terrible facts that they declared the grog shops nuisances, ordered them closed, and they remained closed for three months. " A prominent physician of Glasgow reported : ' Only nine- teen per cent, of the temperate perished, while ninety-one and two-tenths per cent, of the intemperate died.' One extensive liquor dealer of Glasgow, said, ' Cholera has carried off half of my customers.' " In Warsaw ninety per cent, of those who died from cholera were wine drinkers. " At Tifels, Prussia, a town of 20, 000 inhabitants, every drunk- ard died of cholera." The St. Paul Medical Journal, of September, 1899, gives the following report of a railway sur- geon, Dr. Kane : — *' From June i, 1898, to June i, 1899, the author performed a few more than four hundred operations. Forty-nine abdomi- ALCOHOL AS A MEDICINE. 259 nal sections, fifty odd more operations of a graver sort, one hundred miscellaneous of less gravity than above, over one hundred operations upon female perineum and uterus. Of the four hundred, more than three hundred demanded anaesthesia. There were but three deaths, making the mortality a little less than one per cent. " The author does not claim a phenomenally low mortality, nor does he claim specially brilliant results. He has to contend with unreasoning fear on the part of the patients for hospital surgeons, and also most of his cases had been in the hands of quacks, and had subjected themselves to remedies prescribed by old women. Many cases came after the family physician had exhausted his resources. He thinks his results are consid- erably better than the average in hospitals and in country districts. Alcohol medication was dispensed with entirely after the patients came under his care, and to this he attributes much of his success. He does not believe that alcohol is a stim- ulant, or a tonic. On the contrary, he believes that it retards digestion, arrests secretion, and hinders excretion. The courage and fortitude of his patients were lessened instead of increased by the use of alcoholic medication. "Pain is better borne, endured longer and more patiently when alcohol is not used. " He urges the practical surgeon to carefully weigh the subject of alcohol, and verify for himself the expediency of its use." Dr. B. W. Richardson in the report of his prac- tice for 1895 in the London Temperance Hospital refers to non-alcoholic treatment of rheumatism. He said : — " Out of seventy-one cases of acute or subacute rheumatism —the large majority acute, and attended with temperatures moving up to 104° F.— sixty-nine recovered, and two, although they were discharged without being put on the recovery list, 260 ALCOHOL AS A MEDICINE. were so far relieved that a few days' change in country air seemed all that was required to induce full restoration. Com- paring the experience of the treatment of acute rheumatic dis- ease without alcohol with that which I have previously ob- served with alcohol, I can have no hesitation in declaring that it is of the greatest advantage to follow total abstinence abso- lutely in this disease. The pain and swelling of joints is more quickly relieved under abstinence, the fever falls more rapidly, there is less frequent relapse, and there is quicker recovery. In brief, the experience of treament of rheumatic fever minus alcohol, presents to me as much novelty as it does pleasure, and I am convinced that if any candid member of the profes- sion could have witnessed what I have witnessed in this matter, he would agree with me that alcohol in rheumatic fever, how- ever acute, is altogether out of place. I am also under the conviction, though I express it with great reserve, that in acute rheumatism, treated without alcohol, the cardiac complica- tions, endocardial and pericardial, are much less frequently de- veloped than where alcohol is supplied." Dr. Pechuman in Alcohol — Is It a Medicine ^ pub- lished in 1891, says: — " There is no disputing that many deaths occur each day as the result of the administration of alcohol in acute diseases, to say nothing of the deaths caused by its habitual use ; and those who give it ignore the very fundamental principles of phys- iology and the many published statistics. The Boston Hos- pital report tells a sad story in this connection ; it shows that out of 1,042 cases treated with alcoholics 386 died, while out of the same number treated without alcohol only 81 died. Using plain English 305 were actually killed by it." Dr. T. D. Crothers, in the January, \%<^(^, Bulletin of the American Medical Temperance Association^ gave the follov^ing Hospital Statistics, showing a decline in the use of spirits in hospitals : — ALCOHOL AS A MEDICINE. 261 " Evidently a great change is going on in the use of alcohol as a remedy in large hospitals. The annual reports of ten hos- pitals in the New England and the Middle States show the following widely varying figures. The spirits used include beers, wines, whiskies and brandies, and vary from eleven to sixty-one cents a person for all the cases treated. These hos- pitals treat from eighty to seven hundred cases a year, both surgical and medical, and the medical staff are the leading physicians of the towns and cities where they are located. The hospital where the largest amount of spirits was used is not different from others, nor is the one where the lowest amount is reported. The conclusion is that this difference is due entirely to the judgment of the medical men. The lowest rate (eleven cents each) was in a hospital where one hundred and twenty-one cases had been under treatment. The highest rate (sixty-one cents) was in a hospital of five hundred and forty cases. The mortality from typhoid fever and pneumonia was eight per cent, higher in this hospital than in the one where only eleven cents a head had been expended for spirits. The general mortality did not vary greatly in any of these hos- pitals, and the records of one year could not be expected to show this. In the remaining hospitals the mortality of the fever and the septic cases was about the same. The free use of spirits did not show any improvement, but rather an increase of the death-rate, while the same amount of spirits used showed but little change, and that in the line of improvement of death-rate. These are only the figures of one year, but they indicate a change of practice, and show the passing of alcohol as a remedy." CHAPTER XL REASONS WHY ALCOHOL IS DANGEROUS AS MEDICINE. In the chapter upon " The Effects of Alcohol upon the Human Body " are cited some of the reasons assigned by scientific investigators for their disuse of alcohol as a remedy in disease. In this chapter the same may be briefly hinted at, while others, some the results of quite recent research, will be added. In the Bulletin of the A. M. T, A., for January 1898, Dr. N. S. Davis says: — " The supposed effects of alcohol as a medicine were originally based solely on the sensations and actions of the patients taking it. The first appreciable effect of the alcohol after entering the blood is that of an anaesthetic ; that is, it diminishes the sensibility of the brain and nerve structures, in the same direction as ether and chloroform. And, as the brain is the material seat of man's consciousness, the alcohol renders him less conscious of cold or heat, of weariness or pain, and less conscious of his own weight or of any external resistance. Consequently, when under the influence of small doses, he feels lighter and less conscious of any external impressions, and thinks he could do more than without it. It was these effects that led both the patient and his physician to regard the alcohol as a general stimulant or tonic, notwithstanding the fact that by simply increasing the doses of alcohol the 262 ALCOHOL AS A MEDICINE. 263 sensibility soon became entirely suspended, and the patient helpless and altogether unconscious. ***** " Simple increased frequency of the heart action is no evi- dence of either increased force or efficiency in promoting the circulation of the blood. Indeed, it may be stated as a physi- ological law, that the more frequent the heart action above the normal standard, the less efficiently does it promote the circula- tion and strength of the living system. But the effect of a moderate dose of alcohol in increasing the frequency of the heart-beat and of blood pressure is so temporary that the doses must be repeated so often that the alcohol accumulates in the blood and tissues, and extends its paralyzing effects to all the vasomotor, cardiac and respiratory nerv^es. Indeed, all the investigators agree that alcohol in any dose capable of pro- ducing an appreciable effect, diminishes the function of the lungs in direct proportion to the quantity taken ; and as the lungs are the only channel through which free oxygen reaches the blood, and such oxygen is the natural exciter of all vital activities in the living body, it is not possible to explain how alcohol, or any other drug that diminishes the function of the lungs can, at the same time, act as a cardiac, or any other kind of tonic. " The truth is that all intelligent physicians and writers on therapeutics of the present day agree in stating that alcohol in large doses directly diminishes all the vital processes in the living body, and in still larger doses suspends the life of the individual by paralyzing the cerebral, vasomotor, respiratory and cardiac functions, generally in the order named. If large doses produce such effects, we must logically claim that small doses act in the same direction, but in less degree. In other words, alcohol is as truly and exclusively an anaesthetic as is ether or chloroform, and, like them, is to be used as a medi- cine only temporarily to relieve pain, or suspend nerve sensi- bility. But as for these purposes it is less efficient than either ether or chloroform, and other narcotics, there is no neces- 264 ALCOHOL AS A MEDICINE. sity for using it as a remedy in the treatment of disease. And in health its use in any dose can be productive of nothing but injury. The only legitimate fields for the uses of alcohol are in chemistry, pharmacy and the arts." In another issue of the same magazine, Dr. Davis writes of the investigations pursued by M. Robin of France in regard to the chemistry of respiration. These investigations, he says, afford conclusive proof that the acts of oxidation are defensive proc- esses of the organism in its struggle with bacteria, and therefore that the physician should favor in every possible way the absorption of oxygen in every infection, especially when there are typhoid complications. He then speaks of the researches of other scien- tists in the same line, concluding thus : — " If we add to the foregoing investigations the results obtained by Dr. A. C, Abbott, demonstrating that the presence of alcohol directly diminished the vital resistance to infections, we cannot fail to see that the administration of alcohol in diphtheria, typhoid fever, pneumonia and other infectious diseases, is directly contraindicated. If, as shown by M. Robin, ' the acts of oxidation are defensive processes ' against bacterial infections, then certainly the administration of alcohol to pa- tients with such infections is in the highest degree illogical and injurious. The oxygen being obtained for oxidation purposes in the blood and tissues, through the respiratory process, it would be equally abeurd to administer alcohol in all cases in which it is desirable to increase the processes of oxidation, as a long series of experiments has shown that the presence of alcohol diminishes the efficiency of the respiratory process in direct proportion to the quantity used. ALCOHOL AS A MEDICINE. 265 " How much longer will practical writers continue to recom- mend for the same patient on the same day, fresh air, sponge baths, and vasomotor and respiratory tonics to increase the absorption of oxygen and oxidation processes, and alcohol in the form of wine, whisky and brandy to directly diminish the respiratory function and all the oxidations of the living sys- tem ? " In his address before the Medical Congress for the Study of Alcohol, held at Prohibition Park, Staten Island, July 15, 1891, Dr. Davis said : — " If the foregoing views regarding the effects of alcoholic liquids on the human system in health, are correct, what can we say concerning their value as remedies for the treatment of disease ? If it be true that the alcohol they contain acts di- rectly upon the corpuscular elements of the blood, and so far diminishes the metabolic processes of nutrition and disintegra- tion as to lessen nerve sensibility and heat production, and favor tissue degenerations, their rational application in the treatment of any form of disease must be very limited. And yet the same errors and delusions concerning their use in the treatment of diseases and accidents are entertained and daily acted upon by a large majority of medical men as are entertained by the non-professional part of the public. Throughout the greater part of our medical literature they are represented as stimulating and restorative, capable of increasing the force and efficiency of the circulation, and of conserving the normal living tissues by diminishing their waste ; and hence they are the first to be resorted to in all cases of sudden exhaustion, faintness or shock ; the last to be given to the dying ; and the most constant remedies through the most important and protracted acute general diseases. Indeed, it is this position and practice of the profession that constitutes, at the present time, the strongest influence in support of all the popular though erroneous and de- structive drinking customs of the people. 266 ALCOHOL AS A MEDICINE. " The same aricesthetic properties of the alcohol that render the laboring man less conscious of the cold or heat or weariness, also render the sick man less conscious of suffering, either mental or physical, and thereby deceive both him and his physician by the appearance, temporarily, of more comfort. But if administered during the progress of fevers or acute general disease, while it thus quiets the patient's restlessness and lessens his consciousness of suffering, it also directly dimin- ishes the vasomotor and excito-motor nerve forces with slight reduction of temperature, and steadily diminishes both the tissue metabolism and the excretory products, thereby favoring the retention in the system of both the specific causes of disease and the natural excretory materials which should have been eliminated through the skin, lungs, kidneys and other glandu- lar organs. Although the immediate effect of the remedy is thus to give the patient an appearance of more comfort, the continued dulling or ansesthetic effect on the nervous centres, the diminished oxygenation of the blood, and the continued retention of morbific and excretory products, all serve to pro- tract the disease, increase molecuiar degeneration, and add to the number of fatal results. " I am well aware that the foregoing views, founded on the results of numerous and varied experimental researches and well-known physiological laws, and corroborated by a wide clinical experience, are in direct conflict with the very generally accepted doctrine that alcohol is a cardiac tonic, capable of in- creasing the force and efficiency of the circulation, and there- fore of great value in the treatment of the lower grades of general fevers. But there have been many generally accepted doctrines in the history of medicine that have been proved fallacious. And the more recent experiments of Professors Martin, Sidney Ringer, and Sainsbury, Reichert, H. C. Wood and others, have clearly demonstrated that the presence of alcohol in the blood as certainly diminishes the sensibility of the vasomotor and cardiac nerves in proportion to its quantity ALCOHOL AS A MEDICINE. 26/ until the heart stops, paralyzed, as that two and two make four. " After an ample clinical field of observation in both hospital and private practice for more than fifty years, and a continuous study of our medical literature, I am prepared to maintain the position that the ratio of mortality from all the acute general diseases has increased in direct proportion to the quantity of alcoholic remedies administered during their treatment. How can we reasonably expect any other result from the use of an agent that so directly and uniformly diminishes the cerebral respiratory, cardiac and metabolic functions of the living human body ? " The Medical Pioneer of January, 1896, contained a very interesting article by Dr. J. H. Kellogg upon " The Influence of Alcohol upon Urinary Toxicity, and its Relation to the Medical Use of Alcohol." He gives the results of many of his own experi- ments to determine the effects of alcohol in hinder- ing the elimination of poisonous matter by the kidneys. The subject of one experiment was a healthy man of 30 5^ears, weighing 66 kilos. For fifty days prior to the experiment he had taken a carefully regulated diet, and the urotoxic coefificient had remained very nearly uniform. The urine care- fully collected for the first eight hours after the administration of 8 ounces of brandy diluted with water, showed an enormous diminution in the uro- toxic coef^cient, which was, in fact, scarcely more than half the normal coefificient for the individual in question. The urine collected for the second period of eight hours showed an increase of toxicity, 268 ALCOHOL AS A MEDICINE. and that for the third period of eight hours showed still further increase of toxicity, the coefBcient hav- ing nearly returned to its normal standard. Of this Dr. Kellogg says :— " The bearing of this experiment upon the use of alcohol in pneumonia, typhoid fever, erysipelas, cholera and other infec- tious diseases, will be clearly seen. In all the maladies named, and in nearly all other infectious diseases, which include the greater number of acute maladies, the symptoms which give the patient the greatest inconvenience, and those which have a fatal termination, when such is the result, are directly attributable to the influence of the toxic substances generated within the sys- tem of the patient as the result of the specific microbes to which the disease owes its origin. The activity of the liver in destroy- ing these poisons, and of the kidneys in eliminating them, are the physiologic processes which stand between the patient and death. In a very grave case of infectious disease, without this destructive and eliminative activity the accumulation of poison within the system would quickly reach a fatal point. The symptoms of the patient vary for better or worse in relation to the augmentation or diminution of the quantity of toxic sub- stances within the body. " In view of these facts, is it not a pertinent question to ask how alcohol can be of service in the treatment of such disorders as pneumonia, typhoid fever, cholera, erysipelas and other in- fections, since it acts in such a decided and powerful manner in diminishing urinary toxicity— in other words, in lessening the ability of the kidney to eliminate toxic substances ? In infec- tious diseases of every sort, the body is struggling under the influence of toxic agents, the result of the action of mi- crobes. Alcohol is another toxic agent of precisely the same origin. Like other toxins resulting from like processes of bac- terial growth, its influence upon the human organism is un- friendly ; it disturbs the vital processes ; it disturbs every vital ALCOHOL AS A MEDICINE. 269 function, and, as we have shown, in a most marked degree diminishes the efficiency of the kidneys in the removal of the toxins which constitute the most active factor in the diseases named, and in others of analogous character. If a patient is struggling under the influence of the pneumococcus, Eberth's bacillus, Koch's cholera microbe or the pus-producing germs which give rise to erysipelatous inflammation, his kidneys labor- ing to undo, so far as possible, the mischief done by the invad- ing parasites, by eliminating the poisons formed by them, what good could possibly be accomplished by the administration of a drug, one of the characteristic effects of which is to diminish renal activity, thereby diminishing also the quantity of poisons eliminated through this channel ? Is not such a course in the highest degree calculated to add fuel to the flame ? Is it not placing obstacles in the way of the vital forces which are al- ready hampered in their work by the powerfully toxic agents to the influence of which they are subjected ? " In his address before the American Medical Association at Milwaukee, Dr. Ernest Hart, editor of the British Medical Journal, very aptly suggested in relation to the treat- ment of cholera, the inutility of alcohol, basing his suggestion upon the fact that in a case of cholera, the system of the pa- tient is combating the specific poison which is the product of the microbe of this disease, and hence is not likely to be aided by the introduction of a poison produced by another microbe ; namely, alcohol. This logic seems very sound, and the facts in relation to the influence of alcohol upon urinary tox- icity or renal activity, which are elucidated by our experiment, fully sustain this observation of Mr. Hart. " In a recent number of the British Medical Journal, Dr. Lauder Brunton, the eminent English physiologist and neurolo- gist, in mentioning the fact that death from chloroform anses- thesia rarely occurs in India, but is not infrequent in England, attributed the fact to the meat-eating habits of the English peo- ple, the natives of India being almost strictly vegetarian in diet. 270 ALCOHOL AS A MEDICINE. partly from force of circumstances doubtless, but largely also, no doubt, as the result of their religious belief, the larger pro- portion of the population being more or less strict adherents to the doctrines of Buddha, which strictly prohibit the use of flesh foods. " The theory advanced by Dr. Lauder Brunton in relation to death from chloroform poisoning, is that the patient does not die directly from the influence of chloroform upon the nerve centres, but that death is due to the influence of chloroform upon the kidneys, whereby the elimination of the ptomaines and leucomaines naturally produced within the body, ceases, their destruction by the liver also ceasing, so that the system is sud- denly overwhelmed by a great quantity of poison, and succumbs to its influence, its power of resistance being lessened by the in- halation of the chloroform. " The affinity between alcohol and chloroform is very great. Both are ansesthetics. Both chloroform and alcohol are simply different compounds of the same radical, and the results of our experiment certainly suggest the same thought as that expressed by Dr. Brunton. How absurd, then, is the administration of alcohol in conditions in which the highest degree of kidney activity is required for the elimination of toxic agents ! " In a certain proportion of chronic cases there is a tendency to tissue degeneration. Modern investigations have given good ground for the belief that these degenerations are the result of the influence of ptomaines, leucomaines and other poisons pro- duced within the body, upon the tissues. It is well known that many of these toxic agents, even in very small quantity give rise to degenerations of the kidney. It is this fact which ex- plains the occurrence of nephritis in connection with diphtheria, scarlet fever and other infectious maladies. Dana has called attention to the probable role played by ptomaines produced in the alimentary canal in the development of organic disease of the central nervous system. " It is thus apparent that the integrity of the renal functions ALCOHOL AS A MEDICINE. 27 1 is a matter of as great importance in chronic as in acute dis- ease, hence any agent which diminishes the efficiency of these organs in ridding the system of poisons, either those normally and regularly produced, or those of an accidental or unusual character, must be pernicious and dangerous in use." Among the more recent findings of science in regard to the effects of alcohol are the action of this drug upon the leucocytes or "guardian cells" of the body. Leucocytes are defined to be " minute, nucleated, colorless masses of protoplasm, capable of ameboid movements, found swimming freely in blood and lymph, in the reticulum of lymphatic glands, and in bone-marrow and other connective tissue." The white corpuscles of the blood are leu- cocytes. '' The work of these cells is to prey upon and take into their substance bacteria and other micro-organisms within the blood and tissues. This destruction of bacteria, and other noxious organisms, has the biological name of phago- cytosis." Dr. Alonzo Brown in Physician and Surgeon says of phagocytosis : — " Recently a brilliant theory has been projected into the histological world. It is the principle of phagocytosis. The beauty of it is so great that we are attracted by it, and its reasonings have riveted general attention. It is said that certain cells have the power to absorb and so destroy other cells. This is phagocytosis. It is said that * the cells which are known to possess phagocytocic properties are the leu- cocytes, mucous corpuscles, connective tissue cells, endothelia of blood vessels and lymphatic vessels, alveolar eypithehum of 2/2 ALCOHOL AS A MEDICINE. the lungs, and the cells of the spleen, bone, marrow and lymphatic glands.' (Senn). This is a very significant array of colloid matter ; and it has been repeatedly affirmed by the high- est authorities that alcohol is poisonous to the colloid element. " Now, among the most important of the phagocytes just enumerated are the leucocytes. They embrace and enfold the pathogenic germs with which they come in contact by what is known as an ameboid force. They enclose, disintegrate and absorb the enemy. It is well known that the moment the leu- cocytes are submitted to an alcoholic solution, their ameboid movements cease, and their function is arrested. It is plain that their phagocytocic power is immediately destroyed. It is possible, also, that the fixed tissue-cells are likewise impaired or killed by alcoholic imbibition. How deleterious, and even deadly, must the internal administration of alcoholic liquors then be in the treatment of diphtheria, and of other diseases having a germinal origin ? It therefore follows, to my mind, that all the diseases which are the result of germinal infection, are most badly treated when alcohol is used in their therapy. With extreme brevity I advert to another view in the field. It is that of adynamic disease. It has been conclusively proven that alcohol decreases the muscular power. It decreases (from the minimum dose to the maximum) the power of the heart as well as that of all other muscles. I say this has been absolutely demonstrated by Richardson and others. In death from ady- namia it is through failure of muscle, that is, of the heart, of the scaleni and intercostals, of the diaphragm, and of the laryn- geal muscles, et cetera. All of the muscles may gradually fail, become wearied unto death. How pernicious then must alcohol be in adding its influence to bring about the tragic end ! " It is my belief that it is in diphtheria that the most dire results are to be observed. In that disease the vast majority of cases die by asthenia, or else by sudden failure of the heart. To what is this sudden cardiac paralysis due ? The elucidation is as follows. In the grave cases there is almost invariably a ALCOHOL AS A MEDICINE. 273 subnormal temperature, together with great muscular prostra- tion. Also it is a physiological fact that a decrease of the temperature slows nervous conduction. As the system is made colder, the nervous force flows slower and slower. In diphtheria the heart muscle is very weak, the temperature falls, the lessened nervous energy but feebly animates the muscular fibres, and so actual paralysis ensues, death closing the scene almost instantaneously. Now, in such a state of imminent danger, brought about by such causes, what could be worse than to administer an agent which notably reduces temper- ature, and at the same time enfeebles muscular power } May I add, what could be the remedy in such a condition ? and I answer, External heat freely applied to the whole surface of the body. This will prevent the cardiac paralysis whenever it is preventable." The Medical Pioneer of Dec, 1892, contained an editorial article upon " The Toxine Alcohol," which deals with leucocytes and their functions. The following is the article : — " Dr. Broadbent's introductory address at the opening of the session at Owen's College, Manchester, deserves more attention than most of these formal deliveries. He dwelt on the intel- lectual interest which attaches to the study of medical science, and illustrated it, among other ways, by the interest excited by recent observations on the action of bacilli and the combat which goes on between these invading hosts and the guardian cells or leucocytes of the living body. Inflammation surround- ing a wound is regarded as caused by the influx and multipli- cation of leucocytes to engulf and destroy septic bacilli which have gained entrance from the air, a ' local war ' of defence. The issue of this pitched battle will depend on the relative number and activity of the respective hosts. Inflammation round a poisoned wound is an evidence of vital power and a means of protecting the system at large from mvasion and dev- 274 ALCOHOL AS A MEDICINE. astation. If this first line of defence is broken through, the bacilli pass through the lymphatic spaces and ducts to the glands, and another battle ensues which produces glandular swelling and inflammation and possibly abscess. This second line of defence may be insufficient and then we get general septicaemia. It is now well proven that the injury is done, not by the bacilU themselves but by the toxines which they secrete or excrete. Dr. Broadbent very properly points out that the action of the bacilli of fever in the body is strictly comparable to the action of yeast in a fermentable liquid. The yeast cells grow and multiply at the expense of the sugar, in de- stroying which they produce alcohol, carbonic dioxide and other substances. When the alcohol amounts to some 17 per cent, of the liquid the process is stopped by the poisonous action of the alcohol on the yeast cells. In just the same way the toxines produced by the baciUi at length stop their further multiplica- tion and pu.t an end to the disease. Alcohol is in fact, the tox- ine produced by yeast, and, like many other toxines, it is not only poisonous to cells which produce it, but to any animal into whose veins it may happen to get. " There can be little doubt that the state of immunity which one attack of certain fevers confers against future attacks depends partly upon what is called the phagocytic action of leucocytes. These have been actually observed to draw into their interior and destroy bacilli which would otherwise have multiplied and produced their special effects. There can be little doubt, either, that we are continually taking into our systems bacilli of all sorts, and that, again, disease is averted by the activity of the germ-devouring leucocytes. Dr. Broad- bent describes an experiment which proves that power of re- sisting disease is largely dependent on the activity of these cells. A rabbit, having had a certain quantity of bacilli in- jected under its skin, suffers from inflammation at the spot, and perhaps abscess, but recovers. At the same time, another rabbit is treated in precisely the same way, but, simultaneously^ ALCOHOL AS A MEDICINE. 2/5 a dose of chloral is injected into another part of the body. The chloral, circulating in the blood, is known to paralyze leuco- cytes, and, as a result of this, they do not collect and wage war on the bacilli injected under the skin ; there is very little local reaction, the bacilli get free course into the lymph and blood, and the animal dies. But, in the words of Dr. Broadbent, ' alcohol in excess has a similar action on the leucocytes, and this, as well as the deteriorating influence of chronic alcoholism on the tissues, predisposes to septic infection. A single de- bauch, therefore, may open the door to fever or erysipelas.' A similiar experiment of Doyen confirms this. He found that guinea pigs can be killed by the cholera microbe, when intro- duced by the mouth, if a dose of alcohol has been previously administered. It has been the general testimony of observers in cholera epidemics that those addicted to much alcohol are far more liable to fatal attacks. But while large doses of alcohol are, of course, more obviously injurious, it would be absurd to imagine that lesser quantities are entirely without influence in the same direction. It has, indeed, been shown by Dr. Ridge, that even infinitesimal quantities of alcohol, such as one part in 5,000, cause a more rapid multiplication of the bacillus subtilis and other bacilli of decomposition, while, by the same quantities, the growth of both animal and vegetable protoplasm is retarded. Hence there can be no longer any question that alcohol renders the body more liable to conquest by invading microbes, less able to resist and destroy them. Alcohol, a toxine injurious to living cells, is destroyed or re- moved from the body as fast as nature can effect it, but while it remains, and while able to affect the cells at all, its action -is detrimental to healthy growth and healthy life, and the less we take of such an agent the better for us. This is a dictum which it becomes the profession to enunciate far and wide. ' The less, the better ' is a watchword which all may use, and the wise will interpret it in a way which will infallibly preser\'e them altogether from all possible danger from such a source." 2/6 ALCOHOL AS A MEDICINE. On the sixteenth of December, 1897, Dr. Sims Woodhead, president of the British Medical Tem- perance Association, gave a masterly address in London upon '* Recent Researches on the Action of Alcohol." The lecture was illustrated by- lantern slides. From the report given in The Medi- cal Temperance Review oi Jan., 1898, the following is culled : — " In a series of drawings of kidney you will notice first that there is a condition known as cloudy swelling ; this is one of the first changes that can be observed. Notice the character- istic features of this cloudy swelling in the cells of all these specimens. The large swollen cells are granular, and very fre- quently there is a granular mass in the lumen of the tubule. In some cases the cells are so much swollen that the lumen of the tubule is represented merely by a ' star-shaped ' radiating chink. The nucleus is usually somewhat obscured, that this alcoholic cloudy swelling (similar to that met with as the result of the administration of certain poisons) is the first change observed in the parenchymatous cells of the organs of animals that have died of acute alcoholic poisoning. This condition, unless the cause is removed, goes on to a condition of fatty-degeneration, as shown in the next specimen in which we have, in addition to the granular appearance of the protoplasm of the cell, a de- position of masses of fat in and at the expense of this protO'> plasm. " There is another series of changes to which I wish to draw your attention. In the tubules of the kidney we have, in addi- tion to the granular appearance of the protoplasm of the cells, an increase in the number of leucocytes, and connective tissue cells between the tubules around the glomeruli and along the course of the blood-vessels. This condition of small cell infil- tration, we know, i§ constantly associated with inflammatory ALCOHOL AS A MEDICINE. 277 conditions of the kidney as in other organs. Here then arc the changes in the epithelium plus increase in the number of leuco- cytes. " I show you too a specimen of heart muscle, in which the granular degeneration, or cloudy swelling is well marked whilst here and there the process is going on to fatty degenera- tion, similar to that seen in the kidney. Here again, then, the active elements of the organ are becoming broken down, or, at any rate, losing their normal structure and affording evidence of fundamental changes in these cells. Such changes are set up, not by any one poison alone, or by any single disease toxin, but by members of many groups of poisons, by alcohols, ethers, etc. indeed by very various poisons — animal, vegetable and mineral. " Now, it is a peculiar fact, as shown by Massart, Bordet and others, in researches on chemiotaxis, that nearly all these poisons have the power of repelling leucocytes, and of seriously interfering with them in the performance of their functions, and this power assumes a special significance in connection with our subject this afternoon. " Now, two of the great functions of leucocytes under ordi- nary conditions are those of policing and scavenging. Massart and Bordet showed, under the action of certain substances, alcohol amongst others, these functions are lost, but following up Metchnikoff and others they observed that after a time these same leucocytes became accustomed to the presence of these poisons, gradually becoming ' acclimatized ' as it were. At first paralyzed or repelled, they after a time pluck up courage to attack the invading substances and carry on or renew their accustomed work of scavenging ; they try to get rid of both poisons and poison-producers, and even acquire the power of forming substances (anti-toxins) which can neutralize the poison and allow the cells to devote their energy to doing their own proper work. " Here are drawings of minute abscesses that have formed 278 ALCOHOL AS A MEDICINE. in the wall of the heart. We see at once the part that the leuco- cytes play in attacking micro-organisms, and of localizing their action. Look at the blood-vessel in the wall of the heart with its plug of micro-organism (staphylococci) in the centre of a clear space ; here the leucocytes are not numerous, indeed they are very sparsely scattered, and appear to have been driven back by the organisms or their toxics. Then a little distance away from the toxin and toxin-forming organisms, the leucocytes are coming up in large numbers, forming a sort of protecting army, as it were. This is known as leucocytosis. In the small patent vessels around this commencing abscess numerous leucocytes, far in excess of the usual proportion, may be seen — the nearer the abscess, the more numerous they become. Thus the leucocytes make their way to what is to become the wall of the abscess, and form a layer around a mass of micro- organisms, localizing, or attempting to localize, such mass. So long as the leucocytes can make their way to this mass, and shut it off from the surrounding tissue, so long we shall have no extension of the abscess. " Now, if you add something — alcohol in the case we are considerino- — which not only exerts a negative chemiotaxic action — i. e., which drives the leucocyte away — but which, as we have seen, also causes degeneration of nerve, muscle and epithelial cells, shall we not injure the infected patient both directly and indirectly by interfering with the return of the leucocytes driven away, by diminishing or altering the func- tional activity of these cells, and indirectly by interfering with the excretion of the poisons (owing, as we have seen, to a degenerated condition of the secretory epithelium) ? Have we not, in fact, a cumulative action of two substances, either of which alone would do damage, but not in the same proportion as do the two when acting together. " Now let us see what we may learn from a series of experi- ments carried out by Dr. Abbott, working in the Laboratory of ALCOHOL AS A MEDICINE. 279 Hygiene of the University of Pennsylvania, under the auspices of the committee of fifty, to investigate the Alcohol Question. " These are his conclusions : — 1. " That the normal vital resistance of rabbits to infection by streptococcus pyogenes is markedly diminished through the influence of alcohol when given daily to the stage of acute intoxication. 2. That a similar, though by no means so con- spicuous, diminution of resistance to infection and intoxication by the bacillus coli communis also occurs in rabbits subjected to the same influences. " Throughout these experiments, with few exceptions, it will be seen that the alcoholized animals not only showed the effects of the inoculations earlier than did the non-alcoholized rabbits, but in the case of the streptococcus inoculations, the lesions produced (formation of miliary abscesses) w^ere much more pronounced than are those that usually follow inoculations with this organism. " With regard to the predisposing influence of the alcohol, one is constrained to believe that it is in most cases the result of structural alterations consequent upon its direct action on the tissues, though in a number of animals no such alterations could be made out by microscopic examinations. I am in- clined, however, to the belief, in the light of the work of Berkley and Friedenwald, done under the direction of Pro- fessor Welch, in the pathological laboratory of the Johns Hopkins University, that a closer study of the tissues of these animals would have revealed in all of them structural changes of such a nature as to indicate disturbances of important vital functions of sufficient gravity fully to account for the loss of normal resistance. " Following up Dr. Abbott's experiments. Dr. Delearde, working in Calmette's laboratory in the Distitut Pasteur at Lille, made a series of obser\'ations which are, from many points of view, of very great interest and importance as he 280 ALCOHOL AS A MEDICINE. attacks it from an entirely new standpoint, one that will, I hope, ere long, be taken up by those working in this country. It has already been demonstrated that ' alcoholics ' suffer far more seriously from microbic affections than do those of sober life, and it is now accepted that amongst them the mortality from this class of disease is higher than amongst those who are not accustomed to take alcohol regularly or to excess. " It is pointed out, as most of us have from time to time had the opportunity of observing, that, taking pneumonia as an example of this class of disease, there can be no doubt that the alcoholic patient has not merely an appreciably smaller chance for recovery, but an apparently slight attack becomes one in which the chances of recovery come to be against the patient rather than in his favor. I well remember when I was House Physician in the Royal Infirmary at Edinburgh that Dr. Muir- head, who almost invariably treated his pneumonic patients without alcohol, used to say that an ordinary case of acute pneumonia should always recover under careful treatment, but that cases of pneumonia in ' alcoholics ' were always most anxious cases and in every way unsatisfactory. (Slides were shown on screen to illustrate the changes taking place in pneu- monia, the conditions of leucocytosis, and the very important part which leucocytes play in the process of ' clearing up ' dur- ing the course of the patient's recovery). Dr. Delearde in an admirable summary gives the principal features of pneumonia in alcoholics. He describes it as running a comparatively prolonged course, as being often accompanied by a violent delirium, following which is a period of prostration or of coma ; even in those who recover, abscesses frequently occur in the liver, or in other organs. He also points out that there may be a similar chain of events in other infective conditions such as erysipelas and typhoid fever, but as he insists that, until Abbott's experiments on the streptococcus,* staphylococcus * and bacter- ium coli, * in alcoholized and non-alcoholized animals, little * Microbes or bacteria of different kinds. ALCOHOL AS A MEDICINE. 