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The doctor affirmed that this disease presented such various symptoms in each case, that its successful treatment depended upon the particular knowledge of the patient, his history and his habits. He also discussed the general and special symptoms of inebriety, and their pathological meanings, observing that the general symptoms always indicated impaired constitutional power, and debility of organic life, whether apparent or not to the senses. The observation of all writers on this subject agree that the inebriate has a debilitated physical system, which is imperfectly nourished, because of the poisonous alcohol taken into the stomach interfering with the process of repair. The special symptoms of inebriety point to molecular disturbance of the nutrient nerve centres, functional paralysis of the stomach with general diminution of the co-ordinating nerve force. This may be rapidly followed by organic changes in the stomach, liver, kidneys, and lastly of the heart and lungs. The organic changes in the brain begin after the lesions of other organs. But the functional changes of the brain are first in order of time.

The doctor continued: All inebriates have a defective constitution and weakened will power. The function of repair, by which the body is built up and sustained, it deranged, and the mental or nervous system must suffer. The first indication in treatment is to restore the general health. To do this, food is of the first importance. It was the boast of the celebrated chemist Liebig, "that, given the quality, quantity and regularity of food, he could determine the character and enterprise of any race." The hint we are taught by this is that food is a prominent agent in forming the mental and physical health of the individual or nation. A carefully regulated diet, adapted to meet the wants of each case, has been found the most valuable in treatment. Add to this such tonics as act locally on the stomach and nervous system, including such remedies as iron, quinine, bismuth, pepsin, etc. Bathing and regularity of sleep, well ventilated rooms and sunlight are indispensable. Of sunlight we begin to learn that it is a tonic, without which we can not secure health and vigor. By these general means the health of the inebriate is improved, and if we accompany them with cheering mental associations and removal from

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all exciting causes, complete restoration will follow in many cases.

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The mind is treated by rest and change of thought, and companions who have like motives and hopes. Good food and excellent care build up the physical, change of thought, occupation and surroundings, restore the mental, and this constitutes the general plan of treatment.

In answer to the question what can be done scientifically for this disease, Dr. Crothers remarked that for half a century and more, insanity has been treated and studied practically. Large wealthy hospitals, with men of genius and talent to manage them exist all over the country; ponderous volumes of discoveries and speculations on the pathology and treatment of insanity fill the medical libraries. The study and literature have grown with the science until it has become a separate department in the practice of medicine. Statistics of the best hospitals indicate that from 35 to 40 per cent. of all the patients go away cured. Inebriety began to attract attention as a disease fifteen years ago, and since then has been partially recognized by the profession and very imperfectly studied. At present eight asylums exist in the country, many of these but recently started, and all more or less lacking experience and practical adaptation; and yet the statistics of cured exceed those of the best appointed insane asylums. Over 40 per cent. go away entirely recovered, and remain so as far as the observation of three years has determined. Here is a hint of the possibilities of science in behalf of the poor inebriate that we cannot neglect. If with our present imperfect knowledge and means of treatment we are able to cure over 40 per cent. of this class, what may not be done in the progress of the future? If we should never be able to cure more than 40 per cent. and restore that number back to usefulness and society, the value of the work would be inestimable. Hospitals and asylums for this special work bring isolation from temptation and exciting causes, also change of thought and habits with regularity and uniformity of living. Add to this the excellent facilities to carry on judicious medical and hygenic treatment, etc. The value of treatment statistically is significant when we remember that of the six hun

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dred thousand inebriates in this country, at least four hundred thousand would, if in health, be producers. The average income of this class at a low estimate would be for each five hundred dollars a year. At present they without doubt absorb this amount, making the enormous sum of two hundred millions of dollars per year lost to keep up this class, which should be producers of this amount. This is a low estimate considering the varied surroundings of each inebriate, with its connections, which to a greater or less extent become producers or absorbers with him. Not less than one billion of dollars is lost yearly in the country by this class. If the present comparatively imperfect means of treatment prove that 40 per cent. can be restored to health again, the value of treatment is a financial problem of unbounded interest.

