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CHAPTER IV.
ОглавлениеTEMPERANCE HOSPITALS.
THE LONDON TEMPERANCE HOSPITAL.
In 1865 Dr. S. Nicholls, medical officer of the Longford Poor-law Union, published a report of the results of non-alcoholic treatment of disease as practiced by him for sixteen years in the institutions under his control. The figures for 1865 were:—
| ADMITTED. | RECOVERED. | DIED. | |||
| Fever, | 142 | 135 | 7 | ||
| Scarlatina, | 33 | 30 | 3 | ||
| Small-pox, | 48 | 47 | 1 | ||
| Measles, | 8 | 8 | 0 | ||
| 231 | 220 | 11 |
The treatment was altogether without wines, spirits or alcohol in any form.
The death-rate reported by Dr. Nicholls was so small that some of the more observing and progressive physicians were led by it to begin similar experiments in the disuse of alcohol in other hospitals. Among these was Dr. James Edmunds, senior physician at the Lying-in Hospital, London. The experiments continued a year with a reduced death-rate among both mothers and children. But the great brewers of London, who contributed largely to the support of this hospital raised such a storm of opposition to the discontinuance of alcoholic liquors that the experiments had to be abandoned.
The establishment of a temperance hospital was now suggested, and in October, 1873, a temporary institution was opened in Gower Street, accommodating only seventeen in-patients at one time. Later a fine site was secured on Hampstead Road, and in 1881 the east wing and centre were opened by the Lord Mayor of London. In 1885 the west wing was finished, and the opening ceremonies conducted by the Bishop of London.
At the time of the launching of this enterprise, wine and spirits were literally "poured into" sick persons, with frightful results. Death-rates were enormous. The success of the Temperance Hospital has no doubt had much to do in modifying this abuse. Its death-rate, on an average, has been only 6 per cent, throughout the years since its beginning. This is lower than that of any other general hospital in London, and certainly proves conclusively that alcohol is not necessary in the treatment of disease. The physicians connected with it have been men of eminence in the profession, such as Dr. James Edmunds, Dr. J. J. Ridge and Sir B. W. Richardson.
The visiting staff is not compelled to pledge disuse of alcohol, but is required to report if it is used. During all these years it has been given only seventeen times, then almost entirely in surgical cases, and in nearly all of these a fatal result proved it to be useless. The patients who are restored to health leave without having had aroused or implanted in them a desire for alcoholic liquors, neither have they been taught to regard them as valuable aids to the recovery of health and strength. On the contrary, there have been many who have come in, suffering from this delusion, who have had it thoroughly dispelled, both by their own experience and the experience of their fellow patients.
Sir B. W. Richardson took charge of this hospital from 1892 until his death in 1897. In his report in 1893 he said:—
"I remember quite well when according to custom, I should have prescribed alcohol in all those cases that were not actually inflammatory (speaking of diseases of the alimentary system); but I never remember having seen such quick and sound recoveries as those which have followed the non-alcoholic method."
The following selection showing points of practice in this hospital is taken from the same report:
"For medicinal purposes, we are as free as possible from all complexity. We use glycerine for making what may be called our tinctures, and in my clinique I am introducing a series of 'waters'—aqua ferri, aqua chloroformi, aqua opii, aqua quinas, and so on—to form the menstruums of other active drugs when they are called for. I also follow the plan of having the medicines administered with a free quantity of water, and with as accurate a dosage as can be obtained, for I agree with Mr. Spender's original proposition that the administration of medicines in comparatively small and frequent doses is more effective and useful than the more common plan of large doses given at long intervals.
