"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, pyaemia, septicaemia, 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 anaesthetics 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, Schoeneseiffen 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 anaesthetic 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 Moebius, 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 anaemic 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 L8. 3s. 6d., amongst 2,496 patients, while the cost of the same number at the average of the twelve hospitals was L124. 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 habitues, predisposes especially to Bright's disease and insanity, and lays the foundation in the offspring for the majority of the neuroses and degenerations of modern civilized life. The physical fatigue of long working hours, loss of sleep, mental strain, worry and hunger, invite the tired physician, especially, to their seductive use. To totally abstain from them is always business, and very often character, and even life itself. I feel free to speak to you on this subject 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 anaesthetic, 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 haemolytic complement in the blood-serum of certain animals which were tested. They showed also that the formation of specific haemolytic 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 haemolytic power of blood-serum over heterogeneous red blood-corpuscles (rabbits). I have studied not only the haemolytic 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 haemolytic complement in the blood-serum of alcohol-drinking and non-drinking persons is altered in any way by alcohol.

"5. The bactericidal power of blood-serum from both 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 haemolytic 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.