-Z, 5' Nebr' Ety

MEDICAL JURI SPRUDENCE-Z,5'

NEBR

'

ETY .

BE I NG

PAPERS READ BEFORE THE MED ICO -LEGAL SQC I ETYM I

OF NEW YO RK AND THE D ISCUSS IO N.

THEREO N .

PUBL I S HHH HHH

THE M ED I CO -LEGAL JOURN AL ASSOCI AT I ON ,

D E D I CA T I O N .

HON . N OAH DAVI S .

Ex-Chief Justice Supreme Court .

My D ear S ir

I am charged by the Publication Committee of theM ed ico -L egal Society with the duty bf preparing forpublication,th e papers read before that body, touchingon I nebriety,A lcoholism and the M edical -Jurisprudenceof lnebriety .

I‘voice their unanimous wish, in dedicating this

volume of papers to you .

Th e interest you have felt in . this subject,the laborswith which you have been id entified, in struggling withthe social problems growing ou t of the abuses of alcohol, and your long public career upon the bench,makethis all the more easy to me,asid e from our personalfriend ship since y'our ad vent to this city .

That you have presid ed over the d ebates incident tothe read ing of these papers,and closed them with yourown views sharpened by th e thoughts their readingawakened,will, I am sure, add no little interest to theirvalue in the public mind :

That they may be of service at a moment when thepublic heart is so d eeply touched, by the problems of thehour is, I am sure,your wish as well as

Yours ever faithfully,CLARK BELL .

N EW YORK,September . 18 88 .

o o o o o o o o o o o o o o o o o o o o o o o o

PAPERS .

CLARK BELL , ESQ

NORMAN KERR , M . D

A . R . DYETT, ESQ

O. H . HUGHES , M .

E . C. MANN , M . D

M o R I Tz ELL I NGER , ESQ

L . W . BAKER ,M . D .

M . LOU I SE THOMASLUCY M . HALL,M . D

T“

. D . CROTHE R S ,M . D

J OSEPH PARR I SH, M . D

T. L . W RI GHT, M . D

REv . WM . TUCKER, D . D

MARY W EEKS BURNETT,M . D

PROF . E . P. THW I NG,M . D PH . D

STEPHEN ROGERS , M . D

J AMES J . O’DEA,M . D

DI SCUSS I ON .

AUSTI N ABBOTT, ESQ

H . S . D RAY TON,M . D

I SAAO L . PEET,L . L . D

EMMETT DENT, M . D

A . J AGOB I , M . D

WM . F.HOLCOMBE,M . D

LUOY M . HALL, M . D

F . K . PADDOOK , M . D

S . W ATERMAN ,M . D

FRANK H . I NGRAM ,M . D

N OAH DAV I S, ESQ. <

CLARK BELL, ESQ .

PR E FA CE .

The Legal relations of the inebriate, in business, insocial a ” airs,and his responsibility be

'fore the law,have

for many years engaged the attention of the Med icoLegal Society .

As early as December, 1868, Dr. S tephen Rogers,opened the d iscussion by a paper,upon the I nfluence ofM ethomania upon Business and Criminal responsibility .

This was followed in the same year by a paper entitledM ethomania,” by Dr. James J O

’Dea.

I n the fall of 1869, The L aw in R eference to S uicid eand I ntemperance in L ife I nsurance

” Was mad e thesubject of a paper by WM . SHRADY, Esq.,Of the 1

New

Y ork Bar.

I n the paper upon Hered itary Diseases of the N ervousS ystem, read by STEPHEN ROGERS in 1869 before theSociety, j ournal space was given and stress laid upon“the Degeneracy of A lcoholic I nheritance, and theproposition was made in view o f the unusually largenumber of persons,who had during 1866 and 1867 beenadjudized dipo smaniacs, that “ the M ed ico - Legal S ociety"

would be ready to d ecid e by a very large vote, that therewas such a d isease as A lcoholism, that one of its formsis Methomania, and that it was an hered itary and , of

v i PREFACE .

course,a transmissible d isease . (M ed ico -L egal PapersSeries 1,pp .

LaMarch, 1869,Wu . SHRADY Eso , read before theSociety a paper containing the Act passed April 8, 1864,in the S tate o f' N ew Y ork, to establish an A sylum forI nebriates in th e city of N ew Y ork, with the amendments of 1867 .

— (M ed ico -Legal Papers, Series 1, pp . 92

Also, the A cts of May 9, 1867 (Chap . 843,Laws ofto incorporate the I nebriate Home of Kings Coun

ty and the Amendments thereto in 1868 .(M ed -L eg.

papers,Series 1,pp . 97 As well as the several Actsfor the relief of the New'

Y ork S tate I nebriate Asylum,

passed April 15, 1859 : M arch 91, ,1- 61 ; April 15, 1864,

and March 31, 1865,with a resume of the law,regardingthe case of habitual d ru nkard s .

— (I bid ,pp . 102,et .

I ll the same year, Dec . 9, 1869, DR r S . TELLER, read apaper b efore 'th e Society, entitled “

'

M ed icalpoints in re

gard to the S uicid e and I ntelnperance pro viso in L ife‘

I nsurance policies .

”

I n 1871,DR. PALUEL DE MARMON read a paper entitledM ed ico -L egal Cons id erations upon Alcoholism,and the

J/!oral‘

and Criminal R esponsibility of I nebriates .

”

I n November, 187 DR . STEPHEN ROGERS , in his lnaugural address as presid ent of the Society gave considerable space, and laid great

,stress upon the “

M ethomaniac and the d u ty of the S tate to him .

” He thenclaimed “

that the morbid ,and really uncontrollable impulse to d rink and to be d runk,was an impulse which weall know results in more evil to society,and ,finally, in

PREFACE . vii

more d estruction to life, a hund red fold , than all the

higher grad es of crime,”and to this subject and its evils

he called the attention of that body, as being of the veryhighest interest and importance I n its proposed laborsOn April 11, 1872, STEPHEN ROGER S contributed a

paper to the Med ico Legal Society entitled The I nfluenceof Urcemic and A lcoholic Poisoning on Testamentary

Capacity! ”e

I n Feb’

y,188 6,DR . ENR IQUE A . FREMONT,of Ozuluama,M exico, contributed a paper entitled,‘ “

I nebriety and

Criminal R esponsibility in M exico,” which appeared inthe M ed ico-Legal Journal, and the same num ber contained a paper read by DR . GEO . H . SAVAGE, of London,n “

Drunkenness and Criminal R esponsibility.

”—(pp.

84 et . seq . Vol . N o .

I n July, 18 87,CLARK BELL,ESQ, contributed a paperto

'

the I nternational and Colonial Congress of I nebrietyat London entitled, “

the R elation of I ntemperance toI nsanity,

” which was read before the M ed ico -Legal Society, in September, 1887, and the November and De

cem ber M eetings of the Society in 18 87 were d evotedto original papers on this subject ”by d istinguishedmembers, the d iscussion of

'

which, are mad e the basisof the present volume .

I t was d ecided to select from among these variousarticles, thus contributed, enough to make a volume ofat least 200 pages, so that Students of the Science might

Dr. T. D . Cro th ers read a paper o n“ Trance in I neb riety,

” later,which

was also m ad e th e su b j ect o f a paper b y Dr. Geo . M . Beard .

PR EFACE .

have in hand, the more important of these papers bymembers of the Medico -Legal Society, from widely differont . field s of thought,who had given this importantsubject attention .

The compilation of the g reater part of these workswith a reference to those unpublished,has devolved uponthe writer as Chairman of the Committee of Publication,aid ed by the generosity of a few friends,who have contributed the necessary . time to publish this volume,without expense to the M edico-Legal S ociety, of NewY ork, as a testimonial and memento of its labors in acause now exciting the popular mind .

CLARK BELL .

N ew Yo rk, October, 1888 .

NOTE —Dr. T . D . Crothers read'a. paper entitled Should I nebriates be

Punished by Death for Crime !”b efore the M ed ico -Legal So ciety, Septem

b er Session o f 1888, too late for insertion here .

THE MED I CAL J URI SPE UDEN CE OF

I NEBR I E TY .

BY CLARK B ELL , E SQ. , or THE N EW YORK BAR .

President of the M ed ico-Legal Society of N ew York .

—Q

I n a d iscussion like that proposed before the M ed icoLegal Society, in which the questio n is to be consid eredby such able med ical men from the med ical side orstandpoint, it has seemed to me that it would be ofinterest to both professions, as well as to laymen, tohave the inquiry mad e as to those relations which attachby law to inebriety,as well in the civil and domestic relations of the inebriate,as in regard to crimes committedby persons,while acting und er the influence of intoxicants or while in a state of intoxication .

What,then, is the present legal status of the ques

tiou tI shall briefly state (but have neither Opportunity nor

space to discuss),what I believe to be the law upon thesubject ; citing and grouping authorities, the civil S idefirst

,and the question of criminal responsibility, second .

I .

—CI VI L RELATI ONS — 1. I ntoxication was regardedby the common law,when complete and characterizedby unconsciousness,as a species of insanity . Lord Coke ’s

‘ R ead b efo re th e M edico - Legal S o ciety orN ewYo rk,N ovemb er 9th,1887 .

2 MEDI CAL J UR I SPRUDENCE OF I NEBR I ETY .

4th manner of non compos mentis was, 4. By his

own act as aDelirium tremens,wh ich results directly from habits ofintoxication,is in law considered to be a form of insanity,and this has been repeated ly held by the co urts i

I t has alway s been a well - settled rule of law that noperson can m ake a contract bind ing upon himself whilehe is wholly deprived o f his reason by intoxication .

Thiswould b e true as to d eeds,wills,all instruments andobligations of every

'

kind .iThis rule is not changed where the intoxication wasnot procured by the other party to the contract, but isvoluntary on the part of the drunkard . §By the common law, as well as by the New Y ork S tatute,a testator must, at th e time of the execution of awill,be of sound m ind and memory,” and it is as requisite to have the presence of a d isposingmemory,” as asound mind .

”!I

(b . ) By common law and by statute law an intoxicatedperson is thereby rendered incompetent as a witness

.

Coke Litt. ,248,a ; Beverly Case, 3 Hayw . , 78 Buswell on I nsanity,Co ke . 124 ; Buswell on I nsanity,

5 393

295 . Wigglesworth v . S teers, 1 B en .

t Macconchey v . The S tate, 5 M an . , 70 ; Barrett v . Bu xton, 2Ohio S t . 77 Carter v. The S tate, 12 Aiken 167 .

Tex. App. ,500 Buswell on I nsan lN . Y . Rev . S tat" art . 2,chap. 6

ity, 158 Erw mv . S tate, 10 Tex.

, Parr 2, 20, 5th ed . Forman’

s

700. Will, 54 Barb 274 ; Van GuyslingI Prentice v . Acho rn,2 Paige 30 v . Van Kuren, 35 N . Y ., 70 Aiken

l’ itt v . Smith, 3 Camp 33 Cole v. v.Weekerly,19 M ich . ,482 ; LowderB o bb ins,Bul. . P . , 172 ; M orris 0 . v . Lowder, 58 I nd . , 538 ; ConverseClay, 8 J ones (N . C. ) 216 King v . Converse, 21Vt., 168 .

Bryant, 2 Hayw. ,394 ;White 9 . Cox,

MEDI CAL JUR I SPRUDENCE OF I NEBR I E'I‘

Y . 3

The S tatute law usually classifies such intoxicated persons as lunatics, and th e provisions frequently applySimilarly to each, and to both .

*

(c) I n the marriage contract,which in some cases istreated on di " °

erent ground s from all other contracts,from the necessity of the case,and consequences uponconsummation, the sound general rule has been that ifthe party was so far intoxicated as no t to und erstand thenature and consequences of the act, this wou ld invalid ate th e contract . )

L

2 . Th e analogy between lunacy and total intoxication,or even habitual d runkenn ess,is d oubtless most markedin the statutes of the v arious states regard ing th e careand custody of the person and estates of lunatics, id iotsand habitual d runkard s .

(a . ) By English law the Lord Chancellor,as the d irectrepresentative of th e Crown,has always exercised theright of assuming the custody and control of th e persons and estates,of all those who,by reason of imbecility or want of und erstanding, are incapable of takingcare of themselves .

Writs d e lunatico inqu irend o were issu ed in cases toinqu ire whether the party was incapable of conductinghis affairs on account of habitual d runkenness .

Th e Supreme Court of every American S tate woulddoubtless have the right which the Court of Chanceryexercised und er the law of England in the absence of

*N . Y . R ev . Statu tes ; Gen!. S tat.4

f J ohnston v . Browne, Ferg.

M inn , 1878, c . 73, § 9, sub d . 1 ; Const . Law Rep , 229 .

Connoly v. Lynch , 27 M inn 435.

4 MED I CAL J UR I SPRUDENCE o r I NEBR I ETY .

any statute law . This must be so in the nature ofthings in American S tates ; the principle has been exercised and ad jud icated on in Kentucky, in Maryland,I llinois, I nd iana and North Carolina .

*

The Legislatures of the various S tates have vestedthis power by statutory enactments in various tribunals,for example in New Y ork,by the o ld law I n the chancellor ; in New Jersey in the Orphans

’Cou rt ; in South

Carolina equally to the law and equity sid e of the courts,and now in New Y ork,where the distinction betweenlaw and equity has been abolished, in the SupremeCourt,which exercises it .I twill be observed that in many of the American S tatesthe habitual d runkard even,is classified and treated underthe same provisions,and in the samemanner as the lunatic and the id iot,notably in Pennsylvania,N ew Jersey,Maryland, I llinois,New Y ork and many other S tates .Taking New Y ork as a fair illustration of the principic, it has been held by the courts, that all contractsmad e by habitual d runk ard s who have been so adjudgedin proceedings d e lunatico inquirend o are actually v o id .

‘

r

And that the d isability of the habitual d runkard continues after the committee has been appointed evenwhen he is perfectly sober and fully aware of the natureand consequences of his acta i

N ailor v. Nailor, 4Dana, 339 Wiswall,2 I red . Eq ., 294,

Colton in re, 3 M d . Oh . ,446 ; Cor‘

r L . Amoureaux v. Crosby, 2

rie’s Case . 2 Bland

’s Oh ,,448 ; Tom Paige, 422 .

linso n e . Devore, 1 Gill. ,345 ; Dodge tWad sworth v . Sharpsteen, 3 N ,

v. Cole, 97 I I I 338 ; M cCord v . Y 388 .

Ochiltree, 8 Bleckt ., 151; Lathan v.

MEDI CAL JURI SPRUDENCE o r I NEBRI ETY 5

I t has also been held that habitual d runkenness,beingestablished, it is prima facie evid ence of the subject ’sincapacity to manage his aWe may then assume, in considering the med icaljurisprudence of inebriety, that the law has always regard ed and treated intoxication as a species of mentalderangement, and has considered , and treated thehabitual or other d runkard, as entitled to the specialcare and protection of Courts of Equity in allmattersrelating to h is civil rights, his domestic concerns, hisability to make contracts,his intermarrying,and d isposing of his property,by d eed,gift or d evice .

The law has gone farther,for it has thrown around him,

its protecting arm and shield,when it is satisfied, that hehas become so add icted to d rink,as to seriously interferewith the care of his estate, and the courts have thencome in and taken absolute control, of both person and

estate of drunkard s, in their own interest and for theirpresumed good .

M edical men should keep in mind the distinction running all through the law between insanity and irresponsibility . The med ical view, that irresponsibilityshould follow where insanity exists,has nowhere beenconceded by the law,and this d istinction m u st be bornein mind in the subject here und er consid eration .

I I .

—CR lM I NAL RELATI ONS —This brings us to thesecond question : The relation of the inebriate to thecriminal law for illegal acts, committed while intoxir

‘Tracy in re,1Paige,580 ; 1Rev. St. (2d ed Ch . 5, tit. 2, 1

MED I CAL JUR I SPRUDENCE OF I NEBRI ETY .

cated , which seems more harsh, in its practical effect,than the principles which govern him in h is civil andsocial relations,to society and the S tate .

This seeming hard ship,however,is due to the capacityof the d runkard ,consid ered objectively,for wrong - doing .

I n the one case his position as a civil agent is that ofa unit of society merely— one wh o is,as it were, to besaved from himself ” ; in the other case, the criminal

aspect of the d runkard , it is th e weal of society whichis to be conserved and protected .

1. That form of intoxication which results in the totalor partial suspension of or interference with, the normalexercise of brain function, is regard ed at law as mentalunsoundness and sometimes amounts to a species o f.insanity . I t has been held at law,to be a voluntary m ad

ness, caused by the wilful act of the drunkard , and thed ecisions have been uniform that where reason has beenthus suspend ed ,by the voluntary intoxication of a person otherwi se sane, that this cond ition d oes not relievehim from the consequences of his criminal acts, or,morecarefully stating it, from acts committed by him in violation of law,while in that state .

*

(a . ) There are decisions which go to the length of holding, that the law will not cons id er the d egree of into xi

Kenney 0 . People, 31 N . Y . ,

330 ; 27 How. , 202 ; 18 Abb o tt, 91

Lonergan v. People, 6 Park . , 209 ;

50 Barb .,266 ; Freery 11. People, 54

I d . , 319 ; People 13. Po rter,2 Park ,

214 People v. Fuller, I d . ,16 ; Peo

ple v. Wild ey, I d . , 19 Dammaer’

s

( Base, 15 S t, Pr 522 ; Fro st’

s Case,

22 S t. Tr. ,472 State v. To ohey, 2

Rice Dig. (S . C. ) 105 ; People v.

Rogers, 18 N . Y . , 9 ; S tate

Thompso n, Wright, 617 (Ohio ) ;Swan 0 . Th e State, 4 Humphy . ,

136 ; Com . Hawkins, 3 Gray, 463Mass ) ; Cluch 17. S tats,40 I nd . , 264;

S tate Thompson, 12 N ev . , 140

MED I CAL J UR I SPRUDENCE o r I NEBR I ETY . 7

cation,whether partial,excessive or complete,and eventhat if the party was unconscious at the time the actwas committed,such cond ition would not excuse his actand,in some cases,judges have gone so far, as to instructjuries that intoxication is actually an aggravation, of theunlawful act rather than an excuse .

But the better rule of law now und oubted ly is,that ifthe person at the moment of the commission of the act,was un conscious,and incapable of reflection or memory,from intoxication,he could not be convicted .

There must be motive and intention, to constitutecrime,and in such a case the accused would be incapablefrom intoxication of acting from motiva it

(b . ) Th e reasons upon which the rule of law rests may,with great propriety,be considered,and should be carefully studied,before any attempt at criticism is made .

1. The law assumes that he who, while sane, putshimself voluntarily into a cond ition, in which he knowshe cannot control his actions, must take the c onse

quences of his acts,and that his intentions may be inferred .12 . That he who thus voluntarily places himself in

lciently sane to conceive thesuch a position,and is su

‘People v. O’

Co nnell, 62 How .

Pr. , 436 ; People 0 . R ob inson 1

Parker Cr. R ep. , 649 ; Rex v. Car

roll. 7 C P. , 145 ; Dammaer’

s

Case, supra ; Fro st’

s case, supra ;

S tate 19. Thompson, supra ; UnitedStates v. Forb es,Crabbe . , 558 ; Blk .

Com.,26 ; l Coke, 247,

tBuswell o n I nsanity, 446,no te

6 ; People Rogers, 18 N . Y 9,

Denio ; Cluck v. S tate,40 I nd , 264 ;

Kenney v. People, 31 N . Y . , 330.

tPeople v. Garbu tt, 17 M ich . ,9

Comm onwealth v. Hawkins,5 Gray,463 .

8 MEDI CAL JUR I SPRUDENCE OF I NEBRI ETY .

perpetration of the crime,must be assumed to have contemplated its perpetration .

*

3 . That as malice in most cases must be shown or established to complete the evid ence of crim e, it may beinferred,from the nature of the act,how d one,the provocation or its absence,and all the circumstances of thecase TI n cases when the law recognizes d iff erent d egrees ofa given crime,and provides that wilful and d eliberateintention,malice and premeditation must be actuallyproved to convict in the first d egree, it is a proper subject of inquiry whether the accused was in a condition o f

mind to be capable of prem editation j ,‘

Sometimes it becomes necessary to inquire,whetherthe act was d one in heat of passion, or after mature premed itation and d eliberation, in which the actual cond ition of the accused and all the circum stances attend inghis intoxication,would be important as bearing upon thequestion of previous intent and malice . §

(a. ) The New Y ork Penal Code lays down with precision the provision of law governing the question ofresponsibility in that State as follows

22 . I ntoxicated persons . N o act committed by aPeople 0 . Rob inson, 2 Parker J ohnson, 44 Conn . , 136 ; Harte v.

or 235, State, 11 Humph . , 154, and cases

f Buswell on I nsanity, 450; Bus cited in no te to Buswell on I nsanity,well v. Commonwealth , 20Gi st. 450.

1 Buswell on I nsanity, 450 ; g Kelly v. Commonwealth, 1

Hopt People, 104U . S . ; Penn v. Grant (Pa ) 481; Platte v, The StateMcFall, Addison, 255 ; Keenan v. 9 Hump. ,663 .

Com 44 Penn. St” 55 ; State v.

https://www.forgottenbooks.com/join

10 MEDI CAL JUR I SPRUDENCE OF I NEBR I ETY .

responsibility in criminal cases, and such cases will beregarded and treated as cases of insanity .

*

(g. ) I t may now be regarded as a settled rule that evid ence of intoxication is always admissible,to explain theconduct and intent of the accused,in cases of h om icid eHr(h . ) I n crimes less than homicid es,and especially where

the intent is no t a necessary element to constitute a d egree or phase of the crime,this rule d oes not apply .