28 1 attempt has been made to indicate the mechanism, or, at any rate, the process by which alcoholized individuals are rendered more susceptible to the invasion and action of micro-organisms. " As we have already seen, Abbott's experiments prove beyond doubt that attenuated disease-producing organisms, which in healthy animals do not kill immediately, bring about a fatal result when the animal has previously been treated with alco- hol. In order to determine which was the most important factor in the destruction or weakening of the resisting agents in the body, Dr. Delearde conceived the idea of experimenting with those diseases in which it has been found possible to pro- duce, artificially, as it were, and under controlled conditions, an immunity or insusceptibility in healthy animals. He carried out a series of experiments on rabbits, immunizing against and infecting with the virus of hydrophobia, tetanus and anthrax.* To these rabbits he first administered a quantity of alcohol, from 6 to 8 c. c. at first, and gradually rises to 10 c. c. doses per diem. " There is in the first instance a slight falling off in weight of the animal, but after a time this ceases, and the animal may again become heavier, until the original weight is reached. He then took a series of animals and vaccinated them against hydrophobia. In one set the animals were afterwards alco- holized and then injected with a considerable quantity of viru- lent rabic cord. It was here found that immunity against rabies had not been lost. " In a second set the vaccination and alcoholization w^ere car- ried on simultaneously, a fatal dose (as proved by control ex- periment) of rabic cord was then injected, when it was found that httle or no immunity had been acquired. In a third series the alcohol was stopped before the immunizing process was commenced. In this case marked immunity was acquired. " As regards rabies, then, acute alcoholism, especially when * Carbuncle. 282 ALCOHOL AS A MEDICINE. continued for comparatively short periods, simply has the effect of preventing the acquisition of immunity when alcohol is ad- ministered during the period when the immunizing process ought to be going on. This indicates that the action of the alcohol in acute alcoholism is direct, and that although its administration prevents the acquisition of immunity it does not alter the cells so materially that they cannot regain some of their original powers, whilst once the immunity has been gained by the cells, alcohol cannot, immediately, so fundamentally alter them that they lose the immunity they have already acquired. When we come to the consideration of the case of tetanus, however, we are carried a step further. Dr. Delearde repeating his immunizing and alcoholizing experiments, but now working with tetanus virus in place of rabic virus, found— and, perhaps, here it may be as well to give his own words : — (i) " ' That animals vaccinated against tetanus and afterwards alcoholized lose their immunity against tetanus ; (2) " ' That animals vaccinated against tetanus and at the same time alcoholized do not readily acquire immunity ; (3) " ' That animals first alcoholized and then vaccinated may acquire immunity against tetanus if alcohol is suppressed from the commencement of the process of vaccination.' " In the case of anthrax too, as we gather from another series of experiments, it is almost impossible to confer immun- ity, if the animal is alcoholized during the time that it is being vaccinated, and although the animals, first alcoholized and then vaccinated, may acquire a certain amount of immunity, they rapidly lose condition and are certainly more ill than non- alcohoHzed animals vaccinated simultaneously. " We have already mentioned that Massart and Bordet some years ago pointed out that alcohol, even in very dilute sokitions, exerts a very active negative chemiotaxis, i. e., it appears to have properties by which leucocytes are repelled or driven away from its neighborhood and actions. Alcohol thus pre- ALCOHOL AS A MEDICINE. 283 vents the cells from attacking invading bodies or of reacting in the presence of the toxins which also, as is well known, exert a more or less marked negative chemiotaxis, i. e., the cells appear to be paralyzed. In all diseases, then, in which the leucocytes help to remove an invading organism or in which they have the power of reacting or of carrying on their functions in the pres- ence of a toxin, we should expect that alcohol would to a cer- tain extent deprive them of this power or interfere with their capacity for acquiring a greater resisting power or of reinforc- ing the powers of resistance. It appears indeed to reinforce the poison formed by pathogenic organisms. Dr. Delearde maintains moreover that chronic alcoholism increases enor- mously the difficulty of rendering an animal immune to anthrax, whilst as those who have had any experience of cases of anthrax know full well alcoholics, whether acute or chronic, manifest a remarkable susceptibility both as regards attacks of anthrax and the fatality of the disease when once contracted. Further as clinical proof of the correctness of another of these sets of experiments, Dr. Delearde instances two cases of rabies which have come under observation in the Institut Pasteur — one, a man of 30 years of age, of intemperate habits who after a complete treatment of 18 days after a bite in the hand died of hydrophobia ; the other, a child of 13 years who was bitten on the face by the same dog that had attacked the other patient, and on the same day — who underwent the same treatment re- mained perfectly well. In this case the more severe bite (the face being the most serious position in which a person can be bitten) was received by the child ; indeed the intemperate habits of the man, who even took alcohol during treatment, appear to have been the only more serious factor in his case as compared with that of the child. " From all this Dr. Delearde drawls the practical conclusion that patients who have been bitten by a mad dog should as far as possible abstain from the use of alcohol not only during the process of treatment, but also for some time afterwards, even 284 ALCOHOL AS A MEDICINE. for a period of eight months, during which period, apparently, increase of immunity may be going on. Beyond this he main- tains that doctors often commit a grave error in administering strong doses of alcohol to patients suffering from certain infec- tious diseases such as pneumonia, or from certain intoxications such as those produced by snake-bite, during which an increase in the number of leucocytes appear to be a necessary part of any process that leads to the cure of the patient. Finally, he points out how necessary it is that we should respect the integ- rity of the leucocytes in the presence of microbic infections or intoxications. We may accept these statements all the more readily as Dr. Delearde states that * although we must recognize that small doses of dilute alcoholic beverages are indicated in certain cases where it is necessary to stimulate the nervous system, one must guard oneself against an abuse which may certainly be prejudicial to the putting into operation of the mechanism of defence against the organisms of disease.' " In so far as these conclusions rest on a series of exact ex- periments we are justified in accepting them as being a most valuable contribution to the question ; where there is no experi- mental basis, we must exercise our own judgment. To show the very strong impression that exists that there is some con- nection between severe cases of pneumonia and alcohol I may mention that the other day I heard a gentleman (not a medical man) say, * It is well known that most men (of a certain pro- fession) die from alcoholism.' When asked to explain he said, ' They all die from cirrhosis or pneumonia, and if those condi- tions are not due to alcoholism, what is .? ' " There can be no doubt that in addition to its specific action, alcohol has a general action— the mal-nutrition, which is usually associated with the use of alcohol, especially as a result of its action on the mucous membranes of the stomach, etc." That the *' guardian cells " of the body play a part in a considerable number of diseases was illustrated ALCOHOL AS A MEDICINE. 285 by Dr. Woodhead by drawings and photographs, shown on the lantern screen. The photographs in- cluded cells containing anthrax, typhoid and tuber- cle bacilli, the spirilla of relapsing fever, specimens from cases of anthrax. Specimens were shown in which the cells were actually ingesting and digest- ing the specific micro-organisms. In a case of ty- phoid, showing large masses of typhoid bacilli in one of Peyer's patches, there were seen certain of the cells which contained the typhoid bacilli, some of them undergoing degenerative changes, and showing unequal standing. Of the researches made by Dr. Abbott referred to in the foregoing lecture Dr. N. S. Davis says: — " Thus we have another and direct positive demonstration of the fact that the presence of alcohol in living bodies not only impairs all the physiological processes, but also impairs their vital resistance to the effects of all other poisons. It was hardly necessary, however, to trouble the rabbits to obtain proof of this ; for such evidence may be found in abundance by examining the vital statistics of every civilized country. The late Frank H, Hamilton, in his valuable work on military hygiene, gives an interesting account of an experiment executed, not on a few rabbits, but on whole regiments of human beings, who were being exposed to the inhibition, not of the strep- tococcus pyogenes, but to the infections of malarial and typho- malaria fever. And, as many were attacked with sickness, it was thought by some of those in authority that if the soldiers were given a specified ration of alcoholic liquor two or three times a day, it might enable them to resist the morbid influ- ences to which they were exposed. The proposed ration was accordingly ordered, and Dr. Hamilton informs us that the 286 ALCOHOL AS A MEDICINE. soldiers taking the liquor ration succumbed to the morbific influences surrounding them so much more rapidly than before, that in less than sixty days the order was countermanded, and the liquor ration stopped. And that eminent surgeon and sanitarian added, with peculiar emphasis, that he wished never to see the same experiment tried again." Dr. J. J. Ridge, of London, has learned through his experiments that alcohol not only hinders the leucocytes in their war upon disease germs, but also tends to the multiplication of germs. Of this he says : — " The antagonism of alcohol to the fundamental functions of life is further exhibited by its action on the cellular elements of living tissues and the free cells or leucocytes of the blood. Dr. Lionel Beale long ago pointed out how it affected the proto- plasm of cells, and diminished the movements of amoebae, to which leucocytes are apparently analogous. " But while alcohol is thus injurious to living protoplasm, or constructive protoplasm as it may be called, that which builds up, and forms all kinds of structures, and living beings of all higher types, I accidentally discovered that in minute quantities, under about one per cent,, and even in such almost incredible amounts as i part in 100,000. (iV millilitre in 10 litres) it favors the growth and multiplication of many microbes whose func- tion is antagonistic to the protoplasm of organized beings, and which may therefore be called destructive protoplastn. We know that these microbes are kept at bay by the vitality of the tissues : if this vitality is lowered they may prevail : as soon as life departs they set to work, and decomposition is the result. It is, therefore, not very surprising that an agent, like alcohol, which, we have seen, lowers the vitality of constructive pro- toplasm, should, on the other hand increase the vitality of de- structive protoplasm. At any rate such is the fact. In the ALCOHOL AS A MEDICINE. 28/ presence of these minute quantities of alcohol, decomposition goes on more rapidly, and the micrococci and bacilli, thrive and swarm more abundantly. This is easily demonstrable by the more rapid, and thicker, cloudiness of any clear decomposable liquor in the course of a day or two, or in a few days, according to circumstances. But I have demonstrated the more rapid multiplication of some forms by means of plate cultivations, of which I show specimens.. It is true of the bacteria of decom- position, of the streptococci, and staphylococci of pus, and of diphtheria. Time alone has been wanting to demonstrate this in other cases, which I hope to do." The Medical Week some time ago contained this paragraph : — " Dr. Viala, in collaboration with Dr. Charrin, says : ' I have carried out a series of researches on the toxicity of various al- coholic beverages in common use, such as wines and brandies of all brands, from those which are reputed the best to those of very inferior quality. All these products have been analyzed with the greatest care. Our experiments were carried out on fifty animals. Intravenous injections confirm Dr. Daremberg's statement that liquors considered as the best are the most toxic, more particularly as regards their immediate effects. Although the foregoing statement directs the reader's attention to the comparative effects of dif- ferent alcoholic liquors, it also plainly implies sev- eral facts of great importance. The first is, that all alcoholic liquors, fermented or distilled, are toxic or poisonous ; and the more pure alcohol they con- tain, the more poisonous are they, the qualities of liquor differing only in the rapidity of their injuri- ous effects. In the same number of the Medical Weeky Pro- 288 ALCOHOL AS A MEDICINE. fessor Gr^hant states that after injecting a quantity of alcohol into the venous circulation of a dog equal to one twenty-fifth, or four per cent., of the esti- mated weight of the blood of the animal, he found by several analyses at different times that it re- quired '' a little over twenty-three hours for com- plete elimination of the alcohol from the blood." If we consider these results obtained by Viala, Charrin, Daremberg and Grehant, with those ob- tained by Dr. A. C. Abbott, showing the direct ef- fect of alcohol in diminishing the normal vital resistance of the living body to infection, we see excellent reasons why the liberal use of alcohol in the treatment of such infectious diseases as diphthe- ria, typhoid fever and pneumonia, under the sup- position that it was a cardiac tonic, has resulted in so great a mortality as from thirty to sixty per cent. Dr. A. Pearce Gould, a London hospital surgeon of the first rank, has made special study of the surgery of the blood-vessels, and of the chest. He was one of the earliest to practice and advocate the careful removal of the axillary glands in all oper- ations for cancer of the breast. He is a strong believer in the value of total abstinence as promoting robust health of body and mind. He regards the value of alcohol in disease as exceedingly small, and prescribes it only very rarely. He thinks that alcohol increases the activity of cancer and other malignant growths, an opinion which is of great importance from one with ALCOHOL AS A MEDICINE. 289 such exceptional opportunities for observation in these complaints. Dr. N. S. Davis in the American Medical Tern- perayice Quarterly oi January, 1895, gives reports of cases which came under his observation as a con- sulting physician, where the use of alcoholics throughout an extended illness favored the con- tinuance of delirium, or mild mental disorder, after convalescence was established. In each case the withdrawal of the alcohol was followed by a cessa- tion of the mental delusion. One of these cases may be taken as an example : — " The third case was that of a woman over sixty years of age, who had suffered from a mild grade of fever and protracted diarrhoea, somewhat resembhng a mild grade of enteric typhoid fever. " As she became much reduced in strength during the latter part of her diarrhoea, her friends began to give her wine, and sometimes stronger alcoholic drink, under the popular delusion that these could strengthen her. Her mind soon became wan- dering, and she was troubled with illusions, which were attrib- uted to her weakness, and the so-called stimulants were increased. But the mental disorder increased also, and con- tinued after the fever and diarrhoea had ceased, until the ques- tion was raised concerning the propriety of her removal to an asylum for the insane. " Being consulted at that time, and listening to an accurate his- tory of the case, I suggested that the ansesthetic effect of the alco- hol on the cerebral hemispheres, in connection with its effect on the hemoglobin, and other elements of the blood, in lessening the reception and internal distribution of oxygen, might be the cause of both the perpetuation of her weakness, and her 290 ALCOHOL AS A MEDICINE. mental disorder. I advised a trial of its entire omission, and the giving of only simple nourishment, and moderate doses of strychnine and digitalis, as nerve tonics. My advice was fol- lowed, though not without much hesitation on the part of her friends. The result, however, was entire recovery from the mental disorder, and some improvement in her general health." Puerperal mania resulted in one case cited, from the use of a moderate amount of wine at mealtimes ; when the wine was abandoned the mania subsided. CHAPTER XII. WHY DOCTORS STILL PRESCRIBE ALCOHOLICS. Workers in the department of Medical Temper- ance of the Woman's Christian Temperance Union are told repeatedly by the better class of physicians that they would be glad often not to prescribe alcohol if patients and their friends would not insist upon its use. There is a deep-rooted prejudice in favor of alcohol as a remedy in the minds of the great multi- tude of people, and they are ready to distrust as fanati- cal, or incompetent, any physician who does not use it. Dr. Norman Kerr, a well-known physician of England, says, that during a ten years' residence in America, he found people unwilling to pay him as much for his ser\'ices as they were willing to pay one who prescribed alcoholics. Even those who were abstainers from liquors as beverages distrusted him for not using these things as medicines. Indeed, this prejudice goes so far with many that they will refuse to employ a non-alcoholic physician, if they know him to be such. In consequence of this latter fact, there are great numbers of skilful physicians who say nothing about alcohol lest they be con- 291 292 ALCOHOL AS A MEDICINE. sidered '' faddists," and lose practice, but who never prescribe it unless it is asked for by the patient or his friends. Again, consulting physicians will sometimes insist upon the use of alcohol, and thus seeds of distrust of the non-alcoholic physician will be sown. Dr. J. J. Ridge says of medical prescriptions: — " Hundreds of medical men order alcoholic liquors from habit, from ignorance of their real effect, from fashion, or from a desire to please, or not to offend, their patients. Port- wine is constantly being ordered when persons are recovering from various diseases ; day by day they regain their strength, and the port-wine gets all the credit of it, especially since each glass seems to diffuse a comfortable glow over the whole body. They forget that the process of recovery would have gone on without the port, and that hundreds and thousands of people do get well without it. They often ignore the fact that they are taking real tonics in addition. They are misled by the sensations which the alcohol causes ; they do not know that it relaxes the blood-vessels instead of improving their tone ; that it exhausts the heart by making it beat away more rapidly to no profit. Hence the convalescence is actually more prolonged than it would otherwise be. Gentle exercise, regu- lated baths, good food, balmy sleep, these are the true restor- atives of the exhausted system, and no jugglery with sedatives, such as alcohol, can produce the desired result. " It is by its sedative action that alcohol has obtained its posi- tion in public opinion. It will render persons insensible to various uneasy sensations, and the majority prefer to continue the bad habits which produce the uneasy sensations, and then to take them away by a dose or two of some alcoholic liquor, or, indeed, to take this before the uneasy sensations come on. In this way they do themselves injury and make themselves ALCOHOL AS A MEDICINE. 293 unconscious of it. Dr. Beaumont, who had the opportunity of examining the interior of Alexis St. Martin's stomach, and of seeing how digestion went on, was astonished to see how inflamed the mucous membrane could be without any con- sciousness of it. He observed, as a matter of fact, that alco- holic drinks of all kinds hindered the process of digestion, and produced this morbid condition of the mucous membrane. The relief, therefore, which can be obtained by alcohol is delusive and dangerous. " But some persons say they are afraid to abandon the use of alcohol because they have been in the habit of taking it for a long period. This fear is entirely groundless. The alcohol will be missed for a time, just as a person who has been using crutches would miss them if thrown away ; but they will do better without both after a little while. There is no kind of constitution which renders a person unable to do without alco- hol. The prisoners in all our jails have to leave off their drink at once, and altogether, on entering there, and no harm ever ensues in consequence. But some say that this is because their diet is so carefully arranged, and the hygienic condition of the prison so perfect. Quite so. This shows us clearly that when total abstainers become ill outside the prison, their illness is to be attributed to some error in diet or hygiene, or to some accidental circumstance. It is absurd to think that the infrac- tion of one law of health can be nullified by breaking another ; that if you eat too much, or too fast, or too often, or what is not good for you, you can escape the consequences by injur- ing yourself with alcohol." Dr. N. S. Davis was for many years openly sneered at by many of his professional brethren as " a cold-water fanatic." Since his views are now being rapidly adopted by progressive medical men all over the civilized world, it may be that soon those 294 ALCOHOL AS A MEDICINE. physicians who cling to alcohol will deserve the soubriquet of "alcohol fanatics." Dr. Davis said: — "HI am asked why the profession continues to prescribe these drinks, I answer ; simply from the force of habit and tradi- tional education, coupled with a reluctance to risk the experi- ment of omitting them while the general popular notions sanction their use. Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of friends something must be done. A little wine or brandy is given, and as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither wine nor brandy had been used. " Of course both doctor and friends will regard the so-called stimulant as the cause of the recovery. So, too, when patients are getting weak, in the advanced stage of fever, or some other self-Hmited disease, an abundance of nourishment is regularly administered, in the greater part of which is mixed some kind of alcoholic drink. The latter will always occupy the chief at- tention, and if, after a severe run, the fever, or disease, finally disappears, it will be said that the patient was sustained or ' kept alive ' for over two or three weeks, as the case may be, ' solely by the stimulants,' when, in fact, if the same nourish- ment and care had been given without a drop of alcohol, he would have convalesced sooner, and more perfectly, as I have seen demonstrated a thousand times in my experience." Dr. Casgrau, of Dublin, says that physicians who make personal use of alcohol are not able to give an unbiased opinion about its action, as one of its most marked effects is that of a narcotic to the men- tal powers ; such physicians are not so acute to ob- serve the action of this, or any drug. ALCOHOL AS A MEDICINE. 295 Sir B. W. Richardson, M. D., in an address upon the reasons why physicians still prescribe alcoholics, says that the magnetism of public opinion has great weight with professional men. " All professions are under that subtle influence. All pro- fessions whatever their duties, whatever their learning may be, are sensitive and obedient to that influence. In their pride they think they lead public opinion ; it is a mistake, they always follow it on every question in which the people, at large, have a voice. They can assist in influencing the public voice, and sometimes, to quote the words of Abbe Purcelle, spoken in the dawn of the great French Revolution, they may prove that ' respect for sovereign power sometimes consists in transgress- ing its orders,' but as a general rule not merely the orders but the inclinations are obeyed. We have to wait on, and for, pub- lic opinion, and in nothing so much as on the subject of alco- hol. The use of alcoholic beverages rests not on argument but on habit, custom. To those whom it affects personally it is an absolute monarch. It makes its own empire. By the very action which it has upon the body of those who receive it into themselves it rules and governs. The joke of the inebriate man that when he had taken his potation he was quite another man and that then he felt it his duty to treat that other man, is literally true, a terse and faithful expression of a natural fact. The man or woman born and bred under the influence of alco- hol is of the race of alcohol, and as distinct a person as any racial peculiarity can supply. The reason, the judgment, the temper, the senses are attuned by it. It is loved by its lovers like life. The grape to them is no longer a luscious fruit ; it is ' the mother of mighty wine,' and he who is bold enough to dis- own that motherhood must stand apart. How can a profession however strong, march all at once against such an overwhelm- ing influence ? Itself born, perchance, under the influence bred under it, how shall it immediately be transformed ? Why 296 ALCOHOL AS A MEDICINE. disobey the influence ? It is in the interest of the doctor to obey, in a worldly sense of view ; but more — it is in his ftature to obey. The strong bands of nature and interest go hand in hand. Is it wonderful that the genius of a professional man so situated should, according to the quality of his genius, up- hold, root and branch, the role of his nativity } On the con- trary the wonder is that he has ever done anything else. It is most natural that he should be amongst the last to take up what revolutionizes all the manners, and customs, and faiths, of society. A lady will ask her physician the question, May I take wine, Sir } As much as you like Madam ; it is very bad for you and I take none, but that is your business entirely. Henceforth that gentleman is said to be one who prescribes al- cohol in any quantity. In fact, he never prescribes it, for al- though when forbidding is hopeless, there is all the difference in the world between prescribing and permitting, permitting goes down as if it were prescribing. Often a patient will try to compromise. On an ocean of whisky and water, brandy and soda, or other poisonous mixture, he is floating into fatal paraly- sis. You tell him so faithfully, and he says he knows it and will drop down to claret. If you assent, he tells his friends you have changed his brandy or whisky to wine ; if you dissent, he says you have left your duty as a doctor undone, in order to be- come an advocate for abstaining temperance, about which he is as competent a judge as you are, and he won't pay fees for that advice. He pays to be cured of his disease, not to be dragooned into a system peculiar in its tenets. In an alcoholic world there is a strong argument in this decision. It rolls splendidly, especially down hill." After speaking of non-alcoholic physicians, and their opinions of the harmfulness of alcohol, he adds : — " On the other side, there are practitioners who, under the magnetism of public opinion, as earnestly believe the opposite in relation to alcohol, who declare they could not, conscienti- ALCOHOL AS A MEDICINE. 297 ously, practice their profession if they were debarred the use of alcohol, and who look on the advance and the growth of scien- tific abstaining principles — which they cannot avoid recognizing — with positive dread. The extremists on this side are indeed extreme in their fanaticism. They shut their eyes to the most obvious facts, and do not hesitate in their bHndness to misrepre- sent the most obvious truths. They affirm that under the in- fluence of total abstinence and, by inference, because of total abstinence, the yearly decreasing death-rate of the population is accompanied by reduction of vitality ; that people who live long are more enfeebled than those who live short lives and merry ; that under abstinence from alcohol fearful diseases are being developed ; that the total abstainers have less power for resisting disease than the moderate temperate ; and that under the current system of advance towards total abstinence, a very small advance yet by the way, diseases of a low type have de- veloped and extended their ravages." It is only physicians of large conscientiousness, or of great independence of character, who will dare to go counter to the prejudices of the people. Consequently, it is necessary to educate the peo- ple in the teachings of those physicians, whose em- inence in the profession has permitted them, or whose conscientiousness has driven them, to expose the delusions concerning the medical value of alco- holic beverages. When the people cease to believe in alcoholic remedies, physicians will no longer pre- scribe them. But while the majority desire the " physicians' prescription " as a cover for indulgence, there will be found physicians willing to give such prescriptions. That the prescription of alcohol by physicians is 298 ALCOHOL AS A MEDICINE. largely a matter of routine may be seen from the following two cases, reported to the writer by county superintendents of the department of Medical Temperance. In the first case, the physician said to the nurse, " If the patient's heart becomes weak, you might give a little brandy or whisky." Seeing reluctance expressed upon the nurse's countenance, he added hastily, " Or coffee, strong coffee will do just as well." The nurse in reporting this to the writer, said, *' Why couldn't he have ordered coffee in the first place if he thought it equally good ? " The second case was that of an aged woman whose physician ordered whisky as a tonic. Her granddaughter ventured to ask, "Would not whisky have a narcotic rather than a tonic effect?" He replied thoughtfully, " Well, tell the truth, I sup- pose it would." CHAPTER XIII. ALCOHOLIC PROPRIETARY OR 'pATENT' MEDICINES. America has been called the Paradise of Quacks, and with good reason. For years patent medicine manufacturers had such complete control of the American press, both secular and religious, that it was almost impossible to reach the public with in- formation as to the real nature of these concoctions. Consequently the people accepted with amazing cred- ulity the startling claims to miraculous cures of various pills and potions as set forth under glaring headlines in the daily papers. The publicity of the last few years has hurt the traffic seriously, but it still has a great hold upon the ignorant and credulous part of the population, and there is still a very large number of the^e preparations upon the market. Many persons think that the Pure Food Law guarantees every drug preparation now sold to be perfectly safe for use. This is a great error. The guarantee means simply that the manufacturer guarantees that his preparation is as he states upon the label ; the government guaran- tees nothing concerning the matter. That the guaran- tee of the manufacturer is not always truthful has been shown by analyses of some preparations made by state and national chemists. All the advantage that the public has through the, Pure Food Law, so far as drug preparations are concerned, is that the percentage 299 300 ALCOHOL AS A MEDICINE. of alcohol must be printed upon the label, and the presence of certain dangerous drugs, such as morphine, cocaine, and acetanilid must be indicated. Thus per- sons intelligent as to the nature of these drugs will avoid medicines which the label says contains them. The ignorant are not protected. It was difficult to secure even this small restriction upon the sale of pro- prietary medicines because of the opposition of a large number of newspaper pubhshers who were sharing the ill-gotten gains of the medical fakirs. A careful compilation of manufacturers' announce- ments list 1, 806 so-called patent medicines sold in open markets, in which alcohol, opium or other toxic drugs form constituent parts. 675 of the preparations are known as ** bitters," stomachics, or cordials, and alcohol enters into their composition in quantities varying from fifteen to fifty per cent. ; 390 are recommended for coughs and colds, nearly all of which contain opium. Sixty remedies are sold for the relief of pain, and no other purpose. 120 are for nervous troubles, and of this number, sixty-five have entering into their composition coca leaves, or kola nut, or both, or are represented by their respec- tive active principles, cocaine or caffeine. 129 are offered for headaches, and kindred ailments, and usually with a guarantee to give immediate relief. In these are generally compounded phenacetine, caffeine, antipyrine, acetanilid, or morphine, diluted with soda, or sugar of milk. Dysentery, diarrhoea, cholera morbus, cramp in bowels, etc., have ^185 ALCOHOL AS A MEDICINE. 30I quick reliefs or " cures " to their credit, nearly all of which contain opium, many of them in addition, alcohol, ginger, capsicum or myrrh in various com- binations, and there are numerous cases on record where children and adults have been narcotized by their excessive use. Some manufacturers print on the labels covering these goods, words of caution limiting the amount to betaken. Forty-eight com- pounds for asthma contain caffeine and morphine. Sufferers from toothache have their choice from thirty-eight remedies, and thirty-six soothing, or teething, syrups are provided for infants. Many people have ignorantly and innocently formed an alcohol, morphine, or cocaine habit through the use of patent medicines. !^.Iany deaths have occurred from headache powders of which acetanilid is the chief ingredient. Dr. Harvey W. Wiley, chief of the Bu- reau of Chemistry, says of these headache powders : — "A woman has a headache and she uses one of these reme- dies. It relieves the pain. When she has another attack she uses it again and again with the same result. After a while she finds the usual amount of the remedy does not cure the pain. She uses two portions, and so the habit is formed until absolute danger is confronted. For one thing must not be forgotten : these remedies are powerful, for if they were not they would be of no effect. They are in certain doses deadly ; they depress the nervous system ; the}^ disturb the digestion ; they interfere with natural sleep ; they require to be used in increasingly larger quantities as the system be- comes accustomed to their use ; they are almost without ex- ception excreted b}- the kidneys, thus adding an additional burden to organs already badly overworked. They produce a habit of gaining relief which becomes an obsession and in- capable of being resisted. 302 ALCOHOL AS A MEDICINE. It may be asked, '' How is it if these mixtures are harmful only, that so many people profess to have received benefit from them? There are different reasons for this. 1. The nature of such drugs as alcohol, opium and cocaine is to benumb sensation, so that pain is stilled, and the pain, or functional disturbance for- gotten for the time, because the nerves are drugged into insensibility. The person feels better while under the influence of the drug, so thinks it is bene- fiting him. 2. There are people who imagine they have dis- eases which they do not have ; since trained physi- cians occasionally err in diagnosis, it is not strange if the laity should do likewise. Such persons are always ready to aver that a certain medicine " cured " them. A ludicrous example of this is a woman out West, whose picture graces the advertisements of a certain nostrum, accompanied by a testimonial that said nostrum cured her of a ''polypus"! Upon being written to as to how such a preparation could effect such a cure, she answered that, after giving the testi- monial, she found that she had not had a polypus ! 3. Some of the cures attributed to drugs, are doubtless due to Nature. It is estimated that from 30 to 90 per cent, of ailments are cured by Nature, unassisted, and often in spite of, the drugs swallowed. Many of the books advertising these remedies (?) give excellent rules of health, which, if followed, ALCOHOL AS A MEDICINE. 303 would restore persons to vigor more speedily with- out the accompanying medicine, than they can be restored while the system has the poisonous drugs to throw off. It may be reasonably assumed that a goodly number of recoveries ascribed to drug treat- ments are due, in reality, to the resisting force of a good constitution, or to obedience to the laws of health given in the circular. 4. It is not uncommon for people suffering from certain diseases to have temporary remissions in the course of the disease. No doubt, some of the cases reported as cures are such spontaneous remissions, which are followed, after the testimonials have been written, by relapse. The majority of people are ignorant of the natural course of diseases — of what happens when no treatment is taken. They do not know that a great many affections are characterized by periods of apparent recovery. For instance in some varieties of paralysis, as well as in consumption, the sufferer may to appearance recover completely for a few months or longer ; if a remedy was being used at the time, it would naturally get the credit of causing the favorable change. However, all of the glowing testimonials of won- derful benefits accruing from patent medicines are not what they seem to be. Dr. J. H. Kellogg says in his Monitor of Health : — " The average manufacturer of patent medicines regularly employs a person of some literary attainment whose duty it is to invent vigorous testimonials of sufferings relieved by Dr. 304 ALCOHOL AS A MEDICINE. Charlatan's universal panacea. In many instances persons are hired to give testimonials, and answer letters of inquiry in such a way as to encourage business. The shameless dishonesty and ingenious villainy exhibited are beyond description." Recently an advertisement of one of these nos- trums stated in the headlines that said nostrum was used in the Frances Willard Temperance Hospi- tal, Chicago. The testimonial appended purported to be from a nurse in that hospital, but the testimon- ial did not state ^ as did the headlines, that the pre- paration vv^as ever used in that hospital. The presi- dent of the hospital board of trustees states that the nurse positively denies having given any testimonial to the company thus advertising. She did give one to another patent medicine concern, but not to this, and never said either was used in the hospital, nor have they been. Suit could be brought for dama- ges, but unfortunately the patent medicine people have unlimited money, and the hospital has not. Early in the present year there appeared in many daily papers a large advertising picture of a man whose name was appended as a professional nurse of a western city. The following testimonial accompanied the pic- ture : — " Mr. of , who is a professional nurse of experi- ence, writes, — ' My friend is improving, thanks to , and you. I am called on to nurse the sick of all classes. I recom- mend to such an extent that I am nicknamed (giving name of nostrum) by nearly everybody. As the writer of this book was acquainted with a ALCOHOL AS A MEDICINE. 305 physician residing in the small city mentioned in the advertisement, she wrote to him, requesting that he investigate this testimonial. He replied that he found the chief part of thv-: advertisement, namely, that Mr. ■vra.B a pro fessional nurse, false ; " First, by his own strtemen as he told me this morning that he never claimeo to be a professional nurse. And my personal ac- quaintance with him, as well as that of a number of other physicians in our little city, and reliable men and women of this community who are acquainted with him, all testify to the same thing, namely ; that he is not a professional nurse, neither is he a nurse, or even a reliable man. He is an innocent, ignorant man, very close to the pauper class. He told me when I read the commendation to which his name is affixed, that it was all true except the professional nurse part, and that was entirely false, as stated above." As the picture was of a fine-looking, intelligent- appearing man it probably was as genuine as tho testimonial. The following was clipped from a copy of Merck's Report, April, 1899, ^ druggists' paper published in New York city : — Many Druggists Indignant, a patent-medicine advertisement contains unau* thorized endorsements. " Fully a score of East-side druggists are up in arms over the unauthorized use of their names in a full-page newspaper adver- 306 ALCOHOL AS A MEDICINE. tisement of a widely- known specific. This advertisement ap- peared recently in certain New York daily papers, and retail druggists who have made it a rule of their business never to recommend any particular proprietary article, found themselves quoted in unquahfied laudation of the article so liberally adver- tised. The names and addresses of the druggists were given in full, and when several of the men quoted conferred together they found that the most barefaced misrepresentation had been resorted to. " One of the pharmacists thus misrepresented, happened to be Sidney Faber, the secretary of the Board of Pharmacy. He was not selling this particular specific, and had never said a word for or against it, nevertheless, six or eight lines of en- dorsement of the article were directly attributed to him. He called on some of his druggist neighbors whose names he saw in the advertisement, and ascertained that they, too, had been falsely and unwarrantably quoted. Mr. Faber promptly wrote to the proprietors of the specific in question, and denounced the published endorsements bearing his name, as a forgery. His indignation was by no means appeased when he received a letter from the proprietary concern, couched in the following language : ' We regret to learn that you have been annoyed by any statements that have appeared in New York city papers. We will forward your letter to them.' " Within the past few days several of the druggists whose names were used in this advertisement without authority, have been considering the advisability of taking legal proceedings in order to ascertain their rights in the matter. It is contrary to pharmaceutical ethics for a pharmacist to specially endorse any proprietary article, or patent medicine. Some of the offended druggists propose to contribute to a fund for the purpose of publicly, and widely, advertising this unwarranted use of their names." When patent medicine advertisers would dare to ALCOHOL AS A MEDICINE. 