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diff --git a/26774-8.txt b/26774-8.txt new file mode 100644 index 0000000..51b9339 --- /dev/null +++ b/26774-8.txt @@ -0,0 +1,16786 @@ +The Project Gutenberg EBook of Alcohol: A Dangerous and Unnecessary +Medicine, How and Why, by Martha M. Allen + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: Alcohol: A Dangerous and Unnecessary Medicine, How and Why + What Medical Writers Say + +Author: Martha M. Allen + +Release Date: October 4, 2008 [EBook #26774] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK ALCOHOL *** + + + + +Produced by Bryan Ness, Deirdre M., and the Online +Distributed Proofreading Team at http://www.pgdp.net (This +book was produced from scanned images of public domain +material from the Google Print project.) + + + + + + + * * * * * + +TRANSCRIBER'S NOTE: Every effort has been made to replicate this text as +faithfully as possible; please see detailed list of printing issues at +the end of the text. + + * * * * * + + + +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 + + +Published by the + +DEPARTMENT OF MEDICAL TEMPERANCE OF THE +NATIONAL WOMAN'S CHRISTIAN TEMPERANCE UNION + +MARCELLUS, NEW YORK + + +COPYRIGHT, 1900. + + + * * * * * + + +CONTENTS. + + +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 Instruction + in American Schools--Committee of Fifty 9 + + +CHAPTER II. + +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 + Department--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 III. + +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 Switzerland 28 + + +CHAPTER IV. + +TEMPERANCE HOSPITALS. + + The London Temperance Hospital--Methods of treatment--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 + medication--Reports of treatment in Red Cross Hospital--Use of + Alcohol declining in other hospitals 37 + + +CHAPTER V. + +THE EFFECTS OF ALCOHOL UPON THE 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 disease recovered from by total + abstinence--Retards oxidation 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 fermentation--Alcohol not a + Stimulant--Experiments proving this--Alcohol not a + tonic--Professor Atwater on Alcohol as Food 96 + + +CHAPTER VII. + +ALCOHOL IN PHARMACY. + + Strong tinctures rouse desire for drink in reformed + inebriates--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 VIII. + +DISEASES, AND THEIR TREATMENT WITHOUT ALCOHOL. + + Alcoholic Craving--Anæmia--Apoplexy--Boils and + Carbuncle--Catarrh--Hay-Fever--Colds--Colic--Cholera--Cholera + Infantum--Consumption--Displacements--Debility--Diarrhoea-- + Dysentery--Dyspepsia--Fainting--Fits--Flatulence--Headache-- + Hemorrhage--Heart Disease--Heart Failure--Insomnia--La + Grippe--Measles--Malaria--Neuralgia--Nausea--Pneumonia--Pain After + Food--Snake-bite--Rheumatism--Spasms--Shock--Sudden + Illness--Sunstroke--Typhoid Fever--Vomiting 140 + + +CHAPTER IX. + +ALCOHOL AND NURSING MOTHERS. + + Beer not good for nursing mothers--Helpful diet--Opinions of + medical men--Analysis of milk of a temperate woman--Of a drinking + woman--Advice of Dr. James Edmunds, of the Lying-In Hospital, + London--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 XI. + +REASONS WHY ALCOHOL IS DANGEROUS AS MEDICINE. + + Researches of Abbott--Vital Resistance lowered by + alcohol--Experiments upon Urinary Toxicity--Effect of alcohol upon + the guardian-cells of the body--Dr. Sims Woodhead on + immunity--Deléarde's experiments 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--Education of the people in teachings + of non-alcoholic physicians necessary--Prescription of alcohol a + matter of routine--Two examples 291 + + +CHAPTER XIII. + +ALCOHOLIC PROPRIETARY OR "PATENT" MEDICINES. + + The Pure Food Law--The guarantee--Newspaper opposition to the + law--Headache remedies--Fake testimonials--Dangers of soothing + syrups and morphine cough syrups--Fraud orders issued by + Post-Office Department--Internal Revenue Department and Patent + 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 symptoms of + disease--Responsibility of physicians--Opinions 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--Metchnikoff 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 356 + + +CHAPTER XVI. + +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 drinking--Researches + of Dr. Reid Hunt--Mice given alcohol killed by small doses of + poison--Difference in effect of alcohol and starch + foods--Chittenden on food theory of alcohol--Researches of Dr. S. + P. Beebe--Liver impaired 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 XVII. + +MISCELLANEOUS. + + Alcohol Baths--Beverages for the Sick--Tobacco and the + Eyesight--Advertised "Cures" for Drunkenness--How to quit + drinking--Dr. T. D. Crothers' remedy for drink crave--Alcohol and + Children--Alcohol Tested--Beer-Drinking Injurious to Health--Drug + Drinks--Special Directions for Women--Total Abstinence 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 +magazines, 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 secretaries 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 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 frequently up for discussion in society meetings. + +The writer does not presume to set forth her own opinions upon a +question which is still a subject 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 they have very little or no use for +alcoholic liquors as remedial agents, and now, instead of recommending +whisky for consumption 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. Under 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 +stimulant; 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 alcohol will eventually become as obsolete as a belief in +witchcraft." + +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 +poison 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 November 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 inquiry, 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 +superintendents of large hospitals, who so courteously aided her in +preparing a paper for the International Congress on Alcoholism, held in +London, July, 1909, to which she was a delegate, 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 edition because of +the changing views on alcohol and the publicity 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 were 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 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 proclaimed as +the long-looked-for cure-all, if not the very _aqua vitæ_ 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 + strangurie, 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 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. Nathan S. +Davis, of Chicago, who was the founder of the American Medical +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 warming, strengthening and +nourishing. In 1850 he executed 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, reducing temperature, the amount of +carbonic acid exhaled, and the muscular strength. So opposed were these +conclusions to the generally accepted teachings of the day that the +Association did not refer the paper to the committee of publication. It +was published later in the _Northwestern Medical and Surgical Journal_. + +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 +Medical College, 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 Association 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." + +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 practice 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 Dr. Julius Jeffreys drew up a medical declaration which was +signed by seventy-eight leaders of medicine and surgery. This document +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 a 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 profession 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 + intemperate 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 + without 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 Association passed a resolution +that "alcohol should be classed with other powerful drugs, and when +prescribed medically, it should be done with conscientious caution, and +a sense of great responsibility." + +The physicians of New York, Brooklyn and vicinity not long afterward +published a declaration practically the same as that of the A. M. A., +adding: "We are of opinion that the use of alcoholic 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 alcohols, ethylic alcohol, +which is the active principle in wines, beers and other intoxicating +drinks, receiving special attention. + +The following is taken from his "Results of Researches on Alcohol":-- + + "In my hands ethylic alcohol and other bodies of the same group; + 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. + + "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 following + 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. Richardson's paper was returned to him for correction. + +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 +experimental 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 opposition to these +temperance education laws was a great 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 incorrect. 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 endorsed by Mrs. Hunt and her advisory +committee being assailed again and again as containing erroneous +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 Chicago, +Ill.; 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 + investigation." + + "I find them to be in substantial accord with the results of the + latest scientific investigations." + +Dr. Baer, of Berlin, Germany, the foremost European 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 satisfied, and a self +constituted Committee of Fifty undertook 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 +controversy. + +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 investigators were led to drop alcohol from their +pharmaceutical 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 alcohol 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 unless patients or their friends desire it. + + + + +CHAPTER II. + +THE WOMAN'S 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 +immediate result of the organization, however, was that the women began +to study the causes of inebriety, and prominent among the prevailing +influences leading to drunkenness they found the medical use of +alcoholics. The early efforts of these women were chiefly in rescue work +through Gospel temperance 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, that some 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 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 examine +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 distinguished 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 superiority of non-alcoholic +medication by its small death-rate in comparison with hospitals using +alcohol. + +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 medicine. + + 1. Its liability to create or revive an uncontrollable appetite. + + 2. A considerable number of the leading physicians of 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 Therapeutic +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 discussion, the +conclusions of the author were adopted "quite unanimously" as the +sentiments of the Section 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 memorialists. + +The report was published in full by the National Temperance Society, and +may be obtained from it 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 + investigation. + + 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 + promiscuously." + +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. C. T. U. adopted the department in 1883, +but soon dropped it. In 1895 it was reinstated and Mrs. Martha M. Allen, +New York's superintendent, was made national superintendent. In 1905 the +name of the department was changed from Non-Alcoholic Medication, 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 successful 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 publishers of newspapers and magazines against +fraudulent medical advertising. 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-prescribing doctor, and the dangerous "patent" +medicine. + +8. To gather the opinions upon alcohol of well-known physicians who do +not use it, and publish them. + +This department originated the public 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 +refused 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 articles 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 +thousands 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. Medical journals took note of this work and +commended it highly. When Mr. Bok began his campaign of education in the +_Ladies' Home Journal_, for which he deserves 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 members 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 presence 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 everything +but the communion. The Internal Revenue Department has examined a large +number of "patent" medicines and has listed them as intoxicating +beverages. Two state medical societies and some county societies in 1908 +passed resolutions to discourage the medical use of alcoholic liquors. +Two national societies of druggists and pharmacists in 1908 passed +resolutions against whiskey drug-stores. + +These are some of the results of Medical Temperance 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 department 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 _bow_ 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. + +Dr. Mussey says:-- + + "A poison is that substance, in whatever form it may be, which, + when applied to a living surface, disconcerts and disturbs + 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 + living 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 + substances, 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 every 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 of chemists and + physiologists, both in this country and Europe, have shown + conclusively that the presence of alcohol in the blood + diminishes the amount of oxygen taken up through the air-cells + of the lungs; retards the molecular and metabolic changes of + both nutrition and waste throughout the system and diminishes + the sensibility and action of the nervous structures in direct + proportion to the quantity of alcohol present. By its stronger + affinity for water and albumen, with which it readily unites in + all proportions, 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, phosphates, 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 + mortality, 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 + insensibility, but it also, _even in small quantities_, lessens + the oxygenation 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 permanent structural + changes, most prominently in the liver, kidneys, stomach, heart, + blood-vessels and nerve structures, and lessen the natural + duration of life in the aggregate from ten to fifteen years_. + Consequently 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 intoxicate. + + "Another popular error is the opinion that the substitution of + the different varieties of beer and wine in the place of + distilled liquors promotes temperance, and lessens the evil + effects of alcohol on the health and morals of those who use + them. Accurate investigations show that beer and wine drinkers + generally 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, _ending in renal _(kidney)_ and hepatic _(liver)_ + dropsies, cardiac _(heart)_ failures, gout, apoplexy and + paralysis_." + +Sir B. W. Richardson says:-- + + "Alcohol produces many diseases; and it constantly happens that + persons die of diseases which have their origin solely in the + drinking of alcohol, while 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. + + "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 + disease; if the liver gives way first, we say the man has liver + disease, 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 quantity 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, paralysis, vertigo, softening of the brain, +delirium tremens, 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, dilation, +disease of the valves. (d) Diseases of the blood: scurvy, dropsy, +separation of fibrine. (e) Diseases of the stomach: feebleness of the +stomach and indigestion, flatulency, irritation and sometimes +inflammation. (f) Diseases of the bowels: relaxation or purging, +irritation. (g) Diseases of the liver: congestion, hardening and +shrinking cirrhosis. (h) Diseases of the kidneys: change of structure +into fatty or waxy-like condition and other changes leading to dropsy. +(i) Diseases of the muscles: fatty changes in the muscles, by which +they lose their power for proper active contraction. (j) 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 constitution 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 spirituous + or fermented liquors are liable to become hereditary, even to + the third generation, gradually increasing, if the cause be + continued, till the family become extinct." + +Prof. Christison, of Edinburgh, in answer to inquiries 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 + dipsomania, 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, + inability 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 upwards to recover." + +Professor Christison 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 preventive of disease, +says:-- + + "There is no greater error than to imagine that a liberal + allowance of alcoholic liquids fortifies the system against + contagious diseases." + +In a paper read before the Royal Medical and Chirurgical Society, Oct. +22, 1872, Dr. W. Dickinson gave the following conclusions:-- + + "Alcohol causes fatty infiltration and fibrous encroachments; it + engenders tubercles; encourages suppuration, and retards + healing; it produces untimely atheroma (a form of fatty + degeneration of the inner coats of the arteries), invites + hemorrhage, and anticipates old age. The most constant fatty + changes, replacement 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 tuberculosis_, which is evident not only in the lungs, + but in every amenable 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 + produce 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, M. 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 enemy 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 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 + quantities. But a moderate consumption of the same 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 + abstainers. 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 + alcoholism." + + 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 Hospital, 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. RECOVERED. DIED. + + Fever, 142 135 7 + Scarlatina, 33 30 3 + Small-pox, 48 47 1 + Measles, 8 8 0 + --- --- --- + 231 220 11 + +_The treatment was altogether without wines, spirits or alcohol in any +form._ + +The death-rate reported by Dr. Nicholls was so small that some of the +more observing and progressive physicians were led by it to begin +similar experiments in the disuse of alcohol in other hospitals. Among +these was Dr. James Edmunds, senior physician at the Lying-In Hospital, +London. The experiments continued a year with a reduced death-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, a temporary institution was opened in Gower Street, +accommodating only seventeen in-patients at one time. Later a fine site +was 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 Hospital 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 hospital 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 disuse of alcohol, but is +required to report if it is used. During all these years it has been +given only seventeen 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 +implanted 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 experience 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 practice 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 clinique I am introducing a series of + 'waters'--aqua ferri, aqua chloroformi, aqua opii, aqua quinæ, + and so on--to form the menstruums of other active drugs when + they are called for. I also follow the plan of having the + medicines administered with a free quantity of water, and with + as accurate a dosage as can be obtained, for I agree with Mr. + Spender's original proposition that the administration of + medicines 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 ammoniæ + 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 convalescence was + declared. In some of the more extreme instances, 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 bicarbonate of ammonia shall be dissolved + in a cup of coffee or of coffee with milk, and be taken by the + patient in that manner. The coffee can be sweetened with sugar + if that is desired by the patient, and the ammonia can be so + administered without 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. * * * * * I 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 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. Mary 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 + beverage_.' 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 + conflict, 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 + innocent 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 medical + education warranted them in supposing that they knew that of + alcohol which justified them in its full and free use in medical + 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 administering it + herself at her own discretion if the physician is not at hand, + is a terror to the temperance physician. So we included 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 relieving the sick. + + "Our organization lived on paper, and was sustained in purpose + 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 + 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 question, + and decided to eliminate it entirely from our list of + therapeutics, 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 articles + 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 serious + medical and surgical maladies. In no case has any particle 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 + result by means which the highest science of the day approves, + and in addition to this we have especially at heart the + advancement of the temperance reform. There are, we believe, + thousands 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 application_ in the home in serious illness, it + is still feared by the immense majority of even our strongest + prohibitionists. We are organized upon the basis _no alcohol in + medicine_, 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 reason + 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 + informing 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 electric + speed ourselves it is useless to deny. This very hospital is the + latest mile-stone on the highway of progress in the American + temperance reform. The conditions that have made its 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 + omnipotence: 'Hospital, be!' and, behold, the hospital _is_. + + "When I joined the ranks of temperance workers in 1874, a + thought so adventurous as that alcoholics in relation to + medicine 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 his 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 arising from accident that he could not + treat more successfully without any form of fermented or + distilled liquors than with_'; found Dr. James R. Nichols, of + Boston, so long editor of _The Journal of Chemistry_, declaring + as his deliberate scientific opinion that the entire banishment + of these liquors 'would not deprive us of a single one of the + indispensable 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 + exceptional 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 medicines, + and that many, if not a majority of the best physicians, now + believe them _to be worse than useless_. Meanwhile I learned + that across the sea such great physicians as Dr. Benjamin Ward + Richardson, Sir Andrew Clark, Sir Henry Thompson and Sir William + Gull held views which for their latitude were 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 4-1/2 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 87 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 experiences 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 personally 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 _angina 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 whisky 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 + contemplate 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 + 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 alcohol 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 external 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 bottle, + 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 thousand + 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' humanity + with the medicine, as well as the beverage, brewed in Heaven." + + +THE RED CROSS HOSPITAL. + +A philanthropic young woman, Miss Bettina A. Hofker, entered Mount 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 +interesting others in the proposition. The name of 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. Monæ Lesser, Dr. +Thomas McNicholl 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, earthquakes, 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 commissioned to treat diseases without the use of alcoholic liquids. + +Dr. Lesser, the executive surgeon, is a German, and of German education, +having received his medical education in the Universities of Berlin and +Leipsic. In a conversation with a press representative, Dr. Lesser said +some time ago:-- + + "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 + substances 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 physicians, 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:-- + + "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 disease + 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 harmful + 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. I 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 operations + and in fevers. + + "Alcohol was never used as an internal medicine. + + "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 septicæmia, 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 beverage. + The withholding of food does not retard, but rather hastens + convalescence. + + "In the conduct of our Red Cross patients, irrespective of their + condition when admitted, it can be truly said that after + treatment began, delirium 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 160 to 220, patients + suffering from pernicious anæmia, septicæmia, pyæmia, 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. 1. 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 1-10 of a drop of aconite were + given internally; camphorated lard applied externally; with the + result that on the ninth day temperature stood 99; pulse 100; + 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 saw her. Brandy + and all foods were stopped; bowel flushings were given, 1-12 of + a drop of tincture of aconite was administered 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 110. 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 metrorrhagia, nietortes and + peritonitis came under our notice. Brandy which had been + previously given in large quantities had proved of no avail and + the patient was considered beyond recovery. We found her + completely prostrated, temperature 102, pulse 170, and + unconscious. The heart very weak and irregular. The brandy was + discontinued, salicylate of caffeine and nitrate of strychnia + were given with the result that in a short time the patient was + convalescent 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 country 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 evidence 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 hospital." + +Milwaukee City Hospital:--"No alcoholic liquors are used to any extent +in this hospital, or prescribed by the staff. I know of no move against +such use of liquors, but venture the assertion that the physicians +believe they have more reliable agents at their command 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 figures 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:--"Comparatively 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 best." + +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 alcoholic beverages here for +medical purposes is the exception 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 showing the decrease in the use of +alcoholic liquors, and of other drugs in Massachusetts General Hospital, +Boston. + +The following is his table: + + 1898 1899 1900 1901 + + Ale and Beer $759.00 $793.90 $1,062.00 $723.00 + Wines and liquors, 1,563.00 2,209.00 1,348.00 1,063.00 + --------- --------- --------- --------- + Total for alcoholic drinks, $2,321.00 $3,002.00 $2,410.00 $1,786.00 + + Total for other medicines, $8,424.00 $10,013.00 $10,132.00 $9,168.00 + + Number of patients, 5,005 5,203 5,012 5,495 + Cost of alcohol per patient, $0.46 $0.57 $0.48 $0.32 + Cost of medicine per patient, 1.68 1.92 2.02 1.66 + + + 1902 1903 1904 1905 + + Ale and beer, $605.00 $338.00 $431.00 $301.00 + Wines and liquors, 799.00 688.00 904.00 144.00 + --------- --------- --------- ------- + Total for alcoholic drinks, $1,404.00 $1,026.00 $1,335.00 $445.00 + + Total for other medicines, $9,772.00 $7,815.00 $9,162.00 $7,018.00 + + Number of patients, 5,342 5,429 5,709 5,531 + Cost of alcohol per patient, $0.26 $0.19 $0.23 $0.09 + Cost of medicine per patient, 1.88 1.43 1.60 1.26 + + + 1906 1907 + + Ale and beer, $192.00 $203.00 + Wines and liquors, 546.00 610.00 + --------- --------- + Total for alcoholic drinks, $738.00 $813.00 + + Total for other medicines, $5,981.00 $5,492.00 + + Number of patients, 5,513 5,966 + Cost of alcohol per patient, $0.13 $0.13 + Cost of medicine per patient, 1.00 0.92 + +Dr. Cabot says:-- + + "Since there has been no fall in the price of stimulants or + medicine, the diminished expenditure corresponds to a diminution + 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 proportion + of surgical cases among the whole number treated, so that the + decreased use of medicines and alcoholic beverages has not + resulted from an increased resort to surgical remedies. On the + other hand, there has been a great increase 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 substances coming into contact with them. If +substances 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 +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 way building up the formed material while + it is being disintegrated on the outer surface. This process 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 bioplasts are + the workmen of the organism. All wounds are repaired by them, + all fractures are united, and all diseased tissues 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 pabulum and + convert that which is adapted to itself into its own substance, + 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, moves faster, takes up more + pabulum, and divides more rapidly than in the unstimulated + 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 extent, 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 be almost + undiscernible, and takes up very little, if any, pabulum. 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 ignorance + 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 matter. + 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 + bioplasts. Raw meat will turn white and harden in alcohol. + Alcohol 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. Pechuman, + 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, 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 +4/5 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 examined. 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, _excitement by alcoholic liquors_, overloading the + stomach with food, fear, anger or whatever depresses or disturbs + 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 wholesome 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. + +Dr. Figg, of Edinburgh, fed two dogs with roast mutton; to one of them +he gave 1-1/2 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. + + "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 effects."--_Tracy'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 + symptoms which, under the varied names of biliousness, + nervousness, 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 subjective + 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 + 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 + experience 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, without + any other remedy or method." + +In _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, + extinguished 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 _may_ have + strength enough, as many have had, to survive even a serious + error in her treatment. + + "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 + dissolution, 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 + _prevents_ 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 promote + 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 considered +essential. Unfermented grape juice contains 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 produce 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 +non-alcoholic physicians, recommend them highly. They are better than +milk, as milk frequently produces "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, immense numbers +of small bodies will be seen. These are called blood-globules, or +corpuscles, or discs. There are both red, and white or colorless, +corpuscles. Each red corpuscle is soft and jelly-like. Its chief +constituent, besides water, is a substance called hemoglobin, which has +the power of combining with oxygen when in a place where that gas is +plentiful, and of giving it off again in a region 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. + +Hemoglobin, as the coloring-matter of the blood is called, is dark +purplish-red in color; combined with oxygen it is bright "scarlet red." +Accordingly, the blood which flows to the lungs after giving 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 oxygen, +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 +_venous_. + +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 muscles, the + brain, the skin, the lungs, liver and kidneys, are 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 +than they are when alcohol is not present in the blood. Even a +teaspoonful of alcohol to a 1/2 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 whosoever is _deceived_ thereby is not wise." + +That alcohol interferes with the passage of waste matter from the body +is generally conceded. Indeed this is claimed by the advocates of its +medicinal 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_:-- + + "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 fundamental and + universally recognized laws of organic life as to promulgate 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 whatever retards these retards + the phenomena of life; whatever suspends these suspends life. + 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 +inflammatory 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 + 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 reserve, or, if any, but + a very small one, of oxygen, and so he dies very rapidly if his + breathing be prevented. In ordinary language 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 expelled from the body, or they will clog up the +various 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, generated in the body through the +oxidation of food, passes from the system. With every breath inhaled +the life-giving oxygen is taken into the body; providing that the person +is not in a close room from which the fresh air is excluded. + +Any substance taken into the body which interferes 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 _débris_, 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 +substance 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 + comes into such contact with the air we breathe, that the + oxygen gas in the air is freely absorbed by the little + 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 distinctly affected. They undergo a peculiar + process of shrinking 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 breathing 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 unconscious, 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 irregular in shape." + +Dr. J. J. Ridge says in _Addresses on the Physiological Action of +Alcohol_:-- + + "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 life." + +In the light of these scientific facts, what can appear more utterly +foolish than the swallowing of alcoholic patent medicines which are +widely advertised as "Blood Purifiers"? That they will render the blood +impure is only too evident in the light of scientific truth. + +Dr. Nathan S. Davis has written much in disapproval 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 corpuscles +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 +distribution 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 conclusively 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 +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 networks 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 nervous system. The walls of the arteries are abundantly +supplied with involuntary muscular fibres, which have the power of +contraction and relaxation. This power of contraction and relaxation is +controlled by certain nerves called _vasomotor_ nerves, because they +cause or control motion in the vessels to which they are attached. When +arteries supplying blood to any particular part of the body contract, +the supply of blood to that part will be diminished in proportion to the +amount of contraction. If the nervous control be altogether withdrawn, +the arterial walls will completely relax, and the amount of blood in +the part affected will be increased correspondingly. + +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 + nervous 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 successive +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 hours (as + 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 + observations are deficient. The next highest daily mean was 77 + beats. + + "If, instead of the mean of the eight days, or 73.57, we compare + the mean of this one day; viz. 77 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 10th day, with two fluid ounces, 8,172 times more. + + On the 11th day, with four fluid ounces, 12,960 times more. + + On the 12th 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 11th and 13th days, or 18,432. + Adopting this, the mean daily excess of beats during the + alcoholic 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 during 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. + + "Adopting the lowest estimate which has been given of the daily + work of the heart; viz. as equal to 12.2 tons lifted one foot, + the heart during the alcoholic period, did daily work 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, + perhaps, 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 increased 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 +circulation. + + "The more frequent beats under the influence of alcohol + constitute 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 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 1/4 + per cent. by volume of absolute alcohol, almost invariably + diminishes, 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 relative + 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 + _Influence of Alcohol On the Human System_. + +The following letter will be of great interest to all students of the +physiological effects of alcohol:-- + + + "CHICAGO, ILL., March 3, 1899. + + "To MRS. MARTHA M. ALLEN, + "Syracuse, N. Y., + + "MADAM: Your letter asking my attention to the apparent + contradiction of authorities concerning the _work_ done by the + heart when influenced by alcohol was received yesterday. + + "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 _number of times it contracts or + beats per minute_. 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_ + diminishes 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 + circulating the blood in direct ratio to the quantity taken. + + "My own original experiments, made fifty years ago, uniformly + 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 practitioner knows + that the weaker the _heart_ 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 circulating the + blood. Indeed the mechanism of the heart is such that there must + be sufficient time between each of its contractions for its + _cavities_ to _fill_, or it is made to contract on an + insufficient supply, and the efficiency of the circulation is + diminished. + + "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 stimulant." + +As experiments conducted since that time show that it is not a cardiac +stimulant, but a direct cardiac 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 + 'fatty heart,' often resulting in sudden death."--_Tracy's + Physiology_, 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 exclusively + upon the heart, although this organ may show it more permanently + than others."--_Transactions of Second Annual Meeting 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 degeneration of the heart and other muscular +structures. Old age also causes these degenerations, hence alcohol is +said to produce premature aging of the body. + + "In fatty degeneration the cells and fibres of the body become + more or less changed into fat. If a muscular fibre undergoes + fatty degeneration, the particles of which it is made disappear + 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 according 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, because 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 _The 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 training need to be so very careful to +avoid the use of beer and other intoxicating drinks. + +Diseases such as fevers, diphtheria, and pneumonia which interfere with +the reception, and internal 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 show conclusively the +superiority of the latter treatment._ + + +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 + 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 _renews_ the _blood_. When the liver is + disordered 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 _débris_ (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 + diseases 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 + secretion of bile. It brings about a state of things called + _acholia_; the patient is actually poisoned by the non-removal + of those ingredients from the blood which it is the duty of the + liver to remove. This corresponds in effect to the condition + which alcohol can bring about by slow degrees." + +The liver is the first important organ, next to the stomach and bowels, +to receive the poisonous influence 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 in 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 + connective tissue gradually contracts, and in so doing 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 + them. The pressure upon the liver-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 + obstructing 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 Millions_, tells of a +patient of his who was well up to the evening before, when he went out +and drank with some companions, taking the liquor on an empty stomach. +That night, vomiting and pain in the right side came on, with high +fever. Headache began and increased, followed by delirium and a general +jaundiced 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:-- + + "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 affection 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 + estimated the daily amount of sugar eliminated by the patient, + allow him to drink a few glasses of wine, and watch the result. + He will soon find the ingestion of the liquor is followed by an + increase of sugar. If alcoholics increase the amount of + saccharine matter in the urine of the diabetic, we can easily + understand how their excessive use may induce the disease in + individuals _predisposed_ to it."--DR. HARLEY. + +Some physicians claim that in jaundice and certain other bilious +disorders even medicines prepared in alcohol are decidedly prejudicial +and aggravating. + +Dr. J. H. Kellogg, and other writers draw attention to the effects of +alcohol in hindering the liver in its duty of destroying the toxic +substances generated 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 destroying these poisons is one of the physiologic +processes which stand between the patient and death. + +The more this question is studied the more apparent is it that, other +things being equal, the sick person who is cared for by a non-alcoholic +physician 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 + interference with the working of many organs, due to the + accumulation 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 + substances which the kidneys should have got rid of. Serious + kidney-disease amounts to pretty much the same thing as cutting + out the organs, since they are of little use if not healthy. It + is always fatal if not checked, and often kills in a short time. + The things which most frequently cause kidney disease are undue + 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 + crystallizable 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 important + 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 + coming 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 + 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 Boston, 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 with 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 produced 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 when 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 Human 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 + observation, 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 diminished, 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 throughout 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. + Wochensch._, Leipsic, Oct. 22, 1891, demonstrated this, as shown + by the following conclusions:--'Alcohol, in even relatively + moderate quantities, irritates the kidneys, so that the + exudation of leucocytes and the formation of cylindrical casts + may occur. It also produces an unusual amount of uric acid + crystals and oxalates, 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 continued 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 100 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 + diuretic 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 water 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 without 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 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 remained + unaltered, in five it was increased seven per cent., and in + eight it decreased twelve per cent. But whatever may be the + variations 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 completely 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 + function 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 anæsthetic, 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 protract the duration of disease, and increase the + ratio of mortality."