Th e practical result,however, in such cases,and inthose States where the latter provision of the New Y orkPenal Code has not been ad opted , is to leave this wholesubject, to the judges,who fix the d etails of punishment .This is a great public wrong,because each judge acts onhis own id ea,and one ismerciful and another harsh . I f

it is placed by law in the breast of the judges, it shouldbe well-defined and regulated by statute . Lord MacKenzie well says The d iscretion of a judge is the lawof tyrants .3d . I t will be observed that the law has not yet judi

cially recognized inebriety as a d isease,except in thecases of d elirium tremens— above cited —and hardly evenin that case .

I t is for publicists, judges and law -makers to considerthe claim now made, that science has demonstrated inebriety,to be a d isease .

*Lonergan v . People,6Park . , 209 ; iLonergan v . People, 6 Park . ,

50 Barb . , 266 ; O’

Brien v . People, 209 ; 50Barb . ,266° People v . Ham

48 Barb . ,274; People v. William s,43 mil, 2 Park . ,223 ; People 0,Rogers,Cal.,344; U . S . 0 . Drew,5Mason,28 ; 18 N . Y . , 9 .

State v. McGonnigal,5Harling. ,510.

MED I CAL J UR I SPRUDENCE OF I NEB R I ETY . 11

I f this is conced ed ,what changes are needed to modifythe law , as it at present stand s,so as to fully preservethe rights of society, in its relation to the unlawful actsof inebriates,with a proper and just sense of the rightsof th e inebriate himselfThis contribution is made from the legal standpointpurely, and is designed merely to open this interestingd iscussion for bo th professions, to which such namesas Dr. N orman Kerr, Dr. T. D . Crothers, Dr. JosephParrish Dr. Charles H . Hughes, Dr. T. L . Wright andothers will contribute the med ical view, a discussionwhich I hope may arrest the thoughtful attention of theS tud ents of the subject throughout the world .

S OME MED I CO~ LEGAL A SPE CTS OF

BY NORMAN KERR, M . D ., F . L . S ., LONDON .

Co rre spo nd ingm emb er M ed ico -L egal S o ciety .

Consu ltingPhysician Dalrymp le Home for I nebriates . Presid en t S o cie ty for

the S tud y of I nebriety .

Some English judges have held that d runkenness is noexcuse for crime,while others have ruled that drunkenness is an aggravation,as was the law of ancient Sparta .

I n an exceptional case the ruling, however,was exoneration of punishment, on the ground that the inebrietywas virtually insanity . Our various contradictory judgments taken as a whole,however, ind icate, that by thegeneral existing interpretation of English jurisprudence,the sobriety or insobriety of the accused,has little or noinfluence on the punishment .That this legal ruling is unfair and unjust in manycases, few who are acquainted with the diseased condition and abnormal mental state of many inebriates

,

will deny .

There are practical di lculties in the way of a plea fo rinebriate irresponsibility on the ground of disease,as thisplea might be greatly abused but a mixed commission

Read before the Med ico -Legal S o ciety of New York,Nov . 9,1887 .

MEDI Co -LEGAL ASPECTS OF I NEBR IETY . 13

of lawyers and med ical experts in inebriety would, I feelconfident,be able to discriminate certain forms of inebriety,which should fairly be held to be exempt fromresponsibility .

For example,there are many inebriates, the absenceof whose power of control has not been occasioned bytheir own default . There are persons born into theworld with an innate susceptibility to narcotic and anaesthetic action . I f they so much as taste any intoxicanttheir Whole organization is,as it were, set on fire withouttheir consent . I t may be urged that if they haveonce experienced this narcotic conflagration, they areblameworthy if they again touch, taste or hand le the

intoxicating cup . But on the first indulgence in the

(to them) forbidden fruit” they had no suspicion,theywere perfectly innocent of danger . These had no controlover their inborn narcotic susceptibility . I respectfullysuggest to the mixed commissionwhich I have indicated,that crime committed by such subjects of this delicatesusceptibility to narcotic influences, should, for a first

0 ense at least,be leniently considered .

Th e same consideration applies to another numerousclass of inebriates who have not been endowed from birthwith narcotic sensitivity,but wh o have been handicappedfrom their mothers’ womb by a narcotic diathesis,a defactive nervous and mental organism,or a deficiency of

inhibitory power,which makes it extremely d ifficult toresist the potent influence of a neurotic anaesthetic,andrenders them an easy prey to alcohol,opium, chloral, or

14 MEDI Co - LEGAL ASPECTS OF rNEBR I ETY

other inebriety . Y et these had no control over the tooscanty stock of mental force,with which they were fromthe first supplied .

I S it just,is it equitable, that these heavily weightedindividuals, Should be judged by the same standard astheir stronger and more healthy born fellowsThere are two forms of inebriety which ought clearlyto exempt from criminal responsibility, viz . : the lnebriety of insanity,and the insanity of inebriety .

I n the inebriety of insanity,where the inebriate manifestation is the unmistakable product of an insane impulse,a crime committed in this d ru nken state, is theact of a person of unsound m ind , for which he is no moreresponsible than for a similar crim inal act, d one in theabsence of narcotics . I n such cases the d rinking or othernarcotic indulgence is S imply a phase of recurrent insanity . Drink ing here is not the cause,but the effect ofmental unsoundness . These cases are by no means rare,and it is a miscarriage of justice when such a madman ispunished merely because he was intoxicated when hecommitted the offense .By the insanity of inebriety,I mean specially alcoholicinsanity, that state of permanent or apparently permanent mental alienation,wh ich has been induced by longcontinued, excessive indulgence in alcoholic intoxicants .

I f any one is deranged, whatever the cause of the d erangement,he is now mentally unsoun d,unable alwaysto d iscriminate between right and wrong,

‘

o r to controlhis actions . That alcohol has been the fons et origo of the

MED I CO - LEGAL ASPECTS or I NEBR I ETY . 15

lunatic cond ition d o es not aff ect his present state . He isnow unsound in mind,and must, in justice,be held freefrom penal procedure .

I n add ition to these phases of insanity and inebriety,about which there can be little d ifference of opinion,there are other phases on which there are conflictingopinions . There is d elirium tremens,

” for instance, inan a ttack of which crime is sometimes perpetrated . I

have again and again seen patients,undoubted ly insanefor the time, quite unconscious of their actions,d ead toall perception of right and wrong, and incapable of reasoning . I have seen a criminal act in this insane condition, prevented only by force, the patient having norecollection of the circumstances on reason returning .

What good purpose can be served by holding this deliriate accountable for his d eed s ! On what soun d legal pleacan he be thus arraigned !The same observation applies to mania a potu," during the fits of which disease the patient is literally be

side himself . ” He is indeed a maniac for the time,utterly beyond his own control . The paroxysms ofmania a potu greatly resemble outbreaks of epilepticmania . The explosion is S imilar in appearance, thewhole man being overwhelmed and overborne in a tornado of convulsive madness,the only d ifference in manycases being that, the seizure is in one alcoholic,and inanother non -alcoholic . Why should the one be exemptfrom criminal responsibility,and not the other !

I tmay be urged,bo tll in“delirium tremens

” and “ mania

16 MEDI Co -LEGAL A SPECTS OF lNEBR I ETY .

a potu,” that the person would not have been mad,hadhe not partaken of strong d rink . This is not absolutelytrue,as I have occasionally seen sim ilar and (but for theabsence of alcohol) undistinguishable insane paroxysmsin the person of the abstemious, from inherited inebriety . Bu t if it were absolutely true, there are manywho are so constituted,that if they d rink at all, theydrink to madness . Temporary insanity is the penalty oftheir breach of total abstinence practice . I f such shouldbe punished at all,it should be,not for d runken madnesswhich they cannot avert,if they only taste the (to them)maddening potion,but for DR I NK I NG AT ALL . Bu t if thesubject of inh erited inebriety, is to be punished fortasting a madd ening intoxicant, which will provoke aparoxysm, so ought a gouty subject, for indulging in aglass of port . These will su "

ice as examples of cases inlegal medicine,requiring careful reconsid eration .

I t may be granted by some that an alteration in thelaw is justified,yet contended that in suitable cases,thereshould be a plea for mitigation of penalties

,where a dis

eased inebriate cond ition is established . But this wouldbe of little value,though an improvement . Punishmentis no cure for the disease of inebriety . Treatm ent 18called for, and the wiser plan would be to consign thediseased inebriate to a curative institution, for a periodlong enough,to afford a reasonable hope of cure . I f in

curable,the insane inebriate criminal, should be permanently secluded,where he cannot be provoked by a narcotic excitant,to a paroxysm of maniacal criminality

.

THE MED I CAL J UR I S PR UDEN CE OF

I NEBRI ETY .

BY ANTHONY R . DYETT,ESQ ,

of the N ew York Bar .

Med ical Jurisprud ence,sometimes called Legal or Foronsio Med icine, or, as the Germans have it, State M edicine,may be called a composite science . I t is neitherlaw nor med icine,but a happy union of these S istersciences, to aid the former in the administration ofjustice .

And when we speak of the M ed ical Jurisprud ence ofI nebriety,we refer to the application of that science tothe subject of drunkenness .

To und erstand and illustrate this,we should first ascertain the effect of d runkenn ess when it is an elementeither of criminal offences or civil rights .

A s to crimesTh e commission of crime is often the attendant upon

and the consequence of drunkenness . We find it laidd own by Plowd en as early as the reign of Edward V I .

that if a person,while dru nk,kills another, thisshall be felony,and he shall be hanged for it, though hedid it t hrough ignorance, being occasioned by his own* R ead before the M ed ico -Legal S o cie ty, N o vem b er 9, 1887 .

MED I CAL JUR I S PRUDENCE OF I NEBR I ETY . 19

act and folly,and he Shall no t b e privileged thereby .

The same d octrine is laid down by Coke in the I nstitutes,where he calls a drunkard a voluntarias daemon, and

says that drunkenness doth aggravate the crime . (3

Thomas Coke,And Lord M ansfield said, in the celebrated case of the

Chamberlain of London against Evans, in the House ofLord s, in 1767, that a man shall not be allowed to pleadthat he was d runk in bar of criminal prosecution,though incapable of the exercise of reason, becausedrunkenness itself is a crime ; and he shall not excuseone crime by another . I t is a legal maxim that a manshall not d isable himself .And this is the law of this S tate, as declared by the

Court of Appeals as late as 1865, in People v . Kenny, 31N . Y . , 330, following a previous decision in People v .

Rogers, 18 N . Y . , 9 .

When,however, the law of murder in our S tate wasaltered so as to require d eliberation as well as prem edi

tation to constitute murd er in the first d egrees, punishable by d eath, it was held that even voluntary intoxication, if so great as to rend er d eliberation impossible, reduced the crime to murder in the second d egree,whichrequired only an intent to kill.

(People v . Batting,49 How . Pr. Rep. , 392, decid ed in

By our Penal Cod e of 1876, section it is enacted asfollows No act committed by a person while in a stateof voluntary intoxication, Shall be deemed less crim inal

20 MEDI CAL JUR I SPRUDENCE o r'I NEBR I ETY .

by reason of his having been in such cond ition . But

whenever the actual existence of any particular purpo se,motive or intent is a necessary element to constitute aparticular species or d egree of crime, the jury may takeinto consid eration the fact that the accused was intoxicated at the time, in d etermining the purpose,motive orintent with which he committed the act. ”

As to injuries to the person or property of others,either by negligence or wilful act, for which a civilremedy is sought,if the wrong-doer be drunk simpliciter,he is liable for all damages by his acts, includ ing exem

plary damages . I f insane in consequence of d runkenness,he is like all other insane persons, liable only foractual or compensatory damages .

(Krom v . S choonmaker, 3 Barbour,As to W illsI n Peck v . Carey,27 N . Y .,p . 9, the d eced ent, who sewill was there sustained,had for years before his d eathbeen a confirmed drunk ard and scarcely ever sober hehad more than once had delirium tremens while crazedwith drink he had repeated ly sought to put an end to hisexistence,and his efiorts had finally proved successful

.

A fter commenting upon these facts,Denio C. J prono uncing the opinion of the Court, said I t is not thelaw that a dissipated man cannot make a contract orexecute a will,nor that one who has the habit of execs ~Sive indulgence in strong d rink must be wholly freefrom its influence when performing such acts and headded that su ch acts would be valid and effectual in Spite

MEDI CAL JURI SPRUDENCE o r I NEBRI ETY . 21

of such influence,unless the testator were so much intoxicated that his brain was incapable of performing itsproper functions, and he was therefore temporarily insane, or unless a fixed mental d isease had supervenedupon his intemperate habits .

A S to contracts, the general rule,as laid d own by Professor Parsons in his work on Contracts (Vol . I . , 5th ed .

384,and Vol . I I I .,page 416,et in notis) is,that the intoxication of the defendant,at the time of entering into thecontract, is no s

” "

icient d efense, unless the plaintiffpurposely procured or caused that intoxication and tookadvantage of it .But total drunkenness, or

“a d egree of intoxication de

privingthe party of the use of his reason,avoid s any contract,whether at law or in equity .

And in the case of Burns v . O’Rourke,5 Robt . ,N . Y .

Superior Court Reports,page 649,it was held that partialintoxication at the time of executing an instrument, inorder to avoid its obligations, is not sufficient,unlesssome circumstances of fraud or undue influence areadded . The intoxication must be so complete as to d e

prive the party of the use of his reason .

Of course if mania apo tu or d elirium tremens has eu

sued as a consequence of the intoxication, the contract isabso lutely void,as it is then the act of a person insane ornon compo s mentis .

But,as in the case of contracts of all insane persons,if the contract be made in good faith without fraud orknowledge of the insanity by the other party, and the

22 MEDICAL JUR I SPRUDENCE o r I NEBR I ETY .

d efendant has received any property under o r benefitfrom the contract, it will be enforced so far as to compelthe return of the property o r compensationfo r the benefit.

Canfield v . Fairbanks,63 Barb o ur, 461 ; Riley v . Alb’

y Sav . Bank,36

Hun . 5 13,519 ; J ohnso n v . S tone,35 Hun . ,380,383 ; Mut . Life I ns . Co . v .

Hunt,79 N . Y ',541.

Hav ing thus briefly shown the effect of inebriety,theapplication of M ed ical Jurisprud ence to the subject isreadily perceived .

Witnesses who are skilled in any art or science maynot only testify to facts,but to their opinions, as experts,because such witne sses are supposed, from their experi

ence and study, to have peculiar knowledge upon thesubject of inquiry,which ju rors generally have not andto be more capable therefore than the latter of drawingconclusions from facts .

Bu t a layman can testify only to facts within his ownknowledge and observation, tend ing to show the soundness or unsoundness of anoth er’s mind and, althoughhe may characterize as rational or irrational the acts andd eclarations to which he testifies,his testimony must belimited to his conclusions from the specific facts he d iscloses,and he is not competent to express an oplnion onthe general question whether the mind of the person wassound or unsound .

Clapp v . Fullerton, 34 N . Y . ,190,194.

Th e same principle applies to cases o f d runkennesssimpliciter and insanity in consequence of it .

MEDICAL J URLSPRUDENCE o r I NEBR I ETY . 23

M edicine here becomes an invaluable ally of law in determ ining by the evid ence of physicians, d iagnostically,the extent of the inebriety,and how far in the givencase it has affected the brain and m ind of the patient,and whether it has progressed so far as to have d eveloped insanity,as mania a potu or d elirium tremens, orany other of its Protean forms,while without its aidall that could be proved by laymen would be that by histalk and acts the person in question appeared to bedrunk .

TH E S TA TUS EBR I E TA TI S I N OUR COUR TS .

*

BY 0 . H . HUGHE S , M . D .

Correspon d ing M em ber M ed ico -Legal S o ciety Ed itor AL I EN I ST and NEUROL

S t. Lou is, M o .

By common consent . the ineb i iate, in relation to hisnormal environment, like th e lunatic, is conced ed to beout of harmony . I ntoxication extenuates improper conduct in popular judgment,when that conduct is not extrem ely criminal in its character . So that,while inebrietv by common consent mod ifies the popular verd ict,upon conduct at variance with law and propriety inminor d egree,actions highly criminal in appearance findno excuse for crime, because of the inebriety of theirperpetrator . This unequal judgment is mad e, no t because essentially there is nothing in inebriety that mod ifies and perverts the natural will, but because it isdeemed unsafe to society to concede to inebriety an excuse for crime,or unlawful misdemeanors, and this

chiefly because the cond ition of inebriety m ay be v o lun

tarily induced , and a state of alcoholic irresponsibilitym ight be assumed and simulated for criminal and otherunlawful purposes . But the fact exists and remains

Read before the M ed ico -Legal S ocie ty,N ovem br 9,1687.

26 THE STATUS EBR I ETATI S I N OUR COURTS .

ify or make impossible full responsibility,by fettering orpreventing the normal volition . The will can no t be freethough it m ay appear so ,prima facie,in an individual sotyrannically end owed that he cannot pass a saloon without entering it to take a d rink,even though in d oing sohe violates all the proprieties of life, his own previouslyformed resolutions and his highest interests .

There are,und oubted ly, elements of disease in inebriety

,as there are elements of crime in it . I t should be theduty of the law, instead of regard ing its victims alwaysas criminal

,when they are arraigned for crime or mis

d emeanors, to inquire d iligently how much is crime andhow much d isease ; how much are the natural character and inclination changed by overpowering and nonpreventable d isease,and to what extent might the disease have been averted .

Here the intelligence and self-knowledge of the individual as to his organic m ake -up, should become a lawful question,as I believe it should in every question ofmental d erangement or mental soundness .A toxhaem ic influence,powerful enough to produceindurative changes in the brain, to hard en the albumenof the tissues,and produce cerebral sclerosis and peri

pheral neuritis,aswell as the more immed iate vaso -motorparalyses and consequent vascular d isturbances of thebrain and other viscera, cannot be,and ought not to be,ignored when the normal functioning of the organafi ected by it,whether stomach, liver or brain,is in question . Where immediate physical aberration does not

THE STATUS EBR I ETATI S I N OUR COURTS . 27

follow alcoholic toxhaem ia, it may follow and is apt toappear in a succeed ing generation . Th e alcoholism ofone generation may be, and often is, the insanity orepilepsy of the next, or vice versa .

Th e record of neuropathic d ecad ence due to alcohol,asgiven by M orel and confirmed by all observations Since,should conv ince u s without the necessity of furtherillustrative example here,that the volitional impairmentand psycopathic and other neuropathic perversions ofalcohol, as patent significance and worthy of jud icialconsid eration as the recognized crime and vice it engend ers . A lcohol entails d isease of the brain as certainly asit vitiates morals and fosters vice .I t is certainly a very imprudent kind of jurisprudencethat takes legal account of the one class of efi ects,andd oes not recognize the other .A s I write this note I have in mind the unvoluntarycriminal record, of a young man of otherwise reputablefamily,who is now serving a life sentence for the autom atic alcoholic murder of a d ear relation,murd ered incid entally and accid entally,and, I believe, as Stated bythe young man,not consciously,whosehome,beginningwith the germinal life in his mother ’s womb,was in abed of alcohol, whose conception proceed ed from and

was consummated by a chemically alcoholized fatherand mother,who became himself a period ical dru nkardin early boyhood, and an involuntary matricide attwenty . The Governor, in view of the extenuating circum stances of this unfortunate young man ’s birth and

28 THE STATUS EBR I ETATI S I N OUR COURTS .

hereditary environments, justly, we think, commutedhis sentence, for only the Great Omniscient,who knowsthe frame of such unfortunates, and considereth theunseen elements that so mod ify responsibility in the or

ganie potency of impossible hered itary morbid endowment,could d etermine the exact extent of this youngman’s guilt .The history of the 0 . Z . family,as detailed by me inthe Alienist and Neurologist,Vol . I I I . ,No . 4, is but asample of a class of cases continually obtru d ing themselves upon the attention o f the Neurologist . to mouldand mod ify his convictions, at variance with the commouly promu lgated view of the law,that the inebriate isalways responsible for his conduct,and som etimes heldas d oubly responsible. because both of his intoxicationand its sequence . Unlike the Law, sound Neurologyand Psychology would inquire into the pre ~ d eterminingorganism,and the responsibility of the criminal for theorganic cond itions, if any,which may have pre -determined the apparent crime .

THE A TTI TUDE OF LEGAL MEDICINE vs . THE

D I SEA SE OF AL COHOLIC I NEBR I ETY

Br EDWAR D C. MANN , M . D . , Bro oklyn,N . Y .

Presid ent N ew Y o rk Academy o f Anthropo logy Medical Superintend ent

Sunnysid e Private Ho spital for I nebriates,the Morphine Habit and

Diseases of the Mind and N ervo us System .

The present law holds drunkenne ss to be no excuse fo rcrime . The disease of dipsomania is not drunkenness .

Th e state of intoxication is merely one of many symp

tom s of the disease . True dipsomaniacs are totally irresponsible for acts committed imm ed iately before, duringand after attacks, just as epileptics are because of the irintellectual condition before the paroxysm of inebriety,on account of the impulsive character of their actions,and on account of the toxic d elirium with which it iso ften followed . The great reason why the dipsomaniac is not responsible is, because he is no t master of

his d esire to d rink. Even in his lucid intervals the dipsomaniac is no t a normal man,and there is a modifiedresponsib ility attached to all his acts . The d ipsomaniac

is a sick man to be cured,no t a criminal to be punished .

Dipsomania, the great d iagno stic mark of which is an

irresistible craving for alcohol in some form, coming on

30 MEDI CI NE vs . DISEASE OF ALCOHOLIC I NEBRI E'I'Y .

at regular intervals of either day,week,month or year,as the case may he,may be hereditary and evolved withthe natural evolution of a person ’s organism, or it may

be due to post-natal conditions .