3©/ resort to such a wholesale fraud as this, what may they be expected to refrain from ? As an illustration of how commendations from notable persons are sometimes obtained, the follow- ing is cited : In the winter of 1899, appeared an advertising picture of the lovely Christian lady from Denmark, the Countess Schimmelmann, who was spending some time in Chicago. Below her picture were the words : — " Adeline, Countess Schimmelmann, whose portrait is here given, in a recent letter to the company, (mentioning proprietors of nostrum) speaks of friends of hers who have been benefited by (mentioning nostrum), and who first advised her to recommend it to her sick friends. " The Countess, as is well known, is a prominent member of the Danish court. Her coming to this country has been much talked of. Her real object is one of charity. She is stopping in Chicago, and front there writes her straightforward en- dor sejnent of (mentioning nostrum)." The italics are the writer's. The picture and the testimonial were cut from the paper, and sent to the countess, asking if she had so spoken of this medicine, and, if so, did she, a strong total absti- nence woman, know that this mixture contains a large percentage of alcohol. She responded as follows : — " Thank you for asking me about the enclosed. A white- ribbon lady came and asked me if I would do her the great kindness to recommend compound (made up of the juice of celery). I said I could not personally recommend it as I neither use, nor want, medicine. But some very reliable 308 ALCOHOL AS A MEDICINE. friends of mine {temperance people, and true Christians) told me I would do a good thing in recommending it as they used it, and found it excellent. Then I wrote the following : ' I myself cannot recommend compound as I do not suffer from any of the ailments it is said to be good for, but reliable friends of mine tell me that it is excellent, and I would do a good thing in recommending it to my friends. Adeline, Count- ess Schimmelmann.' " I will only consent to the publishing of this letter if you publish the whole letter, and no extract from it, as the white- ribbon lady did for the compound." If a white-ribboner played this mean trick upon this distinguished Christian worker she is un- worthy of membership in the Woman's Christian Temperance Union. It is more than likely that the '* white-ribbon lady," was a paid advertising agent of the patent medicine manufacturer, and wore a white-ribbon to gain the confidence of the Countess. Whether patent medicine manufacturers know how to doctor all ills to which human flesh is heir may be doubted, but that their advertising agents are skilful '' doctors " of testimonials is very evident to any one acquainted with the facts. The Department of Public Charities of New York city in a '' Report on the use of so-called Proprietary Medicines as Therapeutic Agents," says : — " In connection with this subject it might be mentioned that, for years past, the name of Bellevue Hospital has been taken in vain by a number of persons and firms, without any authority ALCOHOL AS A MEDICINE. 309 whatever. It is a common occurrence that samples of proprie- tary medicines, foods, mineral waters, plasters, etc., etc. are sent to the hospital, or to members of the house-staff for • trial,' whereupon the subsequent advertisements of the articles in question often assert that the latter are ' used in Bellevue Hospital,' leaving the impression upon the mind of the reader that the article, or articles, have been used with the sanction of some member of the Medical Board. It is probably impossible to find a remedy for this evil, from which many other institutions of repute likewise suffer. To publish a denial of such false assertions would only aggravate the evil. The utmost that can be done appears to be, to caution the medical staff against any entanglements with, or encourage- ment of, the agents of the interested parties." This report, which was adopted by the Medical Board of Bellevue Hospital, classifies proprietary preparations as " Objectionable " or '' Unobjection- able " according to the following rules : — " Unobjectionable preparations are those, the origin and composition of which is not kept secret, and which are known to serve a useful and legitimate purpose. Malted Milk is an example. Objectionable proprietary preparations, by far the largest group of the whole class, comprise all those which are aimed at under the medical code of ethics under the term ' secret nostrum,' which term may be more closely defined thus : " A secret nostrum is a preparation, the origin or composi- tion of which is kept secret, the therapeutic claims for which are unreasonable or unscientific, or which is not intended for a legitimate purpose, " Examples : The various ' Soothing Syrups,' ' Female Regulators,' ' Blood Purifiers,' and thousands of others." Dr. A. Emil Hiss, Ph. G., says of the secrecy of these preparations : — 3IO ALCOHOL AS A MEDICINE. " A secret compound with a meaningless title is presump- tively a fraud. Why a secret if not to permit extravagant, or fraudulent, claims as to therapeutic merit ? ***** The ruling motive of the secret being essentially false and dis- honest, its employment in the interest of any remedy is clearly a sufficient cause for its condemnation and ostracism." Mothers sometimes wonder vi^hy their boys take so readily to cigarettes, or their daughters to cocaine, never thinking that the soothing syrup, or cough mixture given freely by themselves to their children developed a craving for something stronger later on. Mrs. Winslov^^'s Soothing Syrup, advertised for years in church as well as secular papers as " in- valuable for children," is cited in the report for 1888 of the Massachusetts State Board of Health as containing opium ; also Ayer's Cherry Pectoral, Dr. Bull's Cough Syrup, Jayne's Expectorant, Hooker's Cough and Croup Syrup, Moore's Essence of Life, Mother Bailey's Quieting Syrup, and others too numerous to mention. The report says : — " The sale of soothing syrups, and all medicines designed for the use of children, which contain opium and its preparations should be prohibited. Many would be deterred from using a preparation known to contain opium, who would use without question a soothing syrup recommended for teething children." Again, on page 149 the following is quoted from a prominent physician : — " Among infants, and in the early years of life, soothing syrups are the cause of untold misery ; for seeds are doubtlessly sown in infancy only to bear the most pernicious fruit in adult life. It is said that one of the best known soothing syrups con- ALCOHOL AS A MEDICINE. 3II tains from one to three grains of morphia to the ounce of syrup. I believe that stringent legal measures should immedi- ately be taken to stop the sale of so-called soothing syrups containing opium, morphia or codeine." The writer has known mothers so ignorant of the nature of these soothing syrups as to deliberately put the baby to sleep upon them in order to insure relief from care for some hours. Prof. J. Redding, M. D., says on this point : — " While it may be true that an adult, of his own free will, and without incentive, or predisposing causes, does occasionally be- come a drunkard, I am convinced that nine hundred and ninety-nine out of every one thousand individuals who become drunkards are made so in embryo, infancy, or childhood, by the use of alcoholic decoctions, soothing syrups, opiates, calomel, etc. which are given as medicines to allay pain, obtund nerve sensibility, to cure the little sufferer of his vital matiifestatiotis, of his mental discomforts, but leave the actual disease and its, perhaps, putrid causation to time and debilitated vitality to remove." Of the danger and harmfulness of patent cough mixtures The American Therapist says : — " Cough mixtures as a rule, do more harm than good. Nine times out of ten the principal ingredient is opium. It is true that opium may lessen the tendency to cough, but it does great damage by arresting the normal secretions, and the system becomes affected by the poisons from the kidneys, skin, stomach, intestines and the mucous membrane lining the up- per air passages. Not only do these mixtures arrest every secretion in the body, but they also show their deteriorating and degrading effect through the stomach. They contain sub- stances which tend to disorder and derange digestion." 312 ALCOHOL AS A MEDICINE. Several years ago the Post-Office Department at Washington was led to take an interest in the question of fraudulent "patent" medicines, and an examination of many of these nostrums was undertaken by govern- ment chemists. Fraud orders were issued against some of the most flagrant offenders, forbidding them the use of the mails. This has not done away with the evil, however, for they usually move to another city, and begin business again under another name. The examinations made for the Post Office Depart- ment revealed the fact that a great many of the so- called medicines on the market were intoxicating bev- erages in disguise. The Internal Revenue Department then took up the matter and a long list of these bever- age medicines was sent out to internal revenue agents with instructions that these must not be sold hence- forth unless by persons paying a special tax for the sale of alcoholic beverages. Some of the manufacturers of these nostrums availed themselves of opportunity given to add a recog- nized medicinal agent to their flavored alcohol and water and such preparations were stricken from the list of those requiring a whisky license for their sale. Peruna and Hostetter's Bitters v/ere the best-known of these. Peruna had been up to this time what gov- ernment chemists called "a cheap cocktail." The re- port of the pure food commissioner of North Dakota for 1906 gives on page 157 an analysis of it as now upon the market: "Alcohol by volume, 21.25 per cent. ; total soHds, 3.846 per cent. ; ash, .158 per cent." The report says : — ALCOHOL AS A MEDICINE. 313 "The only thing of a medicinal nature that we could find in this preparation appeared to be a small amount of senna combined with a bitters of some kind." Proprietary "Foods" have not escaped attention from chemists. Dr. Charles Harrington, for several years secretary of ^Massachusetts Board of Heahh, was the first to pubHsh an analysis of these prepara- tions showing their alcoholic strength and their small nutritive content. He lists "foods" examined by him as follows : — "Liquid Peptonoids 23.03 alcohol ; maximum amount rec- ommended will yield less than one ounce of nutriment per day, and the equivalent of 3.50 oz. of whisky. Hemapeptone 10.60 alcohol; Hemaboloids 15.81 alcohol; the maximum dose recommended yields about 34 oz. of nutriment, and the equiv- alent of about i^ oz. of whisky daily. Tonic Beef 15-58 alcohol ; doses recommended yield about V2 oz. nutriment daily, and the equivalent of one ounce of whiskey. iMul- ford's Predigested Beef 19.72 alcohol; doses recommended yield about ij^ oz. nutriment daily, and the alcoholic equiva- lent of about 6 oz. of whisky. There were "Foods" for the sick examined which were non-alcoholic, but their nutritive value was about nothing in comparison to their cost." The Committee on Pharmacy of the American Medical Association reports on the following foods thus : — Carpanutrine 17.3 alcohol; Liquid Peptones (Lilly & Co.) 22.0; Nutrient Wine of Beef Peptone (Armour) 21.5; Nutri- tive Liquid Peptone 23.0 ; Panopepton 18.5 ; Peptonic Elixir 18.8; Tonic Beef 16.1. The report on these says: "There are no fatty substances present in these products; their food value from this point of view is, therefore, nil. A prominent physician of Philadelphia said of these "Foods" in the Journal of the A. ]\I. A. : — 314 ALCOHOL AS A MEDICINE. "I have long been convinced that many a patient has suf- fered severely when preparations such as these were being used, and that not a few of them have died, chiefly of star- vation. * * * A very important disadvantage of these foods is their alcoholic content. Even in the small doses customarily used, the quantity of alcohol is often irritating to the stom- ach, and may be disadvantageous in other ways." The Committee on Pharmacy also reported on cod- liver oil preparations. They said: "A preparation claiming to represent cod-liver oil which does not con- tain oil in some form is fraudulent. Waterbury's Metabolized Cod-Liver Oil and Hagee's Cordial of Cod-Liver Oil are cited as examples. It is claimed by the manufacturers that the latter represents 33 per cent, of pure Norv^egian cod-liver oil, but in neither of these preparations did the tests made by the com- mittee shov^ any oil. Analysis revealed sugar, alcohol, and glycerine, none 6f which is contained in cod-liver oil. Vinol is advertised as Wine of Cod-Liver Oil, but is admittedly without oil, and according to analysis contains 18.8 per cent, alcohol. Wampole's Tasteless Preparation of Cod-Liver Oil showed 20.05 P^^ cent, of alcohol. Cod-Liver Oil is considerably out of date now as a prescribed remedy because physicians have found that it impairs appetite. Cream and fresh butter and olive oil are advised instead. Australia has been such a harvest field for patent medicine manufacturers that a g^vernment commis- sion was appointed to study the subject. This com- mission presented a voluminous report to the parlia- ALCOHOL AS A MEDICINE 315 ment of 1907. This report gives an analysis of most of the extensively advertised medicines. Doan's Back- ache Kidney Piils are said to be made of oil of juni- per I drop, hemlock pitch 10 grains, potassium nitrate 5 grains, powdered fenugreek (Greek hay) 4 grains, wheat flour 4 grains, maize starch 2 grains. The report says: "The stuff is the cheapest kind of skin-plaster made up into pills." The seeds of fenugreek are used mainly for poultices. Doan's Dinner Pills contain two drastic purgatives, podophylHn and aloin. Both of these are dangerous drugs. Aloin frequently produces hemorrhoids (piles). The British Medical Journal says that the material in forty of the Kidney Pills and four Dinner Pills would cost one English halfpenny (one cent). Vitae-Ore is given as consisting of ordinary sul- phate of iron (green vitriol) to which a little Epsom salts has been added. Munyon's Kidney Cure, which claims to cure Bright's disease, gravel, and all urinary diseases, is given as composed entirely of sugar. Dr. Williams' Pink Pills are said to be an iron pill much the same as the ordinary Blaud's Pills which are sold in drug-stores for half, or less than half, the price of the proprietary article. (Iron is said by recent investi- gators to be very injurious to the stomach.) The Committee on Pharmacy of the American Medi- cal Association has analyzed many proprietary medi- cines ; from their reports the following analyses are taken. "Health Grains," which are claimed to be a remedy for "Dyspepsia, Indigestion, Nervousness, etc.," were found to consist of 87.50 per cent, of coarse 3l6 ALCOHOL AS A MEDICINE. quartz sand, and 12.50 per cent, of rock candy and syrup. Hoff's Consumption Cure consists essentially of sodium cin- namate and extract of opium, a mixture at one time sug- gested for the treatment of tuberculosis, but which has been discarded by physicians. A m.edicine which depends on opium for whatever therapeutic effect it may have is, when sold indiscriminately to the laity, inherently vicious." Sartoin Skin Food for "sunburn, and all skin blem- ishes" was made of Epsom salts colored with a pink dye. The government prosecuted the company send- ing out Epsom salts as a "food," and they were fined $20 for thus seeking to dupe silly women. Malt extracts are very extensively used at the present time, under the popular notion that they are an aid to starch digestion. That they are a product of the brewery has caused them to be looked upon with suspicion by cautious people, but the multitude has apparently given no thought, or care, as to whether or not they may be alcoholic. Dr. Charles Harrington presented the results of an examination of these preparations at a meeting of the Boston Society of Medical Sciences, held Nov. 17, 1896. The following is quoted from the journal of the society for November, 1896 : — " Twenty-one different brands of liquid malt extract were obtained and analyzed. That they were not true malt extracts is shown by the fact that in no one was there the slightest dias- tatic power ; all were alcoholic, some being stronger than beer, ale, or even porter. In a number of specimens a large amount of salicylic acid was detected." ALCOHOL AS A MEDICINE. 317 Dr. J. H. Kellogg, in commenting upon this re- port, said in the Dec, 1896, Bulletin of t lie A. M. T. A.:— ■' In the light of these facts, it is apparent that ale or lager beer might as well be prescribed for a patient as these so-called malt extracts, which are practically nothing more than concen- trated ale or lager." There are malt extracts, made up like honey, or syrup, in consistency, which are valuable. The following list of malt extracts, with accom- panying letter from Prof. Sharpies, is taken from a paper published by Hon. Henry H. Faxon, of Quincy, Mass. : — "Boston, Mass., March 20, 1897. " I enclose a list of the malt extracts examined in this office during the past year or two. These samples were all in original packages, obtained by officers in various parts of Eastern Massachusetts. They probably very fairly represent the various malt extracts on the market. I have added two samples of Porter and one of Old Brown Stout for purposes of comparison. " Yours respectfully, " S. P. Sharples. " State Assayer." Name. Solids. Alcohol. 5193 English Malt Extract 9.70 5.63 5214 Old Grist Mill Malt Extract 10,57 5.54 5418 Old Grist Mill Malt Extract 9.98 5.63 5490 Old Grist Mill Malt Extract 12.28 5.86 5626 Old Grist Mill Malt Extract 9.63 5.00 5207 Liquid Food, a Malt Extract 10.47 4.27 5225 Pure Malt, a Liquid Food, a Tonic 9.71 5.00 31 8 ALCOHOL AS A MEDICINE. 5416 Pure Malt, a Liquid Food, a Tonic 10.76 6.32 *56i9 King's Pure Malt 9.52 6.60 5421 A Nutritious Tonic, Pure Malt Extract 10.88 6.24 5226 Noris' Extract of Malt 1 1-57 5-94 5258 Noris' Extract of Malt 9.31 6.55 5397 Noris' Extract of Malt 10.63 6.24 5485 Noris' Extract of Malt 10.50 6.63 5620 Noris' Extract of Malt 12.55 S-9^ 5229 Pabst Malt Extract, The Best Tonic 10.43 5- 16 5230 Hoff's Malt Extract (Tarrant's) 11.33 8.88 5489 Hoff's Malt Extract (Tarrant's) 12.25 7.17 5231 Johann Hoff'sches Malz-Extract, Gesund- heit's Beir 11.31 4.34 5491 Johann Hoff'sches Malz-Extract, Gesund- heit's Beir 1 1 .02 4.85 5621 Johann Hoff'sches Malz-Extract, Gesund- heit's Beir 10.49 4-5° 5408 Johann Hoff'sches Malz-Extract, Gesund- heit's Beir 1 1.47 478 5340 Haffenreffer & Co. Malt Wine 11.02 6.65 5423 Haffenreffer & Co. Malt Wine 1 1.71 5.63 Liquid Bread, A Pure Extract of Malt 6.78 6.63 5395 Durgin's Malt, Liquid Extract of Malt 7.12 5.94 5433 Durgin's Liquid Extract of Malt 6.49 5.55 5396 Wyeth's Liquid Malt Extract 14.80 3.35 5488 Wyeth's Liquid Malt Extract 1 5- 50 2.86 5622 Wyeth's Liquid Malt Extract 15.73 2.35 5406 Wampole's Concentrated Extract of Malt.. 9.84 9.86 5407 Anheuser-Busch's Malt Nutrine 15-98 3.00 5600 Anheuser-Busch's Malt Nutrine 15.82 2.25 5417 Malt Extract (Sterilized), John L. Gleeson. . 7.97 4.71 5422 Malt Extract (Sterilized), Charles C. Hearn.* 8.58 5.00 5436 Burkhart Brewing Co.'s Malt Extract 10.73 7-oi * The label on King's Malt states that for a strong, healthy person, with a good appetite, a pint with each meal and another on retiring at night will not be too much. ALCOHOL AS A MEDICINE. 319 5486 Menzel's Extract of Malt 5-9<^ 5-24 5625 Menzel's Extract of Malt 6.75 4.35 5623 King of Malt Tonics, Lion Tonic 10.95 7-05 5624 Teutonic, " A concentrated Extract of Malt and Hops " 9-95 7-45 5409 Van Nostrand's Old Stout Porter, " a pure malt extract " 7»97 6.55 5233 Philadephia Porter 5-34 6.63 5232 Burke's Guiness Stout 6.66 7.17 The alcohol in the above table represents the cubic centimeters of alcohol in a 100 cubic centimeters of the liquid. The solids are the number of grams of solid extract in each 100 centi- meters of the liquid. S. P. Sharples. The British Medical Journal, and the British Medical Teuiperance Review have been calling atten- tion to the danger in coca wines. Intemperance among invaHds is said to be greatly on the increase from the use of these wines. In every case the basis of these preparations is strongly alcoholic wine, ranging from 18 to 20 per cent. The coca added is either the leaves, or liquid extract of coca, or hydrochlorate of cocaine. Dr. Frederic Coley says in the British Medical Journal : — " Coca, and its chief alkaloid, cocaine, are drugs which pos- sess some power of removing the sense of fatigue, just as anal- gesics remove the consciousness of pain. But they no more remove the physical condition of muscles, and nerve centres, of which the sense of pain gives us warning, than a dose of morphine, which removes the pain of toothache, removes the of- fending tooth, or even arrests the caries in it. The truth of this will be obvious to any one who remembers enough of physio- 320 ALCOHOL AS A MEDICINE. logy to know what fatigue really means. A muscle which is tired out is different chemically from the same muscle in its more normal condition, when it is ready to respond vigorously to ordinary stimuli. It has lost something, and is, besides, over- charged (poisoned, in fact) with the products of its own activity, and it can only be restored by a fresh supply of the material which it requires, and the carrying away of the poisonous waste products. Fatigue of nerve centres is no doubt strictly analog- ous to fatigue of muscles. " It is practically impossible for us, by voluntary exertion, to reach the degree of absolute fatigue, which the physiologist pro- duces by electric stimulation of a nerve-muscle preparation. The sense of fatigue becomes so intense that voluntary effort cannot overcome it. So no man can produce asphyxia by simply holding his breath, because the besoin de respirer be- comes irresistible ; but it is quite possible for a narcotic to so dull the sensory part of the respiratory reflex mechanism as to permit asphyxia to take place. " The sense of fatigue, and the besoin de respirer are both Nature's danger signals. Drugs which hide such signals from Us are a more than doubtful benefit. If it were possible for us to suppose that a fraction of a grain of cocaine could afford to exhausted nerve centres, and muscles, the nutriment which they require for their restoration, and at the same time eliminate the poisonous waste products, then it would be reasonable to pre- scribe the drug for use by all who are overworked, and perhaps suffering from the malnutrition consequent upon, ' nervous dyspepsia,' as well as mere want of rest. " In this go-ahead century it is no wonder that many are but too ready to experiment with a drug which professes to be able to remove fatigue, and to enable a man to go on working when, without its aid, weariness had become unendurable. Cocaine claims all this ; and it is most dangerous just because, for a time, it seems able to keep its promise. That is how victims to cocainism are made. Let us be honest with our overworked ALCOHOL AS A MEDICINE. 321 patients, who want us to help them with drugs ; let us tell them that rest is the only safe remedy for weariness. " To combine such a drug as coca, or cocaine, with an al- coholic stimulant, is to multiply the dangers of cocainism by those of alcoholism. It would be impossible to find terms suf- ficiently severe in which to condemn the recklessness of those who promiscuously recommend such a compound for all who are overworked or debilitated. One firm actually has the as- surance to advertise a preparation of this kind as a remedy for dipsomania. Truly this is casting out devils by Beelzebub, with a vengeance. Invoking Beelzebub for such a purpose has never been a success. And I suspect that any form of coca wine will make a great many more dipsomaniacs than it will cure." Dr. Walter N. Edwards, F. C. S., says of coca wines : — •' These wines are sold as being useful in an immense variety of ailments. The following are a few of the many that are named upon the bottles or in the circulars accompanying them : — " Weakness after illness, " Nervous disorders, " Sleeplessness, " Influenza, •' Whooping cough, " Exhaustion of mind and body, " Allays thirst, " Restores digestive function, " Enables great physical toil to be undergone, " Great value in excesses of all kinds, " General debility, " Prevents colds and chills, " Makes pure, rich blood. 322 ALCOHOL AS A MEDICINE. " Anasmia, " Invaluable after pleurisy, pneumonia, etc., " Aid to the vocal organs. " This is a fairly respectable list of complaints, and the very fact that these preparations of coca wine are put forward as a cure for so wide a range of various complaints is in itself a condemnation of them. " When any particular remedy is said to be of universal application for a large number of different complaints it may be looked upon with great suspicion. " It must always be remembered that there is the commercial side to this question. The proprietors have no particular regard for the welfare of the people ; their business is to make a profit, and many of them gain enormous fortunes. By skil- ful and lavish advertisements, and by carefully worded testi- monials, they appeal to the credulity of the public, and often de- ceive even those who regard themselves as belonging to the thinking classes. " There are two specific dangers in regard to these wines. They are ordinary wines, either port or sherry for the most part, and therefore strongly alcoholic. The user of them is in considerable danger of cultivating a taste for alcohol, and cer- tainly, there is the greatest possible danger to any one having had the appetite, of reviving it. " The dose is an elastic one, it can be repeated with consider- able frequency three or four times a day. " What would be said of growing girls or youths having re- course three or four times a day to the wine bottle ? This is exactly what they are doing when coca, and the so-called food wines are placed in their hands as medicine. They like the pleasant taste, there is the call of habit and appetite, and so there arises the greatest possible danger of a general liking for alcoholic liquors being set up. The ailing man or woman of set years is in similar danger, for they are having recourse to ALCOHOL AS A MEDICINE. 323 alcohol when their powers of mind and body are to some extent exhausted, and they are thus less able to resist the fascination for alcohol that may so quickly be brought into existence. " Another element of danger is that the recourse to coca and kola is an attempt to get more out of the body, and the mind, than nature intended. Overwork, overstrain, worry, all produce exhaustion of physical and nervous power. Nature pulls us up by asserting herself, and we feel run down and seedy, and, per- haps, quite unwell. What is wanted is rest, proper diet, and change. These would quickly be restorative, and once again we should be fit for the duties of life. " In a busy age there is the strongest possible temptation to seek a restorative by some occult method, rather than to give the rest and refreshment that nature demands. It is upon this that the whole trade in these so-called restoratives depends. " There is no food quality in alcohol, cocaine or kola, but there is in them all a narcotizing influence that in its lesser stages is hurtful, and in its greater stages disastrous. " The cocaine habit may be cultivated as easily as the alcohol habit, and the two forms of disease, alcoholism and cocainism, are by no means rare. The great factor in each of them is the loss of will power, and when that is accomplished the descent to complete moral and physical ruin is quite easy. " A pure and simple life, in accord with the laws of health and hygiene, is^the panacea both for the maintenance, and the restoration of health, and that is what we should strive to aim at, rather than having recourse to drugs that are not only ineffec- tive, but positively dangerous." — Umted\Temperance Gazette, In Dr. Milner Fothergill's Practioners Hand-book of Treatment, fourth edition, the following state- ment is made : — " Coca wine, and other medicated wines are largely sold to people who are considered, and consider themselves, to be total 324 ALCOHOL AS A MEDICINE. abstainers. It is not uncommon to hear the mother of a family say, ' I never allow my girls to touch stimulants of any kind, but I give them each a glass of coca wine at 1 1 in the morning, and again at bedtime.' Originally coca wine was made from coca leaves, but it is now commonly a solution of the alkaloid, in a sweet and strongly alcoholic wine. This is really the gist of the whole matter ; coca wine is largely consumed by people who fondly believe themselves to be total abstainers, and who are active enough in denouncing those who take a little wine, or a glass of beer at their meals. The sooner their delusion is dispelled the better for themselves, and for the unfortunate children over whom they exercise supervision." Another physician tells of seeing a distinguished ecclesiastical dignitary, a sworn foe of alcohol and its congeners, giving his young child a generous daily allov^ance of one of these wines. The user of coca wines runs a double risk — an alcohol craving may be revived, or created ; and, at the same time, cocainism may be set up, and nothing but physical, mental and moral ruin follow. The British Medical Journal of January 23rd, 1897, says: — " There can be no doubt that in many parts of the world co- caine inebriety is largely on the increase. The greatest num- ber of victims is to t^e found among society women, and among women who have adopted literature as a profession ; and there is no doubt that a considerable proportion of chronic cocainists have fallen under the dominion of the drug from a desire to stimulate their powers of imagination. Others have acquired that habit quite innocently from taking coca wines. The symp- toms experienced by the victims of the cocaine habit are illu- sions of sight and hearing, neuromuscular irritability, and ALCOHOL AS A MEDICINE. 325 localized anassthesia. After a time insomnia supervenes, and the patient displays a curious hesitancy, and an inability to ar- rive at a decision on even the most trivial subjects." Dr. F. Coley says later on in the article before referred to : — " There is another combination which, though utterly absurd from a therapeutical point of view, is not in itself quite so dan- gerous as coca wine. It will probably do a larger amount of mischief, however, because more people take it. I refer to the various preparations, so largely advertised, which profess to be compounded of port wine, extract of malt, and extract of meat. To the medically uneducated public this doubtless seems a most promising combination : extract of meat for food, extract of malt to aid digestion, port wine to make blood. Surely the very thing to strengthen all who are weak, and to hasten the restor- ation of convalescents. Unfortunately what the advertisements say — that this stuff is largely prescribed by medical men — is not wholly untrue. " I do not suppose that any physician of anything like front rank would make such a mistake. But busy general practition- ers may be excused if they prove to be a bit oblivious of physi- ology, and so become attracted by a formula which is more plausible than sound. In the first place, we all know that ex- tract of meat is not food at all. From the manner of its pro- duction, it cannot contain an appreciable quantity of proteid material. It consists mainly of creatin, and creatinin, and salts. These are, it is needless to say, incapable of acting as food. Extract of meat, and similar preparations, have their uses how- ever ; made into ' beef-tea,' their meaty flavor often enables patients to take a quantity of bread, which would otherwise be refused ; or lentil flour, or some other matter may be added. In this way, though not food itself, it becomes a most useful aid to feeding. It is besides, a harmless stimulant, especially when taken, as it always should be, hot. It should be needless 326 ALCOHOL AS A MEDICINE. to add that to combine extract of meat with port wine is simply to ignore its real use. The only intelligible basis for such an invention must be the wholly erroneous notion that extract of meat is a food." The prices asked for " secret nostrums " are said by chemists to be ofttimes far beyond the value of the materials. Of one article the New Idea, a druggists' paper, says : — " It retails at $1.50 per bottle. Such an article could be put up for less than fifteen cents, including bottle, leaving by no means a small margin for the profit of its manufacturers." The same paper says of a cure for catarrh, neuralgia, etc. sold in the form of a small ball : — " This cure costs $2,50 per ball, A handsome profit cou/d be made upon it at 5 cents a ball." Some proprietary preparations are not harmful, but are positively inert. The Mass. State Board of Health in report of 1896 gives Kaskhie as an ex- ample of these. Although sold at a dollar announce it was found to consist of nothing but granulated sugar of the fine grade used in homeopathic pharma- cy, without any medication or flavoring whatever. Dr. Edward Von Adelung in an article in Life and Health, Dec, 1897, tells of a well advertised cure for consumption, the analysis of which showed it to be composed of water, slightly colored by the addition of a very small quantity of red wine, and two mineral acids, muriatic and impure sulphuric, in quantities just sufficient to lend it a taste ! He says : — ALCOHOL AS A MEDICINE. 32/ " Fortuitously I had the opportunity of observing the influence of this remedy on a consumptive who took it regularly, and who was so enamored of its favorable action that he gave up his busmess to conduct an agency for its sale. It was not long after he had entered upon his new vocation that I received word of his death, due to pulmonary hemorrhage." The " returned missionary " fraud has been ex- posed by different druggists' papers, among them the New Idea. The " missionary " would advertise a *' free cure," if people would send to him. The ** cure " would be in the form of a prescription. There being no drugs in any drugstore bearing the names given in the prescription, the dupe was ex- pected to pay an exorbitant price for them to the philanthropic "missionary." In one case of this kind the '* medicinal plants brought from South America, the only place where they grew," were upon examination by chemists of the New Idea found to be ordinary drugs, not one of which comes from South America. The same paper tells of another "South Ameri- can " fraud, 60,000 bottles of which were said to be sold in Detroit in a few weeks, by an itinerating vendor. A certain liver, and kidney, and constipation cure, sold in the form of herbs, is said by New Idea to be chiefly couch grass, and senna leaves. Yet it sells for 25 cents for a small package. To this paper the public is also indebted for the information that a kind of wafer advertised to " cure 328 ALCOHOL AS A MEDICINE. in a few days all coughs, colds, irritation of the uvula and tonsils, influenza, bronchitis, asthma, sore throat, consumption, and all diseases of the lungs and chest" was found to consist wholly of sugar and corn starch ! Medical World recently told of the investigation of " H " by Prof. John Uri Lloyd of Cincinnati. It was advertised as a plant discovered by a doctor traveling in Florida. Its juices were said to be antidotal to snake poisoning, and would also cure the opium habit. Prof. Lloyd found it to be a liq- uid consisting of a solution of sulphate of mor- phine and salicylic acid, in alcohol and glycerine, with suitable coloring matter. Another fraud exposed by New Idea was a " cure " for the peculiar ills of women. The cure is put up in the form of little oblong blocks about a half inch in length. " A circular accompanies them, and is well calculated to pro- duce alarm in the young. It is another sample of the demor- alizing documents which unscrupulous quacks are continually circulating among the laity, in order to create alarm, and profit by this alarm." After giving a description of the diseases peculiar to the sex it is stated that all of these are curable by using eight dollars worth of this wonderful med- icine. New Idea continues : — "The cure consists, according to our examination, of nothing but flour, made into a paste and allowed to harden in the form ALCOHOL AS A MEDICINE. 329 of small oblong blocks. Evidently the quack relied upon the faith-cure principle, and his auxiliary treatment, as set forth in the rules of living given in the circular." While these inert preparations are of the nature of frauds, they will not injure the health, nor make drunkards, or opium fiends, as the disguised prepara- tions of whisky and morphine are likely to do. That the use of patent medicines has made many drunkards Is a fact well attested. The American Association for the Study of Inebriety appointed a committee several years ago to investigate the vari- ous nostrums advertised especially for the benefit of alcohol and opium Inebriates. The report of this committee, prepared by Dr. N. Roe Bradner, late of the Pennsylvania Hospital for the Insane, In speaking of the marvelous cures advertised in con- nection with the use of these mixtures, calls them ** volumes of gilded falsehood, designed for an Inno- cent, unsuspecting public," and adds : — " The use of such nostrums would do more toward confirm- ing than eradicating the habit, if it existed, and would invite and create addiction to an almost hopeless fatality, where the habit had not previously existed. Insanity, palsy, idiocy, and many forms of physical, moral and mental ruin have followed the sale of these nostrums throughout our land." Dr. E. A. Craighill, President of the Virginia State Pharmaceutical Association, is quoted in the J uly (i 897) Journal of Inebriety, as saying : — "In my experience I have known of men filling drunkards' graves who learned to drink taking some advertised bitters as 330 ALCOHOL AS A MEDICINE. legitimate medicine. It would be hard to estimate the number of young [brains ruined, and the maturer opium wrecks from nostrums of this nature. I could write a volume on the mis- chief that is being done every day to body, mind and soul, all over the land, by the thousands of miserable frauds that are be- ing poured down the throats of not only ignorant people, but, alas, intelligent ones, too." A lady informed the writer recently that her brother had taken forty bottles of one of these preparations, and had become a drunkard through it. Many seem unavi^are that the ethics of the medi- cal profession restrain reputable physicians from ad- vertising themselves or their remedies, so that these much-lauded patent medicines are put upon the market by quacks, never by physicians of good standing. It is purely a money-making enterprise, without consideration of the health or destruction of the people. It is popularly supposed that phy- sicians decry these things from fear that their sale will injure regular practice. This is another error as they increase work for the doctor by aggravating existing trouble, as well as causing disease where there was only slight disturbance. Dr. F. E. Stewart, Ph. G., of Detroit, Mich., says in the October, 1897, Life and Health : — " Taking all these facts into consideration, it is apparent that the patent, trade-mark and copyright laws should be so inter- preted and administered by the court that they will secure the greatest good to the greatest number, and aid in attaining the end of government, viz., ' moral, intellectual and physical per- fection.' It is not the object of these laws to create odious men- ALCOHOL AS A MEDICINE. 33 1 opolies, to throw a mantle of protection over fraud, to enable quacks and charlatans to encroach on the domain of legitimate medical and pharmacal practice, or to support an advertising business designed to mislead the public in regard to the nature and value of medicines as curative agents. The morals of the community are injured by some of this advertising, intellectual vigor is impaired by the use of many things advertised, and physical, as well as moral, degradation frequently results. Crime is often inculcated — even the crime of murder, that the nostrum manufacturer may profit thereby. Cures for incurable diseases are promised, and guaranteed. Every scheme that human and devilish ingenuity can devise to wring money from its victim is resorted to, which can be employed without actually bringing the advertisers into court. All this wicked quackery parades under the guise of ' patent' medicines, and asks the protection of our courts. It is time for the medical and pharmaceutic pro- fessions to unite, and unmask this monster, and show the public its true nature. And this can be accomplished in no better way than through a study of the object of the laws which the secret nostrum manufacturers are now endeavoring to prostitute for their own advantage, and the teaching of the public what these laws were enacted for. " The secret nostrum business in some of its phases has as- siduously found its way into the medical arts, and physicians, pharmacists, and manufacturing houses, seem to have forgotten, to a certain extent, the obligations which they owe to the public. Medicine, in all its departments, must be practiced in accord with scientific, and professional requirement, or it will sink to the level of a commercial business. The e7td of medical prac- tice is service to sufferijig humanity, not the acquisition of money. Money making is a necessary part of the practice of medical arts, not, however, its chief object. This fact must be kept in view always. Once lost sight of, and trade competition substituted for competition in serving the interests of the sick, medical and pharmacal practice will become an ignoble scrabble 332 ALCOHOL AS A MEDICINE. for wealth, in which the sick become victims of avarice and greed. Better set free a pack of ravening wolves in a com- munity than to change the end of medical practice to a commer- cial one, for physicians and pharmacists would soon degenerate into quacks and charlatans, and take shameful advantage of the community for gain." Where Dr. Stewart speaks of murder he probably refers to the sale of abortofacients. Dr. Roe Bradner, of Philadelphia, in his report upon alleged cures for drunkenness before the So- ciety for the Study of Inebriety several years ago, said : — " There is a certain other class of so-called remedies, pre- pared sometimes by physicians and pharmacists, that do a great deal of harm. I allude to the ' non-secret proprietaries ' that claim to publis.h their formulas, hit do -not. •• One in particular has made thousands, and likely tens of thousands, of chloral drunkards, dethroned the reason of as many more, besides having killed outright very many. It is impossible for any one to estimate the mischief that is being done by such remedies, and the physicians who recommend them." Advertising is still the great hindrance in pro- tecting the people from medical imposters. Professor E. W. Ladd, Pure Food Commissioner of North Dakota, says on this point : — "These patent medicines, some of which are of merit, and others are only 'dopes/ or preparations intended to defraud the public, have been altogether too generally advertised and sold to the public. In many ways it seems a deplorable fact that by an unfair method of advertising the American peo- ple have come to be consumers to such an extent of a class of medicines, which, at times, are positively detrimental to ALCOHOL AS A MEDICINE. 