"I treat many cases by inhalation, and for this end I use oxygen in a new and, I hope, efficient manner. I make oxygen gas a medium for carrying other volatile substances that admit of being inhaled with it. The mode is very simple. ***** In the pneumonic and bronchial cases the treatment has been of the simple and sustaining kind. The medicines that have been given during the acute febrile stages have been chiefly liquor ammoniæ acetatis and carbonate of ammonia in small and frequently repeated doses. The patients have all been well and carefully fed on the milk and middle diet until convalescence was declared. In some of the more extreme instances, where there was fear of collapse from separation of fibrine in the heart or pulmonary artery, ammonia has been given freely according to the method I have for so many years inculcated. I have also in cases of depression under which fibrinous separation is so easily developed, lighted on a mode of administering ammonia which combines feeding with the medicine. I direct that a three or five-grain tabloid of bicarbonate of ammonia shall be dissolved in a cup of coffee or of coffee with milk, and be taken by the patient in that manner. The coffee can be sweetened with sugar if that is desired by the patient, and the ammonia can be so administered without any objectionable taste to the beverage. After what is called the crisis in acute pneumonia, I administer very little medicine of any kind; I trust rather to careful feeding with an occasional alterative or expectorant, as may be required. *****I am satisfied that no aid I could have derived from alcoholic stimulants, as they are called, could have bettered my results. I feel sure any candid medical brother who will have the steady courage to put aside many old and unproven, though much-practiced, methods, based only on unquestioning and unquestioned experience, and to move into these new fields of observation and experience, will, in the end, find no fault with me for leaving a track which, though it be beaten very firmly and be very wide and smooth to traverse, may not, after all, be the surest and soundest path to the golden gate of cure."
THE FRANCES E. WILLARD NATIONAL TEMPERANCE HOSPITAL.
This hospital is situated at 343–349 South Lincoln Street, Chicago, in a handsome and well-equipped building. It is connected with a medical school. The history of its origin is best told in the words of the woman to whom the conception of such an institution first came, Dr. Mary Weeks Burnett, for several years the physician in charge:
"In the fall of 1883 there came to a few of us the thought that there was a point of weakness in the temperance pledge. It reads, 'We promise to abstain from all liquors—as a beverage.' We had found in many instances in reform work that pledging to abstain from liquor 'as a beverage,' and leaving the victim to the unlimited use of it in physicians' prescriptions, was simply a skirmish with the devil's outposts, that the conflict, based upon these grounds, was short, and defeat almost sure; and the great fact remained that the innermost recesses of evil force and power were by this pledge still left unassailed. We found that this power of evil had largely entered the homes of our land through the family physicians, and that willingly or not, the physicians were being used to bring in even our innocent children as recruits to this unrighteous warfare.
"Now, how could we hope to eliminate those three little words 'as a beverage' from our pledge?
"In some way we must bring about an arrest of thought in the minds of 100,000 men and women physicians whose medical education warranted them in supposing that they knew that of alcohol which justified them in its full and free use in medical practice. Nothing short of a great national object lesson could ever convict and convert this broad constituency through which the power of darkness is doing his deadliest work.
"In January, 1884, four of us met and organized under the name of the National Temperance Hospital. To have our sick properly cared for in our hospital we found that we should be obliged to train our own nurses. The nurse who has always been accustomed to administering alcohol under the physician's prescription at all times and under all circumstances, and to administering it herself at her own discretion if the physician is not at hand, is a terror to the temperance physician. So we included in our charter a Training School for Nurses. It is now open, and we expect, as the years go by, to send out armed with our training school diplomas, grand, noble women and men thoroughly trained in true temperance methods for relieving the sick.
"Our organization lived on paper, and was sustained in purpose by prayer and planning for two years. In September, 1885, Mr. R. G. Peters, of Manistee, Michigan, signified to us his intention to give $50,000 toward our buildings whenever we had satisfactorily materialized. About the same time a good old gentleman in Michigan placed in his will for us $2,500. The dear man is still living, and we hope will live many years. Even the money when it comes can never be of greater service to us than was the knowledge at that time that the Lord was our leader and was raising up helpers in the work.
"In January, 1886, we found, according to the law under which our charter was obtained, that we must commence active operations at once, or obtain a new charter. After a blessed season of prayer and counseling together in the board meeting held January 29, there being present only the members of the board at that time, Mrs. Plumb offered to advance $3,500, if necessary, toward the expenses for the first year. We accepted it with great thankfulness, rented a building the 15th of March, 1886, and formally opened the National Temperance Hospital on the 4th of May, 1886.
"In April, 1886, we took a firm stand upon the alcohol question, and decided to eliminate it entirely from our list of therapeutics, as we had become convinced that there were better and more reliable remedies as stimulants and tonics.
"In September, 1886, at our annual meeting, we reaffirmed this decision, and we now have the following as one of the articles of our constitution: 'All medicines used in the hospital must be prepared without alcohol, and all physicians accepting positions on the medical staff of the hospital or dispensary must pledge themselves not to administer alcohol in any form to any patient in hospital or dispensary, nor to call in counsel for such patients any physician who will advise the use of alcohol.