Paroxysms of d ipsomania are generally preced ed byd epression,insomnia and excessive nervousness like theother insanities . What now is the real essence of thisd isease ! I t is d eranged organic or special sensation orimpulse,which manifests itself,not as in ordinary insanity by suicidal o r homicidal impulse,o r by the morbidly erratic feeling wh ich mislead s the judgment andconduct of the kleptomaniac, pyromaniac or nymphomaniac,but owing to the changing and misleading subjective impressions of the d ipsomaniac, he is compelledagainst his will and judgm ent,by a blind, irresistibleimpulse, to seek, in excessive indulgence in alcohol, forthe relief of this subjective,morbid cond ition of his nervous system . The craving is beyond the control of thepatient . He cannot help it . His drinking is the product of disease . He is a sick man . He is misled and

perverted in the exercise of his psychic powers by abnormal cond itions o f his brain and centric nervous system . I have seen dipsomania or alcoholic inebriety inits hereditary forms exhibit : 1st . An abnormal aptitude,requiring an add itional excitant factor to d evelop it intoactive morbid expression . 2d . The inborn d efect, sogreat as to requ ire only the natural organic evolution ofgrowth to reveal it and 3d . S till greater,not requiringeven this to unfold it . I have seen it displaying itse lf in

MEDI CI NE US . DI SEA SE OF AL COHOLIC I NEBRI ETY .

states of organic retrogression and nerve instability, soextreme as to be perceptible at the earliest period,whenthe d isplay of mind is perceptible at all ; id iocy,imbecility and infantile insanity .

M orbid organic cond itions, therefore, lie at the root ofthis d isease . Take the case of a lady whose normalcharacter is pure and correct,whose intellect is vigorous,who in her habits is most abstemious,who, as a rule,never d rank anything stronger than tea, coff ee or water .This woman becomes depressed without adequate cause,suffers from insomnia and suffers from great nervousness . Then comes on a craving or impulse for alcohol,and perhaps a fondness for low society . She d rinks tillShe can d rink no more,until intoxicated perhaps d rinksfor several days ; is then horror- struck and filled withremorse,and is perhaps ostracised by her nearest andd eare st friend s . N ow,why has she done this Surelynot because she wanted the liquor and merely chose toindulge in alcohol to excess . She has obeyed an impulseor craving which she could no t resist,which very likelyshe fought against . She could not, however, successfully fight against the subjective morbid change in herorganism which cau sed the craving . That has to beremoved

,if at all, by a careful course of med ical treat

ment and remed ial restraint . That woman is notmorally responsible, either for her paroxysm of d ipsomania,nor for any overt act which she may commit init,and she is liable to commit su icide, or homicide, or tobecome a kleptomaniac or a nymphomaniac . I have

32 MED I CI NE vs . D I SEASE OF ALCOHOL IC I NEBR I ETY .

treated a score of just such cases,and am very sanguineabout their cure . I think that law should respect andaccept the teachings of science,when the latter d eclaresauthoritatively that dipsomania and alcoholic inebrietyis a d isease, the subjects of which

.

are laboring under aspecies of mental alienationand not morally Responsible .

The subjects of this d isease d emand the protection ofmed icine and law,and not fine and imprisonment,andfrom my personal experience of sixteen years I cannotmake my plea for them to o earnest . The disordered impulse or craving for alcohol,and in like manner forchloral, opium and some other d rugs, d ominates thecharacter and morbid ly masters the reason and the conduct . My experience and observation Show the frequentinterchangeability of alcoholic inebriety vi ith grave d iseases of the nervous system and mind, in which theneuropathic d iathesis prevails . The d ipsomaniac tend ency of th e constitution in some families seems vicarious,with the acknowledged or recogn ized neuropathic .

I have frequently seen one branch of a family Show in

sanity, epilepsy o r organic brain d isease, and anotherreveal the neuropathic taint in d ipsomania . The chieftriumphs in the therapeutics of dipsomania, belong tothe plan of treatment which places the patient undermedical supervision and restraint,maintains the physiological tone o f the vase -motor system, and which reestabli shes the perfect stability Of the higher cerebralcentres,the psycho -motor and the psychical,up to th epoint of their highest resisting power . Rest, die t and

34 MEDICINE vs . DISEASE OF ALCOHOLI C I NEBRI ETY .

bility deserving protection by the courts . I am no t

unmindful of the fact that rules of law must beframed with a view to protect the accused, as wellas the commun ity,but I fail to see that public policyrequires that sick men should be pun ished .

J EWS N OT ADDICTED TO THE US E OF

ALCOHOL .

*

BY M OR I Tz ELL I NGER , ESQ.

The intemperate u se of alcoholic and vinous beverageshas become one of the recognized vices of modern times .

Statesmen and public economists have occupied themselves with the problem how to check the growth of avice which has already assumed dimensions that foreshad ow a threatening epid emic . I n no country, however,has the agitation for a correction of the evil beencarried with such forcible energy and persistency as inours . Temperance societies have sprung up all overthe country, and a party which presents almost as

its single issue an uncompromising warfare against themanufacture, sale and u se of intoxicating beverages isgaining daily in Strength and influence . I must confessthat in my opinion the formation of such a party is amisfortune,as it cannot fail to have an opposite effectfrom what its lead ers and advocates intend . Temperance lectures, temperance sermons, temperance societiesare proper . They appeal to the moral sense, to the innate manhood,and will act as a regulator for the gov

Read before the M edico -Legal Society of NewYork .

36 J EW S NOT ADDICTED To THE USE OF ALCOHOL .

ernm ent of unnatural appetites . But the total prohibition of bounties which mother nature has vouchsafed tous will rather increase a d esire for them than otherwise,and the fact that they are sweetswhich have to be tastedin secret will augment the passion . The paradisaicalapple having been stamped as a forbidd en fruit broughtforth the tempting d emon - snake, who proved strongerthan the Divine command .

The Jews,who have an unbroken history for nearly 4,000years,who se continuous pilgrimage from land to land andcontinent to continent made them inhabitants of everyclime and brought them in close and intimate contactwith almost every nationality on the face of the globe,are outsid e of the movement for the correction of thevice, the existence of which is so much deplored,and inwhich the eloquence,the earnestness, the power of someof our best leaders of society are enlisted . I t is a recognized fact that they are singularly free from this vice

,

but are not total abstainers . AS a general ru le,they aregoo d livers . They enjoy the gifts of God,but have beeneducated to keep within proper bounds . I will endeav or to assign some of the causes which, in myopinion,have mad e them a race of temperate habits andhave protected them against the snares and wiles of thetempter who works such terrible havoc among all classesof society and breaks up families,whether they live inpalaces or hovels .One of the first causes is purely ethnological . Y ou

will find on an examination of the races that dwell in

JEWS NOT ADD I CTED To THE USE OF ALCOHOL . 37

frigid, temperate and torrid climates that the formerare more prone to imbibe strong alcoholic beveragesthan the latter . I say alcoholic beverages

,such as

pure alcohol distilled from grain and grape . The Scandinavians use the strongest kind of these beverages,andthe next are the Celts . The England of former days wasalso a land where the d rinking cup d ominated thedinner table to an extent unknown in more southern latitud es . Probably one of the chief characteristics of merryold England was the fact that the majority of theSquires did not rise from the chair upon which theywere seated while partaking of the meal,but from thefloo r where they had fallen in a d runken d ebauch . The

German Knight gave an evidence of his prowess andphysical strength by d raining a bumper of the largestS ize at one d raught, and a home in I reland without thepoteen would be a sorry place for the inhabitants todwell in . The cup, though it does inebriate, nevertheless cheers . France, the country o f light wines, hasknown very little d runkenness until the consumptionof absinthe has added a stimulant which has producedd isastrous e ects that call for corrective remed ies . Ger

many,the land o f beer and beer brewers,consumes com

paratively small qualities of burnt water,” and d runkenness prevails to a smaller extent than in England, I reland and the northern countries . Russia and Poland,onthe other hand, are dotted all over with inns that dispense strong alcoholic drinks,and the “

Pope” is as muchbrutalized by it as the Muschik The farther south

38 J EW S NOT ADD I CTED TO THE USE OF ALCOHOL .

you come the greater is the sobriety of the people . The

I talian d rinks his light wine, but he d oes not intoxicateh imself, and the I talian contingent of this continentis characterized by great sobriety . M ohammed forbad e the u se o f wine and alcohol, and drunkennessis very little known in M ohammedan countries .Witn the Jews the grape was looked upon as one ofthe most precious gifts of Go d and its enj oyment as oneof the legitimate pleasures of life . Wine gladdens theheart of man,” says the Psalmist . And M elchised ek,

the priest of the most high God,brought forth bread andwine,” we read in Genesis . There are many d ispersedpassages in the Talmud which point out the b eneficenteffect of a mod erate use of wine and the harm wroughtby an intemperate use . I n Talmud Babli,(B eracho th 59)we read “Wise people d rink wine and it benefits them,

but the ignorant masses are hurt by it . ” I n Yoma weread I f a man is virtuous,wine will d o him good ifnot, it will d estroy him .

” Wine was used at the sacrificial offering of the Temple,and from there passed intothe religious ceremonies in Synagogue and Temple .

Sabbath evening a benediction was spoken over a cup ofwine after the evening service,and the Friday eveningmeal, as well as every meal on Sabbath and festive days,was initiated with such a benediction . The father thentasted of the wine and passed the cup to his wife, afterwhich it was passed to every member of the family thatwas seated at the table, also to the guests that happened to be there, as well as to the domestic help . At

J EW S NOT ADDICTED To THE USE OF ALCOHOL . 39

the ceremonial service on Passover eve it was a religiouscommand to empty four cups of wine,and the congregation was enjoined to see to it that the poor were supplied with it . The practice of saying a bened iction overthe wine cup as one of God ’s precious gifts was in itselfa corrective against the abuse Of it . This in connectionwith the fact that the mod erate d rinking of wine waslooked upon as an integral and ind ispensable part of thefestive meal on days of rest, recreation and religiouscommemoration contributed no little toward inculcatingthe lesson, that Go d has granted the gifts of nature foruse and enjoyment . All the social enjoyments centredaround the home . Th e father was its high priest and

the mother the d ivinity . Th e conclusion of the festivemeal was invariably followed by the singing of hymns,and a prayer opened and closed the meal . Thus everySabbath constituted a family reunion, and the repastpartook of a religious character . Debauchery, lascivio u sness,promiscuous gathering Of the sexes were madeimpossible, and an unnatural appetite was curbed bythe restraint of religious practice . Drinking, for thesake of gratifying a passion,became unknown,and thiseducation carried on for centuries has mad e the I sraelites a race of sobriety and practical temperance . Of

course,these practices have gone out of date with modern

Jews,but the Jews have retained the d isposition incurred

by the training of ages . Nevertheless, society maylearn a lesson from it, and it is simply this, to leave thecontrol of unnatural appetites to home influence and

40 J EW S NOT ADDICTED TO THE USE OF ALCOHOL .

training, and impress the parents with the fact thattheirs is the responsibility of their sons’ and daughters ’

formation of character . Legislative enactments can accomplish very little, the example of father and mother,the education by the teacher and preacher, must doeverything,and especially woman can exercise an overpowering influence in this direction,not by public agitation,not by the formation of praying bands,but by the

quiet and d etermined influence which she wield s at herhome and in society at large . Let the d runkard be ex

cluded from refined homes and society let the younggirl refuse to recognize the young man who is guilty o fintemperate indiscretion ; let her grace the public andprivate banquets by her presence, and let the women ofthe land preach incessantly against the practice of treating which is much the cause of the prevailing passion fordrink . Of course the d rinking saloons should be underlegal restraint,and every proprietor held responsible forthe drunkard who is supplied with liquor in his place .

Deprive the saloon of its attraction by making the homemore attractive by greater liberality . Do not preach a

crusade against moderate indulgence,d o not preach prohibition,but temperance . Keep within the legitimateand natural boundaries of reform and society can accomplish a great d eal . But beware of hand ing over thequestion of temperance to the mercies of the politician .

Y ou consolidate thereby the material interests into acompact and determined body, and by the fanaticismthereby aroused make drunkards of persons that would

THE M EDI CO-LEGAL TR EATMENT OF COMM ON

I NEBR IA TE S .

Bv L . W . BAKE R , M . D

Superintend ent Fam ily Hom e fo r N ervous I nvalid s, Baldwinville, Mass .

The healthy human organism has no need of alcohol,chloral or opium . These drugs are undoubted ly usefulin cond itions of disease but fulfill no necessary office inhealth . When their use is, for any reason, long continned they tend to establish a morbid habit which,from the changes produced in the cerebral centres, isextremely liable to pass the border line of self - controlwhen it becomes a positive disease requiring medicalcare and treatment .I shall no t now discuss any of the causes, hereditaryor otherwise,which lead to the formation of the alcoholhabit . Neither shall I consider the early period of thishabit, or those peculiar period ical outbursts of pervertednerve force,known as attacks of d ipsomania . I simplyd esire to call attention very briefly to a single class ofinebriates and to a later stage of the d isord er,when,nomatter under what circum stances its use was first comm enced, the d rug has produced its peculiar effects upon

Read befo re the M ed ico -Legal S o cie ty o f N ewYo rk,Dec . 14,1887

THE MED I CO—LEGAL TREATMENT, ETC. 43

the nutrition, and perhaps structure, of the nervouscentres whereby the alcohol habit becomes firmly established .

Here we have an entirely d ifferent cond ition of afiairsfrom that present in the occasional d rinker who choosesto d rink now and then for social or sensual gratificationonly . A distinction must be mad e between the selfcontrolling vice of d runkenness, or acute alcoholism,

and the irresistible impulse of disease . The danger ofcourse is, that the mod erate d rinker will occasionallyindulge to excess and later on become the confirmed inebriate, but when the d esire for alcohol has passedbeyond the power of self - control there is present a positive cond ition of d isease,perhaps not always characterized by changes d iscoverable at the autopsy,any morethan in many cases of insanity,but an abnormal cond ition of the central nervous centres exists which d emand salcoholic stimulation . I n the class here referred to alcoh ol is the cause of the d iseased cond ition,the d eterioration of nerve element produced by th e d rug is the causeof the continued d esire for alcohol . Th e vicious circleis complete and until these facts are clearly recognizedby our law makers and by the public at large ourmethods of d ealing with the chronic inebriate will be asirrational and un scientific as they have been in the past .I doubt very much if a confirmed d runkard was everreformed by punishment . This idea carries us back tothe time when insanity was regard ed as an indwell ingevil spirit to be driven out by chains and the lash . I n

44 THE MEDI CO—LEGAL TREATMENT

ebriety is not a crime to be punished,but a disease to betreated . We have for generations punished the chronicd runkard by fines and imprisonment,and still the greatarmy of inebriates is und iminished by our efforts whilethe tax upon the community for its maintainance issimply enormous .At the I nternational 'Prison Congress in 1871 it wasstated that not one in a thousand persons committed tojail for inebriety ever recovered . Before a committee ofthe House of Lords in England men of the largest experience testified that they had never heard of a case o freformation of inebriates from punishment by fines andimprisonment . This testimony is confirmed by prisonauthOI ities all over the country . I n the vast majorityof cases the first sentence is speedily followed by others .I n 1879 Massachusetts punished by fine and imprisonment over inebriates more than of whomhad been in prison before . Of the inebriatescoming under legal notice in New Y ork in 1852 less than

were punished for the first time . All others hadbeen sentenced before for the same cause . One manhas been sentenced to Deer I sland,near Boston,seventyfive times for drunkenness,and m any cases have beenknown of men who have been sent to jails and workhouses from twenty to two hundred times for the samereason .

The penal treatment of inebriety pays but very littleif any attention to the physical or mental condition o f

the inebriate, I t removes the victim from his alcohol,

OF COMMON I NEBR I ATES . 45

but does not consid er the weakened and d iseased nervoussystem which has been caused thereby . Regard ing himas a criminal it places him in association with the lowestfelons by which the worst elements of his nature arearoused and strengthened . I gnoring the element ofdisease it neglects all the means of restoration to healthwhich are so important in these cases,and surroundshim with influences admirably calculated to increaseand perpetuate his malady .

The lower classes of our larger cities are, from thevery nature of their education and surround ings,pred isposed to the excessive use of alcohol, while the um

healthy physical conditions under which they live arefertile causes Of disease . To transmitted or acquiredd egenerations is very frequently added the deteriorationproduced by alcohol giving a complication of diseaseswhich no penal institution is competent to deal with .

Fines and imprisonment have thus far failed to cureor check the evils of alcoholism . I s it not, therefore,important that other means more in accordance withthe truths of science should at least receive a fair trialI nstead of send ing the chronic inebriate to the penitentiary as is now the custom he Should be committed toan I nebriate Hospital,properly arranged for this specialpurpose . These should have legal powers of d etentionand control S imilar to those of our best asylums forthe insane . They should be located on large farms,away from the cities,and should be supplied with thevarious industrial appliances for the occupation of the

46 THE MEDI CO—LEGAL TREATMENT, ETC .

patients,and in charge of physicians who have madespecial study of the care and treatment of inebriates .

Every county should establish and maintain an I nebriate Workhouse Hospital and our laws should be modified so as to compel the commitment of inebriates tothese institutions rather than to the county jail . I n thisway the unfortunate victim of the alcohol habit will beplaced und er the best possible conditions for his recovery and restoration to society, or if proved to be incurable he will thus b e provid ed with an asylum where hewill in a measure be self- supporting and prevented fromfurther injury to himself or to others .

We humanely provid e asylums for the chronic andhelpless cases of insanity,why should we refuse S imilarprovision for the incurable inebriate Both classes needasylum care if for no other reason than to prevent thetransmission of the insane and inebriate diathesis tosucceeding generations .

The results thus far obtained from the hospital treatment of inebriety in both public and private institutions

,

are sufiicient it seems to me,to warrant a more extendedtrial of this meth od by our State and municipal authorities .

THE MEDI CAL J UR I SPR UBEN CE OF

I NEBR I E TY

BY M . LOU I SE THOMA S .

I know of no question within the range of humanthought so d ifficult of d iscussion and so impossible ofsolution as the Jurisprud ence of I nebriety,” and if thiswas all of the subject before u s to -night I Should declarethe task hopeless .

I t is appalling to consider how much of legislative action has already been had,and to how little purpose to

stem the tid e of inebriety . We have laws to m anu fac

ture,and not to manufacture intoxicating liquors . Wehave low license and high license, and local optionand prohibition, tax for revenue, Maine law, and

to guard minors, and wives, and confirmed inebriates,and so many other forms of law that their aim is defeated as much by their number as by their generalweakness . Friends of temperance shake their headswith sad forebodings,while those engaged in the trafficlift theirs in proud defiance, and thoughtful mind s areled to doubt whether laws can be framed that will guardequally the individual and the state, punish the violator of law,and yet allow a just liberty to all .

m ead befo re th e M ed ico -L egal S o ciety,Dec . 14,1887 .

THE MEDI CAL JUR I SPRUDENCE or I NEBRI ETY

But,adding a third S ide to our angle and making itthe “ M ed ical Jurisprudence of I nebriety,” we have aproposition which in symmetry of thought and reasonableness of purpose awakens a hope that even that stupendons evil,which, to paraphrase the words of another,is “ the source of all human miseries,” may not be eu

tirely beyond control .I t is so reasonable to conclude that inebriety,in all its

forms and every stage, is a d isease, following distinctlines of tendencies,developments and efiects,that I mar

vel it has not so stood upon our statute books from thefirst . Every symptom,from the awakened morbid ap

petite, through all its stages, down to final darkness anddeath,attest the helplessness of the victim,and call forthe enlightened skill and guiding care of the wise physician . The wonder grows why leading temperanceworkers have not sooner perceived this point and calledupon medical science,from whence their help must come .

I dare not declare with many others, most excellentpeople, that the d esire for any and every sort of stimu

lating d rinks is in itself altogether wrong and S inful. I t

may be so,but if so, then all laws permitting, licensingor countenancing the tra r

ic are also S inful . We haveno more right to license this than any other form o f

social crime or evil . I t seems to me to be a natural appetite or in stinct,the same as hunger or thirst or anyother natural human d esire,and the abuse o f it is whatmakes the trouble .I t is found among all kinds and conditions of men,in

50 THE MEDI CAL JUR I SPRUDENCE OF I NEBR I ETY .

away at the public expense they direct the treatmento f the insane,and costly asylums are erected and sus

tained for their comfort and cure ; they Show pleuropneumonia to be dangerous,and the law says Wipe itout, even to the entire destruction of all infected herds,no matter what the money cost may be .

All these dangers together, and multiplied an hund red - fold, must yet sink into insignificance comparedwith the evils of inebriety, so fatal to its victims,so crushing to families, and so costly to the state .

But when the same d istinguished medical skill shallcome forward and boldly and firmly declare that inebriety is a disease and only a d isease, that it mustbe met and treated as a disease, that the patientmust be cared for, restrained and cured,not only as inthe cases already cited,but with infinitely greater care,and still further, as a means of prevention, that theyoungwho are as yet untouched by its baleful influenceshall be educated in the schools to know its true dangerand to avoid it,not merely because the law says so,butbecause over self indulgence in any direction is hurtful

,

then, and not till then, medical science and the lawwalking hand in hand,may we hope that inebriety maybe swept from the earth . A sylums, almshouses andprisons will no longer be needed,capital will be turnedinto clean, legitimate channels for the prosperity ofthe whole people, and then shall come to pass thatheavenly era, the promised millennium of Peace onearth,good will to m en .

”

PR I S ON EXPER I EN CES .

Br LUCY M . HALL, M .D .,

Bro oklyn,N . Y .

