To William Till, Esq. Collector of the Customs at New- ble. On Monday the air was serene and mild, resemcastle, Pennsilvania.

THE

REGISTER OF PENNSYLVANIA.

DEVOTED TO THE PRESERVATION OF EVERY KIND OF USEFUL INFORMATION RESPECTING THE STATE.

VOL. IV.-NO. 22.

EDITED BY SAMUEL HAZARD.

PHILADELPHIA, NOV. 28, 1829.

REPORT OF THE COMMITTEE APPOINTED BY THE
PHILADELPHIA MEDICAL SOCIETY,
To take into consideration the propriety of that Society
expressing their opinion with regard to the use of
ARDENT SPIRITS.

NO. 100.

mens, or, less properly, mania a potu. Beyond compar ison greater, too, is the risk of life undergone in nearly those unfortunate men who have been previously disorall diseases of whatever description, when they occur in dered by these poisons. In attempting to judge of the probability and proximity of death, besides age, s'rength and general constitution, the physician who wishes to avoid the probable sources of error, always finds it ne

The Committee appointed Jan. 24th, 1829, to take into consideration the propriety of this Society express-cessary to inquire into the temperance of the subject.ing their opinion with regard to the use of Ardent Spirits, and to frame such resolutions as they may deem proper,

The intoxicated are also incomparably more exposed to the ordinary causes of disease, from the imprudence to which their privation of reason and judgment so uniRespectfully Report, formly give rise. Thus they suffer from simple expoThat they have given their earnest attention to the sure to the weather, from falling asleep in improper sitsubject entrusted to their consideration; and hope, inuations, and from the want of food. In times of pestiaddition to those reflections which naturally arise in a medical mind, from the contemplation of this important public evil, to furnish some interesting estimates from the labours of others. In so doing, they have been in part compelled, from the very nature of the undertaking, to proceed upon the traces of those of their fellow citizens who are now engaged in similar inquiries; but they hope to be able to present the matter in some points of view, and to glean from some documents and other sources of information, which have, as yet, escaped the search of their immediate predecessors.

Your Committee, in inquiring into the destructive effects of drunkenness, and the deep stake which society has in preventing them, have not felt any great room or necessity for an enlarged dicussion. The disastrous consequences of this degrading practice are, unhappily, but too apparent to every one who witnesses, with a human interest, the good and evil fortunes of his fellow creatures. We behold them in the destruction of health, strength, riches and respectability, and, according to the views which religion has given us of the counsels of the Supreme, in the future misery of an immortal soul.

lence, those who indulge in intoxication are more severely affected, and retain less stamina to resist the onset of the malady; and to all this may be added the deep and powerful influence which mental anxiety, remorse and mortification, during their calmer hours, unques. tionably exert, in sharpening the pangs of disordered nature, and exhausting the vitality intended to support them.

One of the most destructive examples of the aggravation of mortality from this source, is the liability of persons of intemperate habits who meet with fractures and other severe hurts, to the disease called delirium tremens, or mania a potu. Great numbers of accidents annually occur among the labouring classes, of which those who are temperate in their habits regularly recover, while their intemperate mates, with equal original injury, sink under a complication of the latter with that affection which arises from their use of spirituous liquors. For the truth of this remark, it is enough to appeal to the experience of any of those who attend our hospital and alms-house. It will there be found an observation familiar in the mouth of every one, that the intemperate perish of diversified injuries in a ratio altogether disproportionate to the mortality of the other sufferers; a remark which ought to have peculiar terrors for the intemperate among the poor; as the laborer thus unexpectedly deprived of the safeguard of that strong constitution upon which he depended for his power of supporting hardships, and for his recovery from those accidents to which, from his way of life, he is peculiarly exposed.