333 health. In other instances the continued use of the product is liable to result in the formation of a drug habit which may lead to serious consequences. "It should not be understood that this department con- demns the use of legitimate proprietary or patent medicines, but it insists that there is a need for wiping out of existence about half of the products now generally sold, and with re- gard to the others the public have a right to know what is contained in them, and not be misled by false statements, or by statements so cunningly worded as to positively mislead the unwary reader. * * * In view of the fact that about 90 per cent, of the nostrums on the market are sold by news- paper and magazine advertising and not by the customer seeing the package, it would seem advisable to amend the law so as to cover this point." There is no doubt that it is the advertising which makes the patent medicine business so tremendously profitable. One firm boasted, prior to the exposure of the fraud nature of their preparation, that they spent $5,000 a day in advertising. What must have been made on the nostrum to allow such expenditure ? It is said on good authority that the cost of these nos- trums does not exceed fifteen to sixteen cents a bottle, and they sell for a dollar a bottle. Such profits make it easy to buy up newspapers that are conscienceless as to the robbery of the unfortunate sick. The only effectual way of putting an end to the sale of nostrums is to make illegal the advertising of such preparations in the public press. Norway has safeguarded her people thus. The difficulty in gaining such a law in America will be the opposition of the newspapers, the large majority of which still cling to this selfish method of adding to their gains. Even the 334 ALCOHOL AS A MEDICINE. so-called religious press is not all clean yet in this respect. Once they could be excused because of lack of knowledge. Now there is no excuse. During the debate in Congress upon the patent- medicine clause of the Pure Food Bill, Senator Hey- burn said : — "I have always been aggressively against the advertise- ments of nostrums. Some time ago a friend of mine, a very old fellow, that I had taken a special interest in secur- ing a pension for, had reached the age and condition of de- pendency. I succeeded in getting him a comfortable pension that would pay his bills for household provisions. Once, when I found he was very poor, I said to his wife, 'What are you doing with your pension?' She said, 'Don't you know, Mr. Heyburn, that it takes at least one-half of that pension for patent medicine?' Then she enumerated the patent med- icines they were taking. It was being suggested to them through advertisements that they were the victims of ills that they were not troubled with, and that they could find relief through these different medicines. "I am in favor of stopping the advertisements of these nos- trums in every paper in the country." It may well be asked, Would any one of these well- to-do newspaper owners entrust himself, or any of his family, in time of sickness to the cure-all impos- ters whose nostrums they advertise? If one of their children had anaemia would they rely on Pink Pills for a cure? If they had a genuine catarrh would they expect it to be cured by Peruna? Never! The}' would seek the very best medical advice obtainable. Yet, for the ignorant, credulous, sick and suffering poor they allow traps to be laid to rob of both money and such chances of recovery as might come from proper medical attendance. CHAPTER XIV. " DRUGGING." The main reason why so many people use patent medicines is the popular supposition that drugs cure disease. This is a great error Drugs never cure disease. Nature alone has power to heal. There are agents, which in the hands of a trained and painstaking physician may assist nature, but the physician needs to understand something of the idiosyncrasies of his patient's system, or the use of these agents may do great harm instead of good. Those medical men who have made the most dili- gent study of health and disease assert as their deliberate opinion that excessive professional drug- ging has been decidedly destructive of human life. Dr. Jacob BIgelow, professor in the medical department of Harvard University, in a work published a few years ago stated as his belief that the unbiased opinion of most medical men of sound judgment, and long experience, is that the amount of death and disaster in the world would be less, if all diseases were left to themselves, than it now is under the multiform, reckless, and contradictory modes of practice, with which practitioners of 335 33^ ALCOHOL AS A MEDICInE. diverse denominations carry on their differences, at the expense of the patient. Sir John Forbes, M. D., F. R. S., said : — " Some patients get well with the aid of medicine, more without it, and still more in spite of it." Dr. Bostwick, author of The History of Medicine, said : — " Every dose of medicine given is a blind experiment upon the vitality of the patient." Dr. James Johnson, editor of th.Q Medico-Chirurgi- cal Review y says : — " I declare as my conscientious conviction founded on long experience and reflection, that if there were not a single physi- cian, surgeon, man-midwife, chemist, apothecary, druggist nor drug on the face of the earth, there would be less sickness and less mortality than now prevail. " Prof. J. W. Carson, of the New York College of Physicians and Surgeons, says : — " We do not know whether our patients recover because we give them medicine, or because nature cures them. Perhaps bread-pills would cure as many as medicine." Prof. Alonzo Clark, of the same college, has said : — •' In their zeal to do good physicians have done much harm ; they have hurried many to the grave who would have recovered if left to nature." Prof. Martin Paine, of the New York University Medical College, said : — " Drug medicines do but cure one disease by producing another." ALCOHOL AS A MEDICINE. 337 Dr. Marshall Hall, F. R. S. :— " Thousands are annually slaughtered in the quiet sick- room." Dr. Adam Smith : — " The chief cause of quackery outside the profession is the real quackery in the profession." Prof. Gilman : — • " The things that are administered for the cure of scarlet fever and i7ieasles kill far more than those diseases kill." Prof. Barker, of New York Medical College : — " The drugs that are administered for the cure of scarlet fever kill far more patients than the disease does." Prof. Parker : — " As we place more confidence in nature, and less in prepar- ations of the apothecary, mortality diminishes." The examining physician of a large Insurance company in New York said to a Mercury re- porter: — " The primary cause of so many cases of la grippe in this and other cities is the almost universal habit of drug taking from the milder tonics to patent medicines. Whenever the average man or woman feels depressed or slightly ill, resort is made at once to medicine, more or less strong. If they would try to find out the cause of the trouble, and seek to obviate it by regulating their mode of living, the general health of the community would be better. The drug habit tends continually to lower the tone of the system. The more it is indulged in the more apparent becomes the necessity of continuing the downhill course. The majority of persons do not look beyond the fact that they seem to feel better after the use of a stimulat- ing drug, or patent medicine. This feeling comes from a be- 338 ALCOHOL AS A MEDICINE. numbing action of the drug, because it has no uplifting action. With the system in such a weakened state, the microbes of the disease find excellent ground to grow." Dr. J. H. Kellogg says in the April, 1899, Bulle- tin of the A. M. T. A. :— " Every drug capable of producing an artificial exhilaration of spirits, a pleasure which is not the result of the natural play of the vital functions, is necessarily mischievous in its tendencies, and its use is intemperance, whether its name be alcohol, to- bacco, opium, cocaine, coca, kola, hashish, Siberian mushroom, caffeine, betel-nuts, mate or any other of the score or more enslaving drugs known to pharmacology. As the result of the depression which follows the unnatural elevation of sensation resulting from the use of one of these drugs, the second appli- cation finds the subject on a little lower level than the first, so that an increased dose is necessary to produce the same inten- sity of pleasure or the same degree of artificial felicity as the first. The larger dose is followed by still greater depression which demands a still larger dose as its antidote, and thus there is started a series of ever-increasing doses, and ever-increasing baneful after-affects, which work the ultimate ruin of the drug victim. All drugs which enslave are alike in this regard, how- ever much they may differ otherwise in their physiological ef- fects. Alcohol is universally recognized as only one member of a large family of intoxicating drugs, each of which is capable of producing specific functional and organic mischief, besides the vital deterioration common to the use of so-called felicity- producing drugs. " Is it not evident, then, that in combating the use of alcohol we are attacking only one member of a numerous family of enemies to human life and happiness, every one of which must be exterminated before the evil of intemperance will be up- rooted ? " Among the most popular drugs for self-prescrip- ALCOHOL AS A MEDICINE. 339 tlon at the present time are the coal-tar products. Of these Dr. N. S. Davis has said : — " Only a few years since, the profession were taught to re- gard the degree of pyrexia, or heat, as the chief element of danger in all the acute general diseases. Consequently, to con- trol the pyrexia became the leading object of treatment ; and whatever would do this promptly, and at the same time allay pain and promote rest, found favor at the bedside of the pa- tient. " It was soon ascertained that antipyrin, antifebrin, phenacetin and other analogous products, if given in sufficient doses, would reduce the heat, and allay the pains with great certainty and promptness, not only in continued fevers, but also in rheuma- tism, influenza, or la grippe, etc. ; and thus their use soon be- came popular with both the profession and the pubhc. No one, however, undertook to first ascertain by strictly scientific appliances the actual pathological processes causing the pyrexia in each form of disease, or even to determine whether in any given case the increased heat was the result of increased heat production, or diminished heat dissipation. Neither were any of the remedies subjected to such experimental investigation as to determine their influence on the elements of the blood, the internal distribution of oxygen, the metabolism of the tissues, or on the activity of the eliminations. Consequently their exhibition was wholly empirical, and the one that subdued the pyrexia most promptly was given the preference. Yet we all know that the pyrexia invariably returned as soon as the effects of each dose were exhausted, and in a few years the results showed that while the antipyretics served to keep down the pyrexia, and give each case the appearance of doing well, the average duration of the cases, and their mortality, were both in- creased. " Step by step experimental therapeutic investigations have proved that the whole class of coal-tar antipyretics reduce ani- 340 ALCOHOL AS A MEDICINE. mal heat by impairing the capacity of the hemoglobin and cor- puscular elements of the blood to receive and distribute free oxygen, and thereby reduce temperature b}'- diminishing heat production, nerve sensibility and tissue metabolism. There- fore, while each dose temporarily reduces the fever, it retards the most important physiological processes on which the living system depends for resisting the effects of toxic agents ; namely, oxidation and elimination. This not only encourages the reten- tion of toxic agents and natural excretory materials by which specific fevers are protracted, but it greatly increases the num- ber of cases of pneumonia that complicate the epidemic influ- enza, or la grippe, as it has occurred since 1888-89. " The bad work that people make in dosing themselves with patent medicines, without a physician's prescription is not un- frequently punctuated with a sudden death from overdosing with antipyrin, sulphonal, or some other coal-tar prepara- tion." Dr. C. H. Shepard, Brooklyn, N. Y., says : — " Quinine is a most fatal drug. Of course, it is the orthodox treatment for malarial conditions, but quinine never did nor never can cure malaria or any other disease. The action brought about by its use is simply to benumb the nervous activity and interfere with the natural action of the system to throw off the poison, which is expressed by the chill. Because of this interference with the manifestation or symptom of the disease, many imagine that the disease is being cured, but there never was a greater mistake. A drug disease is added to the original disease. This is shown by the invariable depres- sion that follows the administration of the drug, and the length of time required to recuperate, which imperils restoration, and sometimes hastens the final results. This is ordinarily met by the use of what are called stimulants, that is, more drugs, and the last state is worst than the first ; the poor patient is thus made the victin; pf a triple wrong, which only a most vigorous consti- ALCOHOL AS A MEDICINE. 34I tution can pass through and live, and even then he is crippled and made more liable to whatever disease may come along ever afterward. " Disease is not entity to be killed by a shot from a profes- sional gun, but a condition, an effort of outraged nature to free itself from an incumbrance, and should be aided rather than hindered by the administration of any nerve irritant. There never will come a time when the laws of health can be evaded. Nor is there any vicarious atonement. The full penalty of dis- obedience will invariably be exacted. The hunt for a panacea is as sure to be disappointing in the future as it has been in the past." A writer in the Brooklyn Citizen says : — " Few people are aware of the extent of a peculiar kind of dissipation known as ginger- drinking. The article used is the essence of ginger, such as is put up in the several proprietary preparations known to the trade, or the alcohol extract ordinarily sold over the druggist's counter. Having once acquired a liking for it, the victim becomes as much a slave to his appetite as the opium eater or the votary of cocaine. In its effect it is much the most injurious of all such practices, for in the course of time it destroys the coating of the stomach, and dooms its vic- tim to a slow and agonizing death. " The druggist who told me about the thing says that as ginger essence contains about one hundred per cent, alcohol, and whisky less than fifty per cent., the former is therefore twice as intoxicating. In fact, this is the reason why it is used by hardened old topers whose stomachs are no longer capable of intoxicating stimulation from whisky. They need the more powerful agency of the pure alcohol in the ginger extract. He told me that he had two regular customers, one a woman, who had ginger on several occasions for stomachic pains. The re- lief it afforded her was so grateful that she took it upon any recurrence of her trouble, She found, too, that the slight ex- 342 ALCOHOL AS A MEDICINE. hilaration of the alcohol banished mental depression. In this way she got to using it regularly, and finally to such excess that she was often grossly intoxicated. Large doses produce a quiet stupor ; additional doses induce a profound lethargic slumber, which lasts in some cases for twenty-four hours. His other customer was a peddler, who came at a certain hour every morning, bought a four-ounce bottle and drank its con- tents by noon. The man craved the stuff so ardently that he was unable to go about his business until he set the machinery of his stomach in operation, and started the circulation of the blood by means of the fiery draught. He says that the habit is well known to the drug trade." " The morphia habit, the cocaine habit, the chloral habit, and other poison habits which are prevalent in this and other countries, are only different manifestations of a wide-spread and apparently increasing love for drugs which benumb or ex- cite the nerves, which seems to characterize our modern civili- zation. Indeed, there appears to be, at the present time, almost a mania for the discovery of some new nerve-tickle, or some novel means of fuddling the senses. It is indeed high time that the medical profession raised, with one accord, its voice in solemn protest against the use of all nerve-obtunding and felicity-producing drugs, which are all, without exception, toxic agents, working mischief and only mischief in the hu- man body." — Dr. J. H. Kellogg. Much discussion upon careless drug-taking has resulted from remarks made recently in London by Sir Frederick Treves, the King's surgeon, at the open- ing of a hospital. He said that the time is fast approaching when physicians will give very little medi- cine, but will instead teach the people right methods of living so that sickness may be avoided. Although there are some physicians who appear to enjoy the old routine of giving heroic doses of ill- ALCOHOL AS A MEDICINE. 343 tasting liquids, there are others who agree with Sir Frederick, and admit that they would often be glad to give no medicine if their patients would be satisfied without it. But the great mass of people are unwill- ing to take a physician's advice as to proper clothing, suitable diet, and regular habits of living. They do not seek his advice upon those points ; what they want is a drug that will benumb uneasy sensations while they live as they please. Not long ago a business man of intelligence was heard to complain because he had tried several physi- cians and all had failed to cure his sciatica. He said they all told him he must live differently ; several said he must quit smoking and lay aside wine and beer or he could not be cured. With scorn he said, ''What are physicians good for if they don't know a drug that will cure as simple a thing as rheumatism?" He could not and would not believe that rheumatism might be the result of his wrong habits. Akin to him in thought is a woman, much above the average in intelligence, who a few months ago had an operation performed upon her stomach. The stomach was enlarged so that the food did not pass through the p3dorus, the opening into the intestines. The opera- tion consisted in making a new opening and connecting it with an intestine. This bright woman now com- plains that the operation was not a success, because she still has times of great distress with indigestion. Upon being asked what she eats, she laughed and said, "Everything, peanuts, mince-pie, sauer-kraut, frank- forts ; whatever is going. I have a vigorous appetite. 344 ALCOHOL AS A MEDICINE. and keep peanuts and figs in my room, for I often have to eat in the night." Until multitudes of people like that business man, and that bright woman, are educated in matters of health, it will not be easy for physicians to bring Sir Frederick's prediction to fulfilment. The popular supposition is that drugs cure disease, and all that the medical adviser is for is to choose the drug that will produce the desired effect with the great- est speed. Consequently the physician is in many cases driven to prescribe drugs that simply allay pain without removing the cause of the pain. He cannot remove the cause without the patient's co-operation, and as that would require the abandonment of wrong habits few are willing to accept health at such a price. What man will abandon beer to escape rheumatism, or smoking to save his eyesight if he has weakness there ? Or, what woman will cease tea-drinking if she has neuralgia ? The Journal of the American Medical Association for November i6, 1907, contained an editorial article in which, after reference to drugs necessary in the practice of a physician or surgeon, this is said : — "The remark of Holmes years ago that it would be better for the patients, but worse for the fish, if most of the drugs were thrown into the sea, is probably even more true to-day. The vast majority of these drugs have not the slightest ex- cuse for existence." Dr. T. D. Crothers, in his valuable book upon Mor- phinism and other drug addictions, reports a case of murder where it was shown that the assailant was ALCOHOL AS A MEDICINE. 345 delirious from large doses of quinine. He says as- saults are often clearly traced to the drug taking of the assailant. A surgeon from a New York hospital, in speaking of drug habits before an audience at Chau- tauqua, New York, said that some of the ovarian difficulties which demand operations are the result of over-dosing with quinine. There are people who keep morphine in the house all the time lest some little pain or ache should find them unprepared. Dr. Crothers, who has perhaps made more of a study of the evil results of drug taking than any other man in America, says of this : — "Morphine as a common remedy, taken for pains and aches, may suddenly develop into an incurable craze for its con- tinuous use. * * * The early relief which morphine brings to the sufferer is often the beginning of an unknown journey ending in disease and death." Cases are on record where morphine given to moth- ers soon after the birth of children to allay pain, has resulted in the death of the infant, the morphine hav- ing poisoned the milk. Cocaine is possibly the most insidious of all drugs yet known. Few of those who become enslaved to it ever are able to lay it aside. It leads to hallucinations of sight and hearing. Many persons have become en- slaved to cocaine unwittingly through its use in catarrh snuffs, asthma "cures," and other proprietary prepara- tions, the composition of which was secret. Some states now have strict laws regulating the sale of this dangerous drug. It is not only the enslaving drugs which are injuri- 346 ALCOHOL AS A MEDICINE. ous to the body, but even such apparently simple agents as liver pills and pills for the relief of constipation may do more harm than good if resorted to frequently. Some of the ingredients used in the pills for the relief of constipation are said to be injurious to the liver. Dr. Nathan S. Davis, late dean of the Northwestern University Medical School, Chicago, said of the coal- tar remedies, such as phenacetin and antipyrin, in the treatment of influenza and la grippe •' — ''While each dose temporarily reduces the fever it retards the most important physiological processes on which the living system depends for resisting the effects of toxic agents, namely, oxidation and elimination. This not only encourages the retention of poisonous agents by which fevers are protracted, but it greatly increases the number of cases of pneumonia that complicate la grippe. The bad work that people make in dosing themselves with patent medicines is not infrequently punctuated with a sudden death from overdosing with antipyrin, sulphonal, or some other coal-tar prepara- tion." Deaths from acetanilid are becoming- more and more frequent. The presence of acetanilid in headache powders " guaranteed to be harmless" and thrown upon the door-steps as samples has led many persons into grave danger, and not a few to death. Bromo- Seltzer, Orangeine, Antikamnia, Taylor's Headache Powders, and various other preparations have all contained this drug. country. The following article is taken from T/i^ Banner of Gold, of Feb., 1899 : — ALCOHOL AS A MEDICINE. 347 "Value of cocaine leaves imported at the port of New York in 1894 $14,284 Imported in 1897 54.122 Indicated value of imports for 1898 75.ooo " In these simple figures are contained the elements of a warning sermon that would startle all America. We seem to be rapidly becoming a nation of cocaine fiends. If the number of those addicted to the use of the dreadful drug continues to increase at the present rate, the importation of what was origin- ally regarded as a blessed alleviation of pain, will have to be classed with opium, and its use prohibited by law, except for medicinal purposes. " At present the cocaine fiend can purchase the drug without trouble, and the ease with which it is taken is a fatal recom- mendation to those who crave a nerve-deadener. No laborious cooking of pills over a lamp, cleaning of implements, or trouble- some necessity for secrecy, as with the use of opium. Cocaine can be taken at any time, with scarcely any trouble, and with- out a soul besides the user being aware of his being in the toils. " At first, that is. It will not be long before every intimate friend will observe a change, a gradual and scarcely perceptible change, come over the appearance and general conduct of the cocaine fiend. " Begun in many cases in a legitimate way, as an anaesthetic, the surprisingly pleasant effect is sought for again by the one who has had a glimpse at the portals of the elysium. This is the beginning of the terrible habit. The effect is a sense of ex- hilaration followed by a quiet, dreamy state that causes the worried man to forget his troubles, and the sufferer his pain. Once this freedom from physical and mental sickness has been experienced, the cocaine fiend will rob or kill to get the drug. Enforced non-use of it will not cure the victim. Sentence him to a term of imprisonment, and he will go straight from the jail door to the nearest drug store to secure cocaine before he eats or sleeps. 348 ALCOHOL AS A MEDICINE. " From an occasional use of the drug to insatiable craving is the rational course of the cocaine fiend. From thence to the insane asylum and the grave is a swift and easy descent. " In his fall from health to physical and mental disintegration, the cocaine fiend undergoes a terrible experience. When not in the temporary heaven that the drug provides, the victim is in the lowest depths of an mferno. He suffers from insomnia, anorexia, and gastralgic pains, dyspepsia, chronic palpitations, and will-paresis. He is a terror both to himself and others. The life of the man is a living death. He knows it, and with this knowledge staring him in the face, he rushes for the drug, and is happy for a brief period under its influence. " It is time something was done to keep from this high- strung nation a drug so deadly. Clear-minded medical men have recommended its exclusion from the country, believing that its use medicinally should be foregone rather than that such a cursed temptation should be placed in the way of weak hu- manity. " What the real action of the drug is, and how to counteract its influence, are at present puzzling questions to the medical fraternity. A leading member of the profession to whom these questions were put replied after careful consideration as follows : ' Its physiological action is practically unknown. As an anal- gesic, it is uniform in its action, and this is due to the suspen- sion of the physiological functions of the sensory cells which it comes in contact with. Beyond this, it is an excitant of the cerebro-spinal axis, later it has a peculiar action on the encepha- lon, manifest in a wide range of psychical phenomena. Beyond this a great variety of widely variable symptoms appear. In some cases all the intellectual faculties are excited to the high- est degree. In others a profound lowering of the senses and functional activities occur. Morphine-takers can use large quantities of cocaine without any bad symptoms. Alcoholics are also able to bear large doses. Not unfrequently the excite- ment caused by cocaine goes on to convulsions, and death. ALCOHOL AS A MEDICINE. 349 Sometimes its action is localized to one part of the cerebro- spinal axis, and then to another. In some cases well-marked cerebral anaemia appears, and for a time is alarming, but soon passes away. " Small doses frequently given are more readily absorbed than large doses. Habitues always use weak solutions, the effects being more pleasing with less excitation. Morphine and alcoholic inebriates very soon acquire certain tolerance to large doses taken at once. The cocaine user takes large quantities, but in small doses frequently repeated. He becomes fright- ened at the effects of large doses, and when he cannot get the effects from small (to him safe) doses, he resorts to alcohol, morphine, or chloral. In many cases memories of the delusions and hallucinations are so vivid and distressing that other nar- cotics are used to prevent their recurrence. In other cases the recollection is very confused and vague, and strong suspicions fill the mind that the real condition is grossly exaggerated by the friends for some deterring effect. In common with opium and alcoholics, there is moral paralysis, untruthfulness, and low cunning in order to conceal and explain the condition by other than the real causes." Hoffman Drops are used considerably as a heart stimulant. They are much more intoxicating than whisky, and, used as a beverage, make the drinker crazy while under their influence. According to Dr. F. E. Jones, of Mass. Board of Health, they consist of 325 parts ether, 650 parts alcohol, and 25 parts ether oil. They are said to have a very bad effect upon the kidneys. The Banner of Gold iox Oct., 1898, contained a lengthy article upon the dangers of drugging, from which an extract is given here : — " Philanthropists, when trying to stay the hand of rum, do 350 ALCOHOL AS A MEDICINE. not overlook the victims of drugs. If you v^ill go, under the protecting aegis of an officer, to an opium den, such as are to be found in every large city, and as a visitor view for yourself the degradation of hopeless opium users, then train your batteries towards removal of the cause. Do not depend upon preaching, or the writing of essays, or the delivery of an address before some society whose mission ends in telling others what to do, but put on the armor of earnestness, go into the nurs- ery, and demand of the mother to know why, when little lumps of human clay are placed in her keeping for the sacred purpose of moulding them into men and women, she deliberately feeds the prattling babe with soothing syrups, sleeping drops, pare- goric, and opiates in various other forms, rather than with the healthful food, and simple remedies, that nature only requires. With such commercial nostrums the thoughtless mother too often paves the way for her offspring to a life of toxic-slavery by creating a systemic condition, which, in maturer years, develops an abnormal craving, or appetite, for narcotics and stimulants. Follow this little victim of nursery malpractice through the imitative age, and you will discover in him the cigarette smoker, the tippler, the self-abased youth, and later, the man whose life is shadowed with the curse of baneful appetite. " Ask the druggist, and the saloon keeper, why they dispense deadly poisons so freely to old and young, and they will tell you the law permits it ; a sad commentary ! " Converted men relapse into evil ways through coquet- ting with sin ; and cured inebriates relapse to drink, and drugs, through the use of proprietary medicines, with which the domes- tic market is flooded. Tonics, compounds, nerve remedies, bit- ters, vitalizers, appetizers, balsams, pectorals and kindred nos- trums contain, with few exceptions, from 7 to 50 per cent, of al- cohol, or opium in varying quantities, each preponderating in kind, as the effect is designed to be stimulating, or sedative. The ac- tive principle of some of the best known catarrh remedies is co- ALCOHOL AS A MEDICINE. 35 I caine, and a few manufacturers are honest enough to so announce on the labels covering their goods ; more do not, and leave the victims to discover the truth after they have paid the penalty of ignorance, and developed the cocaine habit. Wholesale legisla- tion, as well as vigorous education, is needed along these lines, and while considering means of betterment, the reputable citi- zen, the clergyman, and others of good moral repute, whose names are so generally used to herald the efficacy of so-called re- medial inventions, should not be overlooked for ethical attention. " For the information of those of our readers, who are not fa- miliar with the nature and use of toxic drugs, we here refer briefly to the prominent characteristics of a few most danger- ously potent for evil, and seductive in kind. OPIUM AND MORPHINE : — y Gum opium, the dried milky exu- date from the green capsules of the white poppy, and its product — morphine — are the most reliable drugs known for the relief of pain. The dose of gum opium in medicine is from ^ to i grain. It contains from 8 to 14 per cent, of morphine, which is its principal alkaloid. Opium is a much more stable, and stronger, sedative than morphine. The cumulative effect of repeated medicinal doses is frequently observed, and is followed by dangerous symptoms. It is both a sedative and h^^pnotic, and, if given in large doses, quiets the brain, and excites the spinal cord. Small doses have little perceptible effect upon the circulation, but, under the influence of large doses, the pulse is retarded, and the respiration becomes fuller, deeper, and slower. In poisonous doses the pulse may become rapid, and great de- pression follow, the respiratory centres are parah^zed, thus caus- ing death. If taken in from 2 to 4 grain doses it produces deep comatose sleep, full breathing, full pulse, dry skin, and con- tracted pupils. If the dose is sufficiently large, the sleep will be more profound, the patient can hardly be roused, and if awak- ened quickly, he sinks back into slumber. The face may be swollen, and reddened, and the lips deeply tinged with blue. At this stage the breathing may be characterized as puffing. 352 ALCOHOL AS A MEDICINE. Respiration may be from 8 to lo per minute, perhaps be reduced to 4, 2 or I, and as the toxic effect is more marked, it becomes shallow, the pupils are contracted, and the patient is so thoroughly narcotized that nothing will arouse him, the heart ceases to beat, and he dies by respiratory failure, or paralysis of the pneumogastric nerve. '* Morphine, extracted from gum opium by a slow and expen- sive process, is used much less in proprietary medicines than is tincture of opium, which is more easily manufactured, " A medicinal dose of sulphate of morphine is from | to J of a grain. One grain is a dangerous dose, and 2 grains are liable to prove fatal. Morphine is a true narcotic. It is a seda- tive, lessens tissue change, and weakens every function of the body. TINCTURE OF OPIUM, OR LAUDANUM : — " Laudanum, or the tincture of opium, is a mixture of gum opium with alcohol and water, the solution consisting of equal parts of alcohol and water. Each ounce contains 5i grains of powdered gum opium and half an ounce of alcohol, and is equal in alcoholic strength to one ounce of strong whisky. The ordinary medical dose is from 12 to 15 minims, or from 25 to 30 drops. It is much used as a domestic remedy for pain from any cause, such as ear or toothache, indigestion, insomnia, summer complaints with children or adults, and is often used in poultices over pain- ful sores or swellings. It is also used in many medicines for throat and lung troubles, in nearly all medicines for painful chronic diseases, and in many of the well advertised spring tonics, as well as in nearly all the compounds that are offered for sale for blood troubles, or as alteratives. The opium in laudanum acts the same as morphine, or any other of the thirty preparations of opium, officially recognized by the medical profession. PAREGORIC : — " Paregoric of standard grade is half alcohol, which is as strong of alcohol as high proof whisky. It contains a little opium, some benzoic acid, oil of anise, and camphor. The dose is from 15 to 60 drops. ALCOHOL AS A MEDICINE. 353 COCAINE : — " Cocaine is an alkaloid of coca leaves, and is used in medicine in the form of hydro-chlorate. It is used locally in powder or solution to relieve pain. It is a strong local anaes- thetic. The ordinary dose when used as medicine is from | to ^ grain, and is very unstable and treacherous in its effects. Some patients will tolerate large doses while in others small doses produce unpleasant effects. Deaths are recorded from the use of 1-7 to i grain. CHLOROFORM : — " Chloroform is an ansesthetic, and death is often caused by a few inhalations. The dose internally is from 3 to 20 minims. It is not much used in medicine, except to control pain, and produce sleep. It is inhaled to produce mild slumber, or complete insensibility in surgical operations. Death may come suddenly, and without warning, at any time during its administration. CHLORAL : — " Chloral, or hydrate of chloral, is an hypnotic. It is of but little value in medicine, except to control nervousness, and produce sleep. The dose is from 15 to 30 grains. It should be administered with caution, and only by the physician. It is made by passing chlorine gas through pure alcohol, and gets its name from the first syllables of the two w^ords, chlorine and alcohol. It produces death by inhibition of the heart's action, and by paralyzing the pneumogastric nerve. BROMIDIA : — " Bromidia is the trademark of an hypnotic, the manufacturers of which give out to the public that each fluid drachm contains 15 grains of chloral hydrate, or i ounce to every 4 ounces of bromidia. SULPHONAL : — " Sulphonal is a coal tar preparation, and is valuable in medicine as an hypnotic only. An ordinary dose to produce sleep is from 10 to 40 grains. If it is given in these doses for several days in succession it produces great weariness, an unsteady gait, and may involve paralysis of the lower limbs, with great disturbance of digestion, and scanty secretion of urine of about the color of port wine. There are a number of cases 354 ALCOHOL AS A MEDICINE. of death reported as resulting from acute, or chronic poisoning, by sulphonal. PHENACETINE : — " Phenacetine is a product of coal tar, and an antipyretic, a drug that lessens the temperature in high fevers, and rapidly disintegrates the blood. antifebrin: — *' Antifebrin, another of the coal tar prepara- tions, is the registered name for acetanelid. Its effects are very similar to the effects of phenacetine, and it is used in fevers for lessening the temperature, and for neuralgic pains. The medic- inal dose is from 3 to lo grains. Unpleasant effects follow its continued use, such as great exhaustion, blueness of the lips, and a slow, labored pulse. HEADACHE REMEDIES :— "" The indiscriminate use of the many coal tar products and other hypnotics, such as sulphonal, phenacetine, antifebrin, chloral, bromidia, etc., under the guise of headache remedies is productive of much disaster, all being nerve paralyzants." The public ow^e a debt of gratitude to those physicians, and chemists, who give freely such valu- able information as to the real nature and effects of dangerous drugs. While it is true that the popular belief in drugging is due to professional practice, yet it is also true that what the people know of the preservation of health, and of the danger of alcohol and other drugs is largely owing to the medical pro- fession. There is as much difference among the members of the medical profession as there is among the members of any profession ; some are careless, selfish, unprincipled, unobservant of the ef- fects of various medicines ; while others are anxious to teach the people how to avoid sickness, and gain strength. It is the latter class who warn against ALCOHOL AS A MEDICINE. 355 the self prescription of drugs, especially those of the dangerously seductive, narcotic class. Yet, with all the warnings, few pay heed. Even highly educated, intelligent people seem possessed of a blind faith in the power of drugs. Every little ache or pain must have its sedative, be the future penalty what it may. Were people to quit drugging themselves, avoid indigestible viands, eat at regular hours, chew well, stop eating when they have had enough, take a suf- ficiency of exercise, sleep and fresh air, with a hot bath once a week, and a cold " towel bath " each morning, laying aside all alcoholic beverages, tea and coffee, and tobacco, there would be very little sickness in the world. Over-eating leads to the drug habit for relief from uneasy sensations, so does im- proper food, or poorly cooked food. It should be remembered that it is not possible to violate the laws which relate to the physical well- being, and then escape the natural penalty of transgression by swallowing a few doses of medicine. Remedies may postpone the results of physical transgression, and may even seem to prevent, them altogether, but careful observation will show that the escape from punishment is only apparent. Sometimes a parent escapes, while his child pays the penalty of his transgression, in a weakly nervous system, which may lead to insanity, or other trouble. CHAPTER XV. TESTIMONIES OF PHYSICIANS AGAINST ALCOHOLIC MEDICATION. " In abandoning the use of alcohol it should be clearly under- stood that we abandon an injurious influence, and escape from a source of disease, as we do when we get into a purer atmos- phere. There is not the slightest occasion to do anything, or to take anything to make up for the loss of a strengthening or supporting agent. No loss has been incurred save the loss of a cause of disease and death.'' — Dr. J. J. RiDGE, of London Temperance Hospital. Sir. B. W. Richardson, M. D., said of the London Temperance Hospital : — " No alcohol is administered, and no substitute for it. Any drug with similar action would be bad ; warmth and suitable nourishment are relied on to keep up the system. We know that people who take alcohol often feel better ; this is from the narcotic action. The pain may be stilled, and the disease for- gotten, but it has not been removed ; its symptom has been narcotized." Another writer says : — " I am asked for a substitute for brandy, and frankly and gladly I tell you there is no substitute, for I have no knowledge of any agent equally pleasing to the palate, and yet so destruc- tive of life." 356 ALCOHOL AS A MEDICINE. 