What makes the inebriate, or, in rough Saxon,Whyd o men get drunkTwenty years ago no one asked this question . Now

there is hard ly any one who is not asking it .That every morning a vast army of people shouldarise in the possession of their sober senses,who beforethe day is over will, by their own deliberate act,becomestupid, stumbling imbeciles, or frenzied, dangerousmaniacs,has at last presented itself to the mind of thescientific world as a problem, and more, as a problemwhich requires solution . Following closely upon thishas come the other problem,What shall we d o with theinebriateOf more than two hund red inebriate women examinedand subjected to the most careful scrutiny by me,I foundmore than seventy who gave what seemed conclusiveevidence that somewhere in their wretched history theyhad passed the point where self - control is lost,and poorhuman nature is left helplessly to follow wherever thetemptings of a remorseless appetite may lead .

‘Read b efo re the M ed ico -Legal So cie ty,Dec . 14,1881.

52 PRI SON EXPERI ENCES .

Here is a woman,well reared, always sensitive andproud, once beautiful and rich,who,for a score of years,has been making her d reary round, d runk to -day,arrested and sentenced to -morrow, forlorn,hopeless,deserted by friend s and foes alike,one of humanity ’s dregs,and yet maintaining a sort of remnant of her old - timestateliness and refinement of manner,when the prisondoors are barred between her and her tempter . EveryShadow of her perception of self - control has long sincepassed away . The sight or odor of intoxicating liquorsthrows her into a state of frenzy as loathsome as it isuncontrollable . Her moral sense is absolutely nil .Here are two others, young girls scarcely sixteenyears of age, one blue - eyed and sunny-haired,the otherdark, but equally pretty and pleasing . What havethese two in common with the poor wretch just described!Only this, they are d runkard s . N ever in their lives havethey been able to leave untouched any intoxicant whichwas within their reach,nor to desist from its use untilcompletely stupefied .

These are but three, culled from a motley procession .

The two latter are hopelessly tainted in the ultimatecells from which their nerve centres were builded

,for

they are the children of d runken parents . Of theformer,and the class which She represents,it is di I cult todecide where the mental decadence reached a point fromwhich return to normal standards became impossible

.

We speak of the human will as though it were an independent entity,whereas,this factor of the intellectual

PR I SON EXPERI ENCES . 53

machine is really only the resultant expression of manyopposing forces, none of which can be accuratelyweighed . Certain of these forces by some sudden, sharpor decid ed impression may,und er favorable cond itions,be so stimulated that self- control becomes easy,whereas,under other cond itions ,it would be impossible . Again,care and attention and a gradual upbuilding of thesystem will ensure a response from the brain forces

,

which will protect the inebriate from lapsing iinto hisbesetting vice .

I n either case there are,no d oubt,molecular changesin the brain cells . I f these changes remain and acquirepermanency, the cure is lasting otherwise it is but temporary . But there comes a time in the course of everyunreclaimed inebriate when no such response from thegoverning forces is possible .

There were many of the two hundred unfortunatewomen above noted,who, so far as human wisdom canpenetrate the secrets of the hum an organism,gave noevidence Of having lost,or of never having possessed,thenerve and will power which would enable them to control their tend en ‘y to inebriety . There were others whoexhibited the peculiar nervous phenomena which markthe initial stage of irresponsibility, as the unstable stateof the em otions,the lowered moral sense, the generalbreaking up of all that which goes to fortify characterin the individual .I f a cure is not wrought before this condition becomespronounced,there is little hope, and it is just at this

54 PR I SON EXPER I ENCES .

stage that the heaviest censure is heaped upon the unfortunate wretch, still further degrading him who isalready beaten d own by a sense of his own degradation,and the help, encouragement and control withheldwhich might prove his salvation .

Thus the question ° Why do m en—or women getd runk resolves itself into a psychical and pathologicalstudy of the most profound and the most perplexingnature . Much has been achieved in the last few years,but the problem is yet but partially solved . I n oureagerness to correct old errors we must not fly to anopposite extreme .

All the strength of the victim and of those who wouldrescue him is d emanded in this, the grand est work, themightiest movement of our century, the cure or care ofthe drunkard .

As there is pre - cancerous stage of cancer, a prephthisical stage of phthisis,a stage in which the tendencyis strongly d eveloped, but may be warded Off byproper measures and the patient rescued from his impending doom, So in inebriety, if the tend ency is no t

to o pronounced, timely aid will save him . When thelast stages are reached, and the poor drunkard has sunkto that beastly conditionwhere he seems to have lost hiskinship to humanity,when there is no sentiment left towhich you can appeal, nothing in him which can beawakened in response to your de sire to rescue him,theopportunity is lo st . As well try to cure advanced can

cer or phthisis as to cure him .

PR I SON EXPERI ENCES . 55

To affirm that the habitual inebriate is as sane and

responsible as is his sane and temperate brother, isabsurd . No man or woman believes it .Thi s does not imply that society is to be at the mercyof the frenzied and dangerous inebriate it implies justthe reverse . For in just so far as the inebriate is irresponsible, just to that degree is society responsible forhim, and this responsibility can only be discharged bythe putting forth of every effort on the part of societyto protect and reclaim him .

I t is need less to say how poorly and inadequately thisduty is being discharged,how stupid ly and egregiouslythe errors,which are the result Of old and unscientificmodes of thought, are being perpetuated in the acceptedmethod s of d ealing with these unfortunates .Every boat which goes to Blackwell ’s I sland, freightedwith its throng of blear- eyed and dejected humanity, isa protest against these methods . Every boat whichreturns, with an equally numerous throng, like theothers except that they are a little more degrad edand forlorn, is a protest . The nine - tenths of thisjust liberated throng, who will be returned, batteredand begrimed, so soon as they have had time tocomplete the cycle of another d ebauch,another arrestand another summons to appear before “ his Honor,are a protest in the same d irection .

Every correctionary and penal institution in the land,its cells crowd ed with inebriate wrecks, or those whohave become criminals because they were first drunk

56 PRI SON EXPER I ENCES .

ard s, —every hospital and poorhouse and insane asylum,all our burd ened charities, all the rum -wrecked homes,the disgraced and ruined families, stand as a bitter reproach to the law and the administration of the law asit affects the inebriate .

Lack of tim e and space forbid a further elaboration ofthe subj ect . I can only repeat what with tongue andpen I have so many times reiterated : All legislationwith regard to the inebriate should be for his protection .

He Should not be classed as a criminal nor treated as acriminal, for inebriety alone .

Upon the other hand,he should be regarded as irresponsible, if he fail to control himself,and his course ofself- d estruction speedily arrested . Every effort whichscience can suggest should be put forth for his recovery .

Failing in this,he should be Shielded,and his powers fo rhappiness and usefulness conserved,by a system of control the least d egrading, the most humane,but at thesame time the most absolute and perpetual,which humaningenuity can devise or human power enforce .

58 THE SCI ENTI FI C STUDY OF I NEBR I ATE CRI M I NALS .

the medical and legal professions . My object is to callattention to the inebriate criminal, and to ind icate thescientific method s by which such cases are to be stud ied,and to Show some errors which have followed from thefailure to understand the facts in these cases .The inebriate appears in court as a criminal,the crimeis admitted, and the question is raised of his mentalsoundness . I t is asked : Did the prisoner at the timeof committing the crime realize the nature and cousequences of his acts and conduct ! Had he the power ofself- control to have d one otherwise had he so willed !Was the inebriety and crime voluntary and with motive !or involuntary and without motive ! From the answersto these inquiries, the mental health and condition ofthe prisoner is determined .

The scientific expert wh o is called to answer these inquiries should approach the problem without any knowledge of the legal rulings and questions of responsibilityof such cases,held by courts . His province is simplyto examine the facts, and the conclusions which theyseem to ind icate ,which are in harmony,with the laws ofnature .

As a scientific expert of the phenomena of the mindand its morbid manifestations,he is not called to d etermine questions o f legal responsibility, but must pointout the facts, Show their accuracy and meaning

,no

matter what the consequences or conclusions may be .

This cannot be ascertained from newspaper reports,statements of counsel,or slight examination of the pris

THE SCI ENTI F I C STUDY OF I NEBR I ATE CRI M I NALS . 59

oner . Such a study, to be accurate, should begin and

follow a general order of facts,as follows1. Legally the crime is first stud ied,but medically thisord er is reversed . First, study the history of the criminal, then the crime . Often a history of the criminald istinctly ind icates the nature and character of the crime .

Th e hered ity of the inebriate criminal Should be the firstobject of study . From a knowledge of th e defects and

d iseases of the parents, of their strength, conduct, andcharacter, a general conception can be had of their d escendants .

2 . A study of the prisoner’s early growth,culture,training,nutrition,surround ings and occupation,revealsmany facts ind icating the brain capacity or incapacityto act normally .

3 . Th e inebriety of the prisoner still further points outhis mental cond ition . The origin,duration and characterof the d rink impulse,are most important facts forminutestudy .

4. Th e nature and character of the crime,the associatecircumstances, including the inebriety, all bring ad

ditional evidence pointing out the actual mental state ofthe prisoner . From a systematic study of this kind,theprisoner and his crim e will appear clear and d istinct .N o t as an ou tburst of vice and wickedness, but as thenatural sequence of a long,progressive march of physicalevents

. I nebriety and criminality are not accidents,butthe products of causes, the outcome of cond itions,which have grown up in obed ience to laws that move

60 THE SCI ENTI F I C STUDY OF I NEBR I ATE CR I M I NALS .

on with progressive uniformity . This is illustratedin the history of every case

,which can be followed along

a continuous chain of events, dating perhaps from heredity, d egenerate growths,up to inebriety, then to crime .

Both the crime and inebriety are but symptoms of disease and d egeneration,culminations of events whose footprints can be traced back from stage to stage . Attemptsto apply d ogmas of free -will, and Show at what pointpowers of control existed or were lost,where consciousness and unconsciousness of events j oined, or wheresanity or insanity united, is to attempt the impossible .

To the scientific man, the knowledge required to d etermine these facts extend s far beyond the wid est range ofhuman intellect .

I n the efforts to d etermine the mental soundness andbrain health of a prisoner in court, there are certain general facts already -established that will serve as a foundation from which to date more minute and accuratestud ies .1. The inebriety of any person is in itself evid ence ofmore or less mental unsoundness . A lcohol,used to excess and to intoxication ,is always followed by changesof brain circulation and nutrition . Degrees of mentalimpairment and paralysis always follow,whether recognized or not .2 . I n a large proportion of cases inebriety is only asymptom of slow, insidious brain d isease, particularlygeneral paralysis,also of many forms of mania,dementia,and other brain degenerations .

THE SCI ENTI F I C STUDY OF I NEBR I ATE CR I M I NALS . 6 1

Here,notwithstand ing all appearances, the inebriate isd iseased and unsound mentally.

3 . When crime is committed by inebriates, growingout of the inebriety or associated with it, the probabilityof mental d isease and some form of insanity is verystrong . I nebriety always favors and prepares the wayfor the comm ission of crime .

4. Whenever it appears that persons have used spiritsto intoxication for the purpose of committing crime,thisis evid ence of a most dangerous form of reasoning mania,requiring the most careful study .

From these general facts, which should govern theexpert in such cases, I turn to ind icate the great injustice which has followed in some late prominent trials,from the failure to realize and apply these principles .Peter Otto,a chronic inebriate,Shot his wife in a d rinkparoxysm . On the trial,the insanity of the priso ner wasraised . S everal med ical experts testified to his sanity,and explained his uhu sualconduct as that of a S imulator .He was found guilty and sentenced to d eath . An appealwas taken

,and a year later I examined this case . Begin

ning with hered ity, the prisoner ’s grand father on his

father’s S id e,and grandmother on his mother’s sid e,were

both insane the former died in an asylum . His fatherwas a paroxysmal inebriate,and a morose, irritable man,who died in Andersonville prison . His mother, stillliving, i s a passionate,half insane woman,being irritableand su SpI cious, and drinks beer . One of her S isters d iedinsane

. The prisoner’s early life was one of great

62 THE SCI ENTI FI C STUDY OF I NEBR I ATE CR IM I NALS .

wretchedness and neglect— in the street and saloon . He

was ill -nourished,and d rank beer at home and whereverhe could get it . At ten he was injured on the head,andwas treated in a hospital for several weeks . At pubertyhe drank to intoxication and gave way to great sexualexcess . Later,he was m arried in a state of great intoxication and unconscious of it at the time . Fo r ten yearsbefore the crime he d rank to excess as often as he couldprocure money to pay for spirits . He grew quarrelsome, suspicious and very irritable,and at times actedwild ly . He had the common suspicion of his wife ’sinfidelity, without any reasonable basis . He had

tried to kill himself on two different occasions, bythe most child ish means . r

e was injured again onthe head and complained of bad feelings ever after . He

was arrested on six d ifferent times on complaint of hiswife and mother for violence when intoxicated,and wasconfined in j ail from ten to sixty days . Two months b efore the murd er he was placed in jail suffering frommania . Th e jail physician called his condition alcoholicinsanity . The murder followed,while drinking to greatexcess, and grew out of a quarrel with his wife . He

mad e no e ”

ort to run away or conceal himself . I n j ailhe developed religious delusions of frequent personal conversations with Go d . Heard voices and saw lights whichhe interpreted as God ’s messages to him . His appear

;

ance and conduct indicated great mental enfeeblement.

My conclusion of insanity was sustained by the historyof the heredity,growth,surroundings, inebriety,general

THE S CI ENTI F I C STUDY OF I NEBR I ATE CR I M I NALS . 63

conduct and d elusions . A special commission of physicians d ecid ed that he was sane and fully responsible,and on this conclusion he was executed .

The second case was that of Charles Hermann, achronic inebriate, who, while und er the influence ofSpirits, threw his wife d own on the floor, cut her throat,and placed the body on the bed . That and the twofollowing nights he slept in the b ed with the d ead body,going out in the morning and returning at night, actingas usual,d rinking and manifesting no excitement or con ~

sciou sness of what he had d one . Three days later thebody was d iscovered he d escribed all the circumstancesof the homicide,gave no reason or explanation, exceptthat she would not stay in when he wished her .The d efense was insanity from Spirits . and alcoholic

trance . This was denied by the med ical witnesses for thepeople . From my study of the case the following factswere undisputed1 . Hermann was a German, forty- two years of age,abutcher by trad e . NO hered itary history was obtained .

He was very reticent,and could give no clear history ofhis past .2 . About twenty years ago he began to drink to excess .Wh en under the influence of spirits he was sullen, irritable and suspicious of every one, his character and conduct were changed he had suspicions of his wife ’s infidelity .

When sober no reference to this delusion wasmade he seemed to be a kindhearted man .

3 . For the past five years he has greatly changed in

64 THE SCI ENTI FI C STUDY OF I NEBR IATE CRI M I NALS .

every way . He did not work much, tramped to Chicagoand back,d rank at times to excess, was very quarrelsome with his wife and others,when und er the influenceof spirits . Was rarely stupid when intoxicated,but washeavy and dull . A week before the murder he drankmore than usual .4. The crime was committed automatically and in thesame way he had been accustomed to kill animals . He

seemed oblivious of the nature and character of thecrim e,and made no efforts to conceal it, or escape, butwent about as usual, apparently unconcerned . Thissame ind ifference continued up to his execution . A S inthe former case, a commission d ecid ed that he was notinsane,and was responsible . Both his inebriety and thepeculiarities of the crime were ignored in this conelusion .

Case three was Patrick Lynch, a period ical inebriatewho killed his wife in a similar ind ifferent manner .Th e d efense of insanity was urged, and Opposed by thesame confused med ical testimony . A marked historyof hered ity, embracing insanity, inebriety, and idiocy,was traced back two generations . The prisoner grewup in bad surround ings,was an inebriate early in life .

At the age of thirty he was a periodical inebriate, witha drink period of twelve or fifteen days, during whichhis conduct was markedly insane . He killed his wife bystriking her on the head with a board, und er no excitement and perfectly cool, then went to the station andgave himselfup,giving no reason for the act . He had

66 THE SCI ENTI FI C STUDY OF I NEBR I ATE CR I M I NALS .

I n each of these four cases the medical evidence wasfound ed on theory and not on the facts of the case . The

legal treatment was also imperfect and unjust for thesame reason .

The teachings of all scientific research are in unisonto - day concerning the disease of inebriety,and also thatthis d isease of inebriety may merge into criminality . I t

is Obvious, then,when they are found associated, only afull, exhaustive inquiry and study of the facts can determine the sanity of the case .

The question of the sanity and insanity of inebriatecriminals must be d ecid ed by an appeal to the facts,gathered by scientific experts, and not from any theological or jud icial theory,however ancient in history oruniversally accepted by lawyers and scientists .The question of responsibility in any given case mustbe answered exclusively from its scientific S ide, apartfrom all legal conceptions and tests in such cases . Th e

inebriate criminal belongs to that obscure class of borderline cases who must be studied, both legally and medically, from the facts in their history .

From every point of view it is apparent that the present treatment of the inebriate criminal is far behind thescientific teachings of tod ay . The time has come toput to one S ide all med iaeval theories of the vice and voluntary nature of inebriety, and study each case morethoroughly and from a wider range of facts, estimatingthe d egree of sanity and responsibility by physiological

,

pathological and psychological method s .

THE M ED I CAL J UR I SPR UDEN CE OF

I NEBR I E TY .

*

BY JOSEPH PARRI SH, M .D . , BURLI NGTON, N . J .

Before entering upon the d iscussions of the subject wehave in hand , it is essential to an intelligent view of it,that we agree upon the meaning and application of terms .The word s,Drunkenness, I ntoxication,Alcoholism, I nebriety, etc . ,are so carelessly and interchangeably used,that I shall confine myself to I nebriety, the Disease,

as d istinguished from other forms of alcoholic efiects,

and especially from the daily d runkenness of the saloonand the street . The typical ineb eriate comes into theworld with the mark of the beast upon his forehead ,”

or it may be with a vestige only of an ancestral taint,which inclines him to seek indulgence in intoxicants ofsome kind . I n other words,.

he is born with a d ecidedalcoholic d iathesis,or with a positive tend ency to formone . That is to say, that where the hered itary impulseis not sufficiently potential to impart a complete d iathesis

,it leaves only an inclination or tendency to free

indulgence,which, if continued in excess,will grow into

a constitutional d emand, as imperious and exacting asin the other case .

R ead b efo re the M ed ico -Legal S o ciety o f N ewY o rk,at its AnnualM eeting,held

D ecem b er 14,1887 .


Such persons are moved at times by a passion forindulgence

,which is beyond their control . I t comes at

intervals,it may be weeks, or months,during which

periods of time they not only have no d esire for alcoholin any of its forms, but a loathing and d isgust for them .

I t is not the taste or appetite fo r them that is to besatisfied, but the effect . They long for a cond ition ofoblivion, of forgetfulness of self,and of all selfish andannoying cares and troubles and mood s . Neither havethey any desire for convivial companionship . The glitterand glow of public resorts,where liquor is the primefactor of wrong and ruin, have no attractions for them .

They are not tempted by such d isplays . Th e tempta

tion,with which they are tempted, is within . I t is sub

jective . I t circles in the stream that gives them life .

I t may be likened to a battery that is hidden somewherein the cerebral substance— connected by continuous fierywires,with a coil in every ganglion, from whence theycontinue to extend— attenuating and distributing, asthey go, reaching after the minutest nerve fibrils,whichneed only a throb from the inborn impulse, to transmita force that quivers in every muscle, and burns in everynerve,till the victim is suddenly d riven from himself,into the ways of unconscious d ebauchery . Technically,it is a brain or nerve storm,which dominates all othercond itions,and leaves the patient, for the time,withoutany power to control his own acts .Dr. J . M . Howie, of L iverpool, England, says, thatsuch a man possesses no power of resistance, “ that he

THE MEDI CAL J UR I SPRUDENCE OF I NEBRI ETY . 69

drinks as naturally as a fish swims, or a dog barks l”Dr. I . B . Hurry, also of England, d escribes the cravingfor d rink as “ coming in the form of a paroxysm, whichruns a more or less cy clical course .

” He calls it uncon

trollable d runkenness Y and quotes Dr. Hutchesonas saying, “

That this sort of mania d iffers entirelyfrom d runkenness, the d iagnostic sign of the d iseasebeing an irresistible propensity to swallow stimulants inenormous d oses, whenever and wherever they can beprocured . This form of inebriation is often, if notusually, found in our most useful professions—men ofletters and culture, of refined tastes and manners, whoscorn the low - lived friendships of the groggery,and whovainly strive for liberty .

”

Dr. N orman Kerr, of London,the faithful friend of theinebriate,and eloquent advocate for legislative aid in hisbehalf,has used the following most impressive languageThe struggle of the intemperate for freedom, is a combat more terrible than any other fight on earth . I t ismore arduous than the most celebrated of those, thepraises of which have been from remotest ages imm or

talized by undying verse .