To no class of men is this dreadful concatenation of distresses more visible and more forced on the attention, than to physicians. The ordinary course of our engagements, which brings us so perpetually in contact with disease and poverty, obliges us likewise to see, in the production of these evils, the prevalent and steady influence of spirituous liquors. Besides a numerous class of maladies, of frequent occurrence, to which their use obviously and in a peculiar manner gives rise, they are unquestionably the indirect cause of a still larger num- This catalogue of destruction may be wound up with ber. Their direct effect in exciting to action an exist- those rare and dreadful events, so full of wonder and ing tendency to gastric and hepatic disorders, or in cre- horror that credulity seems tasked to believe their actuating a disposition to them among individuals exposed al occurrence, the instances of human combustion. to the other causes of these morbific derangements, has strange and incredible do these narratives appear, that often been commented on by writers of authority. the reader may well be excused from lightly yielding Nearly as large a share may, with safety, be ascribed to credence to their reality; though evidence, the most auintemperance in the production of diseases of the brain.thentic in appearance, has accumulated to such an exAlthough, from the best authorities, it would now appear, that the agency of this cause in producing insanity has been over-rated, yet, in epilepsy, apoplexy, pal. sy, hypochondriasis and hysteria, its destructive effects cannot be mistaken; while it has exclusively to itself the responsibility of creating that peculiar and frequently mortal affection, known by the names of delirium tre

So

tent that we feel constrained to admit them true. From such various quarters do the accounts reach us, so independent are they of each other, so free, in many cases, from visible motive for deception, so public in the inspection of the scorched remains, and accompanied, in one instance, with such authentic judicial forms, that we cannot avoid considering it as proved that the bodies of those who have indulged, through a long life, in habits of intoxication, are liable to become food for the destroying element, and to be consumed while yet alive.

its.

While, in our investigations of physical causes, we are sable to offer those judgments and opinions which they bound to adhere, as closely as possible, to the compari- have been induced to form from their experience as son of facts with others previously known, we can hard practitioners, of the proportion of the deaths enumeraly refrain from tracing, in this terrific form of death, the ted in the bills of mortality which may be reasonably asdirect and avenging interference of an insulted Deity. cribed to intemperance. In doing this they have expeIf such be the truly distressing amount of morbid e- rienced great difficulty, and they are well aware that vils to which the unhappy propensity alluded to expo- their conclusions must necessarily possess a character ses its victims, its agency in the production of poverty highly conjectural. By running over the diseases menand dishonesty is not less obvious to the members of the tioned in the bills, and making an estimate of each, the medical profession. We have frequent and melancholy total amount averages about one-sixth of the whole; or opportunities of witnessing, in the abodes of the unfor- 700 deaths in 4292. A very large proportion of accitunate, the manner in which pecuniary difficulties are dents, such as burns, fractures, &c. are referrable to this generated; and we believe it is the universal senti- cause; as also are an equally large share of the diseases ment of those who possess such means of information, of the head, as apoplexy, epilepsy, &c. The deaths rethat the greater portion of the existing distress in this ported as from drinking cold water, are, your committee country, is the result of the employment of ardent spir- believe, not unfrequently really produced by drinking To make good this strong assertion, it is only ne- spirituous liquors; which are often given as a remedy cessary to recount the poverty which is the result of where the disease in fact is apoplexy, or at least, condiseases produced by intemperance, the actual loss of gestion in the brain. A cousiderable share of the fever time consumed in spirituous potations, the money ex- Cases are, they apprehend, owing, directly or indirectly, pended on them, which, small in each single instance, to the same cause, as well as various inflammations naamounts, by its thou and repetitions, to a heavy draught med in the bills. In this estimate are included those on the funds of the laboring poor, the loss of character cases which were not originally occasioned by inand consequently of employment, the destruction of temperance, but which owe their aggravation and morpunctuality in pecuniary engagements, and, as a neces-tality to that source; and it is also believed that a porsary result, of credits and the domestic quarrels and tion of the still-born children receive their death from waste of the household. Against the combined action the intemperance of the mother, or from violence and of all these causes no human industry can successfully other mal-treatment received by the latter and produced contend; and we accordingly find the habitually intem- by the same cause. perate unable to discharge their engagements, always To confirm the impression that these opinions and esin want, and, if they do not either yet possess a fund to timates are not exaggerated, by exhibiting an extent in expend, or receive assistance from their friends, always the operation of the cause which may appear adequate in actual suffering. to such an effect, your committee take the liberty to abYour Committee are far from willing to cast reflec-stract a statement of the number of houses in which distions upon the poor. There is no station in life which tilled liquors are sold, from papers which have been alis more entitled, intrinsically, to our high respect, than ready laid before the public. In their opinion, the rehonorable poverty. Yet, though poverty be the inflic-sults are surprising and alarming; they cannot be too oftion of Providence, and the natural condition of the whole human race, it is notorious in the moral world, as the cruelest thing of misfortune, that it subjects us to temptation; and it cannot be doubted that we meet with that species of moral offence which consists in incurring obligations beyond the power of the individual to discharge them, most frequently as the result of pecuniary distress, and that distress, very often, if not generally, as the consequence of the use of spirituous liquors.

