"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 cla.s.ses. 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 h.e.l.l 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 anaesthesia. There were but three deaths, making the mortality a little less than one per cent.

"The author does not claim a phenomenally low mortality, nor does he claim specially brilliant results. He has to contend with unreasoning fear on the part of the patients for hospital surgeons, and also most of his cases had been in the hands of quacks, and had subjected themselves to remedies prescribed by old women. Many cases came after the family physician had exhausted his resources. He thinks his results are 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 r.e.t.a.r.ds digestion, arrests secretion, and hinders excretion. The courage and fort.i.tude 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 a.s.sociation_, 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 pa.s.sing 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 a.s.signed by scientific investigators for their disuse of alcohol as a remedy in disease. In this chapter the same may be briefly hinted at, while others, some the results of quite recent research, will be added.

In the _Bulletin of the A. M. T. A._, for January 1898, Dr. N. S. Davis says:--

"The supposed effects of alcohol as a medicine were originally based solely on the sensations and actions of the patients taking it. The first appreciable effect of the alcohol after entering the blood is that of an anaesthetic; that is, it diminishes the sensibility of the brain and nerve structures, in the same direction as ether and chloroform. And, as the brain is the material seat of man's consciousness, the alcohol renders him less conscious of cold or heat, of weariness or pain, and less conscious of his own weight or of any external resistance.

Consequently, when under the influence of small doses, he feels lighter and less conscious of any external impressions, and thinks he could do more than without it. It was these effects that led both the patient and his physician to regard the alcohol as a general stimulant or tonic, notwithstanding the fact that by simply increasing the doses of alcohol the 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 acc.u.mulates 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 quant.i.ty taken; and as the lungs are the only channel through which free oxygen reaches the blood, and such oxygen is the natural exciter of all vital activities in the living body, it is not possible to explain how alcohol, or any other drug that diminishes the function of the lungs can, at the same time, act as a cardiac, or any other kind of tonic.

"The truth is that all intelligent physicians and writers on therapeutics of the present day agree in stating that alcohol in large doses directly diminishes all the vital processes in the living body, and in still larger doses suspends the life of the individual by paralyzing the cerebral, vasomotor, respiratory and cardiac functions, generally in the order named. If large doses produce such effects, we must logically claim that small doses act in the same direction, but in less degree. In other words, alcohol is as truly and exclusively an anaesthetic as is ether or chloroform, and, like them, is to be used as a 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 quant.i.ty 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 const.i.tutes, at the present time, the strongest influence in support of all the popular though erroneous and destructive drinking customs of the people.

"The same anaesthetic 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 anaesthetic 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 quant.i.ty 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 quant.i.ty 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 acc.u.mulation 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 quant.i.ty 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 const.i.tute the most active factor in the diseases named, and in others of a.n.a.logous 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 quant.i.ty 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 a.s.sociation 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 anaesthesia 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 circ.u.mstances 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 quant.i.ty of poison, and succ.u.mbs to its influence, its power of resistance being lessened by the inhalation of the chloroform.