The efforts of philanthropists, through the means of societies, appealing to the moral and mental faculties of the inebriate, are not successful, because they ignore the physical system, and attempt to build up a weakened will power which depends entirely upon the constitution. We can only reach the mental and moral through the physical, and the efforts to pledge the poor inebriate, whose debilitated system will fail to sustain his mental desires, is worse than useless. The pledge repeatedly broken, from causes beyond control, hastens the final ruin of the inebriate by lowering all selfrespect and mental conscience. Both practically and scientifically, the present mode of reaching this malady by appeals, associations and agitations, is a sad reflection on the intelligence of the age. The legal method of treatment by fines and imprisonment, and the old medical treatment which never recognized inebriety as a disease until it reached the last stage, that of delirium tremens, are degrees of ignorance which will be regarded with amazement by the future. Dr. Willard Parker of New York, in a private letter, writes: "The profession needs light as much as the laity. We must grapple with this subject, and understand it, then by our united efforts we can do more than all the temperance movements of the age." The temperance labors of to-day only benefit the inebriate by calling attention to his condition, and the real reform sought for must come from the medical profession, and their studies of this malady in asylums and hospitals. This is con

firmed by statistics which indicate that inebriety is increasing despite all popular movements at reform. Scientific inquiry has been turned towards this subject, and we are just beginning to recognize and understand the true methods of reaching and preventing this disease. The success of the Binghamton asylum and its recognition by the State as one of its great charities are significant of the future. The efforts made in several States to organize similar institutions show that public opinion is moving in the right direction at last. No field of practical medicine promises such widespread and lasting results to both individual and State. Inebriety and its management are great facts yet in their infancy, which at no distant day will be studied in the asylum in every city and county in the country.

The present temperance agitation is an opportune moment for the medical profession to come forward as teachers and educators of public opinion, and in this way attempt to guide this lavish outpouring of energy and wealth of purpose, that would convert rumsellers and save inebriates by the thousands. This tide of public opinion should be turned into the channels of practical science, stimulating the birth and growth of inebriate asylums and opening wide the doors of its health fountains that the diseased inebriate may drink and live again. Teach men that inebriety is a dangerous disease, and the one hundred thousand victims yearly will dimish to an insignificant number, and rumselling will also die out as the malaria of western river bottoms.

An observation by Dr. Bowditch, of Boston, was spoken ofthat north of an isothermal line of an average temperature of 50° drunkards commit crime when intoxicated, while south of it they are harmless, presenting milder types of mental derangement.

Dr. Van DeveeR enquired what were the changes in the brain of inebriates; whether it lay in a destruction of the phosphatic fats, of nerve fibre, nerve cells or what. Why should this change spoken of by Dr. Crothers be the primary lesion, instead of these of the stomach, liver or other organs, and when men stop drinking at once, are these brain conditions removed?

He also spoke of the hypodermic use of alcohol, as recently suggested, in shock of extreme depression.

DR. CROTHERS explained the change in the brain as one of function rather than of structure.

Remarks were made by DR. DAVIS and others on the subject.

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ART. IV.-Abstract of Proceedings of Buffalo Medical Association, June 2d, 1874.

Reported by JOSEPH FOWLER, M. D. Secretary, pro tem.

The Association met at the usual time and place. Members present, Drs. Rochester, Wyckoff, Johnson, Brecht Shaw, Bailey, Walsh, Fowler,

In the absence of the permanent president and secretary, on motion of Dr. Rochester, Dr. Shaw was called to the chair, and Dr. Fowler made temporary secretary.

Dr. WYCKOFF moved that Dr. Boysen be invited to participate in the proceedings of the meeting. Adopted. On motion of Dr. Rochester the same invitation was extended to Dr. W. W. Miner.

Dr. ROCHESTER, chairman of special committee appointed at the last regular meeting, to settle with the Real Estate Commissioners of the Young Men's Association, reported that he has paid to them the amount of one hundred dollars, this sum being the entire indebtedness of this association to them, and presented a receipt for the same.

The report was received and committee discharged.

Reports of prevailing diseases being in order, Dr. WYCKOFF said, that owing to his absence from the city, he could not form a very definite opinion concerning those diseases which prevailed most extensively, but since his return had seen some scarlatina, and had two fatal cases.

One case, a girl aged six years, died Sunday having been ill about a week. The eruption could never be distinctly seen. Brain symptoms were developed early, slight convulsions being present. In a few days the intellect became clear, and convalescence quite fairly established, when suddenly diphtheritic complication developed itself, the fauces being copiously covered with the characteristic exudation.

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