” I t remains yet to notice amost important and prominent symptom of inebriety,which

,together with periodicy, constitutes its real

pathognomonic Sign, namely, loss, or suspension of consciou sness and memory,without sleep or stupor, duringwhich the patient acts automatically, being withoutknowledge of his actual cond ition,at th e same time appearing to be,and to act,naturally. I have had numer


ous cases of the kind, of which the following are examples .G. A . , a young gentleman who resided about fourteen miles from the city, left home to visit friend s,and to attend to a few errand s,agreeing to return by anearly evening train . He called on his friends, attendedto his business, accomplishing all that he intended to doon leaving home,but d id not take the early evening trainto return . I nstead Of doing so,he unfastened a fine looking horse and vehicle from a hitching post on the sid ewalk,mounted the carriage,and d rove safely to his homefourteen miles away . He crossed the river by a bridgeavoided collision with vehicles of all sorts on a crowdedthoroughfare,paid tell at all the turnpike gates throughwhich he passed, and reached home in safety and ingood season, with the horse in good cond ition, showingthat he had not been abused by fast driving . He wastaken to the stable, and the young man retired to hisroom . I n the morning,havrng slept Off the effects of afew potations of whiskey, he met his family in thebreakfast -room,having no knowledge of having reachedhome in the way he did, and was surprised to find in amorning paper an advertisement for the horse and

wagon A shamed and humiliated by the d iscovery, heproceeded at once with an attendant to answer theadvertisement . The owner,being a physician and taking in the situation, was thankful to find his favoritehorse unabused . The two gentlemen, Shaking hands andcongratulating each other upon the safe and satisfactory

THE MEDI CAL J UR I SPRUDENCE OF I NEBRI ETY . 71

issue of a bold and reckless experiment,with abundant

apologies on one S id e,and full forgiveness on the other,separated, having left for you and me a record of aninteresting case of cerebral automatism,to become a partof the proceed ings of this society .

Another,Professor W a Christian gentleman andscholar,a popular and succcessful teacher . The passioncomes to him unbidd en, and even without previousthought on the subj ect, and sometim es sudd enly . He

may be engaged in h is study preparing to meet his class,and there comes over him a seeming cloudiness whichdarkens his mind ,and he seems lost to things about him .

Without seeming to know why, he leaves his study andhis home, seeks the village near which he lives, takes afew drinks of whiskey,casts aside all sense of self-respect,all care for the Opinion of others, resists all appeals tostop and stay,and with a recklessness unknown to himin a state of sobriety,abandons himself to his cups and

their consequences . During his carouse,he hires a horseand buggy,drives into the country,visits friend s, d inesor sups with them, remains till the next day, returns tothe village, pays for his horse and carriage, settles hissaloon bills, and when quite himself again,goes to hishome, seats himself in his study, resumes his preparationfor his classes,without remembering anything that wasdone during his absence . The interval between thecloudy feeling in his study and his return, sobered,mortified, and overcome with self- reproach and remorse, isa complete blank .

72 THE MEDI CAL J URI SPRUDENCE OF I NEBRI ETY .

My friend and colleague, Dr. Crothers, of Hartford,Conn . , has brought to light a number of similar cases,and published them in a valuable brochure which everystudent of this subject Should read ; it is called “ Cerebral Trance, or Loss of Consciousness and M emory inI nebriety .

The phenomenon of unconscious cerebration,of whichI have produced two examples, is seen,and sometimesin a more marked d egree,in the d isorder known as S omnam bulism ,which has no connection with alcohol as afactor,and yet its exhibition of amnesia under remarkable cond itions leads to the suspicion that both disordersmay be traced to a want of equilibrium in the same nervecentres, or in those that are closely allied to each other,by which, in both, there is im paired consciousness . Dr.

Clouston tells us of one S imon Fraser,a highly neuroticsubject,who had been a sleep -walker all his life,and didall sorts of things in accordance with his illusions andfalse beliefs, during his somnambulistic state . He oncewent up to his neck in the sea of Norway,and did notawake . At last one night,while in a somnambulisticstate,he seized his child, to whom he was much attached,thinking it was a white animal,and dashed it againstthe wall and killed it .

*

From Dr. Crothers ’ pamphlet we learn of a record madeby Dr. Forbes Winslow, Of a somnambulist who,whilewalking about,his night dress caught fire, and with

*A full acco unt o f the case and the trial,is given in The J o urnal of M ental Science,Vo l

'. XXI V .,p . 451.

PERS ONAL RESPON S I B I L I TY A S AFFE CTED

B Y A LCOHOLI C I NFL UEN CE .

BY T . L . WR I GHT, M .D . , BELLEFONTAI NE, OH I O .

I will speak of the responsibility for crime committedwhen alcohol enters as a factor in its inception— as wellas a comm on incitem ent to crime— from two points ofview only First,when nerve function is impressed andembarrassed by alcoholic influence ; and, second,whennerve structure is afiected through alcoholic influence .

lst. As to nerve FUNCTI ON, I am not assuming anything when I say that it is the universal verd ict of science,that accurate knowledge is wholly d ependent uponaccurate consciousness that is, consciousness healthy,not morbid in kind ; and complete, not fragmentary ord eficient, in degree .

N ow, what is consciousness,and what are its conditions !

“ Consciousness, says Wundt (see Ribot, German

Psychology,p . 247, et. seq ),“ psychologically, is a uni

fication, although itself a unit . ” There is no organ orcenter ” of consciousness . The entire organism is es

sential to its completeness . “Thus,perception,represen

tation, idea, feeling,volition, form the continuity calledconsci ousness,of which only tautological definitions can

PERSONAL RESPONS I B I L I TY, ETC. 75

be formulated . Taken as a whole, the act whichphysiological psychology seeks to interpret — and uponwhich the question of responsibility is pend ing— “ embraces the following moments First, impression second, transmission to a nerve centre third entrance intothefield of consciousness (largebut vague perceptionfourth, passage to the particular point of appercep

tion (d efim te,no longer vague) fifth, voluntary reaotion sixth, transmission by the motor nerves . ”Careful authorities agree that alcohol is a poison, themost Obvious effect of which is to induce paralysis .This was pointed out by Dr. T. W . Poole, of Ontario, ina work published in 1879 . Prof . A . B . Palmer, of AnnA rbor,M ich .,discusses the same thing in the J ournal ofI nebriety,July,1884. Doctor S idney Ringer,of England,d eclares that alcohol is not a stimulant as comparablewith its radically d epressant properties . He says thatthe ultimate e ” ect of any considerable quantity of alcohol is paralyzing . Doctor C. H . Hughes,of St . Louis,ina letter to the writer,uphold s the same d octrine,and b elieves it to be o f very great import .But it is not necessary to rely upon authorities in thispart of our discussion . Everybody is familiarwith the staggering gait and the distorted countenance of the d runkenman— evincing partial paralysis of the muscular system .

Everybody is aware of the confusion and incoherence ofthought which d emonstrates the repression in functionalpower of the nerve centres of rational movement . Every

L_,l

Ribo t,pp. 246-248.

76 PERSONAL RESPONS I B I LI TY AS AFFECTED

body is cognizant of the lying and treacherous propensities o f the d runkard— showing a partial paralysis of thenerve centres which presid e over the manifestations ofthe moral nature : and falsehood is the corner - stone ofthe whole ed ifice of crim e .

Universal paralysis, when complete, is death . But

universal paralysis,when incomplete, is d isorganizationof function . I t is absence of perfection, in the essentiald etails of all the departments of a sound individuality .

How can a man, hand icapped by d eficiency and incapacity of nerve throughout his whole organism, correctly judge and d iscriminate in d ifficult and involvedquestions ! The consciousness of sound, for instance, isone “ of the most S imple and plain of all . And yetthe mind must be alive to the d istinctions and qualities ofpitch,intensity and timbre, in order to determinethe quality of sound with accuracy . These several properties d epend upon the “ number, amplitude, and formof certain atmospheric vibrations .I n regard to the capacity of a drunken man,by an actof volition,to raise himself above the level of his drunkenstate—and upon the possession of which capacity thequestion of his responsibility turns, it is only necessaryto say this S ince the beginning of the world no example has been known ’

Of a d runken man improving uponthe condition and phenomena of his drunkenness . I n

every other possible relation,the same mind steadily improves and advances upward but the drunk ” of threescore years and ten is, in all its essential features and

BY ALCOHOLI C I NFLUENCE . 77

exhibitions, the “ same Old d runk ” that was characteristic of the individual at the age of twenty or thirtyyears . I n other word s, the d runken man is no t his own

master . Alcohol d ominates him,and guides him in itsown way .

2nd . As to nerve STRUCTURE, alcohol interferes withthe co - ordinate or co - equal nutrition of the physicaltissues which enter into the composition of the humanbody . Substantial growth in certain d irections is morb idly increased ; and the result is, that a relationshipis established amongst the several bod ily parts which isnot symmetrical . The particular structure which mainlytakes on inord inate and unhealthy growth,is the fibrousor fibre - cellular substance or,as it is called in med icalparlance,tissue . I t is therefore proper to inquire specifically,what is the fibre - cellular tissue, and what is itsoffice ! AS I W ish to be plain, rather than technical, Iwill say in general terms I t is the gray, d ense structure in the body which hold s and bind s the entire organism together,giving to it Shape, tenacity,and elasticity .

I t enters into the substance of the liver, giving itstrength and form . I t enters into the mechanism of thekidneys,giving them strength and form . I t enters intothe texture of the brain,giving it strength,tenacity andform

. And SO likewise,it enters into the substance ofevery organ and structure of the body—Of the muscles,bones

,lungs,heart, skin,and so on, giving all of them

strength,protection, tenacity and form . And besides,

this same fibre - cellular tissue binds— through itsm odifica

78 PERSONAL RESPONS I B I LI TY AS AFFECTED

tions in shape and position,as by ligaments,hand s,leaders,etc .,

— the various portions of the body into one grandand harmonious whole . I n every organ of the body,thefibrous tissue is liable to be substantially mod ified andpermanently changed in form through the toxic p owerof alcohol .I t is not surprising, therefore, that Dr. Bartholow declares that “ few structures escape the deforma; ive in

fluence of alcohol when it is habitually taken into thesystem . The kidneys, the stomach, the liver, and thebrain, all exhibit,” the doctor continues, an increase inthe substance of the fibre - cellular tissue which is foundwithin them .

”And Dr. Sieveking, of London, in his

work on L ife A ssurance, says There is scarcely a degenerative condition of the body that may not resultfrom the habitual use of ard ent spirits . ” I economizeSpace by d eclaring that the authorities are a unit onthis point .When, therefore, the complexion becomes muddy,andthe eyes tinged with a greenish hue ; when the appetiteand spiri ts fail, and an incessantly recurring jaund icecolors the skin of the habitual tippler, we know thatthe liver is becoming structurally injured through themischievous effects of alcohol upon the cellular tissuewhich enters into its structure .

When we perceive the habitual drinker—previously ofgood report in most respects— beginning to steal ; orwhen we perceive in him some surprising lapse in decencyand public morality, we know that the fibrous tissue

BY ALCOHOL I C I NFLUENCE . 79

within the brain is being injured by alcoholism . We

know that nerve cells are being squeezed and oppressedby the intrusion of a foreign substance ; and at a laterstage we know that nerve corpuscles are being transformed into fat, or are absorbed altogether ; that brainfibres are torn in sund er,and that the blood -vessels ofthe brain are strangled and obliterated . We know thatin a few months the scene will close upon a paralytic dement —imbecile and driveling .

Such is a partial description of the power of alcoholcarried to its logical conclusions . While a portion ofhabitual inebriates, only, reach this woeful end, it is yetproper to und erstand its occasional reality ; for the tendency of habitual drinking, even though called m oderatein degree, is always, to some extent,greater or less, inthis direction .

But in impairing the constitution,the worst effects ofalcohol must take place within the brain . The cellularstructure within the brain,at first morbid ly and inordi

nately increased in volume,at length begins,by little andlittle,to contract . To illustrate A fter a severe burn ishealed, the scars are apt to appear prominent in the formof unsightly welts and ridges . These scars are one formof cellular tissue . But in time these prom inences will disappear . The scars shrink, very considerably, becoming,at the same time,very hard and tense ; and not infrequently

,by drawing portions of the body out of their

natural relationships with each other, they produce serions inconvenience and deformity . A similar contrac

80 PERSONAL RESPONS I B I L I TY AS AFFECTED

tion in the overgrown fibrous tissue of the liver producesthe “ hob nail liver of the habitual d runkard .

I n a manner exactly parallel, the redundant fibroussubstance in the d runkard ’s brain shrinks, and it involves and strangles some of the brain ’s blood -vessels .

Thus,nerve cells and nerve centres perish through lackof nutrition— their blood supply being cut o ff . This contraction of the fibrous structure within the brain mayeven tear nerve fibres apart . And in many other waysit imposes mod ifications, and, of course, degradations,on the mental and moral activities .

U sually,these lapses and defects in mental and moralaction are referred to a willful disregard for the principles of good sense and good morals . But the microscopewill dispel that misapprehension . I t will d isclose physical d egeneration in nerve cells, nerve fibres, and nervecentres, sufficient to explain some misconduct as theChild of disease, rather than of criminal will .After a time the damage to the central nervous tissue

(when not excessive) becomes assimilated, or adopted,by the constitution . That is, the human constitutionb ecomes mod ified . I t takes on new and inferior characteristics,and occupies a plane of existence lower thanbelonged to its original nature . The important point is,this bad constitution is liable to be reproduced in posterity . Quite likely the newly - transmitted constitutionwill difler in the forms of its exhibition from its parent

.

I t may take on some of its kind red forms . There maybe, for example,defective intelligence, as imbecility, or

THE HEREDI TAR Y EFFE CTS OF I N TEM PER

AN CE , A S I T EFFECTS RE SPON S I B I L I TY,

L EGAL AND M ORAL .

*

BY REV . W I L L I AM TUCKER , D . D .

The brain is the instrument, not the cause, of mind .

I t cond itions all the manifestations of mind in this stateand in this life . Experimentally we know thought andintelligence,emotion and volition,only in connection withbrain organismi This theory will cover and explain allthe established facts of Physiology,Pathology,Psychology,Ethics and Religion . Whatever I nj uriously. affectsthe material instrument of the mind,mod ifies its action,whether rational, emotional or volitional, as really asthough it aff ected the Spiritual cause o f thou ght . I n

sanity,in all its forms, is, a d isease of the material instrument of mind, and as such can be reached by thesame class of remed ies used in the treatment of othernervous d iseases . This has been established by medicalexperience and history in the treatment o f diseasedmental action . N o t only is healthy mental action dependentupon a healthy cond ition of the brain and a healthyaction of the vital organs, b I

’

I t a healthy action of theorgans are as really and as truly dependent on the states

i«Read before th e M ed ico - L egal S o ciety .

0

THE HEREDI TARY EFFECTS o r I NTEMPERENCEL 83

and cond ition of the mind . This has been establishedby an induction as broad and reliable as that by whichwe established the truth of the other proposition .

There is constant action and/

reaction between the dualforces of man’s nature . A drug ‘ received into th estomach and taken into the circulation, will affect allth e revealed actions of the mind, and a thought received by the intellect affects the action of all the vitalorgans . I n the one case th e manifestation of mentalaction is controlled by" the cond ition of the material instrument of intelligence in the other,the vital organismis a “

ec ted by the action of the mind on the nervoussystem .

A lcohol acts on the brain through the blood, and thusproduces a d iseased condition of the great organ or instrument of thought and intelligence . This injury to thebrain is so great as to become transmissive and hered itary . I t is transmitted from father to son and parent tochild, and thus descend s as an inheritanc e of diseasefrom generation to generation .

A s early as 1781, Erasmus Darwin, in his B otanicalGard en,wrote “

I t is remarkable that all d iseases fromdrinking spirituous or fermented liquors are liable to b ecome hereditary, even to the third generation,graduallyincreasing until the family becomes extinct . ” One hundred years after (1886) Dr. Crothers, of Hartford, in apaper on I nebriety and Heredity,wrote “

I n these casesthere seems to be, in certain families,a regular circle ofdegenerative diseases . Thus, in one generation, great

THE HEREDI TARY EFFECTS OF I NTEMPERENCE.

eccentricity,genius and a high order of emotional developm ent . I n the next generation, inebriates, feebleminded, or idiots . I n the third generation, paupers,criminals, tramps,epileptics,idiots,consumptives,insaneand inebriates . ”

Dr. H . P. Stearns makes this statement I mayfrankly say, that my own opinion 18, that in a large ma

jority of cases'where individuals have daily or habituallyused alcohol as a beverage, in any consid erable quantity,and so as to become frequently inebriated, that there isestablished an abnormal state of the brain, which maybe transmitted to offspring ; and that this takes placethrough the elective action of alcohol aff ecting the vasomotor portion

‘

o f the nervous system,and through it thecapillary portion ofthe circulation and ultimately the cellstructure of the brain that in consequence of this physiological action of alcohol upon the nervous system,whenfrequently and ‘

longused,there results a less sensitive anddelicate condition of these constituent portions of brainsurface,and that they become correspondingly less responsive to both objective and subjective impressions orinfluences . and that, therefore, there will result a less

normal discharge of thought function in its various manifestations,moral and intellectual . ”

There are but few doctrines of physiology better established or more generally received as true, than thedoctrine that

'

affirm s,that the physical, intellectual andmoral results of inebriation, are transmitted to thechildren of the drunkard . The question o f great prac

THE HEREDI TARY EFFECTS OF I NTEM I ’ERENCE .

tical, ethical and legal importance is : To what extentdoes this hereditary taint affect the moral and legal responsibility of the child ren of inebriates sufiering

' fromthe mental and moral weakness thus transmitted . I t isa principle sound in law and ethics that ability is themeasure of obligation and responsibility . N 0 man isunder obligation to do that which he has no abilitytodo . N 0 o ne is responsible for a failure to d o that whichhe could not do, or for d oing that which he could nothelp . This is a well established principle in both moralsand law . I t is evid ent,therefore,that transm itted weakness modifies responsibility to the extent that it impairsability for free mental and moral action . I f the inherited weakness amounts to mental and moral id iocyor insanity,moral and legal responsibility are destroyed .

I f the inherited taint is no more than a d egree of inh erited feebleness of mind and will,then responsibility ismodified but not d estroyed . I n that condition '

persons

so affected have the ability to improve their physical,mental and moral health,and increase their brain powerfor thought and action by the use of proper means and

for the use of such means they are morally responsible .

The function o f ed ucation, physical,mental and ethicalculture

,hygiene, sanitary science,med icine, law and re

ligio n,is to enable us to overcome inherited weakness ofbody and mind, and develop physical,'m ental and moralpower . Even those sufiering from transmitted physicaland mental disease may be benefited by the u se of theseremedial influences and agencies, so as largely to over

I

_J

86 THE HEREDI TARY EFFECTS or I NTEMPERENCE .

come and erad icate the inherited taint o f brain andmind from which they sufi er.

This being so, they are und er moral obligation, to useall the means that modern science and human benevolence places within their reach,to improve their physicalcond ition,and increase their mental and moral power .

I f they fail or refuse to d o this, they are responsible inmorals, for the evil consequences of their failure to usethe appliances to which they had access, and which, ifused,would have benefited them . This, if not whollyd emented or insane, they have the ability to do, andthey are under obligation to use it . While man is no t

under obligation to do that which he has no ability to,he is under obligation to try or make the e ffort to dothat which he has not the ability todo . He has theability to try, but not the ability to succeed . The

ability to su cceed'

com es by repeated trials and failures .

I t is developed by efiort. I t is in this way we acquirethe ability to walk, talk,work,write, sing,play, think,reason and practice morals and religion . All sane menhave the ability to develop this power . They are therefore under obligation to d o it . The limitations causedby hered ity does not remove this obligation,unless theyamount to a total d estruction of rational and moralpower . Man has the power to modify and improve hisorganism,to change his environment, and to increasehis capacity to work in nearly all directions . I t isthrough this power that responsibility takes hold ofthose who suffer from inherited weakness .

THE HEREDI TARY EFFECTS OF I NTEMPERENCE . 87

Man is not only under the law of hered ity, but thelaw of variation and the law of progress . I t is,therefore,possible for the weak to become strong, the feebleto d eveloppower, the d iseased to be restored to health,the ignorant to be ' educated, criminals to be reformedand sinners to be saved . I t is this that makes law and

med icine as remedial sciences possible .

PROH I B I TI ON AND I NEBR I ETY .

BY MARY W EEKS BURNETT, MD .

Member M edico -Legal Society,President Natio nal Temperance Hospital, etc.

I n the many problems which have arisen through theinterm ingling of labor, in law and med icine,satisfactorysolutions have been most read ily secured when the und er

lyingcauses have been made the basis of study . I nV iewof the fact, that there now exi st many and great differences of opinion, in

'

the M edical Jurisprudence of I nebriety,we need to keep prominently before us the causesof,as well as the remed ies for, inebriation .

I nebriety, or drunkenness, is a cond itioni

o f mentalunsoundness or derangement, induced by the use ofintoxicating liquors . The law assumes, that he who,while of sound m 1nd,puts himself voluntarily into a cond ition in which he knows he cannot control his actions,may be consid ered to have contemplated the perpetration of his crime, and Should suffer the legal consequence s of his

” acts . Drunkenness being apparently ad eliberative or voluntary act, o f a presumably soundmind,the law d oes not admit that it is a disease.

I t is a rule in med icine that a mentallyd iseased o r disabled person is incapable of responsible motive or intent,and should not be h eld responsible for aéts committed

90 PROHI B ITI ON AND I NEBR I ETY.

d ecision based upon the 14th amendment,has declaredthat the public health, the public morals and the public safety is endangered by the general use of intoxicating d rinks, and that it is a fact established by statisticsaccessible to every one,that the d isorder,pauperism andcrime prevalent in this country,are in some degree atleast traceable to this evil . ”

And it further states, in an Opinion from which therecan be no appeal, that “

the people of a State have aright,under the 14th amendment to the Constitution, toabsolutely prohibit the manufacture and sale of intoxicating liquors for ‘ other than medical, scientific andmanufacturing purposes . ” Here, then, seems to be outlined a medico - legal remedy for inebreism the suppression of intoxicating liquors as a beverage—in a word,prohibition .

Three prominent objections have been raised against .prohibition as a remedy for inebreismlst. That prohibition is impracticable .

2d . That other measures present a more satisfactorybasis for the Medical Jurisprudence o f I nebriety .

3d . That prohibition is not necessary .