--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." + + + + +CHAPTER VI. + +ALCOHOL AS A MEDICINE. + + +Although nearly all of the foremost scientific investigators 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 recourse 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 recommend 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, knowing nothing +to the contrary. Indeed, thousands of those who advocate the prohibition +of the sale of 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 question before the +medical profession, and the people generally, than that of the action of +alcohol in disease, and, as a goodly number of the most distinguished +and successful physicians of Europe and America declare it to be harmful +rather than helpful, it behooves thoughtful people to carefully study +the reasons they assign for holding such an opinion. Certainly it is +true that if physicians and people would all adopt the views of the +advocates of non-alcoholic medication the temperance 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 body, and of the purposes for which alcoholics are prescribed +medically. + +_Alcohol 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 in pharmacy._ 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 substances 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 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 experiments 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 build up the tissues of the body._ All physiologists 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 _Manual of Hygiene_. + + "Alcohol contains no nitrogen; it has none of the qualities of + the structure-building foods; it is incapable of being + transformed 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 experimenters exclude it from the +diet of children, and why is 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 Alcohol" 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 accustomed 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 line in medicine, + 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 continuous use of alcohol as a +medicine is equally injurious 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 consumed, by this test it is proved to not be a food. + +_Foods give strength._ Alcohol weakens the body. This has been +determined again and again by experiments 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 to be made upon their strength. The latest example 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 intoxicating 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 sickness and +showing so much endurance. Some Greek merchants ran a large consignment +of liquors through by the Berber-Suakim route, but Sir Herbert 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 lasting + 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 officers, +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 which the +lifted weight could be raised. As an illustration 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 experience that alcohol does +not give strength, but is, in reality, a destroyer of muscular power. No +careful 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 defeated 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 +substantially 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. + +A question worthy of serious consideration is: how are the sick to be +strengthened and "supported" 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 + possibility 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 experience and experiment +unite in testifying that alcohol does not give strength, hence differs +radically 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 food cannot be assimilated. Truly, "My people +is destroyed for lack of knowledge." + +_Foods give force to the body._ + +Dr. Richardson says:-- + + "We learn in respect to alcohol that the temporary excitement 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 disseminated." + +Dr. Benjamin Brodie says in _Physiological Inquiries_:-- + + "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 force_." + +Dr. Auguste 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." + +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 stimulant." + +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 digestion, to + deaden nervous sensibility, to lower animal heat, to kill + molecular life, _and to waste, through the excitement it creates + in heart and head, the grand controlling 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 +between 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 them. + +_Food gives heat to the body._ + +Alcohol does not, but really robs the body of its natural warmth. This +finding of science was received with the utmost incredulity when first +presented to the medical world, but the invention of the clinical +thermometer settled it beyond controversy. 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 succeeded 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 +swallowed 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. + +Dr. Richardson says in his _Temperance Lesson Book_:-- + + "The sense of warmth occurs 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 feeling + 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 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 drunkenness + 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 muscles 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-producing in the body were +necessary it could be found in the fact that the products of combustion +are decreased 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 interviewed by a reporter of the London _Daily News_:-- + + "The common opinion that alcohol becomes in some way 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 _Fram's_ equipments, Nansen did not include any spirits, + with the exception of some spirits of wine for lamps and + stoves." + +In the list of stores taken upon the long sledging expedition after +leaving the _Fram_ no liquors are mentioned. See _Farthest North_, by +Nansen. The omission of spirits was not because of any "temperance +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 conclusively in the +Franco-Prussian war during the siege of Paris. Food was scarce in the +French Army, and wine was liberally supplied. The men complained +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 dreadful 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 apoplexy, or influenced by alcoholism. If the clinical thermometer +shows the temperature to be above normal, it is apoplexy; if below +normal, it is alcoholism. + + "Alcohol is clearly proved to be not 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 _Lesson Book_. + +Yet because it creates a glow of warmth in the skin immediately after +drinking it, thousands of 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 declare 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 "lived 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 examples + 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 shown 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:-- + + "A careful study of the conditions and processes necessary for + both tissue building or nutrition, and tissue waste or + disintegration, 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 properties 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 forget 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 theory that alcohol directly combines with the oxygen + of the blood by which it would be converted into carbonic 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 as already stated. + Physiologists of the present day very generally 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 corpuscular 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 undergoing 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 within 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:-- + + "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 accumulate + either in the blood or tissues, or both. In consequence 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, insensibility, 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 disease 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 retards the passage of waste matter is shown to be utterly +unscientific, as any agent which interferes with the natural processes +of assimilation and disintegration 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 man drinks daily 8 or 10 quarts of the best Bavarian + 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 nourishment 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, tartaric, 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 +possessing 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 + distilled."--_Influence 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 undeceive the toiling masses as to the +food-value of alcoholic 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 increasing _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 respiration 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 anæsthetic and sedative, or + depressor of vital activity." + +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 executed + series of experiments on the isolated heart of the frog, found + that all the alcohol when mixed with the blood circulating + 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 + regard 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 outset, _no stage of increased force of contraction + preceding_.' + + "Professor Martin, while in connection with the Johns Hopkins + University, performed an equally careful series of experiments + 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 absolute + 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 sufficient + 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 Anæsthesia 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 + 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 anæsthesia. 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 anæsthetic 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 + tablespoonful 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 + demonstrated 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 experiments + that while alcohol apparently increases the force and volume of + the heart's action, the irregular tracings of the sphygmograph + 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. + +Dr. J. H. 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 anæsthetic, rather than a + stimulant, and that its use as a supporting and tonic remedy is + a practice without foundation in either scientific theory or + natural clinical experience." + +Sir B. W. Richardson at a medical breakfast in London in 1895, stated +that though alcohol produced an increase in the motion of the heart it +was ultimately 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 + evidence 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 + chloroform is an anæsthetic, alcohol is an anæsthetic. 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." + +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 excellent 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 + instance 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 + beat-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 swallowed. + * * * * * + + "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 wine 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 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 + stimulating 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 influence 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 + 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 will 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 + promote 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? My patients who refused, or did + not take alcohol, 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 + recommending it merely to hasten recovery of strength. As a + tonic, I found it of no value." + +Dr. 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 alcohol 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 State, + 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, prescribed + for her by the family physician as a tonic. At first she refused + to take it, having always been a teetotaler, but persuaded 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 SEDATIVE. + +Dr. J. J. Ridge says in the _Medical Pioneer_, April, 1893:-- + + "Alcohol, chiefly in the form of spirits, is often given to + procure 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 feeling 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 + containing 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 comparison with the proper application of water to the + surface, or with the internal administration of sulphate of + quinia, salicylic acid, digitalis, etc. that no one thinks of + using it for antipyretic purposes."--Dr. N. S. Davis in + _Principles and Practice of Medicine_. + + +PROFESSOR ATWATER'S CONCLUSIONS UPON ALCOHOL AS A FUEL-FOOD. + +In 1899 a decided sensation was caused by the announcement 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 vigorously +opposed by many scientists of high standing. Professor Abel, of Johns +Hopkins University, Baltimore, 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 nourish * * * * + Although alcohol contributes energy it diminishes working + ability. We are not able to find that its energy is turned to + account for nerve and muscle work. Very small amounts, whose + food value is insignificant, show an injurious effect upon the + nervous system." + +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 diminishing the activity of the vital processes. + It also diminishes very greatly the power of the muscles, and it + diminishes the intellectual power of the nervous 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 American 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 symmetrical; the earthworm + is bilaterally symmetrical; therefore the earthworm is a bird.' + Oxidation within the body is simply one of several important + properties of food, as bilateral symmetry is one of several + important characteristics of a bird." + +Schafer's Physiology says:-- + + "It cannot be doubted that any small production of energy + resulting from the oxidation of alcohol is more than + counterbalanced 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 + must be assimilated. The forces manifested by the body, the + muscular forces, or nervous energy, are the result of the + breaking down of organized structure into simpler forms. For + example, in the case of nervous energy, material from which + 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 substance + 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 received 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 the _Journal of the American Medical Association_ 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 which 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 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 + irritation and excitement that clearly comes from this source. + It is also the experience of persons who are very susceptible to + alcohol, 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 action + 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 physiologic + 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 + proprietary 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 +following 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 + precludes the employment of alcoholic tinctures, but it was felt + that in such a test case as this it was important to obviate the + objection 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 vehicle 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 + alcohol 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 Birmingham, + with the result that new non-alcoholic tinctures were made + replacing the following alcoholic tinctures and wines:-- + + Tinct. Aloes. + " Arnicæ. + " Aurantii. + " Belladonnæ. + " Buchu. + " Calumbæ. + " Camph. Co. + " Capsici. + " Cascarillæ. + " Catechu. + " Chiratæ. + " Cinchonæ Co. + " " Flav. + " Cinnamomæ. + " Colchici Sem. + " Conii. + " Digitalis. + " Ferri Acet. + " Ferri Perchlor. + " Gentiani Co. + " Hyosciami. + " Kino. + " Krameriæ. + " Limonis. + " Lobeliæ. + " Nucis Vomicæ. + " Opii. + " Quassiæ. + " Rhei. + " Scillæ. + " Serpentariæ. + " Stramonii. + " Valerianæ. + " " Ammon. + Vin. Aloes. + " Colchici Rad. + " " Sim. + " Ipecac. + " Opii. + " Rhei. + + "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 majority + 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 taking + 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 tinctures + will be gradually added to this list. + + "As external liniments those commonly used are the linimentum + terebinthinæ and the linimentum terebinthinæ aceticum, which do + not contain alcohol. A strong solution of iodine is made with + iodide of potassium. + + "The spiritus ammoniæ 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 surface. + The spiritus etheris nitrosi is impossible without alcohol, but + nitrite of amyl, and nitrites of potash or soda can be + substituted. The spiritus chloroformi is replaced by aqua + chloroformi, or as a sweetening agent by solution of saccharin. + Thus a favorite 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 belongs 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 alcohols, it is of a very +different nature from ethyl alcohol, which is used for beverage +purposes. Ethyl alcohol, the alcohol in all intoxicating beverages 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 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 pharmacist 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 incompatibles. 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_ before 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 omitted, although it should be familiar +to temperance 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 substances. 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 alcohol, + and this is the ingredient which aids their sale. The whole + unclean list might, with advantage to mankind, be thrown to the + fishes. + + "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 hydrate, 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 chloroform, the + apparatus for alcohol may be made a part of the devices from + which the ultimate agents, ether and chloroform, result. + Fermentation and distillation may be conducted at one end, and + the anæsthetics 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 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 following 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 commenced to abstain from all beverages containing +it. Or, it may occur periodically, as a sort of irresistible impulse. +For the periodical craving Dr. Higginbotham, of England, recommends that +a half drachm of ipecacuanha be taken so as to produce full vomiting. 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 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. + +ANÆMIA:--In this complaint there is a deficiency 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 imperfect 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, sometimes also giddiness, sickness, fainting and neuralgia. + + "In the treatment of anæmia, 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 anæmia, 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 + intensified, though covered up."--_Medical Pioneer._ + + + "Deficiency of nutrition, of light and of pure air may be + mentioned as common causes of anæmia. * * * * * 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, purée 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 anæmia 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 breakfast, + 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 + incentives to appetite. Change of scene, and life in the open + air are the very best aids to appetite, when aids are really + required." + +APOPLEXY:--"There is a popular idea that whenever a person is + taken ill with giddiness, fainting or insensibility, brandy + should be at once procured and poured down his throat. Nothing + can be more dangerous in apoplexy. This disease is 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 _treatment_ 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 England, 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 Tannin_ may then be applied. +If any redness appears, especially if any dusky patch is formed, +_collodion_ may be applied with a brush, and all pressure should be +taken off the part by a circular 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 _resin 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 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 liability to cold. Care in diet, good ventilation and +the morning cold bath are essential if a radical cure is desired. Local +measures, while giving relief, will not remove the predisposing causes. +Dr. Kellogg recommends 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 avoided by those afflicted with this +trouble. The bowels should be kept in good condition. If constipated, +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 sufficient. No one able to walk should depend upon drugs +to relieve a constipated condition. + +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 contrary, 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, 1/4 pound to a gallon; then go to bed in a well ventilated room. +Drink freely of hot lemonade or hot water. Catarrh, colds and hay fever +may all be effectually relieved by hot baths. Relief may be gained also +from inhaling the vapor from pine needles or hemlock 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 1 pint water, strain, add two +teaspoons honey, 1 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 +convulsions. 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 following is a discussion upon Alcohol in Cholera which +was held at the annual meeting of the British 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 different + 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 circulation + 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 temperature, + 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 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 reactive + fever following collapse caused a great number of deaths. In + this stage alcohol was absolutely poisonous. He could recall + 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 without + assistance, and often with wonderful rapidity. People apparently + 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 + paralyzing vascular inhibition and checking elimination of + effete matter, could not be otherwise than harmful in the stage + of reaction. 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 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 circulating 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 abstainers. + 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 doctor after dinner + was more likely to take a roseate view of a case, looking at it + through an alcoholic pair of spectacles. Alcohol was not really + a stimulant, but a depressant, and this is a very depressing + disease; it was important to have our vital resisting 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, apparently stimulating, + is in reality, a paralyzer and therefore mischievous; the + death-rate might be considerably reduced provided 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 assisting + it out; but alcohol keeps it in by blocking the doors, just as + the doors were blocked in the terrible calamity at Sunderland + not long ago. The alcohol makes the heart and circulation 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 recommend 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 circumstances in that disease the action of a stimulant + is bad. Flushing 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 substance as alcohol, +itself being a product of germ action, 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 vomiting. 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 egg dissolved in water is + an excellent preparation in these cases. Egg enemata may also be + advantageously used. + + "Warm baths, the hot blanket pack when the surface is cold, and + the hot enema are all useful. Keep the child wrapped warmly. + + "Great care should be taken in returning to the milk diet. The + milk should be thoroughly sterilized by boiling for half an + hour, and should be mixed with some barley water so as to avoid + the formation of large curds in the stomach. Cream, diluted with + water, may be used instead of milk." + + +CONSUMPTION. + +Dr. Koch, the celebrated German microscopist, pronounces consumption +contagious, because during its progress a very minute bacterium is +developed which may be transmitted from one person to another. + +It is said that a person with healthy lungs might daily breathe millions +of tubercle bacilli without any danger, and that the best preventive of +this disease is to live much in the open air, or if this is impossible +to spend ten or fifteen minutes a day in deep breathing exercises in the +open air. "Fresh-air and disease-germs are antagonistic." + +Alcohol, chiefly in the form of whisky, was for many years considered of +great value in the treatment of consumption of the lungs. Indeed, it was +looked upon not only as a curative, but also as a prophylactic, or +preventive, of great service to those predisposed to this disease by +reason of narrow chest and weak lungs. + +Sir Benjamin Ward Richardson was the first medical scientist who showed +plainly that alcohol, instead of being a preventive of consumption, is +really the sole cause of one type of this disease, the type now classed +under the head of "alcoholic phthisis." For this kind of phthisis there +is no hope of cure. + +French physicians some years ago came to the conclusion that alcohol was +a prolific cause of tuberculosis and that the administration of +alcoholic liquors in tubercular troubles was a great error, and in the +International Anti-Tuberculosis Congress held in Paris in 1905, about +2000 medical scientists being present, they presented the following +resolution, which was adopted: "In view of the close connection between +alcoholism and tuberculosis, this Congress strongly emphasizes the +importance of combining the fight against tuberculosis with the struggle +against alcoholism." + +Since that time a great crusade against tuberculosis has been carried on +by means of exhibits and lectures, and in connection with these, almost +invariably the people are warned against intemperance. For example, a +pamphlet sent out by the Boston Association for the Relief and Control +of Tuberculosis says: "Do not spend money for beer or other liquors, or +for quack medicines or 'cures.' Self-indulgence and intemperance are +very bad. Vice which weakens the strong kills the weak." The New York +State Charities Aid Association, working with the State Board of Health, +says in a pamphlet: "Patent medicines do not cure consumption. They are +usually alcoholic drinks in disguise, and the use of alcoholic drinks is +dangerous to the consumptive." At the great exhibit in Washington in +September, 1908, in connection with the International Anti-Tuberculosis +Congress different warnings against alcohol were upon the walls. Among +these was a large poster of white cloth on which was printed the +opinions on alcohol, in brief, of some of the best-known authorities on +consumption. The opinions as given on that poster are given here, with +others, in order to show the great change of sentiment regarding alcohol +and consumption which has come about within a few years:-- + + "Alcohol has never cured and never will cure tuberculosis. It + will either prevent or retard recovery. It is like a two-edged + weapon; on one side it poisons the system, and on the other it + ruins the stomach and thus prevents this organ from properly + digesting the necessary food."--S. A. KNOPF, M. D., New York, + Honorary Vice-President of the British Congress on Tuberculosis. + + + Dr. Knopf in his prize essay on "Tuberculosis and How to Combat + It," says in several places: "Avoid all alcoholic beverages." He + says also, "Alcohol should never be given to children even in + the smallest quantities." + + + "It is a recognized fact in the medical profession that the + habitual use of alcoholic drinks predisposes to tubercular + infection. It is also recognized, I think, by most physicians + that alcohol as a medicine is harmful to the tubercular + invalid."--FRANK BILLINGS, M. D., Chicago, Ill., Former + President American Medical Association. + + + "Alcoholic liquors are of damage to consumptives because they + tend to impair nutrition, disturb the action of the stomach, and + give a false strength to the invalid on which he is sure to + presume. Besides, we know that in countries where drinking + prevails most, the ravages of tuberculosis are most + marked."--EDWARD L. TRUDEAU, M. D., Adirondacks Sanitarium for + Consumptives, Saranac Lake, N. Y. + + + "In my judgment whisky should not be used by people who have + consumption, and in my practice I prohibit its use absolutely. + At the White Haven Sanitarium and Henry Phipps Institute we do + not use alcohol in any form in the treatment of our + patients."--LAWRENCE F. FLICK, M. D., Vice-President of the + National Association for the Study and Prevention of + Tuberculosis, Philadelphia, Pa. + + + "I do not feel that I can emphasize strongly enough the harm + that can be done by the use of alcohol in tuberculosis, and the + indiscriminate use of it certainly borders on the criminal. I do + not believe that any legitimate reason can be given for the + routine employment of alcohol in the treatment of tuberculosis. + I furthermore know of no emergency in which it is indispensable. + My experience with patients who have been accustomed to the use + of alcohol, especially moderately, is very unsatisfactory. They + seem to show an abnormally low resisting power to the tubercle + bacillus. The fact has been established that alcoholism is a + very potent factor in the causation of tuberculosis. I find it + not only unnecessary in treatment but believe it to be + contraindicated."--F. M. POTTENGER, M. D., Superintendent the + Pottenger Sanitarium for Diseases of the Lungs and Throat, + Monrovia, California. + + + "I have met with a small class of consumptive patients who could + take alcoholic liquors freely for a length of time, without + deranging either the stomach or the brain, and with a decided + amelioration of the pulmonary symptoms, and an arrest of the + emaciation. Some of these have actually increased in + _embonpoint_, and for three to six months were highly elated + with the hope that they were recovering. But truth compels me to + say that I have never seen a case in which this apparent + improvement under the influence of alcoholic drink was + permanent. On the contrary, even in those cases in which the + emaciation seems at first arrested, and the general symptoms + ameliorated, the physical signs do not undergo a corresponding + improvement; and after a few months the digestive function + becomes impaired; the emaciation begins to increase rapidly; and + in a short time the patient is fatally prostrated."--DR. NATHAN + S. DAVIS, SR., of Chicago. + + + "The use of whisky in this disease positively interferes with + digestion which must under all circumstances be kept as perfect + as possible in order that the patient may assimilate the food + which is so necessary to the upbuilding of the system and to + gain strength to fight the onslaught of the disease. + + "Its constant use would not only interfere with digestion but + would have a tendency to create disease in other organs of the + body so that we therefore consider the use of whisky in + tuberculosis positively contraindicated. + + "Wishing you success in your laudable campaign."--DR. M. + COLLINS, Superintendent National Jewish Hospital for + Consumptives, Denver, Colorado. + + + "It is difficult for many people to adapt themselves to a + methodical plan of life long enough to establish a permanent + cure in consumption. I have known many a young fellow with only + a slight trouble in his lungs to die in the Adirondacks more + from the effects of whisky than from the disease itself."--DR. + HENRY P. LOOMIS, of New York City, in a Lecture on Consumption. + (See page 232, of Handbook, on the Prevention of Tuberculosis.) + + + "The majority of our patients receive no medication whatsoever. + The stomach is rarely in condition to bear excessive medication, + and the promiscuous use of creosote and similar preparations is + to be condemned. Milk and raw eggs are the best articles of diet + in addition to a regular diet of simple food."--JAMES ALEXANDER + MILLER, M. D., of the Vanderbilt Clinic, New York. (From Medical + Record.) + + + "In my specialty, the treatment of pulmonary diseases, I rarely + prescribe alcohol in any form, and in the sanitaria with which I + have been connected it is the exception where alcohol in any + form is prescribed. I have advised against its use where such + has been the custom, believing that as a rule alcoholic liquors + do more harm than good in the treatment of this disease."--PROF. + VINCENT Y. BOWDITCH, M. D., Harvard Medical School, Boston. + + + "From personal experience in handling pulmonary tuberculosis, + not only at the Nordrach Ranch Sanitorium, for the past five + years, but in an active practice of thirteen years, I am more + than convinced that whisky and liquor, in any form, are + absolutely poisonous to the consumptive. + + "Whenever we admit a patient to the Nordrach Ranch Sanitorium, + we ascertain whether the individual is an alcoholic or not; and + we invariably find that such an individual is lacking in + vitality enough to combat the disease. They may look fat and + strong, pulmonary tuberculosis usually makes quick work of them. + + "It is also a noticeable fact, proven by various statistics, + that a very large percentage of alcoholics become tubercular; + and if we ever stamp out tuberculosis, we will also have to + stamp out intemperance. + + "Trying to cure consumption with whisky is like trying to put + out a fire with kerosene. This is very easy to understand when + we stop to consider the nature of this disease. In the first + place, we have a very rapid heart's action, dating from the very + earliest manifestations of the disease. The pulse is often in + excess of 100, even in incipient cases, and if the stimulation + of alcohol is added, we have what might be called a 'runaway + heart'; and if there is one thing needed in the long combat + against tuberculosis, it is a good heart."--JOHN E. WHITE, M. + D., Medical Director Nordrach Ranch Sanitorium, Colorado + Springs, Colorado. + + + "You ask me my opinion as to the use of whisky in the treatment + of consumption. In reply permit me to say that I regard its use + in this disease as most universally pernicious."--PROF. CHARLES + G. STOCKTON, M. D., Buffalo Medical College, Buffalo, N. Y. + + + "It was formerly thought that alcohol was in some way + antagonistic to tuberculous disease, but the observations of + late years indicate clearly that the reverse is the case, and + that chronic drinkers are more liable to both acute and + pulmonary tuberculosis. It is probably altogether a question of + altered tissue soil, the alcohol lowering the vitality and + enabling the bacilli more readily to develop and grow."--DR. + OSLER, formerly Professor of Medicine in Johns Hopkins + University, Baltimore, Md., now of Oxford University, England. + + + "Upon investigation I found 38 per cent. of our male tubercular + patients were excessive users of alcohol, 56 per cent. moderate + users. From my study of the cases I am led to believe that in a + vast majority of these cases drink has been a large factor in + producing the disease, by exposure, lowering of vitality, etc. I + believe that alcohol has no place in the treatment of + tuberculosis. Many patients are deceived by the false strength + it gives them."--O. C. WILLHITE, M. D., Superintendent of Cook + County Hospital for Consumptives, Dunning, Ill. + + + "In tuberculosis there is a state of over-stimulation of the + circulatory system due to the toxins. The use of alcoholics + simply makes the condition worse. It reduces resistance and + makes the person more susceptible to the disease."--H. J. + BLANKMEYER, M. D., Sanatorium Gabriels, in the Adirondacks, + N. Y. + + + "The practice of taking alcoholics of any sort, and in any + quantity, over a considerable length of time, is certain to + produce more or less injury to a tubercular patient, and their + use by tubercular people cannot be too strongly condemned."--H. + S. GOODALL, M. D., Lake Kushaqua, N. Y. + +Most of these opinions were written for the author of this book in +response to letters of inquiry. Are they not indicative of a day when +the medical profession will lay aside alcoholic liquors in the treatment +of all diseases? It is acknowledged that the past usage of giving whisky +and cod-liver oil to consumptives was an error; some day, it may be not +far distant, a larger acknowledgment may be made, and the medical use of +alcoholic liquors will be entirely a thing of the past. + +Rev. J. M. Buckley, D.D., editor of _The Christian Advocate_, was in +early manhood considered an incurable consumptive. Being a man of great +will power and indomitable perseverance, he resolved to try the open-air +cure, together with the use of an inspirator. The result was perfect +restoration to health, so that, as is well known, he can be easily heard +by audiences of thousands at Chautauqua and other places where he is +greatly in request for lectures. He has written a pamphlet giving a full +history of his case. It can be obtained from Eaton & Mains, 150 Fifth +Avenue, New York, for fifty cents, and should be read by all +consumptives who have any "grit" in their composition. + +Dr. Forrest, a hygienic physician, says:-- + + "What is to be done if the germs have already obtained lodgement + in the lungs? Increase the general nutrition of the body in + every way, and then the lungs can resist the inroads of the + disease. The first thing necessary to improve the nutrition of + the body is to stimulate the digestive and absorbent functions + of the stomach and intestines. Naturally then, you must throw + the so-called cough medicines out of the window. The drugs used + to stop a cough are sedatives. Now, no sedative or nauseant is + known that does not lock up the natural secretions and thus + lessen the digestive powers. The cough is nature's method of + expelling offending matter from the lungs and bronchial tubes. + It is infinitely better to have this stuff thrown out of the + lungs than retained there." + +Keep the bowels clean is this physician's next recommendation. + +Sweet cream is preferable to cod-liver oil as it is not so likely to +derange the stomach. Easily digested food is necessary, as the organs +of digestion are in weakened condition. + +Again Dr. Forrest says:-- + + "The consumptive should live as much as possible in the open + air. + + "Dr. Trudeau inoculated twelve rabbits with tubercle or + consumptive germs. Six of these he turned loose on an island + where they ran wild. The other six were kept confined in hutches + such as rabbits are usually kept in. Results--All the six + rabbits in the open air recovered from the inoculation and + remained well. Five of the confined rabbits died of tubercles in + the lungs and different parts of the body. The sixth was still + lingering, badly diseased, when the experiment was brought to a + close. Fresh air and exercise enabled the first six to overcome + the disease germs. Confinement gave full play to the disease in + the others. + + "Now, you house lovers, sleepers in close bedrooms, people + afraid of cold air, you are the rabbits in the hutches. Beware, + lest the verdict be in your case, 'Died of tubercles in the + lungs.' If you are not able to leave your home, live with open + windows, day and night, summer and winter. + + "Exercise systematically, especially those exercises, + accompanied by deep breathing, that open and strengthen the + lungs--exercises without fatigue. + + "If you are hoping that some wonderful, mysterious drug has been + or will be discovered, a drug that will cure consumption without + your help, you are hoping against hope. Improved nutrition is + your salvation, and that must come through exercise, diet and + fresh air." + +Dr. J. H. Kellogg, in his _Home Hand-Book of Hygiene and Medicine_, +recommends a salt sponge bath upon retiring, to arrest night sweats, or +sponging with hot water. He adds:-- + + "It is important that patients should know that the sweats are + greatly aggravated by opium in any form, and hence are increased + by cough mixtures of any sort which contain this drug. Very + simple remedies are often effective to relieve the most + distressing cough, such as gargling of water in the throat, + holding bits of ice in the mouth, taking occasional sips of + strong lemonade, and similar remedies. As a general rule, + patients run down and the disease progresses much more rapidly, + after beginning the use of opium in any form. Sometimes it is + best that the cough should be encouraged instead of being + repressed. When the patient expectorates very freely, the cough + is a necessary means of relieving the chest of matters which + would seriously interfere with the functions of the lungs if + retained, by filling up the bronchial tubes and air-cells. The + kind of cough needing relief is an irritable, ineffective cough, + unaccompanied by any considerable degree of expectoration. Loaf + sugar, honey or a mixture of honey and lemon juice, and other + simple, familiar remedies are often effective in relieving such + a cough. * * * * * + + "It is perhaps needless to add that the numerous quack remedies + for consumption advertised in the newspapers are wholly without + merit. There is no known drug which will cure this disease, or + in any certain degree influence its progress. Numerous remedies + have been recommended as curative, but not one has thus far + stood the test of experience." + +DISPLACEMENTS OF THE UTERUS:--These conditions are not among those for +which alcoholic liquors are likely to be advised by a physician, but +women frequently resort to Lydia Pinkham's Compound and other alcoholic +preparations in the vain hope of finding the relief so positively +promised in the nostrum advertisements. Women are sometimes seriously +injured by using the nostrums specially advised for uterine weaknesses, +for this reason: a drug which may be of service in an anæmic condition +of the womb may do much damage in an inflamed or engorged condition, yet +the nostrum vendors advise their preparations for all alike, without a +word of warning as to possible dangers. + +Ordinary displacements may be recovered from by cleanliness of the parts +and by exercises which strengthen the muscles in the pelvic region. The +writer has known a considerable number of women who have been restored +to health by exercises after months, in some cases, and several years in +others, of weakness and misery. One of these women was a close relative +of a celebrated specialist in women's diseases. He said he could not do +any more for her, and gave permission for her to try the exercises, +which were given her by a well-equipped teacher of physical training. + +There are three kinds of displacements: anteversion, retroversion, and +prolapsus. The causes of these troubles are various; lack of proper care +in child-bearing, miscarriages, heavy lifting, a hard fall, jumping out +of a carriage, straining, too violent exercise in gymnasium work, and +tight-lacing, also gradual weakening of the ligaments which sustain the +uterus in position. + +An abdominal supporter should be worn constantly during the day for a +year or so, then left off gradually an hour or two at a time. It should +be worn during the second year whenever any extra work is to be done. + +There is a supporter sold by the Battle Creek Sanitarium which is highly +recommended, but any physician can get one for a patient. + +Perfect cleanliness is necessary. For this purpose a hot vaginal douche +should be taken two or three times a day. This douche should be made +astringent by adding to a pint of water a quarter ounce of alum or +tannin. The hot astringent injections tone up the lower supports of the +uterus, and cleanse the passage. The patient should remain in a +recumbent position for some hours after the douche if possible. +Considerable rest hastens a cure. Take the rest in the fresh air when +weather permits. Persistent use of sitz baths will be found helpful. + +For prolapsus the simplest form of internal supporter is a small roll of +cotton. After the organ is carefully put into position this supporter +should be pressed up against the mouth of the womb, the patient +meanwhile lying upon her back. The ball of absorbent cotton should be +large enough to be retained in position, and should be saturated with a +weak solution of glycerine and alum or glycerine and tannin before being +applied. A piece of white cord should be tied firmly around the centre +of this tampon by which it may be removed. Remove before taking the +douche. + +Persons who feel unable to purchase an elastic or other abdominal +supporter can make a substitute (not so good, but of considerable +service) from unbleached muslin made in the shape of the letter T, and +having the cloth double. It should go up to the waist and be made to +fit over the hips, then should be fastened firmly in front with +safety-pins, and the cross-piece be drawn up from the back and fastened +securely in front. + +The daily exercises are the most important part of the treatment. They +must be begun gradually, and taken at greater length as strength is +gained. Those for prolapsus will be given first:-- + +The patient should lie upon a rug, or on a firm long sofa or couch. The +feet should be drawn up as close to the body as possible. Now lift the +lower part of the body so that the hips and lower portion of the trunk +will have no support but what comes from the feet and shoulders. Hold +this position for a minute or two (longer when able without much +fatigue). After a few minutes' rest repeat. This exercise may be +continued from twenty to thirty minutes, according to patient's +strength. The elevation of the hips in this exercise aids in the +restoration of the organ to its natural position. This exercise should +be continued daily, the number of times being increased as strength +increases. + +A second exercise which is very helpful in prolapsus is to support the +body on the toes and elbows with the face downward, and the hips raised +as high as possible. Another exercise may be taken with an assistant; +the patient should lie face downward, supporting the body by the chest, +and keeping the limbs rigid while the assistant lifts the feet as high +as possible without hurting. These movements strengthen the abdominal +muscles and draw fresh blood to the weakened parts, and cause quickened +circulation in addition to restoring the displaced organ to natural +position. They should be taken at night just before retiring after a hot +douche. The bowels should be kept open by the free use of fruit. The +patient should sleep with the hips elevated as much as can be endured +without real discomfort and sit with the feet on a stool. When strength +sufficient is acquired the exercises for anteversion will be found +useful, and any other exercises which strengthen the abdominal muscles, +such as bending