In order to enable the members of this society to judge at a glance, of the extent of physical evil, in the shape of disease, induced by intemperance, your Committee have thought it proper to refer, for this purpose, to the last annual bills of mortality for the City and Liberties of Philadelphia. Your Committee are well aware, that, in order to execute this task with the best approximation to accuracy of which the case admits, it would be necessary to induce a number of physicians, practising among diversified classes of society, to keep a register with this especial object. Fach individual so employed should carefully note down the whole number of deaths occurring under his care during a year; and designate that proportion of them which may, in his opinion, be fairly referred to the cause alluded to. Such a register should be carefully made to embrace those who have passed out of his charge during the continuance of their last illness; unless where the physician who succeeds him is engaged in preparing a similar record. For reasons easily apprehended, this course is indispensable to the formation of a just numerical average. Documents thus obtained would possess a character for accuracy truly valuable; not that they would obtain that absolute certainty which, in this case, is really impracticable, but that they would furnish the nearest approach to it. Your Committee, therefore, would respectfully but earnestly press upon the members of this society the formation, individually, of such a register.

In the mean while, in the absence of such more authentic materials, your committee have thought it advi

ten presented to view, and are quite applicable to the subject of their present inquiry. By tables collected under the direction of the Temperance Society of this city, and published in Hazard's Register of Pennsylva nia, of the 7th of February, 1829, it appears from an actual enumeration made in the Summer of 1828, that the City of Philadelphia, the Northern Liberties, Penn Township, Kensington and Southwark, estimated from the taxables at a population of 159,480 individuals, contained no less than 1239 houses in which spirituous liquors were sold; or one for about every 129 persons of all ages and both sexes. In one section, the proportion runs as high as one to every 79 persons, or, of individuals above 18 years of age, one to every 39. That is, there are no 39 persons grown up in the district who have not a tavern to support; or there is a tavern to every twenty men!

Corresponding impressions with regard to the extent of the evil may be gained from the replies to one of the queries circulated by the committee of superintendence appointed by the Citizens of Philadelphia, at a townmeeting held February 17th, 1817, "to devise measures for the relief of the poor and the prevention of pauperism." Circulars were sent, on this occasion, to those individuals who were engaged in the management of the various public and private charitable institutions in the city; as well as to such other persons as were deemed capable of imparting the desired information. Public attention being, at that time, strongly directed to this important subject, replies were very generally obtained from the individuals so addressed; no less than thirty out of thirty-three guardians of the poor alone responding to the printed letters. From the official abstract of the replies thus obtained, we extract the following query, and its general answer.

"Query 10. Is, or is not, the use of ardent spirits the cause of poverty; and do, or do not, those who receive, expend the means afforded for their subsistence in pur chasing that article?"

"Answer. All the reports, excepting in one or two

1829.]

REPORT ON THE USE OF ARDENT SPIRITS.

instances, reply to the former part of this query in the affirmative. The following extracts, written by different persons, will exhibit, at one view; the almost universal sentiment upon this subject."

339

placing it by substances capable of deceiving the taste; such as potions made with a combination of alcohol and | ether, or ether itself, administered on lumps of sugar. to be held in the mouth. Opium was frequently found necessary during the cure.