35/ Dr. Norman Kerr, President of the Society for the Study of Inebriety, England, says : — " My own experience of thirty-four years in the practice of mv profession has taught me that in nearly all cases and kinds of disease the medical use of alcohol is unnecessary, and in a large number of instances is prejudicial and even dangerous. Hav- ing given an intoxicant, in strictly definite and guarded doses, probably on the whole only about once in 3,000 cases (then usually when nothing else was available in an emergency), and having had most varieties of disease to contend with, my death- rate and duration of illness have been quite as low as my neigh- bors. The experience of the London Temperance Hospital and other similar institutions, the current reports of that hospital being now reliable scientific records, amply support this ex- perience. " The chief peril of narcotic drugs has always appeared to me to lie in their disguising the real state of the patient from himself as well as from his doctor and his friends. If there is any serious ailment, such as cholera or fever, the sufferer may seem to be and may feel better. He is not better. He is actually worse — made worse by the alcohol, and not unseldom, after the evanescent alcoholic disguise and deceptive improve- ment has faded, it is found that the malady itself has been pro- gressing, unseen and unsuspected from the delusive aspect of the alcohol, steadily toward a fatal termination, which might, in many cases, have been averted but for the true state of the pa- tient having been completely masked. "jWherever the blame really has lain, one thing is now clear, that alcoholic intoxicants are very rarely useful as a medicine ; are at the best dangerous remedies ; and that, other things being equal, the less they are resorted to the better for the chances of the patient's recovery, the better for body and brain, the bet- ter for physical, intellectual and moral well-being. Alcohol does not nourish, but pulls down ; does not stimulate, but de- 358 ALCOHOL AS A MEDICINE. presses ; does not strengthen, but excites and exhausts. Alco- hol is the pathological fraud of frauds, degenerating while it claims to be reconstructing, enfeebling while it appears to be invigorating, destroying vitality while it professes to infuse new life." A medical writer in the Toledo, O., Blade holds up in clear light the relation of the materia rncdica and alcohol, and the opportunity of the physician to become a benefactor, and active temperance worker. His remarks follow : — " One of the signs of the times in the temperance movement is the steady growth among physicians of a sentiment against the administration of liquor of any kind as a medicine. The accepted scientific view of alcohol is that it is a poison, and its administration should be as guarded as that of any other poison used as a medicine. Perhaps the hardest thing a physician finds in his effort to restore his patients to health without the use of liquors is the common, but erroneous, belief that they are ' strengthening,' and that the convalescent, by their use, reaches recovery more quickly. The error is in sup- posing that any alcoholic liquor is nourishing, or strengthening. They are neither. Alcohol does not nourish, but it pulls down ; it does not strengthen, but excites and exhausts, for every stimulation is necessarily followed by a period of de- pression, and this is inevitably unfavorable to the patient. " There is a grave responsibility resting on the physician who prescribes alcoholic liquor. It may arouse in a suscepti- ble patient a dormant, inherited tendency to drink. He may, by authorizing its use during the period of convalescence, fix a habit upon a patient of feeble will, which the latter will never be able to shake off. No physician who realizes this great moral responsibility will be willing to accept it habitually. He cer- tainly knows that the best medical authorities agree that alcoholic intoxicants are rarely useful as a medicine ; that at ALCOHOL AS A MEDICINE. 359 best they are dangerous remedies, and that the less they are resorted to, the better for both brain and body. " In point of fact the physician who does his duty to his patient teaches him the error of the prevalent belief in the virtues of liquor in restoring the sick to health. He becomes an active temperance worker in effect. And he can do a noble and useful work in the rescue of those who are under the control of the drink habit. ***** " Furthermore, every physician owes it to his profession to teach his patients the utter fallacy of the common belief that alcohol is an article of food value. It has no such value. The use of intoxicants in any quantity whatever, or at any time, is entirely useless and unnecessary. The continued use of them gradually induces structural degradations and func- tional derangements of the great bodily organs, thus leading to the gravest physical disorders." " I have demonstrated by actual experience that no form of alcoholic drink is necessary, or desirable, for internal use, either in health, or any of the varied forms of disease ; but that health can be better preserved, and disease more successfully treated, without the use of such drinks.* * * * * Simple truth compels me to say that I have never yet seen a case in which the use of alcoholic drinks either increased the force of the heart's action, or strengthened the patient. But I could detail very many cases in which the administration of alcoholics was quieting the patient's restlessness, enfeebling the capillary circulation, and steadily favoring increased engorgement of the lungs and other internal viscera, and thereby hastening a fatal result, where both attending physician and friends thought they were the only agents that were keeping the patient alive. " I have found no case of disease and no emergency arising from accident, that I could not treat more successfully without any form of fermented or distilled Hquors than with. It is easy to see that the anaesthetic properties of alcohol can be made available by an intelligent and skillful physician to meet a very 360 ALCOHOL AS A MEDICINE. limited number of indications in the treatment of some cases that will come before him. But the same intelligence and skill will enable him to select other remedies capable of meeting the same indications more perfectly, and, with less tendency to secondary bad effects. I have no hesitation, therefore, in stat- ing that for the attainment of the highest degree of success in the management of all forms of disease, whether acute or chronic, we need no form of fermented, or distilled, alcoholic drmks. And whoever will boldly make the trial, will find that his patients, of every kind, will make better progress, on good air and simple nourishment, without any admixture of alcoholic liquids, than they will with such addition. In other words he will find that the supposed benefits of this class of agents in medicine, are as illusory as they are in general society, and that the words of the wise man are worthy of careful consideration when he says : ' Wine is a mocker and strong drink is raging, and whosoever is deceived thereby is not wise.' " — Dr. N. S. Davis, Chicago, 111. " Dr. Hirschfield, a well-known physician of Magdeburg, Germany, was recently arrested on a charge of malpractice. The specific charge was that he had refused to give alcohol to one of his patients who was supposed to need it. The doctor, like the more advanced German physicians, is discarding liquor from his practice, and made such a hot defence to the charge that the court not only discharged the physician, but assessed the cost of the defense against the prosecution."— ^«//^//« of A. M. T. A. Dr. Greene, of Boston, when addressing his breth- ren and sisters of the medical association in that city, upon alcohol, said in closing : — " It needs no argument to convince you that it is upon the medical profession, to a very great extent, that the rum-seller depends to maintain the respectability of the traffic. It re- quires only your own experience, and observations, to convince ALCOHOL AS A MEDICINE. 36 1 you that it is upon the medical profession, upon their pre- scriptions and recommendations for its use upon many occa- sions, that the habitual dram-drinker depends for the seeming respectability of his drinking habits. It is upon the members of the medical profession, and the exceptional laws which it has always demanded, that the whole liquor fraternity depends, more than upon anything else, to screen it from opprobium, and just punishment for the evils which the traffic entails upon society; and it is because the rum-seller, and the rum-drinker, hide under this cloak of seeming respectability that they are so difficult to reach either by moral suasion, or by law. Physicians generally have only to overcome the force of habit, and the pre- vailing fashion in medicine, to find an excellent way, when they will all look back with wonder and surprise, that they, as indi- viduals, and members of an honored profession, should have been so far compromised." " It will be asked, IVas there Jio evidence of a7iy good service rendered by the agent in the midst of so imcch obvious bad service? I answer to that question that there WAS NO such evidence whatever, and is none." — sir b. w. Richardson. •' A prominent general practitioner expressed surprise that any one could do without alcohol in general medicine. He was persuaded to make a trial, by abandoning the internal use of spirits as medicine. A year afterward he wrote that his success in the treatment of disease had been equal to that of any year in the past, and that his cases recovered as well without alcohol as with it. In a recent medical meeting he remarked, ' I thought for many years that I could not do without spirits as medicine. I was mistaken, I am constantly treating cases of all degrees of severity without alcohol, and my success is fully equal to the average.' " — Quarterly of A. M. T. A. " Happily, the belief in alcohol is passing away." — Dr. C. R. Francis, late Professor of Medicine, Calcutta Medical College. 362 ALCOHOL AS A MEDICINE. Dr. Moor, the distinguished editor of the Pacific Record^ says : — " While the use of alcohol is always injudicious and injurious, it is particularly so in summer, when the system is predisposed to disturbances of the gastro-intestinal tract. " Alcohol flushes the capillaries of the mucous membranes just as it does the capillaries of the skin, and where there is al- ready a smouldering congestion, it will take but little to light the fire of acute inflammation, which will rage with greatly in- creased intensity. " It is wiser to habitually avoid even the medicinal use of al- cohol, as there are plenty of other stimulants which will give the desired results without entailing any disastrous after effects." " All the pleasant sensations of increased mental and physi- cal power, which the use of alcohol produces, are deceptive and arise from the paralysis of the judgment and the momentary benumbing of the sense of fatigue which afterwards returns so imperiously with perhaps even greater intensity." — Prof. Adolf Fick, of Wurzburg. Dr. Frank Payne, vice-president of the London Pathological Society, says : — " Alcohol is a functional and tissue poison, and there is no proper or necessary use for it as a medicine." " When I first heard that there was going to be a total absti- nence hospital, I thought it would be a complete failure. That was because I had been taught as a student to regard alcohol as absolutely necessary in the treatment of disease. Nevertheless I was an abstainer myself. When I was asked to join as physi- cian, I did not consent without a good deal of consideration, and then only on the understanding that if I thought a person need- ed it, I should be allowed to administer alcohol. I remember the first case of severe typhoid fever I had. He was hovering between life and death, and I was anxiously watching to see ALCOHOL AS A MEDICINE. 363 whether it would be necessary to give alcohol, but the man made a good recovery without it. After watching many cases to whom I should have given alcohol if I had been treating them elsewhere, I came to the conclusion that I had been com- pletely deluded. I gave it at one time to a woman in the Hospital who was in a dying condition, but it did not save her. I do not think I am likely to administer alcohol again. We have had progress and efficiency in the Hospital. It has been like an experiment for the profession, and our success shows that this giving of alcohol is certainly a matter for re-considera- tion for the medical profession. I believe that they are mistak- en. There is no doubt that the amount of alcohol used in other hospitals has diminished greatly, compared with what was used in the past. To the outside public also this Hospital is an example. I believe that an immense number of the public have been teetotalers some time in their lives, but a great many of them have gone back to the drink in time of illness, be- cause they have been advised to do so. This Hospital is a standing witness that disease and surgical injuries can be treated without alcoholic liquors." — Dr. J. J. Ridge, of London Temperance Hospital. "I find very little use for alcohol in the practice of medi- cine. Where there is one element of good in alcohol there are thousands that are bad." — Dr. Alfred ]\Iercer, Syracuse, N. Y., Professor of Medicine in Syracuse Medical School. "Alcohol is rarely necessary. Other remedies are m.uch more efficacious. In my department of the University of Buffalo I follow Cushny, who claims that alcohol is a poison, a depressant in direct proportion to the amount ingested, and a so-called false food." — Dr. De Witt H. Sherman, Adjunct Professor of Therapeutics, University of Buffalo Medical Department. 'T believe that alcohol is the greatest foe to the human race to-day. I feel that it would not be a serious harm if its use as a medicine were totally discontinued." — Dr. Walter E. Fernald, Professor in Tufts Medical School, Boston, Mass. 364 ALCOHOL AS A MEDICINE. "I rarely or never prescribe alcohol as a medicament or a food, or sanction its use as a beverage. Physiologically I look upon alcohol as a narcotic, with perhaps a primary stimulat- ing effect, but I believe that such desired action as it is capa- ble of producing can be equally well brought about by other agents. As a beverage the use of alcohol, particularly in ex- cess, is attended with definite and well-known dangers." — Dr. A. A. EsHNER, Professor of Clinical Medicine, Philadelphia Polyclinic and College for Graduates in Medicine. "I agree with you altogether in your agitation against the use of alcohol in any form. I believe that wine is a mocker, and belief in wine as a benefit, mockery." — Dr. Matthew Woods, Philadelphia, Pa. "It is extremely seldom that I ever advise the use of alco- hol in any form for my patients." — Elliott P. Joslin, M. D., Professor in Harvard Medical School, Boston, Mass. "My belief is that there is very little need of the medical use of alcohol. I almost never use it in my practice, and think that its use by practitioners generally is far less than it was a few years ago." — Dr. E. G. Cutler, Professor in Har- vard Medical School, Boston, Mass. "I believe that the trend of teaching in the Harvard Medi- cal School has been growing less favorable, of late years, to the use of alcohol in the treatment of disease, and in fact it is far less used than it was a generation ago." — Dr. James J. Putnam, Professor in Harvard Medical School. "My personal opinion in regard to the use of alcoholic drinks is very decidedly averse to such use. I have long been of the opinion that while the use of alcohol may re- strain tissue metamorphosis, it cannot legitimately be con- sidered a food." — Dr. William O. Stillman, Albany Medi- cal College, Albany, N. Y. "I do not think you will meet with very many physicians who favor alcohol and its use. I believe the trend of the teaching in the Albany Medical College is that alcohol is not a food or stimulant."— Dr. A. Vander Veer, Albany, N. Y., Medical School. ALCOHOL AS A MEDICINE. 365 "I think the medical profession could get along perfectly well without the use of alcohol, except as it is needed in the manufacture of drugs. As a therapeutic agent, it has ver}' little value. I do not suppose I have used a pint of alcohol in the last ten years. I think the tendency of the medical profession throughout the country is to give up alcohol in the treatment of disease." — Dr. Matthew D. Mann, Dean of the Medical Department of the University of Buffalo, N. Y. "I very seldom prescribe alcohol as a medicine, and think its effects are positively harmful in the vast majority of med- ical cases." — Dr. Allen A. Jones, Adjunct Professor of Med- icine, Buffalo, N. Y. 'At the Baptist Hospital I have not ordered alcohol for a patient in several j^ears. At the Massachusetts General Hos- pital, in the out-patient department, I never prescribe it." — Dr. Richard Badger, of Harvard ]\Iedical School, Boston. 'Alcohol is used much too freely in the treatment of the sick, especially in such conditions ae mild typhoid fever, neur- asthenia and early tuberculosis. It should be prescribed only when there is definite indication for it, and then in definite dose for a limited period in the same manner as any other powerful and potentially harmful drug," — Dr. S. S. Cohen, Jefferson Medical College, Philadelphia. "It is seldom necessary to prescribe alcohol as a medi- cine." — Dr. James B. Herrick, Professor of ]^Jedicine in Rush ]\Iedical College, Chicago. "As I have said but little about the use of medicine in the treatment of typhoid fever, save for one symptom, I may add, for the purpose of dehniteness, that I use none except for special symptoms. The rare exceptions are stimulants such as strychnia, in less marked indications coffee. Alcohol as a routine drug I have entirely abandoned, having found that the doses formerly given before or after the bath are altogether unnecessary. Hot milk internally, or hot water bags externally, more than replace spirits according to my experience." — Dr. George Doek, New Orleans. 366 ALCOHOL AS A MEDICINE. ** I have no use for alcohol, either personally, or in my prac- tice. Yet I cannot say that I have entirely abolished it. Al- cohol is used in compounding most of our tinctures, but in rem- edies proper my experience has been that other stimulants, such as ammonia, strychnine, caffeine, kolafra, etc., answer the same purpose without alcohol's dangerous effects. In my prac- tice, which is confined to surgery, I find very, very little use for it. During the past year, in extreme cases, I used it in hypo- dermic injections, and afterwards felt that ether, or ammonia would have answered the same purpose. I think, in general practice, physicians are dispensing with alcohol more and more, but perhaps unconsciously." — D. W. B. De Garmo, Professor of surgery in Post-Graduate Hospital, New York City. " Medicine, to-day, would be in a more satisfactory condition if the use of alcohol as a medicine had been interdicted a hundred years ago, and the interdict had remained to the present day. The benefits derived from its use are so small (even when they can be proved, which is much more rarely the case than most people imagine), and the advantages gained are so slight, that they are completely outweighed when we set against them the evil that has been wrought by the abuse of afcohol, and that has arisen out of the loose methods of pre- scription that have obtained, and even still obtain, in regard to this drug."— Dr. G. Sims Woodhead, F. R. C. P., F. R. S., Director of the Research Laboratories of the Royal College of Physicians and Surgeons, London. " The effect of continually dosing with this drug is too apparent wherever it is used, benumbing the senses, and ren- dering more difficult every natural function. Alcohol never sustains the powers of life. It sometimes changes the symp- toms of disease, but at the expense of the vitality of the body. What is called its supporting action, is a fever induced by the poison, which finally prostrates the patient. The secret of its action is found in the laws of vitality. The man who takes ALCOHOL AS A MEDICINE. 36/ alcohol to help digest his food, must first throw off the alcohol, before his stomach can act healthfully. " There is one encouraging fact to be noted in this connec- tion, that the use of alcohol in medicine has very much dimin- ished during the past twenty-five years, and the present tendency is constantly in that direction. Right here is an important point which I wish to make : When the physician ceases to prescribe alcohol as a medicine, the drink problem will have reached the final stage of its solution. Mankind will eventually learn that safety lies not so much in skillful doctors, or in some wonderful ' new remedy,' as in daily obedience to the laws of health. A small amount of prevention is of more worth than all the power of cure." — Dr. C. H. Shepard, Brooklyn, N. Y. " My observation has been that there is a decided tendency among educated physicians to give less alcohol than formerly in the treatment of disease. Of late years I have given but very little alcohol in my own practice. The tendency is due, in my opinion, to the study of the physiological action of drugs, and to the better understanding of the causation of disease and pathological processes. Modern investigators now know that we have therapeutic agents that meet the requirements of disease processes with more scientific accuracy than is obtained by the exhibition of alcohol." — Dr. Donnelly, Secretary of Minnesota State Medical Society, St. Paul, Minn. " Dr. Pearce Gould recently made a speech to the National Temperance League on alcohol and the advantage of doing without it, both in health and in the treatment of disease. It takes a strong man to say the strong things which Mr. Gould said on the subject, especially if he happens to be a medical man. No doubt, as Dr. Gould says, the use of alcohol in medical practice is nothing now compared to what it was twenty years ago, much more forty years ago, when Dr. Todd's influence, and the reaction from the so-called antiphlog- istic treatment were at their height. Public opinion has been 368 ALCOHOL AS A MEDICINE. enlightened by the evidence of leaders in medicine, such as Dr. Parkes, Sir William Gull, Dr. Gairdner, Dr. Sanderson, and others, and medical men have dared to treat disease vidthout alcohol, or with only small quantities of it. There are physi- cians and surgeons of reputation and success, who are so strong in their convictions that alcohol is of little use in the treatment of disease, that it destroys tissues, lessens the resistance to microbes, deranges functions, spoils temper, and shortens life, that they are ready to testify to this effect in public, in company with redoubtable champions of the temper- ance cause like the Archbishop of Canterbury, Sir William White (chief constructor of the navy), and the Bishop of Derry, who have as much prejudice to contend against in their spheres as the medical man has in his. We recognize with pleasure the good done by such testimony as Dr. Gould's. Men whose record and authority in the profession are such as his have the courage of their opinions, and their honest testi- mony will be respected even by those who do not go quite so far in discarding alcohol as an element of diet, or as a medicine. — The Lancet, London, May 14, 1898. "The light of exact investigation has shown that the thera- peutic value of alcohol rests on an insecure basis, and it is constantly being made clearer that after all alcohol is a sort of poison to be handled with the same care and circumspec- tion as other agents capable of producing noxious and deadly effect upon the organism. It has been shown by Abbott and others that alcoholic animals are more susceptible to infec- tions than normal animals. And Laitinen, after having stud- ied the influence of alcohol upon infections with anthrax, tubercle and diphtheria bacilli in dogs, rabbits, guinea-pigs and pigeons, reaches the same general results with certainty and directness. Under all circumstances alcohol causes a marked increase in susceptibility no matter whether given before or after infections, no matter whether the doses were few and massive or numerous and small, and no matter ALCOHOL AS A MEDICINE. 369 whether the infection was acute or chronic. The alcoholic animals either die while the controls remain alive, or in case both die, death is earlier in the alcoholic. The facts brought out b}^ the researches of Abbott and Laitinen and others do not furnish the slightest support for the use of alcohol in the treatment of infectious diseases in man.'" — Journal Ameri- can Medical Association, Editorial, September 8, 1900. "Step by step the progress of science has nullihed every theor}^ on which the physician administers alcohol. Every position taken has been disapproved. Alcohol is not a food and does not nourish, but impairs nutrition. It is not a stim- ulant in the proper acceptation of the term ; on the contrary it is a depressant. Hence its former universal use in cases of shock was, to say the least, a grave mistake. It has been proved by recent experiments that alcohol retards, perverts, and is destructive either in large or small doses to normal cell growth and development." — Nathan S. Davis, Sr., M. D., former Dean of Northwestern University Medical School, Chicago, Illinois. (Deceased.) "It seems to me that the field of usefulness of alcohol in therapeutics is extremely limited and possibly does not exist at all. Probably ever}^ supposed indication for its use can be met better and more safely by other drugs. The recent work on the so-called food value of alcohol is the subject of much misunderstanding. While it is true that under some circum- stances, for example, after a person has acquired a certain degree of tolerance to its poisonous effects, alcohol seems to act as a food in the sense that fats and carbohydrates do, I believe this to be at present a matter of little more than theo- retical importance.'' — Dr. Reid Hunt, Chief of the Depart- ment of Pharmacology, Public Health and Marine Hospital Service, Washington, D. C. "The physician should have blazoned before him, 'If you can do no good, do no harm.' If this rule is adhered to, in ninety-nine cases out of one hundred the physician will give no alcohol. In the medical wards of the Pennsylvania Hos- pital I have found that in acute as well as chronic disease 370 ALCOHOL AS A MEDICINE. we can do without alcohol. It does harm rather than good. Alcohol masks the symptoms of disease, so that we cannot know the patient's real condition." — J. H. Musser, M. D., Philadelphia, Pa., Ex-President American Medical Associa- tion. "It is time alcohol was banished from the medical arma- mentarium; whisky has killed thousands where it cured one." — J. H. McCoRMACK, M. D., Secretary Kentucky Board of Health, and Organizer for the American Medical Associa- tion. "I very rarely use alcohol in my practice. I think that its use is never essential. Physicians are using it less and less in the treatment of disease owing to the recognition that it is a narcotic, not a stimulant, and that other narcotics are usu- ally better when a narcotic is required." — Richard C. Cabot, M. D., Professor of Clinical Medicine, Harvard Medical School, Boston, Mass. "My position has, been that alcohol should be prescribed with as much care as to indications and circumspection as to dose and method as in the use of any other drug that in health would prove harmful, as morphine, belladonna, aco- nite, quinine, etc. I believe strongly that in pneumonia, ty- phoid fever, and tuberculosis especially, the indiscriminate use of alcohol in the past has caused an incalculable amount of distress and needless disaster to suffering humanity." — How- ard S. Anders, M. D., Professor of Physical Diagnosis, Med- ico-Chirurgical College, Philadelphia, Pa. "I do not think alcohol of any value in the treatment of disease ; formerly it was used a great deal in the hospital wards, and liquor slips' were daily signed. Now, I never order liquor in any quantity, and at times for weeks I have not signed a single slip ordering liquor." — Henry Jackson, M. D., Professor in Harvard Medical School. "In the overwhelming majority of cases I am in entire sympathy with the movement to abolish the routine use of alcoholics from medicine, and I rarely advise such in my practice." — Edward R. Baldwin, M, D., Saranac Lake Sani- tarium, New York. ALCOHOL AS A MEDICINE. 37I "I seldom prescribe alcohol." — George Blumer, M. D., Yale Medical School, New Haven, Conn. "Whereas, The study of alcohol from a scientific stand- point has demonstrated that its action is deceptive, and that it does not have the medical properties that we once claimed for it ; now, therefore, be it "Resolved, By the West Virginia State Medical Associa- tion, That we deplore the fact that our profession has been quoted so long as claiming for it virtues which it does not possess, and that we earnestly pledge ourselves to discour- age the use of it, both in and out of the sick room." — Resolu- tion passed at annual meeting May, 1908. "I have been actively engaged in the practice of medicine for nearly twenty-five years, in the early portion of which I prescribed alcoholics moderately but yet with considerable frequency. For the past ten years I have been finding pro- fessionally less place for alcoholics of any sort in my prac- tise, and for perhaps three years I have scarcely ever pre- scribed them. I am satisfied that my cases of pneumonia and typhoid come through in better condition without any- thing alcoholic, even wines, and I no longer prescribe these at all in cases of tuberculosis. I have noted also that among my professional associates of the thinking rather than of the automatic type, the medicinal use of alcohol is rapidly lessening." — C. G. Hickey, M. D., Lecturer on Medicine, Den- ver and Gross College of Medicine, Denver, Colorado. "In the thirteen years I have taught in Michigan I have not used alcohol in the treatment of disease in a routine way. Even alcoholic preparations, such as tinctures, have been used in very rare instances. I have occasion to speak on this sub- ject every year to about two hundred students. My reasons for taking this stand are chiefly medical, though I am heartily in sympathy with the ethical and moral phases of the tem- perance movement." — Dr. George Dock, formerly Professor of Medicine, University of Michigan Medical College, now of Tulane University, New Orleans. "Alcohol is distinctly a poison, and the limitation of its use 372 ALCOHOL AS A MEDICINE. snould be as strict as that of any other kind of poison. It is not an appetizer, and even in small quantities it hinders digestion. The use of alcohol is emphatically diminishing in hospital practise." — Sir Frederick Treves, Surgeon to King Edward. "If during the last quarter of a century I have prescribed almost no alcohol in the treatment of disease, it is because I have found very little reason for its use, and it seemed to me that my patients got on better without it." — Sir James Barr, Dean of the Medical School of Liverpool University. "With the increase of medical knowledge and with the increase of medical observation, it is shown every year that the value of alcohol as a drug has been enormously over- estimated. It is a very poor agent, and only in common use because it is so easily obtained. The medical profession is using it less and less, because they appreciate it now at its true value. Personally I never order it, because I believe patients recover better without it." — Sir Victor Horsley, Sur- geon to London Hospital. "The same care and discrimination should be given to the prescribing of alcohol as to the most deadly drug with which we have to deal. In looking at the report of Radcliffe In- firmary for the past month I see that in dealing with twenty- five cases I ordered alcohol costing exactly i% pence." — Dr. William Collier, President British Medical Association, 1904. "In England at present the use of large doses of alcohol seems to have greatly gone out of hospital practise, and opin- ion is certainly growing that not even small doses are re- quired. Diseases of the stomach, liver, heart, and kidneys have appeared to me, in my practise, to be much more sat- isfactorily treated without beer, wines, or spirits." — Dr. C. R. Drysdale, Consulting Physician to the Metropolitan Hos- pital, London. "Alcohol is a functional and tissue poison, and there is no proper or necessary use for It as medicine." — Dr. Frank Payne, Vice-President London Pathological Society. ALCOHOL AS A MEDICINE. 373 "Of scarlet fever I have treated some 2,000 cases. I have never seen a case in which, in my opinion, alcohol was neces- sar}' ; no case in which its administration was beneficial ; but I have seen more than one case in w^hich its action was di- rectly injurious. * * * Alcohol in no case averts a fatal is- sue where such is impending. * * * The facts are dead against alcohol. In hospitals there has been an increase of 300 per cent, in the use of milk, and a decline of 47 per cent, in the use of alcohol. Progress in treatment of disease has gone hand in hand with disuse of alcohol. The use of alco- hol formerly was the outcome of ignorance, a confession of weakness and defeat; to-day it is the expression of inability to discard the fetters of an outworn routine." — Dr. C. Knox Bond, in Medical Times. "For many years I have dispensed almost entirely with al- cohol as an aid in surgical treatment. As a student I saw it used, almost as a matter of routine, for every kind of surgi- cal malady except head injuries, and in m}^ early years I na- turally followed the practise of my teachers ; but as soon as I made trial for myself of the effect of withholding alcohol, I found how entirely overrated its value was, and how gravely mistaken had been the teaching. It is commonly held, I be- lieve, that alcoholic stimulants are of especial value in all forms of septic inflammation, such as er3^sipelas, pyemia, septicaemia, and hectic fever. I believe that this belief is founded solely upon tradition unsupported by an}* trustworthy evidence, and untested by experiment or experience." — Dr. A. Pearce Gould, F. R. C. S., Surgeon to the ^Middlesex Hos- pital, London. "I have not prescribed alcohol to my patients for more than ten years, and can affirm positively that they have fared well under this change of treatment. Since I formerly fol- lowed the universal practice, I am competent to make com- parisons, and these speak unconditionally in favor of treat- ment without alcohol. As a preventive of waste I use among fever patients nothing but real foods ; in addition to milk, 374 ALCOHOL AS A MEDICINE. particularly sugar, which can be administered to any fever patient in ample quantity in the form of fruit juices, stewed fruit, sweet lemonade, fruit ices, sugared tea, etc., concern- ing which hundreds of investigations have demonstrated posi- tively that it prevents the waste of both albumen and fat. As a stimulant I emplo}--, besides hydriatic methods, which at the same time abstract heat, almost nothing but camphor, and I can affirm that it is unconditionally preferable to alcohol for its prompt results and the absence of disagreeable after- effects (intoxication, benumbing). Pneumonia, especially, subsides without alcohol to perfect satisfaction, and I re- joice to agree in this respect with Aufrecht, one of the best authorities on this disease, who in his monograph in Noth- nagle's manual, acknowledges himself hostile to the use of alcohol in the treatment of pneumonia, and hopes that its use may be speedily abolished. For the reasons previously specified, I should like to see that extended to all use of al- cohol in therapeutics. However, that can come to pass only when all thinking physicians clearly appreciate the fact that no substance is able to undertake the double role of a food and a poison, and, also, that for alcohol no nutritive, but only toxic properties can be claimed." — Max Kassowitz, M. D., Professor in the University of Vienna, Austria "Besides its deleterious influence on the nervous system and other important parts of our body, alcohol has a harm- ful action on the phagocytes, the agents of natural defense against infective microbes." — Prof. Metchnikoff, Pasteur Institute, Paris, France. "Alcoholic liquors are, to my mind, not only not valuable, but distinctly disadvantageous, in the treatment of disease, except in rare instances, as for example in the initial chill of some acute infectious disease. However, I have almost given up the use of alcohol in the treatment of disease." — Dr. D. L. Edsall, Professor of Therapeutics in the University of Pennsylvania Medical School. "As a rule which might well be regarded as universal in the practice of medicine, alcohol in the treatment of disease ALCOHOL AS A MEDICINE. 375 is an evil. In ordinary doses and in continuous use the sum of its reactions increases exhaustion, which may terminate fatally." — Dr. John Van Duyx, Professor of ^Medicine in Syracuse, N. Y., University ^Medical School. "In sixteen years of active practice I have not used alco- holics at all. I am medical director of the Scranton Sani- tarium, and I have considerable trouble in trying to cure those who use alcohol, and to undo some of the work my fellow practitioners have unwittingly made." — D. Webster Evans, j\L D., Scranton, Pa. "I am opposed to the use of alcoholic liquors as a bever- age, and with rare exceptions, to their use in the treatment of diseases." — Dr. Eugene Kerr, Physician to Phipps Dis- pensar}', Johns Hopkins Hospital, Baltimore, Md. "In my profession'al work I do not advise or permit the use of alcohol as a beverage or medicine in any form what- ever. No alcohol is used medicinally in my hospital wards. Beer or wine is not permitted to convalescents. Children are never given tinctures. Cases of delirium tremens receive no alcohol. The hypodermic use of alcohol is not permitted in cases of shock. There are other much more effective and less depressing diffusable stimulants. "Among my colleagues the employment of alcohol as a med- icine has diminished at least seventy-five per cent, in the past fifteen 3-ears. "I have cast it out entirely." — J. P. Warbasse, 'M. D., Chief Surgeon German Hospital, Brooklyn, X. Y. "The habitual use of alcohol in an}- disease is worse than harmful." — Robert B. Preble, ^l. D., Chicago, 111. "The last few years I find I have used less and less alco- hol in prescribing for my patients until at the present time I use very little. I think my typhoid cases do better without alcohol than with it." — H. H. Healy, ]\I. D., former Sec'y North Dakota Board of Health. "Alcohol is a poison. It is claimed by some that alcohol is a food. If so, it is a poisoned food." — Frederick Peterson, 'M. D., Professor of Psychiatry, Columbia University, N. Y. 376 ALCOHOL AS A MEDICINE. "Few physicians now credit alcohol as a food (that is, as a tissue builder) or as having any valuable medicinal qualities. In fact, it is considered by many to have a destructive rather than a constructive quality. I believe it should never be put into the human body." — Eugene Hubbell, M. D., St. Paul, Minn. "The medical profession is learning that alcohol has been much abused in the treatment of the sick, and is largely dis- carding it. I hardly find occasion to prescribe it once a 3^ear." — W. A. Flecker, M. D., Sec'y State Board of Health, Hamp- ton, Va. "The use of alcohol as a beverage or therapeutically, is in either case a habit of the user. The stimulation is but tem- porary, the reaction leaving the nerve cells of the individual with less resisting power than before the ingestion of alco- hol. * * * Never permit a verbal or written prescription of yours to give rise to the use of a habit forming drug." — From a lecture to students in Omaha Medical College by J. M. Aiken, M. D., Clinical Instructor and Lecturer upon Nervous and Mental Diseases. 'The use of spirits as a stimulant in diseases, except in a very limited circle, is a mere empiricism for which no good reasons can be given. The teachings of medical men are no more to be followed blindly and without question. The tests of alcohol as a tonic, as a food, as a stimulant, as a retarder of waste, are all negative. There is no reliable evidence to support these claims, but a constant accumulation of facts to indicate the danger from the use of spirits. To give alcohol or any other drug without some rational theory in accord with the scientific researches of to-day is unpardonable." — Dr. T. D. Crotpiers, Hartford, Conn., Editor of the Journal of Inebriety. "Many physicians prescribe alcohol only because it is the desire of the patient, and because patients refuse medicine which the physicians would rather use." — Everett Hooper, M. D., Boston, Mass. ALCOHOL AS A MEDICINE. 