backward and forward, and sideways. Kneading and +percussing the abdomen by an osteopath or masseur strengthens, and also +relieves constipation. Rest during the day should be taken with the feet +higher than the head. + +Prolapsus due to laceration in child-birth may require a surgical +operation. + +In case of antiflexions the first exercise given for prolapsus should be +taken daily. (The advice for the prolapsus treatment and the exercises +are taken from the writings of Dr. J. H. Kellogg, superintendent of the +Battle Creek Sanitarium.). + +ANTEVERSION:--Persons suffering from anteversion or retroversion should +sleep without pillows under the head, and lie flat upon the back; they +should sit with the feet as high as convenient and avoid high seats +which hinder the feet from touching the floor. They should discard +corsets and tight stocking supporters which push or hold down the organs +which need to be replaced. Stocking supporters should be fastened over +the hips and comfort waists can be bought in place of corsets. + +It is well to have an attendant to prepare weak patients for first +exercises in all uterine troubles by the use of towels wrung from hot +water applied to the back and abdomen for a few minutes to relax the +muscles, or a hot water bottle, or hot salt bag may be used. Then, with +the patient lying with head low, the attendant should give the abdomen +and small of the back a thorough rubbing or kneading for ten minutes or +less according to strength of patient. Olive oil can be used on the hand +in the rubbing. + +FIRST EXERCISE FOR ANTEVERSION:--Lie on bed or rug; fold arms on chest; +hold trunk of body still; stretch legs, and hold the position about half +a minute, then relax at the knee and ankle. Then point the toes down and +stretch upper leg muscles; relax; then stretch under leg muscles by +stretching heel out. The patient will feel the exercise as far as the +shoulders, and should be careful not to lift the body from the floor at +first. When patient can hold stretching exercise for a minute then lift +first the right, then the left leg, and take same exercise until the +person can give a quick little kick for, say, twelve times, as the leg +is straightened. + +SECOND EXERCISE:--Lying on the back, stretch to full length; move the +left leg out at the side, then up and back to position, forming a +semi-circle, keeping muscles tense throughout. Then move right leg out +at the side--left--stretch toes long--relax--stretch heel--, lift a +little higher and bring back to place in a circle and rest. Same with +left leg and then both together. Few people can do this easily at first, +the weight of the legs is too much for the weak muscles at the back; but +some one can hold the foot at first. When the patient can do this easily +without bringing on any pain or ache, she may sit in a low chair and +take arm lifting exercises. + +Raise both arms out at the sides, then slowly raise them up close to the +head and consciously lift all the organs of the body up, relax, and +lower arms down front and repeat slowly, six or ten times at first, +until for five minutes the patient can do this sitting. Then take it +standing for ten minutes or more. Stand with feet wide apart. Dr. +Anderson says, "A woman who will do this twenty times each day can never +have anteversion, if she dresses properly, for it lifts the organs in +place each time." It lifts the chest and abdomen up, and brings a +feeling of exhilaration if done in the open air. + +After the patient has taken exercises for five or six weeks she may lie +flat on the back, fold arms and raise body up to sitting position +without unfolding arms. Then turn on right side and do the same, then on +left side and do the same. This is fine for back and abdomen muscles. + +Anteversion needs the Rest Cure, and resting with the body in a position +in which nature can right things is an important thing to remember. Rest +always after exercise, either with a pillow under the knees or with the +legs hanging over a low foot-board, or lying on a couch with the feet +higher than the head. Exercise will relax the muscles and call for +blood which will revitalize and stimulate the weakened conditions. A +woman with this trouble should be careful about bending quickly over, or +climbing stairs, until she gains strength. + +RETROVERSION:--Place the patient with face downward on bed or mat and +with a small pillow under the lower part of the abdomen. Relax the +muscles by applying a hot towel, hot salt bag or hot water-bottle just +below the small of the back, and lower part of the abdomen for ten or +fifteen minutes. (Hot salt bags are most effective and are easy to +handle.) Then rub the back briskly with a circular movement; if tender +in front, do not rub the abdomen. The circulation will gradually carry +away any inflammation as soon as the muscles reach a normal condition, +though kneading of back and abdomen, using sweet oil on the hand, is +helpful if the patient can bear it. + +The patient must remember that these conditions have been months in +coming and only painstaking work and time can restore the weakened +organs. The manner of dress is very important; loose, comfortable +clothing must be worn. Sleep with the face down as much as possible; +nature will correct itself, if allowed, many times. + +FIRST EXERCISE:--Fold arms under forehead and draw right knee up close +to body and hold two minutes (unless painful) and slowly straighten, and +stretch very slowly. Do the same with the left leg until the patient can +repeat the exercise twelve times with each leg and hold five minutes +instead of two, with the knee close to the body. It will probably take +two weeks to gain strength for this. After that time raise the body up +on hands, and move legs just as a baby does when creeping, except that +the patient only follows the movement and does not move along. + +SECOND EXERCISE:--Patient take sitting position on floor and clasp hands +under knees, and bring knees up, so that chin and knees meet and hold. +Then straighten legs, slide hands toward the heels as far as hands can +reach, (stretch hands toward heels); make a continuous movement of this. + +THIRD EXERCISE:--Sit on floor. Place the hands on floor at sides, legs +straight out in front, lift the body from the floor with the arms, up +and down. This is a fine exercise for raising up the misplaced organs. + +FOURTH EXERCISE:--Place the patient flat on back and push the body up to +sitting position with hands quite far back and palms down, recline +again, up and down until arms and back are very tired. Then sit up, legs +straight in front, raise the body from the floor, (an inch) and move +backward, resting weight on hands, then move over on knees as at first +exercise and creep, then sit up and move backward again. These will take +a month to perfect. Begin by exercising five minutes and gradually work +up to half an hour, rest between, always. The patient must have the +right mental attitude, must think that she is trying to replace the +uterus by lifting it to its natural position. The exercises must not be +lazily done. + +Sitting in a tub of hot water is most helpful where there is much +tenderness, or inflammation. Witch-hazel in hot water douches or a weak +solution of hot salt water is a wonderful tonic in some cases. + +EXERCISE FOR REPLACING UTERUS TO BE TAKEN JUST BEFORE RETIRING:--Kneel +on the bed; bend forward until the chest is touching the bed and the +hips are elevated as high as possible. The inlet of the vagina should +then be opened so as to admit air. As soon as the air enters the womb +falls into position. Lie down at once and give nature a chance to regain +strength while you sleep. + +The tampon soaked in glycerine and alum, and the douches of hot water, +in which a little alum is dissolved, are both of great service in +controlling the flooding which so frequently accompanies change of life +and miscarriages. (Exercises for anteversion and retroversion supplied +by a successful teacher of such work.) + +The writer of this book asked a well-known medical writer why physicians +do not advise exercises for the cure of displacements instead of +operations. He said it is because women are not willing to do anything +to help themselves. They expect the physician to cure them, and the only +way a physician can "cure" is to operate. Sensible women, however, will +be glad to practice helpful exercises. + +DEBILITY:--"The debility of convalescence requires fresh air, + easily digested food, the avoidance of over-exertion, with a + gradually increasing amount of exercise. Such debility is only + aggravated by alcohol, though it may for a time be partially + masked thereby. Milk, eggs, fresh fruit and farinaceous + articles are the best foods. General debility without obvious + cause, may be treated by cold or tepid bathing. Salt added to + the bath is helpful. Change of air is a good tonic. Port wine + and other alcoholics while giving a false sensation of increased + vigor, really _reduce the tone of the pulse_, and therefore tend + to enfeeble the system. Alcohol is a relaxant, _not a tonic_." + +DEPRESSION OF SPIRITS:--"Learn the Delsarte exercise for the + 'blues,' and practice them daily. Hot air baths. Avoid rich + food. Take out-door exercise." + +DIARRHOEA:--"This is a symptom of the presence of an irritant + of which the stomach is trying to be rid. Do not arrest it + prematurely, but assist it. If it persists, arrowroot, or corn + starch, or flour, mixed with cold water to the consistency of + cream may be taken, a tablespoonful at a time. 2. Bread charcoal + with cold milk. 3. A tablespoonful of cinnamon water with a + teaspoonful of lime water, mixed, every one, two or three hours. + Smaller dose for a child. Diet should be confined to toast, milk + toast, milk, cold or boiled. Tea, broth, meat, etc., are sure to + renew the trouble. Diarrhoea in infants is generally due to + errors in feeding, either over-feeding or the use of improper + kinds of food. Boiled milk thickened with flour is a simple + remedy in light cases. Alcoholics are utterly unnecessary in + diarrhoea, and to order them for young children is quite + wrong. A full enema of water, as hot as can be borne, will + remove offending substances from the bowels. + + "Beware of diarrhoea medicines containing opium in any form. + They are unnecessary and dangerous, particularly for young + children." + +DYSENTERY:--"At the beginning of the disease the stomach should + be relieved by the use of a large warm-water emetic. The + quantity of food should be restricted to the smallest amount + compatible with comfort. Ripe fruits, especially grapes, and + most stewed fruits, may be used in abundance to keep the bowels + regular. Salads, spices and other condiments, fats and fried + foods should be strictly avoided, together with tea, coffee, + alcoholics and all other narcotics. + + "The diet should consist chiefly of simple soups, well boiled + oatmeal gruel, egg beaten with water or milk, and similar foods. + In many cases regulation of the diet is sufficient. Either the + hot or the cold enema may be employed. + + "The use of opium, which is exceedingly common in this disease, + is not advisable, as it produces a feverish condition of the + system, decidedly prejudicial to recovery. Herroner, an eminent + German physician, very strongly discourages the use of opium in + this disease."--DR. J. H. KELLOGG. + +DYSPEPSIA:--"It is commonly supposed that a little good whisky + or brandy aids digestion, while on the contrary it has been + proved conclusively by observing the processes of digestion upon + persons who have fistula of the stomach, or by evacuating the + contents of the stomach by means of a stomach-pump about an hour + after taking a meal--in one instance after taking an ounce of + alcohol, and in another where no alcohol was taken--that alcohol + coagulates the albuminoids, throws down the pepsin, decreases + the acidity (the combined chlorin and free hydrochloric acid), + and increases the fixed chlorids. Any one can make the + observation upon himself, that a meal taken without alcohol is + more quickly followed by hunger than one with it. + + "Blumenau says: 'On the whole, alcohol manifests a decidedly + unfavorable influence on the course of normal digestion even + when ingested in relatively small quantities, and impairs the + normal digestive functions.' + + "Dr. Chittenden, professor of physiologic chemistry in Yale + College, as a result of some investigations made by himself and + Dr. Mendel, states in the _American Journal of Medical + Sciences_, that he finds that as small a quantity as three per + cent. of sherry, porter, or beer lessens the activity of the + digestive powers."--_Bulletin of A. M. T. A._ + + "It should be observed that doses of alcohol which have no + appreciable effect in delaying digestion, are so small as to be + practically useless for any beneficial action."--_Medical + Pioneer._ + +One doctor writes:-- + + "What makes dyspepsia so hard to cure? This very alcohol taking. + The best cure is to refuse all alcoholic drinks, at meals and + all other times, and drink nothing but water." + +The causes of dyspepsia are various; errors of diet being the most +common. Others are mental worry, care and anxiety, and the use of drugs. +An eminent writer upon this disease says: + + "My main object in the treatment is to prevent the sufferers + from resorting to drugs, which in such cases, not only produce + their own morbid conditions, but also confirm those already + existing. + + "The extensive and often habitual use of alkalies for acidity, + of purgatives for constipation, nervines and opiates for + sleeplessness, and after-dinner pills to goad into action the + lagging stomach, has been a potent factor in the production of a + large class of most inveterate dyspepsias." + +Underdone bread, cake, and pie, are unfit for any stomach, yet are seen +upon many tables. "Breakfast foods," cooked for ten or twenty minutes, +are also dyspepsia producers. All breads, cakes, pies and cereals, +require thorough cooking to fit them for digestion. Most cereals are +better for supper than for breakfast, as they should be cooked in a +double boiler for several hours. A young man, troubled with dyspepsia, +learned to his amazement that the oatmeal, which he supposed was his +best food, had much to do with the giddiness which often overcame him. +He was advised to use dry foods, such as toast, zwieback and shredded +wheat. This diet, together with the abandonment of nostrums, led to a +cure. Zwieback is bread sliced, and dried in a moderate oven until light +brown. Whole wheat bread is best. It is very delicious and is quite +easily digested. In the case of the young man, it is probable that the +difficulty with the oatmeal was the lack of sufficient cooking. Oatmeal +made into gruel, well cooked, and diluted with a large quantity of +scalded milk is easy of digestion. + +Eating between meals, and excess in eating, lead to stomach derangement. + + "The best remedy for acidity of the stomach is hot-water + drinking. Two or three glasses should be taken as hot as can be + sipped, one hour before each meal, and half an hour before going + to bed. The effect of the hot water is to wash out the stomach, + and so remove any fermenting remains of the previous meal. + Heartburn may be treated the same as acidity." + +Persons troubled with slow digestion are better to eat only two meals a +day. The writer has personal knowledge of a goodly number of women who +have been benefited wonderfully by adopting the two meal a day plan. + +Some persons, much troubled with dyspepsia, have adopted the plan of +prolonged fasting advocated by Dr. Dewey, and testify to a cure by this +method. While heroic, it is certainly more rational than drug treatment. +For acute dyspepsia a fast is requisite. + +All that alcoholics can do for dyspepsia is to allay the uneasy +sensations for a time, while adding to the trouble. It has been +abundantly proved that alcohol must pass from the stomach before +digestion can begin. + +Dr. Ridge says:-- + + "Many cases which seem to be relieved by the use of beer are + really benefited by the hop, or other bitter, which the ale or + beer contains. _Hop tea_ is a useful stomachic, and a quarter of + a pint, or half that quantity, may be taken cold. It is made in + the same way as tea, using a handful of hops to a pint of + boiling water. Make fresh every day." + +Dr. Kellogg says:-- + + "In cases of chronic dyspepsia the use of alcohol seems to be + particularly deleterious, although not infrequently prescribed, + if not in the form of alcohol or ordinary alcoholic liquors, in + the form of some so-called 'bitters,' 'elixir' or 'cordial.' + Nothing could be further removed from the truth than the popular + notion that alcohol, at least in the form of certain wines, is + helpful to digestion. Roberts showed, years ago, that alcohol + even in small doses, diminishes the activity of the stomach in + the digestion of proteids. Gluzinski showed, ten years ago, that + alcohol causes an arrest in the secretion of pepsin, and also of + its action upon food. Wolff showed that the habitual use of + alcohol produces disorder of the stomach to such a degree as to + render it incapable of responding to the normal excitation of + the food. Hugounencq found that all wines, without exception, + prevent the action of pepsin upon proteids. The most harmful are + those which contain large quantities of alcohol, cream of tartar + or coloring matter. Wines often contain coloring matters which + at once completely arrest digestion, such as methylin blue and + fuchsin. + + "A few years ago I made a series of experiments in which I + administered alcohol in various forms with a test meal, noting + the effect upon the stomach fluid as determined by the accurate + chemic examination of the method of Hayem and Winter. The result + of these experiments I reported at the 1893 meeting of the + American Medical Temperance Association. The subject of + experiment was a healthy young man whose stomach was doing a + slight excess of work, the amount of combined chlorin being + nearly fifty per cent. above normal, although the amount of free + hydrochloric acid was normal in quantity. Four ounces of claret + with the ordinary test meal reduced the free hydrochloric acid + from 28 milligrams per 100 c. c. of stomach fluid to zero, and + the combined chlorin from .270 to .125. In the same case the + administration of two ounces of brandy with the ordinary test + meal reduced the combined chlorin to .035, scarcely more than + one eighth of the original amount, the free hydrochloric acid + remaining at zero. Thus it appears that four ounces of claret + produced marked hypopepsia in a case of moderate hyperpepsia, + whereas two ounces of brandy produced practically apepsia." + +FAINTING OR SYNCOPE:--The following letter from the late Sir B. W. +Richardson was addressed to a lady who had sought the great physician's +advice on the subject:-- + + + "25 Manchester Square, W., July 18, 1896. + + "DEAR MADAM: There is no substance which acts as a substitute + for alcohol, nor is anything like it wanted. The human body is a + water engine, as I have often described it, and alcohol plays no + part in its natural motion. The idea that when it begins to + fail, a stimulant has to be called for, springs merely from + habit, and if, whenever any of the symptoms of fainting you + speak of occur, the person merely lies down on the side or back + and drinks a glass of hot water, or hot milk and water, all that + can be done is done. In the London Temperance Hospital I have + been treating the sick for diseases of all kinds and during all + stages, and have never administered a minim of alcohol, or any + substitute for it, and we have got on better than when + I--feeling it at all times at command--made use of it in the + ordinary way. + + "I am, dear Madam, faithfully yours, + "B. W. RICHARDSON." + + + TREATMENT:--"Lay the patient down in a current of air with the + feet raised higher than the head, preferably on one side in case + of sickness occurring, or bend the head down to the knees, to + restore the flow of blood to the brain. Loosen all clothing. Rub + the limbs, chest and over the heart with the hand or a rough + towel. Sprinkle cold water on the head and face. Smell ammonia, + strong vinegar, smelling salts or any pungent odor. Put hot + bottles to the feet, and in severe cases a mustard plaster over + the heart. Sip hot milk, hot water, hot tea, hot black coffee, + beef tea or a meat essence. Crowding round the patient and all + excitement should be avoided. In 999 cases out of 1,000, no + medicine is necessary. + + "Faintness often proceeds from indigestion, flatulence inducing + pressure on the heart." + +FAINTNESS, WEAKNESS, EXHAUSTION, FATIGUE:--"The truth is that + for simple weakness, faintness, exhaustion, fatigue, cold or + wet, the best remedies are simple fresh air, pure water, + digestible food and rest. These are nature's restoratives, and + the sooner both physicians and people learn to rely upon them + instead of upon drugs the better it will be for all parties. And + as the effect of alcoholic liquors are directly depressing to + the strength and activity of all the natural functions and + processes of life, as shown by the most varied and scientific + investigations, it is important that this fact be taught to both + doctors and people everywhere."--DR. N. S. DAVIS. + +FITS:--"Whether the fit be apoplexy or epilepsy all alcoholics + are extremely bad, both at the time and afterwards. Alcohol, the + 'genius of degeneration,' is the chief cause of apoplexy, and + also a cause of epilepsy, especially when taken in the form of + beer. It diminishes the tone of the arteries and blood-vessels, + and thus tends to cause, aggravate and maintain a congested + state of the capillaries throughout the whole body. In the + treatment of epilepsy, therefore, neither alcohol nor any + so-called substitute should be given. * * * * * + + "In the convulsions of children alcohol is equally + injurious."--DR. RIDGE. + +FLATULENCE:--"Many uneasy sensations or pains, even in distant + parts of the body, are due to wind in the bowels, resulting from + indigestion. Asthma, cramps, depression of spirits, faintness, + giddiness, hiccough, prostration, sinking sensations and + sleeplessness, are all frequently due to the same cause. The + diet needs careful attention where there is much flatulence; tea + is often a cause. Charcoal biscuits are useful in some cases; + lemon juice in others. Fluid Magnesia may be taken. Watch for + the cause and remove it." + +HEADACHE:--_The New Hygiene_ says: "This is the manifestation of + a deeper-seated trouble, usually in the stomach. The use of + stimulants is a sure promoter of headache. All users of + alcoholic liquors are, I believe, subject to headache, and it is + also a sure result of overindulgence in tea and coffee. + + "To prevent the attacks, live regularly, avoid late hours and + excessive brain work; avoid tea, coffee and alcoholic beverages, + also sweets of all kinds, including sauces and pastries, and + anything fried in fat. Eat plenty of good, plain food, including + fruit, especially oranges. Eat none late at night. Exercise + regularly in such a way as to bring all the muscles into play, + at least once a day. + + "To relieve an attack flush the colon. + + "Headaches, which so largely result from the retention of impure + matter in the body, will be cured if a good quantity, say two or + three glasses, of hot water be drank in the morning or at night, + and then the next regular meal omitted, so that an interval of + house-cleaning can be had before other material is moved + in."--_Life and Health._ + + "Avoid pills and powders. Persons suffering from headache need + to be warned against taking remedies that contain opium and + alcohol, and also against the use of a recent popular remedy, + usually called a 'white powder' or 'white tablet.' They take the + latter readily because the druggist or physician says it + contains no opium. This is true, but it is one of the lately + discovered coal tar preparations (anti-febrine, acetanilid, + etc.) and is very depressing to the human system. Headache is + usually a symptom of trouble somewhere else, often in the + alimentary canal, an overloaded stomach, constipation, or tight + clothing. Learn the cause and remove that, and the headache will + disappear."--DR. H. J. HALL, Franklin, Ind. + + "Gentle massage is helpful and the use of cold compresses. Lack + of sufficient sleep will cause headache. Women often bring on + nervous headache by overwork and worry." + +HEMORRHAGE:--"Never give alcohol in a case of profuse + hemorrhage. The faint feeling, or irresistible inclination to + lie down is nature's own method of circumventing the danger, by + quieting the circulation and lessening the expulsive force of + the heart, thus favoring the formation of clot at the site of + the injury."--_Clinique._ + + "For uterine hemorrhage an emetic to induce vomiting is the best + cure."--Dr. Higginbotham in _British Medical Journal_. + + "If the faint is dispelled too quickly, and the blood-vessels + are relaxed by alcohol, or the heart aroused to energetic action + by any remedy, the hemorrhage may recommence, and may prove + fatal. Quiet, the application of cold, pressure, the elevation + of the wound where possible, and the absence of stimulants, are + the cardinal points of treatment in most cases."--DR. RIDGE. + + "If then, it seems absolutely necessary to rouse a person out of + a dead faint, what can be done? Swallowing is out of the + question, lest the patient choke. The head must be laid low, + and the face and chest flapped with a cold wet cloth, or + alternately with hot wet cloths; smelling salts (not too strong) + may be applied to the nose. + + "When the faint has been recovered from, but the hemorrhage + continues so much that it is feared another faint may occur, + and, perhaps, be fatal, it may be warded off by drinking any hot + liquid; if Liebig's extract of meat, or strong beef tea, is at + hand and can be given hot, there is nothing better." + +HEART DISEASE:--Dr. Ridge says: "I trench here on a delicate + subject, because, when there is real disease of the heart, + medical advice will of course have been obtained, and very + probably a doctor may have said that some alcoholic liquor is + essential. There are, also, several different forms of heart + disease which require altogether different treatment, and only a + physician can tell the difference, or appreciate the necessity + for the particular treatment required. But it may be pointed out + that alcohol is utterly unable to 'strengthen' the heart, or + give tone to the blood-vessels, or to the system at large. + + "The alteration in the pulse due to alcohol is chiefly owing to + its paralyzing action on the blood-vessels, and when they are + too contracted, and thereby cause the weakened heart to labor + too much, the alcohol will give relief for the time. But we have + in nitrite of amyl, a fluid which will act more quickly and more + powerfully; but this must not be employed without medical + direction. It is very useful in cases of _angina pectoris_, or + _breast pang_, but is rarely required in the majority of cases + in which the valves of the heart are diseased. The paralyzing + action of alcohol is not generally produced by less than half a + wine-glassful of brandy or whisky, or twice that quantity of + wine, and often much more is required. The relief to uneasy + sensations which much smaller quantities sometimes produce is + due to their anæsthetic or benumbing action, by which the nerves + of the patient are rendered less sensible, although the danger + is by no means diminished. * * * * + + "The only sensible way to avert the evil consequences of heart + disease is to strengthen the heart, and that is to be done by + strengthening the body generally. The amount of exercise, the + kind of baths, etc., which should be taken, have to be modified + in accordance with the nature of the case. If these natural + health-giving measures cannot be employed nothing is an + effectual substitute. + + "_Weak_ or _feeble heart_ is a common complaint, and is as + ordinary an excuse for resorting to alcoholic liquors as + 'Timothy's stomach.' If there is no organic disease; if the + valves of the heart are healthy and act properly, all anxiety on + this point may be entirely banished. The slow pulse, the feeble + pulse, the cold feet, the want of energy, these are not to be + got rid of by such a mere temporary agent as alcohol, even if + relief can be thus obtained from day to day. The constant + application of alcohol to the tissues of the body alters them + gradually by its chemical action. In addition to this, the + balance of the nervous system is altered, an unnatural condition + is produced, and the unhappy patient becomes more liable to + disease and more easily succumbs when attacked. + + "Many of these 'feeble hearts' mean too little exercise, very + often also, too much or improper food and drink. + + "The best remedies are cold sponging (according to the season); + avoidance of coddling; plain, wholesome food; abstinence from + tea, hot drinks and condiments; regular out-of-doors exercise + and all similar true _tonic_ measures." + +Dr. Kellogg says:-- + + "Persons subject to attacks of _angina pectoris_ should carry + with them a small bottle containing a sponge saturated with + nitrite of amyl, and place it to the nose when necessary. + + "Sympathetic palpitation may be relieved by bending the head + downward, allowing the arms to hang down. The effect of this + measure is increased by holding the breath a few seconds while + bending over. Another ready means of relief is to press strongly + upon the large arteries on either side of the neck. + + "Palpitation of the heart is often mistaken for real organic + disease of the organ. * * * * * A careful regulation of the diet + is in most cases all that is necessary to effect a cure." + +Dr. Edmunds, of London, was asked during a medical discussion what he +thought of the use of alcohol in heart disease. His answer is embodied +in the following:-- + + "With regard to the use of brandy in cases of heart disease, he + was convinced it was a mistake to use it in such cases. There + were many forms of heart disease, but the most common kind arose + from the heart being too fat. Excess of fat debilitated the + heart and injured its working, just as a piece of wax attached + to a tuning fork would impair its usefulness. In such cases he + dieted his patients in order to reduce their weight. Every dose + of brandy taken for heart disease increased the evil. The moment + brandy was taken for heart disease, or any other chronic + complaint of a similar kind, the disease was increased. If + doctors recommended alcohol to their patients, he had been asked + what abstainers should do. In such cases, as had been suggested, + he thought the patients might ask what the alcohol was to do for + them, and if the reply was not satisfactory, they should get + another doctor." + +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 experiments that while alcohol +apparently increases the force and volume of the heart's action, the +irregular tracings of the sphygmograph show that the real vital force +is diminished, and hence its apparent stimulating power is deceptive. + +Dr. C. W. Chapman, of the National Hospital for Diseases of the Heart, +wrote in the _Lancet_:-- + + "The very thing (alcohol) which they supposed had kept their + heart going was responsible for many of its difficulties." + +Of cases of palpitation and irregularity caused by business anxieties or +indigestion, he said:-- + + "To give alcohol is only to add fuel to the fire." + +HEART FAILURE:--"In cases of cardiac weakness, the thing needed + is not simply an increased rate of movement of the heart, or an + increased volume of the pulse, but an increased movement of the + blood current throughout the entire system. In the application + of any agent for the purpose of affording relief in a condition + of this kind, the peripheral heart as well as the central organ + must be taken into consideration. In fact, the whole circulatory + system must be regarded as one. The heart and the arteries are + composed of essentially the same kind of tissue, and have + practically the same functions. The arteries as well as the + heart are capable of contracting. + + "Both the heart and the arteries are controlled by excitory and + inhibitory nerves. These two classes of nerves are kindred in + structure and in origin, the vagus and the vasodilators being + medullated, while the accelerators of the heart and the + vasoconstrictors of the arteries are non-medullated and pass + through the sympathetic ganglia on the way to their + distribution. + + "Winternitz and other therapeutists have frequently called + attention to the value of cold as a cardiac stimulant or tonic. + The tonic effect of this agent is greater than that of any + medicinal agent which can be administered. The cold compress + applied over the cardiac area of the chest may well replace + alcohol as a heart tonic. The thing necessary to encourage the + heart's action is not merely relaxation of the peripheral + vessels, but, as Winternitz has shown, increased activity of the + peripheral circulation in the skin, muscles and elsewhere. + Alcohol paralyzes the vasoconstrictors, and so dilates the small + vessels and lessens the resistance of the heart action; but at + the same time it lessens the activity of the nerve centres which + control the heart, diminishes the power of the heart muscle, and + lessens that rhythmical activity of the small vessels whereby + the circulation is so efficiently aided at that portion of the + blood circuit most remote from the heart. A continuous cold + application applied to that portion of the chest overlying the + heart stimulates the nerves controlling the walls of the + vessels, and at the same time energizes the corresponding + cardiac nerves. It is wise to remember that the vasoconstrictor + nerves are one in kind with the excitor nerves of the heart, + while the vasodilators are in like manner associated with the + vagus. With this in mind, it is clear that while alcohol + paralyzes the vasoconstrictors, it at the same time weakens the + nerves which initiate and maintain the activity of the heart; + while, on the other hand, cold excites to activity those nerves + which produce the opposite effect. + + "The apparent increase of strength which follows the + administration of alcohol in cases of cardiac weakness is + delusive. There is increased volume of the pulse for the reason + that the small arteries and capillaries are dilated, but this + apparent improvement in cardiac action is very evanescent. This + is a natural result of the fact that while the heart is relieved + momentarily by sudden dilation of the peripheral vessels, the + accumulation of the blood in the venous system, through the loss + of the normal activity of the peripheral heart, gradually raises + the resistance by increasing the amount of blood which has to be + pushed along in the venous system. This loss of the action of + the peripheral heart more than counterbalances the temporary + relief secured by the paralysis of the vasoconstrictors. + + "Thermic applications, general and local, may safely be affirmed + to be the true physiological heart tonic. In the employment of + the cold pericardial compress as a heart tonic, the application + should generally be continued not more than half an hour at a + time, and its use may be alternated with general cold + applications to the surface. A cold towel rub, or the cold trunk + pack is the best form for application if the patient is very + feeble. + + "The cold towel rub is applied thus: wring a towel as dry as + possible out of very cold water, and spread it quickly and + evenly over the surface; rub vigorously outside until the skin + begins to feel warm; then remove, dry the moistened surface, rub + until it glows, and make the same application to another part; + and so on until the whole surface of the body has been gone + over. The procedure should be rapid and vigorous. + + "If the cold trunk pack is employed, a sheet of not more than + one thickness should be wrung as dry as possible out of very + cold water, and wrapped quickly about the body, after first + dipping the hands in water, and rubbing the trunk vigorously. In + cases of extreme cardiac weakness, very cold and very hot + applications may be alternately applied over the region of the + heart. The duration of the hot and cold applications should be + about fifteen seconds each. + + "Any one who has ever witnessed the marvelous effects of + applications of this sort in reviving a flagging heart will + never doubt their efficacy, and will have no occasion to resort + to alcohol, or any other intoxicant, to stimulate a flagging + heart. The writer has employed these measures for stimulating + the heart for more than twenty years, and might cite hundreds of + instances in which their efficiency has been demonstrated. They + are applicable not only to the cardiac depression encountered in + the adynamic stage of typhoid and other fevers, but in cases of + heart failure from hemorrhage, of surgical shock, collapse under + chloroform or ether, opium poisoning, coal gas asphyxia, + drowning, etc."--Dr. J. H. Kellogg, in _Bulletin of the A. M. T. + A._, Jan., 1899. + +Dr. N. S. Davis tells of a case of threatened collapse where he was +called in consultation. Patient was in a small, unventilated room. + + "It was easy to see that what she needed was fresh air in her + lungs. Instead of giving alcohol in any form she was moved into + a large, well-ventilated room. All symptoms of 'heart failure' + disappeared. Had she begun to take whisky or brandy, physician + and friends would have attributed her recovery to that, when in + fact it would have retarded recovery by hindering oxygenation of + the blood." + + "It would also be a very great mistake to suppose that when + reaction follows collapse, in cases in which alcohol has been + given, this result is always due to the alcohol. I have seen so + many cases of severe collapse recover without alcohol that I + cannot but be skeptical as to its necessity, and even as to its + value. I was much struck many years ago by a case of post partum + hemorrhage which was so severe that convulsions set in. I should + then have given brandy if there had been any to give, but there + was none in the house and none to be got. I administered + teaspoonfuls of hot water and the patient revived and recovered; + next day, except for anæmia, she was as well as ever, with no + reactionary fever or other disturbance, as would almost + certainly have been the case if brandy had been given. + + "In collapse from hemorrhage, we have learned the value of + injections of warm saline water, either into the veins, the skin + or the rectum, and the same treatment is available in other + cases of collapse with contracted vessels. + + "Another measure which has proved most efficacious is the + _inhalation of oxygen_ gas. This is especially useful in cases + in which alcohol is decidedly injurious, namely, those in which + there is increasing congestion of the lungs, which the heart, + though doing its utmost, is unable to overcome. Alcohol only + increases the congestion, and the heart is already over-exerted + and nearly exhausted. The effect of the oxygen is apparent in a + few seconds, and cases have been rescued in which death appeared + to be inevitable and imminent."--DR. RIDGE. + +HEART STIMULANTS:--"The advantage of beef extract over alcohol + as a stimulant was demonstrated on a large scale in the Ashantee + war."--DR. RIDGE, London. + +For those who must have a drug: aqua ammonia, 8 drops to 1/2 cup of hot +water, or 20 grains carbonate ammonia to 1/2 cup water. Hot water alone +is a useful stimulant; also water, hot or cold, with a few grains of +Cayenne pepper added. The latter is good, not only to start the heart's +action in collapse, but also to relieve violent pain. Hot milk is a most +valuable stimulant. Many persons to whom hot milk has been given during +the extreme weakness of acute disease have testified afterward to its +good effects in comparison with the wine formerly administered. The wine +caused an after-feeling of chilliness and weakness, while the milk gave +warmth and added strength. + +INSOMNIA OR SLEEPLESSNESS:--"A person who suffers from + sleeplessness should avoid the use of tea and coffee, tobacco, + alcoholic liquors and all other disturbers of the nervous + system. Eating immediately before retiring has been recommended, + but the ultimate result may be an aggravation of the difficulty + instead of relief. If a person suffers from 'all gone feelings' + so that he cannot sleep, he should take a few sips of cold water + or a glass of lemonade. As complete relief will generally be + obtained as from eating, and the stomach will be saved work when + it should be resting. A warm bath just before retiring, a + wet-hand rub, a cool sponge bath, gentle rubbing of the body + with the dry hand, a moist bandage worn about the abdomen during + the night, are all useful measures. When the feet are cold, they + should be thoroughly warmed by a hot foot or leg bath, and + thorough rubbing. When the head is congested, these measures + should be supplemented by the application of cold to the head, + as the cold compress or the ice-cap." + +A walk in the evening, or gentle calisthenics, may help those of +sedentary habits. Bicycle riding and horse-back riding in the evening +have helped many. + +The practice of long deep breathing will often put persons to sleep when +all other devices fail. The lungs should be filled to their utmost +capacity, and then emptied with equal slowness, repeating the +respiration about ten times a minute, instead of eighteen or twenty, the +natural rate. Those who fall asleep upon first going to bed, and after a +few hours awake, and are unable to sleep again, may find relief by +getting out of bed, and rubbing the surface of the body with the dry +hand. Or walk about the room a few minutes, exposing the skin to the +air, go back to bed and try the deep breathing. + + "The use of drugs for the purpose of inducing sleep should be + avoided as much as possible. Opium is especially harmful. Sleep + obtained by the use of opiates is not a substitute for natural + sleep. The condition is one of insensibility, but not of natural + refreshing recuperation. Three or four hours of natural sleep + will be more than equivalent to double that amount of sleep + obtained by the use of narcotics. When a person once becomes + dependent upon drugs of any kind for producing sleep, it is + almost impossible for him to dispense with them. It is often + dangerous to resort to their temporary use, on account of the + great tendency to the formation of the habit of continuous use. + The use of opiates for securing sleep is one of the most + prolific means by which the great army of opium-eaters is + annually recruited. Chloral, bromide of potash, whisky and other + drugs are to be condemned almost as strongly as opium."--DR. + KELLOGG. + +Dr. Furer, of Heidelberg, Germany, in a paper before the International +Congress against alcohol, held in Basle, Switzerland, in Sept., 1895, +said:-- + + "The sleep from alcohol does not act as a mental tonic, but + leaves the mind weaker next day." + +Some noble specimens of manhood have become wrecks through accepting the +advice to try "whisky night-caps." Edison recommends manual labor, +instead of going to rest, for aggravated insomnia. He says sleep will +soon come naturally. + +LA GRIPPE:--"Alcohol has no place in the treatment of _la + grippe_; on the contrary it is because of the too frequent use + of this, and other narcotics, that epidemics make such fearful + headway in our land, and such must be the rule until the people + study the laws of health and obey them. Profuse sweating, + followed by a careful bathing of the body in tepid water, + gradually cooling it to a normal temperature, and avoiding + unnecessary exposure, will relieve. The patient should sleep in + pure air and eat as little as possible, and that only when + hungry. * * * * * Quinine is essentially a nerve poison, and + capable of producing a profound disturbance of the nervous + centres. A drug of such potency for evil should be employed with + the greatest care, and never when a milder agency will secure + the result. Exceedingly pernicious is the habit of dosing + children with this drug."