Of a date subsequent to the above is the following paragraph, quoted from Johnson's Medico-Chirurgical Review for September 1824; and in this is contained all the information which we possess, from a foreign source, relative to the particular use of sulphuric acid as a cure for intemperance: In one of the foreign Journals it is stated that a German physician, M. Brubl Cramer, has discovered that the exhibition of diluted sulphuric acid, with occasional bitters, causes, at length, such a disgust towards brandy and other spirituous potations as to eradicate the disposition to inebriety." This brief hint was sufficient for our inquiring and indefatigable townsman and fellow-member of this society, Dr. Brinckle. What indeed appears "like bread cast upon the waters," became, in his hands, productive of fruitful results. In his essay on the subject, contained in the fourth volume of the North American Medical and Surgical Journal, published in this city, he gives the highly successful results of a number of cases in which he administered the acid with this view. Your committee early felt that they could not do justice to the subject of their inquiries without requesting of Dr. Brinckle the inferences afforded by his further experience. Accordingly, one of their number addressed him a note, to which was promptly returned the polite reply which they have inserted in the Appendix to this Report.

'I he authors of the abstract alluded to, then proceed to insert nine extracts from different reports, all strongly inculcating the prevalent agency of this cause of poverty. Your Committee, in order to correct or confirm their views on this subject, resolved to make an application to the members of the late commission appointed, une der a law of Pennsylvania, to investigate the cause of pauperism. Some of their number accordingly waited on Messrs. Vaux and Pettit. From these gentlemen it is unnecessary to state that they met with every polite ness, and the strongest disposition to favour their inquiries. The documents collected by the commission are in the hands of individuals amply competent to the task, for the purpose of forming an abstract; which we hope will soon be laid before the public in a most valuable weekly journal, to which we have already had occasion to refer. The members of the commission above named, in their private capacity, fully concurred in the views which we have expressed in the preceding paragraphs; and this testimony is the more valuable from the very enlarged advantages which they possessed for forming a judgment on this highly important subject. In the mean time, we were allowed to inspect a large mass of documents, furnished by the secretaries of various charitable associations in this city. Many of these omitted, in their reports, to reply particularly to that query which related to the causes of the distress which the societies were intended to relieve; and some of the latter appear, by their regulations, to exclude the intemper-have made trials of the sulphuric acid; and success has ate from the benefit of their funds. The reports of nearly all the others mention ardent spirits among the principal causes of poverty; and several of them in very strong language.

In addition to the remarks of Dr. Brinckle, your committee have collected but little. Some of their number

appeared, in a part of the cases, to crown their efforts; while the event was, in other instances, doubtful and disappointing. The general impression which they have received from all which they have seen and read on this Having become thus impressed with a sense of the subject, is, that the sulphuric acid is well worthy of furenormous extent of the evil they are investigating, your ther trials in cases of habitual intemperance; while on Committee propose next to consider the means which we the other hand its usefulness is greatly diminished by the possess for its discouragement and prevention; intend- frequent unwillingness of patients to take it, by the dif ing to conclude by some remarks which appear natural-ficulty of disguising it, and by its occasional failures.ly to flow out of the peculiar situation of members of the medical body.

The means of preventing intemperance have been recently the subject of considerable public attention and some discussion. They naturally divide themselves in to the medical and the moral.

They are happy to state they have met with no instance in which this remedy appeared productive of injury. It is hardly necessary to add that they repose every confidence in the accuracy and candour of Dr. Brinckle's statements. On the whole they will conclude with recommending the members of this society, to make further trials of the acid in conjunction with the other medicines advised by Drs. Cramer and Adersbach.