"Any physician of pure character, and in good standing, who is a total abstainer from liquor and tobacco can, by subscribing to this pledge, become a member of our physicians' association, and if so desired, be placed upon the visiting and consulting staff of the hospital.
"The cases treated in the hospital include many of the serious medical and surgical maladies. In no case has any particle of alcohol been used, and the usual inflammatory secondary symptoms resulting when alcohol is used have been entirely avoided.
"Our course of building-up treatment is, we believe, unique in hospital practice. It consists of treatment by massage, heat, rest, passive exercise, etc. together with proper medication and a thoroughly nutritious diet adapted to the individual needs of the patient.
"To alleviate, and, if possible, cure disease, is the design of all hospital treatment. In our hospital we seek to gain this result by means which the highest science of the day approves, and in addition to this we have especially at heart the advancement of the temperance reform. There are, we believe, thousands of temperance adherents, who do not yet fully apprehend the importance of this hospital to the permanent extension and progress of temperance principles. Although prohibition as a principle has been accepted by many, yet in its practical application in the home in serious illness, it is still feared by the immense majority of even our strongest prohibitionists. We are organized upon the basis no alcohol in medicine, and we are preparing to demonstrate fully and scientifically, so he who runs may read, that as in health, so in disease and accident, alcohol in any form works to the hindrance and injury of the vital forces, and prevents the establishment and advancement of health processes in the system."
At the opening of the hospital, May 4, 1886, Miss Frances E. Willard, the president of the National W. C. T. U., gave the following address:—
"Nothing is changeless except change. The conservatives of one epoch are the madmen of the next, even as the radicals of to-day would have been the lunatics of yesterday. To prove this, just imagine the founders of this hospital declaring to my great-grandfather that because he had taken a cold was no reason why he should take a toddy; and per contra, imagine my great-grandfather's doctor marching into our presence here and now, with saddle-bags on arm, and after treating us each to a glass of grog for our stomach's sake, giving us a scientific disquisition on the sovereign virtues of the blue pill, and informing us that bleeding, cupping and starvation were the surest methods of cure!
"That the story of Evolution is true I am by no means certain, but that 'We, Us, and Company,' are 'evoluting' with electric speed ourselves it is useless to deny. This very hospital is the latest mile-stone on the highway of progress in the American temperance reform. The conditions that have made its existence possible have developed in this country within about twelve years.
"Public opinion, that mightiest of magicians, has within that time been educated up to this level and has said in its omnipotence: 'Hospital, be!' and, behold, the hospital is.
"When I joined the ranks of temperance workers in 1874, a thought so adventurous as that alcoholics in relation to medicine were a curse and not a blessing had never lodged within my cranium. But, as in duty bound, I studied the subject from the practical, which is the nineteenth century standpoint.
"I investigated the cause of inebriety, and found the medical use of alcoholic stimulants a prominent factor in this horrible result; I sought for expert testimony, and found Dr. N. S. Davis, ex-President American Medical Association, saying 'that in his ample clinical practice he had for over thirty years tested the medical uses of alcoholics, and had found no case of disease and no emergency arising from accident that he could not treat more successfully without any form of fermented or distilled liquors than with'; found Dr. James R. Nichols, of Boston, so long editor of The Journal of Chemistry, declaring as his deliberate scientific opinion that the entire banishment of these liquors 'would not deprive us of a single one of the indispensable agents which modern civilization demands'; found Dr. Green, of Boston, saying before the physicians of that city that it is upon the members of the, medical profession and the exceptional laws which it has always demanded, that the whole liquor fraternity depends more than upon anything else to screen it from opprobrium and just punishment for the evils it entails, and that after thirty years of professional experience he felt assured that alcoholic stimulants are not required as medicines, and that many, if not a majority of the best physicians, now believe them to be worse than useless. Meanwhile I learned that across the sea such great physicians as Dr. Benjamin Ward Richardson, Sir Andrew Clark, Sir Henry Thompson and Sir William Gull held views which for their latitude were almost equally radical; and Dr. James Edmunds, founder of the London Temperance Hospital had demonstrated publicly and on a grand scale the more excellent way, his hospital having 4½ per cent, fewer deaths than any other in London, taking the same run of cases, and that the Royal Infirmary at Manchester reported the medicinal use of alcohol fallen off 87 per cent, in recent years, with a decrease in its death-rate of over one-third. Besides all this, and independent of any such investigation, the 'intuitions' of our most earnest women were leading them out of the wilderness. As is their custom, they determined to put this matter to the test of that 'experience which one experiences when he experiences his own experience,' and a whole body of divinity upon the advantages of non-alcoholic treatment could be furnished from their evidence. I was not able personally to pursue this method, my own condition of good health having become chronic. Away back in 1875, in executive committee, one of our leading officers was stricken with angina pectoris. A physician was promptly summoned. 