--DR. CHARLES H. SHEPARD, Brooklyn, N. + Y. + + "A late surgeon of the gold coast of Africa wrote the following + to the London _Lancet_ of Jan. 2, 1890: 'Some of the worst cases + of this disease, the grippe, remind me of an epidemic I saw + among the natives of the swamps of the Niger. * * * * * + Irrespective of disinfectants and inhalations there is a simple, + effective and ready remedy, the juice of oranges in large + quantities, not of two or three, but of dozens. The first + unpleasant symptoms disappear, and the acid citrate of potash of + the juice, by a simple chemic action decreases the amount of + fibrine in the blood to an extent which prevents the development + of pneumonia.'" + +The Syracuse (N. Y.) _Post-Standard_ contained the following during the +epidemic of 1899:-- + + "Dr. George D. Whedon declared to a _Post-Standard_ reporter + yesterday that there is practically no subsiding of the grippe + in this city. Dr. Whedon said that the weather conditions have + little, if anything, to do with the disease, and that it is + impossible to define the conditions which produce it. It is some + morbific agency, the influence of which, Dr. Whedon said, is + exerted upon the pneumogastric nerve. + + "_Dr. Whedon was emphatic in denouncing treatment by means of + alcoholic stimulants, and coal tar derivatives._ In discussing + the subject at some length he said:-- + + 'I find that infants and young children are practically exempt + from the disease, and the liability increases with age. In my + own experience, which has since 1889 amounted to an aggregate of + 3,000 cases, alcoholic stimulants have appeared to be usually of + little or no value; their usual stimulating effect does not seem + to be realized in this condition. Unless malarial complications + exist quinine appears of no benefit, and then should not be used + in larger than two grain doses. Large doses depress the weakened + heart, and in all cases increase the terrible confusion and + headache constantly present in severe cases. + + 'From the views I entertain of its pathology, and from the + terrible fatality which has attended the extensive use of the + coal tar derivatives in treatment of _la grippe_, I argue that + the manner in which they have been prescribed in the beginning + of the disease, to reduce fever, and relieve the often intense + suffering, lowers the heart's action, which is already + sufficiently incapacitated by the toxic agent producing the + disease. + + 'The intention is usually to stimulate later, but later is in + many cases unfortunately too late. The heart being overwhelmed + by the poison, and by the added depression of all coal tar + preparations, cannot keep up the pulmonary circulation. The + swelling of the lungs increases, and the result is fatal. + + 'I am aware of the weight of authority for their administration + and of the relief they afford, but am just as well assured that + were their use discontinued, the greatly increased death-rate + from _la grippe_ would cease to appear. + + 'These coal tar remedies are being used everywhere, and the + medical journals recommend them despite the fatal results. They + are being used every hour in the day in Syracuse, and, as a + result, are knocking out good people. Among the most popular + coal tar derivatives I might mention anti-kamnia, + salol-phenacetine, anti-pyrine and salicylate of soda. + + 'Prognosis is favorable at all ages. Patients should be kept + warm, and perfectly quiet in bed, and supplied with such + nutritious and easily digested food, at frequent intervals, as + the partially paralyzed stomach can take care of. All + nourishment must be fluid and warm rather than cold.'" + +The _Journal of Inebriety_ for April, 1889, says:-- + + "The present epidemic of influenza has proved to be very fatal + in cases of moderate and excessive alcoholic drinkers. + + "Pneumonia is the most common sequel, breaking out suddenly, and + terminating fatally in a few days. Heart failure and profound + exhaustion, is another fatal termination. One case was reported + to me of an inebriate, who, after a full outbreak of all the + usual symptoms, drank freely of whisky and became stupid and + died. It was uncertain whether cerebral hemorrhage had taken + place, or the narcotism of the alcohol had combined with the + disease and caused death. + + "A physician appeared to have unusual fatality in the cases of + this class under his care. + + "It was found that he gave some form of alcohol freely, on the + old theory of stimulation. Another physician gave all drinking + cases with this disease alcohol, on the same theory, and had + equally fatal results. It has been asserted that alcohol, as an + antiseptic, was useful in these bacterial epidemics, but its use + has been followed by greater depression, and many new and + complex symptoms. The frequent half domestic and professional + remedy, hot rum and whisky, has been followed by more serious + symptoms, and a protracted convalescence. Many facts have been + reported showing the danger of alcohol as a remedy, also the + fatality in cases of inebriates who were affected with this + disease. + + "The first most common symptom seems to be heart exhaustion and + feebleness, then from the catarrhal and bronchial irritation, + pneumonia often follows." + +The vapor or Turkish bath is the best means of "breaking up" this +disease, together with hot lemonade and rest in bed for a day or two. +The inhalation of hot steam should be tried when there is much bronchial +irritation. + +LIFE-SAVING STATIONS, THE USE OF ALCOHOL IN:--"There is no + possible useful place for alcoholic liquors in connection with a + life-saving station. Applied externally the rapid evaporation of + alcohol reduces the temperature; taken internally it diminishes + the efficiency of both respiration and circulation, and by + increasing congestion of the kidneys it directly increases the + danger of secondary bad effects from exposures of any kind. To + restore warmth and circulation to the surface, light, rapid + friction and the wrapping with dry flannel is the safest, + cheapest and most efficient, while free breathing of fresh air, + and frequent small doses of milk, beef-tea, ordinary tea or + coffee, or even simple water, will afford the greatest amount of + strength and endurance, and leave the least secondary bad + consequences. It is just as easy to keep at hand a jug or flask + of any one of the articles named as it is to keep a flask of + whisky or brandy. There is no need of keeping them hot, as they + act well at any temperature at which they can be drunk."--DR. N. + S. DAVIS, Chicago. + +MEASLES:--"In mild cases, very little treatment is required, + except such as is necessary to make the patient comfortable. + Good nursing is much more important than medical attendance. If + the eruption is slow in making its appearance, or is repelled + after having appeared, the patient should be given a warm + blanket pack. + + "The old-fashioned plan of keeping the patient smothered beneath + heavy blankets, and constantly in a state of perspiration is + wholly unnecessary. The irritation of the skin, as well as the + sensitiveness to cold, may be relieved by rubbing the skin + gently two or three times a day with vaseline or sweet oil. + There is no danger from the application of cold water to the + surface except in the last stages of the disease, after the + eruption has disappeared. + + "The patient should be allowed cooling drinks as much as + desired. During the disease a simple but nutritious diet should + be allowed, but _stimulants of all kinds should be prohibited_." + + "It is wholly unnecessary, and dangerous as well, to give whisky + to bring out the eruption."--DR. I. N. QUIMBY, Jersey City. + + "Any hot drink, such as ginger tea or hot lemonade, may be used + to hasten the eruption, if delayed." + +MALARIA:--Observers of this disease in such regions as the gold coast of +Africa have noted the fact that malarial attacks are generally preceded +by impaired digestion. The disease is said to be due to animal +parasites. These parasites are supposed to generate in the soil of +certain regions, and thence, through the drinking water, or otherwise, +find entrance to the human body. + + "A healthy stomach is able to destroy germs of all sorts, hence + the best protection from malaria is the boiling of all drinking + water, and the maintenance of sound digestion and purity of + blood by an aseptic dietary." + +Dr. J. H. Kellogg says in _The Voice_:-- + + "It must be understood, however, that fruit in malarial regions, + especially watermelons, may be thickly covered with malarial + parasites and the parasites may sometimes find entrance to the + fruit when it becomes over-ripe, so that the skin is broken. It + is evident, then, that care must be taken to disinfect such + fruit by thorough washing, or by dipping in hot water, which is + the safer plan. The same remark applies to cucumbers, lettuce, + celery, cabbage and other green vegetables which are commonly + served without cooking. Not only malarial parasites but small + insects of various kinds are often found clinging to such food + substances, their development being encouraged by the free use + of top dressing on the soil, a process common with market + gardeners. + + "The treatment of malarial disease is too large and intricate a + subject for proper treatment in these columns. We will say + briefly, however, at the risk of being considered very + unorthodox, that the majority of cases of malarial poisoning can + be cured without the use of drugs of any sort. In fact, in the + most obstinate cases of chronic malarial poisoning, drugs are of + almost no use whatever. Quinine, however, is certainly of value + as a curative agent in these cases, either in destroying the + parasites, or in preventing their development; but as it does + not remove the cause, its curative effect is likely to be very + transient. The practice of habitually taking quinine as a + preventive of malarial disease is a most injurious one, as + quinine is itself a non-usable substance in the system, and + therefore must be looked upon as a mild poison, to be dealt with + by the liver and kidneys the same as other poisons. By habitual + use it may itself become a cause of disease. One or two + periodical doses of quinine often prove of great service in + interrupting the paroxysms of an intermittent fever, but other + treatment must also be employed to develop the bodily + resistance, and fortify the system against disease. The morning + cold bath, followed by vigorous rubbing, is a most excellent + measure for this purpose, but the old-fashioned German wet-sheet + pack is one of the best remedies known. The paroxysm itself can + generally be avoided by means of the dry pack, begun before the + chill makes its appearance; but this requires the services of an + expert nurse. In not a few cases it is wise for a person who + suffers frequently from malarial disease to seek a change of + climate to some non-malarial region. + + "Col. T. W. Higginson of the First South Carolina Volunteers, in + 1862, said of Dr. Seth Rogers, an eminent Southern physician, + who was surgeon of the regiment: 'Fortunately for us, he was one + of that minority of army surgeons who did not believe in whisky, + so that we never had it issued in the regiment while he was with + us, and got on better, in a highly malarial district, than those + regiments which used it.'" + +MATERNITY:--Dr. Ridge says:--"It is one of the greatest mistakes + to make use of alcoholic beverages to 'keep up the strength' + during labor. It is, of course, impossible to predict at the + commencement how long the labor will last; if then brandy, or + other similar drink, is resorted to early, it acts most + injuriously. The desire for food is often entirely removed; the + demand of the system being therefore unperceived, and so not + supplied, a state of weakness and prostration is in time + produced, if the labor should be protracted, which may be really + serious. The nervous system becomes exhausted by the repeated + action of the alcohol. If a fatal result is not occasioned, yet + the prostration of body and mind after delivery is aggravated, + and convalescence thereby retarded. Alcoholic drinks produce + paralysis and congestion of the blood-vessels, and in this way + largely increase the liability to flooding after the labor is + over. Alcohol also increases the liability to a feverish + condition. + + "It is necessary to take small quantities of plain, nourishing + food at regular intervals, and nothing is of greater value than + well-cooked oatmeal: other farinaceous food may be substituted, + if preferred. If there is much prostration, meat extracts or + beef tea are of great value. Tea tends to produce flatulence and + to prevent sleep. + + "After the labor is over, the best restorative is a cup of hot + beef tea or an egg beaten up in warm milk or a cup of warm + gruel. Rest, and absence of excitement and worry are essential + and alcohol is specially injurious." + +MENSTRUATION, PAINFUL:--Young girls often resort to the use of brandy +during the monthly period, and parents ask anxiously, "What can they use +instead of the brandy?" + +The very best thing that can be done is to go to bed, wrapped in +flannels, with a hot-water bottle or other hot application to the +abdomen, and to the feet. Take hot ginger tea, or pepper tea. + +A warm hip-bath taken at the beginning may give relief, or a large hot +enema retained for half an hour or so. Rest is necessary. + +For those who must go to work, Dr. Ridge recommends five drops of oil of +juniper, to be taken on sugar. + +NEURALGIA:--"The principal cause of neuralgia is defective + nutrition of the nerves. Disorders of digestion are very often + accompanied by neuralgia in various parts of the body. It may + also result from taking cold, from loss of sleep, from + dissipation, and also from the use of tobacco, alcohol, tea and + coffee. + + "The patient's general health must be improved by a wholesome, + simple diet, and the employment of tonic baths, as a daily + sponge bath, and massage in feeble cases. Sun-baths and exercise + in the open air are of first importance. Ordinary neuralgia may + almost always be relieved by either moist or dry heat. In some + cases, cold applications give more relief than hot. As a rule, + abnormal heat requires cold, and unnatural cold requires hot + applications. In many cases it is necessary to give the patient + a warm bath of some kind. Electricity often succeeds when all + other remedies fail. + + "For facial neuralgia apply hot fomentations, together with the + use of sitz baths, or hot foot baths. The head may be steamed by + holding it over hot water, adding pieces of hot brick + occasionally to keep water steaming, head being covered. + + "There is no complaint, perhaps, in the treatment of which the + use of port wine will be more strongly urged by kind friends, + with the assurance that it is impossible to get well without it. + This is quite untrue, as thousands can testify."--DR. RIDGE. + + "Avoid opiates of all sorts. 'It is better to bear the ills we + have than fly to others that we know not of.' The pangs of + neuralgia are as nothing to endure compared with the sufferings + of an opium wreck. Build up the general health, and the + neuralgia will disappear." + +NAUSEA.--"A feeling of sickness is not uncommonly due to + indigestion. If it is caused by rich food take a pinch of + bicarbonate of soda in a little water, or a teaspoonful of fluid + magnesia. The acidity of the food will thus be neutralized, and + this course is far preferable to benumbing the stomach with + brandy. If indigestion is the cause, it is often salutary to + miss one or two meals, so as to allow the stomach to recover. + + "When due to pregnancy, a little aërated water, or soda water is + useful; sometimes a small wafer or a crust, eaten before rising + in the morning, will check it. An early morning walk, if the + weather is pleasant, is helpful. + + "The moist abdominal bandage is a very excellent means of + relieving nausea during pregnancy. It should be worn constantly + for a week or two, and then omitted during the night. Daily sitz + baths are also of great advantage. In many cases electricity + relieves this symptom very promptly. In very urgent cases in + which the vomiting cannot be repressed, and the life of the + patient is threatened, the stomach should be given entire rest, + the patient being nourished by nutritive injections. + Fomentations over the stomach, and swallowing small bits of ice, + are sometimes effective when other measures fail."--DR. J. H. + KELLOGG. + +OUTGROWING THE STRENGTH:--"There is sometimes debility or + weakness in rapidly growing boys and girls which is attributed + to this cause. It is popularly supposed that port wine or beer, + is the great remedy; but nothing can be worse. It is true that + gin given continuously to puppies will keep them small, but no + one would advocate the amount of spirit required in proportion + by a lad or girl to produce the same effect. If the growth could + be checked by chemicals it would be most injurious to do so. + + "In the treatment of such cases fresh air by day and night is + essential; cold sponging, followed by friction with a rough + towel, and exercise are desirable." + + +PNEUMONIA. + +Dr. Julius Poheman says in _Medical News_:-- + + "The effect of alcohol upon nearly all the organs of the body + has been carefully investigated. But, strange to say, literature + contains only a few straggling hints upon the action of alcohol + on the pulmonary tissue. It has long been known that the abuse + of alcohol is a predisposing cause of death when the drinker is + attacked with pneumonia. No experimental evidence has been + published of the action of alcohol in producing pathological + conditions in the lungs. In order to determine this action, a + series of experiments was made upon dogs in the winters of + 1890-1891 and 1892-1893. The dogs were a mixed lot of mongrels + gathered in by the city dog catchers. They varied in weight from + fifteen to twenty-five pounds, and were apparently in good + health. In all, thirty animals were experimented on. + + "The experiments were performed as follows:--A carefully + etherized animal had injected into his trachea just below the + larynx a quantity of commercial alcohol varying from one dram to + one ounce in amount. The effects of equal amounts of alcohol + upon animals of the same weight varies greatly. Two dogs, + weighing twenty-five pounds each, were injected with two drams + of alcohol. One died in one hour, and the other in six hours + after the injection. Four other dogs, two weighing twenty-four + pounds each, another eighteen pounds, and the fourth fifteen + pounds, were all injected with the same amount, two drams. All + four survived, and were as well as usual in four weeks. Another + dog of eighteen pounds died five minutes after an injection of + two drams, while another of fifteen pounds took one ounce and + recovered. + + "The symptoms in the dogs were all alike, dyspnea, increasing as + the inflammation increased, until the accessory muscles of + respiration were called into play. The stethoscope showed that + air had great difficulty in entering the bronchi and air + vesicles, and showed also the tumultuous beating of the heart + in pumping blood through the lung. It was impossible to take the + temperatures. Post-mortem examinations showed the lungs dark, + congested and solid in some places. The air passages were filled + with frothy, bloody mucus, even in the dog that died in five + minutes. On section, the lungs were dark, congested, and full of + bloody mucus. This shows how acutely sensitive the respiratory + passages are to the action of alcohol. On microscopic + examination of the lungs, the air tubes and vesicles were found + filled with immense numbers of red and white corpuscles and much + mucus. The same picture was presented as in a slide from the + lungs of a broncho-pneumonic child. + + "The striking similarity between the two is enough to prove that + the pathological condition is the same, and that alcohol has + produced a lesion very closely resembling, if not absolutely + like, that of broncho-pneumonia in the human subject. This to + some extent explains why drunkards attacked by pneumonia succumb + more readily than the temperate. The sensitive lung tissue is + enveloped in alcohol--flowing through the capillaries of the + lung on one side, and exhaled, filling the air vesicles and + tubes on the other. The condition must create a state of + semi-engorgement or of mild inflammation, similar to the + drunkard's red nose, or his engorged gastric mucous membrane. + Such a state will reduce the vitality of the pulmonary tissue, + and its power of resistance to external influences. Add to this + an inflammation such as a pneumonia, and the lungs find + themselves unable to stand the pressure." + +As previous chapters contain much showing the reasons why alcohol is +dangerous in pneumonia, space need not be taken here to do more than +indicate briefly some points of non-alcoholic treatment. + +Pneumonia is generally supposed to result from a cold; it is ushered in +by the symptoms of a chill, followed by fever, headache, shortness of +breath, pain in chest, etc. It sometimes occurs as a complication of +typhoid fever and other acute diseases. + + "It is not a very fatal disease in young and healthy subjects, + but in weak children, old persons and habitual drinkers, it is a + very fatal malady." + +_Nature Cure_ recommends a vapor bath immediately upon the appearance of +the first symptoms, together with copious drinking of hot lemonade, and +a good supply of pure fresh air in the room, together with the +application of alternating hot and cold compresses, _and no drugs_. + +Dr. Kellogg says:-- + + "Cool compresses or ice-bags, alternated every three hours by + hot fomentations for ten minutes, should be applied to the + chest, particularly to the affected side, the seat of pain. The + hot fomentations relieve the pain, and the cold compresses check + the diseased process. The compresses should be wrung out of cold + water, and changed every five to eight minutes, or as often as + they become warm. Although the cool compresses are not usually + liked by the patient, they will soon give relief if their use is + continued, and they do much towards shortening the course of the + disease. Care should be taken to keep the patient's body from + being wet except where the treatment is applied. The cold + compress is much used in the large hospitals of Germany. When + the pulse becomes as rapid as 95 to 110 or more, cool sponging, + the wet-sheet pack, the cool full bath or the cool enema should + be employed. When much chilliness is produced by the contact of + water with the skin, the cold enema is a most admirably useful + measure. The amount of water required is from half a pint to a + pint. The temperature may be 40 to 60 degrees. The apartment + should be kept as cool as possible without discomfort, and an + abundance of fresh air should be continually supplied. + + "The diet of the patient should consist of milk, oatmeal gruel, + ripe fruit, and similar easily digested food. No meat, eggs or + other stimulating food should be allowed. + + "Discontinue the cold treatment after the first twenty-four to + forty-eight hours. If the surface is cold, apply hot sponging or + a hot pack. Avoid causing chilliness." + +PRE-NATAL INFLUENCE OF ALCOHOL:--"The use of beer as a medicine + during pregnancy is without doubt perilous to the health and + vigor of the offspring. Children born under such conditions are + sickly and feeble, and suffer from disease more severely than + others, or die early. Alcoholic prescriptions to pregnant women + are, from all present knowledge of the facts, both dangerous and + reprehensible in the highest degree."--DR. T. D. CROTHERS, + Hartford, Conn. + + "M. Fere, an eminent French physician, recently reported to the + Biological Society of Paris the results of experiments which he + had been conducting for the purpose of throwing light upon this + question. These experiments demonstrate that the exposure of + hen's eggs to the influence of the vapor of alcohol, previous to + incubation, retards the development of the embryo, and favors + the production of malformations. It is evident from these + experiments that alcohol may act directly upon the embryo when + there is no marked influence of alcoholism in the parent." + +PAIN AFTER FOOD:--"This may occur in acute or chronic gastric + catarrh, or in a neuralgic or oversensitive condition of the + stomach, or in ulcer or cancer of that organ. In all these it + comes on soon after food has been swallowed; but, if occurring a + long time after a meal, it is probably due to atonic dyspepsia. + Alcohol will undoubtedly sometimes relieve this kind of pain by + deadening the nerves of the stomach so that the pain is not + felt so much; but this effect soon passes off, and if the cause + of the malady is not removed by other means, increasing + quantities of alcohol will be required to give relief. Many + cases of drink-craving have originated in this way. Medical aid + will generally be required. A small mustard poultice over the + pit of the stomach is often useful, especially in inflammatory + cases, or any other outward application of heat. Food should be + fluid, or semi-fluid, and digestible. Ginger tea, or peppermint + water, may serve to disperse gas." + + +POISON, ANIMAL. + +The following by Dr. Chas. H. Shepard, of Brooklyn, who introduced the +Turkish bath into America, is taken from the _Journal of the A. M. A._, +for Nov. 13, 1897:-- + + "Animal poison is by no means uncommon, and so quick and + mysterious is its action that a prompt remedy is a vital + necessity. There is good reason to believe that the numerous + remedies that have been recommended from earliest times as + antidotes for animal poison are worthless, as they have not the + properties commonly ascribed to them. The paucity of remedies is + so great that alcohol is the one which comes most quickly to the + mind of those who have been taught in the traditions of the + past, and who are not fully aware of its action on the human + system. We shall endeavor to show that the action of alcohol is + not helpful, but on the contrary is really detrimental; and also + that there is a better way out of the difficulty. + + "If we get a splinter in the body, vital energy is aroused to + get rid of the offending substance, inflammation is set up, and + sloughing goes on until the splinter is voided. If the splinter + is covered with acrid material, the same process is intensified, + and nature endeavors to eliminate the offending substance + through the natural excretions. Upon the peculiarity of the + material depends the direction of this elimination. + + "It is well known that some poisons are thrown off by the + kidneys, some by the lungs, while others again are attacked by + all the emunctories. The difference in the power of the system + to absorb different substances, appropriate whatever can be + utilized, and throw off whatever can not be used, is sometimes + called idiosyncrasy, but more properly it may be called vital + resistance, and upon the integrity of this power rests the + ability to combat disease in all its forms, whether it be the + absorption of any animal virus or the poison resulting from + undigested food. This ability is in proportion to the integrity + and soundness of every tissue and organ of the body. This may be + illustrated by the fact that with a person suffering from kidney + disease, which necessarily impedes elimination, the ordinary + effects of a poison are intensified; therefore whatever aids in + the promotion of good health, or in other words, the normal + action of all the functions, will contribute to the safety of + the individual in any and every emergency. + + "When a person dies from the effect of poisoning, it is simply + because the system was unable to eliminate the offending + substance and was exhausted in the effort. There is a tolerance + of some substances which frequently results in chronic disease, + and again it is shown in what is called the cumulative effect or + acute disease. + + "Those who would hold that a substance is at one time a + medicament, and at another time a poison, have much trouble in + drawing the line between the beneficial and the poisonous + effect. The idea that poisonous substances act on the system is + responsible for many grave mistakes, whereas always, and under + all circumstances, it is the system that does all the action. + + "There might be some excuse for the idea that disease is an + entity, from the facts that have been brought to light by the + germ theory, but this theory is of recent date, while the entity + theory is as old as superstition. + + "Snake poison, which may be cited as a type of other animal + poisons, takes effect through the circulation, and acts by + paralyzing the nerve centres, and by altering the condition of + the blood. In ordinary cases death seems to take place by arrest + of respiration, from paralysis of the nerves of motion. The + poison also acts septically, producing at a later period + sloughing and hemorrhage. + + "Dr. Calmette, a noted French scientist, claims that what is + poisonous in the snake's bite, is not the venom absorbed into + the blood, but a principle which the blood itself has developed + out of the poison. This would necessitate very quick action when + the poison is inserted in one of the large veins, as that is + followed by instant death. + + "The following cases fairly represent some of the tragedies that + are occurring in our everyday life. + + "A man 60 years old falls and dislocates his finger, he goes to + the hospital, where in a short time he dies from blood + poisoning. * * * * * Another man 48 years old, many years a wine + merchant, whose great toe was severely crushed by a heavy man + stepping on it, was taken with blood-poisoning and in spite of + all treatment, even to the amputation of the leg, he soon + succumbed to the disease. * * * * * A young woman 24 years old, + picks a pimple on her chin and at once her face begins to swell. + In vain was all medical treatment, for in a few days she died in + terrible agony. * * * * * About a year ago there died in + Brooklyn, N. Y., a physician in his 38th year, who six days + previously received a slight scratch in his hand while + performing a post-mortem examination. All that medical science + could suggest was done to no avail. * * * * * In the summer of + 1896 a young woman 22 years of age was bitten on the leg by an + insect. Several physicians were called in but their treatment + gave no relief; blood-poisoning set in; it was decided to + amputate the leg, but before it could be done she died. * * * * + * In July, 1896, a veterinary surgeon 34 years of age, while + removing a cancer from a horse pricked his finger with his + knife. The wound was so slight that he forgot all about it. A + few days later blood-poisoning set in and in a short time his + end came. * * * * * Some forty years ago a man named Whitney was + teasing a rattlesnake in a Broadway barroom, was bitten by it, + and, though whisky was poured down his throat by the quart, he + soon died. + + "Such results seem entirely unnecessary were the proper course + pursued, and at the same time they are a fearful commentary on + the medical resources of the day. + + "The latest researches in regard to alcohol reveal it as a + poison to the human system in whatever way it may be diluted or + disguised. Its effect is always the same in proportion to the + amount taken. It is impossible to habitually use it in any form, + even in small quantities, without disease and degeneration + resulting therefrom. When taken into the stomach the action is + the same as with any other narcotic; the meaning of this word is + _to become torpid_. It benumbs the nerves of sensation, and thus + the vital resistance to any offending material is reduced, and + while the patient _feels_ less of any disturbance the real harm + goes on with accumulated force because of the lack of vitality + and non-resistance of the nervous system. + + "When the body is in the throes of a vital struggle with a + virulent poison it would seem, to any unprejudiced mind, the + height of folly to further weaken the vital resistance by the + administration of any narcotic, and especially alcohol. + + "The eminent German, Professor Bunge, says: 'All the results + which on superficial observation appear to show that alcohol + possesses stimulant properties, can be explained on the ground + that they were due to paralysis.' * * * * * Professors S. Weir + Mitchell and E. T. Reichert, in _Researches on Serpent Poison_, + make this notable statement: 'Despite the popular creed, it is + now pretty sure that many men have been killed by the alcohol + given to relieve them from the effects of snake bite, and it is + a matter of record that men dead drunk with whiskey and then + bitten, have died of the bite.' + + "As a great contrast to the weakness of the mass of our people + who are drug-takers and alcohol-consumers, and who are liable to + almost any epidemic that comes along, and quickly succumb to a + serious injury, may be mentioned the Turkish soldiers of to-day, + who know nothing of drugs as we use them and never use alcohol + in any form. During the late controversy with the Greeks, one of + them who was reported as having been shot in the stomach, + remained in the ranks, and afterward walked ten miles. Another + one who was wounded twice in the legs and once in the shoulder, + continued attending to his duties for twenty-four hours, until + an officer noticed his condition and ordered him to the + hospital. The heat was tremendous, but the troops endured it + without complaint, and the doctors were astonished at the + wonderful vitality of the wounded Turks, who recovered with + remarkable rapidity. This, with good reason, is attributed to + their abstemious lives. + + "It has been stated that the Moqui Indians handle the + rattlesnake with impunity, and are not inconvenienced by its + occasional bite. + + "The rational treatment of animal poison is to endeavor to + prevent the entry of the virus into the circulation and to + neutralize it in the wound before it is absorbed; but when it + has entered the system everything should be done for its + elimination. + + "The most powerful aid to the human system, and the most perfect + eliminator known to man is heat. It is used with much advantage, + and great success by means of water, both internally and + externally, but above all is its use by hot air, as in the + Turkish bath, which works in harmony with every natural + function, promoting the action of all the secretions, and more + particularly the excretions. By this means will the system + unload itself of an accumulation of impurities in an incredibly + short space of time, while the heat aids in destroying whatever + there may be of virus therein. + + "Calmette, whom we have previously quoted, has shown that + whatever be the source of snake venom, its active principle is + destroyed by being submitted to a temperature of about 212 + degrees for a variable length of time. + + "In the not remote future thousands of human beings will owe to + the Turkish bath not only an immunity from disease in general, + but also an escape from the horrors of a premature death from + hydrophobia, the poison of snake bite, or the slower action of + infectious disease. + + "The mass of testimony that has been accumulating for over + thirty years past is more than sufficient to convince any + reasonable mind that is willing to examine the facts. + + "The medical profession has searched the world over and under + for the means of controlling disease, while within the human + body itself lies the vital power which needs only to be + cultivated and exalted to its true function to banish the mass + of disease from the land." + +Dr. Shepard states in another article that Turkish baths are now used in +London and Paris for the cure of hydrophobia. + +Dr. J. H. Kellogg says:-- + + "A great number of remedies have acquired the reputation of + being cures for snake bites. The partisans of each one of these + have been able to produce a large number of cases, which + apparently supported their claims; the uniform testimony of all + scientific authorities upon this subject, however, is that all + these so-called antidotes are worthless. Prof. W. Watson Cheyne, + M. B., F. R. C. S., surgeon of Kings College Hospital, London, + England, states, in the _International Encyclopedia of Surgery_, + that 'there is no known antidote by which the venom can be + neutralized, nor any prophylactic.' This eminent authority also + remarks further: 'Hence medication with this view is to be + avoided altogether, and the aim of treatment should be to + prevent the poison from gaining access to the general + circulation, and to avoid its prostrating effects if its + entrance has already taken place.' The same writer asserts that + the only aim of the constitutional treatment should be 'to + sustain the strength until the poison shall have been + eliminated.' The idea that the saturation of the body with + whisky to the point of intoxication, if possible, is beneficial + in these cases, is in the highest degree erroneous. Whisky + intoxication, according to Dr. Cheyne, actually 'favors the + injurious effect of the poison. What is required is to keep the + patient alive until the poison has been eliminated.' Whisky will + not do this, but actually aids the poison in its fatal work by + lessening the resistance of the patient, and hence lessening his + chances for recovery. + + "The reputation of whisky as a remedy in these cases is due to + the fact that on an average only one person in eight who is + bitten by a rattlesnake is really poisoned; the reasons for this + were fully explained in an interesting paper on 'Rattlesnakes,' + by the eminent Dr. S. Weir Mitchell, and published in the + Smithsonian Contributions to _Knowledge_ for 1860. If the snake + strikes several times before inflicting a wound, the sacs + containing the venom may be emptied, so that the succeeding bite + will introduce only the most minute quantity of poison--not + enough to produce serious, or fatal results. If the part bitten + is covered by clothing, the poison may be absorbed by the + clothing, so that but very little enters the circulation. In + various other ways the snake is prevented from inflicting a + fatal wound. The popular idea, that every bite of a rattlesnake + is necessarily poisonous, is thus shown to be erroneous. It is + not at all probable that the administration of whisky has ever + in any case contributed to the long life of a person bitten by a + rattlesnake. + + "Whisky is often recommended by physicians with the idea that it + will sustain the energies of the patient, or will stimulate the + heart, etc.; but it has been clearly shown that alcohol in all + forms is not only useless for these purposes, but does actual + damage, since it lessens the resistance of the patient, weakens + the heart, and helps along the prostration which is the + characteristic effect of the rattlesnake venom. Alcohol has, for + many years, been used as an antidote for collapse under an + anæsthetic administered for surgical purposes, but no + intelligent physician nowadays thinks of using alcohol for such + a purpose; instead, alcohol is given before the anæsthetic for + the purpose of facilitating its effect. Errors of this sort + which have once become established are very hard to uproot. + Probably some physicians will continue to use alcohol for shock, + exhaustion, general debility and similar conditions as well as + for rattlesnake poisoning for another quarter of a century, but + such use of alcohol does not belong to the domain of rational + medicine and is not supported by scientific facts." + + "Under the Pasteur method, a man who did not take alcohol was + much more likely to recover from the bite of a mad dog than one + bitten under the same conditions, who used that drug; while in + lock-jaw there was absolute failure to secure immunity if the + patient had taken alcohol. In India it used to be given in large + quantities for snake bite, but it was found that it had a direct + effect in interfering with the processes of repair, and so is + being abandoned."--DR. SIMS WOODHEAD, of the Royal College of + Physicians and Surgeons, London, Eng. + + "Nothing could be more irrational and dangerous than the popular + notion concerning the antagonism of whisky and snake-bites, and + Willson reports that several of the fatalities in his series + were directly due to alcohol rather than to the + bite."--_Editorial, Journal of the American Medical Ass'n._ + +RHEUMATISM:--"Unquestionably, the most active cause of + rheumatism, as well as of migraine, sick-headache, Bright's + disease, neurasthenia and a number of other kindred diseases, is + the general use of flesh food, tea and coffee, and alcoholic + liquors. As regards remedies, there are no medicinal agents + which are of any permanent value in the treatment of chronic + rheumatism. The disease can be remedied only by regimen,--that + is, by diet and training. A simple dietary, consisting of + fruits, grains, and nuts, and particularly the free use of + fruits, must be placed in the first rank among the radical + curative measures. Water, if taken in abundance, is also a means + of washing out the accumulated poisons. + + "An individual afflicted with rheumatism in any form should + live, so far as possible, an out-of-door life, taking daily a + sufficient amount of exercise to induce vigorous perspiration. A + cool morning sponge bath, followed by vigorous rubbing, and a + moist pack to the joints most seriously affected, at night, are + measures which are worthy of a faithful trial. Every person who + is suffering from this disease should give the matter immediate + attention, as it is a malady which is progressive, and is one of + the most potent causes of premature old age, and general + physical deterioration. American nervousness is probably more + often due to uric acid, or to the poisons which it represents, + than to any other one cause."--_Good Health._ + + "Alcohol favors the development of rheumatism. It does this by + preventing waste matter from leaving the system. Beer and wine, + because they contain lime and salts, are said to cause + rheumatism, or at least to aid in its development. These salts + are absorbed into the system, unite with the uric acid, and form + an insoluble urate of lime, which is deposited around the + joints, thus causing them to become enlarged and stiff. * * * * * + + "The success of the Turkish bath treatment has been phenomenal. + Of over 3,000 cases treated here at least 95 per cent. have been + entirely relieved, or greatly helped. Some who were treated over + twenty years ago have stated that they have not had a twinge of + rheumatism since. Very few have persevered in the use of the + bath without experiencing permanent relief."--DR. CHARLES H. + SHEPARD, Brooklyn. + + "Those having a bath cabinet can have a good substitute at home + for the Turkish bath. Remember that if tobacco and alcohol are + indulged in, there can be no permanent relief." + +_The New Hygiene_ says:-- + + "Under no circumstances take any of the thousand and one + nostrums advertised as sure cures for this disease. Pure + unadulterated blood is the only remedy. This can only be + produced by cleansing the system of impurities, and giving it + the right kind of material out of which to make it. Keep out the + poisonous physic, clean out the colon, strengthen the lungs, and + feed the system with proper food, and this disease will vanish + like a fog before the rising sun." + +The same book in advocating the use of the Turkish bath for rheumatism, +says:-- + + "The fact, which is well attested, that when a person enters the + bath the urine may be strongly acid, but, on leaving the bath, + after half an hour, it is markedly alkaline, shows that the bath + has a strong effect upon the system." + +Dr. Ridge says of _rheumatic fever_:-- + + "I would urge most strongly the desirability of avoiding every + form of alcoholic liquor, from the very commencement of the + disease, as affording the best chance for a speedy and safe + recovery. The highest authorities are agreed on this point, but + there is a lingering practice which makes reference necessary in + order to confirm the wavering." + +In Mt. Sinai Hospital, New York, the hot blanket pack is used in acute +rheumatism, almost to the exclusion of other methods. The pack should be +continued two to four hours at least, and may be repeated two or three +times within the twenty-four hours with advantage. + +_Nature Cure_ says that thorough massage, and half a dozen cups of hot +lemonade will cure a severe case of sciatica:-- + + "The massage should be commenced moderately, and increased as + the patient can bear it. Rubbing and slapping of the muscles + with bare hands will hasten a cure, and be agreeable to the + patient. One to two hours treatment, if _vigorous_, will effect + a cure." + +SEA-SICKNESS:--Brandy is a common resort in this trouble, many taking it +under such circumstances who would under no other. Yet it frequently +adds to the sickness, instead of relieving it. + + "Be sparing in diet for two or three days before the expected + voyage. If very sensitive, take to your berth as soon as you go + on board, or lie down on deck; get near the centre of the + vessel, and lie with your feet to the stern. Go to sleep if + possible. Iced water may be sipped, but nothing solid should be + taken at first; after a while a cracker or wafer may be taken." + +It is said upon good authority that if two or three apples are eaten +shortly before going on board, or before rough water is encountered, +sea-sickness is entirely averted. It will be well to partake of no other +food for some hours previous to the voyage when trying this. + +_Good Health_ says:-- + + "If any of our readers have occasion to cross the ocean in the + stormy season, we recommend three things; keep horizontal, with + the head low; put an ice-bag to the back of the neck, keep the + stomach clean, free from greasy foods and meats, and eat nothing + till there is an appetite for food. A habitually clean dietary + before going on board is doubtless a good preparation for such a + voyage, as well as for any other nerve strain, or test of + endurance. It pays to be good--to your stomach, as well as in + other ways." + +The following is guaranteed by a Russian physician to be an effective +cure and a means of avoiding sea-sickness when the symptoms first make +their appearance. Take long and deep inspirations. About twenty breaths +should be taken every minute, and they should be as deep as possible. +After thirty or forty inspirations the symptoms will be found to abate. +This is recommended for dyspepsia also. + +SORE NIPPLES:--"Alum water, or tannin, used for several months + in advance will harden as effectually as brandy. If there is + soreness on commencing to nurse, put a pinch of alum into milk, + and apply the curd to the nipple." + +SPASMS:--"These are caused by flatulence, as a result of + indigestion. A little hot ginger tea, or capsicum tea, may do + all that is required. If these are not at hand, loosen every + tight band, rub well the region of the heart and stomach, slap + the face with the corner of a wet towel, and give sips of cold + water." + +SHOCK:--"In shock, or collapse, the state is similar in some + respects to that which is present in fainting. Every function is + almost at a standstill; absorption from the stomach and + elsewhere is at its lowest point, because the circulation of the + blood is so much interfered with. Hence much of the brandy which + is so often given, and to such a wonderful amount, with very + little apparent effect of intoxication, is really not absorbed + at all, and is very often rejected from the stomach by vomiting, + when reaction does occur, if not before. + + "The patient should be wrapped up warmly, and put to bed as soon + as possible. The limbs may be rubbed with hot flannels, and hot + water bottles put to hands and feet. In some cases, also, towels + wrung out of hot water may be wrapped around the head. Hot milk + and water, hot water slightly sweetened, or with a little + peppermint water in it, should be given as soon as the patient + can swallow. Hot beverages will warm the skin more rapidly and + powerfully than any alcoholic liquor. + + "If the patient cannot swallow, an enema of hot water, or hot, + thin gruel, should be administered, and may be of use in + addition to hot drinks. Beef extract may be added to the hot + water with advantage. + + "In the vast majority of cases there need be no anxiety so far + as the shock is concerned; reaction will occur in due time if + ordinary care be taken, and will be more natural and steady if + the system is not embarrassed by the presence of the narcotic + alcohol. In the state of collapse the voluntary nervous system + is depressed; alcohol diminishes the power and activity of the + nervous centres of the brain, hence its action is undesirable in + shock or collapse."--DR. J. J. RIDGE, London. + + "No procedure could be more senseless than the administering + alcohol in shock. A stimulant of some kind is necessary in such + cases, and alcohol, instead of being a stimulant is a narcotic. + * * * * * Alcohol causes a decrease of temperature, the very + thing to be avoided in cases of shock."--DR. J. H. KELLOGG. + + "I am perfectly sure that a large dose of alcohol in shock puts + a nail in the coffin of the patient."--DR. H. C. WOOD of the + University of Pennsylvania. + +SINKING SENSATIONS:--Many women have a feeling of weakness or "goneness" +at about eleven o'clock in the morning, and are led by it to the +injurious practice of eating between meals. It is often due to +indigestion, or to the use of beer or wine. A few sips of hot milk, of +fruit juice, or even of cold water will often relieve it, especially if +total abstinence is persevered in. + +SUDDEN ILLNESS:--"Those taken suddenly ill are likely to fare + best if placed in a recumbent position, with head slightly + elevated, all tightness of garments about the neck or waist + relieved, and a little cold water given in case of ability to + swallow. A mustard plaster on the back of the neck, or over the + stomach, and hot water or hot bottles to the feet, are never out + of place, while vinegar, or smelling salts, or dilute ammonia to + the nostrils is reviving."--EZRA M. HUNT, M. D., late secretary + of New Jersey State Board of Health. + + "Both the popular and professional beliefs in the efficacy of + alcoholic liquids for relieving exhaustion, faintness, shock, + etc. are equally fallacious. All these conditions are temporary, + and rapidly recovered from by simply the recumbent position, and + free access to fresh air. Ninety-nine out of every hundred of + such cases pass the crisis before the attendants have time to + apply any remedies, and when they do, the sprinkling of cold + water on the face, and the vapor of camphor or carbonate of + ammonia to the nostrils, are the most efficacious remedies, and + leave none of the secondary evil effects of brandy, whisky or + wine."