others in England; Forel, Kassowitz and one or two more on the Continent, and Nathan S. Davis, T. D. Crothers and J. H. Kellogg, in America, were about all that could be quoted largely as opposed to alcoholic liquors as remedies in disease. Whisky was then looked upon as necessary in the treatment of consumption and diphtheria. Ten years have brought about a great change. There are many American physicians now willing to admit that they have very little or no use for alcoholic liquors as remedial agents, and now, instead of recommending whisky for consumption anti-tuberculosis literature almost everywhere warns against the use of intoxicating drinks. The use of anti-toxin in diphtheria has driven out whisky treatment in that disease with markedly favorable results. Under the whisky treatment death-rates ran up to fifty-five and sixty per cent.; now the diphtheria death-rate is very low. Ten years ago many good authorities still ranked alcohol as a stimulant; now, almost all rank it as a depressant. In England, leading physicians and surgeons have spoken so strongly against alcohol in the last few years that the London Times, England’s leading newspaper, said: “According to recent developments of scientific opinion, it is not impossible that a belief in the strengthening and supporting qualities of alcohol will eventually become as obsolete as a belief in witchcraft.”

So far as the writer can learn from replies sent to her inquiries by teachers of medicine, and by study of text-books on medicine, and articles in good medical journals, alcohol now has only a very limited use in medicine with the great majority of successful physicians. Some recommend wine in diabetes mellitus, saying that it acts less like a poison and more like a food in that disease than in any other. Some use alcoholic liquors in fevers as a food “to save the burning of tissue,” but an article on “Therapeutics” in the Journal of the American Medical Association, for November 6, 1909, page 1564, says that sugar would probably have equal value in such case. The same article says that hot baths, with hot lemonade, and a quickly acting cathartic, will abort a cold without any need of recourse to alcohol.

The writer wishes here to make grateful acknowledgment of courtesies received from busy physicians who have aided materially in her work by answering personal letters of inquiry, also letters published in the Journal of the American Medical Association, by kindness of the editor. Especially would she thank those professors of medicine and superintendents of large hospitals, who so courteously aided her in preparing a paper for the International Congress on Alcoholism, held in London, July, 1909, to which she was a delegate, representing the United States government. A few of the replies received at that time are given in this book. There was not room for all.

She wishes also to acknowledge kindness and much help received from pharmacists and druggists in the fight against dangerous patent medicines and drug drinks sold at soda fountains. The Druggists’ Circular, of New York, deserves special mention in this connection.

It has been necessary to make many changes in this edition because of the changing views on alcohol and the publicity on patent medicines. Physicians will find Chapter XVI entirely new, and of great interest.

M. M. A.

ALCOHOL.

CHAPTER I.

HISTORY OF THE STUDY OF ALCOHOL.

The only intoxicating drinks known to the ancients were wines and beers. That these were used for medicinal as well as beverage purposes is evident from sacred and secular history. About the tenth century of the Christian era, an Arabian alchemist discovered the art of distillation, by which the active principle of fermented liquors could be drawn off and separated. To the spirit thus produced the name alcohol was given. A plausible reason cited for this name is that the Arabian for evil spirit is Al ghole, and the effects of the mysterious liquid upon men suggested demoniacal possession.

Medical knowledge at this time was very limited: there was no accurate way of determining the real nature of the new substance, nor its action upon the human system. It could be judged only by its seeming effects. As these were pleasing, it was supposed that a great medical discovery had been made. The alchemists had been seeking a panacea for all the ills to which flesh is heir, indeed for something which would enable men even to defy Death, and the subtle new spirit was eagerly proclaimed as the long-looked-for cure-all, if not the very aqua vitæ itself. Physicians introduced it to their patients, and were lavish in their praises of its curative powers. The following is quoted from the writings of Theoricus, a prominent German of the sixteenth century, as an example of medical opinion of alcohol in his day:—

Being a medicine, which very rapidly creates a craving for itself, the demand for it became enormous, and, as time advanced, people began prescribing it for themselves, until its use both as medicine and beverage became almost general.

If the medical profession is responsible for the wide-spread belief that alcoholics are of service to mankind both as food and medicine, it should not be forgotten that it is to members of the same profession the world is indebted for the correction of these errors. All down through the centuries there have been physicians who doubted and opposed its claims to merit. It remained for the medical science of the latter half of the nineteenth century to clearly demonstrate with nicely adjusted chemical apparatus and appliances the wisdom of these doubts.

The scientific study of the effects of alcohol upon the human body began about sixty years ago. The first American investigator was Dr. Nathan S. Davis, of Chicago, who was the founder of the American Medical Association. During the months of May, June, July, September and October, 1848, Dr. Davis published in the Annalist, a monthly medical journal of New York City, a series of articles controverting the universal opinion that alcoholic drinks are warming, strengthening and nourishing. In 1850 he executed an extensive series of experiments to determine the effects of a diet exclusively carbonaceous (starch), one exclusively nitrogenous (albumen), and alcohol (brandy and wine), on the temperature of the living body; on the quantity of carbonic acid exhaled; and on the circulation of the blood. The results of these investigations were embodied in a paper read before the American Medical Association in May, 1851. They showed that alcohol, instead of increasing animal heat, and promoting nutrition and strength, actually produced directly opposite effects, reducing temperature, the amount of carbonic acid exhaled, and the muscular strength. So opposed were these conclusions to the generally accepted teachings of the day that the Association did not refer the paper to the committee of publication. It was published later in the Northwestern Medical and