Are these objections sustained by facts !lst . The Supreme Court of the United States

‘ hasd eclared that prohibition is entirely practicable . I n certain places,where high S tate 0

“

cials vie with each otherin violations of the law, it is true that the law may no tbe enforced,but there is abundant evidence that whereever there is harmonious action,among the educated

PROHI B I TI ON AND I NEBR I ETY . 91

forces of any community where prohibitory law hasbeen secured, the law is a success .2d . That other measures present a more satisfactorybasis for the med ical jurisprud ence of inebriety .

Among the m ost popular of the measures now beingtested are moral suasion,high license, local option,jails,penitentiaries,inebriate and insane asylums . What realpromise is there in these 2M oral suasion ' has little effect upon minds and bod ieswrithing in the clutches of the d rink power . Takingthe pledge will not redeem a d runkard,nor will it prevent a man

“

from becoming one .

L icense,high or low,makes intoxicating drink lawful,and the drinking placesare by it made the fashionableand legal breed ing-ground,of disease and vice and crime .

Local option can be voted in as a law one year, and

voted out the next, and in its very instability there isgreat danger . We can name one of many instances .A . R .,a man of talent,with inherited narcotic su scepti

bility, remained for years in a local option county, at agreat pecuniary d isadvantage, for the sake of the safetyit afforded him from his appetite . But the liquor trafficeventually prevailed over this temporary local optionlaw

,and the man is now in prison for life as a result of

crime committed because liquor was not kept awayfrom him .

A sylums for the cure of inebriates, are necessary now .

They serve a needed end in shutting the patients awayfrom liquor . But suppose we could shut the liquor

92\ PROHI B I TI ON AND I NEBRI ETY .

away from the patients . The very large proportion ofthe now victims of inebreism would,under careful nonalcoholic medical superV1s1on, be enabled to take theirplaces with the wage - earners and producers,instead o f,asnow,being helpless dependents upon public and privatecharity .

Our j ails and penitentiaries are full of men,women,boys and girls, committed for the crime of inebriety .

There is'

no assurance from past experience that theywill not, the moment they are free and again und er theinfluence of liquor,commit as grievous, if not greatercrime . More than this . Great numbers of those,of neurotic and

parcotic susceptibilities, of hereditary and

acquired hyper-sensitive organisms, are daily and hourlyswelling the ranks o f this great multitu d e,before whichthe world already stand s appalled .

Temporizing measures give no promise of a true solution of the problem .

3d . May not, then, the prohibition of intoxicatingliquors as a beverage be nece ssary !An authority says that ninety -five per cent . of thosewho leave the Concord (Mass . ) - Reformatory,go out witha firm resolve to do right, and if they backslid e it isbecause of the evil influences and d rink habits to whichthey return . Other institutions of a like nature furnish practically the same statement . Did space permit

,I

co uld cite a large number of cases wh ich have comeunder my immed iate observation, of men and womenleaving our hospitals,asylums or jails with firm hope in

94 PROHI B I TI ON AND I NEBRI ETY .

and crime, cannot be the subj ects of the d isease andcrime of inebriety until they have come under the influence of intoxicating liquors . There may be brain incapacity or mental unsoundness, but the d isease of inebriety cannot be grafted upon these condition s withoutintoxicating liquors . They cannot have the d isease ifthey cannot get the

.

liquor.

I nebreism ,whether manifested in disease or crime, orboth,can be wholly extirpated from the great catalogueof med ico - legal problems . I s there any valid excuse forits continuance

AMER I CAN L I FE A S RELA TED TO I NEBR I ETY*

BY PROF . EDWAR D P. THW I NG,M .D . ,PHD .

I t was my privilege to speak a few word s at the I nternational Congress held in London,July, 1887, und er theauspices of the Society for the S tudy of I nebriety, as tocertain factors which contribute to make the theme ofI nebriety in America especially serious and urgent . I

have been d esired to recall, record and expand t tho se

unwritten utterances . Novelty and originality they maynot possess, yet old truths in a new lightmay be helpfulto us in the interpretation of the pathological and psy

chblogical phenomena of this disease .

A lthough there are abid ing factors, the world over, inAmerica we have elements to study which are peculiarand unique . By America is meant the American Republic, the States and Territories bounded by the seas,thelakes and the gulf . I t will be my aim to Show that thesixty millions of this vast country are placed und er thosephysical,psychic, political and social conditions whichcombine to make life more vivid ly intense and exacting

than anywhere else on this planet, and are thereforemore susceptible to the malady of I nebreism .

This region has been called “ the intemperate belt,becau se, as my lamented friend, the late Dr . George M .

B eard, of New Y ork,has said I nebriety, as distinRead b efo re the M ed ico -Legal So ciety o f N ew Y o rk .

96 AMERI CAN LI FE As RELATED To I NEBRIETY .

guished from the vice or habit of d runkenness, may besaid to have been born in America has developed soonerand far more rapid ly than elsewhere ; like other nervemalad ies,is especially frequent here . I t is for this reason,mainly, that asylums for inebriates were first organizedhere . Here also the Total Abstinence S ocieties ofmodern days began“

. Why ! Because of the abnormalnerve sensibility which the feverish rush o f life here hasd eveloped,a physiologicalcondition that will not tolerate stimulants .Dr. Beard says that it I S a greater sight than N iagara

Which is presented to the European coming to this land,to behold an immense body of intelligent citizens,voluntarily and habitually abstaining from alcoholic beverages . There is perhaps no single fact in sociology mbreinstructive and far reaching than this and this is but afraction of the general and sweeping fact that the ‘

heightened sensitiveness of the Americans forces themto abstain entirely, or to use in incred ible and amusingmoderation,not only the stronger alcoholic liquors,butthe milder wines,ales and beers,and even tea and cofiee .

Half my nervous patients give up coff ee before I seethem,and very many abandon tea . Less than a centuryago,a man who could not carry many bottles of winewas thought effem inate . Fifty years ago opium produced sleep,now the same dose keeps us awake, likecoffee and tea . Susceptibility to this drug is revolutionized .

”

Dr. Beard makes the ability to bear stimulants a meas

98 AMER I CAN LI FE As RELATED To I NEBR I ETY .

Nowhere, for instance, are such extremes in thermal

changes . I have seen, in New England,a range of 125°

from 25° below to 100° above, in the shade . The year’srecord at M innesota has read from 39° below toabove, a range of 138 8 . Even within twenty four hours,and in balmy regions like Florida, the glass has Showna leap from torrid heat to frosty chill .No wonder,then, that the greatest fear of some is the

atmosphere . They dread to go out to face Arctic rigoro r tropic fire,and so get in the way of staying in d oorseven in exquisite weather of June and October . Theymake rooms small,put on double windows,with list onthe d oors,and build a roaring furnace fire in the cellar,add ing another of bright anthracite in the grate . The

d ifference between this hot,dry,baked air within, andthe wintry air without, is sometimes I t is estimated that the di " erence of temperature inside and outside an English home averages 208 ,and that within andwithout an American dwelling is 608 . The relation ofthis to the nervousness of the people is apparent .The uniform brightness of American Skies favors evaporation . The Y ankee is not plump and ruddy, like hismoist,solid British brother,but lean,angular,wiry,witha dry,electrical skin . He lights the gas with his fingersand fortells with certainty the coming storm by his neuralgic bones . Hourly observations were conducted forfive years with Capt . Catlin,U . S . A ., a su

~erer fromtraumatic neuralgia, in care of Dr. Mitchell . The relation of these prognostic pains to barometric depression

AMERI CAN L IFE As RELATED To I NEBRI ETY . 99

and the earth ’s magnetism,was certified beyond d oubt,and was reported to the National Acad emy of Science,April, 1879 . Even animals in the Sacramento Valleyand on the Pacific coast are unwonted ly irritable whilethe north d esert winds are blowing and electricity,seeking equilibrium,going to and from the earth . Fruits,foliage and grass, toward s the wind, Shrivel . Jets oflightning appear on the rocks and sometimes on one ’swalking stick . (American N ervousness,p .

But psychic and social factors cannot be ignored .

Some one has said that insanity is the price we pay forcivilization . Barbarians are not nervous . They may say,with the Duchess of Marlborough, that they were bornbefore nerves were invented . They take no thought ofthe morrow . Market returns and stock quqtations areunknown telephones and telegraphs,daily newspapers,with all their crowded columns of horror and crimes,arenot thrust upon them ; and the shriek of the steamengine does not disturb their m id -day or their midnightS leep. Once a day they may look at the su n,but theynever carry watches . This bad habit of carrying watchesis rebuked by a distinguished alienist,who says that alook at one ’s watch,when an appointment is near, sensibly accelerates the heart ’s action and is correlated toa definite loss of nervous energy . Every advance ofrefinement brings conflict and conquest that are to bepaid for in blood and nerve and life .

N ow it is true that watches are occasionally seenin England . Sun -dials are not in common use in Ger

100‘

AMER I CAN LI FE As RELATED To I NEBR I ETY .

many and Switzerland . But the American Watch” isan institution . Not the Elgin, the Waterbury or anyparticular watch, but the watchf ulness, the worry andhaste and incessant strain to accomplish much in a littletime— all this, symbolized in the pocket time-piece, ispeculiarly American . I t was an American who, atBu

” alo,wanted to wire on to Washington . When toldit would take ten minutes,he turned away,and said I

can ’t wait . ” He now uses the Edison telephone and

talks mouth to mouth with his friend . Dr. Talmagesays : We are born in a hurry,live in a hurry,die in ahurry and are driven to Greenwood on a trot !” The

little child, instead of quietly saying to its playmate,Come,” nervously shouts Hurry up 1” Y o u cannotapproach the door of a street car,or railway carriage,but what 6you hear the same fidgetty cry Steplively !”

Said a New Y orker to me I am growing old fiveyears every year . ” Can such physical bankrupts,whosebrains are on the brink of collapse,bear the added excitem ent of drink ! The gifted Bayard Taylor was butone of thousands who burned a noble brain to ashes in atoo eager race of life . Reviewing sixteen months,henotes the erection of a dwelling house,with all its mul

titudinous cares, the issuing of two volumes of his writings,the preparation of forty-eight articles for periodicals,the d elivery of 250 lectures . one every other day, and

miles travel . The same story might be told of otherbrain -workers who never accepted the gospel o f rest . ”

102 AMER I CAN L I FE As RELATED To I NEBRI ETY .

in America . I t is stated that insanity has increased inI taly since there has been civil and religious liberty guaranteed . A post ho c is not always a propter ho c . But itis obvious that the sense of responsibility which citizenship brings the ambitions awakened by the prospect ofoffice, position, power and influence ; the friction andd isquiet,bickerings and wranglings,disappointment andchagrin that attend the struggles and agitations ofpolitical life,do exhaust men,and more in a land whereopportunities for advancement are abundant as inAmerica While writing these word s,news are receivedof the sudd en d eath of a promm ent N ew Y ork politician,comparatively young, d irectly traceable to disappointment in carrying out a scheme onwhich his heart wasset . Chagrin acted like a virulent poison on a systemalready unstrung by the severe political struggle inwhich he was d efeated .

M ultitudes contract the vice of drunkenness or d evelopthe full malady of inebriism under the continued pressure o f these political campaigns . The patient of afriend of mine had for two years been kept in workingorder . He was living, however, on a small reserveof nerve force . A few days before election he wasd rawn into a five -minutes eager discussion and becameentirely prostrated,more exhausted than by months ofsteady work .

Other nations have their measure of liberty and aspirations for social and political eminence to gratify . But

nowhere have men the exhilarating possibilities of posi

AMERI CAN LI FE As RELATED To I NEBR I ETY . 103

tion, wealth and influence that this republican community offers . The history of the last half century, asrelated to this fact,read s like a romance . But liberty,like beauty, is a perilous possession, and it has beentruly said “

The experiment attempted on this continent of making every man,every child,every woman anexpert in politics and theology is one of the costliest ofexperiments with living human beings, and has beendrawing on our surplus energies for one hundred years . ”Finally, American life is cosmopolitan . A curiousobserver noted nine nationalities in a single street car inN ew Y ork, one day . I repeated the fact to a few of mystudents who were rid ing with me through those samestreets . Looking over the ten or dozen passengers onboard,one of them at once replied Well,here arefivenationalities represented here .

”

I n one aspect,these importations,particularly EnglishGerman and S candinavian,are compensative and antidotal . We m ay hope,with the author before quoted,that “ the typical American of the highest type will, inthe near future,be a union of the coarse and fine organizations ; the solidity of the German, the fire of theSaxon, the delicacy of the American,flowing togetheras one ; sensitive, impressible, readily affected throughall the avenues of influence,but trained and held by a

owill of steel ; original, idiosyncratic with more wirinessthan excess of strength, and achieving his purpose notso much through the amount of his force as in the wisdom and economy of its use .

104 AMER I CAN LI FE As RELATED To I NEBR I ETY .

This hope may be realized in the future and in thehighest type of American manhood . I t is a bright,optimistic view of things,but we have to d o with thepresent,and the evils of society as they exist . We haveto face the fact that our civic life is growing at theexpense of the rural that our cities are massing peopleby hund red s of thousand s,among whom,on the ground sof contiguity, association and psychic sympathy, evilinfluences become more potent to und ermine the welfareof society ; that we have to encounter in America thed rink traffic in its belligerent aspects, as nowhere else,not only politically and financially organized most thoroughly,but ready, it would seem , to use fraud,violenceor assassination if other means fail ; and that we haveanarchism stirring up discontent and firing the passionsof the desperate classes,who und erstand liberty to meanlicense,equality to be the abolition of all the diversitiesof position and property wh ich intelligence, temperance and industry have mad e,and will make to the endof time .

We have had a practically unrestricted importation ofthe refuse population of Europe . Of every 250 immigrants, one is insane, while but one of 662 natives isinsane . Add to all these facts the cond itions of American life already enumerated as related to the development of neuroses, particularly inebriety, and we have .the material which makes the study,as was stated at thestart, serious and urgent,alike in its medical and forensic bearings .

At the Med ico -Legal Society,November 10, 1887 .

Mr. AUSTI N ABBOTT —W e have had presented to -nighta d iscussion to which I have listened with great interest,and with no small profit . Very clearly has it put thecontrast between the medical and legal aspect of thequestion . Jurisprudence differs from med icine in this,that it is for judges to say what is ; not in a scientificbut in a jud icial and sociological sense ; while medicalmen are privileged to say what ought to be . This makesa discussion on med ical jurisprudence one of great interest,because here the door is opened to consider howjurisprud ence ought to be mod ified in the light of scientific insight and understand ing . Now,why is it that, ofall d epartments of the law, that of med ical jurisprud ence, where there are no pecuniary interests againsthumane change in the law, no vested rights arrayedagainst an improvement,and the d oor is open to seientific suggestion more freely than in any other d epartment,and the d iscussion of amelioration in the law is sofrequently carried on in the courts by expert witnesses ofexperience,insight and ability in dealing with this greatsubj ect,and the courts are ready to listen,why is it thatunder these circumstances the rules of law stand soinflexible and are so slowly and almost imperceptibly

DI SCUSS I ON . 107

changed,generation after generation . There are morechanges going on in any department of the law than inthe questions of med ical jurisprudence,in its mental aspeet of insanity and inebriety . I wish to draw attentionto this point particularly,because it appears to me thatthe services which med ical men can,and I trust will,accomplish on this subject would be greatly acceleratedShould they d irect their attack against the other end ofthe line . Let us suppose that my good friend,DoctorCrothers,was appointed chief of police in this city,withfull powers of administration : I venture to say that,notwithstand ing his very just views of the med icalaspect of the question . he would find, were he mad eresponsible to preserve peace,good order and the securityof property throughout the city,he would not wish his0 I cers instructed that when they found that a manarrested for crime was an inebriate they should let himgo . He could not undertake to keep the peace in thiscity on that basis . And he could not carry out hisviews,because in the present state of penal laws thereis nothing else to do with the inebriate Offender buteither to let him go or send him to prison . I f you gointo the police courts Sunday morning and ask to havedischarged every man who has been arrested for d runkenness,

—to let him go on the principle that inebriety is adisease,and ask to have that v iew carried into generale ”ect,— the result of it would be that the occasional conv1vial Offenders, the men who are guilty Of crimes committed under exceptional passion, under exceptional

108 DI SCUSS I ON .

temptation, und er exceptional stimulus,would be sentto jail,and the men wh o are wholly giv en over to it,and are going to do it again and again,would be setfree .

Society is und er an absolute necessity of protectingitself, and its courts and officers must d o it by suchmeans as legislation allows . I freely concede that tosend a man to prison is not the best means to d eal withhis inebriety . But that is about all that present legislation allows now . His family can have him placed und errestraint, perhaps, for social reasons, but the criminallaw does not take cognizance Of inebriety for that purpose,nor d eal with it in that way,nor does such restraintas now imposed adequately protect society .

The question I wish to put is : Whether the way to advance the reform now und er discussion is,instead of contesting the question in the courts, on the trial Of criminal inebriates,with the result of mere acquittal, ratherto formulate such legislation as Shall provide propersegregation and restraint,und er medical supervision, forhabitual inebriates . I f that can be d one,the courts willyield to the advancing light of science, as fast as theprotection of society is seen to be secured .

But in my Opinion you must open the door at thatend before you can close it at this .H . S . DRAYTON,M . D .

—This is certainly an unexpectedcall. I came here to act merely in the capacity of alistener,and now you turn the tables upon me in thisstartlingfashion,not only callingme to my feet to fol

110 DI SCUSS I ON .

typical disturber of mental balance,but all habits basedupon appetite and carried to excess are to be condemned .

Anything, Sir, that disturbs that highest part of themind,moral sentiment,affects a man at the centre of hisbeing, for moral balance is absolutely essential to thed ischarge of the proper duties of manhood . I think, sir,that the courts do not sufficiently consider the influenceof alcohol in this respect I think, further, that medicalgentlemen,as a class,do not su

”

iciently insist upon thisspecial, lead ing effect of alcoholism, although observersof inebriet y, like my friend Dr. Crothers, and someothers,are appreciative of this e

”ect,and are well warranted in the earnest Siand which they take . Dr. Richardson,of England,not long S ince mentioned that winewas indeed a mocker,because o f its immediate e

" ”

-3ct

upon the higher faculties of the mind,disturbing andclouding their action,and therefore clouding the intellect, so that a man under the influence Of wine is lacking in judgment and sound discretion, without beingconscious of his lapse .

Dr. I SAAC L . PEET.

—I have h ardly formulated anyspecial principles in regard to this matter . I have observedmen falling unexpectedly, without desiring it,withoutintending it,under social conditions, into S ituations inwhich they seemed to have lost all the ordinary powersof mental action in which they seemed to be in a sortof dream in which they acted contrary to all the principles of their natures . I f,under these circumstances,in this condition o f absolute alienation from their true

DI SCUSS I ON . 111

nature,they Should commit a crime,and then when ac

cu sed of it the next day Should deny it, because if theyhad d one it they had no recollection of it,they had nokn owledge of it, that would be a condition which, in myOpinion, removed all the elements of responsibility,andin which the man,if treated by ord inary legal principles,was the most unfortunate human being you could possibly imagine,and yet I believe that there are cases of exactly that d escription .

Dr. CHAS . H . SHEPARD—Mr. President I have enjoyedlistening to these papers exceedingly,and have receiveda great d eal of instruction from them, and there isbut little to add . I t seems to me that man in his d esireto get th e b est of everything, inasmuch as he seeks toget the best kind of food,necessarily seeks to get thebest kind of drink,and it may be one step in his progressin life that eventually he will succeed in getting thatdrink which Shall be best for his welfare in every way .

Th e d rink problem,or the cure for its excess,has longengaged the attention of thoughtful minds, and yet it isunsolved . The moralist off ers us,as his latest and bestnaught but prohibition . But so long as there is a demand for alcoholic drink there will be an ample supply,nor is it to be supposed that we can make people temperate by legal statute . The physician takes a broaderview and would deal with its excess as a disease,wellknowing that in many cases the fault lies more with theparent than the child .

But what is the origin of so much excess in drink !

112 DI SCUSS I ON.

First,even before th e cause justm entioned,is the one mostevident to all close observers,namely, excessive alim en

tation . I t is not too much to say that this causes moreloss to society than excess in drink,and this is apparent tothe med ical man in a thousand ways—he sees it in everystage of life, from the infant to old age ; in fact, thelargest part of his practice comes from those who aresimply suffering from excess in eating,and this,partienlarly with those not well informed,very readily leadsup to excess in drink . Even physician s have not beenwholly guiltless in the administration of alcoholic stimu

lants . I t frequently happens that those subj ect to overwork and severe mental strain, seek to recoup themselves by the use of alcoholic stimulants ; but the delusion is sure to manifest itself at no distant day . I t ismost evident that those who disobey the laws of healthand longevity necessarily in so far cut short their ownlives,and also the duration of their posterity,while onthe contrary those who seek to obey those laws Shallthereby possess the land .

The remedy for the drink excess must be found in ahigher and better,yes,a broader,education . The wrecksnow on hand need medical and hospital treatment,conjoined with the best resources of modern science,and they should be taken and kept from society till cured,and thus fitted for the duties of life . The infant must befed more in accordance with the dictates of hygiene,andless with soothing syrups ; the youth must be given onlyplain,wholesome food,and taught to seek the tonic o f

114 DI SCUS S ION .

cal change noticed in.

the drinker, one'

has an Oppor

tunity of verifying the views here expressed by visitingthe d ifferent institutions of correction in

’

this city . He

will, in add ition,find out that a large number are sentto asylums,and that they are discharged from asylumsrecovered,and in a short time are again sent to the ihstitu tion of correction . I t would surprise some of youto know the frequency of this occurrence, yet , th e

asylum authorities cannot hold them when they havereached the degree of rationalitv at which they discharge them recovered, nor the authorities of the institution of correction, when their time has expired,which was determined by a J udge .