--DR. N. S. DAVIS. + +SUNSTROKE:--"There has lately been a correspondence in the + _Morning Post_ on the subject of 'Sunstroke and Alcohol.' We + quite agree with the statement that 'nothing predisposes people + to sunstroke so much as this pernicious habit of taking + stimulants (so-called) during the hot weather.' As far as this + country is concerned, nearly every case of sunstroke might be + more appropriately designated 'beerstroke.' One effect of + alcohol is to paralyze the heat-regulating mechanism; the blood + becomes overloaded with waste material, and the narcotism, and + vasomotor paralysis, produced by the alcohol, is added to that + produced by the heat. Abstainers, other things being equal, can + always endure extremes of temperature better than consumers of + alcohol."--_Medical Pioneer_, England. + + "During the month of January, 1896, there occurred over three + hundred deaths from sunstroke in Australia. When called upon to + offer suggestions relative to its prevention, the medical board + promptly informed the Colonial government that, of all the + predisposing causes, none were so potent as indulgence in + intoxicating liquors, and in its treatment nothing seemed to + have a more disastrous effect than the administration of + alcoholic stimulants."--_Medical News._ + +The _Bulletin of the A. M. T. A._ for August, 1896, contained the +following:-- + + "Recently a leading medical man, a teacher in a college, warned + his student audience against the anti-alcoholic theories urged + by extremists and persons whose zeal was greater than their + intelligence. He affirmed positively that the value of alcohol + was well known in medicine, and established by long years of + experience. + + "Not long afterward a man was brought into his office in a state + of collapse from sunstroke, and this physician and teacher + ordered large quantities of brandy to be administered; the + patient died soon after." + +Dr. T. D. Crothers tells of a case where alcohol was administered to a +child for partial sunstroke, and says, "there were many reasons for +believing that the profound poisoning from alcohol gave a permanent bias +and tendency that developed into inebriety later." + + "When a person falls with sunstroke (or heatstroke) he should at + once be carried to a cool, shady place. His clothing should be + removed, and cold applications made to the head, and over the + whole body. Pieces of ice may be packed around the head, or cold + water may be poured upon the body. Cold enema may also be + employed. In case the face is pale, hot applications should be + made to the head and over the heart and the body should be + rubbed vigorously."--DR. J. H. KELLOGG. + + +TYPHOID FEVER. + +As many lives are lost by this disease, its treatment must ever be one +of intense interest, not only to physicians, but also to all humanity. +Since non-alcoholic treatment has reduced the death-rate in typhoid to +five per cent., the views regarding such treatment expressed by leading +practitioners will doubtless be read with eagerness. + +The following is a paper by Dr. N. S. Davis taken from the _Medical +Temperance Quarterly_. + + "ALLEGED INDICATIONS FOR THE USE OF ALCOHOL IN THE TREATMENT OF + TYPHOID FEVER:--On the first page of the first number of a new + medical journal bearing date July, 1895, may be found the + following statement: 'The question of administering alcohol + comes up in every case of typhoid fever. In mild cases, + especially when the patient is young, healthy and temperate, + stimulants are not needed so long as the disease follows the + typical course. Here, as elsewhere, alcohol should be avoided + when not absolutely demanded. There is, however, generally such + a dangerous tendency toward nervous exhaustion, that in a + majority of cases more or less alcohol is required. The + indication which calls for its use is an inability to administer + enough food. * * * * * Again, the existence of high temperature + nearly always makes it necessary to stimulate the patient, as + does threatened nervous exhaustion and heart failure, for + immediate effect; likewise a weak, small, compressible, rapid + pulse, with impaired cardiac impulse and systolic sound, is a + frequent indication; other remedies may be required, but alcohol + cannot be dispensed with.' The next paragraph continues: 'It is + necessary to give alcohol in serious complications of typhoid + fever, such as pneumonia, pleurisy, hemorrhage and severe + bronchitis or diarrhoea. It is best to begin giving it early + and in small quantities: two to six ounces is a moderate amount, + eight to twelve ounces daily is not too much for adynamic or + complicated cases.' + + "The foregoing quotations purport to have been condensed from + one of our recent authoritative works on practical medicine, and + doubtless fairly represent the prevailing opinions concerning + the use of alcohol in the treatment of typhoid and other fevers, + both in and out of the profession. A careful reading will show + that the whole is founded on the following four assumptions: + + "1. That alcohol when taken into the living body acts as a + general stimulant, and especially so to the cardiac and + vasomotor functions. 2. That in mild, uncomplicated cases of + typhoid fever in young and previously healthy subjects, + stimulants are not required and no alcohol should be given. 3. + That in a 'majority of cases' the tendency toward dangerous + 'nervous exhaustion' and 'heart failure' is so great that the + giving of 'more or less alcohol is required.' 4. The amount + required may vary from two to twelve or more ounces per day. + + "In the two preceding numbers of this journal, I have endeavored + to show that the chief causes of nervous exhaustion and heart + failure, in typhoid and other fevers were impairment of the + hemoglobin and corpuscular elements of the blood, deficient + reception and internal distribution of oxygen, and molecular + degeneration of the muscular structures of the heart itself. + These important pathological conditions are doubtless caused by + the specific toxic agent or agents giving rise to the fever. + Consequently the rational objects of treatment are to stop the + further action of the specific cause, either by neutralization, + or elimination, or both; to stop the further impairment of the + hemoglobin and other elements of the blood; and to increase the + reception and internal distribution of oxygen, by which we will + most effectually prevent further fatty or granular degeneration + of cardiac and other structures. The language of the paragraphs + I have quoted, fairly assumes that alcohol is a _stimulant_ + capable of relieving nervous exhaustion and cardiac failures, + regardless of the causes producing those pathological + conditions, and consequently its use is necessary in the + 'majority of cases' of typhoid fever. + + "Can such an assumption be sustained by either established + facts, or correct reasoning? Can nervous and cardiac exhaustion, + induced by the presence of toxic agents in the blood, with + deficiency of both hemoglobin and oxygen, be relieved by a + simple _stimulant_, that neither neutralizes nor eliminates the + toxic agents, nor increases either the hemoglobin or oxygen? + That alcohol does not neutralize or destroy toxic ptomaines, or + tox-albumins, is proved by abundant clinical experience, and + also by the fact that chemists use it freely in the processes + for separating these substances from other organic matters for + experimental purposes. That its presence in the living body + retards metabolic changes generally, and thereby aids in + retaining instead of eliminating toxic agents of all kinds, has + been so fully shown in the pages of preceding numbers of the + _Medical Temperance Quarterly_, that the leading facts need not + be repeated here. That its presence does not increase the + hemoglobin, or favor oxy-hemoglobin or increased internal + distribution of oxygen, but decidedly the reverse, has been + equally well demonstrated by numerous and reliable experimental + researches in this and other countries. + + "Then it must be conceded that alcohol is not capable of + fulfilling either of the important indications presented in the + treatment of typhoid fever as stated above. Nevertheless, the + advocates of its use apparently recognize but two ideas or + factors in these cases, namely, the popularly inherited + assumption that alcohol is a _stimulant_, and as the patient is + in danger from nervous and cardiac weakness, therefore the + alcohol must be given, _pro re nata_ without the slightest + regard to the existing causes of the weakness, or the _modus + operandi_ of the so-called stimulant. + + "This is proved by the fact that they group together as + stimulants, and give to the same patient in alternate doses, + remedies of directly antagonistic action, as alcohol and + strychnine, or digitalis, etc. + + "The accepted definition of a stimulant in medical literature, + is some agent capable of exciting or increasing _vital activity_ + as a whole, or the natural activity of some one structure or + organ. + + "For instance, both clinical and experimental observations show + that strychnine directly increases the functional activity of + the respiratory, cardiac and vasomotor nervous systems, and + thereby increases the internal distribution of oxygen, which is + nature's own special exciter of all vital action. Therefore it + is properly a direct respiratory, cardiac and vasomotor + stimulant and indirectly a stimulator of all vital processes. + But the same kind of clinical and experimental observations show + that alcohol directly diminishes the functional activity of all + nerve structures, pre-eminently those of respiration and + circulation, and also of all metabolic processes, whether + respirative, disintegrative or secretory. Consequently it not + only acts as directly antagonistic to strychnine, but equally so + 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 + anæsthetic and sedative, or depressor of vital activity. + + "And a thorough and impartial investigation will show that its + use in the treatment of typhoid and other fevers, while + deceiving both physician and patient, by its anæsthetic effect + in diminishing restlessness, both prolongs the duration and + increases the ratio of mortality of the disease, by its + impairment of vital activity in the organizable elements of both + blood and tissues." + +Equally interesting is the following outline of treatment pursued by +Dr. W. H. Riley, of the Battle Creek Sanitarium. + + "The purpose of the present paper is to give briefly an outline + of the method of treatment of typhoid fever as used by the + writer in a considerable number of cases. + + "A consideration of the pathology of this disease does not + properly come under this head, but we wish simply to call + attention to the well-known fact that typhoid fever is a germ + disease. The germ which causes this fever has generally been + supposed to be the bacillus of Eberth. More recent + bacteriological studies rather indicate that the bacillus coli + may also cause the disease. These germs are usually carried into + the body in food or drink, and, lodging in the small intestines, + begin to grow and multiply, and by their life produce poisonous + ptomaines which are absorbed and carried by the circulation to + all the organs and tissues of the body. + + "It is these ptomaines, thus carried to all parts of the body, + that are largely the immediate cause of the pyrexia and + attending symptoms. The organisms which produce these poisons + for the most part remain in the intestines, although they have + been found in the spleen. + + "The indications for treatment are:-- + + "1. To remove or destroy the cause (to eliminate the germs and + ptomaines from the body). + + "2. To sustain the vital and resisting powers of the patient. + + "If the patient is seen early in the disease, it has been my + practice to immediately put him to bed and give a free dose of + magnesium sulphate. This is preferably given in the morning or + forenoon, and may be repeated once or twice on successive days. + Besides this the patient should have a large enema of water at a + temperature of from 75° to 80° F.; and this may be repeated + daily or even oftener, for some time, if necessary, to keep the + bowels empty of the poisonous substances. + + "The salines and enemas thus used carry out bodily a large + number of germs and ptomaines that are present in the + intestines; and further, the salines, by producing an increased + secretion of the mucous membrane of the intestines, tend to + disentangle and set free many of the germs that have found a + lodging place in the walls of the intestines. + + "For the elimination of the ptomaines which have been absorbed + into the circulation and carried to the tissues, nothing is + better than the internal use of water. From three to five pints + should be drunk during every twenty-four hours. It should be + taken in small quantities--six to eight ounces every hour or two + during waking hours, except when food is taken. I will refer to + this point more in detail later. + + "A consideration of the general care of the patient properly + comes under the second head of the indications for treatment as + given above. The patient should be put to bed in a large, light, + well-ventilated room. At least two sides of the room should + communicate directly by windows with out-of-doors, in order that + the room may be properly ventilated. + + "All unnecessary articles of furniture, such as carpets, + couches, upholstered chairs, pictures, etc. should be removed. + + "The room should be thoroughly cleaned before the patient is put + into it. + + "There should be two beds in the room for the use of the + patient. These should be, preferably, narrow and so placed in + the room that there is a free approach to both sides of the bed, + for the convenience of the nurse in giving treatment. Iron + bedsteads are preferable to wooden. The bedding should be firm, + yet soft and smoothly drawn. There should be just sufficient + covering to protect the body. The patient should be changed from + one bed to the other daily. This may be done by placing the two + beds side by side and carefully moving the patient from one to + the other. The sheets on the bed from which the patient has been + taken should be washed and disinfected at each change of the + beds, and all other bedding should be thoroughly aired and + exposed to the sunlight daily. + + "The patient should have the care of a thoroughly educated, + careful and competent nurse, one who understands perfectly the + various methods of using water in the treatment of fevers. + + "There is no other single remedy that I consider so valuable in + the treatment of fever as the internal use of water. As above + stated, the patient should drink six or eight ounces every hour + during the waking hours, except for about two hours after food + is taken. The water should be thoroughly sterilized, and as a + rule may be taken either cool or hot. Ice water is + objectionable. Hot water is often preferable. This is a simple + remedy, but nevertheless is efficacious. It should be given to + the patient whether he calls for it or not, and it should be + considered an important part of his treatment. When water is + taken into the stomach and absorbed into the circulation, it + throws into solution the ptomaines which have been absorbed from + the intestines and are present in the circulation and tissues, + and thereby puts them in a favorable condition for elimination. + It increases the activity of the kidneys, and thus hastens and + increases the elimination of the poisons in the system. + + "In the early stage of the fever, when the pulse is full, and + the action of the heart increased, it is best to give the + patient cool water. Later in the disease, when the action of the + heart is weak, and the patient feeble, it is best to give the + water hot. + + "Winternitz, many years ago, demonstrated that hot water taken + into the stomach acts as a cardiac stimulant, and the increased + heart's action is immediate, or at least before the water has + time to absorb, which indicates that the water in the stomach + acts reflexly as a cardiac stimulant. The water after absorption + also increases the circulation by filling the blood-vessels, and + increasing arterial pressure. The writer has frequently noticed + a decided increase in the fullness, and rapidity of the pulse, + after a patient has drunk a glassful of hot water. + + "The external use of water also forms an important part of the + treatment. The patient should be sponged off with tepid water + every hour or two when the temperature is 103°, or above. When + the temperature is less than this, it is not necessary to sponge + the body so frequently. Sometimes a hot sponge bath is more + efficacious in reducing the temperature than the tepid or cool + bath. The sponge bath reduces the temperature, relieves many of + the distressing nervous symptoms, is refreshing to the patient, + and promotes sleep. The temperature of the body may also be + reduced by the use of cool compresses placed over the abdomen, + and changed frequently. + + "The matter of diet is an important factor in the treatment of + typhoid fever. The diet should be aseptic, easily digested, and + should contain the necessary food elements. Probably no one + article of diet meets all these requirements as well as + sterilized milk. The patient should take from two to three pints + daily. The milk is best taken four times during the day at + intervals of four hours, taking eight to ten ounces at a time. + Should the patient become tired of the milk, gluten gruel may be + substituted for the milk. + + "The diarrhoea and bowel symptoms, when present, may be + relieved by the application of hot fomentations to the abdomen, + warm or hot enemas and twenty grains of subnitrate of bismuth + given every four hours. + + "The patient should be kept as quiet as possible, and should be + turned in bed at intervals, to prevent hypostatic congestion and + the formation of bed-sores. The bony prominences which are apt + to become eroded should be sponged frequently with a solution of + tannic acid in equal parts of alcohol and water; a dram of the + tannic acid to a pint of alcohol and water, is about the proper + strength to use. + + "By the methods briefly outlined above--that is by the free use + of water internally and externally, by keeping the intestines + thoroughly emptied of poisonous material by the free and + frequent use of enemas, by proper feeding and the careful + attention of a good nurse to the patient and his + surroundings--the duration of the fever may be shortened and the + severity of the disease lessened; heart failure, and other + complications will seldom occur, and the patient will in nearly + every instance make a good recovery. The best method to pursue + to prevent heart failure is to keep the poisons which are + generated in the bowels and absorbed into the body, and which + are the direct cause of the heart failure, eliminated from the + body. Should the heart become weak, it may be effectually + stimulated by giving hot water to drink, applying heat to the + heart in the form of a fomentation, and the application of + fomentations to the upper spine. + + "In the treatment of a large number of cases of typhoid fever, + extending over several years' practice, the writer has never + made use of alcohol internally to support the action of the + heart, or for any other purpose. + + "The number of cases of death from typhoid fever coming under + the writer's observation, where the method of treatment pursued + has been similar to that briefly indicated above, have been very + few, a much smaller per cent. than in practice where alcohol has + been used as a 'cardiac stimulant.' I believe that the use of + alcohol in the treatment of typhoid fever is not only useless, + but absolutely harmful." + +Dr. Kate Lindsay, of Battle Creek Sanitarium and Hospital, contributed +an article upon Typhoid Fever to the _Bulletin of the A. M. T. A._ for +January, 1896, from which a few notes are here taken:-- + + "The chief toxic centre is evidently the intestinal tract, + especially the termination of the ileum. The ulcerations, + necroses, perforations and hemorrhages are most frequently found + in the last twelve inches of the small intestine, and may extend + into the large intestine. The ulcerated surface and open vessels + increase the facility with which the poison finds entrance into + the circulation. The microbes, blood clots, necrosed tissue and + pus, furnish abundant supplies of toxic matter, which, + saturating the system, over-power and stop the activity of the + functions of all the organs of the body, causing degeneration of + tissues. Death is said to take place from heart, lung or brain + failure, but the failure involves every other organ as well. + + "Regarding the intestinal tract as any other abscess at this + time, the physician should seek for methods of treatment or + remedies which will remove the morbid matters, and destroy, or + at least inhibit their action, thus decreasing the fever and + stimulating the circulation. Secondary toxic centres often + develop in the course of this disease, notably in the glands, + lungs and dependent organs, the hypostatic congestion resulting + from lying in one position, causing stasis of blood, death and + necrosis of tissue, both of the external and internal organs. + All vessels connected with the dying tissues carry toxins to + other parts of the body. Suppurating glands, and phlebitis of + the femoral veins are examples of this secondary infection, and + are accountable for the heart failure and collapse so often + fatal during the second, third and fourth weeks of typhoid + fever. * * * * * + + "The old idea that in peristaltic action lay the great danger of + increase of the hemorrhage and perforation of the bowels, is + giving way to the more rational view that gaseous distention and + septic absorption, are what bring about fatal results from these + complications, and that the moderate peristalsis of the + intestinal walls lessens these dangers by closing the gaping + ends of the injured vessels, and expelling the septic matter and + foul gases. To meet these indications I have found lavage of the + bowels, even during hemorrhage, with water of 105° to 110° F. or + even hotter, given in moderate quantity of from one pint to + three, to give great relief by freeing the large intestines of + blood clots, fecal matter and other morbid matter. It also + increases peristaltic action in the small intestines, thus + favoring the expulsion of gas. The heat stimulates the + circulation in the peripheral vessels of the intestines, and + overcomes the tendency to blood stasis. + + "In the cases cited, ice-bags, alternated with fomentations, + were used over the abdomen externally, and heat, or hot and + cold, to spine. The extremities were kept warm. From ten to + thirty minims of turpentine, in an ounce of gum acacia or starch + water, increased the efficiency of the enemata, and aided in + expelling the gas and checking hemorrhage. + + "The tendency to hypostatic congestion and bed-sores, was + prevented by frequent change of position, and the use of hot and + cold to the spine by fomentations and compresses, or better + still, hot fine spraying, or the alternate hot and cold spray. + In one grave case, spraying was kept up for about twelve hours, + with only short intermissions. The heart was stimulated by heat + applied over it, whenever depression and collapse threatened, + and by hot and cold sponging of the spine." + +Dr. Noble said some time ago in the _London Times_:-- + + "Although it is true that alcohol is an antipyretic, yet its + exhibition neither shortens nor modifies (favorably) the + diseases of which the fever is but a symptom. The paralysis of + the brain which is so frequent a cause of death in typhoid + fever, is more often brought about by alcohol than any other + cause, and more than one woman suffering from puerperal fever + has been done to death by the administration of this substance, + which, not being _convenienter naturæ, is contra naturam_." + +J. S. Cain, M. D., in an able paper, read at the Nashville Academy of +Medicine, on "Rational Suggestions in the Treatment of Typhoid Fever," +dissents from the practice, which still obtains largely in the medical +profession, of administering alcoholic liquors, in the belief that they +are "stimulants, conservators of force and even nutrients," and says:-- + + "After a careful and thoughtful study of this subject, I have + reluctantly, and against firm early convictions, been forced to + the conclusion that these theories with regard to the beneficial + effects of alcohol in disease are wholly fallacious. The only + rational conclusion at which I can arrive is that the agent is + ever, and under all circumstances, a depressor of temperature; + that it arrests the physiological interchange of carbonic acid + gas and oxygen in the tissues, as well as in the air vesicles of + the lungs; that it impedes the elimination of tissue waste, and + causes the accumulation of this refuse in the system; that it is + lethal anæsthetic in all quantities; that it is not stimulant in + the true sense, and never exerts that influence; and that it + supplies no element to the diseased and vitiated system + calculated to antagonize disease, repair waste, or invigorate + lowered vital forces, and therefore for these purposes is not + called for in the rational treatment of typhoid fever." + +At the annual meeting of the American Medical Association held in +Atlanta, Georgia, in 1896, Dr. G. B. Garber, of Dunkirk, Ind., read a +paper upon "Alcohol in Typhoid Fever" from which a few points are here +taken:-- + + "The fact that the mortality from typhoid fever seems to be + gradually lowering is no doubt due in great measure to the + non-use of alcohol in the treatment of the disease. Hardly a + week passes that some of our journals do not report a series of + cases treated without the aid of alcohol in any form. I used + alcohol in the treatment of the disease until two years ago, + when I became alarmed at the mortality; so I changed my plan, + and in 1894 I treated thirty-seven well marked cases of varying + degrees of intensity. I had two fatal cases, and in both of them + I had used alcohol. In 1895 I treated thirty cases of about the + same type, with no death. I only used alcohol in one of them, + and it caused me more trouble than any of the others. As this + case was in the family of a saloon-keeper, I could not control + the matter, as they would give it during my absence. On my + return I would find the face flushed, the temperature high, the + pulse rapid and the patient nervous. By close inquiry I would + find that some of the family had given 'just a little good + whisky' which had been in the house for twenty years. + + "In closing, I wish to state that I am well convinced that in + the treatment of typhoid fever our patients will do better and + stand a greater chance of recovery, if we abstain entirely from + the use of alcohol in the treatment of the disease." + +Prof. J. Burney Yeo, of London, in a paper read before the International +Medical Congress held at Rome, Italy, said:-- + + "In order to maintain the intestinal antisepsis which forms an + essential part of this method of treatment, I insist on the + necessity of scrupulous attention and caution in feeding + patients suffering from enteric fever, great danger arising from + a failure to note the extremely limited digestive and absorptive + capacity exhibited by such patients. + + "In conclusion, the use of alcoholic stimulants, and the common + employment of depressing antipyretic agents, must be condemned." + +In a report of the treatment of typhoid fever by seventy-two physicians +of Connecticut, thirty-eight declared that they did not use alcohol in +any stage of this disease. The remainder used it sparingly in the last +stages, and only two considered it valuable from the beginning of the +disease. + +In a discussion of typhoid fever by a medical society meeting in +Rochester, N. Y., recently, sixty physicians being present, only three +spoke in favor of using alcohol in this disease. + +Hygienic physicians all insist upon a rigid fast as long as the high +temperature continues, or until the patient is sufficiently hungry to +eat a piece of plain, stale, graham bread, "dry upon the tongue." Dr. +Charles E. Page of Boston says there would be very few relapses if this +plan were carefully carried out. He contends that the whisky and milk +diet, together with the not over-fresh air of the average sick room is +enough to produce fever in a healthy person, hence is not likely to be +conducive to recovery in one already infected with the disease. + +In an article in the _Arena_ of September, 1892, Dr. Page says:-- + + "In my fever practice I have frequently observed the effect of + fasts of six, eight, ten and twelve days to be in the highest + degree productive of the health and comfort of patients, as, on + the other hand I have, during the past twenty years observed the + deplorable effects of the almost universal plan of constant + feeding. In some of the most distressing cases that have + happened to be thrown in my way, when all hope in the minds of + friends had been abandoned, I have found that withdrawal of + food, drugs and stimulants, and the substitution of simple, + fresh, soft water, has produced results that seemed almost + miraculous." + +Fruit juices are now permitted by many physicians in fever, a few drops +of lemon or orange juice, being a grateful addition to the water. Grape +juice, unfermented, is highly recommended by some. + +A young minister of great promise died recently of typhoid fever. His +young wife, only one year married, is in settled melancholy, because she +cannot understand why "God took her husband." Inquiry developed the fact +that the physician in attendance was a believer in alcohol as a remedy, +and used it in this case. In view of the better chances of recovery +under non-alcoholic treatment shown by comparative death-rates, may it +not be that the alcohol was responsible for the young man's death, +instead of its being "God's will to take him?" The Author of all good +has too frequently been held responsible for the errors of physicians, +and the carelessness of nurses. + +VOMITING:--"If the vomiting is due to undigested food, and the + sickness can be traced to excess, or to improper diet, draughts + of hot water should be taken in order to be rid of offending + matter in the stomach. After the stomach is empty bits of ice + may be sucked, or cold water sipped. A quarter of a Seidlitz + powder may be taken. A flannel, folded to four thicknesses, + dipped in hot water, and wrung dry in a towel, may be applied to + the pit of the stomach. Cover the flannel with a hot plate, + being careful to have the flannel large enough to prevent the + plate's burning the skin. Pin a dry towel over all, around the + body. This may be renewed every half-hour or hour, as required. + Sometimes a cold wet compress on the pit of the stomach, covered + with a dry towel is more efficacious, heat developing by + reaction. Fluid magnesia is often helpful."--DR. RIDGE. + + + + +CHAPTER IX. + +ALCOHOL AND NURSING MOTHERS. + + +It frequently happens that the nursing mother is unable by reason of +defective digestive apparatus, or imperfect assimilative powers, to +supply sufficient nourishment for her babe. In such case she is often +advised to drink ale or beer. It is true that these liquors will excite +the secretions of the mammary gland, but it is increase in quantity, not +in quality, for the milk is impoverished by the added water and alcohol, +taken in the beer. Milkmen sometimes salt cows heavily so that they will +drink largely of water, and thus give more milk, but one quart of good, +rich milk is worth three quarts of the poor, thin stuff resulting from +such method. It is proper feeding, and care, that ensure good milk. + +When women complain that they are unable to nurse their babies the cause +is often an error in diet. Too great reliance is put upon meat as +strength-giving. While meat, used in moderation, may be valuable to many +persons, the nursing mother should not depend upon it to any great +extent. She will find farinaceous foods, with plenty of warm milk, what +she most requires. At bedtime she should have a bowl of well-cooked +oatmeal gruel, diluted with rich milk, and sweetened, if she prefer it +so. The milk should be added to the gruel while it is boiling, as it +digests more readily if scalded. People who cannot, or think they +cannot, take milk of itself, often find it easy to digest it, after it +is scalded in the gruel. Anything that a mother can do in the way of +nourishing her babe will be done upon such a diet, that is, farinaceous +foods and milk. Sweet fruits are of course valuable also, as tending to +keep the system in good order. + +It is well to bear in mind that it is not the quantity of food eaten, +but that which is digested, and assimilated, that goes to build up the +tissues of the body. So the habit of eating between meals is pernicious, +as it disturbs the digestive processes, and robs the stomach of +much-needed rest. This habit is the cause, in many cases, of the falling +off in the milk after the first month or two. + +As nourishment for both mother and babe can come from food only, good +appetite, and good digestion are essential to health and strength. The +very best help towards gaining a good appetite is exercise in the open +air. All mothers recognize the need of keeping their little ones out of +doors a while every day, but all do not see the necessity of the same +mode of life for themselves. Dr. Nathan S. Davis has said: "I have +persuaded thousands of mothers to try fresh air, instead of wine or +beer, with gratifying results." The mother who takes her babe out, +herself, for its daily airing, is laying up stores of health and +vitality, to aid her in providing for the needs of the little one, +dependent upon her. + +Good digestion is as essential as good appetite. Alcohol, whether in +beer, wine, whisky, or any other form, is injurious to the stomach, and +a hinderer of digestion, hence must do harm, rather than good, to the +mother in search of added nourishment for her babe. + +Dr. Condi says:-- + + "The only drink of the nurse should be water or milk. All + fermented and distilled liquors, as well as strong tea and + coffee, she should strictly abstain from. Never was there a more + absurd or pernicious notion than that wine, ale or porter is + necessary to a nursing mother in order to keep up her strength, + or to increase the quantity, and improve the properties of her + milk. So far from producing these effects, such drinks, when + taken in any quantity, invariably disturb more or less the + health of the stomach, and tend to impair the quality, and + diminish the quantity, of nourishment furnished by her to her + infant." + +Dr. William Hargreaves says:-- + + "Every farmer knows that all a healthy cow requires to give good + milk and butter is, to give her good feed, and pure water; and + he also knows that the way to make a cow give poor watery milk, + which they might churn until doomsday without obtaining butter, + is to feed her on distillery slops, or grains from the brewery. + It is also well known that cheese cannot be made from such milk, + it being deficient in curd, or casein. + + "Alcohol is not only useless but injurious; for children whose + mothers try to keep themselves upon beer, etc., very frequently + suffer from vomiting and diarrhoea, and often from + convulsions. Sometimes a single glass of whisky, taken by the + mother, will produce sickness and indigestion in the child, for + twenty-four hours after. + + "In the milk of a healthy woman the water ranges from 879 to 905 + parts in 1,000. The oily substance ranges from 25 to 42; casein + from 15 to 39; sugar of milk from 31 to 45, and the salts from 1 + to 4 parts in 1,000. + + "Alcoholic drinks materially alter these proportions, for, on + the analysis of the milk of the same woman, a few hours before + and after the use of a pint of beer, it was found that the + alcohol increases the proportion of the water, and diminishes + that of casein; and that alcohol is very perceptible in it." + + "The only rational way to be adopted by mothers to increase the + supply of nutrition for their infants, is to secure plenty of + suitable nutritious food, prepared in the way that will most fit + it for digestion, while they at the same time, avoid as far as + possible all fatigue, and mental excitement. It is impossible + that alcoholic beverages can add anything to the nutrition of + either the infant or mother."--Dr. Bussey, in _Stimulants for + Nursing Mothers_. + +Dr. E. G. Figg, in _The Physiological Operation of Alcohol_, gives the +analyses of the milk of a temperate woman in good health, and of a +drinking woman as follows:-- + + + Milk of temperate mother. Milk of drinking mother. + + Salts, " " 8.50 Salts, " " 5.50 + Casein, " " 3.0 Casein, " " 2.0 + Oil, " " 7.50 Oil, " " 6.5 + Water, " " 81.0 Water, " " 84.0 + Alcohol, " " 2.0 + ------ ------ + 100.00 100.00 + + +Dr. Edward Smith says in his _Practical Dietary_:-- + + "Alcoholics are largely used by many women in the belief that + they support the system, and maintain the supply of milk for the + infant; but I am convinced that this is a serious error, and is + not an infrequent cause of fits and emaciation in the child." + +Dr. James Edmunds, of the Lying-In Hospital, London, Eng., says in _Diet +for Nursing Mothers_:-- + + "The nursing mother is peculiarly placed, in that she has to + provide a supply of nutriment for the child which is dependent + upon her, as well as for the ordinary requirements of her own + system. The nutrition of the child is to be provided for upon + the same principles, and by the same food-elements, as is the + nutrition of the mother, the only difference being that the + young child is possessed of less perfect masticatory and + digestive powers, and therefore requires food to be presented to + it in a state more simple, uniform, and readily assimilable than + the adult, who is furnished with strong teeth, and possessed of + a fully-grown stomach. The mastication, digestion, and primary + assimilation of the nursing infant's food is thrown upon the + mother's organs; but the tissues of the child are nourished + precisely as are the tissues of the mother, and a nursing mother + requires simply to digest a larger supply of wholesome, and + appropriate food. As a matter of course mothers with imperfect + teeth, or weak stomachs, cannot perform the digestion of extra + food for the infant so well as those mothers who have an + abundance of reserve power in their digestive apparatus; and + with such patients, the question arises, how are they to make up + for the deficiency which they soon experience in the supply of + milk? Such mothers appeal to their medical advisers to prescribe + some stimulant which will enable them to overcome the difficulty + which they experience, and often are greatly dissatisfied if + informed that there is no drug in the _materia medica_ which + will make up for structural weakness in the organs which + masticate, digest or assimilate the food. The proper course for + such women to adopt is a simple and rational one. They should + assist their digestive apparatus as much as possible by securing + an abundance of suitable and nutritious food, prepared in the + best way, and as is most digestible, while they should lessen + the demands of their own system by the avoidance of bodily + fatigue, and mental excitement. These means, aided by that + philosophical hygiene which is at all times essential to the + preservation of pure and perfect health, will enable them to + supply a maximum quantity of pure and wholesome milk; and + further calls by the child require proper artificial food. + Unfortunately such advice fails to satisfy many anxious mothers + who refuse to admit, or believe, that they are less robust, or + less capable, than other ladies of their acquaintance, and such + mothers fall easy victims to circulars vaunting the nourishing + properties of 'Hoare's Stout,' 'Tanqueray's Gin,' or Gilbey's + 'strengthening Port,' circulars which are always backed up by + the example, and advice, of lady friends, who themselves have + acquired the habit of using these liquors, and who view as a + reproach to themselves the practice of any other lady who may + not keep them in countenance, as the perfection of all moral and + physical propriety. Unfortunately the pressure of such lady + friends is often so persistent as to paralyse the influence of a + conscientious and thoughtful medical adviser, while the + appetites and beliefs of such friends often throw them into + active antagonism to any medical adviser, who may not endorse + the habits in which, as they believe, and no doubt + conscientiously, duty to their child requires them to indulge. + The only course that a medical practitioner, whose family is + dependent upon his practice, can safely take with veteran + mothers on this question, is to let them have their own way + without reiterated admonition. When once they have acquired the + habit of depending upon large quantities of beer for nursing + their children, they become perfectly infatuated, and are + practically incapable of passing through the probationary + fortnight which takes place before the digestive apparatus can + work under its natural, but to them strange, conditions, while + the temporary longing for beer, and the sudden lessening of the + quantity of milk afforded by their strained and impoverished + systems, are at once set down as clear proofs that their medical + adviser is a crochetty, and dangerous person, who must be + superseded at the first convenient opportunity. Facts and + arguments have no more influence on such mothers than they have + upon opium-eaters, drunkards, or inveterate consumers of + tobacco; while the extreme propriety of conduct which these + ladies manifest, and the encouragement they receive from other + medical men, make the convictions based upon their own personal + sensations incontrovertible, and their position practically + unassailable. I think I might fairly say that among the + comfortable middle classes of society the views at present held + on this question are so deplorable that a large proportion of + children are never sober from the first moment of their + existence until they have been weaned; while often after a few + years the use of alcohol is again introduced to the children as + a 'medical comfort,' as a part of their regular diet, or as an + invariable accompaniment of all their juvenile visitation, and + company-keeping. Under such circumstances, it is not surprising + that temperance reformers appeal in vain on this question, and + that their facts and arguments are viewed with plausible + indifference, or insidious opposition, by persons whose + appetites and instincts have been undergoing debasement, and + perversion from the very dawn of their lives. My own deliberate + conviction is that nothing but harm comes to nursing mothers, + and to the infants who are dependent upon them, by the ordinary + use of alcoholic beverages of any kind. + + "Infants nursed by mothers who drink much beer also become + fatter than usual, and to an untrained eye sometimes appear as + 'magnificent children.' But the fatness of such children is not + a recommendation to the more knowing observer; they are + extremely prone to die of inflammation of the chest (bronchitis) + after a few days' illness from an ordinary cold. They die, very + much more frequently than other children, of convulsions and + diarrhoea, while cutting their teeth, and they are very liable + to die of scrofulous inflammation of the membranes of the brain, + commonly called 'water on the brain,' while their childhood + often presents a painful contrast--in the way of crooked legs, + and stunted or ill-shapen figure--to the 'magnificent,' and + promising appearance of their infancy. + + "Those ladies who adopt the general views I have thus expressed + in relation to the nursing of their children, will want to know + what is the 'proper artificial food' with which to supplement + their milk when it is deficient in quantity. With some patients + the milk will fall off in quantity at the end of two or three + months. With others, although the quantity may not fall off, the + child seems unsatisfied; and there is a third class with whom a + profusion of milk is supplied, and the child thrives + exceedingly, but the mother gets flabby, weak, nervous, pale and + exhausted. In the last case, the mother is simply goaded on by + susceptibility of her nervous system, or by inordinate activity + of the breasts to yield an amount of milk which her digestive + powers are not equal to providing for. The treatment of such + cases should be simply repressive. The mother should separate + herself somewhat more from the child, and make a rule of only + nursing it from five to eight times in the twenty-four hours, + while the neck of the mother should be kept cool in regard to + dress, and cold sponging may be practiced carefully night and + morning. Her attention should be diverted by outdoor exercise on + foot, and additionally in a carriage if necessary. When the + mother's milk, though apparently not deficient in quantity, + proves unsatisfying to the child, great attention should be paid + to varying the diet of the mother, while such staple foods + should be taken as are most easily and thoroughly assimilated + into milk. The unsatisfying quality of the milk will generally + be remedied by taking a more varied diet, together with three or + four half pints of milk in the course of the day, accompanied + with farinaceous matter, as in the shape of well-made milk + gruel; and in case these measures fail, the only alternative is + to supplement the mother's milk by obtaining a wet-nurse to + suckle the child three or four times a day alternately with the + mother, or by feeding the child with proper artificial food. The + same measures may be resorted to where the milk, though + satisfying in character, is deficient in quantity; and in + preparing artificial food for the child it must always be + remembered that the food requires to be adapted to the stage of + development which is manifested by a young infant's digestive + organs. The infant's digestive apparatus is, in fact, designed + to digest milk, and to digest nothing else, but when the teeth + are cut farinaceous matter of a more or less solid character + should be gradually mixed with the milk. Almost all the + illnesses of infants under twelve months of age are caused by + some gross impropriety of diet, or otherwise, on the part of the + mother, for which the child suffers through the medium of the + milk, or they are caused by feeding the child with improper + artificial food. Thick sop, and many other articles often given + as food are as indigestible to an infant of three months old as + beefsteaks would be to a horse; and, until the child has cut its + teeth, it should have nothing but food resembling the mother's + milk as closely as possible. + + "The proper way to feed an infant of three months old, whose + mother is only able to partially support it, is as follows: When + the child wakes in the morning it should not go to the mother, + but should