With regard to those remedies, the obvious and unde

Of those means afforded by the art of medicine for the cure of that unhappy propensity but little was known till of late years. A few scattered and isolated cases, frequently resting on doubtful authority, are all that canniable operation of which takes place by the production readily be found prior to the inquiries of Dr. Cramer of nausea, your committee find themselves in nearly the This physician published, in Berlin, in 1819, an essay on same situation. They are obliged, as before, to draw a the passion for intoxicating liquors; which he found ac- large share of their information from Dr. Brinckle.companied by so many morbid symptoms, as, in his o- They have heard of one or two successful and corrobopinion, to justify the considering and treating it as a di-rative cases; and they can adduce trials from their own sease. Other cases were collected by Dr. G. Aders- practice, in which, however, the effect was doubtful.— bach; and Dr. Hufeland, the editor of a German Medi- The administration of nauseating remedies for the purcal Journal, of high character, has given the malady the pose of producing an aversion to spirituous liquors, name of dipsomania, which may be paraphrased by would seem to harmonize well with that practice, highly "insane thirst," or "thirsting insanity." The catalogue recommended by some, of treating delirium tremens by of symptoms, most of which, indeed, can be recognised | the same articles. Your committee have only to add, in many of our drunkards, your committee will not ab- as before, the expression of their anxious wish for the stract. Drs. Cramer and Adersbach found this affec- collection of additional facts. tion varying in duration from a few days to several In the class last mentioned is generally ranked the weeks, and, in different cases, either continued or inter-popular remedy of Dr. Chambers. Of this your commitmittent, mild or severe, mortal or terminating in recove- tee have learned but little. It is generally sold from ry. They combated it with bleedings of various a-shops to individuals who employ it without the presence mounts, with warm baths, the semicupium, and acidulated watery drinks. They found it the most successful practice not suddenly to deprive the patient of the whole of his accustomed stimulus, but to make the change gradually; and they derive advantages from re

* From dipsa, thirst, and mania, insanity.

of experienced and scientific men. They are disposed to view a medicine composed of such active ingredients, and empirically used, with great mistrust. It is believed that the principal beneficial effects of this compound are owing to the presence of emetic tartar. One of their members states that two or three cases are known to him in which death followed the administration of this