'Give her brandy,' he said, and insisted so stoutly upon it as vital to her recovery that we should probably have sent for it, but the dear woman gasped out faintly, 'I can die, but I can't touch brandy.' She is alive and flourishing to-day. Another national officer absolutely refused whisky for a violent attack of a very different character, the physician telling her that she could not live through the night without it; but she is still an active worker—a living witness that doctors are not infallible. Instances like these have multiplied by hundreds and thousands in our Woman's Christian Unions and Bands of Hope. 'No, mamma I can't touch liquor; I've signed the pledge,' is a protest 'familiar as household words.' Meanwhile, I beg you to contemplate something else that has happened. Behold, our own beloved beverage itself,
'Sparkling and bright,
In its liquid light,'
has come grandly to our rescue in this crusade against alcohol in the sick room. Water has become a favorite—nay, even a fashionable—medicine! The most conservative physicians freely prescribe it in the very cases where some form of alcohol was the specific so long. To be sure, they give it hot, but we do not object to that, since 'water hot ne'er made a sot,' and it cures dyspepsia and all forms of indigestion as whisky never did, but only made believe to; while its external use as a fomentation is banishing alcohol even for old folks' 'rheumatiz' where, as a remedy, it would be likely to make its final stand.
"Farewell, thou cloven-foot, Alcohol! Thou canst no longer hide away in the home-like old camphor bottle, paregoric bottle, peppermint bottle or Jamaica-ginger bottle; and a tender good-by, Mrs. Winslow's Soothing Syrup, for be it known to you that the wonderful discovery stumbled over for six thousand years has in our day been made, namely, that hot water will soothe the baby's stomach-aches and the grown people's pains, and drive out a cold when all else fails. Jubilate! Clear out the cupboard and top shelf of the closet now that the sideboard has gone. Let great Nature have a glance to 'mother up' humanity with the medicine, as well as the beverage, brewed in Heaven."
THE RED CROSS HOSPITAL.
A philanthropic young woman, Miss Bettina A. Hofker, entered Mount Sinai Training School for Nurses in 1891. Her desire was to fit herself as a nurse for the poor. After her graduation in 1893, she met Mrs. Charles A. Raymond, a benevolent lady, who offered her pecuniary assistance in her work. Miss Hofker suggested that she would like to institute a Red Cross Hospital and Training School for Nurses. Mrs. Raymond succeeded in interesting others in the proposition. The name of Red Cross however could not be used without permission of the officers of the society bearing that name, but after consultation with Miss Barton, permission was granted. Several years previous to this, Dr. A. Monæ Lesser, Dr. Thomas McNicholl and Dr. Gottlieb Steger had opened a small hospital under the name of St. John's Institute. This was now amalgamated with the Red Cross, and Dr. George F. Shrady and Dr. T. Gaillard Thomas, two of New York's leading physicians, were requested to act as consulting physicians.
The hospital does not confine itself to service in its building alone, but sends its workers wherever called, to mansion or tenement. The "Sisters" are trained for field service or for any national calamity such as floods, earthquakes, forest fires, epidemics, etc. When neither war nor calamities require their presence, they devote themselves to the service of the needy poor, or wait upon the rich, if called. The heroic service rendered by the surgeons and nurses from this hospital in the Cuban War, brought their work to great prominence.
At the suggestion of Miss Barton, the medical department of the hospital was commissoned to treat diseases without the use of alcoholic liquids.
Dr. Lesser, the executive surgeon, is a German, and of German education, having received his medical education in the Universities of Berlin and Leipsic. In a conversation with a press representative, Dr. Lesser said some time ago:—
"We have been convinced that the use of alcohol can be entirely eliminated from our medical practice, and this has been practically accomplished at the Red Cross Hospital. We find that where stimulants are required, such remedies as caffeine, nitro-glycerine and kolafra take the place of alcohol, and are even more satisfactory. The main use of alcohol is to stimulate the action of the heart in various ailments. The blood is thus forced to the remote parts of the system, and poisonous substances carried away. But, besides serving this good purpose, the drug tears down and ultimately destroys the cellular tissues of the body. A relapse is certain to follow the application. The drugs that I have mentioned serve exactly the same purpose without the disastrous results. We are proving this every day at the Red Cross Hospital.