be taken away by the nurse, and immediately fed from + the bottle, sucking its milk through a suitable teat. After the + mother has breakfasted the child may go to the breast, and + during the day it should be alternately fed from the bottle, and + nursed by the mother. At six o'clock the baby should invariably + be placed in its crib, by the side of the mother's bed, and fed + just before going to sleep, and the habit of going to bed at six + o'clock should be strictly and invariably enforced. If once the + child be allowed to come down to the family circle after dark, + the habit of going to sleep will be broken, and the child will + continuously cry to come down. In the course of the evening the + mother may nurse the child once, and at ten or eleven o'clock, + when the mother goes to bed, the child should be again fed from + the bottle, and the mother should have a basin of well-made + milk-gruel; and by her bedside should be placed, at the last + moment, as much gruel as she is likely to drink with relish + during the night. Whenever the child is restless it should be + taken out of its crib, gently, by the mother, and nursed, say + two or three times during the night, and put back again into its + crib, the child never being allowed to sleep with the mother. + When the night is fairly over, and the child awakens, it should + be fetched by the nurse, and have its first morning meal from + the bottle. This plan of feeding should be persisted in + continuously until the child has cut its teeth; and it is only + when every means have been taken to ensure the sweetness, + freshness and niceness, not only of the milk and water, but of + the bottle and of the teat, and the child still fails to get on, + that, in rare cases, I advise the admixture of a little + farinaceous matter, in the way of food containing one part milk, + and two parts of properly sweetened barley-water. As the milk + teeth come through, other farinaceous matter may be gradually + blended with the milk, and there is nothing better than to begin + at about eight months with a teaspoonful of baked flour, well + boiled in a pint of milk and water, or in the water, to be + afterwards cooled with milk. Oftentimes a little salt, as well + as sugar, will materially help its digestion. The child will do + well on that food--the quantity being duly increased--until it + has cut almost all its milk teeth, when it may eat bread and + butter, rice, and egg puddings, and occasionally eat a boiled + egg once a day. I believe that it is a great mistake to give red + flesh meat to children in their early years, unless there be + some very special reason for it, and then it should only be + temporarily used; but nice potatoes, flavored with fresh gravy + from a joint, may be given at dinner, as the child becomes able + to feed itself. * * * * * + + "Bear in mind that when you take wine, beer or brandy, you are + distilling that wine, beer or brandy into your child's body. + Probably nothing could be worse than to have the very fabric of + the child's tissues laid down from alcoholized blood." + +Another English physician deplores "the pernicious habit of drinking +large quantities of ale or stout by nursing mothers, under the idea that +they thereby increase and improve the secretion of milk, whereas they +are in reality deteriorating the quality of that upon which the infant +must depend for health and life." + +Dr. Edis says:-- + + "Infant mortality is mainly due to two causes, the substitution + of farinaceous food for milk, and the delusion that ale or beer + is necessary as an article of diet for nursing mothers. * * * * + * Countless disorders among infants are due simply and solely to + the popular fallacy, that the nursing mother cannot properly + fulfil her duties, unless she resorts to the aid of alcoholics." + +Dr. N. S. Davis says:-- + + "The opinion prevails quite extensively among certain classes of + people, and with some physicians, that a liberal use of beer is + beneficial to women while nursing their children. They drink it + under the impression that it will both strengthen them and make + their milk more abundant. But I have never seen a case in which + it had been used regularly for any considerable period of time, + where it did not result in more or less indigestion from gastric + irritation and disordered secretions, and an early failure in + the secretion of milk. It probably never increases the flow of + milk any more than would the drinking of the same quantity of + pure water; while the alcohol it contains, by daily repetition, + induces congestion of the gastric mucous membrane, with + disordered gastric and hepatic secretions. + + "A case strikingly illustrating these results was examined by me + to-day. The patient was a young married woman who was nursing + her first child, now nine months old. At the time of her + confinement she was in fair health, rather nervous temperament, + weight 120 pounds. During the first few days her milk did not + flow very freely, and she says her physician advised her to + drink beer. Consequently she commenced to drink a glass of beer + at each mealtime, and a bottle during the night. During the + first six months she had sufficient milk for her baby; but + before the end of that time she had begun to suffer from + flatulency, constipation, gaseous and acid eructations, what she + calls 'heart-burn,' and sometimes vomiting. During the last + three months she has suffered, in addition to the preceding + symptoms, one or two attacks each week of extreme pain, from the + lower point of the sternum to the back between the scapula, + accompanied by retching, or severe efforts to vomit. To relieve + these attacks she has taken liberal doses of gin, in addition to + her regular supply of beer. Now at the end of nine months, her + milk has nearly ceased to flow, her bowels are costive, her + stomach tolerates only small quantities of the simplest + nourishment, her flesh and strength are very much reduced, her + weight being only 96 pounds; and yet she thinks both the beer + and gin make her feel better every time she takes them. Such is + the delusive power of the anæsthetic effect of alcohol. A + persistence in the same management would probably terminate + fatally in from six to twelve months more, from chronic + gastritis, and inanition. But if she will rigidly abstain from + all alcoholic remedies, and take only the most bland, + unirritating nourishment, aided by mildly soothing and + antiseptic remedies, and fresh air, she will slowly recover." + +In a clinical lecture delivered before the Senior Class in the +Northwestern University Medical School, Dr. Davis told of a case similar +to the preceding:-- + + "The flow of milk in her breasts has also diminished to such a + degree that she does not have half enough for her baby. Yet she + says the _beer_ makes her feel better after each drink, and that + the _gin_ helps to relieve the severe attacks of pain, and + consequently she thinks she could not do without them. It is + undoubtedly true that the patient feels temporary relief from + the anæsthetic effect of the alcohol in her beer and gin, just + as she would from any anæsthetic or narcotic. And it is equally + true that so long as the alcohol is present in her blood it so + modifies the hemoglobin and albuminous constituents, as to + diminish the reception and internal distribution of oxygen, and + thereby retards metabolic changes. But the combined influence of + the alcohol in retarding the internal distribution of oxygen and + the drain upon the nutritive elements of her blood, in + furnishing milk for her baby, led to rapid impoverishment of the + blood and tissues, and the early establishment of a sufficient + grade of gastritis to cause indigestion, frequent vomiting, and, + later, paroxysms of severe gastralgia, with general emaciation, + and loss of strength. + + "In accordance with the present popular ideas, both in and out + of the profession, this patient tells me she has tried a great + variety of foods, peptonized, sterilized, and predigested, but + all to no purpose. And why?--Simply because her troubles are not + in the kind of food she takes, but in the morbid condition of + her blood, and of the mucous membrane and nerves of her stomach. + Consequently the rational indications for treatment are: (_a_) + to get her stomach and blood free from the alcohol of beer and + gin; (_b_) to encourage the reception and internal distribution + of oxygen by plenty of fresh air; (_c_) to give her the most + bland, or unirritating food in small, and frequently repeated + doses, of which good milk with lime-water, and milk and + wheat-flour gruel are the best; (_d_) such medicines as possess + sufficient antiseptic, and anodyne properties to allay the + irritability of the gastric mucous membrane, and lessen + fermentation." + + + + +CHAPTER X. + +COMPARATIVE DEATH-RATES WITH AND WITHOUT THE USE OF ALCOHOL AS A REMEDY. + + +A study of statistics relating to the difference in results of the +treatment of disease with and without the use of alcohol, cannot but be +of great interest to all students of the alcohol question. The appended +statistics are culled mainly from the _Medical Pioneer_ of England, now, +_Medical Temperance Review_, the journal of the British Medical +Temperance Association, and from the _Bulletin of the American Medical +Temperance Association_. + +A paragraph in the _British Medical Journal_, for Dec. 2, 1893, says:-- + + "An interesting fact has been noted by Dr. Claye Shaw, at the + London County Asylum, Banstead, for the Insane. Since the + withdrawal of _beer_ from the dietary, the rate of recovery has + gone up. During the past year, for example, the recoveries + reached 46.97 per cent. Nearly one half of the patients had thus + recovered during the period stated. The inmates take their food + better without the liquor, and they are thus taught that + intoxicants are not a necessity of ordinary health." + +In the _Medical Pioneer_ for January, 1894, Dr. John Mois, medical +superintendent of West Haven Infectious Diseases Hospital, states that +prior to 1885 he had treated 2,148 cases of smallpox "in the usual +routine method, with the use of alcohol when the heart's action seemed +to indicate it;" resulting in a mortality of 17 per cent. But since 1885 +he has treated 700 additional cases under similar circumstances except +that the use of alcoholic preparations was entirely omitted, and the +resulting mortality was only 11 per cent. + +In the same journal, Dr. J. J. Ridge states that he had treated the 200 +cases of scarlet fever admitted into the Enfield Isolation Hospital +during the years 1892 and 1893, without alcohol in any form, with a +mortality of only 2.5 per cent.; while the mortality in the hospitals +under the Metropolitan Asylums Board in 1893, in which alcohol was used +in accordance with the usual practice in scarlet fever, was 6.3 per +cent. + +Dr. J. J. Ridge says later:-- + + "In January, 1894, I published the result of the treatment of + the first 200 cases of scarlatina admitted into the temporary + wards of the Enfield Isolation Hospital during 1892 and 1893. I + stated that there had been five fatal cases, but that one was + dying when admitted and only lived a few hours. The mortality + was 2 per cent., or 2.5 if the later case is included. + + "Since then 300 more cases have been admitted and discharged and + among these there have been 7 fatal. Hence there have been 14 + deaths in 500 consecutive cases extending over a period of a + little more than four years. One of these ought to be excluded, + no time having been given for treatment. Hence the mortality + has been just 2.6 per cent. This, I think it will be admitted, + is a low mortality, although it is possible it may be even lower + when the cases are treated in a permanent hospital about to be + erected. + + "It may be interesting to state that 4 of the cases died on the + third day after admission; 1 on the fourth; 1 on the sixth; 1 on + the tenth, with pneumonia; 1 on the thirteenth; 1 on the + fifteenth; 1 on the sixteenth; 1 on the eighteenth; 1 on the + thirty-sixth, with nephritis and pleuropneumonia; and 1 on the + forty-sixth, with otitis and meningitis. + + "All the cases have been treated without alcohol either as food + or drug, although many have been of great severity with various + complications. It is certain that the absence of alcohol has not + been detrimental, since the mortality is less than three-fourths + of that of the mortality among all notified cases in England and + Wales. I am bound to say that it is my firm conviction that had + alcohol been given in the usual fashion, the death-rate would + have been higher. Cases have been admitted to which alcohol has + been given previous to admission, apparently with harm, as they + have improved without it. One case was particularly noticeable + in this respect. A child, aged 6, had had a good deal of whisky, + and was supposed to be dying when admitted on the fourth day of + the disease, so that the doctor who had seen it was surprised, + when he called the following day to inquire, to find it was + still alive. Without a drop of alcohol it began to improve and + made a good recovery. I may say that delirium is very rare, even + in the worst cases treated non-alcoholically." + +Dr. Norman Kerr says:-- + + "In my paper on 'The Medical Administration of Alcohol,' read to + the section of medicine at the Sheffield meeting in 1876, I + cited several medical testimonies in favor of non-alcoholic + treatment of fevers, notably that of my friend, the late Dr. + Simon Nicolls, who had a mortality of less than 5 per cent. in + 230 cases. + + "The record of the results of a greatly lessened administration + of alcohol in the treatment of smallpox in the London hospital + ships, is of deep interest. Having been requested to inquire + into the effects of this diminished alcoholic stimulation on + mortality and convalescence, Dr. Birdwood stated that though the + gravity of the cases had increased, with a mortality of 15 per + 100 in the metropolis, the ship's death-rate had remained at + less than 7 per 100. Convalescence had been more rapid, and + there had been fewer and less serious complications from + abscesses and inflammatory boils. Other causes had contributed + to this improvement, but the medical officers attributed a + considerable share in the amelioration to a greatly diminished + prescription of alcohol." + +The _Medical Pioneer_ says:-- + + "In 1872 there appeared in the _Saturday Review_ an article in + which the medical practitioners of this country were accused of + inciting their patients to free drinking, and in the discussion + which this article called forth, Dr. Gairdner, of Glasgow, said + that fever patients in that city, when treated with milk and + without alcohol, did much better than those reported as having + been treated by Dr. Todd with large doses of alcohol; the latter + resulting in a mortality of about 25 per cent., while those + treated by Dr. Gairdner with milk had had a death-rate of only + 12 per cent. About this time the British Medical Temperance + Association was founded, owing to the exertions of Dr. Ridge, of + Enfield, and in 1876 it was enrolled, under the presidency of + Sir B. W. Richardson. It now contains 269 members in England and + Wales, 53 in Scotland and 80 in Ireland, or more than 400 + altogether, all professional men and women. This, I think, is + but a sign of the change of opinion on the use of alcoholic + fluids in medical practice, for all who remember what medical + practice was in London thirty years ago know that the use of + wine and brandy in hospital practice was so common that it was + quite a rarity in some hospitals to find a patient who was not + ordered, by some of the staff, from three to four ounces of + brandy or six to eight fluid ounces of wine. The expense caused + to the hospitals by this practice was, of course, great, and + increased notably between 1852 and 1872, owing to the prevalence + of the views of Liebig and his follower, Dr. Todd. The writings + of Parkes, Gairdner, Dr. Norman Kerr and of Sir B. Ward + Richardson, Dr. Morton and others, gradually lessened this + predilection for treating diseases by alcohol, and accordingly + between 1872 and 1882 a great change came over the practice of + London hospitals. Thus the sum paid for milk in 1852 in Saint + Bartholomew's Hospital was £684, and in 1882 it was £2,012; + whilst alcohol in that hospital cost in 1852, £406; in 1862, + £1,446; in 1872, £1,446; and in 1882 only £653. Westminster + Hospital in 1882 spent £137 on alcohol and £500 on milk. One + hospital, St. George's, long continued to use large quantities + of alcohol. That hospital in 1872 had the high mortality among + its typhoid fever patients of 24 per cent., which was twice as + high as that noted by Dr. Gairdner as occurring in Glasgow, when + alcohol was abandoned and milk used instead. Dr. Meyer, who + reported these cases of typhoid treated in Saint George's + Hospital at that time, mentioned that alcohol in large doses was + given to 87 per cent. of the patients. Three-fifths of these + patients took daily eight ounces of brandy when there was danger + of sinking from failure of the heart's action. One-fourth of the + number took sixteen fluid ounces of brandy in the 24 hours." + + "In 230 typhoid cases in St. Mary's Hospital, Dr. Chambers + reduced the ratio of deaths from 1 in 5 with alcohol to 1 in 40 + without it. Dr. Perry, of Glasgow, found that of 534 cases + treated with alcohol, 138 died, while of 491 treated without + alcohol, only 9 died." + +In a recent text-book on medicine occurs the following:-- + + "English physicians use spirits in fevers, and all experience + sustains the conviction that no substitute has been found for + them." + +In a late number of the _Temperance Record_, Dr. Smith gives a different +view of the experience of English physicians:-- + + "When Bentley Todd was at King's College, and leading his + profession, brandy was the rule in febrile cases. Then the + mortality varied from twenty-five to thirty-five per cent. That + the treatment was as fatal as the disease, experience + demonstrates:-- + + "1. Professor W. T. Gairdner, of Glasgow, writing to the Lancet + (1864), gave his experience as follows:-- + + Fever cases Average of + treated. wine and spirits. Mortality. + + 1,829 34 oz. to each 17.69 per cent. + 595 2-1/2 oz. to each 11.93 per cent. + 212 none 1 death only. + (young lives) + + "These were mostly typhus cases, but the rationale, so far as + alcohol is concerned, is the same as in typhoid. + + "2. At the British Medical Association in 1879, Professor H. + MacNaughton Jones gave particulars of 340 cases of typhus, + typhoid and simple fever. I append a summary:-- + + Cases. Deaths. Mortality + per cent. + + Given brandy 58 19 32.7 + Given claret 51 2 3.8 + Given no alcohol 231 4 1.7 + + "3. Dr. J. C. Pearson writes to the _Lancet_ (Dec. 5 and 26, + 1891), giving his experience of typhoid. He had treated several + hundreds of cases without a single death, and never prescribed + stimulants in any shape or form in the disease. + + "4. Dr. Knox Bond writes to the _Lancet_ (Nov. 25, 1893), giving + his experience of typhoid at the Liverpool Fever Hospital. He + says: 'As a resident for some years in the fever hospitals, my + views of the value of alcohol in fever underwent, solely as a + result of the experience there gained, entire modification. The + conviction became forced upon my mind that in no case in which + it was used did benefit to the patient ensue; that in a + proportion of cases its use was distinctly hurtful; and that in + a small but appreciable number of cases the resultant harm was + sufficient to tilt the balance as against the recovery of the + patient.' + + "In plain terms, alcohol tended to the destruction of the + patients. Dr. Bond's figures are:-- + + No. of cases. No. of deaths. + + Given alcohol 71 18 + Given no alcohol 309 15 + --- --- + 380 33 + + + + +In May, 1890, Dr. Nathan S. Davis, read a paper before the American +Medical Association upon the use of certain drugs in disease. Among the +drugs mentioned was alcohol, and comparative death-rates were given in +typhoid fever and pneumonia, between Mercy Hospital, Chicago, during a +term of years when no alcohol was used in the medical wards, Dr. Davis +being in charge of them, and some of the large metropolitan hospitals +using alcohol. In Mercy Hospital without alcohol, the death-rate in +typhoid fever was only five per cent.; in pneumonia only twelve per +cent. + + "Of 161 cases of typhoid fever treated in Cook County Hospital + during 1889, 27 died, or one in six--nearly 17 per cent. + + "According to the annual report of the Cincinnati Hospital for + 1886, 47 cases of typhoid fever were treated during that year, + with seven deaths, a mortality rate of 16 per cent. + + "The Garfield Memorial Hospital, at Washington, reported for the + year 1889, 22 cases of typhoid fever, with 5 deaths--or 22 per + cent. + + "In the Pennsylvania Hospital the mortality rate in pneumonia + for the years 1884-1886, was 34 per cent. + + "The mortality of pneumonia in the Massachusetts General + Hospital, between the years 1822 and 1889, comprising 1,000 + cases, was 25 per cent.; but a gradual increase in mortality had + been noted from 10 per cent. in the first decade of the seventy + years represented by this report, to 28 per cent. in the last + decade. + + "According to the report of the Supervising Surgeon General of + the U.S. Marine Hospital Service for 1888, the number of cases + of pneumonia treated between 1880 and 1887 was 1,649, with 311 + deaths--nearly 19 per cent. + + "The Cincinnati Hospital reported for 1886 a mortality rate in + pneumonia of 38 per cent. + + "The mortality rate in the Cook County Hospital, Chicago, for + 1889, according to Dr. Heltoin, relating to 80 cases of + pneumonia, was 36 per cent." + +Only a five per cent. death-rate in typhoid fever without alcohol, and +from sixteen to twenty-two per cent. with alcohol; only a twelve per +cent. death-rate in pneumonia without alcohol, and from 19 to as high as +38 per cent. with alcohol. Such are the comparative death-rates given by +Dr. Davis. They should be committed to memory by every opposer of the +use of alcohol, as they show clearly that people have many more chances +for recovery, other things being equal, in the diseases mentioned, if +alcohol is not used than if it is. + +It is worthy of mention in this connection that Cook County Hospital +contains in its report for 1897 the following items: Number of patients +19,536; 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 advance 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 treatment 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 believe better results are obtained by the use of +other agencies. In the October, (1893) number of the _American Medical +Temperance Quarterly_ now _Bulletin of the A. M. T. A._, Dr. J. H. +Kellogg gives statistics of deaths from various diseases in the Battle +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 alcohol as a remedy in acute +diseases is not necessary, 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 3,000 surgical cases have been treated, to whom alcohol has + never been administered except in connection with chloroform + anæsthesia; my uniform custom being to administer an ounce of + brandy or whisky five minutes before beginning the + administration of the anæsthetic, 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 antiseptic measures have been perfected, the record is still + better, showing a succession of 172 cases of laparotomy for the + removal of ovarian tumors, or diseased uterus and ovaries, + without a death. These cases include a number of hysterectomies, + and many cases so desperate that those who trust in alcohol as a + heart stimulant, and as a means of supporting the vital + energies, 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 + 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 eminent + physician who gave spirits freely in all cases of pneumonia from + their entrance to the hospital. The other visiting physicians + 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 pneumonia. 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 personally, 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. + +The _Bulletin of the A. M. T. A._ is authority for the following:-- + + "During the epidemic of 1832, Dr. Bronson said: 'In Montreal + 1,000 persons have died of cholera, only two of whom were + teetotalers.' A Montreal paper said: 'Not a drunkard who has + been attacked has recovered from the disease, and almost all the + victims have been at least moderate drinkers.' + + "In Albany, N. Y., the same year, cholera carried off 366 + persons 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 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 + remained, 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 122 of the + others died. In many parts of the city the saloon keepers saw + and acknowledged the terrible connection between their business + 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 nineteen 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 + drunkard died of cholera." + +The _St. Paul Medical Journal_, of September, 1899, gives the following +report of a railway surgeon, Dr. Kane:-- + + "From June 1, 1898, to June 1, 1899, the author performed a few + more than four hundred operations. Forty-nine abdominal + 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 anæsthesia. 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 considerably + 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 stimulant, 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 practice 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, were so far + relieved that a few days' change in country air seemed all that + was required to induce full restoration. Comparing the + experience of the treatment of acute rheumatic disease without + alcohol with that which I have previously observed with alcohol, + I can have no hesitation in declaring that it is of the greatest + advantage to follow total abstinence absolutely 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 treatment 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 profession could have witnessed what I have + witnessed in this matter, he would agree with me that alcohol in + rheumatic fever, however 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 complications, endocardial and pericardial, are much + less frequently developed than where alcohol is supplied." + +Dr. Pechuman in _Alcohol--Is It a Medicine_, published 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 physiology + and the many published statistics. The Boston Hospital 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, 1899, _Bulletin of the American +Medical Temperance Association_, gave the following Hospital Statistics, +showing a decline in the use of spirits in hospitals:-- + + "Evidently a great change is going on in the use of alcohol as a + remedy in large hospitals. The annual reports of ten hospitals + 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 hospitals 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 hospitals, 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 XI. + +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 anæsthetic; 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 + sensibility soon became entirely suspended, and the patient + helpless and altogether unconscious. * * * * * + + "Simple increased frequency of the heart action is no evidence + of either increased force or efficiency in promoting the + circulation of the blood. Indeed, it may be stated as a + physiological law, that the more frequent the heart action above + the normal standard, the less efficiently does it promote the + circulation 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 nerves. Indeed, all the + investigators agree that alcohol in any dose capable of + producing 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 anæsthetic as is + ether or chloroform, and, like them, is to be used as a medicine + only temporarily to relieve pain, or suspend nerve sensibility. + But as for these purposes it is less efficient than either ether + or chloroform, and other narcotics, there is no necessity 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 processes 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 scientists 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 patients 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 absurd 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. + + "How much longer will practical writers continue to recommend + 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 system?" + +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 + directly upon the corpuscular elements of the blood, and so far + diminishes the metabolic processes of nutrition and + disintegration 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 destructive drinking customs of + the people. + + "The same anæsthetic 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 + diminishes 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 + glandular organs. Although the immediate effect of the remedy is + thus to give the patient an appearance of more comfort, the + continued dulling or anæsthetic effect on the nervous centres, + the diminished oxygenation of the blood, and the continued + retention of morbitic and excretory products, all serve to + protract the disease, increase molecular 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 increasing the force and efficiency of the + circulation, and therefore 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 + 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 experiments to determine the effects of +alcohol in hindering the elimination of poisonous matter by the kidneys. +The subject of one experiment was a healthy man of 30 years, weighing 66 +kilos. For fifty days prior to the experiment he had taken a carefully +regulated diet, and the urotoxic coefficient had remained very nearly +uniform. The urine carefully collected for the first eight hours after +the administration of 8 ounces of brandy diluted with water, showed an +enormous diminution in the urotoxic coefficient, which was, in fact, +scarcely more than half the normal coefficient for the individual in +question. The urine collected for the second period of eight hours +showed an increase of toxicity, and that for the third period of eight +hours showed still further increase of toxicity, the coefficient having +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 + infectious 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 system of the patient as the result of the specific + microbes to which the disease owes its origin. The activity of + the liver in destroying 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 substances 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 + infections, 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 + infectious diseases of every sort, the body is struggling under + the influence of toxic agents, the result of the action of + microbes. Alcohol is another toxic agent of precisely the same + origin. Like other toxins resulting from like processes of + bacterial growth, its influence upon the human organism is + unfriendly; it disturbs the vital processes; it disturbs every + vital 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 + laboring to undo, so far as possible, the mischief done by the + invading 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 + already 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 treatment of + cholera, the inutility of alcohol, basing his suggestion upon + the fact that in a case of cholera, the system of the patient 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 toxicity 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 neurologist, in + mentioning the fact that death from chloroform anæsthesia rarely + occurs in India, but is not infrequent in England, attributed + the fact to the meat-eating habits of the English people, the + natives of India being almost strictly vegetarian in diet, + partly from force of circumstances doubtless, but largely also, + no doubt, as the result of their religious belief, the larger + proportion 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 + suddenly overwhelmed by a great quantity of poison, and succumbs + to its influence, its power of resistance being lessened by the + inhalation of the chloroform. + + "The affinity between alcohol and chloroform is very great. Both + are anæsthetics. 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 + produced 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 + explains 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 + is a matter of as great importance in chronic as in acute + disease, 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 leucocytes. "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 +phagocytosis." + +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 leucocytes, + mucous corpuscles, connective tissue cells, endothelia of blood + vessels and lymphatic vessels, alveolar eypithelium of 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 highest + 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 leucocytes 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 adynamia it + is through failure of muscle, that is, of the heart, of the + scaleni and intercostals, of the diaphragm, and of the laryngeal + 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 + subnormal temperature, together with great muscular + prostration. 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 temperature, 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 + intellectual 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 + surrounding a wound is regarded as caused by the influx and + multiplication 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 + invasion and devastation. 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 septicæmia. It is now well proven that the + injury is done, not by the bacilli 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 destroying 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 bacilli at length stop + their further multiplication and put an end to the disease. + Alcohol is in fact, the toxine 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. Broadbent + describes an experiment which proves that power of resisting + disease is largely dependent on the activity of these cells. A + rabbit, having had a certain quantity of bacilli injected 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, a dose + of chloral is injected into another part of the body. The + chloral, circulating in the blood, is known to paralyze + leucocytes, 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 debauch, therefore, may open the door to + fever or erysipelas.' A similar experiment of Doyen confirms + this. He found that guinea pigs can be killed by the cholera + microbe, when introduced 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 removed 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 preserve them altogether from all possible danger + from such a source." + +On the sixteenth of December, 1897, Dr. Sims Woodhead, president of the +British Medical Temperance 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 Medical +Temperance Review_ of 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 + characteristic features of this cloudy swelling in the cells of + all these specimens. The large swollen cells are granular, and + very frequently 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 deposition of masses of fat in and at the expense + of this protoplasm. + + "There is another series of changes to which I wish to draw your + attention. In the tubules of the kidney we have, in addition 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 + infiltration, we know, is constantly associated with + inflammatory conditions of the kidney as in other organs. Here + then are the changes in the epithelium plus increase in the + number of leucocytes. + + "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 degeneration, + 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 ordinary + 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 in the + wall of the heart. We see at once the part that the leucocytes + 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 + considering--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 + functional 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 experiments + carried out by Dr. Abbott, working in the Laboratory of 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 + conspicuous, 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) were 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 inclined, however, + to the belief, in the light of the work of Berkley and + Friedenwald, done under the direction of Professor 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. Deléarde, working in + Calmette's laboratory in the _Institut Pasteur_ at Lille, made a + series of observations which are, from many points of view, of + very great interest and importance as he 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. Muirhead, + 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 pneumonia, the conditions + of leucocytosis, and the very important part which leucocytes + play in the process of 'clearing up' during the course of the + patient's recovery). Dr. Deléarde 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,[A] staphylococcus[A] and bacterium coli,[A] in + alcoholized and non-alcoholized animals, little 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. + + [Footnote A: Microbes or bacteria of different kinds.] + + "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 alcohol. + In order to determine which was the most important factor in the + destruction or weakening of the resisting agents in the body, + Dr. Deléarde conceived the idea of experimenting with those + diseases in which it has been found possible to produce, + 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.[B] + 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. + + [Footnote B: Carbuncle.] + + "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 alcoholized + and then injected with a considerable quantity of virulent rabic + cord. It was here found that immunity against rabies had not + been lost. + + "In a second set the vaccination and alcoholization were carried + on simultaneously, a fatal dose (as proved by control + experiment) of rabic cord was then injected, when it was found + that little 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 + continued for comparatively short periods, simply has the + effect of preventing the acquisition of immunity when alcohol is + administered 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. Deléarde 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:-- + + (1) "'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 immunity, 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-alcoholized animals vaccinated simultaneously. + + "We have already mentioned that Massart and Bordet some years + ago pointed out that alcohol, even in very dilute solutions, + 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 prevents 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 + presence of a toxin, we should expect that alcohol would to a + certain extent deprive them of this power or interfere with + their capacity for acquiring a greater resisting power or of + reinforcing the powers of resistance. It appears indeed to + reinforce the poison formed by pathogenic organisms. Dr. + Deléarde maintains moreover that chronic alcoholism increases + enormously 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. Deléarde 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 remained + 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. Deléarde draws 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 + for a period of eight months, during which period, apparently, + increase of immunity may be going on. Beyond this he maintains + that doctors often commit a grave error in administering strong + doses of alcohol to patients suffering from certain infectious + 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 + integrity of the leucocytes in the presence of microbic + infections or intoxications. We may accept these statements all + the more readily as Dr. Deléarde 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 + experiments we are justified in accepting them as being a most + valuable contribution to the question; where there is no + experimental basis, we must exercise our own judgment. To show + the very strong impression that exists that there is some + connection 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 + profession) die from alcoholism.' When asked to explain he said, + 'They all die from cirrhosis or pneumonia, and if those + conditions 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 by Dr. Woodhead by drawings and +photographs, shown on the lantern screen. The photographs included cells +containing anthrax, typhoid and tubercle bacilli, the spirilla of +relapsing fever, specimens from cases of anthrax. Specimens were shown +in which the cells were actually ingesting and digesting the specific +micro-organisms. In a case of typhoid, 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 + streptococcus 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 + influences to which they were exposed. The proposed ration was + accordingly ordered, and Dr. Hamilton informs us that the + 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 + protoplasm 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 1 part in 100,000, (1/10 millilitre in 10 + litres) it favors the growth and multiplication of many microbes + whose function is antagonistic to the protoplasm of organized + beings, and which may therefore be called _destructive + protoplasm_. 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 protoplasm, should, on the + other hand increase the vitality of destructive protoplasm. At + any rate such is the fact. In the 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 decomposition, 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 + alcoholic 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 different alcoholic liquors, it also plainly +implies several facts of great importance. The first is, that all +alcoholic liquors, fermented or distilled, are toxic or poisonous; and +the more pure alcohol they contain, the more poisonous are they, the +qualities of liquor differing only in the rapidity of their injurious +effects. + +In the same number of the _Medical Week_, Professor Gréhant 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 estimated +weight of the blood of the animal, he found by several analyses at +different times that it required "a little over twenty-three hours for +complete elimination of the alcohol from the blood." If we consider +these results obtained by Viala, Charrin, Daremberg and Gréhant, with +those obtained by Dr. A. C. Abbott, showing the direct effect 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 diphtheria, typhoid fever +and pneumonia, under the supposition 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 operations 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 such +exceptional opportunities for observation in these complaints. + +Dr. N. S. Davis in the _American Medical Temperance Quarterly_ of +January, 1895, gives reports of cases which came under his observation +as a consulting physician, where the use of alcoholics throughout an +extended illness favored the continuance of delirium, or mild mental +disorder, after convalescence was established. In each case the +withdrawal of the alcohol was followed by a cessation 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 resembling 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 wandering, + and she was troubled with illusions, which were attributed to + her weakness, and the so-called stimulants were increased. But + the mental disorder increased also, and continued after the + fever and diarrhoea had ceased, until the question was raised + concerning the propriety of her removal to an asylum for the + insane. + + "Being consulted at that time, and listening to an accurate + history of the case, I suggested that the anæsthetic effect of + the alcohol 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 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 + followed, 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 Temperance 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 +multitude of people, and they are ready to distrust as fanatical, 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 services 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 considered "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, regulated baths, good food, balmy + sleep, these are the true restoratives 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 + position 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 + 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 consciousness of it. He + observed, as a matter of fact, that alcoholic 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 + alcohol. 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 + infraction 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 + injuring 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 physicians who cling to alcohol will +deserve the soubriquet of "alcohol fanatics." Dr. Davis said:-- + + "If I am asked why the profession continues to prescribe these + drinks, I answer; simply from the force of habit and traditional + education, coupled with a reluctance to risk the experiment 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-limited 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 + attention, 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 nourishment 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 mental +powers; such physicians are not so acute to observe the action of this, +or any drug. + +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 + professions 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 Abbé Purcelle, + spoken in the dawn of the great French Revolution, they may + prove that 'respect for sovereign power sometimes consists in + transgressing its orders,' but as a general rule not merely the + orders but the inclinations are obeyed. We have to wait on, and + for, public opinion, and in nothing so much as on the subject of + alcohol. 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 + alcohol 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 + disown that motherhood must stand apart. How can a profession + however strong, march all at once against such an overwhelming + influence? Itself born, perchance, under the influence bred + under it, how shall it immediately be transformed? Why 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 _nature_ 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, uphold, + root and branch, the rôle of his nativity? On the contrary 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 alcohol in any + quantity. In fact, he never prescribes it, for although 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 paralysis. 