There is a grand field for theory, but the questionfor med ico - legal men is,whether drinking,carried to th eextent of inebriety, is or is no t insanity ! I think theday is not far distant when the law will extend a proteeting arm to this class of poor unfortunates,and instead of being chided for their morbid ity they will b econsoled for their infirmity .

DR . JACORI .

—I come here invited as the representativeof the Acad emy of M ed icine, which we med ical menconsider to be the representative of the . med ical pro fession of the city of N ew Y ork . I n that capacity I camewillingly because I knew that it was customary at yourbanquets that law and med icine,wolf and lamb,wouldalways be together, harmoniously, as perhaps at n oother occasion . At the same time I knew that it wasdu e to this society,which 'is of such an old standing and

DI SCUSS I ON . 115

has d eserved so well of the community and of the twoprofessions . I wasanxious to come here and hear whatwould be Spoken, and perhaps contribute my share inprivate conversation . As, however, you have calledupon me,M r. President, let me say,publicly,h ow I lock

upon the co - Operation of the two professions in a societylike this .Forensic medicine has grown with civilization and the

constitution and establishment of commonwealths . I

need not say that in old en times there was as little for eensic medicine as there was law . The Oldest nations Iknow of who had anything like forensic med icine werethe Hebrews and the Romans . I have always been o f

the opinion that that was so because they,more thanany others, had

'State establishments fixed , well con

stituted,and endowed with certain solid forms . Otherswere n o t so organized or in about the same cond ition as,

for instance,the American municipalities before the constitution was made .

I t looks to me as though we could not have m uchforensic med icine unless we have a S tate Constitutionand a good d eal of centralization . I can imagine

.

we d o

not require much forensic med icine when we have twoor three millions of people on one million square milesSpread Over an immense territory and d istributed in alarge number of small municipalities . Bu t when wehave one hundred millions on the same territory, thecase is different . Then there is more friction and crimeon one S ide, more social need s and more scientific

116 D I SCUSS I ON .

thought On the other . We have more population,moresolid constitution,and with the formal establishment ofsociety we have and require more forensic law .

On the othe r hand,we could no t have forensic med ic ine as long as there was not much n -ed icine,and no

great observations and scientific principles in med icine,but as soon as there is a d evelopment of physiologicalanatomy and biochemistry,it is possible to have theprinciples and science Of forensic med icine . Thus, i tappears to me,that in the same d egree that law is established in a community and exact med icine is born, thereis a scientific,forensic med icine .

I do not mean to say that we are at the end o f the dev elopm ent ; if that were SO, we would no t d isagreeabout important points . I say, for instance,that Itotally d isagree with th e learned judge who gave uswhat looked to me like a very impressive charge to .

ajury. A s a med ical man, I believe hewas to tally'

m is

taken in his law points . Fo r instance,he compared theextension of malarious diseases on the one S id e,and thatof murd ers and inebriety on other from the same pointof v1ew. Th e learned judge says : “

Y ou doctors mustextinguish th e cause of malaria ; you must extinguishthe germs ; you must do away with the dirt, etc . Y ou

m ust extinguish it radically ; if you leave the meresttrifle,preventatives are good for nothing .

Now,you doctors have,to -night,declared a diseasetherefore you must do away with the cause .

”

B ut,Mr. President, if you want to draw a parallel,

118 D I SCUS S I ON .

eye, you take his ; if he takes your life, other peoplewill take his . Take Lynch law—there is this kind Of

punishment,there is revenge on the spur Of the moment .What the judge wants is the protection of the comm u

nity,and in regard to this point the practice of our ownlaw is very much more sensible than our theory . Whenwe speak of punishment we carry in our m 1nd s the ideao f revenge,but the fact that we carry our cases beforea jury of human b elngs, that we look for mitigatingc ircumstances or for an explanation of

‘

th e unsocial,abnormal, criminal ” act,proves that our practice isnobler than th e id ea of punishment . ”

There is only one way in which to define punishmentin a civilized community that is,protection of society .

A man wh o knows he has committed murder is himselfm urdered or put into a State ’s prison . A

. man who didthe same thing but did no t know of it because of acloud ed mind, is, however, just as dangerous to thecommunity . That is true . Thus he must be made uhinjurious by putting him where society cannot betroubled or endangered by him again .

He is lodged in an insane asylum . But then it mayhappen that after twelve ‘months a cheap doctor and anexpensive lawyer combined get him ou t. He is d eclaredcured,and he does the same thing over again . Such ac ase came under my observation .

S ome twenty-five years ago a man' killed ‘ two women,

wh om he married one after the other. The second hem arried after he had been declared well and sound

. The

DI SCUSS I ON . 119

d octors cured ” him,and a year afterward they had tocure ” him over again in both cases a “ legal mind

and an “ intelligent jury pronounced th‘

e e icacv o f'his

cure . These are the.

cases in which both med icine andlaw, as represented I n this Society of yours,have animportant work yet to perform .

Excuse me now,M r. President . Unfortunately,I wasn ot present at the read ing of the papers Of the evening,and therefore ought not to try to participate in the d iscuSsion . I heard you say,M r. President,that after thed inner there might be some seriousness,and I admit itm ight have been quite a serious matter to listent o 'me .

DR . wm. ,F . m i ssu s —A d octor of London has saidthat where there is such a large consumption of any onearticle, as

‘ of opI um , for example, that it shows theL ord made it for the benefit of the world . I can alsobelieve that alcohol is made for the necessity of mank ind . I ts abuse is

'

what d oes the injury . Doctors, I amo bliged to confess,have a good deal to do with the creat ion of appetites for liquors,by prescribing tinctures andmed icines containing alcohol . Drunkard s c annot haveh ealthy children . Therefore, I believe that many disease scannot be eradicated until you stop the use of alcohol inspirituous form s . I n Germ anv and France . wh ere lightwines and beer are used , there are no t many cases ofe xcessive drunkenness . I t is wise to limit the use ofalcohol to ligh t wines and beers . I believe that wou ld

prevent much intemperance and lessen the diseases

120 DI SCUS S I ON .

which come from alcohol and their inheritance by theofi spring of drunkards .DR . LUCY M . HALL .

—With regard to the questionwh ich Mr. Bell has brought forward in‘ connection withwomen ’s work in the care of inebriate women in our

prisons : I do not consid er inebriate women criminalwomen . Five years of work among these women hastaught me to believe most thoroughly that there is nogreater mistake—nothing more cruel or inhuman, nothing more unjust than allowing them or forcing them tobe so characterized .

Wherever crime may be added to the fact of inebriety,then there is room for consid eration,but where inebrietyis the only Ofiense where,as I have seen,women aresnatched from their families simplvb ecau se they havetaken a glass of beer too much, it d oes not ju stify theirbeing arraigned and brought before the tribunal and sentenced and sent 0

M to prison as criminals .Considering what Dr. Jacobi said this eveningof the protection of society against the inebriate ,I think we should consider the protection of theinebriate ; and we cannot protect the inebriate fromhimself without at the sam e time protecting societyfrom him . There is a better way of doing this than theold prejudiced way which is rapidly yield ing before thecombined force o f persons who are thinking this matterout . I

‘

h ope and pray and believe that better days arecoming with regard to the manner in which inebriatesare to be treated . I believe that no possible legislation

122 DI SCUSS I ON .

DR . WATERMAN .

—The use of alco hol'in drink seems

to me to be spread all over the world and through everynation, and I have no d oubt that in the maj ority o f

cases,perhaps without an exception,there is a secretiono f alcoholic element which is necessary for the propersustenance of the human system,and in looking for thecause of inebriety we may find that the secretion of thisdynamic alcohol has ‘

sufiered a suppression from somecause or other and produces a want in the system thatinduces the ind ividual irresistibly to find some artificialsub stitute .

I t is not in my power to verifywhat I say to -night,"

but if it is permissible I shall write out my ideas andhand them to the Presid ent of this organization . This isa subject that interests not only medical men,but everym an in soc iety .

Dr. FRANK H . I NGRAM (Assistant M edical Superintende nt of the New Y ork City LunaticA sylum) . —I t is whenthe man has no longer the power to resist the desire forintoxicating drinks that he becomes a true inebriate ;that vice leaves OH and disease

,begins . After attaining

this state,he is no t a responsible being, and he doesm any acts which are inconsistent with a sound mental‘

condition . The craving fo r drink is so powerful that allthe higher attributes are held in abeyance ; the victimwill resort to any means to satisfy his appetite .

A lthough the inebriate may try for a time to overcome his morbid tendency,he cannot do so for a longperiod . I f his friends take measures to have a guardian

DI SCUS S I ON . 123

appointed,

'

and by depriving him of his income removethe means of obtaining that which has been the sourceof his trouble,he may submit for a time,but he broods-over his misfortuneuntilhe passes into a state of gene ral mental d epression . The melancholy soon vanishes,and is follOvVed by a cond ition of irritability—one inwhich the good and the bad struggle for supremacyand at this time the desire for d rink is most pronounced ;

and the inebriate will pawn his clothes, f

or even steal, ino rder to get money for

,

d rink .

I n regard to the best means of curing this evil, theO pinions expressed in all of the papers,and “particularlyin the last one presented,seem to point to one greatremedy, ed ucation: We must appeal to the

‘

selfish nature of man, and teach him to avoid an evil because Ofthe injury which it may do to him as an individualEx JUDGE NOAH DA V I S .

— I have been requested by thePresid ent to Speak a fewwords I n conclusion,on the subj ect you have had under consideration for the last twomeetings

“I regret to say that I have had no time to

m ake any preparation,and what I do a must be saI d on!

the spur Of the occasion . Nearly all of themed ical paperswhich have been read lead our minds to the same conclus ion, to wit that inebriety is in its nature,consequencesand effects, a disease,and ought to be treated

‘

as such .

A ssuming that position to be true,as I am in duty boundb ecause when doctors d o no t d isagree laymen are toaccept their conclusions, then,as a m atter of course, alldoctors should unite I n their treatment of inebriety as a

124 DI SCUS S I ON .

d isease, and, as in modern days all good d octors do,should seek to exterminate the disease by d estroying itscause .

I n malaria the first inquiry of a good d octor is,whatis the cause What local conditions have you whichproper sanitation will discover and remove ! Wheneverthere I s danger of invasion of yellow fever or of cholerafrom abroad , the first step is to find and stamp out thegerms . When that is d one, the d octors are able to proclaim to the public that safety against the disease exists .All the doctors, therefore,who have concurred in theview that inebriety is a d isease should first devote theirattention to th e grave question,What will remove or destroy the cause that produces this d iseaseWill it d o in any community, instead Of removing the’

cause, to Spread it in every direction I s it proper to fillup a gre it city like ours “ I th more than ten thousandgrog shops, each dealing o u t on every hand th e cause o f

a'

d isease which doctors declare to be of the most seriousand d es tructive character !

'

Why, I suppose that it isem inently proper under such circumstances that ovaryd octor should do with inebriacy precisely what he woulddo with ca-zes of malarial fever or virulent diseases of anykind among his patients,and especially if they were of akind easily spread by

'

topical and controllable causes .Then it follows, in my judgment .

that thefi rst duty o f

th e doctors is to enlighten the community against thedangers of this disease and its work and effects ; and,secondly,upon the best possible mode of getting rid o f

126 DI SCUSSI ON .

‘idea . But I think the views of some of those papers arenot sound when

"

applied for the protection of society . Y ou

will recollect that in the forming of criminal laws and intheir application and execution the great motive mustnecessarily be the protection of society . The massesof mankind who make up communities are not inebriates . The vast majority are persons who do not ihdulge in intoxicating liquors . They are to be protected intheir business,their homes,in Short,in all their lives,bythe application of certain legal rules which of course areto be firmly established and properly applied . Now,in theadministration of laws of that character,it becomes, as a.

matter of course,a necessity to apply and enforce them .

as against all classes of criminals, and the criminal ine ~

briate cannot therefore be excused . He who 15 d runkand violates the law cannot be exempted because he

l

is .

d runk . I n point Of fact,the principle of the rule of lawwhich originally held the d runkard to be a voluntarymadman, required him to be punished for thus makinghimself mad,and therefore to be held responsible for his .

acts in violation of law,although performed by himwhen drunk .

‘

Now, in the application of that principle to cases of“

guilty inebriacy, there was never any d eparture fromthe true philosophy of th e law . Whether d runkennessbe or be no t a d isease ,was not the point to be determined,but the point was then,as now,whether drunkenness, if it be a d isease, is or is

'

not to be treated likeother d iseases,

'

in the commission of crim e . N O d isease

D I SCUS S I ON . 127

excuses any man for the commission of crime . A manin the last stages of consumption is to be hanged for a.

murder as S I I rely as though he were in perfect health,and no d isease by reason of its own existence can,und erany circumstances, excuse any man for the commissiono f crime hence,to establish that inebriety is a

l

disease,

is only to put it on the exact footing on which all otherdiseases stand in respect of violations Of law and theirpunishment .I think this is a plain solution of any question thatarises as to the duty Of society, or its right to enforcelaws against people wh o are inebriates,and,being Such,commit crimes . There cou ld be no safety in any otherrule, for the simple reason that if the fact o f being drunkwas an excuse for committing a crime,every man would .

get drunk who contemplated committing a crime .

Th e state of things would be intolerable,as every onecan readily \ see,

“

if we alloweds uch a rule to prevail inthe administration of the laws . With such a rule wecould not protect society from the evil consequences of ’

crime . I f such a rule were to prevail, it would extend toany other of the intoxicants or stimulants which put.men into cond itions in which they are more ready tocommit crimes than when free from such cond itions .There can be no manner of d oubt that the vast majority of crimes against our laws, and especially thosewaich involve personal violence, find their cause indrunkenness . I t is one eff ect of intoxicating liquor to SO»

excite the nervous systems of men as to lead them more

128 D I SCUSS I ON .

0

readily to the commission of crimes and crimes arecommitted—especially those that involve violence to theperson— almost always in or near the grog shop wherethe criminal has first excited himself by d rink .

At a late Oyer and Terminer, I tried three young menfor homicide, each one committed in one o f the grogshops of the city,early on Sunday morning,kept open inviolation of the law. I n each case no Offence wouldhave been committed except from the effects of intoxicating drink but to have excused the d runken criminalin those cases would have been an example of evil asbad as his crime . I n point of fact,there is no d oubt thatmany persons first subd ue their own consciences by preparing to commit crime through d rink .

Y ou recollect, doubtless, that celebrated murderer,Burke,who, in Edinburgh,many years ago, committedhis murders in a manner which subsequently took his ownname . He himself, in his confessions while inprison,stated an instance . He said he had never in his life

,in

all the crimes he committed—and his murd ers were verynumerous— had had any compunctions of conscience

,

but once,and on that occasion he held in his arms aninfant t Ch he was about to smother,and the little babelooked up and smiled in his face .

“But,

” said he, I

took a good glass of brandy and then I had no furthertrouble .

”

This, in point of. fact,is an innstration of the effect o i'

intoxicating liquor on many persons . N ow, the lawtreats inebriety precisely as it does any other disease,and

1 30 DI SCUSS I ON .

therefore,’ does not make any difference,in treating ine

briety as a disease,between the efi ects of that d isease inreducing the human mind to the condition which isd enominated insanity, and the effect of other diseases .I t pauses not to inquire what is the cause after the cond ition is satisfactorily Shown to exist .I have myself tried cases where a conviction wasdenied by the law because d runkenness had produced anabsolute cond ition of insanity . N ow, whether we calld runkenness a d isease,or not,makes no d ifference in theOperation of th e law . A voluntary d emon who has produced a cond ition himself,by his own act, which is notthe d isease known as insanity, is not excused and justso it would be if that cond ition had been produced byany other kind Of d isease .

I have only to add, in conclusion, that in administeringthe law on this subject, it I S an absolute necessitythat the rule shall be that a d runken intent is just asguilty as a sober intent . I n every case,therefore,wherethe inquiry upon the trial is,was the aCt done with theintent to d o it ! the party accused having knowledge ofwhat he was doing and of the consequences of what hewas d oing, the rule is precisely the same,whether hewas d runk or sober, for the law has settled that ad runken intent is just as guilty as a Sober one ; and inseeking to determine whether or not the intent exists,ittakes into 'consideration this inebriety, if that be the supposed superinducing cause, just as it takes into consideration another disease, or any other cause that may have

D I SCUSS I ON . 131

affected the intellect of the m an so that he could notform the necessary intent . I f the law did make a difference in favor of intoxication,then it would favor the terrible evil that produces intoxication and thus it wouldinvite men to get d runk before committing crime,instead of treating d runkenness as an aggravation where

,

it d oes not reach the result Of producing actual insanity .

N ow, in insanity, the question submitted to the juryalways is . was th e man ’s mind in such a condition whenh e fired the pistol, or struck the blow which d estroyedthe life of his fellow man, that h e knew what he wasd oing,and the consequences that might and probablywould follow theact he was doing,and intend ed to produce them In such caSe,if the jury find adversely tothe prisoner, the alleged I nsanity ceases to be of anyimportance, because there is not existing that state ofinsanity which causes the act not to be criminal ; andth at question is submitted to the jury . I have no recollection, in all my experience, of having a jury fail tounderstand the real point and pass upon it,and whereinsanity actually exists it seldom fails that the jury discovers it,and givesthe alleged criminal its full benefit .I n considering this subject, doctors are very apt to fallinto the idea that inebriety should, of itself, act as anexcuse for crime . TO prevent its punishment it shouldnot so act in any case . I t may,perhaps,operate justlyin some cases,as a modification of the guilt in the mindof an intelligent judge, to grade the crime, or to affectthe sentence ; but in all other respects inebriety must

132 D I SCUS S I ON .

stand upon the footing of all other d iseases, and whenit is attempted to excuse crime because of its existenc e,it must be treated as any other d isease .

I am sorry I have not had time to pu t my thoughtson paper . I have been exceed ingly interested in th e d isleussions here, and I regret that I have not been accustom ed to attend them before . All th e papers containid eas worthy of consid eration and preservation . I was

greatly interested by the paper read by th e lady who sitsbehind me,and wh o seems to have taken a good, comm en - sense grasp of the subject,and forgotten all to chnicalitI es in endeavoring to present it so that plain mindslike mine could comprehend it .

CLARK B ELL,ESQ—I n introducing this t opic for . cousideration and d iscussion in the M ed ico -Legal Society atthis time, I have d esired to arrest th e attention of twoclasses of thinkers, to what must be conced ed by all, tobe one of the most important social problems of the time .

-

1. The med ical men, to establish alch olism as a trued isease,within well d efined limitations, that could b eeasily recognizable by the lay or legal mind and

2 . To S tatesmen, legislators and jur ists, to inquirewhether legislation was necessary, or able to remedyexisting evils, in the social cond ition of the inebriate, o rhis relation to the state, or society .

I d o not feel that I have quite the right to enter intothe d iscussion,which has been so able, so broad, andwhich touches all the bord ers Of th e subject, from suchvaried and widely divergent standpoints .

THE I NFL UEN CE OF ~ME THOMAN I A UPON

B US I NE S S AND CR I M INAL RESPON S I

BY STEPHEN ROGER S, M .D . , OF NEW Y ORK .

*

From the earliest human record s down to our ownday, effects of alcohol upon the body and upon the mindof man have constituted an im portant item in his history . Physiologists, pathologists, physicians, lawyers,judges and d ivines have each and all taken prominentparts in the d iscussion and in the management of thisgreat subj ect . I t is a most intim idatlng CI rcum stance to

any change of the views hitherto entertained by thecourts of the enlightened nations, that this society maychance to advocate,that they have with solid uniformity,been careful about admitting alcoholic mental affections as

“causes for legal interference with the liberty ofthe individual,or with his responsibility for crime . No

hope may be entertained o f efi ecting a reconsiderationof these time -honored rulings,unless it can be shown ina most convincing manner that there exists suchadisease,both of body and of intellect, as may be termedalcoholic .

We will, therefore, first review this branch of thesubject .

Read b efore th e So ciety,Decemb er-

I8, 1868 .

BUS I NESS AND CR IM INAL RESPONS I B I LI TY . 135

While it is undisputed that any substance which hasthe power o f producing d isease of the stomach, liver andother organs connected with the digestive system,willind irectly affect more or less gravely

'

th e brain, it is sufficient for the purposes of our d iscussion that the knowne "ect of alcohol upon the brain and nerve, substancedirectly,be examined . We will, to that end, start withthe proposition that the affinity of water for alcohol isgreater than it is for any of the tissues of

,

the body .

While this is a proposition d irectly d emonstrable upond ead tissues only, in which the removal of their wateryconstituents by saturation in a lcohol may be Shown tobe n early fifty per cent . ,physiological effects present allrational proofs that even the tissues endowed with vitality are liable to the operations of the same chemical law .

I n the dead tissue,a more o r less rapid sinking of itssubstance takes place when immersed ‘ in alcohol, theresults of the escape of its contained water,and the substitution of alcohol . That this process also takes placewhere living membranes filled with capillary vessels arecovered with alcohol,is Satisfactorily shown by d roppingthis fluid upon the web of the frog ’s foot or the bat ’swing

. Und er these circumstances,the m oy em ent of theblood in the vessels soon stops,the corpuscles congregateand contract, the caliber of the vessels d im inishes,till atlast all movement and perhaps vitality ceases in the part,and it remains . a shrunken, leathery, insensible stru c

ture,very liable to slough and disappear . This e ect is

more or less marked,according as the fluid is more ‘

or

less purely alcoholic .