377 *'You are right in indicting alcohol for its insidious wrongs to humanity. It is an old and sly offender and very much the 'mocker' in medical practise that it has been pronounced in holy writ. It exhausts the latent energy of the organism often when that power is most needed to conserve the fail- ing strength of the body in the battle with disease." — Dr. C. H. Hughes, St. Louis, ^Missouri. ''The best class of thinkers, men of the best intellectual gauge, are those who are doing away with this miserable, unscientific practise of giving liquor." — Dr. Boynton, Clifton Springs, N. Y. "I believe that in the scientific light of the present era alco- hol should be classed among the anaesthetics and poisons, and that the human family would be benefited by its entire ex- clusion from the field of remedial agents." — Dr. J. S. Cain, Dean of the Faculty, Medical Department, University of the South, Sewanee, Tenn. "Let me cite my experience in surgery for the last three years in proof of the uselessness of alcohol, and the benefit of abstinence from its administration. During that time I have performed more than one thousand operations, a large portion upon cases of railroad injuries, one hundred for ap- pendicitis, and in none of these was alcohol administered in any form, either before, during, or after operations. I defy any one who still adheres to alcohol to show as good results. Equally gratifying results have been obtained with my medi- cal cases, and I fail to understand how any observing and thinking physician can still cling to so prejudicial a drug as alcohol, when he has within his reach a multitude of valu- able, exact, and reliable methods for combating, governing, and controlling disease." — Dr. Evan C. Kane, Surgeon Penn- sylvania Railroad, Kane, Pa. "In my neurological practice I emphatically forbid my pa- tients the use of alcohol. This poison has a special predilec- tion for the nervous system which it influences sometimes to an alarming extent." — x-\lfred Gordon, M. D., Jefferson Medi- cal College, Philadelphia, Pa. 378 ALCOHOL AS A MEDICINE. "Alcohol finds no place in my remedial list. It has been banished, not from sentiment, but from knowledge secured by scientific investigation." — T. Alexander MacNicholl, M. D., New York City, one of the founders of the Red Cross Hospital, New York. "No sound, scientific argument can be offered for the med- ical use of alcohol, either internally or externally. It is a toxic substance which ought to be retired from the materia medica, and placed in the catalog of obsolete drugs along with tobacco, lobelia, and like useless but highly toxic drug substances." — Dr. J. H. Kellogg, Superintendent Battle Creek Sanitarium, Battle Creek, Michigan. "The majority of medical men, without making any search- ing investigation into the abundant recent literature upon the subject of alcohol, are disposed to regard it with less and less favor as the years go by, while those who have closely followed the thorough investigations into the physiological action of alcohol recently made by scientists, have repudi- ated it altogether. * * * It is a lack of information upon this subject — together with the fact that alcohol has been used as a therapeutic agent for hundreds of years, during which it has formed the basis of all tonic or stimulating treatment — that gives alcohol its present hold upon a part of the medical profession." — John Madden, M. D., Portland, Oregon, formerly professor in jMilwaukee Medical College. "Alcohol may fill an emergency when better means are not at hand, but, apart from this, I know of no use in the prac- tise of medicine and surgery for which we have not better weapons at our command. There is but one reason for the continued use of alcohol — men use it because they love it." Dr. W. F. Waugh, Chicago, Editor Journal of Clinical Medi- cine. "If alcohol had become a candidate for recognition years ago instead of centuries ago it is safe to say that its applica- tion in medicine would have been very much more limited than we find it at the present time. Its wide therapeutic use is to be attributed in part to fallacies and misconception re- ALCOHOL AS A MEDICINE 379 garding its pharmacology, and in part to a disinclination on the part of the average practitioner of medicine to depart from old and well-beaten lines." — Winfield S. Hall, M. D., Professor of Physiology, Northwestern University Medical School, Chicago. "In its relation to the human system, alcohol is never con- structive and always destructive." — Prof. Frank Woodbury, M. D., Philadelphia, Pa. "The clinicians who decide for the deleterious action of alcohol in infectious conditions have what evidence of an experimental nature we possess at the present time to sup- port their impressions. The advocates of the continuous use of the drug have this evidence against them." — Henry F. Hewes, M. D., Harvard Medical School, Boston, IMass. "I am very glad that you are undertaking so important a work as this in connection with the terrible problem of alco- holism. Physicians need awakening in this matter; they need reform. The evil results of alcohol are unfortunately brought to my notice each day of my life as I pursue my vocation and my public duties as Health Officer, and a reform in pre- scribing so as to eliminate alcohol would undoubtedly have far-reaching beneficent effects." — Edward von Adeluxg, M. D., Health Officer, Oakland, Cal. "I am forwarding you a report of 303 cases of typhoid fever treated without alcohol, and my reasons for not using it. I believe the results will not suffer by comparison with those obtained in other hospitals where alcohol is used. Wish- ing you lasting success in your war upon the greatest evil of the times." — J. H. Landis, M. D., Cincinnati, O. "Only precise evidence that it (alcohol)' is able to protect albumen from destruction can warrant its employment and establish its value as a food in the sick diet. And this evi- dence which is of determinative importance must be looked upon as having failed, according to the recent investigations of Stammreich and Miura (who both worked under von Noorden's direction), as well as by Schmidt, Schoneseiffen and Roseman. The uniform result of all these experiments, 380 ALCOHOL AS A MEDICINE. arrived at by altogether different methods, is that alcohol does not possess albumen sparing power; that it even brings about an undoubted breaking down of albumen, and conse- quently it is entirely unequal to carbohydrates and fat." — Dr. Julian Marcuse, a contributing editor of Die Heilkunde, a German medical magazine. See issue of July, 1900. "Thirty years ago the general principle of practice was stimulation. Alcohol was supposed to rouse up and support vital forces in disease. Twenty-three years ago the first practical denial was put into a permanent position in a pub- lic hospital in London, where alcohol was seldom or never used * * * Doctor Richardson's researches showing the an- aesthetic nature of alcohol have had a great influence in changing medical practice in England. * * * On the Con- tinent a number of scientific workers have published re- searches confirming Doctor Richardson's conclusions, and bringing out other facts as to the action of alcohol on the brain and nervous system. These papers and the discussions which followed have been slowly working their way into the laboratory and hospital, and have been tested and found cor- rect, materially changing current opinions, and creating great doubts of the value of alcohol. "In 1896, the prosecution of Doctor Hirschfeld, a Magde- burg physician, in the German courts, for not using alcohol in a case of septicemia, seemed to be the central point for a new demonstration of the danger of the use of alcohol in medicine. Doctor Hirschfeld was acquitted on the testimony of a large number of leading physicians from the large hos- pitals and universities of Europe. It was proved that alco- hol was not a remedy which was specifically required in any disease ; also that its value was most seriously questioned as a general remedy by many able men, and its substitution was practical and literal in most cases. Statistics were presented proving that alcohol was dangerous, and never a safe rem- edy, and laboratory investigations confirming and explaining its action were given. Since then a sharp reaction has been going on in Europe, and alcohol is rapidly declining and passing away as a common remedy. ALCOHOL AS A MEDICINE. 381 "Doctor Frick, an eminent teacher of medicine in Zurich, Switzerland, and Doctor von Speyer, of the University of Berne, have made statistical studies of cases treated with and without alcohol, and have analyzed the effects of spirits as medicinal agents to check and antagonize disease, and assert very positively, that alcohol is a dangerous and ex- ceedingly doubtful remedy. Doctor Meyer, of the Univer- sity of Gottenburg, Doctor Mobius, of Leipsic, and Doctor Wehberg, of Dusseldorf, are equally prominent physicians who have taken the same position, and are equally emphatic in their denunciations of the current beliefs concerning alcohol in medicine. — Journal A. M. A., January 6, 1900. Dr. H. D. Didama, Dean of the Medical College of Syracuse University, Syracuse, N. Y., said in January, 1898, in the Voice : — " For many years after my graduation at Albany, in 1846, I prescribed alcohol, and for twenty years, while occupying the chair of professor of the science and art of medicine in the College of Medicine of Syracuse University, I followed in my lectures — often reluctantly and usually afar off, but still I followed — the almost unanimous teaching of authors, ancient and modern, and the professors in the medical schools. " Convinced that a great number of the diseases I was called to treat owed their existence or aggravation to the use, in alleged moderation, of alcoholic beverages, and that not in a few instances this use was commenced and even continued by the advice of the medical attendants ; convinced also by the published experiments of many acute observers at home and abroad, and by my own observations, that almost all diseases could be managed as weU if not better by the non-use of alcohol, and satisfied from the communications of some brother practitioners that the fatality in certain specified dis- eases was not delayed, to say the least, by the employment of increasing and enormous doses of wine, whisky and brandy. 382 ALCOHOL AS A MEDICINE. and influenced also, I must admit — overwhelmed, indeed — by what I know and what I read daily of the pauperism, domestic wretchedness, crime, insanity and incurable maladies trans- mitted to innocent offspring, I abandoned entirely, more than three years ago, the use of alcoholic remedies. " I have endeavored by personal example and earnest council to dissuade my patients from the use of intoxicating beverages and medicines. " The outcome of this practice, medically and morally, has been satisfactory to myself, and, I have reason to believe, to my patients also. " Whatever regrets I may feel for my former teaching and practice, I have no apology to offer for my inconsistency ex- cept that once given by Gerrit Smith : — * I know more to- day than I did yesterday ; the only persons who never change their minds are God and a fool' " Permit me to add that while there may be an honest differ- ence of opinion regarding the efficacy of legislative enactments in overcoming or restraining the drink habit, there should be little doubt that a whole-hearted, persistent, precept-and-ex- ample effort of the medical profession exerted as individuals on their patients and the families of their patients, and as associa- tions on the community at large, would do immeasurable good. " And the newspapers might aid materially in this beneficent work if, while they continue to spread before our households every day the details of the brawls and fights of drunken men and the horrible murders which they commit, they would dis- continue advertising, without warning or dissent, side by side with the atrocities, the ' innocuous beers,' the pure malt whis- kies, the genuine brandies, guaranteed to prevent and cure all manner of diseases." The follow^ing testimony from an English physi- cian is significant : — " Although I know beforehand that their united testimony ALCOHOL AS A MEDICINE. 383 must be in favor of the practice of total abstinence from all intoxicating drinks, being most conducive to health and lon- gevity of their patients, but very inimical to the pocket interests of themselves, my own experience is, that my teetotal patients are seldom ill, and that they get well very soon again, if they are attacked by disease. A higher principle than that of gain must influence a medical man's mind, or he will never advocate the doctrine of total abstinence."— J. J. Ritchie, M. R. C. S., Leek. " One of the most dangerous phases of the use of alcohol is the production of a feeling of well being in weakly, dyspeptic, irritable, nervous or ansemic patients. In consequence of the temporary relief so obtained, the patient develops a craving for alcohol, which in many cases can end only in one way, and, as I felt compelled to tell an assembly of ladies a short time ago, the very symptoms for the alleviation of which alcohol is usually taken are those, the presence of which renders it exceedingly desirable that alcohol should not be taken." — Dr. G. Sims Woodhead, of London. In an address upon the London Temperance Hospital delivered shortly before his death, Sir B. W. Richardson gave a brief review^ of the influences which led him to abandon the medical use of alco- hol. The follov^ing is taken from that address as reported in the Medical Pioneer : — •' I was a member of the Vestry of St. Marylebone, and we had in our parish a very serious outbreak of small-pox, attend- ed with a considerable mortality. In his report to us Dr. Whitmore stated that in his treatment of earlier cases of the confluent and hemorrhagic, and malignant forms of disease, stimulants of wine and brandy were freely administered with- out any apparent benefit ; and, that after consultation with Mr. Cross, the resident surgeon, they resolved to substitute simple 384 ALCOHOL AS A MEDICINE. nutriments, such as milk, eggs and beef-tea, at frequent inter- vals, with discontinuance of stimulants altogether. The result of the change was most satisfactory, and many bad cases did well, which under the stimulant plan they believed would have terminated fatally. Again I was struck very much by a report made by Mr. Cadbury, in which that gentleman showed the course that was going on in various hospitals. The amount of alcohol in twelve hospitals in London, taken by the inpatients, varied in ounces from 37,531 in one establishment to 300,094 in another during the year 1878. I also found, from the same author, that the whole cost in St, George's Union Infirmary for the year 1878 was £8. 3s. 6d., amongst 2,496 patients, while the cost of the same number at the average of the twelve hospitals was £124.. About this same time I also remarked that in many of the public institutions of England there was a reduction something similar in kind, if not to the same extent, and that the number of persons who suffered seemed to make better re- coveries than those who were taking the free amount of stimul- ant. The effect of these observations chimed in very remark- ably with the physiological experiments it had been my duty to carry out, and which tended to show in a most striking manner that the action of alcohol in the body very much differed from the ordinary opinion that had been held upon it, and thereupon, in my own practice, I abandoned the use of alcohol, and began to give instead small quantities of simple, nourishing, dietic food, a course I pursued up to the present time with the most satisfactory results, results I have never felt any occasion to re- gret. By these steps, learned in the first place from the study of alcohol in its action on man, I was led to become a believer that alcohol is of no more service in disease than it is in health, and a lengthened experience in this matter has really confirmed the correctness of the idea." In his last report as physician to the Temperance Hospital Dr. Richardson made some remarkable ALCOHOL AS A MEDICINE. 385 statements upon the fallacy of the general ideas of stimulation. So interesting are his views that they are incorporated here : — " Sir B. W. Richardson, M. D., who was unable to be pres- ent, communicated (through the secretary) his annual report as physician to the hospital. After twelve months further trial of the treatment of all kinds of disease in this institution without the assistance of alcohol, either as a diet or a medicine, he (Sir B. W. Richardson) was fully sustained in the belief that the plan pursued had been attended with every possible advantage. About 500 cases had come under his observation and treatment as in previous years, and these cases had been of the most varied kind, including all patients who were not directly suffer- ing from contagious disease. In not one instance had alcohol been administered, nor had anything like it been used in the way of a substitute, and there had not been a single case in which he could conceive that it was ever called for, while the success v/hich had attended the treatment generally had been superior to anything he had ever seen following upon the administration of alcoholic stimulants. One great truth which had forced itself upon him had reference to the doc- trine of stimulation generally. It had been one of the grand ideas in medicine that there came times when sick peo- ple were benefited by being stimulated. It was argued that they were low, and in order that they might be raised and brought nearer to the natural life they required something like alcohol to quicken the circulation, quicken the secretion, and help to preserve the vitality. But the experience which was learned here tended to show in the most distinct manner that that very old and apparently rational idea was fallacious. Such stimulation only tended ultimately to wear out the powers of the body, as well as change the physical conditions under which the body worked. True lowness meant practical over-fatigue, and when the body was spurred on, or stimulated, over-fatigue was 386 ALCOHOL AS A MEDICINE. simply intensified and increased. What, therefore, was wanted was not stimulation, but repose. The sufferer was placed in the best position to gain entire rest, and all the surroundings or environments were employed which tended to prevent waste. The air was kept at the proper temperature, the body of the patient kept warm, and the simplest and most easily digested foods were used ; the patient's condition then swung round to a natural state, and he began to get well. In other cases where the sick were brought under observation suffering already from excitable condition of the senses, with congestions here and there of the circulatory or nervous systems, with imperfect condition of the brain, and with the elements of what was usually denom- inated inflammatory or febrile state — the stimulant was al- ready present (was, indeed the cause of th^ symptoms) and did not want in any degree to be enforced further by the acts of treatment. Here, therefore, they were on the safest grounds as regarded methods of administration, for they calmed as well as they possibly could both mind and body and left nature to do the rest, which she did with the best and most tranquilizing ef- fect. On both sides, therefore, in the treatment of disease, they did good, and that was the reason, he believed, why their re- turns were so satisfactory. It often happened in an institution where some particular plan was carried out that the old ideas in which they had been bred were without intention refined or suppressed. For example, he had been taught, and believed for a nutnber of years, that some medicament of a particular kind was needful for some particular train of symptoms, be the sur- rounding conditions what they might. There was no doubt that this same feeling had given rise to the persistent use of alcohol; but, greatly to his own surprise, he discovered that when the surroundings were all good, the rule that applied to alcohol constantly applied to other substances that were called remedies, with the result that recovery was often just as good without the particular remedies as with them, so that a revision came quite simply with regard to stimulating agents and their ALCOHOL AS A MEDICINE. 38/ properties, and also with regard to every medicine that might at earlier times have been employed. He had seen many cases in this hospital recover u^ithout any other aid than that of the environments, which cases he would have said could not possi- bly have gone on well, or towards complete recovery, unless some special recipe had been followed. He believed the day would come when others, learning this same truth as he had been obliged to learn it, would act on such simple principles that the books of remedies would have to be vastly curtailed. It would be seen that there was such a tendency of disease to get well of itself, or by virtue of natural processes, of which people had at present but a very poor idea, that the art of physic would pass into directions how to live rather than into dogmatic asser- tions that particular means must be employed in addition to the common details of life for the process of cure. If therefore they learned in this hospital by their reduced death-rates the true lesson, the institution would have performed a double duty, and become one of the test objects in medicine, and in the field of disease. They made no attempt by selection, or by any side action, to exaggerate their results. The cases were taken in- discriminately, except that they gave admission to the worst cases first ; that was to say, they never caused patients to come under their treatment if they saw they were only slightly affect- ed, and were bound to get well." — Medical Pio7ieer. Dr. Landmann, of Boppard-on-the-Rhine, Ger- many, says : — " The members of the Association of Abstaining Physicians, reject the use of spirituous liquors in every form, and particu- larly declare the use of alcohol at the sick-bed a scientific error of the saddest kind. In order to war against this abuse, they earnestly appeal to the officers having charge of funds for the sick, henceforth, under no circumstances, any longer to permit the prescription of wine, whisky and brandy for sick members ; but to resist to the utmost, according to the right given them 388 ALCOHOL AS A MEDICINE. by the laws insuring the sick, the taking of spirituous liquors, under the false pretext that they have a curative and strength- ening effect." Dr. Bleuler, Rheineau, Switzerland, says : — " The treatment of chronic diseases with alcohol is contrary to our knowledge of the physiological effects of alcohol. There is no probability that its use will be beneficial, certainly its ben- efits have not been established. Often an injurious result is proved. " It is not implied that there may not be some benefit in the use of alcohol in cases of sudden weakness with or without fever. But even in such cases the benefit is not demonstrated. At any rate, other remedies can with advantage be substituted for alcohol. " The essential thing in the treatment of all alcoholic dis- eases, delirium tremens included, is total abstinence. " The physiological effect of alcohol is that of a poison, whose use is to be limited to the utmost. Even the moderate use as now practiced is injurious. "The customary beneficial results unquestionably depend chiefly on suggestion, and by making the patient believe falsely that the momentary subjective better feeling means actual im- provement. " Physicians share the blame of the present flood of alcohol- ism. They are, therefore, morally bound to remedy the evil. Only by means of personal abstinence can this be done." Dr. A. Frick, professor in Zurich, is a careful student and an influential writer on alcohol. His statements are weighty. This is his testimony : — " In larger doses, alcohol is absolutely injurious in the treat- ment of acute fevers, especially in case of pneumonia, ty- phus and erysipelas. They first of all injure the general state ALCOHOL AS A MEDICINE. 389 of the patient, they cause delirium, or increase it if already ex- isting, and, secondly, they injure most seriously the organs of digestion and interfere with proper nourishment ; thus they have a weakening effect, instead of preventing weakness, which they are usually supposed to do. In case no alcohol is used, the convalescence is much more rapid. In no case has the benefit of treatment with alcohol been established. According to the view of the most eminent pharmacologists, the stimulating effect of alcohol consists simply in a local irritation of the mu- cous membrane of the stomach, similar to that produced by a mustard plaster." The following selection from the excellent address of Dr. Harvey, president of the Virginia State Med- ical Society, at a recent meeting, is a most timely caution : — " Our prisons, asylums and homes are filled with the victims of the careless and indiscriminate use by the medical profession of those twin demons, alcohol and opium, which, save tubercu- losis, are doing more to debase and destroy the human race than all the other diseases together. I most earnestly beseech you, young men, who are just starting out in life, to stay your hand in the use of these agents in your own persons, and in your daily work, and to beware of the seductive needle, and the cup that inebriates. Make it an invariable rule, never to pre- scribe alcohol, nor one of the solinaceus or narcotic drugs, if you can possibly avoid it. The use of alcohol and opium de- bases the minds and morals of habitues, predisposes especially to Bright's disease and insanity, and lays the foundation in the offspring for the majority of the neuroses and degenerations of modern civilized life. The physical fatigue of long working hours, loss, of sleep, mental strain, worry and hunger, invite the tired physician, especially, to their seductive use. To totally abstain from them is always business, and very often character, and even life itself. I feel free to speak to you on this subject 390 ALCOHOL AS A MEDICINE. very earnestly, my younger brothers, for, having prescribed alcohol for over thirty years, I am familiar with its tendencies and its dangers." Dr. T. D. Crothers of Hartford, Conn., in an arti- cle upon " The Decline of Alcohol as a Medicine," says : — " Thoughtful observers recognize that alcohol as a medicine is rapidly becoming a thing of the past. Ten years ago leading medical men and text-books spoke of stimulants as essentials of many diseases, and defended their use with warmth and positiveness. To-day this is changed. Medical men seldom refer to spirits as remedies, and when they do, express great conservatism and caution. The text-books show the same changes, although some dogmatic authors refuse to recognize the change of practice, and still cling to the idea of the food value of spirits. " Druggists who supply spirits to the profession recognize a tremendous dropping off in the demand. A distiller who, ten years ago, sold many thousand gallons of choice whiskies, al- most exclusively to medical men, has lost his trade altogether, and gone out of business. Wine men, too, recognize this change, and are making every effort to have wine used in the place of spirits in the sick-room. Proprietary medicine dealers are putting all sorts of compounds of wine with iron, bark, etc., on the market with the same idea. It is doubtful if any of these will be able to secure any permanent place in therapeutics. " The fact is, alcohol is passing out of practical therapeutics because its real action is becoming known. Facts are accumu- lating in the laboratory, in the autopsy room, at the bedside, and in the work of experimental psychologists, which show that alcohol is a depressant and a narcotic ; that it cannot build up tissue, but always acts as a degenerative power ; and that its apparent effects of raising the heart's action and quickening functional activities are misleading and erroneous. ALCOHOL AS A MEDICINE. 391 " French and German specialists have denounced spirits both as a beverage and a medicine, and shown by actual demonstra- tion that alcohol is a poison and a depressant, and that any therapeutic action it is assumed to have is open to question. " All this is not the result of agitation and wild condemnation by persons who feel deeply the sad consequences of the abuse of spirits. It is simply the outcome of the gradual accumula- tion of facts that have been proven within the observation of every thoughtful person. The exact or approximate facts relat- ing to alcohol can now be tested by instruments of precision. We can weigh and measure the effects, and it is not essential to theorize or speculate ; we can test and prove with reasonable certainty what was before a matter of doubt, " Medical men who doubt the value of spirits are no more considered fanatics or extremists, but as leaders along new and wider lines of research. Alcohol in medicine, except as a nar- cotic and ansesthetic, is rapidly falling into disfavor, and will soon be put aside and forgotten." CHAPTER XVI. RECENT RESEARCHES UPON ALCOLOL. In the year 1900 Prof. Taav Laitinen, of the Uni- versity of Helsingfors, Finland, pubHshed an account of experiments made upon 342 animals — dogs, rab- bits, guinea pigs, fowls and pigeons — to determine the effects of alcohol upon the resistance of the body to infectious diseases. He used as infecting agents, anthrax bacilli, tubercle bacilli, and diphtheria bacilli. The doses of alcohol given varied with the animal. For his "small dose" experiments he used the quan- tity of alcohol given as a food or as a medicine, or both, in a neighboring sanitorium. The alcohol em- ployed was, as a rule, a 25 per cent, solution of ethyl alcohol in water. It was given either by esophageal catheter, or by dropping it into the mouth from a pipette. It was administered in several ways, and for varying times; sometimes in single large doses, at others in gradually increasing doses for months at a time, in order to produce here an acute, and there a chronic poisoning ; in fact, he produced the conditions consequent upon steady, moderate drinking. His first conclusion from these experiments, most carefully carried out, is that alcohol, however given, induces in the animal body a markedly increased sus- ceptibility to infectious diseases; and he maintains 392 ALCOHOL AS A MEDICINE. 393 that his experiments indicate that the use of alcohol, at least in the treatment of anthrax, tuberculosis, and diphtheria, is not only useless but probably injurious. From a number of other experiments carried out with scrupulous care he comes to the same conclusion as Abbott, Welch, and others that the predisposing to disease of alcohol must be explained by its action in producing abnormal conditions — pathological changes in the ahmentary canal, liver, kidneys, heart, and nerv- ous system. He found that the alkahnity of the blood Vv^as slightly diminished, and the number of leucocytes somewhat decreased. He also draws attention to the fact that his experiments prove that pregnant animals and their offspring are markedly affected by the con- tinued use of small doses of alcohol. He shows, too, that the temporary lowering of the body temperature by alcohol produces the most favorable condition for the invasion of disease germs. Since the publication of these experiments, and of others similar to them, the use of alcohol in diphtheria and tuberculosis has very largely ceased. Boards of health and charity organizations unite in warning against indulgence in alcoholic drinks as conducive to tuberculosis. At the International Congress on Alcoholism, held in London in July, 1909, Professor Laitinen delivered two lectures. The first was upon "The Influence of Alcohol on Immunity." The following is taken from this lecture: — ■ "Modern researches have done much to explain the ex- tent and nature of the protective powers by which the or- 394 ALCOHOL AS A MEDICINE. ganism endeavors to defend itself against the attacks of all kinds of injurious agencies, and especially against invasion by the germs of infective diseases. It is now a well-estab- lished fact that alcohol weakens the normal resisting power of the body against the above-named disease-producing in- fluences. In the hope of contributing something to the ex- planation of the way in which alcohol weakens the organism, I have made a number of experiments bearing upon the ques- tion of the influence of alcohol on immunity. "Early in this century careful experiments went to show that alcohol certainly had some influence upon immunity. Two Americans, Abbott and Bergey, were the first to dis- cover that this agent produces a diminution of the hsemolytic complement in the blood-serum of certain animals which were tested. They showed also that the formation of spe- cific hsemolytic receptors (immune bodies) may be retarded by the action of alcohol. "The extent of the evil effects upon the human body re- sulting from the consumption of alcoholic liquors is as yet far from being fully known, and stands in need of scien- tific verification. Many other injurious influences such as unsanitary dwellings, bad feeding, excessive toil, and toxic agents like nicotine, etc., may produce somewhat similar mor- bid effects. It is therefore necessary, in the scientific study of the question, to take these possibilities into consideration. In my investigations, the results of which I am now to lay before you, I have endeavored to select as subjects for my experiments both abstainers from alcohol, and those who indulge more or less in its use, in such a way that their conditions of life and their habits in other respects should be as nearly as possible the same. All persons, for instance, suffering from any acute or chronic disease were rejected, and very few of the persons selected were smokers. The subject of this research has been human blood, and especi- ally its two principal components, namely, red blood-cor- puscles and blood-serum, both of which up to the present time have been very little studied in relation to the ques- ALCOHOL AS A MEDICINE. 39$ tion under discussion. I have gone into these matters chiefly because the modern theoretical study of immunity during the last few years has, in general, attracted greater attention to the blood, and shown the important role which the different parts, properties, and capacities of the blood play in defend- ing the organism against internal and external injurious agencies. Further, the subtle methods employed in the study of immunity (such as organic reactions, and reactions between greatly attenuated organic liquids) would also seem to be available for our purpose, as they allow of the detection of the minutest differences which alcohol may produce in any part of the organism in question. "During the course of this research, which has lasted over a period of three years, I sought to investigate the action of alcohol on the resistive power of human red blood-corpus- cles. I wished to ascertain whether the resistivity of the red blood-corpuscles in a healthy man could be lowered by the consumption of alcohol. * * * "It may be well for me here to explain that in this lec- ture I mean by the term 'drinker' a person who has taken alcohol in any quantity whatever. Many of these 'drinkers/ therefore, were in fact most moderate consumers of alcohol. By the term 'abstainer' I mean a person who has never taken alcohol in any quantity worth mentioning. In the course of my investigations I have examined blood from two hundred and twenty-three persons. They were of different classes and ages. There were professors of medicine and other physicians, University fellows, students of both sexes, hos- pital nurses, school-teachers, waiters, and other men and women belonging to the working-classes." The rest of the lecture as given here is an abstract made by Professor Laitinen: — "My studies have been directed to an investigation of the following points : "i. I sought to ascertain whether the resistance of human red blood-corpuscles against a heterogeneous normal serum, 396 ALCOHOL AS A MEDICINE. or an immune serum, can be diminished by the use of alcohol. "2. I have studied the action of alcohol in drinking and abstaining persons on the haemolytic power of blood-serum over heterogeneous red blood-corpuscles (rabbits). I have studied not only the hsemolytic power of the human blood- serum, but also its power of precipitation in the presence of rabbit-serum, with a view to ascertain if the reaction be- tween a known dilution of rabbit-serum and n certain dilu- tion of serum of alcohol-users and non-drinking persons is different or not, and if the reaction is more apparent with the former or with the latter. "3. The resisting power of serum obtained both from alco- hol-drinking and from non-drinking persons was further tested by human blood, with the object of discovering whether any difference in reaction existed between the same immune serum and the two kinds of human sera above mentioned. "4. I have studied the problem as to whether the haemolytic complement in the blood-serum of alcohol-drinking and non- drinking persons is altered in any way by alcohol. "5. The bactericidal power of blood-serum from both alco- hol-drinking and non-drinking persons was determined by some experiments. "The above experiments have given the following results : "i. The normal resistance of human red blood-corpuscles appears to be somewhat diminished against a heterogeneous normal serum or an immune serum by the consumption of alcohol, provided that tolerably large equal, or nearly equal, numbers of drinkers and abstainers of both sexes be exam- ined, and the average of resistance be taken on both sides : this last-named precaution being necessary because the re- sistance of red blood-corpuscles from different human beings varies largely. The difference is often greater when using weaker solutions than when using stronger dilutions of lysin. "2. These experiments have shown the normal haemolytic power of human blood-serum to be less in the case of alco- ALCOHOL AS A MEDICINE. 397 hol-drinkers than in that of abstainers. "3. The precipitating reaction between a solution of i per cent, human blood-serum and different dilutions of immune serum was greater in the case of drinkers than in that of abstainers. "4. These experiments have also shown that the bacterici- dal power of blood-serum against typhoid bacteria w^as less in the case of drinkers than in that of abstainers. "It seems clear, therefore, that alcohol, even in compara- tively small doses, exercises a prejudicial effect on the pro- tective mechanism of the human body." The lecturer made his points clear by a carefully prepared series of charts. At its close Sir Victor Horsley, Professor Sims Woodhead, A. Pearce Gould, and several other distinguished physicians spoke in high terms of the painstaking care exhibited in the experiments. Professor Laitinen's second lecture was upon "The Influence of Alcohol Upon Human Offspring." He sent out 15,000 circulars to his countrymen, asking many questions relative to themselves and their infant children, and received 5,845 replies relative to 20,008 children. He also studied personally a large number of drinking and abstaining families. From these stud- ies he shows by careful tables that the drinking of alcohol by parents, even in small quantities, has an injurious influence upon human offspring. His stud- ies in former years showed the same unfavorable influence upon the offspring of animals. One of his tables gives percentages of deaths of children in the homes of abstaining parents, moderate drinkers, and harder drinkers. Children of abstainers dying in the 39^ ALCOHOL AS A MEDICINE. first year, 13.45 per cent.; of moderates, 23.17 per cent. ; of harder drinkers, 32.02 per cent. Other tables show that abstainers' children gain in weight more steadily in the first year than drinkers' children, and have their teeth earlier, as a rule. At the International Medical Congress of 1909, held in Budapest, Professor Laitinen lectured again upon his researches, and summarized his conclusions thus : — "i. The importance of alcohol as an article of food is ren- dered very questionable by recent researches. 2. These re- searches prove that alcohol diminishes the natural power of the tissues to resist injury, promotes degeneration, and has a disastrous effect on future generations. 3. The questions of relation of alcoholic liquor to crime and of the manufacture and sale of such beverages deserve the serious consideration of the legislature. 4. It is the duty of medical men to direct more attention than formerly to the alcohol question, and by careful study to decide whether recent researches are justi- fied or not in regarding alcohol and alcoholic beverages as a poison and one of the principal causes of degeneration in the human family ; they ought also to consider whether it would not be advisable in medical practice, and especially in hospitals, either to banish it altogether or at least to pre- scribe it with the same care as other poisonous drugs. In this matter the attitude taken by medical men as representa- tives of public hygiene was of quite exceptional importance." Metchnikoff, the illustrious Russian scientist, who has for some years been connected with the Pasteur Institute in Paris, was the discoverer of the work assigned by nature to the white corpuscles of the blood. These blood-cells are the "guardian-cells" of the body, and their duty is to destroy disease germs which may gain an entrance. They actually devour ALCOHOL AS A MEDICINE. 399 disease germs. Metchnikoff has been studying the effect of alcohol upon these protective cells, and he asserts that alcohol, even in small doses, has a harm- ful action on these agents of defence against disease. Alcohol seems to paralyze them more or less so that they are unable to do their full duty in destroying the infective microbes. Thus disease germs can multiply more rapidly when alcohol is in the blood. In his book called "The New Hygiene," Metchnikoff sug- gests that the administration of alcoholic liquors in infectious disease appears to be attended with danger to the patient. The researches of Kraepelin, Ach, Aschaffenberg and other German scientists have become so well known through the articles by Henry Smith Williams in McClure's Magazine that only brief reference need be made to them here. Kraepelin used very small doses of alcohol for some of his experiments. He found that after ^ to ^ ounce of alcohol had been taken the time occupied in making response to a sig- nal was slightly shortened, but in a few minutes, in most cases, this quickening action passed and a slow- ing process began, and continued until the body was free from the influence of the alcohol, which was sometimes four or five hours. The ability to add figures was tested, and this de- creased very rapidly under minute doses of alcohol. Memory tests showed that only 60 figures could be remembered from numbers written in columns after alcohol had been taken, while 100 figures could be 400 ALCOHOL AS A MEDICINE. remembered correctly when the mind was free from the alcohoHc influence. Type-setters were tested, and the average number of errors they made and the amount of work they did in a given time was care- fully recorded. After a small dose of alcohol none of the men could in the same time do as much work, or as accurate work. Yet every one of the men experi- mented upon thought he was doing better work after his drink. This proves the narcotic effect of alcohol. The economic loss to a people from beer and wine drinking is worthy of serious consideration since a bottle of wine or its equivalent in beer could diminish by ten to fifteen per cent, the amount of work done by these type-setters experimented upon by Professor Aschaffenberg. Professor Kraepelin says : — "I must admit that my experiments, extending over more than ten years, have made me an opponent of alcohol." He says again : — "The laborer who wins his livelihood by the working power of his arm strikes at the very foundation of his power by the use of alcohol." Professor Aschaffenberg says of moderate doses : — "Any quantity of alcohol must be regarded as consider- able which causes a disturbance, even if only transitory, of bodily and mental efficiency." Dr. Reid Hunt, chief of the Division of Pharma- cology, Hygienic Laboratory, United States Public Health and Marine Hospital Service, made some very interesting experiments to determine the physiological changes upon animals which would result from the strictly moderate use of alcohol. These are described ALCOHOL AS A MEDICINE. 