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 become 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, + conscientiously, practice their profession if they were + debarred the use of alcohol, and who look on the advance and the + growth of scientific 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 + blindness to misrepresent the most obvious truths. They affirm + that under the influence 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 developed 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 people_ in the teachings +of those physicians, whose eminence in the profession has permitted +them, or whose conscientiousness has driven them, to expose the +delusions concerning the medical value of alcoholic beverages. When the +people cease to believe in alcoholic remedies, physicians will no longer +prescribe 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 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 suppose 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 information as to the real nature of +these concoctions. Consequently the people accepted with amazing +credulity 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 these 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 +guarantees nothing concerning the matter. That the guarantee 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 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 persons +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 +proprietary medicines because of the opposition of a large number of +newspaper publishers who were sharing the ill-gotten gains of the +medical fakirs. + +A careful compilation of manufacturers' announcements 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 respective 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 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 combinations, +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 be +taken. Forty-eight compounds 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. Many deaths have +occurred from headache powders of which acetanilid is the chief +ingredient. Dr. Harvey W. Wiley, chief of the Bureau of Chemistry, says +of these headache powders:-- + + "A woman has a headache and she uses one of these remedies. 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; they disturb the digestion; they interfere with natural + sleep; they require to be used in increasingly larger quantities + as the system becomes accustomed to their use; they are almost + without exception excreted by the kidneys, thus adding an + additional burden to organs already badly overworked. They + produce a habit of gaining relief which becomes an obsession and + incapable of being resisted." + +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 forgotten 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 benefiting him. + +2. There are people who imagine they have diseases which they do not +have; since trained physicians 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 testimonial, 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, would restore persons to vigor more speedily +without 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 treatments +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 wonderful 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. 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 nostrums stated in the +headlines that said nostrum was used in the Frances Willard Temperance +Hospital, Chicago. The testimonial appended purported to be from a nurse +in that hospital, _but the testimonial did not state, as did the +headlines_, that the preparation was ever used in that hospital. The +president 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 damages, 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 picture:-- + + "Mr. ---- of ----, who is a professional nurse of experience, + writes,--'My friend is improving, thanks to ----, and you. I am + called on to nurse the sick of all classes. I recommend ---- 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 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 the advertisement, namely, +that Mr. ---- was a professional nurse, false; "First, by his own +statement as he told me this morning that he never claimed to be a +professional nurse. And my personal acquaintance 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 the testimonial. + +The following was clipped from a copy of _Merck's Report_, April, 1899, +a druggists' paper published in New York city:-- + + + MANY DRUGGISTS INDIGNANT. + + A PATENT-MEDICINE ADVERTISEMENT CONTAINS UNAUTHORIZED + ENDORSEMENTS. + + "Fully a score of East-side druggists are up in arms over the + unauthorized use of their names in a full-page newspaper + advertisement of a widely-known specific. This advertisement + appeared 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 unqualified laudation of the article so liberally + advertised. 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 endorsement + 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 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 following 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 from there writes her straightforward endorsement + 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 abstinence 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 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, Countess 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 unworthy 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 + whatever. It is a common occurrence that samples of proprietary + 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 encouragement 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 +"Unobjectionable" 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 composition 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:-- + + "A secret compound with a meaningless title is presumptively 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 dishonest, its employment + in the interest of any remedy is clearly a sufficient cause for + its condemnation and ostracism." + +Mothers sometimes wonder why 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. Winslow's Soothing +Syrup, advertised for years in church as well as secular papers as +"invaluable 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 contains + from one to three grains of morphia to the ounce of syrup. I + believe that stringent legal measures should immediately 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 + become 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 + manifestations_, 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 upper 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 substances which tend + to disorder and derange digestion." + +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 government +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 Department revealed the fact +that a great many of the so-called medicines on the market were +intoxicating beverages in disguise. The Internal Revenue Department then +took up the matter and a long list of these beverage medicines was sent +out to internal revenue agents with instructions that these must not be +sold henceforth 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 recognized 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 were the best-known of these. Peruna had been up to this time +what government chemists called "a cheap cocktail." The report 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 solids, 3.846 per cent.; ash, .158 per cent." The report +says:-- + + "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 Health, was the first to publish an analysis of these preparations +showing their alcoholic strength and their small nutritive content. He +lists "foods" examined by him as follows:-- + + "Liquid Peptonoids 23.03 alcohol; maximum amount recommended + 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 1/4 oz. of nutriment, and the equivalent of about 1-1/2 + oz. of whisky daily. Tonic Beef 15.58 alcohol; doses recommended + yield about 1/2 oz. nutriment daily, and the equivalent of one + ounce of whiskey. Mulford's Predigested Beef 19.72 alcohol; + doses recommended yield about 1-1/4 oz. nutriment daily, and the + alcoholic equivalent 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; Nutritive 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. M. A.:-- + + "I have long been convinced that many a patient has suffered + severely when preparations such as these were being used, and + that not a few of them have died, chiefly of starvation. * * * 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 stomach, 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 contain 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 Norwegian cod-liver oil, but in neither of these +preparations did the tests made by the committee show any oil. Analysis +revealed sugar, alcohol, and glycerine, none of 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 per 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 government commission was appointed to study the +subject. This commission presented a voluminous report to the +parliament of 1907. This report gives an analysis of most of the +extensively advertised medicines. Doan's Backache Kidney Pills are said +to be made of oil of juniper 1 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, podophyllin 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 sulphate 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 investigators +to be very injurious to the stomach.) + +The Committee on Pharmacy of the American Medical Association has +analyzed many proprietary medicines; 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 quartz sand, and 12.50 per cent. of rock +candy and syrup. + + "Hoff's Consumption Cure consists essentially of sodium + cinnamate and extract of opium, a mixture at one time suggested + for the treatment of tuberculosis, but which has been discarded + by physicians. A medicine 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 blemishes" was made of +Epsom salts colored with a pink dye. The government prosecuted the +company sending 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 + diastatic 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." + +Dr. J. H. Kellogg, in commenting upon this report, said in the Dec., +1896, _Bulletin of the 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 + concentrated 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 accompanying letter from Prof. +Sharples, 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 + 5416 Pure Malt, a Liquid Food, a Tonic 10.76 6.32 + 5619 King's Pure Malt[C] 9.52 6.60 + [Footnote C: 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.] + 5421 A Nutritious Tonic, Pure Malt Extract 10.88 6.24 + 5226 Noris' Extract of Malt 11.57 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 5.90 + 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, Gesundheit's Beir 11.31 4.34 + 5491 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 11.02 4.85 + 5621 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 10.49 4.50 + 5408 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 11.47 4.78 + 5340 Haffenreffer & Co. Malt Wine 11.02 6.65 + 5423 Haffenreffer & Co. Malt Wine 11.71 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 15.50 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 7.01 + 5486 Menzel's Extract of Malt 5.90 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 Philadelphia 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 centimeters + of the liquid. + + S. P. SHARPLES. + + +The _British Medical Journal_, and the _British Medical Temperance +Review_ have been calling attention to the danger in coca wines. +Intemperance among invalids 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 possess + some power of removing the sense of fatigue, just as analgesics + 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 offending tooth, or + even arrests the caries in it. The truth of this will be obvious + to any one who remembers enough of physiology 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, overcharged (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 analogous to fatigue of + muscles. + + "It is practically impossible for us, by voluntary exertion, to + reach the degree of absolute fatigue, which the physiologist + produces 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_ becomes + 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 + prescribe 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 + 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 alcoholic + stimulant, is to multiply the dangers of cocainism by those of + alcoholism. It would be impossible to find terms sufficiently + 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 assurance + 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, + "Anæmia, + "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 skilful and lavish + advertisements, and by carefully worded testimonials, they + appeal to the credulity of the public, and often deceive 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 + certainly, 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 + considerable frequency three or four times a day. + + "What would be said of growing girls or youths having recourse + 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 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, perhaps, + 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 + ineffective, but positively dangerous."--_United Temperance + Gazette._ + +In Dr. Milner Fothergill's _Practioners' Hand-book of Treatment_, fourth +edition, the following statement is made:-- + + "Coca wine, and other medicated wines are largely sold to people + who are considered, and consider themselves, to be total + 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 11 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 allowance 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 cocaine + inebriety is largely on the increase. The greatest number of + victims is to be 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 symptoms experienced by + the victims of the cocaine habit are illusions of sight and + hearing, neuromuscular irritability, and localized anæsthesia. + After a time insomnia supervenes, and the patient displays a + curious hesitancy, and an inability to arrive 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 + dangerous 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 restoration 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 practitioners may be + excused if they prove to be a bit oblivious of physiology, and + so become attracted by a formula which is more plausible than + sound. In the first place, we all know that extract of meat is + not food at all. From the manner of its production, 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 however; 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 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 could 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 _Kaskine_ as an +example of these. Although sold at a dollar an ounce it was found to +consist of nothing but granulated sugar of the fine grade used in +homeopathic pharmacy, 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:-- + + "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 + business 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 exposed 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 expected 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 American" 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 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 liquid consisting of a solution of sulphate of morphine 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 produce + alarm in the young. It is another sample of the demoralizing + 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 medicine. + +_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 + 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 preparations 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 various 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 connection with the use of these mixtures, calls +them "volumes of gilded falsehood, designed for an innocent, +unsuspecting public," and adds:-- + + "The use of such nostrums would do more toward confirming 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 July (1897) _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 + 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 mischief that is + being done every day to body, mind and soul, all over the land, + by the thousands of miserable frauds that are being 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 unaware that the ethics of the medical profession restrain +reputable physicians from advertising 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 physicians +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 + interpreted 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 + perfection.' It is not the object of these laws to create odious + monopolies, 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 professions 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 + assiduously 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 end of medical + practice is service to suffering 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 for wealth, in which the sick become victims of + avarice and greed. Better set free a pack of ravening wolves in + a community than to change the end of medical practice to a + commercial 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 Society for the Study of Inebriety several years +ago, said:-- + + "There is a certain other class of so-called remedies, prepared + sometimes by physicians and pharmacists, that do a great deal of + harm. I allude to the 'non-secret proprietaries' that claim to + publish their formulas, _but 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 protecting 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 people have come to + be consumers to such an extent of a class of medicines, which, + at times, are positively detrimental to 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 condemns 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 regard 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 newspaper 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 nostrums 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 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 Heyburn said:-- + + "I have always been aggressively against the advertisements of + nostrums. Some time ago a friend of mine, a very old fellow, + that I had taken a special interest in securing a pension for, + had reached the age and condition of dependency. 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 medicines 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 nostrums + 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 imposters whose nostrums they advertise? If one of their +children had anæmia 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! +They 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 diligent study +of health and disease assert as their deliberate opinion that excessive +professional drugging 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 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 the _Medico-Chirurgical Review_, says:-- + + "I declare as my conscientious conviction founded on long + experience and reflection, that if there were not a single + physician, 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." + +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 _measles_ 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 preparations + of the apothecary, mortality diminishes." + +The examining physician of a large insurance company in New York said to +a _Mercury_ reporter:-- + + "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 stimulating drug, or patent medicine. + This feeling comes from a benumbing 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, _Bulletin 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, tobacco, opium, cocaine, coca, kola, hashish, Siberian + mushroom, caffeine, betel-nuts, maté 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 application finds the subject on a little lower level + than the first, so that an increased dose is necessary to + produce the same intensity 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, however much + they may differ otherwise in their physiological effects. + 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-prescription 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 regard + the degree of pyrexia, or heat, as the chief element of danger + in all the acute general diseases. Consequently, to control 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 patient. + + "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 + rheumatism, influenza, or la grippe, etc.; and thus their use + soon became popular with both the profession and the public. 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 increased. + + "Step by step experimental therapeutic investigations have + proved that the whole class of coal-tar antipyretics reduce + animal heat by impairing the capacity of the hemoglobin and + corpuscular elements of the blood to receive and distribute free + oxygen, and thereby reduce temperature by diminishing heat + production, nerve sensibility and tissue metabolism. Therefore, + 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 toxic agents and natural excretory materials by + which specific fevers are protracted, but it greatly increases + the number of cases of pneumonia that complicate the epidemic + influenza, 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 + unfrequently punctuated with a sudden death from overdosing with + antipyrin, sulphonal, or some other coal-tar preparation." + +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 depression 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 victim + of a triple wrong, which only a most vigorous constitution 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 + professional 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 + disobedience 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 victim 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 relief it + afforded her was so grateful that she took it upon any + recurrence of her trouble. She found, too, that the slight + exhilaration 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 contents 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 excite + the nerves, which seems to characterize our modern civilization. + 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 human 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 +opening of a hospital. He said that the time is fast approaching when +physicians will give very little medicine, 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-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 unwilling 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 physicians 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 pylorus, the opening into the intestines. The operation consisted in +making a new opening and connecting it with an intestine. This bright +woman now complains 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, frankforts; whatever is going. I have a vigorous appetite, +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 greatest 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 16, 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 excuse for + existence." + +Dr. T. D. Crothers, in his valuable book upon Morphinism and other drug +addictions, reports a case of murder where it was shown that the +assailant was delirious from large doses of quinine. He says assaults +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 Chautauqua, 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 continuous 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 mothers soon after the birth +of children to allay pain, has resulted in the death of the infant, the +morphine having 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 +enslaved to cocaine unwittingly through its use in catarrh snuffs, +asthma "cures," and other proprietary preparations, 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 injurious 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 preparation." + +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. + +The use of cocaine is advancing rapidly in this country.[TN: see Errata +at end of text] The following article is taken from _The Banner of +Gold_, of Feb., 1899:-- + + "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 75,000 + + "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 originally + 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 + recommendation to those who crave a nerve-deadener. No laborious + cooking of pills over a lamp, cleaning of implements, or + troublesome necessity for secrecy, as with the use of opium. + Cocaine can be taken at any time, with scarcely any trouble, and + without 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 anæsthetic, 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 + exhilaration 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. + + "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 _inferno_. 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 humanity. + + "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 + analgesic, it is uniform in its action, and this is due to the + suspension 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 encephalon, 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 + highest 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 excitement + caused by cocaine goes on to convulsions, and death. Sometimes + its action is localized to one part of the cerebro-spinal axis, + and then to another. In some cases well-marked cerebral anæmia + 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 frightened 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 narcotics + 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_ for 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 not + overlook the victims of drugs. If you will go, under the + protecting ægis 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 + nursery, 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, paregoric, + 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 coquetting with + sin; and cured inebriates relapse to drink, and drugs, through + the use of proprietary medicines, with which the domestic market + is flooded. Tonics, compounds, nerve remedies, bitters, + vitalizers, appetizers, balsams, pectorals and kindred nostrums + contain, with few exceptions, from 7 to 50 per cent. of alcohol, + or opium in varying quantities, each preponderating in kind, as + the effect is designed to be stimulating, or sedative. The + active principle of some of the best known catarrh remedies is + cocaine, 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 + legislation, as well as vigorous education, is needed along + these lines, and while considering means of betterment, the + reputable citizen, the clergyman, and others of good moral + repute, whose names are so generally used to herald the efficacy + of so-called remedial inventions, should not be overlooked for + ethical attention. + + "For the information of those of our readers, who are not + familiar with the nature and use of toxic drugs, we here refer + briefly to the prominent characteristics of a few most + dangerously potent for evil, and seductive in kind. + + OPIUM AND MORPHINE:--"Gum opium, the dried milky exudate 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 1/4 to + 1 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 hypnotic, 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 + depression follow, the respiratory centres are paralyzed, thus + causing death. If taken in from 2 to 4 grain doses it produces + deep comatose sleep, full breathing, full pulse, dry skin, and + contracted pupils. If the dose is sufficiently large, the sleep + will be more profound, the patient can hardly be roused, and if + awakened 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. + Respiration may be from 8 to 10 per minute, perhaps be reduced + to 4, 2 or 1, 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 expensive + 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 1/8 to 1/4 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 sedative, + 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 5-1/2 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 painful 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. + + 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 + anæsthetic. The ordinary dose when used as medicine is from 1/4 + to 1/2 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 1 grain. + + CHLOROFORM:--"Chloroform is an anæsthetic, 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 words, 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 1 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 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 preparations, + 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 + medicinal dose is from 3 to 10 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 owe a debt of gratitude to those physicians, and chemists, +who give freely such valuable 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 profession. +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 effects 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 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 sufficiency 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 improper 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 + understood that we abandon an injurious influence, and escape + from a source of disease, as we do when we get into a purer + atmosphere. _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 + forgotten, 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 destructive + of life." + +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 my + 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. + Having 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 + neighbors. 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 + experience. + + "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 improvement has + faded, it is found that the malady itself has been progressing, + 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 patient having + been completely masked. + + "Wherever 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 + better for physical, intellectual and moral well-being. Alcohol + does not nourish, but pulls down; does not stimulate, but + depresses; does not strengthen, but excites and exhausts. + Alcohol 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 medica_ 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 supposing 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 depression, 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 susceptible + 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 + certainly knows that the best medical authorities agree that + alcoholic intoxicants are rarely useful as a medicine; that at + 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 functional + 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 liquors than with. It is easy to + see that the anæsthetic properties of alcohol can be made + available by an intelligent and skillful physician to meet a + very 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 stating 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 drinks. 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, Ill. + + "Dr. Hirschfeld, 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."--_Bulletin of A. M. T. A._ + +Dr. Greene, of Boston, when addressing his brethren 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 + requires only your own experience, and observations, to convince + you that it is upon the medical profession, upon their + prescriptions and recommendations for its use upon many + occasions, 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 + opprobrium, 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 prevailing fashion in medicine, to find an + excellent way, when they will all look back with wonder and + surprise, that they, as individuals, and members of an honored + profession, should have been so far compromised." + + + "It will be asked, _Was there no evidence of any good service + rendered by the agent in the midst of so much 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. + +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 already + a smouldering congestion, it will take but little to light the + fire of acute inflammation, which will rage with greatly + increased intensity. + + "It is wiser to habitually avoid even the medicinal use of + alcohol, 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 physical + 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 + abstinence 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 physician, I did not consent without a good deal of + consideration, and then only on the understanding that if I + thought a person needed 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 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 + completely 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-consideration for + the medical profession. I believe that they are mistaken. 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, because 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 medicine. + Where there is one element of good in alcohol there are + thousands that are bad."--DR. ALFRED MERCER, Syracuse, N. Y., + Professor of Medicine in Syracuse Medical School. + + + "Alcohol is rarely necessary. Other remedies are much 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. + + + "I 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. + + + "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 stimulating + effect, but I believe that such desired action as it is capable + of producing can be equally well brought about by other agents. + As a beverage the use of alcohol, particularly in excess, 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 alcohol 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 Harvard Medical + School, Boston, Mass. + + + "I believe that the trend of teaching in the Harvard Medical + 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 restrain tissue + metamorphosis, it cannot legitimately be considered a + food."--DR. WILLIAM O. STILLMAN, Albany Medical 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. + + + "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 very 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 medical + cases."--DR. ALLEN A. JONES, Adjunct Professor of Medicine, + Buffalo, N. Y. + + + "At the Baptist Hospital I have not ordered alcohol for a + patient in several years. At the Massachusetts General Hospital, + in the out-patient department, I never prescribe it."--DR. + RICHARD BADGER, of Harvard Medical School, Boston. + + + "Alcohol is used much too freely in the treatment of the sick, + especially in such conditions as mild typhoid fever, + neurasthenia 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 + medicine."--DR. JAMES B. HERRICK, Professor of Medicine in Rush + Medical 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 definiteness, 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 DOCK, New + Orleans. + + + "I have no use for alcohol, either personally, or in my + practice. Yet I cannot say that I have entirely abolished it. + Alcohol is used in compounding most of our tinctures, but in + remedies 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 + practice, which is confined to surgery, I find very, very little + use for it. During the past year, in extreme cases, I used it in + hypodermic 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 alcohol, and that has + arisen out of the loose methods of prescription 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 rendering more + difficult every natural function. Alcohol never sustains the + powers of life. It sometimes changes the symptoms 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 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 connection, + that the use of alcohol in medicine has very much diminished + 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 antiphlogistic treatment were at their + height. Public opinion has been 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 without alcohol, or with only small quantities + of it. There are physicians 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 temperance 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 testimony + 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 therapeutic + 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 circumspection 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 infections than normal + animals. And Laitinen, after having studied 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 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 by 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 American + Medical Association, Editorial, September 8, 1900._ + + + "Step by step the progress of science has nullified every theory + 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 stimulant 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 every 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 + circumstances, 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 + theoretical importance."--DR. REID HUNT, Chief of the Department + 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 Hospital I have found that + in acute as well as chronic disease 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 Association. + + + "It is time alcohol was banished from the medical armamentarium; + whisky has killed thousands where it cured one."--J. H. + MCCORMACK, M. D., Secretary Kentucky Board of Health, and + Organizer for the American Medical Association. + + + "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 usually + 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, aconite, quinine, etc. I + believe strongly that in pneumonia, typhoid 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."--HOWARD S. ANDERS, M. + D., Professor of Physical Diagnosis, Medico-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 Sanitarium, New York. + + "I seldom prescribe alcohol."--GEORGE BLUMER, M. D., Yale + Medical School, New Haven, Conn. + + + "WHEREAS, The study of alcohol from a scientific standpoint 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 Association, + 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 discourage the use of it, + both in and out of the sick room."--_Resolution 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 + professionally less place for alcoholics of any sort in my + practise, and for perhaps three years I have scarcely ever + prescribed them. I am satisfied that my cases of pneumonia and + typhoid come through in better condition without anything + 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, Denver + 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 subject + 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 temperance + 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 + should 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 overestimated. 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, Surgeon 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 Infirmary + for the past month I see that in dealing with twenty-five cases + I ordered alcohol costing exactly 1-3/4 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 opinion is + certainly growing that not even small doses are required. + Diseases of the stomach, liver, heart, and kidneys have appeared + to me, in my practise, to be much more satisfactorily treated + without beer, wines, or spirits."--DR. C. R. DRYSDALE, + Consulting Physician to the Metropolitan Hospital, 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. + + + "Of scarlet fever I have treated some 2,000 cases. I have never + seen a case in which, in my opinion, alcohol was necessary; no + case in which its administration was beneficial; but I have seen + more than one case in which its action was directly injurious. * + * * Alcohol in no case averts a fatal issue 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 alcohol 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 alcohol as + an aid in surgical treatment. As a student I saw it used, almost + as a matter of routine, for every kind of surgical malady except + head injuries, and in my early years I naturally 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 believe, that alcoholic + stimulants are of especial value in all forms of septic + inflammation, such as erysipelas, pyæmia, septicæmia, and hectic + fever. I believe that this belief is founded solely upon + tradition unsupported by any trustworthy evidence, and untested + by experiment or experience."--DR. A. PEARCE GOULD, F. R. C. S., + Surgeon to the Middlesex Hospital, 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 followed the + universal practice, I am competent to make comparisons, and + these speak unconditionally in favor of treatment without + alcohol. As a preventive of waste I use among fever patients + nothing but real foods; in addition to milk, 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., concerning which + hundreds of investigations have demonstrated positively that it + prevents the waste of both albumen and fat. As a stimulant I + employ, 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 rejoice to agree + in this respect with Aufrecht, one of the best authorities on + this disease, who in his monograph in Nothnagle'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 alcohol 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 harmful 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 is an + evil. In ordinary doses and in continuous use the sum of its + reactions increases exhaustion, which may terminate + fatally."--DR. JOHN VAN DUYN, Professor of Medicine in Syracuse, + N. Y., University Medical School. + + + "In sixteen years of active practice I have not used alcoholics + at all. I am medical director of the Scranton Sanitarium, 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, M. D., Scranton, Pa. + + + "I am opposed to the use of alcoholic liquors as a beverage, and + with rare exceptions, to their use in the treatment of + diseases."--DR. EUGENE KERR, Physician to Phipps Dispensary, + Johns Hopkins Hospital, Baltimore, Md. + + + "In my professional work I do not advise or permit the use of + alcohol as a beverage or medicine in any form whatever. 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 medicine has + diminished at least seventy-five per cent. in the past fifteen + years. + + "I have cast it out entirely."--J. P. WARBASSE, M. D., Chief + Surgeon German Hospital, Brooklyn, N. Y. + + + "The habitual use of alcohol in any disease is worse than + harmful."--ROBERT B. PREBLE, M. D., Chicago, Ill. + + + "The last few years I find I have used less and less alcohol 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, M. 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. + + + "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 discarding + it. I hardly find occasion to prescribe it once a year."--W. A. + PLECKER, M. D., Sec'y State Board of Health, Hampton, Va. + + + "The use of alcohol as a beverage or therapeutically, is in + either case a habit of the user. The stimulation is but + temporary, the reaction leaving the nerve cells of the + individual with less resisting power than before the ingestion + of alcohol. * * * 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. CROTHERS, + 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. + + + "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 failing 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 + alcohol should be classed among the anæsthetics and poisons, and + that the human family would be benefited by its entire exclusion + 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 appendicitis, + 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 medical 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 valuable, exact, and reliable + methods for combating, governing, and controlling disease."--DR. + EVAN C. KANE, Surgeon Pennsylvania Railroad, Kane, Pa. + + + "In my neurological practice I emphatically forbid my patients + the use of alcohol. This poison has a special predilection for + the nervous system which it influences sometimes to an alarming + extent."--ALFRED GORDON, M. D., Jefferson Medical College, + Philadelphia, Pa. + + + "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 medical + 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 searching + 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 repudiated 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 Milwaukee 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 practise 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 Medicine. + + + "If alcohol had become a candidate for recognition years ago + instead of centuries ago it is safe to say that its application + 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 regarding 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 + constructive 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 support 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, Mass. + + + "I am very glad that you are undertaking so important a work as + this in connection with the terrible problem of alcoholism. + 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 prescribing so as to + eliminate alcohol would undoubtedly have far-reaching beneficent + effects."--EDWARD VON ADELUNG, 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. Wishing 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 + evidence 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, Schöneseiffen and Roseman. + The uniform result of all these experiments, 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 consequently 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 public hospital in + London, where alcohol was seldom or never used. * * * Doctor + Richardson's researches showing the anæsthetic nature of alcohol + have had a great influence in changing medical practice in + England. * * * On the Continent a number of scientific workers + have published researches 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 + correct, materially changing current opinions, and creating + great doubts of the value of alcohol. + + "In 1896, the prosecution of Doctor Hirschfeld, a Magdeburg + 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 hospitals and + universities of Europe. It was proved that alcohol 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 remedy, 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. + + "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 exceedingly doubtful + remedy. Doctor Meyer, of the University of Gottenburg, Doctor + Möbius, 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 well if not better by the non-use of + alcohol, and satisfied from the communications of some brother + practitioners that the fatality in certain specified diseases + was not delayed, to say the least, by the employment of + increasing and enormous doses of wine, whisky and brandy, 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 transmitted + 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 except + 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 difference + 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-example effort of the medical profession exerted as + individuals on their patients and the families of their + patients, and as associations 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 discontinue + advertising, without warning or dissent, side by side with the + atrocities, the 'innocuous beers,' the pure malt whiskies, the + genuine brandies, guaranteed to prevent and cure all manner of + diseases." + +The following testimony from an English physician is significant:-- + + "Although I know beforehand that their united testimony must be + in favor of the practice of total abstinence from all + intoxicating drinks, being most conducive to health and + longevity 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 anæmic 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 alcohol. The +following 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, attended 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 without any apparent + benefit; and, that after consultation with Mr. Cross, the + resident surgeon, they resolved to substitute simple + nutriments, such as milk, eggs and beef-tea, at frequent + intervals, 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 + recoveries than those who were taking the free amount of + stimulant. The effect of these observations chimed in very + remarkably 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 regret. 