remedy as rapidly as it succeeds that of a dose of arsenic. this point a still more complete and impressive effect is It cannot be denied, on the other hand, that the use of to be desired; and that those of our fellow-citizens are this article has, in some instances, been followed by an in the right who, at various times, and particularly at the aversion to liquor enduring for a more or less consider-present moment, endeavour to effect the entire disuse of able interval of time. intoxicating liquors. Between the moderate and the imWith regard to the moral means of diminishing intem-moderate employment of these substances, there is no perance, the first and most obvious course, the institu- clear dividing line. They are only separated by insention of such public measures as are calculated to raise sible and ambiguous gradations; to slide through which the price of spirituous liquors, would appear to be for- is the natural propensity of every one who indulges in bidden by the political state of the country. It is under- them in any degree. Originally adopted for the purstood that a majority of our fellow citizens have express-pose of producing a vivid impression on the nervous ed their opinion in opposition to the proposed plans, system, and one which forms no part of the gratification in such a manner as effectually to prevent any reasona- of any natural appetite, ardent spirits are notorious for ble expectation of their speedy adoption. We appre- the facility with which the human frame becomes familhend, then, that those are in the right who aim at the iarized to them; and, in order to renew the sensations suppression of intemperance by acting, in a gradual and enjoyed at first, it becomes indispensable to increase persevering manner, upon public opinion; that the the dose. This change takes place by such slow defriends of sobriety should exert their private influence grees that the patient is seldom aware of the fact, and in their proper sphere, and endeavour thus to increase finds himself subjected to an imperious craving, where their numbers, in hopes, by this means, to accelerate he fancied he was only enjoying an indulgence capable the approach of period, when a decided and over- of being regulated by a proper discretion. It is desirawhelming majority of the people shall agree with them ble, therefore, in order to effect a salutary_reformation in their sentiments on this subject. The government of in this respect, to disuse spirituous liquors altogether.— this nation is emphatically one of the people; and when It has been well remarked that no man ever became a the opinion of the community is once distinctly express- drunkard without first using intoxicating liquors modered, the legislature will follow it of course. It is there- ately. On those who consume them immoderately, effore to the private and personal influence of each individ-forts are generally wasted; and it is only among those ual that your committee think the task should be refer- who are as yet temperate in their employment that benred; and upon physicians it seems peculiarly imperative, efit is to be expected. both from their frequent opportunities, their knowledge These arguments, or a part of them, have been extenof the case, which is unquestionably greater than that sively used among our fellow citizens; amidst whom possessed by any other class of citizens in the communi- physicians have been considered as holding the same ty, from the respect attached to their character, and stake and incurring the same responsibility with men of from the wide extent of their influence. Every mem- other professions. Yet there exist considerations which ber of the nation, and, in particular, every physician, a- may well induce the question whether we do really ware of the magnitude of the evil, and of the existence stand on the same ground with others. Are not physiof a simultaneous effort to reform it, has it in his power cians in various ways the means of introducing habits of to exert a salutary influence among his acquaintance, by intoxication? Are they not, in too numerous instances, precept, where that is admissible, and universally by instrumental in leading their patients into this destrucexample. It is, however, to the latter that we conceive tive practice, by the long continued use of these subit particularly important, at the present time, to direct stances as a medicine, and by speaking of them and rethe members of this society. Physicians unquestionably commending them as restorative? How many deplorable possess greater opportunities for bestowing useful ad- cases of intemperance, in men of previously irreproachvice on this subject than most other citizens. It is fre- able character, trace their origin to a long course of stimquently their solemn and imperative duty to forewarn ulation for the cure of typhus fevers and the recovery the individual, who tempts the fatal bowl, of the danger of strength! There was a time when this evil existed he is incurring to his health and his existence; and where to a far greater degree than it does at the present motheir character is calculated to command high personal ment. We allude to the epocha of the Brunonian therespect, they are enabled sometimes to give moral and ory. Never, probably, was there an instance where the prudential admonition. Yet to the physician these op- hypothesis of a single man produced such powerful efportunities are frequently, perhaps generally, forbidden fects upon the minds of his cotemporaries, in disorganby that proud feeling of independence which must be re-izing useful science, and leading the wise into error, as spected, as it forms a necessary ingredient in the char in this celebrated, but ill-starred medical doctrine. Af acter of a high-spirited and honorable population. While ter suffering mortification and persecution during his the moral adviser, then, finds his arguments always aug- lifetime, Dr. John Brown was destined, after his death,, mented in their influence by a corresponding example, to exert a splendid but destructive influence upon the in a variety of other instances, the example is the only great mass of the medical profession. By this strange means which he can employ. aberration of unfortunate genius, it was taught, that inflammatory affections of different parts of the body, were, comparatively, of but little importance. Pleurisy, pneumonia, phrenzy, &c. derived almost all their severity and danger from the general affection of the whole body with which they were accompanied. This affection was pronounced to consist, in nine cases out of ten, in direct or indirect debility; and this debility was to be met with powerful stimulants. The practice corresponded with the theory; and the wild, though ingenious pages in which the latter is disclosed, but too much exhibit the sincerity of the candid author. Stimulation, to the most extravagant extent, was often the notorious consequence; and at last the patient was not unfrequently landed in habitual drunkenness. Among those diseases in which weakness was most conspicuous was typhus fever; and Brown introduced a habit of pouring strong liquors into patients suffering with that malady, which is thought by many physicians to have left a perceptible effect upon the usages of the present day.

It is, indeed, surely to be hoped, that the great body of the profession do, at the present moment, discharge this obligation, by refraining from the intemperate use of alcoholic liquors. Yet it is the lamentable fact that instances exist in which this is not the case; and mortifying and distressing are the occurrences to which these exceptions have given rise. But it is not with the unfortunate victims, as your committee apprehend, that labour can be employed with advantage. The instances of recovery from habits of intoxication, though such sometimes occur, are unhappily so rare as to leave but little encouragement for efforts in these quarters. The united force of all the moralists, and the concentrated voice of numerous friends are too commonly unavailing to arrest the degrading practice. It is then to those who are as yet free from this unfortunate propensity that we are to appeal. With these it may be said that our labour is unnecessary, and that they already furnish the example of which we speak. Yet we apprehend in