continued and uninterrupted use of all his mental powers, and it should be the earnest effort of every one so to order his own course of life, and to aid others to direct theirs that he and they may at all times be prepared to render their full tribute of gratitude and praise to Him from whom all these and all other blessing have been derived, and to whom they must render an account for the right improvement of all He has intrusted to their keeping. REPORT OF THE COMMITTEE ON INTEMPERANCE AS A DISEASE. AT the last annual meeting of this Society it was unanimously "Resolved, That a committee be appointed to report to the next meeting on the medical, social, and civil aspects of intoxication fro alcohol and opium, and our duty as physicians in the premises." Your Committee have endeavored to consider the subject carefully, and most respectfully submit the following REPORT. The statement that there is a "medical aspect" to this subject, presupposes that intoxication, either from alcohol or opium, is, in some of its phases, a disease; and if this be true, it is an interesting inquiry how far this fact modifies the relation of the subject to morals and law. In the very outset, we find ourselves confronted by recognized authorities in law and morals which, while they may not deny that intemperance is sometimes a disease, still deal with it exclusively as an offence against law and morality. In this respect, it is an anomaly in our profession, because not only has it positive and well-defined symptoms by which even nonprofessional observers can distinguish it, but it is made a punishable offence against common decency and public order. Your Committee therefore find it difficult to reconcile this peculiarity of the subject with the ordinary methods of professional thought and inquiry as related to other diseases which have no such embarrass ments. There are, however, distinct forms and varieties of alcoholic excess, which are well defined, and which we propose briefly to notice. Of that class of men who take their wine, as Cowper did his tea, "to cheer, but not to inebriate," we shall not speak. These are technically known as moderate drinkers, and are not necessarily subjects, on that account, for medical observation and treatment. There are, however, at least three other classes : : 1. The occasional drinker, who sometimes, but seldom, crosses the boundaries of sobriety. 2. The periodical drinker, who, at intervals, throws the reins on the neck of appetite, abandons himself to his passion for excitants, and who may do so almost unconsciously, or with deliberate intent and purpose. 3. The habitual drinker, who indulges without deliberation or without sudden impulse, but because there is an appetite which has corrupted his constitution and made him a victim to a habit which he cannot of himself overcome. The multitudes of persons who are addicted to these several forms of inebriation, and the terrible consequences of the disease upon the domestic and industrial interests of the world, render its discussion one of the most important which can claim our thought. It seems to your Committee to be a medical and physiological question, which should be studied as any other medical question; and in whatever legislation may be required concerning it, that this fact should be recognized. CAUSES.-Your Committee are further of the opinion that there are constitutional tendencies inherent in mankind to seek artificial support. In vindication of this statement, we find that in every soil and climate there is some indigenous product from which man, whatever be the stage of his civilization, extracts an intoxicating ingredient. The rudest people of the globe, without any of the appliances of modern art or science, are not so rude and uncultivated, that they do not manufacture alcoholic liquors from the growth of their fields; and we know of no nation or people on the earth among whom intoxication is not a common vice. There is a demand for intoxicants, and there is a supply. Accepting this fact of history, comparing it with the experience of our own time, and noting the evidences which are daily presented to us in the practice of our profession, we are convinced, beyond doubt or controversy, that there does exist in men a tendency to the use of exhilarating beverages or narcotic drugs. Man, frequently uneasy and restless, naturally longs for and seeks something to raise him from suffering, and elevate him to what he discovers to be a pleasurable point of feeling; a point which he may obtain from various sources, according to his tastes or inclinations. Sometimes it may be found in the pursuit of art, science, literature, or society; and frequently in the productions of the animal and vegetable world. The prudent man, especially if he be a man of domestic habits, may be content with the exhilaration afforded by his tea or coffee and his cigar. One may be satisfied with home-made wine, cider, or beer; another thinks he requires a stronger stimulant, and another a still stronger, who partakes of more dangerous varieties till he becomes narcotized or drunken. Whiskey and brandy are the intoxicants of America, Russia, Scotland, and Ireland; ale and beer, of England, Germany, Japan, and Egypt; wine, of France and Italy; bouza, of Nubia; pulque, of Mexico; tuka, of Kamschatka; betil, of Polynesia; arrack, of Africa and Hindoostan; opium and shamshu, of China and Turkey; bangue and hashish, of Arabia and the Grecian Archipelago; coca leaves, of Peru; palm leaves, of the palm countries; hyoscyamus, of Syria; rue, of the Crimean valley; and, in more recent times, ether and chloroform among the cultivated and refined of our own country. It thus appears clear that the production of intoxicating beverages or drugs is restricted to no country or clime. It is as widely spread as the existence of language. Wherever we find a national speech, there we as certainly find a national intoxicant; nor does. this remark apply only to the present age, but, as far as the voice of history can be heard, it applies to every age of the world. Whence this universality of production? How happens it that, in every country and clime, plants grow, which are capable of yielding intoxicating products-such products as possess the threefold quality of exhilarant, roborant, and anodyne, and which are either deleterious or beneficial according to the quantity used? Observe the adaptation. Man, says a poet and philosopher, is at once "the child and sure heir of pain." He needs many a time such a draught as may exhilarate, strengthen, or compose. Nature, aided by human ingenuity, supplies it. Shall we say that man must not partake of these products? Let us consider. Nature offers them with a liberal hand. There is within man a sense of want, which bids him partake. Nature, however, human experience, our own observation, and the moral law prescribe the limit-moderation; beyond which, suffering is the result. In view of the wide-spread evils resulting from the careless and indiscriminate use of such beverages, it seems to be the province of the medical profession to recommend only the common use of such as experience has proved to be safe, and abstinence from those known to be injurious. A philosophic writer has said: "Every inordinate cup is unblest, and the ingredient is a devil." Unhappily, men do not partake in moderation, and therefore must, and do, endure the penalty. With a "demon" in the breast, their sufferings are fearful, till even death seems a shelter from the agony of a lacerated constitution and an avenging conscience. In this category falls the habitual drunkard. What is our duty towards him? What prescription has the medical fraternity that shall meet his case? Are there any means even to restore partially our brother man to ease and serenity, and to throw around his spirit a shadow of hope even for corporal salvation? We believe there are such means. The popular cry is, "Remove the cause." If we ask for the cause, the answer is, "The dramshops, and the law by which they are authorized and sustained." In view, however, of the momentous facts already referred to, your Committee must take a broader and deeper view of the causes which underlie this evil. It is alike unphilosophical and unjust to classify social usages and dramshops as the chief causes of intemperance. They are temptations, not causes; temptations which are in the way of sober people as well as of those who drink. In dealing with this subject, we should be careful in the use of terms, and understand the terms we use. A cause is an invariable antecedent. Drinking at dramshops or in social circles does not invariably antecede the habit of drunkenness, but a susceptibility or capacity for such a condition must always exist in the person who becomes an inebriate. The dramshop or social glass may only be the occasion. Some forms of intoxication are peculiarly exclusive. The custom of "treating" at public bars is applicable only to a class. The habitual drinker indulges at home, in his office or place of business, at particular times and under circumstances of unusual effort or exposure. He does not think of depending upon invitations and associations for the enjoyment of his accustomed draught. With him the demand is from within; a craving analogous to that of hunger, which he feels must be satisfied or he is unfitted for the service of life. Many a periodical inebriate carries liquor to his room, and remains for days, and even weeks, in seclusion, while he passes through the satisfying narcotism which obliterates all thought and care from his mind, and puts his body in a condition of protracted slumber and repose. Opium-using is a secret vice. Hashish is used privately, and ether and chloroform are inhaled in solitary places. |