"Only a few days ago a boy was brought in, apparently at the point of death. He was put into bed and watched by the nurse. After a little ammonia had been given to him as a stimulant, he unconsciously expressed himself to the effect that it was not the same as they gave him in another place, and gradually when it dawned upon him that no alcohol was administered by the Red Cross, he said, 'Gin has allers made me better.' The doctor in charge, who already suspected that the boy was pretending illness for the sake of the drink, was not surprised an hour or two afterwards to learn that he had demanded his clothes, dressed himself, and left the hospital most ungratefully, but apparently quite well."
Dr. George F. Shrady, one of the consulting physicians, is famous as having been in attendance upon both President Garfield and President Grant. He is the editor of the Medical Record, one of the most important medical journals published in America. While not a non-alcoholic physician, he says of the medical use of intoxicants:—
"There is altogether too much looseness among physicians in prescribing alcohol. It is a dangerous drug. There is much more alcohol used by physicians than is necessary, and it does great harm. Whisky is not a preventive; it prevents no disease whatever, contrary to a current notion. Another thing, we physicians get blamed wrongfully in many cases. People who want to drink, and do drink, often lay it on to the physician who prescribed it. ***** I think that in most cases where alcohol is now used, other drugs with which we are familiar could be used with far better effect, and with no harmful results."
Dr. Steger, another physician of the staff, says:—
"I don't use alcohol at all in my practice. I used to use it, but my observation has been that other drugs do the same work without the harmful results. Alcohol over-stimulates the heart, and tears down the cellular tissues of the system, besides causing other deleterious effects. The use of alcohol is simply a superstition among physicians. They have used it so long that they think they always must. I am not a total abstainer, but that only shows that I take better care of my patients than I do of myself. It is not good for a healthy man to drink, but sometimes folks like myself do things which had better be left undone. I have seen patients in hospitals made absolutely drunk by their physicians."
The following interesting items in regard to practice in this hospital are culled from the report of 1897:—
"Temperature was never reduced by active drugs known as antipyretics.
"Water was allowed freely after all kinds of surgical operations and in fevers.
"Alcohol was never used as an internal medicine.
"The free use of water in saline solutions directly injected into the tissues was found of great service. Quarts have been injected that way with most satisfactory results.
"Antipyretics were altogether discarded as it is well known that their action diminishes the tone of the heart. Artificial reduction of temperature only deludes one into the belief that the drug has improved the condition of the patient, while in reality, it has no beneficial influence on the disease, and has reduced the vital resistance of the patient. In no case has high temperature harmed a patient and there was every evidence that in some instances a high temperature was preferable to a low one.
"Special attention has been given to the use of alcohol in disease, not with any desire to approve or disapprove it, but solely for the purpose of discovering the truth, for nothing seems of greater public interest from a medical standpoint than the truth regarding a subject for which so many virtues are claimed on the one hand, and so many destructive elements proven on the other. *****
"We criticise the treatment of no institution, antagonize no school of medicine, claim no unusual or peculiar scientific virtue, but what we do maintain and insist upon is this; that the human body may be ever so afflicted, ever so reduced, the heart ever so feeble, and the spark of life ever so dim, the conscientious student of medicine can secure as good results without as with administration of antipyretics, sparkling wines, beers or liquors.
"Experience teaches that true science does not antagonize nature. In surgical cases, in septicæmia, in pneumonia, or in any of the fevers, water freely administered has proven to be a real source of comfort, and an aid to recovery. It is amazing how favorably diseases terminate under this beneficent beverage. The withholding of food does not retard, but rather hastens convalescence,
"In the conduct of our Red Cross patients, irrespective of their condition when admitted, it can be truly said that after treatment began, delirium has not been witnessed in a single instance, and as our hospital reports indicate, our mortality has been unusually small.
"Alcohol has not figured as a life-saver in our institution. Cases of extreme collapse following major operations, cases of pneumonia, where the pulse ranged from 160 to 220, patients suffering from pernicious anaæmia, septicæmia, pyæmia, cholera infantum and typhoid fever, some of whom when first seen were in the worst stages of delirium and collapse have without alcohol regained consciousness, overcome delirium and made excellent recoveries.