401 in Bulletin No. 33 of the Hygienic Laboratory, pub- lished in 1907. Mice and guinea-pigs were used. The food, usually oats, was soaked in diluted alcohol, at first of five per cent, strength, then gradually increased to forty or fifty per cent. By carefully observing the weight of the mice, and not increasing the strength of the alcohol too rapidly, it was possible to keep the animals for months on this diet without any material loss of weight. After the lapse of weeks, in some cases, and months in other cases, these alcohol fed ani- mals were given small doses of a poison known as acetonitrile. Other mice to whom no alcohol was fed were given similar doses of this poison. In the first series the mice which had received alcohol died from about one-half the quantity of acetonitrile required to kill those which had not received alcohol. In the sec- ond series with a somewhat stronger dilution the alco- hol mice succumbed to one-half to one-third the dose necessary to kill the non-alcoholized animals. In no case was enough alcohol given for any symptoms of intoxication to appear, nor was there any outward indication of any injury being done by the alcohol. In another experiment a mouse was kept for four months on a diet of oats soaked in water, then 0.5 milligram of acetonitrile per gram body weight was injected. The mouse recovered. It was then fed on oats soaked in an alcoholic solution which was gradually increased to 45 per cent. After a little more than a month of this diet 0.2 milligram acetonitrile per gram body weight proved fatal. The weight of the mouse had remained about the same throughout. 402 ALCOHOL AS A MEDICINE. Alcohol increased the susceptibility of the guinea pigs also. Dr. Hunt says on page 33 of the bulletin: — . "These experiments with alcohol and acetonitrile are of interest in another connection. The greatest advance in re- cent years in our knowledge of the physiological action of alcohol has been the clear demonstration that alcohol is oxi- dized in the body, and may replace fats and carbohydrates and to a certain extent, the proteids of an ordinary diet. So clear has been this demonstration that the view that alco- hol, in moderate amounts, should be regarded as a food is almost universally accepted by physiologists, and the drift of opinion is certainly toward the view that it is in all re- spects strictly analagous to sugar and fats, provided always that the amount used does not exceed that easily oxidized bv the body. Under these premises it would be expected that alcohol in a diet would have the same effect upon an ani- mal's susceptibility to acetonitrile as has dextrose, for ex- ample. This is by no means the case, however; on the con- trary, the action of these substances in this regard is en- tirely different. Mice fed upon oats soaked in a solution of dextrose or upon cakes containing considerable dextrose, or upon rice, show a very distinct increase in their resistance to acetonitrile ; such mice may recover from two or three times the dose fatal to controls. (Controls are the animals fed in the ordinary way without alcohol or in this case dextrose. — Ed.) While these facts are not sufficient to justify the con- clusion that in many cases alcohol has not a true food value, yet they are sufHcient to indicate caution in applying, with- out further consideration, the brilliant and very exact re- sults on the proteid sparing power of alcohol to practical dietaries." Various other experiments were made, but there is not room here for a record of them. ALCOHOL AS A MEDICINE. 403 In the summary Dr. Hunt says : — "It is believed that these experiments afford clear experi- mental evidence for the view that extremely moderate amounts of alcohol may cause distinct changes in certain physiological functions, and that these changes may, under certain circumstances, be injurious to the body. The results also afford further evidence that in some respects the action of alcohol as a food is different from that of carbohydrates, and finally that in all probability certain physiological proc- esses in 'moderate drinkers' are distinctly different from those in abstainers." Professor Chittenden, of Yale University, has made extensive researches upon alcohol and digestion. A full report of these may be found in the "Physiological Aspects of the Liquor Problem." In the Medical News, vol. 86, page 721, Professor Chittenden says of the theory that alcohol is a food similar to sugar and fats:— "It is, I think, quite plain that while alcohol in moderate amounts can be burned in the body, thus serving as food in the sense that it may be a source of energ}-, it is quite mis- leading to attempt a classification or even comparison of alcohol with carbohydrates and fats, since, unlike the latter, alcohol has a most disturbing effect upon the metabolism or oxidation of the purin compounds of our dail}- food. Alco- hol, therefore, presents a dangerous side wholly wanting in carbohydrates and fats. The latter are simply burned up to carbonic acid and water, or are transformed into glycogen and fat, but alcohol, though more easily oxidizable, is at all times liable to obstruct, in some measure at least, the oxi- dative processes of the liver, and probably of other tissues also, thereby throwing into the circulation bodies such as uric acid, which are inimical to health ; a fact which at once tends to draw a distinct line of demarcation between alcohol and the two non-nitrogeneous foods— fat and carbohydrate." 404 ALCOHOL AS A MEDICINE. Dr. S. P. Beebe, now of the Cornell Medical College Laboratory, New York City, has made some very valuable experiments with alcohol. It is well known that impairment of the functions of certain organs re- sults in the appearance in the urine of nitrogeneous compounds which do not normally occur there. In certain diseases of the liver the same quantity of nitrogen may be excreted as in health, but a portion of it is in the form of acids never found in the urine during health. Dr. Beebe, with this knowledge in mind, sought to discover the effects of alcohol upon the excretion of uric acid in man. Most of the experi- ments were made on the same person, a young man in good health, of regular habits, unaccustomed to the use of alcohol in any form. Absolute alcohol, diluted with water, whisky, ale, and port wine were used at different times. Dr. Beebe reported his experiments in the American Journal of Physiology, vol. 12, No. i. His conclusions are given as follows : — "After a consideration of these experiments, it hardly seems possible to doubt that alcohol, even in what is con- sidered by the most conservative as a moderate amount, causes an increase in the excretion of uric acid, and this effect is seen almost immediately after taking the alcohol. The following points indicate that the effect is due to a toxic effect on the liver, thereby interfering with the oxi- dation of the uric acid derived from its precursors in the food : Alcohol taken without food causes no increase. The maximum increase occurs at the same time after a meal as it does when purin food but no alcohol is taken. Alcohol is rapidly absorbed and passes at once to the liver, the organ which has most to do with the metabolism of proteid cleav- age products^ ALCOHOL AS A MEDICINE. 405 "There is no evidence that the alcohol has merely hastened the excretion of urates normally present in the blood ; the increased excretion means that a larger quantity has been in circulation, and although it is classed by Van Noorden among the substances easily excreted, still most physiologists would consider the presence in the blood of this larger quantity as undesirable. Certainly in pathological conditions it might be harmful. "If we accept the origin of the increased quantity of uric acid to be in the impaired oxidative powers of the liver, the results of these experiments will have greater significance than can be attributed to uric acid alone. For the impaired function would affect other processes which are normally accomplished by that organ, and the possibilities for en- trance into the general circulation of toxic substances, of intestinal putrefaction, for instance, would be increased. The liver performs a large number of oxidations and syntheses designed to keep toxic substances from reaching the body tissues, and if alcohol, in the moderate quantity which caused the increase in uric acid excretion, impairs its power in this respect, the prevalent ideas regarding the harmlessness of moderate drinking need revision." Dr. Winfield S. Hall, professor of physiology at the Northwestern University Medical School, Chicago, has interpreted these researches of Beebe and Hunt in a very striking way. He says that they prove that the oxidation of alcohol in the body is a protective oxida- tion, the same as the oxidation of any other poisonous substance by the liver. His views have such an im- portant bearing upon the commonly accepted theory that alcohol is in some sense a food that they are given here, somewhat abbreviated, as a fitting finish to this chapter. Dr. Hall says : — "The fact that alcohol is oxidized in the body has been generally misunderstood. The first impression naturally was: 406 ALCOHOL AS A MEDICINE. 'Foods are Oxidized; Alcohol is Oxidized; therefore alcohol is a food.' But many difficulties appeared. A real food pro- motes muscular, glandular and nerve activity, and its oxida- tion maintains body temperature. But alcohol disturbs mus- cular, glandular, and nervous activity, and its oxidation does not maintain body temperature. When one eats a real food it is assimilated largely by muscle tissue and is oxidized for the purpose of liberating the life energy. When one in- gests alcohol it is carried by the blood to the tissues, mostly to the liver, where it is oxidized, as any toxine would be, for the purpose of making it harmless. Its oxidation liber- ates heat energy but this energy cannot be utilized by the body even for the maintenance of body temperature. If a food is defined as a substance which, taken into the body, is assimilated and used either to build or repair body struc- ture, or to be oxidized in the tissues to liberate the energy used by the tissue in its normal activity, then alcohol is not a real food. "But, if alcohol is not a real food, what is the significance of its oxidation? It has been long known that the liver pro- duces oxidases and that it is the site of active oxidation of mid-products of katabolism of toxins and of other toxic substances. Alcohol, usually formed as an excretion of the yeast plant, is also found as a mid-product of tissue katabo- lism. On a priori grounds we should expect alcohol to be oxidized in the liver along with leucin, tyrosin, uric acid, xanthin bodies, and various amido bodies. There have re- cently appeared two most important papers based upon ex- tended researches upon man and lower animals. These researches practically clear up this knotty question." Dr. Hall then reviews the work of Dr. Reid Hunt and Dr. S. P. Beebe, and continues : — "The value of this work can hardly be over-estimated. In the first place the rapid oxidation of the alcohol in the liver is explained. Alcohol itself being one of the toxic sub- stances which reach the liver from the alimentary canal is at once attacked by the liver, and if the oncoming tide of ALCOHOL AS A MEDICINE. 407 alcohol is not too great it will practically all be oxidised. "But the liver oxidation of other toxic substances is im- paired in the meantime so that they get past the liver to the tissues, where they may do injury. Some of these toxins are excreted unoxidized by the kidneys. There are three ways of accounting for this condition: (i.) The oxidation capac- ity of the liver is limited. The physiological limit of alcohol ingestion is that amount which taxes the oxidation capacity of the liver to its limit. When thus taxed all other toxic substances including uric acid and the xanthin bodies pass through the liver unoxidized to appear in the urine. (2.) The presence of alcohol in the blood, through its toxic action upon the liver cells, impairs the hepatic oxidation capacity and thus permits toxic substances to pass unoxidized. (3.) A combination of these conditions may represent the real situa- tion. It is hardly conceivable that the relation of alcohol to the liver activity is not covered in the hypotheses above formulated. "We may therefore accept it as practically demonstrated by the researches of Beebe, Hunt, and others that the oxida- tion of alcohol in the liver is simply one of the defensive activities of that organ, /. e., it is a pfotective oxidation and belongs strictly in the same category with the oxidation of uric acid, xanthin bodies, 'leucin, tyrosins, and the amido acids. "The next question which arises is, why does the liver select alcohol first and oxidize that substance to the ex- clusion of other toxic substances up to the oxidation capac- ity? The answer is probably to be found in the chemical composition of alcohol. "It oxidizes very easily, much more so than any of the other toxic substances which gain access to the liver. Its early oxidation may be due to this fact alone, or in part to an actual selection on the part of the liver. Another question of importance : Is the energy liberated in the oxidation of alcohol in the liver available for the use of the muscles, nervous system, or glands? 4o8 ALCOHOL AS A MEDICINE. "If this question is answered affirmatively, then alcohol is a food. If negatively then alcohol is not a food. Let us reason together. All body oxidations may be classified in two groups: (i.) Active oxidations which take place in the active tissues — muscles, nervous system, or glands — and take place incident to action. It is under the perfect control of the nerv- ous system and is proportional to normal activity, (2,) Pro- tective oxidations which take place in the liver. This class of oxidation processes is wholly independent of the usual tissue activity and is proportional to the ingestion of toxic substances and quite independent of muscle action, brain action, or gland action, other than liver action. "If the oxidation of alcohol in the liver belongs to class i, the following consequences should be found: (i,) The in- gestion of alcohol would lead to an increase in muscular power and in the working capacity of the brain or glands. (2.) The ingestion of alcohol would serve to maintain body tempera- ture in the healthy individual subjected to low external tem- perature, (3,) The accession of muscle, brain, or gland activ- ity would be proportional to the amount of alcohol ingested, but laboratory observations and general experience show that none of these things are true ; i. e., the ingestion of alcohol decreases muscle, brain, and gland work, and depresses body temperature when external temperature is low. "In the nature of the case there can be no proportional rela- tion. The oxidation of alcohol does not therefore belong to class I. If the oxidation of alcohol in the liver belongs to class 2, the following consequences would be found: (i.) The ingestion of alcohol would be followed by its early oxidation in the organs in question. (2.) If the oxidation capacity of the liver is limited this capacity may be overloaded by ex- ceeding the physiological limit of alcohol. (3.) If the oxida- tion capacity of the liver is taxed nearly to its limit in the oxidation of uric acid, xanthins, and other toxic substances, the introduction of alcohol may seriously interfere with this protective oxidation by overtaxing the capacity. (4.) If the oxidation capacity is overtaxed, an excess of uric acid, xan- ALCOHOL AS A MEDICINE. 409 thin bodies, and other toxic substances will get by this portal and reach the active tissues or the kidneys. Now all of these things take place, so we are forced to the conclusion that the oxidation of alcohol is a protective oxidation. In the light of this presentation the significance of Dr. Hunt's work becomes very clear. The alcohol given to the animals taxed the oxida- tion capacity of the liver to the limit and left the organism defenseless against bacterial or other toxic substances." CHAPTER XVII. MISCELLANEOUS. Alcohol Baths : — The action of alcohol upon the sur- face of the body is that of a refrigerant. Alcohol baths for debility, weakness, and states of exhaustion are opposed by non-alcoholic physicians. The old custom of bathing a new- born babe with whisky was simply a superstition, and a dangerous one, because the infant should not have a re- frigerant applied to its body so soon after leaving the warm nest where it had been sheltered so long. Warm water is the proper liquid for a baby's bath until it becomes hardy. There is nothing of strength imparted by an alcohol rub ; the 'rub' is good, but vinegar, or water, or olive oil can be used according to what is desired. Alcohol is not neces- sary internally nor externall3^ Its proper use is for me- chanical purposes and to give light and heat. WiLHELMINA LEMONADE : — Take four or five rough-skinned oranges (according to size) and two pounds of sugar, in big lumps. After having cleaned the oranges, rub the sugar with them, till the oranges are quite white — the sugar yellow. Place the sugar in a big earthernware pan or jar, and add three pints of cold wdit^r. Then cover it up and let it stand two days, stirring it occasionally to help the melting. Now take two ounces of citric acid, dis- solved in a little boiling water, and add it to the syrup, stirring the whole. Then strain the whole 410 ALCOHOL AS A MEDICINE. 4I I through a fine sieve, covered with muslin, so that it becomes perfectly clear. In well-corked bottles it will keep for more than a year. Mix one-third of the lemonade with two-thirds water. [Instead of the oranges five or six lemons may be used.] Beverages for the Sick: — Unfermented grape juice. Hot milk. Egg cream, made as follows: Beat the white and yolk separately, add milk and sugar, and stir well, flavor to suit taste. Egg lemon- ade — beat yolk and sugar thoroughly, add lemon and water, shake well, then add white, beaten stiff. Barley water, made by boiling pearl barley five or six hours, and straining the water from it ; add milk or cream if wished. These are used in the National Temperance Hospital of Chicago. Baths : — " If all people understood the value of water to cool, cleanse, invigorate and sustain life, and how to use it, and would use it, one-half of all the afHictions from disease would be removed ; and the other half might be banished if all the people understood how and what to eat, how to breathe, and the ne- cessity of daily vigorous exercise. A daily towel bath will do more to counteract disease, and restore the body to its normal health condition, than any other method or remedy yet discov- ered. After the bath, the body should be thoroughly rubbed with a crash or Turkish towel. Rub until a warm glow is pro- duced. This bath is a fine tonic if taken upon rising in the morning." Hot Water as a Medicine : — " One is never," says a physician, ''far from a pretty good medicine chest with hot water at hand. It is a most useful assistant to the mother of a family of small children, who is frightened often to find herself confronted by a sudden illness of one of her flock, without her 412 ALCOHOL AS A MEDICINE. usual dependence — the family doctor. If the baby has croup ^ fold a strip of flannel or a soft napkin lengthwise, dip into very hot water, and apply to the child's throat. Repeat and con- tinue the application till relief is had, which will be almost at once. For toothache, or colic, or a threatened lung congestion, the hot-water treatment will be found promptly efficacious if resorted to. Nature needs only a little assistance at the first sign of trouble to rally quickly in the average healthy child, and often hot water is all that is wanted." Alcohol Injurious to the Insane: — Dr. Richard Maurice Bucke, wliose valuable paper on '' The Evolution of the Mind " appeared in the De- cember number of t\i^ Journal of Hygiene, in a recent report of the Asylum for the Insane in London, Canada, makes the following statement concerning the use of alcohol in the institution over which he presides : — " As we have given up the use of alcohol, we have needed and used less opium and chloral ; and as we have discontinued the use of alcohol, opium and chloral, we have needed and used less seclusion and restraint. I have, during the year just closed, carefully watched the effect of the alcohol given, and the progress of cases where, in former years, it would have been given, and I am morally certain that the alcohol used during the past year did no good. With humiliation I am forced to admit that in the recent past my noble profession has been to an alarming extent, and is still too much so, guilty of producing many drunkards in the land, directly or indirectly, by the reckless and wholesale manner in which so many of its members have prescribed alcoholic stimulants in their daily practice for all the aches and pains, coughs and colds, inflam- mations and consumptions, fevers and chills, at the hour of birth and at the time of death, and all intermediate points of ALCOHOL AS A MEDICINE. 413 life, to induce sleep and to promote wakefulness, and for all real or imaginary ills." Tobacco and the Eyesight : — " Prof. Craddock says that tobacco has a bad effect upon the sight, and a distinct dis- ease of the eye is attributed to its immoderate use. Many cases in which complete loss of sight has occurred, and which were formerly regarded as hopeless, are now known to be cura- ble by making the patient abstain from tobacco. These pa- tients almost invariably at first have color blindness, taking red to be brown or black, and green to be light blue or orange. In nearly every case, the pupils are much contracted, in some cases to such an extent that the patient is unable to move about without assistance. One such man admitted that he had usually smoked from twenty to thirty cigars a day. He con- sented to give up smoking altogether, and his sight was fully restored in three and a half months. It has been found that chewing is much worse than smoking in its effects upon the eyesight, probably for the simple reason that more of the poison is thereby absorbed. The condition found in the eye in the early stages is that of extreme congestion only ; but this, unless remedied at once, leads to gradually increasing disease of the optic nerve, and then, of course, blindness is absolute and beyond remedy. It is, therefore, evident that, to be of any value, the treatment of disease of the eye due to excessive smoking must be immediate, or it will probably be useless." — Journal of Inebriety. *' Dr. Isaac Fellows was for many years a prominent phy- sician in Los Angeles. A temperance man, he was persuaded by an old physician whom he loved to try for a year substituting alcohol in drop doses in water for such patients as demanded alcoholic stimulants. He was delighted with the result. When his patients found they could not have wine, beer or brandy under the guise of medicine, but must take it in drop doses in water, as they did their other medicines, they speedily learned to do without ' a stimulant.' " — Pacific Efisign. 414 ALCOHOL AS A MEDICINE. ADVERTISED "CURES" FOR DRUNKENNESS. ''Poudre Coza, an English product, is sold at $3.00 for thirty powders. On analysis these powders were found to con- tain an impure form of sodium bicarbonate, together with a little aromatic vegetable matter. Gloria Tonic was exam- ined by the Massachusetts Board of Health, and found to consist of sugar of milk and cornstarch, with a small quan- tity of ground leaves resembling those of senna. White Ribbon Remedy was found to be made of milk sugar and ammonium chloride. Of course such things are clearly frauds, as they can have no power to destro}' a craving for liquor. The Infallible Drink Cure was 98 per cent, sugar and 2 per cent, common table salt. Another 'cure' was made of chlorate of potash and sugar. Cases of poisoning by chlorate of potash are on record. Another 'cure' contained tartar emetic, a dangerous poison. Most of tlie liquid 'cures' for drunkenness sold prior to the passage of the National Pure Food Law contained large quantities of cheap alcohol. It is safe to say that practically all of the secret cures for drunkenness are fraudulent, and some are dangerous. "If a man wants to quit drinking, he can be helped by a proper diet, and by frequent use of the Turkish bath, or even of the ordinary hot bath at home, with a quick cold sponge or shower bath each morning as a tonic. The hot bath is to draw out impurities from the system. The diet should consist of plenty of fruit, nuts, grains and vegeta- bles. It is better to eat no meat. It has been fully demon- strated in Lady Henry Somerset's work with women drunk- ards that a vegetarian diet is a great help in allaying the alcohol crave. The Salvation Army, in England, have also found by experience that a meat- free diet is a great aid in overcoming the drink habit. "Dr. T. D. Crothers, who has for years conducted a large sanitarium for the cure of inebriety, at Hartford, Connecti- cut, says that a valuable remedy to break up the impulsive craze for spirits is a strong infusion of quassia given in two- ALCOHOL AS A MEDICINE. 415 ounce doses every hour. As desire for liquor abates the quassia can be given less frequently, until it is no longer needed. "Dr. Alexander Lambert, of Bellevue Hospital, New York, has been treating drunkards and other drug habitues success- fully of late. A description of his treatment may be found in Success for November, 1909." Medical Puffs of Whisky and Other Alcoholics : — " Every medical man knows how he is pestered with advertis- ing circulars of so-and-so's genuine whisky, and what-do-you- call-em's extra stout, to say nothing of the tempting offers of wines and spirits on sale with special discounts to medical men. Other enterprising firms send samples or offer to send them with the implied understanding that a testimonial is to be given, or that at least the wares in question will be recommended to patients. Even our medical papers have not always been in- corruptible. We have little expectation ourselves of being fav- ored with an offer of full-page advertisements of extraordinary wines and spirits. We are not prepared to recommend them except as vermin killers. Nor are we prepared to remain silent as to their alleged virtues. The whole system of testimonials is a huge imposture. Granted that the sample is all that it is described as being, who can guarantee that what is served to the public in the face of severe competition will be up to the sample ? "But there is another and a sadder view of the case. We cannot believe that all the eulogies of all the medical trumpeters of the wines and the spirits are wilfully false or even exagger- ated. It is a lamentable fact that a vast number of doctors have a genuine faith in the value and virtue of these pernicious drinks. It is not simply a question of medicinal use, though even on that we should join issue. These things are vaunted as valuable for the promotion of health in spite of all the accu- mulating evidence to the contrary. We wish that these doctors would carefully study this evidence. The pity of it is that the 4l6 ALCOHOL AS A MEDICINE. very worst offenders are the least likely to study it. We sup- pose they must die out, and be replaced by men less prejudiced and bound by the chain of alcoholic habit. We can only re- gret that they should be doing so much harm in fastening the fetters of drink on other people, and hindering their emancipa- tion from, the evil customs which play havoc amongst us." — Medical Pio7iee7'. Alcohol AND Children :— " Parents often labor under the delusion that alcoholic drinks are good for children and act as tonics. Mothers will put drops of brandy into the milk with which their children are fed, increasing the quantity with the age of the recipient. In the illness of children the same is given to meet disturbances of the stomach or to increase growth and development, without taking the advice of any medical man as to the wisdom of the practice. This is all erroneous. The excitement of the central nervous system under alcohol, excite- ment which seems to be a relief to weariness and to give strength, is nothing more than temporary at best, and injurious, causing in fact symptoms of alcoholic poisoning, abnormal ex- citement, ending, in extreme cases, in convulsions succeeded by exhaustion of body and mind, and inducing a kind of paralysis. Many cases of stomach and gastric catarrh in children followed by emaciation and debility are due to the early administration of alcoholic drinks ; and impediment of growth from the same cause is thereby produced. The most serious derangement is that of the nervous system, and the development in the young, under the influence of alcohol, of what is known as nervous- ness, to which is added the moral paralysis with which the habit of alcoholic drinking smites its victims in the very spring- time of life." — Prof. Demme, of Berne, Switzerland. " The action of the New York Board of Health, in recom- mending to tenement house parents, that on the hottest days of summer a few drops of whisky be added to the water or food of their infants, has received a strong protest and rebuke in a meeting at Prohibition Park, where the opinions of eminent ALCOHOL AS A MEDICINE. 41/ physicians, collected by the Voice, were read, condemning such a course. A resolution of protest was also adopted," — Sel. " For nineteen years we lived with a physician whose success may be estimated from this one item : He had between i,6oo and 1,700 labor cases, and never once lost the mother, and only twice the child, and what seems still more remarkable never used instruments. When other physicians, as often happened, would come to him to know how he did it, he always answered, ' A woman will do anything if you only encourage her.' Nor was obstetrics his specialty — he had none. " In a fifteen years' practice in Chicago and New York, where these diseases are so very fatal, and he was much sought after to treat them, he did not lose a case of scarlet fever, diphtheria or cholera infantum which he managed himself, and saved many a one where he was called in consultation, or after some other physician. Now when such a man after an experience more than fifty years long and as wide as the continent, gives it as his unqualified opinion that wines, beers, liquors of every kind, alcohol itself, are not medicines and should never be used as such, for scientific reasons, not to mention moral, is not his opinion entitled to a hearing ? Isn't it probable it weighs more than the doctor's you were just quoting ? Is it too great a risk to act upon it ? " — Pacific Ensigii. " A lady. Airs. A., tenderly nurtured, refined, cultured, mov- ing in an influential position, belonged to a family in whom the tendency to intemperance existed. Realizing the danger, she, for seven years of her married life, adhered to total abstinence. Illness came, and the doctor ordered wine ; and her husband, deaf to her arguments, insisted on her taking it. She fell into habits of intemperance. Her husband died, and for a time she pulled up and trained as a hospital nurse ; but temptation pre- vailed, and she fell from bad to worse. Loving hands received her time after time, and at last placed her in an Inebriate Home. For a short time she did well, but soon became un- manageable. After another desperate period she entered 4 4l8 ALCOHOL AS A MEDICINE. second home, but after leaving she yielded again, was twice in prison, and fell into the lowest degradation and utter ruin, surely deserving our deepest pity. Her doctor and her husband had persisted in working her fall in spite of her own strongest convictions." — Selected. They did not Die. — " Dr. Lord of Pasadena suffered from rheumatism of the heart for more than half of a long Hfe- time. No doctor ever felt his pulse (which intermitted) with- (lut exclaiming, ' Why, doctor, you have no business to be alive with such a pulse,' — or something similar. For nineteen years his wife never retired without having at least one medicine she could put her hand on in the dark, the ammonia bottle within reach, the electric battery ready to start like a fire-engine, and preparations for heating water in less than no time. His acute attacks usually came in the night— an uninterrupted night's sleep was something unknown to either the doctor or his wife in all these years. " They lived in sight of an open grave, and seldom a week passed when it did not seem as if death had actually occurred. If ever a case called for alcoholic stimulants this one did. But none were ever administered, none were ever kept in the house. The doctor's standing orders were : ' If all the doc- tors in the country order you to give me liquor, and say my life depends upon it, don't do it. Tell them I know more about it than they do. It won't save my hfe ; it will only lessen what httle chance I have.' All who knew about this case, and hun- dreds did, were driven to the conclusion that if these two peo- ple, one in this condition and the other feeble, could live all alone as thev did, miles from a doctor, and neighbors not near, and could get along without alcoholics of any kind, everybody can do the same everywhere. And the doctor finally wore out his heai^t trouble and died of another disease."— Pa^;;?^ Ensign. An English weekly journal is responsible for the following anecdote : — ALCOHOL AS A MEDICINE. 419 " A Birmingham physician has had an amusing experience. The other day a somewhat distracted mother brought her daughter to see him. The girl was suffering from what is known among people as ' general lowness.' There was nothing much the matter with her, but she was pale and listless and did not care about eating or doing anything. The doctor, after due consultation, prescribed for her a glass of claret three times a day with her meals. The mother was somewhat deaf, but apparently heard all he said and bore off her daughter, de- termined to carry out the prescription to the very letter. In ten days' time they were back again, and the girl looked a different creature. She was rosy-cheeked, smiling and the picture of health. The doctor congratulated himself on his diagnosis of the easel ' I am glad to see that your daughter is so much better,' he said. ' Yes/ exclaimed the excited and grateful mother. ' Thanks to you, doctor ! She has had just w^hat you ordered. She has eaten carrots three times a day since we were here, and sometimes oftener — and once or twice uncooked — and now look at her ! ' " The Rest Cure : — " After all, the veneer of civilization is quite thin. Scratch most people, and very near the surface you come on the savage. This is specially true when they are sick. They at once want charms and miracles to restore them to health, and come to the doctor — or ' medicine man,' as they look upon him — with this demand : ' I want something, doctor, to fix me up.' But he, unhappy man, has not w^herewith to satisfy them, unless he is a quack. " He knows that in most cases all he can do is to give advice as to how best Nature may be allowed to effect a cure ; for Na- ture is the great physician, and the doctor's main duty is to stand by and see that she gets fair play. Nature's chief cure, in a large number of the diseases to which flesh is heir, is rest. The tired man needs rest. The tired brain, the tired stomach, the tired liver and kidnevs, need the same rest. 420 ALCOHOL AS A MEDICINE. " So, when the patient turns up with an overworked and ex- hausted organ of some sort within him — be it what it may — heart, brain or stomach — the true physician prescribes, first and chiefly, not drugs, but rest. " Now, this is generally the advice the patient doesn't want. His desire is for a bottle of something, no matter how nasty it may be, which shall ' fix him up,' and let him go on doing what he has been doing previously. Common-sense is always at a discount, and never more so than in this case. The tired brain- worker doesn't want to stop. Give him something to whip up his brain and his body, something to drive the spurs into them. • What I want,' he says, ' is a really strong tonic ' ; though, if he knew that before, what was the use of coming to the doctor ? Or he would hke to be told to take a glass of whisky-and- water when he is tired, which is the maddest and most disas- trous advice that could be given. " The man who has been ill-treating his stomach, eating too much or too well, also demands a tonic — something to give him an appetite so that he may eat more. And his poor over- wrought stomach is all the time crying out for rest. " So it is all along the fine. The possessor of an inflamed and swollen knee prays for a liniment to rub into it which will cure it straight away, and is highly disgusted when told that he will have to lie up for a week or two. " Again, for the tired stomach the cure is starvation. Let the person live on his own fat, and a little milk-and-water for a few days, and his stomach will take courage again and return to work with renewed zest. But it is the most difficult thing in the world to persuade the patient or his kind relatives of the truth of this. There are many diseases in which, for a short time at least, the less food the sick person has the better. But the relatives are always much wiser than the doctor. They in- sist ' that the strength must be kept up,' and would like to force the patient to eat more than he does when well. ' You will let ALCOHOL AS A MEDICINE. 42 1 his strength down, doctor,' is a common complaint, and one of the difficulties hospital authorities have to face is to prevent kind friends from smuggling in food to the inmates, who, in their opinion, are being brutally starved. " I myself have cured people by making them rest — lie in bed and starve. But the next time they were sick, I wasn't the doctor. — " Physician " in Our Federation. " The blessings of sunlight and fresh air should be more ap- preciated. The sun is the godfather of us all. The source of all light, heat, electricity and energy, what wonder that it was once worshipped as the Creator. The future will recognize it not only as the best disinfectant, an all powerful preventive of disease, but also as a wonderful healer of disease. The more people can be taught to live in pure air out of doors, and bask in the rays of the sun, the less of disease there will be to pre- vent." — Dr. C. H. Shepard, Brooklyn, N. Y. ALCOHOL TESTED. " Some years ago Dr. Beddoes, a physician of eminence, was very anxious to put to the test the disputed question as to the power of alcoholic liquors to give strength to the system. He discovered that those who had most calls upon their physical endurance were the smiths who were engaged in forging ship's anchors, for at one moment they would be exposed to a heat so fierce that one marveled that any human organization could en- dure exposure to it, and then their work would call them away to a temperature that was chilly and cold, added to which all the time their work lasted they were bathed in a profuse per- spiration, the demands upon their physical energy were so great. To counteract this perpetual drain upon their system they were in the habit of drinking unlimited quantities of beer, which their masters provided for them as a matter of course, and a sine qua non. One day, as they were resting from their work at midday, Dr. Beddoes made his appearance amongst some of these men who were employed in a certain foundry. 422 ALCOHOL AS A MEDICINE. and submitted a formal proposition to theai, to this effect, that twelve of their number, the strongest and stanchest, should be selected for an experiment, and they should work for a week, six of them drinking only water, and the other six taking their beer as usual. His proposition was laughed to scorn. The m.en would not hear of it. ' Look here, mate,' said their spokesman, ' do you want us to be all dead men ; you don't know what our work is, and how it takes all a man's strength to weld an anchor. Why, if we did not have our beer and plenty of it, it would be all up with us in a brace of shakes.' " The doctor said : ' I should be very sorry for any harm to come to you. You know I am a doctor, and I will be con- stantly at hand to see if any of you are going wrong, and I promise that if I see any of you breaking down I will at once stop my experiment.' And then taking out of his pocket ten crisp five-pound notes, he displayed them to the anchor smiths. ' I will put down these notes, ^50 in all ; six of you shall try water for one week honestly and fairly ; if you pull through without giving in, the £s^ shall be yours ; if not, I'll take the £^0 back again. Is it a bargain } ' " This clenched the matter, and very soon the doctor's offer was accepted, and a gang of six men volunteered to begin their work on the Monday without beer. The beer drinkers did their best to chaff the water drinkers, and aggravated them by taking good care to show them how very nice it was to have recourse to unlimited beer. The water drinkers kept firm, and the first day, to their astonishment, found that they could do just as much work as the rest of their mates. On Tuesday the water drinkers began to crow over the beer drinkers, for they found that, while the latter complained and grumbled at the heat, they were enabled to take the work in a philosophical kind' of way. Wednesday, Thursday and Friday wore away, and the teetotal band became more and more triumphant, the laugh was all on their side, for not only did they feel more comfortable than their beer-loving companions, but the ^50 ALCOHOL AS A MEDICINE. 423 camt, nearer and nearer, and at last, on Saturday, when the time for finishing work came, they threw down their tools and their hammers, and crowded up to the doctor to claim the prize, and to give a faithful record of their experiences ; and one and all declared that they had done their hard work with more ease and comfort to themselves than ever it had been done before, and, instead of feeling tired and jaded, as they often did on the Saturday afternoon, they were quite ready to begin work again, and if the doctor had another ^50 to dispose of, they would most gladly give him a chance of protracting his experiment for another week. The doctor expressed himseJi perfectly satisfied with the trial which had already taken place, and left the place amidst three hearty cheers, while the men proceeded to discuss the ins and outs of the matter among themselves." — National Advocate. BEER-DRINKING INJURES HEALTH. "I think there is no doubt that beer-drinking is deleterious to health, and personally I have never seen any case of dis- ease where I thought it useful. I believe it is more dele- terious to health than the stronger spirits, and this opinion is derived from the report of the actuaries' investigations for our insurance companies a few years ago." — Dr. John M. DoDSON, Dean of the Medical Department of the University of Chicago. "My connection with large medical institutions for many years past has given me, I think, an excellent opportunity to observe the effect of beer-drinking and the use of other alcoholic liquors in many cases. I can say as a result of my own observation that heer-drinking has a very pernicious effect upon nearly every organ of the body. It produces disease of the stomach and digestive tract, of the heart and circulating system, of the kidneys and liver, and of the nerv- ous system. In addition to this it lessens the vigor and vital resistance of the whole body, makes the beer drinker very much more susceptible to infection such as pneumonia, and other acute infections, and also lessens his ability to 424 ALCOHOL AS A MEDICINE. recover from illnesses of any kind. An untold amount of misery and disease would be avoided if the use of beer and other intoxicating liquors could be wiped off the face of the earth." — Dr. W. H. Riley, Battle Creek Sanitarium, Battle Creek, Mich. In the report of Bellevue Hospital, New York City, for 1904, Dr. Alexander Lambert, in speaking of delirium trem- ens, says : "The delirium tremens from beer does not come on so readily as that from whisky, but is slower in clearing up." Page 138 of report. 