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 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 present, + 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 suffering 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 which 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 doctrine of stimulation generally. It had been one of the + grand ideas in medicine that there came times when sick people + 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 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 denominated + inflammatory or febrile state--the stimulant was already present + (was, indeed the cause of the 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 effect. On both + sides, therefore, in the treatment of disease, they did good, + and that was the reason, he believed, why their returns 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 number of years, + that some medicament of a particular kind was needful for some + particular train of symptoms, be the surrounding 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 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 + without any other aid than that of the environments, which cases + he would have said could not possibly 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 assertions 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 indiscriminately, + 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 affected, and were + bound to get well."--_Medical Pioneer._ + +Dr. Landmann, of Boppard-on-the-Rhine, Germany, says:-- + + "The members of the Association of Abstaining Physicians, reject + the use of spirituous liquors in every form, and particularly + 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 + by the laws insuring the sick, the taking of spirituous + liquors, under the false pretext that they have a curative and + strengthening 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 + benefits 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 diseases, + 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 + improvement. + + "Physicians share the blame of the present flood of alcoholism. + 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 + treatment of acute fevers, especially in case of pneumonia, + typhus and erysipelas. They first of all injure the general + state of the patient, they cause delirium, or increase it if + already existing, 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 + mucous 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 Medical 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 tuberculosis, + 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 prescribe + alcohol, nor one of the solinaceus or narcotic drugs, if you can + possibly avoid it. The use of alcohol and opium debases the + minds and morals of habitués, 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 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 article 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, almost + 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 + accumulating 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. + + "French and German specialists have denounced spirits both as a + beverage and a medicine, and shown by actual demonstration 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 accumulation of + facts that have been proven within the observation of every + thoughtful person. The exact or approximate facts relating 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 + narcotic and anæsthetic, is rapidly falling into disfavor, and + will soon be put aside and forgotten." + + + + +CHAPTER XVI. + +RECENT RESEARCHES UPON ALCOHOL. + + +In the year 1900 Prof. Taav Laitinen, of the University of Helsingfors, +Finland, published an account of experiments made upon 342 +animals--dogs, rabbits, 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 quantity of +alcohol given as a food or as a medicine, or both, in a neighboring +sanitorium. The alcohol employed 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 susceptibility to infectious diseases; and he maintains 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 alimentary canal, liver, kidneys, heart, and nervous system. He +found that the alkalinity of the blood was 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 continued 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 extent and + nature of the protective powers by which the organism 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-established fact that + alcohol weakens the normal resisting power of the body against + the above-named disease-producing influences. In the hope of + contributing something to the explanation of the way in which + alcohol weakens the organism, I have made a number of + experiments bearing upon the question 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 discover that + this agent produces a diminution of the hæmolytic complement in + the blood-serum of certain animals which were tested. They + showed also that the formation of specific hæmolytic receptors + (immune bodies) may be retarded by the action of alcohol. + + "The extent of the evil effects upon the human body resulting + from the consumption of alcoholic liquors is as yet far from + being fully known, and stands in need of scientific + verification. Many other injurious influences such as unsanitary + dwellings, bad feeding, excessive toil, and toxic agents like + nicotine, etc., may produce somewhat similar morbid 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 especially its two principal components, + namely, red blood-corpuscles and blood-serum, both of which up + to the present time have been very little studied in relation to + the question 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 defending + 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-corpuscles. 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 lecture 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, hospital 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: + + "1. I sought to ascertain whether the resistance of human red + blood-corpuscles against a heterogeneous normal serum, 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 hæmolytic power of blood-serum over + heterogeneous red blood-corpuscles (rabbits). I have studied not + only the hæmolytic 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 between a known dilution of + rabbit-serum and a certain dilution 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 + alcohol-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 hæmolytic + 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 + alcohol-drinking and non-drinking persons was determined by some + experiments. + + "The above experiments have given the following results: + + "1. 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 examined, and the average of + resistance be taken on both sides: this last-named precaution + being necessary because the resistance 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 hæmolytic power of + human blood-serum to be less in the case of alcohol-drinkers + than in that of abstainers. + + "3. The precipitating reaction between a solution of 1 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 bactericidal + power of blood-serum against typhoid bacteria was less in the + case of drinkers than in that of abstainers. + + "It seems clear, therefore, that alcohol, even in comparatively + small doses, exercises a prejudicial effect on the protective + 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 studies he shows by careful tables that the drinking of alcohol by +parents, even in small quantities, has an injurious influence upon human +offspring. His studies 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 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:-- + + "1. The importance of alcohol as an article of food is rendered + very questionable by recent researches. 2. These researches + 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 justified 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 prescribe it with the same care as + other poisonous drugs. In this matter the attitude taken by + medical men as representatives 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 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 harmful 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 suggests 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 1/4 to 1/2 ounce of alcohol had been +taken the time occupied in making response to a signal was slightly +shortened, but in a few minutes, in most cases, this quickening action +passed and a slowing 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 decreased 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 remembered correctly when the +mind was free from the alcoholic 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 carefully 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 experimented 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 considerable which + causes a disturbance, even if only transitory, of bodily and + mental efficiency." + +Dr. Reid Hunt, chief of the Division of Pharmacology, 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 in Bulletin No. 33 of the Hygienic +Laboratory, published 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 animals 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 second series with a somewhat +stronger dilution the alcohol 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. + +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 recent years in + our knowledge of the physiological action of alcohol has been + the clear demonstration that alcohol is oxidized 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 alcohol, 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 respects strictly analogous to sugar and + fats, provided always that the amount used does not exceed that + easily oxidized by the body. Under these premises it would be + expected that alcohol in a diet would have the same effect upon + an animal's susceptibility to acetonitrile as has dextrose, for + example. This is by no means the case, however; on the contrary, + the action of these substances in this regard is entirely + 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 conclusion + that in many cases alcohol has not a true food value, yet they + are sufficient to indicate caution in applying, without further + consideration, the brilliant and very exact results 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. + +In the summary Dr. Hunt says:-- + + "It is believed that these experiments afford clear experimental + 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 processes 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 energy, it is quite misleading + 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 daily food. Alcohol, 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 oxidative 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." + +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 results 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 experiments 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. 1. His conclusions are given as follows:-- + + "After a consideration of these experiments, it hardly seems + possible to doubt that alcohol, even in what is considered 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 oxidation 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 + cleavage products. + + + "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 entrance 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 oxidation, the same as +the oxidation of any other poisonous substance by the liver. His views +have such an important 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: + 'Foods are Oxidized; Alcohol is Oxidized; therefore alcohol is + a food.' But many difficulties appeared. A real food promotes + muscular, glandular and nerve activity, and its oxidation + maintains body temperature. But alcohol disturbs muscular, + 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 ingests 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 liberates 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 structure, 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 produces + 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 katabolism. 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 recently appeared two most + important papers based upon extended 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 substances + which reach the liver from the alimentary canal is at once + attacked by the liver, and if the oncoming tide of alcohol is + not too great it will practically all be oxidized._ + + "But the liver oxidation of other toxic substances is impaired + 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: (1.) The oxidation capacity 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 situation. 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 oxidation of + alcohol in the liver is simply one of the defensive activities + of that organ, _i. e._, it is a protective 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 exclusion of + other toxic substances up to the oxidation capacity? 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? + + "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: + (1.) _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 + nervous system and is proportional to normal activity. (2.) + _Protective 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 1, + the following consequences should be found: (1.) The ingestion + 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 temperature in the + healthy individual subjected to low external temperature. (3.) + The accession of muscle, brain, or gland activity 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 + relation. The oxidation of alcohol does not therefore belong to + class 1. If the oxidation of alcohol in the liver belongs to + class 2, the following consequences would be found: (1.) 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 exceeding + the physiological limit of alcohol. (3.) If the oxidation + 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, + xanthin 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 oxidation + 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 surface 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 refrigerant 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 necessary +internally nor externally. Its proper use is for mechanical 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_ water. Then cover it up and let it stand two days, +stirring it occasionally to help the melting. Now take two ounces of +citric acid, dissolved in a little boiling water, and add it to the +syrup, stirring the whole. Then strain the whole 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 Grapejuice. 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 lemonade--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 afflictions 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 necessity 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 + discovered. After the bath, the body should be thoroughly rubbed + with a crash or Turkish towel. Rub until a warm glow is + produced. 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 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 continue 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, whose +valuable paper on "The Evolution of the Mind" appeared in the December +number of the _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, inflammations and + consumptions, fevers and chills, at the hour of birth and at the + time of death, and all intermediate points of 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 disease 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 curable by making the + patient abstain from tobacco. These patients 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 consented 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 physician 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 Ensign._ + + +ADVERTISED "CURES" FOR DRUNKENNESS. + + "_Poudre Coza_, an English product, is sold at $3.00 for thirty + powders. On analysis these powders were found to contain an + impure form of sodium bicarbonate, together with a little + aromatic vegetable matter. Gloria Tonic was examined by the + Massachusetts Board of Health, and found to consist of sugar of + milk and cornstarch, with a small quantity 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 destroy 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 the 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 vegetables. It is better to eat no meat. + It has been fully demonstrated in Lady Henry Somerset's work + with women drunkards 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, Connecticut, + says that a valuable remedy to break up the impulsive craze for + spirits is a strong infusion of quassia given in two-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 successfully 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 advertising 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 incorruptible. We + have little expectation ourselves of being favored 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 + exaggerated. 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 accumulating evidence to the contrary. We wish that these + doctors would carefully study this evidence. The pity of it is + that the very worst offenders are the least likely to study it. + We suppose they must die out, and be replaced by men less + prejudiced and bound by the chain of alcoholic habit. We can + only regret that they should be doing so much harm in fastening + the fetters of drink on other people, and hindering their + emancipation from the evil customs which play havoc amongst + us."--_Medical Pioneer._ + +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, + excitement 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 + excitement, 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 nervousness, 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 recommending 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 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 1,600 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 Ensign._ + + "A lady, Mrs. A., tenderly nurtured, refined, cultured, moving + 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 + prevailed, 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 + unmanageable. After another desperate period she entered a + 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 lifetime. + No doctor ever felt his pulse (which intermitted) without + 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 doctors 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 life; it will only lessen what little + chance I have.' All who knew about this case, and hundreds did, + were driven to the conclusion that if these two people, one in + this condition and the other feeble, could live all alone as + they 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 heart + trouble and died of another disease."--_Pacific Ensign._ + +An English weekly journal is responsible for the following anecdote:-- + + "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, determined 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 case. '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 what 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 wherewith 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 Nature + 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 kidneys, need the same rest. + + "So, when the patient turns up with an overworked and exhausted + 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 like to be told to take a glass of whisky-and-water when + he is tired, which is the maddest and most disastrous 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 overwrought + stomach is all the time crying out for rest. + + "So it is all along the line. 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 insist + '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 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 + appreciated. 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 + prevent."--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 + endure 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 + perspiration, 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, and submitted a + formal proposition to them, 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 men 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 constantly 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 + £50 shall be yours; if not, I'll take the £50 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 came 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 himself 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 disease + where I thought it useful. I believe it is more deleterious 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 beer-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 nervous 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 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 tremens, 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 susceptible persons, + favoring dilatation of the stomach."--DR. E. P. JOSLIN, + Professor in Harvard Medical School. + + + "It is not the concentrated alcoholic liquors alone that cause + heart and kidney trouble but pre-eminently the continued + immoderate use of beer. Nothing is more false than the belief + 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."--_Liebig, the great German chemist._ + + + "Beer-drinker's heart is a term well-known to the physicians of + our large hospitals, and indicates a special condition 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 Munich one in every sixteen of the + hospital patients died from this disorder. It is 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 standpoint, 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 whisky + and brandy has been that the consumption of the distilled + liquors has changed very little, while to these liquors 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 inflammation 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 occupations. * * * Beer-drinkers have a marked + tendency to enlargement of the stomach, and to chronic + diarrhoea. Beer causes also inflammation of the nerves. This is + often announced by 'rheumatic' pains in the legs. * * * Beer + alcoholism, as well as alcoholism in general, lowers the + resistance 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 + attacks of infectious disease. * * * The brutalizing effect of + beer-alcoholism is shown most clearly by the fact that in + Germany crimes of personal violence, particularly dangerous + bodily injuries, occur most frequently in Bavaria where there + is the highest consumption of beer."--DR. HUGO HOPPE, Nerve + Specialist, Konigsberg, Germany. + + + "The life insurance companies make a business of estimating + men's lives, and can only make money by making correct estimates + of whatever influences life. Now they expect a man otherwise + healthy, who is addicted to beer-drinking, 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 witnessed 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. Indeed, so grave + are the evils caused by beer-drinking that the fight against + beer should now be conducted as strenuously as that against + stronger liquors."--DR. LEGRAIN, Paris, France. + + +DRUG DRINKS. + +In the report of the President's Homes Commission, Senate Document 644, +may be found a list of soft drinks examined by the Bureau of Chemistry. +The report says:-- + + "Attention is directed to the danger of soft drinks containing + 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 developed 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-O, 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 + company claims that their coca extract is now without 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 humanity 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. When + a person becomes habituated to its use he suffers torments when + not under its influence. The real cocaine fiend will rob or kill + to get the drug. What can be thought of men, 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 caffeine, 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, Kumfort, + Lime Juice and Kola, Lon Kola, Meg-O, 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: Charcola, Cherry + Kola, Cola Soda, Cola Ginger, Field's Coca, Imported 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 manure 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 caffeine in their product is made + from tea. It is claimed by the manufacturers of caffeine drinks + that they are as harmless as tea or coffee. But physicians + advise against the use of tea and coffee for children and for + delicate, nervous people, 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 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 + injurious 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 general effect is + to induce that unhappy state described as nervousness, with + deranged digestion and impaired health." Dr. H. H. Rusby, Dean + of the College of Pharmacy, of Columbia 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 results 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 experimenter 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 relief 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 concern." (See + volume on Social Betterment of Senate Document 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 relief + from pain, many resort to its use during painful menstruation. + Each month either whisky, or some medicine containing 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 + congestion which causes the pain, but by paralyzing or benumbing + the nervous system. In fact, alcohol, instead of relieving, + aggravates the internal congestion. It is a deceiver, for it + makes the patient believe she is benefited when in fact the + condition is made worse. The uterus has become 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 correspondingly. 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 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 menstruation + and each form has a treatment by itself. The congestive type + which is due to taking cold is better relieved by a hot sitz + bath before the date expected, the temperature of the water + should be 101°-103° with the feet in water a degree 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 pernicious practice, for + these irritants inflame the mucous membrane 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 necessary to give one dose of either to relieve pain at + such times. Hot applications with the enema, vaginal douche, or + 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 hysterical + 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 alcoholic + liquors have a tendency to shorten life than the figures + published by life insurance companies. A most interesting 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 different 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 companies, 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. 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, expected 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 percentages of mortality + in the various occupations of life, invariably 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 richest brewers, upon any terms, and not one of + the companies, to my knowledge, admits liquor dealers upon as + advantageous 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 + bartenders: '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 business 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' Society 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 abstainers 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 careful in our selection of + risks, and only those who drink in moderation will be accepted. + I think it safe to say that, other things being equal, all + American life insurance companies 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 abstainers 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 continued 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 Mackenzie + Moore, read a paper before the Institute of Actuaries, in 1903, + in which he reviewed the work of this company during 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 difference 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. + + 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 general 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 various + 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 foundation for disease'; Knights of the + Maccabees, 'Drink tends to destroy life'; Knights Templar and + Masons' Life Indemnity, 'Drink lessens ability to overcome + disease'; Sun Life, 'Drink injures constitution. Habit apt to + grow'; Massachusetts Mutual Life, 'Drink causes organic changes. + Reduces 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, 368 + + Abdominal bandage, 199 + + Abel, Prof. J. J., 128 + + Abernethy, Dr., 36 + + Acetanilid, 180, 301, 346 + + Acetic acid in pharmacy, 134, 136 + + Acid drinks kill bacilli, 150 + + Adelung, Dr. Edward Von, 326, 379 + + Adynamic disease, 272 + + Aiken, Dr. J. M., 376 + + Alabama law and alcoholic prescriptions, 27 + + Albumen, 30, 60, 62, 152, 173 + + Alcohol, + food claims, 112-114, 128 + a mocker, 364, 377 + a narcotic, 121, 123 + a poison, 28, 29, 100, 105, 358, 371, 388 + injurious to living cells, 275 + advance in study of, 380 + affinity for blood and tissues, 114 + affinity for water, 148, 149 + and foods, action contrasted, 406 + and empty stomach, 100 + mental work, 400 + anti-spasmodic, 124 + apparent benefits; deceptive warmth from evanescent, 108 + anæsthetic and paralyzant, 120, 181 + anæsthetic effect deceptive, 222, 262, 266 + antipyretic, 127 + as medicine, 96-130 + as medicine, causes waste of force, 83 + as medicine, diminished use, 20, 53-57 + as medicine, need of popular education regarding, 297 + as medicine, opposition to by W. C. T. U., 21-27 + causes disease, 28-36 + as sedative, 127 + as tonic, 124, 126 + beginning of scientific study, 11 + a cause of Bright's disease, 34, 91 + causes malnutrition, 284 + craving, 140 + delusion that it "supports", 294 + depressant, 150, 178 + dangerous in pneumonia, 201 + difference in action from carbohydrates and fats, 403 + diminishes arterial pressure, 119, 120 + effect on respiration, 263, 266 + experiments, 11, 15, 62, 65, 80, 93, 101, 119, 120, 149, 200, 266, + 267, 268, 275, 279, 288, 392-405, 421 + + Alcoholic diseases ascribed to other causes, 33 + drink, no danger in sudden stopping, 293 + drinks, stories of life sustained on, 112 + dyspepsia, 63 + proprietary medicines, 299-334 + + Alcohol, medical use bulwark of liquor-traffic, 96, 97, 360, 361 + medical use causes death, 260 + medical use delays recovery, 115 + medical use evidence against, 336-391 + medical use result of habit and tradition, 292, 294, 295, 298, 378 + medical use, Toledo Blade on, 358 + medical use, mortality increased by, 247-261, 267 + + Ammonia, 40, 188 + + Anæsthesia, 119, 120 + + Anæmia, 141 + + Anders, Dr. Howard S., 370 + + Angina pectoris, 181, 182 + + Animal poison, 206-211 + + Anthrax, 281, 282 + + Alcoholism, 36, 111 + + Ale, 120, 142, 236 + + Alkalies for stomach, 174 + + Alum, 143, 164, 171, 215 + + American Association for Study of Inebriety, 329 + + American Druggist and Patent Medicine Agitation, 26 + + American Medical Association, declaration on alcohol, 14 + + Antikamnia, 192, 346 + + Anti-Tuberculosis Congress resolution, 154 + + Apoplexy, 31, 32, 111, 142 + + Appetite, loss of, 142 + + Aschaffenberg, Prof., 400 + + Association of Abstaining Physicians, Germany, 387 + + Asthma, 179, 345 + + Athletes and alcohol, 103 + + Atwater, Prof., 128-130 + + Australian Government Commission on Patent Medicines, 314 + + + Baldwin, Dr. Edward R., 370 + + Barton, Miss Clara, 48 + + Baths, 57, 145, 146, 147, 152, 164, 193, 197, 199, 410, 431, 432 + + Battle Creek Sanitarium, 223-227, 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, 244-246, 247, 423-426 + + Bellevue Hospital, 36, 54, 309 + + Berkley and Friedenwald, 279 + + Beverages for the sick, 411 + + Bigelow, Dr. Jacob, 335 + + Billings, Dr. Frank, 155 + + Bitters, 176, 329 + + Blankmeyer, Dr. H. J., 159 + + Bleuler, Dr., 388 + + Blood, 66-75, 76, 86,106, 113, 114, 119, 393 + + Blood purifiers, 75 + + Blood vessels, 63, 75, 76, 108, 109, 120, 124, 143 + + Blumenau, alcohol and digestion, 173 + + Boils and carbuncles, 144 + + Bond, Dr. Knox, on fevers, 252, 373 + + Bostwick, Dr., 336 + + Bowditch, Prof. Vincent Y., 157 + + Boynton, Dr., 377 + + Bradner, Dr. Roe, 329, 332 + + Brain, 32, 36 + + Brandy, 35, 120, 143, 151, 173, 177, 183, 196, 215, 356 + + Brewers, 38, 425 + + Bright's disease, 34, 91, 94 + + British army, experiences with alcohol, 101, 102 + + British Medical Journal, 180, 247, 269, 270, 319, 324 + + British Medical Temperance Association, 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 + + Carpanutrine, 313 + + Carpenter, Dr. Alfred, 86 + + Carson, Prof. J. W., 336 + + Casgrau, Dr., doctors who personally use alcohol less observant + 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 + + Children of beer-drinking mothers, 236, 237 + + Children, per cent. of deaths of those of abstaining and drinking + parents, 397, 398 + + Chills, 146 + + Chittenden, Prof., 93, 403 + + Chloral, 127, 138, 190, 275, 332, 353 + + Chlorodyne, 127 + + Chloroform, 119, 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, 101 + + Clinique, The, 180 + + Coal-tar drugs, 75, 180, 192, 339, 340 + + Coca wines, 319-324 + + Coca Cola, 427 + + Cocaine, 300, 319-325, 345-351, 427 + + Cod-liver oil, fraudulent preparations, 314 + + Coffee, 40, 141, 194, 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, 83, 87 + from alcoholic diseases ascribed to other causes, 31-34 + + Death-rates, comparative, 75, 85, 247-261, 267 + lowered by non-alcoholic treatment, 37, 46, 219 + + Debility, 171, 172 + + Davis, Dr. Nathan S., Sr., 11, 12, 29-31, 45, 66, 75, 80-82, + 91-95, 107, 112, 117, 118, 125, 128, 178, 193, 217, 219, + 244, 253, 262, 267, 289, 294, 358-360 + + De Garmo, Prof., 366 + + Deléarde, Dr., Pasteur Institute, 279, 284 + + Delirium tremens, 388 + + Depression of spirits, 172, 179 + + Diabetes, 88, 89 + + Diarrhoea, 172 + + 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, 388 + + Eshner, Dr. A. A., 364 + + Exhaustion, 178 + + + Fainting and faintness, 177, 178, 180, 181 + + Fatigue, 178, 320, 430 + + Fatty degeneration, 34-36, 82-85, 114 + + Fats digested in small intestines, 60 + + Fere, Dr., 203 + + Fermentation, 116, 274 + + Fevers, 75, 85, 249-255, 388 + + Fibrine, 40, 62 + + Fits, 238 + + Flatulence, 179 + + Flick, Dr. Lawrence, 156 + + Fomentations, 147, 199, 229 + + Food, alcohol as indirect, 112-114, 29, 98-117, 128-130 + + Foods, proprietary, 313 + + Forel, Dr. A., 36, 105 + + Forrest, Dr., 160, 161 + + Foster, Dr., 68 + + Franco-Prussian War, wine, 110, 111 + + 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 prescriptions, 27 + + Germs, 70, 115, 223, 272, 286, 287 + + Giddiness, 179 + + Gilman, Prof., treatment leads to death, 337 + + Gin, 61, 117, 199, 246 + + Ginger drinking, 341 + + Gloria Tonic, 414 + + Gluzinski and digestion, 61, 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, 65 + + Gréhant, 288 + + Gruber, Prof., 128, 129 + + Guardian cells, see leucocytes + + Gull, Sir Wm., 35, 104 + + Gum resins, non-alcoholic preparation, 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, 95 + + Hargreaves, Dr. W., 35, 85, 86, 105, 236, 237 + + Harley, Dr., alcohol and diabetes, 88, 89 + + Harrington. Dr. Chas., 313, 316 + + Hart, Dr. Ernest, 126, 152, 269 + + Harvey, Dr., counsel to young physicians, 389 + + Hay Fever, 145, 146 + + Hayes, Dr., arctic work, 110 + + 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 + + Hirschfeld, Dr., 360, 380 + + Hiss, Dr. A. Emil, 309, 310 + + History of study of alcohol, 9-20 + + Hob-nailed liver, 87 + + Hoffman drops, 349 + + Hoff'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 alcoholic liquors, 53-57 + + Hugounencq, alcohol and pepsin, 176 + + Hunt, Mrs. Mary H., temperance education, 17 + + Hunt, Dr. Reid, 369, 402 + + Hydrochloric acid, 173, 177 + + Hydrophobia, 281-283 + + + Internal Rev, Dep't. and Nostrums, 27, 312 + + International Congress on Alcoholism, London, 1909, 9, 393 + Encyclopedia of Surgery, 209 + Medical Congress 1876, and National W. C. T. U., 23, 82 + + 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, 368, 369, 425 + + 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, 110 + + 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, 195, 199, 255, 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. Monæ, success in treating fevers in Cuban War, 53 + + Leucocytes, 271, 272, 274, 275, 278, 282, 283, 284, 285 + + Life insurance and total abstinence, 36, 423, 426, 432-435 + + Life saving stations and alcohol, 193 + + Liniments, non-alcoholic, 134, 135 + + Liquid Peptones, 313 + + 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., 157 + + Lungs, 30, 201 + + Lying-in-Hospital, London, 37, 38 + + + Martin, Dr. Newell, 63, 79, 84, 85, 91, 109, 119, 158 + + Massage, 166, 180, 213, 214 + + Mass. State Board of Health, 34, 310 + + Massart and Bordet, leucocytes, 277 + + McNicholl, Dr. T. A., 48, 378 + + Madden, Dr. John, 378 + + Magnesia, 179 + + Malaria[D], 195, 196 + + [Footnote D: Of late years malaria is attributed to the bite of + a certain kind of mosquito. In preparing this edition that item + was overlooked.] + + Malt Extracts, 316-319 + + Manassein's Clinic, alcohol and kidneys, 93, 94 + + Mann, Dr. Matthew D., 365 + + Martin, Alexis St., 61, 293 + + McCormack, Dr. J. H., 370 + + Measles, 194 + + Meat extracts, valueless, 325, 326 + + Medical temperance department of W. C. T. U., 25-27 + + Menstruation, painful, 197 + + Mercer, Dr. Alfred, 363 + + Metchnikoff, 374, 398 + + Milk, 141, 153, 188, 236, 237, 251, 373 + + Miller, Dr. James Alex., 157 + + Mitchell, Dr. S. Weir, 207, 210 + + Miura, investigations, 379 + + Morphine, 300, 345, 351, 352 + + Mossop, Dr., experiments, 120 + + Mother Bailey's Quieting Syrup, 310 + + Munyon's Kidney Cure, 315 + + Mulford's Predigested Beef, 313 + + Muscles and alcohol, 33, 103, 124 + + Musser, Dr. John H., 369, 370 + + Mussey, Prof. R. D., 12 + + + Nansen and polar expedition, 110 + + Narcotic drug dangers, 345, 346, 350-355, 357 + + Nausea, 199 + + Nerves, 32, 36, 76, 77, 105, 118, 185, 425 + + Nervous system affected by retention of waste, 115 + + Neuralgia, 198 + + New York State Board of Health, 154, 155 + + Newspapers and whiskey ads., 382 + and patent medicine ads, 333 + + Nichol, Dr., experiments, 120 + + Nichols, Dr. Jas. R., 136, 138 + + Nitrite of amyl, 15, 181, 182 + + Non-alcoholic treatment, 37, 89, 140-233, 258-260, 360 + + Nurses, abstinence in cholera, 149 + + Nursing mothers and beer, 234, 426 + + Nutrition retarded by alcohol, 114 + + + Oatmeal, 197, 235 + + Oils, essential, non-alcoholic preparation, 134 + + Opium, 127, 132, 149, 150, 172, 180, 189, 190, 300, 351, 352, 389, 412 + + Orangeine, 346 + + Osler, 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 + + Phenacetine, 300, 339, 340, 346, 354 + + Physicians need awakening as to evils of alcohol, 379 + responsibility for prescribing 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 + + Panopepton, 313 + + Paralysis, 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 alcohol, 120, 124 + + Rheumatism, 211-214, 259, 260, 343 + + Richardson, Sir B. W., 15, 17, 31, 39, 63, 72, 105, 111, + 121, 148, 153, 177, 259, 295-297, 356, 383, 385-387 + + Ridge, Dr. J. J., 73, 84, 124, 127, 143, 149, 180, 188, 196, + 213, 216, 248, 250, 275, 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, 373 + + Schafer's physiology on alcohol, 129 + + Scientific temperance education, 17, 18 + + Sedatives, dangers of, 127 + + Shock, 215, 216 + + Sight impaired by alcohol, 120 + + Sleeplessness, 179 + + Small-pox, 247-250 + + Smith. Dr. E., 105, 238 + + Snake-bite, 207, 211 + + Soft drinks, dangerous, 427 + + Soldiers, 101, 102, 285 + + Soothing syrups, 310 + + Sore nipples, 215 + + Sore throat, 145 + + Sphygmograph, 79, 120, 122 + + Stammreich, investigations, 379 + + Starch, 116, 129, 130 + + Stimulant, definition, 118, 222 + + Stimulants, 105, 177, 179, 186, 188, 190, 194, 237, 338 + + Stimulation, fallacy of theory,, 385 + + 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, 177 + + + 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, 154-158 + + 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, 365, 373, 379 + + Typhus, 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, 315 + + Vomiting, 140, 233 + + + Water, 30, 95, 112, 128, 135, 143, 145, 150-152, 175, 177, + 187, 188, 224, 225, 232, 411 + + Weakness in growing youth, 125, 178 + + W. Va. Medical Society resolutions, 371 + + Whisky, 28, 50, 112, 127, 155, 157, 173, 190, 193, 196, + 210, 265, 370, 390 + + Willhite, Dr. O. C., 159 + + Wine, 13, 31, 64, 65, 109, 110, 117, 123, 125, 141, + 176, 236, 325, 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., 158 + + White Haven Sanitarium, 155 + + White Ribbon Remedy, 414 + + Wiley, Dr. H. W., 301, 428, 429 + + Willard, Miss Frances E., 23, 44-47 + + Williams, Henry 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, 211, 276-284, 366, 383 + + Woods, Dr. Matthew, 364 + + Wood, Dr. H. C., 119 + + + Zwieback, 175 + + + +ERRATA + +Page 346, third line from bottom omitted: + +The use of cocaine is advancing rapidly in this + +[Transcriber's Note: The text was emended to include +the above correction.] + + + * * * * * + + +TRANSCRIBER'S NOTE: + +Every effort has been made to replicate this text as faithfully as +possible, including obsolete and variant spellings. Obvious +typographical errors in punctuation (misplaced quotes and the like) have +been fixed. Note that the index has _not_ been resorted +alphabetically.Corrections [in brackets] in the text are noted below: + +page v: typo corrected + + Sims Woodhead on immunity--Delearde's[Deléarde's] experiments + +page vi: typo corrected + + Dr. Knox Bond on Scarlet Fever--Metchinkoff[Metchnikoff] on + white blood-cells--Kassowitz describes his + +page vii: typo corrected + + to quit drinking--Dr. T. D. Crother's[Crothers'] remedy + +page 21: typo corrected + + THE WOMAN[']S CHRISTIAN TEMPERANCE UNION IN OPPOSITION TO + ALCOHOL AS MEDICINE. + +page 48: typo corrected + + department of the hospital was commissoned[commissioned] to + treat diseases without the use of alcoholic liquids. + +page 53: typo corrected + + treatment for seven weeks for metorrhagia[metrorrhagia], + nietortes[TN: unsure what this word is] and peritonitis + +page 106: typo corrected + + who, but for its mistaken use, might have recovered from the + illness affecting then[them]. + +page 111: typo corrected + + or influenced by alcoholism. If the clinical + thermometor[thermometer] shows the temperature to be above + +page 129: typo corrected + + An editorial in the Journal of the Amercian[American] Medical + Association said: + +page 158: typo corrected + + E. White, M. D., Medical Director Nordrach Ranch + Sanatorium[Sanitorium], Colorado Springs, Colorado. + +page 172: typo corrected + + irritant of which the stomach is trying to be rid. Do not arrest + it permaturely[prematurely], but assist it. + +page 180 + + is usually a symptom of trouble somewhere else, often in the + alimentary canal, and[an] overloaded stomach, + +page 238: duplicate word removed + + which they soon experience in the [the] supply of milk? + +page 255: typo corrected + + Dr. A. L. Loomis, in the treatmemt[treatment] of 600 typhus + fever cases on Blackwell's Island in 1864, excluded + +page 256: typo corrected + + These cases include a number of hyterectomies[hysterectomies], + and many cases so desperate that those who trust in alcohol + +page 257: aded missing single quote + + be called criminal. I certainly feel that punishment would be + just.[']" + +page 260: typo corrected + + there is less frequent relapse, and there is quicker recovery. + In brief, the experience of treament[treatment] of rheumatic + +page 275: typo corrected + + therefore, may open the door to fever or erysipelas.' A + similiar[similar] experiment of Doyen confirms this. + +page 301: added missing quote + + a habit of gaining relief which becomes an obsession and + incapable of being resisted.["] + +page 302: added missing quote + + harmful only, that so many people profess to have received + benefit from them?["] There are different + +page 313: added missing quote + + no fatty substances present in these products; their food value + from this point of view is, therefore, _nil_."] + +page 314: added missing quote + + show any oil. Analysis revealed sugar, alcohol, and glycerine, + none of which is contained in cod-liver oil.["] + +page 316: added missing quote + + ["]Hoff's Consumption Cure consists essentially of sodium + cinnamate and extract of opium, a mixture at one time suggested + +page 319: typo corrected + + 5233 Philadephia[Philadelphia] Porter + +page 348: end of quote ambiguous + + questions were put replied after careful consideration as + follows: '[could not find ending single quote]Its physiological + action is practically unknown. + +page 360: typo corrected + + "Dr. Hirschfield[Hirschfeld], a well-known physician of + Magdeburg, Germany, was recently arrested on a charge + +page 361: typo corrected + + more than upon anything else, to screen it from + opprobium[opprobrium], and just punishment for the evils which + the traffic entails upon + +page 381: added missing quote + + in their denunciations of the current beliefs concerning alcohol + in medicine.["]--_Journal A. M. A._, January 6, 1900. + +page 392: typo corrected + + RECENT RESEARCHES UPON ALCOLOL.[ALCOHOL] + +page 402: typo corrected + + strictly analagous[analogous] to sugar and fats, provided always + that the amount used does not exceed that easily oxidized + +page 421: added missing quote + + and starve. But the next time they were sick, _I wasn't the + doctor_.["]--"Physician" in Our Federation_. + +Throughout the index, typos corrected: + + Berkley and Friendenwald[Friedenwald], 279 + + Delearde[Deléarde], Dr., Pasteur Institute, 279, 284 + + Fére[Fere], Dr., 203 + + Grehaut[Gréhant], 288 + + Hirschfield[Hirschfeld], Dr., 360, 380 + + International Congress on Alcoholism, London, 1909, 9, 393 + " Encyclopædia[Encyclopedia] of Surgery, 209 + + Lesser, Dr. A. Monae[Monæ], success in treating fevers in Cuban + War, 53 + + Massert[Massart] and Bordet, leucocytes, 277 + + Panopeptone[Panopepton], 313 + + Phenacetin[Phenacetine], 300, 339, 340, 346, 354 + + Rushy[Rusby], Dr. H. H., 429 + + Stamreich[Stammreich], investigations, 379 + + Whiskey[Whisky], 28, 50, 112, 127, 155, 157, 173, 190, 193, 196, + 210, 265, 370, 390 + + Zweiback[Zwieback], 175 + + + + + +End of the Project Gutenberg EBook of Alcohol: A Dangerous and Unnecessary +Medicine, How and Why, by Martha M. 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