"The following cases very forcibly illustrate the results of non-alcoholic treatment:
"Case No. 1. A child, aged nine months, under treatment for six days for pneumonia, came under our notice on the seventh day. The temperature was 106 5–10; pulse was 220; respirations 90. Whisky, which had been given previously to the extent of two ounces daily, was stopped. Carbonate of ammonia, caffeine salicylate, nitro-glycerine and 1–10 of a drop of aconite were given internally; camphorated lard applied externally; with the result that on the ninth day temperature stood 99; pulse 100; respiration 20. The child made a complete recovery.
"Case No. 2. L. was a child aged eight months, suffering from a very violent attack of entero-colitis. For three weeks previous to coming under our notice the patient received brandy, stimulating foods and alkaline mixtures. Fearfully emaciated, temperature 106, feeble pulse 182, frequent bloody discharges from the bowels, numbering as much as thirty in a day and constant vomiting, the child was considered beyond hope. Under these circumstances, and at this time we first saw her. Brandy and all foods were stopped; bowel flushings were given, 1–12 of a drop of tincture of aconite was administered every half hour and salicylate of caffeine every two hours. In twenty-four hours the temperature was 105 and the pulse 160. In two days, temperature was 102 and the pulse 140. In one week, temperature was 99 5–10, pulse 110. In three weeks, the patient was discharged cured.
"Case No. 3. Mrs. C, aged forty-three, who had been under treatment for seven weeks for metorrhagia, nietortes and peritonitis came under our notice. Brandy which had been previously given in large quantities had proved of no avail and the patient was considered beyond recovery. We found her completely prostrated, temperature 102, pulse 170, and unconscious. The heart very weak and irregular. The brandy was discontinued, salicylate of caffeine and nitrate of strychnia were given with the result that in a short time the patient was convalescent and finally recovered.
"Each case in our hospital is an additional proof that whether found in wines, spirits or beers, alcohol can claim no right as an indispensable medicine."
Dr. Lesser, who was Surgeon-General of the American Red Cross in the Cuban War said after his return from his first visit to Cuba that four out of six of his patients, to whom he allowed liquor to be given as a concession to the popular idea that it was necessary, died; while subsequently in treating absolutely without alcohol sixty-three similar cases, only one died, and he upon the day on which he was received at the hospital.
ALCOHOL IN OTHER HOSPITALS.
In the spring of 1909 a circular letter was sent to some of the best known hospitals throughout the try asking if the use of alcoholic liquors had decreased in those institutions during the past ten years. From the replies received the following statements are taken:—
Cook County Hospital, Chicago, sent figures for two years only, 1907, and 1908. With 28,932 patients treated in 1907, the bill for wines and liquors amounted to only $719.40. In 1908 with 31,202 patients the bill for liquors amounted to $970.65. This makes a per capita expenditure for liquors for 1907 of .024 cents, and for 1908 a per capita expenditure of .031 cents. The per capita expenditure for liquors during the same years in Bellevue and Allied Hospitals of New York city, with from 30,000 to 40,000 patients treated was .0246 and .029. Two or three cents as the yearly per capita expenditure for alcoholic liquors in the two largest hospitals in America is striking evidence that the physicians practicing there have not large faith in whisky, or other alcoholic liquors as remedial agents.
Long Island, N. Y., State Hospital:—"We are not using more than half the amount of alcohol we used ten years ago."
Manhattan State Hospital, Ward's Island, New York City: "Our patient population has averaged nearly 4,500 the last four years, and we have had about 750 employees, many of whom are prescribed for by institution physicians. The per capita cost of distilled liquors for the last fiscal year was .0273 at this hospital."
Milwaukee City Hospital:—"No alcoholic liquors are used to any extent in this hospital, or prescribed by the staff. I know of no move against such use of liquors, but venture the assertion that the physicians believe they have more reliable agents at their command for most cases."
Pennsylvania Hospital, Philadelphia:—"We are now using about one-third the amount of liquor that was used in the Pennsylvania Hospital ten years ago."
The Presbyterian Hospital of Philadelphia sent figures for the years from 1900 to 1908. Those for 1900 show the cost of liquors to be $774.20 and for 1908 only $331.48. The number of patients was not given.
Grady Hospital, Atlanta, Georgia:—"That less liquor is now used than formerly is a fact well known to all connected with the institution."
Garfield Memorial, Washington, D. C, sent figures for ten years. For 1899 the cost of liquors was $490.08, with a steady decrease to 1908 when the cost was $274.58. Number of patients in 1899 was 1,171; in 1908, 1,898 patients. The per capita for 1908 was .144 cents.