'Apart from its toxic effect it is seldom realized how harmful beer may be by promoting obesity, and, in suscepti- ble persons, favoring dilatation of the stomach." — Dr. E. P. JosLiN, Professor in Harvard IMedical School. "It is not the concentrated alcoholic liquors alone that cause heart and kidney trouble but pre-em.inentl}' the continued im- moderate use of beer. Nothing is more false than the be- lief that the progressive dislodgement of other alcoholic drinks by beer will diminish the destructive influences of alcoholism. * * * It has been conclusively established by thousandfold experiments that soldiers in all climates, in heat, cold and rain, endure best the most fatiguing marches when they are absolutely deprived of alcoholic drinks." — Prof. G. Von Bunge, M. D., Basle, Switzerland. "Beer, wine and spirits furnish no element capable of entering into the composition of blood, muscular fibre, or anything which is the seat of vital principle. If a man drinks daily 8 or 10 quarts of the best Bavarian beer in a year he will have taken into his system as much nourishment as is contained in a five-pound loaf of bread.'' — Liehig, the great German chemist. "Beer-drinker's heart is a term well-known to the physi- cians of our large hospitals, and indicates a special condi- tion of unhealthy enlargement of the heart due to dilatation, accompanied by some increase of tissue and of fat. Doctors Bauer and Bollinger found that in ]\Iunich one in everj^ six- teen of the hospital patients died from this disorder. It is ALCOHOL AS A MEDICINE. 425 common in Germany — the land of beer-drinking — and proves incontestably that the habit of drinking even such a mild alcoholic beverage as lager-beer is one that is undesirable and unwise." — From "Alcohol and the Human Body," by Sir Victor Horsley, M. D., London. "Nothing is more erroneous from the physician's stand- point, than to think of diminishing the destructive effects of alcoholism by substituting beer for other alcoholic drinks, or that the victims of drink are found only in those countries where whisky helps the people of a low grade of culture to forget their poverty and misery."' — Prof. Strumpel, Breslau, Germany. "The result of extolling beer as the mightiest enemy of whisk}- and brandy has been that the consumption of the distilled liquors has changed ver\^ little, while to these liq- uors has been added beer, the use of which has led to a great and still increasing beer alcoholism. * * * "The beer drinker who is not at all a drunkard in the popular sense, is very frequently the victim of chronic in- flammation of the kidneys. * * * An enlarged and fatty condition of the liver, marked by a dull pain in the region of the organ, often follows from the habitual use of beer. The death-rate from liver diseases among brewers of beer in England is more than double that in all other occupa- tions. * * * Beer-drinkers have a marked tendency to en- largement of the stomach, and to chronic diarrhoea. Beer causes also inflammation of the nerves. This is often an- nounced by 'rheumatic' pains in the legs. * * * Beer alco- holism, as well as alcoholism in general, lowers the resist- ance of the body to all diseases by injuring most of the organs. And herein lies the chief danger in the general wide- spread use of beer. The drinker is especially open to at- tacks of infectious disease. * * * The brutalizing effect of beer-alcoholism is shown most clearly by the fact that in Ger- many crimes of personal violence, particularly dangerous bodily injuries, occur most frequently in Bavaria where there 426 ALCOHOL AS A MEDICINE. is the highest consumption of beer." — Dr. Hugo Hoppe, Nerve Specialist, Konigsberg, Germany. "The life insurance companies make a business of estimat- ing men's lives, and can only make money by making cor- rect estimates of whatever influences life. Now they expect a man otherwise healthy, who is addicted to beer-drink- ing, will have his life shortened from 40 to 60 per cent. For instance if he is twenty years old and does not drink beer he may reasonably expect to live until he is 61. If he is a beer-drinker he will probably not live to be over 35. If he is 30 years old when he begins to drink beer he will probably drop off somewhere between 40 and 45 instead of living to 64 as he should. There is no sentiment, prejudice or assertion about these figures. They are simply cold- blooded business facts, derived from experience, and the companies invest their money on them just the same as a man pays so many dollars for so many feet of ground or bushels of wheat."— Dr. S. S. Thorn, Toledo, Ohio, in U. S. Senate Document, published in 1901. "Fatty degeneration of various organs is frequently wit- nessed in beer-drinkers. Diabetes mellitus is frequently due to beer-drinking, and is made much worse by its continuance. In Germany more than half of the cases in the inebriate asylums enter from beer-drinking. In Bavaria, the women are not able properly to suckle their children because of the universal consumption of their favorite national drink. In- deed, so grave are the evils caused by beer-drinking that the fight against beer should now be conducted as strenu- ously as that against stronger liquors." — Dr. Legrain, Paris, France. DRUG DRINKS. In the report of the President's Homes Commis- sion, Senate Document 644, may be found a list of soft drinks examined by the Bureau of Chemistry. The report says : — ALCOHOL AS A MEDICINE. 427 "Attention is directed to the danger of soft drinks contain- ing caffeine, and extract of coca leaf, the active principle of the latter being cocaine. * * * We have seen how the opium habit may be acquired by the use of the various proprietary or secret preparations, and so the cocaine habit may be devel- oped by the use of these much lauded soft drinks. * * * No wonder that insanity and diseases of the nervous system are on the increase." The following is a list of drinks examined by the Bureau of Chemistry. Investigation showed that these contained both caffeine and extract of coca leaf : Afri Cola, Ala Cola, Cafe Coca, Carre Cola, Celery Cola, Chan Ola, Chera Cola, Coca Beta, Coca Cola, Pilsbury's Coke, Cola Coke, Cream Cola, Dope, Four Kola, Hayo Kola, Heck's Cola, Kaye Ola, Koca Nola, Koke, Kola Ade, Kola Kola, Kola Phos, Koloko, Kos Kola, Lime Cola, Lima Ola, Mellow Nip, Nerv Ola, Revive Ola, Rocola, Rye Ola, Standard Cola, Toka Tona, Tokola, Vim-0. French Wine of Coca, Wise Ola. The manufacturers of some of those listed claim that their coca extract is prepared from a decocainized coca leaf, the refuse product discarded in the manufacture of cocaine. The Coca Cola compan}- claims that their coca extract is now with- out cocaine, and most of the recent analyses show this to be true, yet the Pure Food Commissioner of North Dakota says in his report for 1907 that Coca Cola as examined by him, "Gave a reaction for cocaine." It is easy to see that so long as even refuse coca leaves are used some cocaine may at times be in the product. As cocaine is the most destructive drug known to humxan- ity its presence in any of the so-called temperance drinks is a frightful evil calling for speedy legislation. It is practically impossible to cure a person of the cocaine habit. This drug causes insomnia, dyspepsia, chronic palpitations, and complete paralysis of - will-power, with a tendency to criminal acts. W^hen a person becomes habituated to its use he suffers tor- ments when not under its influence. The real cocaine fiend will rob or kill to get the drug. What can be thought of men. 428 ^ ALCOHOL AS A MEDICINE. who knowing the deadly nature of this drug, will hide it away in a drink sold as harmless to children and women who would never touch beer or wines? It is placed in the drink to form a craving for that drink and thus create a demand that will enrich the conscienceless manufacturers. The following preparations were found to contain cafifeine, but there was no evidence to the effect that coca leaf in any form had been used in their manufacture : Calcycine, Celery Cocoa, Citro Cola, Deep Rock Ginger Ale, Fosko, Heck's Star Pepsin, Koke, Koke Ola, Kalafra, Kum- fort, Lime Juice and Kola, Lon Kola, Meg-0, Mexicola, Pau Pau Cola, Pedro, Pepsi Cola, Speed Ball, To-Ko, Vril. The report says that the following list were not examined but from their names, and from the evidence submitted, they contain either caffeine or coca leaf extract, or both : Char- cola, Cherry Kola, Cola Soda, Cola Ginger, Field's Coca, Im- ported French Cola, Jacob's Kola, Koko Ale, Kola Cream, Kola Pepsin Celery Wine Tonic, Kola Vena, Loco Kola, Mintola, Mate, Pikmeup, Ro-Cola, Schelhorn's Coca, Vine Cola, Viz. Dr. Harvey W. Wiley, chief of the Bureau of Chemistry, says that the sale of all such drinks should be prohibited. Caffeine is a drug much used in headache remedies. It is derived from the kola nut, and from tea and coffee. It is also made artificially from uric acid occurring in the guano or bird manure deposits of South America. This bird ma- nure product is said to be used in some of the drinks while in others caffeine obtained from refuse tea sweepings is used. The sales-manager of the Coca Cola Company says the caf- feine in their product is made from tea. It is claimed by the manufacturers of caffeine drinks that they are as harm- less as tea or coffee. But physicians advise against the use of tea and coffee for children and for delicate, nervous peo- ple, and every intelligent person knows that these drinks should not be indulged in immoderately. The secret caffeine drinks at the soda-fountain are not warned against because ALCOHOL AS A MEDICINE. 429 few people know of what they are made. So it frequently happens that children whose parents do not permit them to drink tea and coffee are taking caffeine in a much more in- jurious form at the drug stores. Dr. Harvey W. Wiley, Chief of the Bureau of Chemistry, says: "When caffeine is separated from tea and coffee, and used as a separate drug, it exerts a much more specific action upon the system than when in natural combination. Its gen- eral effect is to induce that unhappy state described as nerv- ousness, with deranged digestion and impaired health." Dr. H. H. Rusby, Dean of the College of Pharmacy, of Colum- bia University, New York City, a high authority, says: "Caffeine is a genuine poison, both acute and chronic. Taken in the form of a beverage it tends to the formation of a drug habit, quite as characteristic, though not so effective, as ordinary narcotics. Permanent disorders of the cardiac function, and of the cerebral circulation, result from its continued use." The Druggists Circular, for May, 1908, contained a query from a druggist as to a good formula for a kola nut soda syrup. The answer was in part as follows : "There are two kinds of druggists. One kind puts any and every kind of stuff into stock, and passes it out to his customers, young and old, ignorant or learned, foolish or wise, his only desire being to get a profit. The other kind of druggist refuses to stock some things at all. Kola drinks owe their vogue to the caffeine which they contain. Caffeine is a poison which is cumulative in its effects, and an excess of which has not infrequently caused death. We believe you would better be on record as discouraging rather than encouraging the growth of the caffeine habit, especially among young people, who constitute a large part of the soda-water trade." The London Lancet of January 25, 1908, reports the re- sults of experiments made in Paris with kola given to horses to determine its action in relieving fatigue. It apparently diminished fatigue, but the horses receiving it lost more; weight than those to whom it was not given. The experi- 430 ALCOHOL AS A MEDICINE. menter said this showed that kola (caffeine) like alcohol, can give the tissues a lash with a whip, but that such energy, artificially produced, is at the expense of the organism. So, when people see the alluring advertisements of caffeine drinks which "relieve fatigue," let them beware of the re- lief which carries with it injury to the body. Of the most widely advertised of these caffeine drinks the government report says: "The prevalence of the 'Coca Cola fiend' is becoming a matter of great importance and con- cern." (See volume on Social Betterment of Senate Docu- ment 644, page 268.) M. M. A. SPECIAL MEDICAL DIRECTIONS FOR WOMEN. "In the treatment of diseases of women, alcohol has been considered a very important remedy. Because it affords re- lief from pain, many resort to its use during painful men- struation. Each month either whisky, or some medicine con- taining a liberal supply of alcohol, is considered a necessity. "The alcohol habit is not infrequently formed in this way. I have in my mind several cases of inebriety which were traceable to the habit of taking something to relieve pain at these periods. A woman whose husband held a high official position, thus acquired a craving for alcohol and became a confirmed drinker. He was finally compelled to place her in an institution for treatment. "Alcohol affords relief, not by lessening the internal con- gestion which causes the pain, but by paralyzing or be- numbing the nervous system. In fact, alcohol, instead of relieving, aggravates the internal congestion. It is a de- ceiver, for it makes the patient believe she is benefited when in fact the condition is made worse. The uterus has be- come more congested by its use, and when the paralyzing effect of the alcohol has worn off the pain will be found more severe, and the demand for alcohol increased cor- respondingly. The only safe and wise plan when suffering from pain due to internal congestion is to remove the cause. If uterine misplacement exists suitable treatment must be ALCOHOL AS A MEDICINE. 431 taken to correct this. Almost immediate relief from pain due to congestion of the pelvic organs may be obtained by taking a hot full bath. A hot foot or leg bath is also a good treatment since the warming of the extremities quickens the circulation in the limbs and relieves congestion in the pelvic region. "There are various forms of dysmenorrhea or painful men- struation and each form has a treatment by itself. The con- gestive type which is due to taking cold is better relieved by a hot sitz bath before the date expected, the temperature o'f the water should be ioi°-i03° with the feet in water a de- gree or two hotter. If at the time of the period the pain still continues, an enema or vaginal douche will usually give the necessary relief unless the patient should be exposed to cold by allowing the hands, arms, feet or legs to become chilled. "Many women do not dress their limbs warmly enough at any time. Just before the menstrual period the tendency is for the pelvic organs to become congested ; there is a greater tendency to cold feet then, than at any other time. I would therefore advise warmer clothing on the limbs at such times. The drinking of hot pepper tea, ginger tea, etc., is a perni- cious practice, for these irritants inflame the mucous mem- brane of the stomach and intestines. Hot lemonade or hot water will afford the same relief without leaving an inflamed surface behind to be irritated by the next meal. "There are some cases of great constriction of the uterine canal which have reflex irritability in the stomach. Those having the stomach affected cannot take food, the least thing is rejected. It is best for such to remain quiet in bed, applying heat to the stomach and abdomen and to the feet until relief is experienced. Those suffering from headache should also remain quiet in bed. Some resort to anodynes and form the habit of using codeine, morphine. All these are bad and should be avoided. I have never found it nec- essary to give one dose of either to relieve pain at such times. Hot applications with the enema, vaginal douche, or 432 ALCOHOL AS A MEDICINE. foot bath, has usually been all that was required. "I recall many cases of severe pain where the extremities were cold and clammy and the entire body was in a hys- terical contraction that were immediately relieved by a hot vaginal douche. The muscles relaxed, the patient warmed up and recovered nicely. "For securing sleep in insomnia, a hot toddy is often used, but a quicker and better effect can be gained by a hot, or neutral bath. The latter given at 99° or 100° for twenty minutes will produce sleep and refreshment, as it equalizes the circulation by bringing the blood to the surface. "It is safer under all circumstances to do without alcohol or other dangerous drugs in treatment of these diseases." — Dr. Lauretta E. Kress, Washington, D. C. Note — An experienced nurse says that prompt relief in painful menstruation may often be found by sitting upon a toilet water-jar half full or more of hot water. The steam rises and the heat relieves. TOTAL ABSTINENCE AND LIFE INSURANCE. Nothing shows more clearly and convincingly that alco- holic liquors have a tendency to shorten life than the fig- ures published by life insurance companies. A most inter- esting and valuable paper upon this theme was read before the Actuarial Society of America, in 1904, by Mr. Joel G. Van Cise, actuary of the Equitable Life Assurance Society of the United States. In it he gives the experience of differ- ent life insurance companies which have separate sections for total abstainers and non-abstainers. The Mutual Life Insurance Company of New York, one of the large com- panies, showed after a few years' experience with the two sections a death-rate 23 per cent, higher among the drinkers than among the abstainers. The Sceptre Life for the years from 1884 to 1903, inclusive, gave the following: Expected deaths of abstainers, 1,440; actual deaths, 792, being 55 per cent, of the expected. Expected deaths of non-abstainers, 2,730; actual deaths, 1,880, or 79 per cent, of the expected. ALCOHOL AS A MEDICINE. 433 The Scottish Temperance Life from 1883 to 1902 gave the following: Abstainers, expected deaths, 936; actual deaths, 420, or 45 per cent, of the expected. Non-abstainers, ex- pected deaths, 319; actual deaths, 225, or 71 per cent, of the expected. Mr. Van Cise goes on to show that the statistics which have been published from time to time, giving the percent- ages of mortality in the various occupations of life, invari- ably show a higher death-rate among those engaged in the liquor business than among those engaged in other lines of work, except such as are specially hazardous. He says : 'The higher death-rate among liquor dealers is so universally recognized by life assurance companies that a number of them will not issue policies, even on the lives of the rich- est brewers, upon any terms, and not one of the companies, to my knowledge, admits liquor dealers upon as advantage- ous terms as those engaged in other ordinary occupations.' He then quotes from a circular sent to the agency force of a prominent United States company, in which attention is called to a rule which forbids the taking of any risks on bar- tenders : 'Saloonkeepers, generally, not taken, but best of this class may be accepted on 10 or 15 year endowments only.' Others connected more remotely with the liquor busi- ness might be taken with a charge of $5.00 per thousand extra. The circular of instructions adds that the limitations of liquor dealers are made necessary 'by the very excessive rate of mortality found to exist among persons so employed.' Mr. Van Cise closed his address before the Actuaries' So- ciety by saying: 'I contend that the facts given in this paper show conclusively that the effect of total abstinence is to lower the death-rate, and increase the average duration of human life.' The Equitable Company had a section for total abstain- ers for a few years which was discontinued on account of the new insurance laws which came into effect in 1907. The actuary writes in response to inquiry: 'We are very care- ful in our selection of risks, and only those who drink in 434 ALCOHOL AS A MEDICINE. moderation will be accepted. I think it safe to say that, other things being equal, all American life insurance com- panies would consider a total abstainer a more desirable risk than a moderate drinker.' The United Kingdom Temperance and General Provident Institution, of London, is a large and successful company which was organized in 1840, expressly for total abstainers, because at that time larger premiums were asked from ab- stainers than from drinkers, the common opinion then being that alcoholic liquors were necessary to health. In 1846, this company added a general section, in which carefully selected moderate drinkers were accepted, but each section was kept entirely separate from the other. This separation has con- tinued to the present time, both classes paying the same premiums, but sharing in profits according to the earnings of the section to which the members belong. From 1866 to 1900, for every 100 deaths in the temperance section there were 137 deaths in the moderate drinking section, based on a corresponding number of lives at risk. The dividends for a recent five years average $20 to the temperance members, and $17 to the drinking members. The actuary of this English company, Mr. Roderick Mac- kenzie Moore, read a paper before the Institute of Actuaries, in 1903, in which he reviewed the work of this company dur- ing its history of sixty years' experience with abstainers and over fifty with non-abstainers. He showed that there has been no marked difference in the number of policies in force in the two sections, and the average amount of the policies in each section has been about the same, so that the comparison is as fair as could possibly be made. He gives these figures: 'Non-abstainers, male, expected deaths, 8,911; actual deaths, 8,947; per cent, of actual to expected, 100.4. Abstainers, male, expected deaths, 6,899; actual deaths, 5,124; per cent, of actual to expected, 74.3.' This shows a differ- ence of 26.1 per cent, between the actual and expected deaths of abstainers and moderate drinkers, and the full figures show the death rate among the drinkers to be 35 per cent, higher than among the abstainers. ALCOHOL AS A MEDICINE. 435 The American Temperance Life Insurance Association was organized in 1887. It gives a lower premium rate to members of the abstainers' section than to those in the gen- eral section. The circulars sent out by this company state that the average life of moderate drinkers is thirty-five and a half years ; tipplers, fifty-one years ; total abstainers, sixty- four and one-fifth years. Very interesting is the result of an inquiry made of vari- ous insurance companies not long ago as to whether they consider the habitual user of intoxicating beverages as good an insurance risk as the total abstainer; 'if not, why not?' All but two out of forty-one companies answered, 'No.' The two answered, 'Depends on quantity used.' In answer to the 'Why not?' the Etna said, 'Drink diseases the system and shortens life'; Hartford Life, 'Moderate use lays foun- dation for disease' ; Knights of the Maccabees, 'Drink tends to destroy life' ; Knights Templar and Masons' Life Indem- nity, *Drink lessens ability to overcome disease'; Sun Life, 'Drink injures constitution. Habit apt to grow' ; Massa- chusetts Mutual Life, 'Drink causes organic changes. Re- duces expectation of life nearly two-thirds.' The rest of the answers are much the same as these. — M. M. A. INDEX Abbott, Dr. A. C, 264, 278, 280, 281, Abdominal bandage Abel, Prof. J. J Abernethy, Dr Acetanilid 180, 301, Acetic acid in pharmacy. . .134, Acid drinks kill bacilli Adelung, Dr. Edward Von, 326, Adynamic disease Aiken, Dr. J. M Alabama law and alcoholic pre- scriptions Albumen 30, 60, 62, 152, Alcohol, food claims ..112-114, " a mocker 364, " a narcotic 121, " a poison... 28, 29, 100, 105, 358, 371, " injurious to living cells " advance in study of... '* affinity for blood and tissues " affinity for water, 148, " and foods, action con- trasted " and empty stomach . . . " mental work " anti-spasmodic " apparent benefits; de- ceptive warmth from evanescent " anaesthetic and paralyz- ant 120, " anaesthetic effect de- ceptive ....222, 262, " antipyretic " as medicine 96- " as medicine causes waste of force " as medicine diminished use 20, 53- " as medicine, need of popular education re- garding " as medicine, opposition to by W. C. T. U., 21- " causes disease 28- " as sedative " as tonic .124, " beginning of scientific study 368 199 128 36 346 136 150 379 z-72 Z7(i 27 173 128 377 123 388 275 380 114 149 406 100 400 124 108 181 266 127 130 83 57 297 27 36 127 126 Alcohol, a cause of Brigbt's disease 34, 91 causes malnutrition . . 284 craving 140 delusion that it "sup- ports" 234 " depressant 1 50, 17S " dangerous in pneu- monia 201 " difference in action from carbohydrates and fats 403 " diminishes arterial pres- sure 119, 120 effect on respiration, 2(>:^, 266 " experiments, 11, 15, 62, 65, 80, 03, loi, 119, 120, 149, 203^ 266, 267, 263, 275, 279, 2S8, 392-405, 421 Alcoholic diseases ascribed to other causes 33 " drink, no danger in sudden stopping .... 293 " drinks, stories of life sustained en ii4 " dyspepsia 6j^ *' proprietary medicines, 299- 334 Alcohol, medical use bulwark of liquor-traffic, 96, 97, 360, 361 '' medical use causes death 260 " medical use delays re- covery 115 " medical use evidence against 336- 391 " medical use result cf habit and tradition, 292, 294, 295, 29.S, 37S " medical use, Toledo Blade on 358 " medical use, mortality increased by, 247-261, 267 Ammonia 40, 188 Anaesthesia 119, 120 Anaemia 141 Anders, Dr, Howard S 370 Angina pectoris 181, 182- Animal poison 206- 2H Anthrax 281, 282 Alcoholism 36, iix II INDEX. Ale 120, 142, 236 Alkalies for stomach 174 Alum .••?43> 164, 171, 215 American Association for Study of Inebriety 329 American Druggist and Patent Ivledicine Agitation • . • 26 American Medical Association, declaration on alcohol 14 Antikamnia 192, 346 Anti-Tuberculosis Congress res- olution 1 54 Apoplexy 31.32, m, 142 Appetite, loss of 142 Aschaffenberg. Prof 400 Association of Abstaining Phy- sicians, Germany 387 Asthma 179, 345 Athletes and alcohol , 103 Atwater, Prof 128- 130 Australian Government Commis- sion on Patent Medicines ... 314 Baldwin, Dr. Edward R 370 Barton, Miss Clara 48 Baths ..57, 145, 146, 147, 152, 164, 193. 197, i99j 410, 431. 432 Battle Creek Sanitarium, zzz-zzj, 255, 256 Bavaria, beer-drinking effects . . 425 Beale, Dr. Lionel 99, 286 Beaumont, Dr 61, 293 Beddoes, Dr 13, 421 Beebe, Dr. S. P 404, 405 Beef-tea 194, 197, 325 Bacteria 150 Badger, Dr. Richard 365 Baer, Dr 19 Barker, Prof 337 Barr, Sir James 372 Beer. .31, 66, 116, 117, 124, 126, 142, 179, 239, 24.4-2^6, 247, 423 426 Bellevue Hospital 36, 54, 309 Berkley and Friendenwald .... 279 Beverages for the sick 411 Bigelow, Dr. Jacob 335 Billings, Dr, Frank i5S Bitters 176, 329 Blankmeyer, Dr. H. J 1 59 Bleuler, Dr 388 Blood 66-75, 76, 86, 106, 113, H4, 119, 393 Blood purifiers 75 " vessels 63, 75, 76 108, 109, 120, 124, 143 Blumenau, alcohol and di- gestion 1 73 Boils and carbuncles 144 Bond, Dr. Knox, on fevers, 252, 373 Bostv/Ick, Dr 336 Bowditch, Prof. Vincent Y. ... 157 Boynton, Dr 377 Bradner, Dr. Roe 329, 332 Brain 32, 36 Brandy ..35, 120, 143, 151, 173, ^77, 183, 196, 215, 356 Brewers 38, 425 Bright's disease 34, 91, 94 British army, experiences with alcohol loi, 102 British Medical Journal . . 180, 247, 269, 270, 319, 324 British Medical Temperance As- sociation 148-151, 250 Broadbent, Dr. 274 Brodie, Dr. Benj 105 Bromidia 353 Bromo Seltzer , 346 Brown, Dr. Alonzo 271- 273 Brunton, Dr. Lauder 269, 270 Bucke, Dr. R. M., alcohol and the insane 412 Buckley, Rev. J. M., D.D., cured of consumption 159 Bunge, Prof. G. Von 207, 424 Bureau of Chemistry 426, 427 Burnett, Dr. Mary Weeks . .41- 44 Burt, Mrs. Mary T 24 Bussey, Dr 237 Butter, substitute for cod-liver oil 314 Cabot, Dr. Richard C 57, 370 Caffeine 49, 135, 300, 428- 430 Cain, Dr. J. S 229, 377 Calmette, Dr., snake-bite ..206- 209 Camphor 217, 374 Cancer and alcohol 288 Carbolic acid 138, 145 Carbon dioxide 71- 73 Carbonic acid in wine 117 Cardiac paralysis in diphtheria, 272, 273 Carpanutrlne 313 Carpenter, Dr. Alfred 86 Carson, Prof. J. W 336 Casgrau, Dr., doctors who per- sonally use alcohol less ob- servant of Its effects 294 Catarrh 144, 145, 345 Cells 58-60, 68, 130, 271, 272 Chapman, Dr. C. W 184 Charcoal 179 Charrin, Dr 287 Cheese, cannot be made from milk of cows fed on distillery slops 236 Cheyne, Prof. W. W., snake- poison 209, 210 Children, danger of alcohol for, 416 " ofbeer-drlnking moth- ers 236, 237 INDEX. in Children, per cent, of deaths of those of abstaining and drinking par- ents 397, 398 Chills 146 Chittenden, Prof 93, 403 Chloral, 1^7, 138, 190, 275, 332, 353 Chlorodyne 127 Chloroform. . 1 19, 120, 121, 270, 353 Cholera 35, 147-152, 257, 258 " infantum 152, 153 " morbus 152 Christian Advocates, The, and patent medicines 26 Christison, Prof 34 Cincinnati Hospital 254 Circulation 76, 77, 184- 186 Claret 120, 177, 419 Clark, Dr. Alonzo 336 " Sir Andrew 35, loi Clinique, The 180 Coal-tar drugs ...75, 180, 192, 3.39, 340 Coca wines 319- 324 Coca Cola 427 Cocaine, 300, 319-325, 345-351, 427 Cod-liver oil, fraudulent prep- arations 314 Coffee 40, 141, 394, 236 Cohen, Dr. S. S 365 Cold, as a heart stimulant, 184- 186 " as tonic 125 " pack 186 " treatment for pneumonia, 202 Colds, cause and treatment ... 146 Colic 147 Collier, Dr. Wm 372 Collier's Weekly and nostrums, 26 Collins, Dr. ........_ 157 Coloring matter in wines arrests digestion 176 Coma from waste retention ... 115 Committee of Fifty ...19, 128, 279 " on Pharmacy . .314, 315, 316 Condi, Dr., nursing mothers . . 236 Constipation 146 Consumption 153-162, 326 Convalescence and alcohol, 292, 294 Convulsions 147, 179 Cook County Hospital, 54, 159, 253 Cordials in dyspepsia 176 Cough medicines 310- 312 " simple remedies, 146, 147, 162 Cramps 179 Cream, substitute for cod-liver oil 160, 314 Crothers, Dr. T. D., 120, 131, _ 183, 218, 345, 390 Cures for inebriety 329, 414 Deaths from alcohol ....28, S3, S7 " from alcoholic disenres ascribed to orher causes 31- 34 Death-rates, comparati e, 75, 85, 247-261, 267 lowered by non- alcoholic treat- ment . . . ,37, 46, 2ig Debility 171, 172 Davis, Dr. Nathan S., Sr., 11, 12, 29-31, 45, 66, 75, 80-82, 91-95, 107, 112, 117, ii3, 125, 128, 178, 193, 217, 219, 244, 25^, 262, 267, 289, 294, 358- 360 De Garmo, Prof 366 Delearde, Dr., Pasteur Insti- tute 279, 284 Delirium tremens 388 Depression of spirits 172, 179 Diabetes 88, 89 Diarrhoea 1 72 Digestion ...106, 155- 157 Digestive organs, injured 389 Digitalis -. 128, 135 Diphtheria 75, -85, 272 Diseases of women 430 " non-alcohol treatment, 140- 233 Distilled liquors, composition . . 117 Doan's Pills 315 Dodson, Dr. John M 423 Dogbite 211 Dock, Dr. George 365, 371 Douches 164, 431 Drowning 193, 194 "Drugging" . 335- 355 Drug habits formed by patent medicines 301 Drugs, medical opinions of, 336- '338 Druggists' resolutions against whiskey drug-stores 27 Druggist's Circular 8,429 Druggists, liquor selling by . . . 139 Drunkards made in infancy ... 311 Drunkards 126, 350 Drysdale, Dr 372 Dubois, experiments 119 Dysentery 172; 173 Dysmenorrhea 431 Dyspepsia 65, 127, 173- 177 Edmunds, Dr., 37, 38, 183, 238- 243 Edsall, Dr. David L 374 Epilepsy 32, 36, 178 Erysipelas 74, 3S8 Eshner, Dr. A. A 364 Exhaustion 17S Fainting and faintness, 177, 178, 180, 181 Fatigue 178, 320, 430 IV INDEX. Fatty degeneration 34-3<5, S2-85, 114 F?ts digested in small intestines, 60 Fere, Dr , 20J Fermentation 1 16, 274 Fevers 75, 85, 249-255, 388 Fibrine 40, 62 Fits 238 Flatulence 1 79 l^lick,. Dr. Lawrence 156 Fomentations 147, 199. 229 Food, alcohol as indirect, 112- 114, 29, 98-117, 128-130 Foods, proprietary ............ 3!^3 . Forel, Dr. A ......36, 105 Forrest, Dr 160, 161 Foster, Dr. .^ , 68 Franco-Prussian War, wine, ito, irr Francis, Surgeon Gen'l, cholera, 150 Frick, Dr. A 388, 389 Fruit 141, 146, 374 " juice 65,232,374 Gairdner, Dr., fevers 251, 252 Garber, Dr., typhoid 230 Garfield Memorial Hospital, 55, 254 Gastric juice .62, 65 Gastritis from beer and gin . . . 246 Georgia^ law and alcohol pre- scriptions 27 Germs ..70, lis, 223, 272, 286, 287 Giddiness 1 79 Gilman, Prof., treatment leads to death s^y Gin 61, 117, 199, 246 Ginger drinking 341 Gloria Tonic 414 Gluzinski and d:gestion ...,6i, 176 Glycerine in pharmacy, 134, 135, 138 Glycogen ....85, 130 Gordon, Dr. A 377 Gould, A. Pearce 288, 367, 373 Gout 31. 74 Grape juice 6'^ Grehaut ^ . . . . 288 Gruber, Prof 128, 129 Guardian cells, see leucocytes. Gull, Sir Wm. • .35, 104 Gum resins, non-alcoholic prei)- aration 134 Hagee's Cordial of Cod-Liver Oil ,314 Hall, Dr, W. S 379, 405 409 Hamilton, Dr. Frank H., 285, 286 Hammond, Dr. W. A 36, g^ Hargreaves, Dr. W., ^ 35, 85, 86, IDS, 236, 237 Harley, Dr., alcohol and dia- betes ...88, 89 Harrington, Dr. Chas 313, 316 Hart, Dr. Ernest 126, 152, 269 I Harvey, Dr., counsel to young physicians 389 I Hay Fever 145, 146 I Hayes, Dr., arctic work no j Headaches 179, 180 Headache remedies 301, 354 Health, how to preserve 355 Health Grains 315 Healy, Dr. H. H 375 Heart abscesses 277, 278 " and alcohol ...31, 75-85, 263 " beer-drinkers 424 " disease 181, 182 " failure, 83, 85, 184, 185- 188, 227, 273 " force diminished 183 " stimulants 188 " weak 182 Hemaboloids 313 Hemapeptone 313 Hemaglobin 30, 67, 114, 221 Hemorrhage 34, 180, 197 Heredity of alcoholic diseases . . .33 Herrick, Dr, James B 365 Hewes, Dr. Henry F 379 Heyburn, Senator, nostrums . . 334 Hiccough 179 Higginbotham 13, 140, 180 Higginson, Col. T. W 196 Hirshfield, Dr 360, 380 Hiss, Dr. A. Emil 309, 310 History of study of alcohol, 9- 20 Hob-nailed liver 87 Hoffman drops 349 Hoif's Consumption Cure 316 Holmes, Dr. Oliver W., on drugs 137. 344 Hop tea 66, 142, 176 Hoppe, Dr. Hugo, beer 425 Horsley, Sir Victor, 129, 372, 424, 425 Hospitals, Temperance 37- 53 " death-rates 252- 261 ** decreased use of al- coholic liquors, 53- 57 Hugounencq, alcohol and pepsin, 176 Hunt, Mrs. Mary H., temper- ance education 17 Hunt, Dr. Reid 369, 402 Hydrochloric acid 173, 177 Hydrophobia 281- 283 Internal Rev. Dep't. and Nos- trums 27, 312 International Congress on Alco- holism, London, 1909 9. 393 " Encyclopaedia of Surgery 209 " Medical Congress, 1876, and Na- tional W. C. T. U 23, 82 INDEX. Immunity, influence of alcohol on 281, 282, 393- 395 Indigestion and alcohol 32 Infant feeding _ 242,243 Infection, liability to increased, 392, 393 Infectious diseases ...288, 36S, 369, 42s Inflammation in wounds 74 Influenza and drinkers ....192, 193 Iron, injurious to stomach .... 315 Jackson, Dr. Henry 370 Jaundice, alcohol prejudicial . . 89 Jayne's Expectorant 310 Johnson, Lieut., arctic work . . no Joslin, Dr. E. P 364, 424 Journal Amer. Med. Ass'n., 129, 204-209, 211, 368, 369 Journal of Inebriety, 131, 192, 329, 413 Kansas prohibits whiskey drug- stores 27 Kassowitz, Prof. Max 373, 374 Kellogg, Dr. J. H., 36, 89, 95, 121, 129, 141, 152, 166, 176, 185, 19s. 199. 25s, 378 Kerr, Dr. Norman 150, 357 Kidneys 30, .89-95, 276, 425 Koch, Dr., consumption 153 Knopf, Dr. S._ A 155 Kola, see caffeine. Kraepelin 399, 400 Kress, Dr. Lauretta 430- 432 La grippe 190-193, 337 Ladd, Prof 332, 333 Ladies' Home Journal 26 Laitinen, Prof. T., 368, 369, 392- 398 Lambert, Dr. Alex 415, 424 Lancet, The London ..191, 184, 252, 368, 429 Landis, Dr. J. H., and typhoid, 379 Laudanum 137, 352 Laxative pills often harmful... 346 Lees, Dr. F. R 106 Legrain, Dr 426 Liebig 116, 251, 424 Lemon ....146, 147, 179, 194, 411 Lesser, Dr. A. Monae, success in treating fevers in Cuban War S3 Leucocytes, 271, 272, 274, 275, 278, 282, 283, 284, 285 Life insurance and total ab- stinence ..36, 423, 426, 432- 435 Life saving stations and alcohol 193 Liniments, non-alcoholic ...134, 135 Liquid Pepto nes 313 *0f late years malaria is attributed mosquito. In preparing this edition Liver ...31, 33, 85-89, 404-409. 425 Lloyd, Prof. J. U 328 London Temperance Hospital, 37-41. 132-135, 357 Loomis, Dr. A. L 255 " Dr. Henry P 1 57 Lungs 30, 201 Lying-in-Hospital, London, 37, 38 Martin, Dr. Newell, 63, 79, 84, 85, 91, 109, 119, Massage 166, 180, 213, Mass. State Board of Health, 34. Massert and Bordet, leucocj'tes, McNicholl, Dr. T. A 48, Madden, Dr. John Magnesia *Malaria 195, Malt Extracts 316- Manassein's Clinic, alcohol and kidneys 93, Mann, Dr. Matthew D Martin, Alexis St 61, McCormack, Dr. J. H Measles Meat extracts, valueless . . .325, Medical temperance department of W. C. T. U 25- Menstruation, painful Mercer, Dr. Alfred ?,Ietchnikoff 374, Milk ..141, 153. 188, 236, 237, 251, Miller, Dr. James Alex Mitchell, Dr. S. Weir 207, Miura, investigations Morphine 300, 345, 351, Mossop, Dr., experiments Mother Bailey's Quieting Syrup, Munyon's Kidney Cure Mulford's Predigested Beef . . . Muscles and alcohol ...33, 103, Musser, Dr. John H 369, Mussey, Prof. R. D 1 5? 214 310 277 378 37S 179 196 319 94 365 293 370 194 326 27 197 363 398 373 157 210 379 352 120 310 315 313 124 370 . 12 Nansen and polar expedition .. no Narcotic drug dangers, 345, 346, 350-355, 357 Nausea i99 Nerves ....32, 36, 76, 77, 105, 118, 185, 425 Nervous system affected by re- tention of waste 115 Neuralgia 198 New York State Board of Health I54, ^55 Newspapers and whiskey ads., 382 " and patent med- icine ads 333 to the bite of a certain kind of that item was overlooked. VI INDEX. Nichol, Dr., experiments 120 Nichols, Dr. Jas. R 136- 138 Nitrite of amyl 15, 181, 182 Non-alcoholic treatment, zi, 89, 140-233, 258-260, 360 Nurses, abstinence in cholera . . 149 Nursing mothers and beer, 234, 426 Nutrition retarded by alcohol.. 114 Oatmeal i97> 235 Oils, essential, non-alcoholic preparation 134 Opium, 127, 132, 149, 150, 172, 180, 189, 190, 300, 351, 352, 389, 412 Orangeine 346 Osier, Dr 158 Oxidations 408 Oxidation checked by coal-tar drugs . . .339, 340, 346 " hindered by alcohol, 263 Oxidative powers of liver effected by alcohol 404 Oxygen ....40, 67, 71, 75, 92, 113, 114, 118, 130, 187, 264 Page, Dr. C. E., on typhoid . . . 232 Pain after food 203, 204 Palmer, Dr. A. B 79, 121- 123 Pepper, Cayenne 147, 188 Pepsin _ 62, 64, 173, 176 Peptonic Elixir 313 Peruna 312 Peterson, Dr. Frederick 375 Phagocytes 271, 272, 374 Pharmacy, non-alcoholic ...132- 139 Phenacetin . .300, 339, 340, 346, 354 Physicians need awakening as to evils of alcohol . . 379 " responsibility for pre- scribing alcoholic liquor . ..358, 359. 388 " why they prescribe alcoholics ....291- 298 Pneumonia ....40, 75, 85, 192, 200-203, 253, 254, 257, 280, 340, 346, 371, 388 Poheman, Dr. Julius 200, 201 Poisons 29, 204-211, 300, 301 Port Wine ...64, 65, 144, 172, 292 Porter 236 Pregnancy, danger of alcohol in 203 " vomiting in 199 Packs, hot 194, 202, 213 Panopeptone 313 ParalysiSj caused by alcohol, 31, 36 Paregoric 352 Parkes 77-79, 100, 102 Patent medicines, 26, 27, 299- 334, 350 Preble, Dr. Robert B 375 Proprietary "Foods" 313,314 Prostration 179 Protoplasm and alcohol, 59, 60, 286, 287 Psychical treatment, Cabot ... 57 Ptomaine poisoning 152, 270 Puerperal fever 229, 290 Pulse and alcohol 79, 181 Pure Food Law 299, 300 Putnam, Dr. J. J 364 Quackery, cause 337 Quinine 128, 190, 196, 340, 345 Rattlesnakes, bite of 210 Recent researches on alcohol, 276-284, 392- 409 Reichert, alcohol and snake-bite, 207 Retina, blood-vessels and alco- hol 120, 124 Rheumatism, 211-214, 259, 260, 343 Richardson, Sir B. W., 15, 17, 3i» 39. 63, 72, 105, III, 121, 148, 153, 177, 259, 295-297, 356, 383. 385- 387 Ridge, Dr. J. J., 72, 84, 124, 127, 143, 149, 180 188, 196, 213, 216, 248, 250, 27s, 286, 292, 356, 362 Riley, Dr. W. H 223-227, 423 Ringer and Sainsbury 80, 119 Ritchie, Dr. J. J 383 Roberts, Sir W 176 Robin 264 Rusby, Dr. H. H 429 Salicylic acid 128 Saline injections 187 " solutions 145 Sartoin Skin Food 316 Scarlet fever ._ 91, 248, 337, Z7?, Schafer's physiology on alcohol, 129 Scientific temperance education, 17, 18 Sedatives, dangers of 127 Shock 215, 216 Sight impaired by alcohol 120 Sleeplessness i79 Small-pox 247- 250 Smith, Dr. E 105, 238 Snake-bite 207, 211 Soft drinks, dangerous 427 Soldiers loi, 102, 285 Soothing syrups 310 Sore nipples 215 Sore throat i45 Sphygmograph 79. 120, 122 Stamreich, investigations 379 Starch 116, 129, 130 Stimulant, definition 118, 222 Stimulants, 105, I77. i79. 186, 188, 190, 194, 237, 338 Stimulation, fallacy of theory, 385 INDEX. vu Stockton, Dr. C. G 158 Stomach ...32, 60, 63, 87, 293, 425 Strychnia 222, 365 Strumpel, Prof., on beer 425 Sudden illness 217 Sugar ....86-88, 116, 117, 129, 130, 374 Sulphonal 346, 353 Sunstroke 217, 218 Switzerland and alcohol deaths, 36 Syncope 1 77 Tannin 124, 152, 164 Taylor's Headache Powders . . . 346 Tea 236 Temperance hospitals 37- 53 Tonic Beef 313 Toxins 267-269, 406- 409 Treves, Sir Frederick 342, 372 Trudeau, Dr. Edward 155, 161 Tuberculosis 35» i54- 158 Tetanus 281, 282 Thompson, Sir Henry 120 Tinctures 131- 137 Tissue changes 113- 115 " waste retarded 115 Tobacco and alcohol, 212, 343, 413 Todd, Dr. B 250, 252 Turkish baths ...193, 208, 212, 213 Type-setters and alcohol 400 Typhoid fever ...219-233, 251, 252, 253, 268, 36s, 373. 379 T^T^hus 252, 255, 388 Uric acid 93, 404, 405 Urine and alcohol ..89, 92, 93, 267, 268 Uterine displacements 163- 171 *' hemorrhage 180 Van Duyn, Dr. John 374 Vasomotor nerves 76, 77, 83 Vegetarian diet for drink crave, 414 Vinol 314 Vita-Ore 3x5 Vomiting 140, 233 Water, 30, 95, 112, 128, 135, 143, 145, 150-152, 175, ^77, 187, 188, 224, 225, 232, 411 Weakness in growing youth ... 125 178 W. Va. Medical Society resolu- tions 371 Whiskey, 28, 50, 112, 127, 155, 157. T-73, 190, 193, 196, 210, 26s, 370, 390 Willhite, Dr. O. C , . . 159 Wine, 13, 31, 64, 65, 109, no, 117, 123, 125, 141, 176, 236, 32s, 417, 424 Wampole's Cod-Liver Oil 314 Warbasse, Dr. J. P 375 Waste, retention invites disease, 70 Welch, Dr. W. H 393 White, Dr. John E. _ 15S White Haven Sanitarium .... 155 White Ribbon Remedy 414 Wiley, Dr. _H. W. ...301, 428, 429 Willard, Miss Frances E., 23, 44- 47 Williams, Henrv Smith 399 Pink Pills 315 Willson, alcohol and snake-bite, 211 Winternitz 184, 185, 225 Wolff 176 Wollowicz 77-79, 81 Woodhead, Dr. G. Sims, 2^11, 276-284, 366, 383 Woods, Dr. Matthew 364 Wood, Dr. H. C 119 Zweiback 175 ERRATA Page 346, third line from bottom omitted : The use of cocaine is advancing rapidly in this r r^i TTA/fRTA TTNTVERSITY LIBRARIES This expira as pre DATE DUE 1 with 1 1 DATE B< MM pi '5fW - \\ - - — — ""~ __ , Demco, Inc. 38-293 I C28 (665) 50M 1 COLUMBIA UNIVERSITY LIBRARIES 005283699 Demco, Inc. 38-283