University Hospital, Ann Arbor, Michigan:—"Very little alcohol is prescribed in this hospital."
Maine General Hospital, Portland:—"Comparatively speaking, we use but little alcohol for the reason that we now have many remedies which, especially for continued use, are superior to alcohol, which twenty years ago we did not have. For the conditions or emergencies in which we think alcohol has a value it is used when required or deemed best."
Buffalo, New York, State Hospital sent figures for six years which include cost of alcohol used in the manufacture of pharmaceutical preparations, which, of course, makes a very decided difference. Per capita for 1903 was 22 cents; for 1908 it was 18 cents.
Buffalo, New York, General Hospital:—"The use of alcohol as a drug in this hospital has diminished about one-third in the past ten years, but I wish to add in this connection that the use of all drugs has diminished in this hospital, and to the best of my knowledge in other institutions of a like character. The use of the microscope, and other studies have advanced the science of medicine the same as all other branches of learning, and other methods are coming to be used beside the use of drugs."
Mount Sinai, New York City:—"The use of alcoholic beverages here for medical purposes is the exception rather than the rule. The majority of our cases are surgical cases, and in these alcoholic liquors are rarely prescribed for any purpose whatsoever."
Massachusetts Homeopathic Hospital, Boston, sent figures for five years. For 1904 the cost of alcoholic liquors was $197.69 with 3,720 patients; for 1908, the cost was $69.82 with 4,543 patients. The per capita cost for the five years is as follows: 1904, cost .0531 cents; 1905, cost .0474; 1906, cost .034; 1907, cost .0171; 1908, cost .0153.
In the Boston Medical and Surgical Journal of April 15, 1909, Dr. Richard C. Cabot gave a table showing the decrease in the use of alcoholic liquors, and of other drugs in Massachusetts General Hospital, Boston. The following is his table:
| 1898 | 1899 | 1900 | 1901 | 1902 | |
| Ale and Beer | $759.00 | $793.00 | $1,062.00 | $723.00 | $605.00 |
| Wines and liquors, | 1,563 | 2,209.00 | 1,384.00 | 1,063.00 | 799.00 |
| Total for alcoholic drinks, | $2,321.00 | $3,002.00 | $2,410.00 | $1,786.00 | $1,404.00 |
| Total for other medicines | $8,424.00 | $10,013.00 | $10,132.00 | $9,168.00 | $9,772.00 |
| Number of patients. | 5,005 | 5,203 | 5012 | 5,495 | 5,342 |
| Cost of alcohol per patient. | $0.46 | $0.57 | $0.48 | 0.32 | $0.26 |
| Cost of medicine per patient, | 1.68 | 1.92 | 2.02 | 1.66 | 1.88 |
| 1903 | 1904 | 1905 | 1906 | 1907 | |
| Ale and beer. | $338.00 | $341.00 | $301.00 | $192.00 | $203.00 |
| Wines and liquors. | 688.00 | 904.00 | 144.00 | 546.00 | 610.00 |
| Total for alcoholic drinks. | $1,026.00 | $1,335.00 | $445.00 | $738.00 | $813.00 |
| Total for other medicines, | $7,815.00 | $9,162.00 | $7,018.00 | $5,981.00 | $5,492.00 |
| Number of patients. | 5,429 | 5,709 | 5,531 | 5,513 | 5,966 |
| Cost of alcohol per patient. | $0.19 | $0.23 | $0.09 | $0.13 | $0.13 |
| Cost of medicine per patient. | 1.43 | 1.60 | 1.26 | 1.08 | 0.92 |
Dr. Cabot says:
"Since there has been no fall in the price of stimulants or medicine, the diminished expenditure corresponds to a diminution in the number of doses of medicine and stimulants, and indicates a rapid and striking change of view among the members of the staff of the hospital, especially in the past five years, when it has become generally known that alcohol is not a stimulant but a narcotic and that drugs can cure only about half a dozen of the diseases against which we are contending. "There has been during this period no increase in the proportion of surgical cases among the whole number treated, so that the decreased use of medicines and alcoholic beverages has not resulted from an increased resort to surgical remedies. On the other hand, there has been a great increase in the utilization of baths (hydrotherapeutics), of massage, of mechanical treatment and of psychical treatment, all of which accounts no doubt for part of the falling off in the use of alcohol and drugs."