136 THE I NFLUENCE OF METHOMAN I A UPON

That a similar result may take place—does indeed take

place—When more or less concentrated alcohol is intro'

d uced . into the cavities of the living b ody,may be reasonably inferred from the well -known fact that thirstfollows the use of alcoholic d rink,at the same time thatincreased urinary dischargeoccurs the alcohol d isplacing a more or less consid erable amount of water fromthe tissues of the body, throwing it into the circulatingb lood,whence it passes o ff by the kidneys facts whichwere unknown to the good mother,w ho felt sure hers ons did not drink at night for they were always verythirsty in the morning .

I t therefore, appears satisfactorily shown, that both inthe dead and living tissues of the animal body, theaffinity between alcohol and water is actively manifest .

This fact in animal chemistry finds it application to thesubject we are investigating in the next proposition weshall make,viz . : the great amount of water any animaltissue may contain,the more marked will be the actionof alcohol upon it . N ow, of all the structures of thehuman body,the brain is that which contains the largestpercentage of water,and therefore, und er similar circum stances, it w ill be the organ most marked ly affectedby alcohol .M ore than thirty years ago, Dr. Percy,of England,performed a series of experiments,with the object o fd etermining the

'

presence of alcohol in the substance ofthe brain and ventricles,in animals po 1soned by alcoholin the course of which he found that alcohol, after a

138 THE I NFLUENCE OF METHOMANI A UPON,

blood, even in very minute proportion, to modify thenutrition of the nervous substance more than that ofany other tissue ; for the alcohol will seek out, as itwere, the nervous matter, and will fasten itselfupon it .Though it is in all probability true that alcohol, in theconcentrated form, d oes act upon living tissues in a

destructive manner when th ey are exposed to it with noprotection, yet in the d egree of dilution it is usuallyimbibed by hum anity, its effects are, except remotely,transitory . I ts d em onstrable eff ect upon the capillarycirculation, however, enable us to form some id ea,approximating the truth,perhaps, of the commotion setup during a fit of intoxication,between the alcohol inthe blood circulating through thevessels of the brainand the watery portion of the brain substance surrounding those vessels,which watery portionconstitutes abouteightyper ,cent . of the mass of the brain .

M ost persohs have witnessed‘ the intellectual and

nervous phenom ena this com m otiongives rise to, varying from the slightest exhilaration or torpor to the wildest frenzy or ‘ d eepest coma, from the most mod erateeffect upon thought and powers of motion,to the totalabolition of both . To be intoxicated would ,therefore,appear to theoretically involve the wond erfully intricatestructure o f the brain in no trifling risk

'

of more or lesspermanent injury

“

. Practically, however, it is amongthe wonders of the restorative powers of the economy,that such risks are not manifested till many repetitions

BUS I NES S AND CRI M I NAL RESPONS I B I LI TY . 139

of the act . S ooner or later the results beginto appear .Permanent d erangements of the intellectual faculties,orof the motive power, o r both, become apparent .Dr. Carpenter remarks,very justly, that “ There are,in fact, scarcely any diseases of the brain which are notso much more frequent among the habitually intemperate, than among the habitually Sober,as to justify us inregarding the excessive use of alcoholic liquors as amongthe most ’ e I caciou s of the cond itions of their production .

”

To be thoroughly impressed with a proper idea of thed isturbing d isorganizing tend ency of these alcoholicshocks upon the intimate d elicate brain structures,Iknow of no better means than a careful study of themwith the aid of the microscope . As we have alreadystated,the d iseased cond itions resulting from theseshocksmanifest themselves in both the motor and mental d epartm ents of the brain system . Though our inquiriescarry us into the mental manifestations of those diseased conditions,the intimate relations of the two classesmake it essential that we know and recognize the motorindication of alcoholic disease also . Twenty years ago,Dr; Carpenter,after concluding a graphic d escription o fdelirium tremens,wrote

That a slighter form of this disorder, mark ed bytremors of the hand and feet, deficiency of nervouspower

,and occasional illusions,will sometimes appear

as a consequence of habitual tippling, even withoutintoxication having been once produced . And a still

140 THE I NFLUENCE OF METHOMANI A UPON

slightermanifestation of the want of control over musonlar apparatus— such as the trembling of the hands inthe execution of a voluntary movement—is familiar toevery one,as extremely frequent among the habituallyintemperate . We thus see that the d isease is at least asmuch dependant upon the disordered state of nutrition,consequent upon the habitual presence of alcohol in theblood,as it is upon the violence of the excitement,whichis the more immediate effect of the stimulus .”

Alth oiI gh he d oes not so d istinctly express it,‘

Dr. Car

penter allud es to the nutrition of the brain exclusivelyin his remarks . These symptoms of functional motordisturbance, the result of chronic alcoholic poisoning,Dr. Marcet states, in his work on Chronic A lcoholicI ntoxication, “ may last forweeks,m onths, or years,even after the habit of excessive drinking has beengiven up the truth of which remarks the experienceof most observers confirms . The sharp features, or,if . he be fat,‘

the inj ected cheeks and"

nose, and theirviolet appearance, the trembling of the limbs, often o f

the whole body,or a want o f stead iness and co - ordination in the movements,not very unlike incipient c hore a,are all symptoms which we should no t fail to observe .

”

This tremulousness is more or less marked, especiallyby day,and when the person is sitting sometimes it isconfined to a part of the'body,as of the tongue, or oneextremity ; some only tremble when they rise in themorning,giving them difficulty in d ressing . I n othercases,where trembling is not present, an awkwardness


ravages,« the : efore,may be committed upon the motorsystem by the continued excessive ingestion of alcohol,we have undoubted reason to expect that th e intellectualSystem will be a still greater sufferer.

Practically,we find it to be a fact, that of all the casesof insanity admitted to the asylums in various parts ofthe world, a per cent . varying from fifteen to fifty andsixty is put down to the e ""ect Of the intemperate useof alcohol on the individual or ancestors . Dr. Carpenterthought that twenty-five per cent . would be quite sm allenough an estimate for the asylums of Great Britain .

There is no reason for supposing our own country ’s number would be found to be less, if we may judge from thefact, that in a single asylum the cases of maniac -

potu,in 1867,amounted to about eleven per cent . I t is S tatedin the petition to the Legislature of the State of NewY ork, for the establishment of the I nebriate A sylum in

1857, that fifty -five per ‘ cent . of all our insanity, andsixty- eight per cent . of all our idiocy, springs d irectly orind irectly frominebriety alone .

” The action of alcohol,then,as a m ere physical agent in the production of d isease o f the brain substance, is abundantly shown,andthat means d isease of mind also, for,as a distinguishedauthor truly remarks, it is ridiculous to suppose thatinsanity is a disease of the mind and not of the body'.

-M ens sana‘

in corpore sano is undoubtedly a very goodand true general proposition, but it finds its specialapplication in relation to the brain .

Now,diseases of the brain,when produced by alcohol

BUS I NES S AND CR I M I NAL RESPONS I B I LI TY . 143

as well as by other causes,have their various degrees Ofseverity . I t is sufficient for the purposes of our inquirythat we have shown the ability of alcohol to produceextreme brain d isease, so we will now review the variousgrades of brain unsoundness it is recognized as producing, and thereby show th e phases of m ental unsoundn ess it gives rise to . Passing over the inebriating influences,and the various phenomena primarily produced byalcohol, transitory effects which leave no appreciableresults after more or less tim e,we will mention insomn olence,aw ell known result of cere oral d erangement,from a great variety of causes, and a very constantsymptom in the positively insane . These period s ofinsomnia follow fits of intoxication for a long time insome cases,before they give place to d eclared d elirium .

They are not infrequently attended wi th hallucinationso f a generally d isagreeable character, th e objects oftenappearing d ouble or greatly m agnlfied, or performingsome movement which the person interprets as of evilomen . A gentleman of my acquaintance,wh ile und erth e effect of an over- indulgence in alcoholic d rinks,sup

posed he saw two doves start up from the road, alongwh ich he was driving,and , after fluttering along for amoment over his horses, soar away to a considerable distance

,and suddenly plunge into a new—made excavation

in the earth . So real . d id it appear to him that hebecame at first quite out of patience with a friend whowas riding with him,because he d id no t see the d ovesalso . He,

however,became Convinced that he had seen


nothing but a ghost, foretelling some calamity which hesu spec ts

'

bu t does not express . I have,unfo riunately,only partially succeed ed in convincing him that it wasalcoholic,and I have in consequence had bu tbad successin improving his habits ! This person has never hadd elirium . Dr. Marcet relates the case of a cabman suffering from alcoholic d isease,wh o frequently pulled uphis horse in the street suddenly to avoid running againstan Obstacle he d istinctly saw, bu t which he found,uponexamination, no t tangible . On another occasion thissame patient saw things multiplied as m any p

as tentimes, so that he could not tell which o f the ten to d riveclear of,and he was in c onsequence obliged to give upd rivingfor the time . S im ilar hallucinations of thehearing, of the taste . and of the smell are known tooccur, the patients believing that they are d rinking orsm elling brandy instead of water, or that

'

they hearvoices and

'

so unds that d o not exist. These mostly occurduring th e long sleepless nights, bu t occasionally duringthe intervening days . They often Immed iately preced ed elirium, bu t may. as already stated,be the only manifestations of unsoundness of brain for a long period .

Jl‘

his affection Of the brain is as a rule promptly reco vered from , if the cause is no t repeated . Unfortunately,however, this measure is too frequently d isregarded, onaccount of the existence of a d isease already more orless considerably advanced,viz . ,morbid desire for intoxication,which is in fact only an expression meaning apositive d isease of brain - structure, as much as any ofthe hallucinations above referred to .

‘

I


seized with,and yield s to,an impetuou s d esire to drinkardent spirits . This is lamented by the individual asmuch as by his friend s,but by successive indulgenceswhich he cannot refrain from,and from which he is notprevented by others, he reaches the sad mental andmoral cond ition of the inebriate Such,” headds, deserve,but d o not have sympathy,inasmuch asmental disord er

/

preceded and causes the excess . ”

Now,as these are all causes ,

recognized as productiveof more or less permanent and grave lessons of eitherintellect or motor power,

‘

or both, we are irresistiblyd rawn to th e conclusion, that when they produce methemania, they d o so by the production of positive braind isease,m ainfested by

am orbid appetite or d esire .

An obvious corollary would then be, that all cases ofmethomania are produced by positive brain -disease,whether such d isease be produced by the causes justenumerated,or the habitual and excessive introductionof alcohol or other similar agents into the substance ofof that organ, or be inherited . This desire for stimu

lants seems to arise from a depressed or Impalred vitality,an instinctive consciousness of which creates a longing for the means of improving or relieving it by stimu:

lation .

“

The second reason for believing that it arisesfrom brain-d isease we may advance is, that this diseaseis hereditary,

“ in the same manner that insanity,epi

lepsy,syphilis, consumption,and other well-known diseases are hereditary . This f act,-established as it is byan enormous amount of miserable example, presentsthe most frightful aspect of this whole subject .

BUS I NESS AND CRI M I NAL RESPONS I B I L I TY . 147

Hereditary inebriety has been an admitted fact formany centuries . Thus Aristotle is reported as de claringthat drunken women bring forth children like untothemselves and Plutarch says that one drunkardbegets another . ” Dr. Carpenter states that all evidenceupon the subject not only goes to show that the intemperate use of alcohol aggravates the operation ofother causes of insanity, but that it has in itself a‘f special tendency to produce idio cy,. insanity or mentald ebility inthe offspring .

” He further remarks Looking to the d ecided tendency to hereditary pre -dispositionin the ord inary forms of insanity ; looking also to thefact that any perverted or imperfect cond itions of thenutritive functions established in the parents are alsoliable to manifest themselves in the offspring (as in thecase of gout or

.

tubercular d isease),we should expect tofind that the offspring Of habitual drunkards wouldshare with those of lunatics in the pre disposition toinsanity, and that they would,moreover, be especiallyprone to intemperate habits . That such is the case, iswithin the knowledge of all who have enjoyed extensiveopportunities of observation . The same author quotesfrom a report of the physician Of a lunatic asylum thefollowing statement : The drunkard not only injuresand enfeebles his own nervous system,but entails mental disease upon his family . At present I have twopatients who appear to inherit a tendency to unhealthyaction of the brain from mothers addicted to drinkingand another,an id iot, whose father was a drunkard .

”


I t is believed by some authors that parents give to theirchildren only those qualities or powers and tendenc I es tod iseases and propensities which may be most conspicuous in them at the time the creature is begotten . I haveyet to see the first case in support of the doctrine that achild begotten during an accidental fit of intoxication bya parent of sober habits, as a rule, is liable to inheriteither id iocy or methomania . But that the permanentalteration and

'

di'

seased constitution of the brain, as anorgan, should transmit its peculiarities to the progeny insome form, there is too much evidence to dispute .

Says Dr. Maud sley, in his learned work on the Physiology and Pathology of the M ind, p . 228

“The influ

ence of alcohol upon the mental function furnishesthe simplest instance in illustration of the action offoreign matter in troduced into the blood from withouthere,where each phase of an artificially produced insanity is successively passed through in 'a brief space oftime,we have the abstract and brief chronicle of thehistory

,Of insanity, because the action of the poison

upon the nutrition of the nervous centres is quick andtransitory ; but we have only to Spread the p oisonousaction over years,as the drunkard d oes, and we may geta chronic and enduring insanity, in which the insanephases of drunkenness are more slowly a cted , but ifdeath puts a stop to the full d evelopm ent o f this tragedyin his life,we may still not be disappointed at seeing itplayed out in the lives of his descendants ; for thed runkenness of the parents sometimes observed ly becomes the insanity of the offspring .

”

15 0 THE I NFLUENCE OF METHOMANI A UPON

alcoholic stimulants was almost uniformly present amongthese pitiable progeny of inebriety . Dr. Howe remarksof them,that they were

“d eficient in bodily and vital

energy,and predisposed,by their very organization, to

have cravings for alcoholic stimulants . ” A very intelligent reviewer o f Dr. Howe ’s reports make the following remarks upon the subject of this propensity to stimulata in the children of the intemperate

Many of these child ren are feeble, and live irregularly . Having a lower vitality, they feel the want ofsome stimulation .

I f they pursue the course of their father, whichthey have more temptation to follow and less power toavoid than the child ren of the temperate, they add totheir hered itary weakness and increase the tendency toidiocy in their constitutions,and this they leave to theirchildren after them .

”Dr. Anstie says, in his article on

Alcoholism, “Reynolds’ System of M edicine,” “

The

su”

erers from this disease are, I believe, usually descended of families in which insanity,and Often insanityof the same type, is hereditary .

”

I need not accumulate more evidence Of this character,which it would be easy to do . The effect is,beyond adoubt,established,that a d iseased brain and body,as theresults of alcoholic poisoning,m anifest by methomania,transmit their acquired or inherited

'

habits and propensities to the offspring . And the fact is striking, that th eOrgan which has suffered most in the parent is,with fewexceptions, the one most aff ected in the child . The

B us I NEss AND CRI M I NAL RESPONS I B I LI TY . 151

child has, in fact, inherited t he brain'

disease of thefather or mother, or both . I t is not an inheritance of anaccidental condition,such conditions are not transmit

“

ted . The parent who has accidentally lost a leg, or themobility of a knee, or has lost an eye, or -

a tooth,doesnot beget one - legged, stiff - j ointed, one -eyed,or toothlesschild ren .

‘

Positive alterations of the vital organizationof the economy are alone transmitted as acquired orinherited d isease . M ethomania is so transmitted, therefore it is the expression of a positive d isease . we canno longer doubt the truth of this doctrine . I t has beend oub ted

'

tOO long already . I t is clearly the d uty of everyphysicianin the land to know it, to acknowledge it,andto promulgate it .No more truthful or important sentiments were everuttered than are those which follow, written by Dr.

Howe,a score of years ago I f ever,” he says,“ the raceis to be relieved of one tithe of the bodily ills which it isnow heir to, it must be by a clear understanding of,anda willing obed ience to, the law which makes parents theblessing o r the curse of the children the , givers ofstrength

,and vigor and beauty ; or the dispensers of

d ebility, and disease, and deformity .

” We have seenwith how much truth and propriety he may have added,and hands down to them a d isposition to sobriety andvirtue, or blasts them for time and eternity with a pro

pensity—to intemperance and vice .

As the last reason we shall adduce for the belief thatalcohol produces a positive brain -disease,we will men ~


tion the fact that many o f the symptoms recognized asproduced by alcohol po I sonlng upon the brain,are ‘ con

trolled or cured by the same m edicinal/

agents as areknown

'

to be effective in various brain diseases, such asepilepsy, chorea, etc . Such agents are digitalis and theoxide o f zinc the former a well -known remedy in epilepsy,as well as much vaulted in delirium tremens,andthe latter has long enjoyed a high reputation in epilepsyand other diseases of the brain,while Dr. Marcet, ofLondon,has lately written a book about its virtues inwhat . he terms Chronic Alcoholic I ntoxication . I n ju s

tice to my own conviction, however, I must be permitted to remark that this therapeutical evidence of a similarity between epilepsy and alcoholic disease is not, inmy estimation, of the most convincing character . A s

others entertain a higher estimate of the value of thecurative effects of both d igitalis and oxide of zinc inthed iseases m entioned than I d o, I present the reason forany weight it may carry . Dr. Anstie, in his article onAlcoholism, subscribes to the

‘

efficacy of the oxid e ofzinc in this disease . But it would appear,that with allthe reasons heretofore advance d, no additional oneswould be required to establish the truth of the propositiOn,

‘ that methomania is a manifestation of braindisease .

While the line of argument I have followed has beenin some respects unusual among writers upon this subject, the conclusions arrived at are not d ifferent fromtheirs . Methomania has been regarded by the highest

154 THE I NFLUENCE OF METHOM AN I A UPON

which need s the control and med ical treatment of anasylum more than any other class of insane .

’

I t must not be forgotten,while studying these effectsof alcohol, that there are many other substances which,if employed in the same manner, and for equal time,produce permanent derangement Of the brain cell—work .

Of these may be mentioned Opium, belladonna, straln o nium, I ndian hemp, and tobacco . The disturbinginfluence of these substances upoh the nervous centres,each one d iffering more or less from the other, is toowell understood to require mention here : These difierences, however, ind icating what is known or termedelective affinities, a peculiarity before referred to, asmarked in alcohol and strychnine,promise to furnish usmore definite knowledge as to the d iseased condition ofthe tissue elected, than we have hitherto been able toobtain . I allud e to the elective a ffinity, if it may be socalled,which produces the d isease of the optic nerve inthose addicted to the more or less excessive use oftobacco . Tobacco—blindness,,

or amaurosis, is attractingmuch attention,and bids fair to open new fields of pathological study . While: a trophy of the optic nerves,resulting from suspended nutrition,and slow disappearance of its capillary blood -vessels, is demonstrated byboth the Ophthalmoscope and the microscope to be thecondition here,may not the same. condition of the brainfollow the use of alcohol, or t he narcotics mentioned 2Dr. Tyler,whom we have before quoted, and whose

Opinions we regard as possessing the greatest weight,

BUS I NESS AND CR I M I NAL RESPONS I B I L I TY . 155

Speaks of this affection as follows Pathological lnvestigation Show that the brain is changed from ahealthy to a diseased state by the acti on of alcohol .Healthy thoughts and healthy moral sentiment are notevolved by a diseased brain . To its possessor we attachno moral responsibility . An inebriate has a d iseasedbrain . N0 will or agency of his can bring forth therefrom other than diseased mental and moral products :A person who is governed by an uncontrollable appetite,or by any uncontrollable influence, is not a responsiblebeing,and Should be so treated .

”

Dr. Ray, the present Superintendent of the New Y orkS tate I nebriate Asylum,and late Superintendent of thelVaShington Home,BoSton,in his report for 1867, saysThe extent to which the morbid craving for stimiilantsand the infirmity of will in resistance,which combinedconstitute the disease,having its source and sustenancein the impaired functional activity of the various organsof the body, can only be appreciated by One who hascarefully observed it in a large number and variety ofcases . '

As a disease,its character is most complex and

obscure, involving as it does abnormal cond itions of bothbody and mind, and vary ing in every case

’ with ind ividual temperament and characteristics . ”

A commission appointed by the State of Massachu ~

sctts some four years since, to report upon the conditionof the asylums of the State, in speaking of this form ofinsanity. classes it as a disease under whose paroxysmsOr influence the victim shou ld be cleared from criminal


responsibility . Under the conviction that the methoI naniac is a victim of an uncontrollable desire,and therefore d angerous both to himself and those about him,andhence a fit subject for the interference of the S tate,morethan fifteen hund red medical men of this S late signed apetition to the Legislaturein 1857, in favor of the establishm ent of an asylum for that purpose . I n that petition we find the following paragraphWithout such an institution. the physiclan has been

compelled to turn from his patients d iscouraged, disheart ened and defeated, and the victim of this painfulmalady has found a drunkard ’s d eath and a drunkard ’sgrave . With this institution we can save hund red s whoare now crowd ing our insane asylums, inundating ourcourts, dying in our prisons, and perishing in ourstreets . ” Dr. Anstie, in his article on A lcoholism,Reynold s ’ System of M ed icine,” says of methomaniaI t is, in truth, rather a variety of constitutional insanity than of alcoholic d isease,but as the outbreaks owemany of their characteristic symptoms to the influenceof d rink, the d isease requires notice in a treatise onalcoholism .

”I f, after a review of the facts we have

here laid before it, there shall still be found a mind soconservativeas not to admit them as evidence of theexistence of such a disease as methomania,which moreor less seriously impairs the responsibility of its victim,then I have little hope of its conviction unless in someevil hour it become a subject of the d isease .

I confidently believe,however, that but few such will


son is seized at more or less long intervals . This is calledperiodic methomania . I have never seen a good description of it except the one given by Dr. Hutcheson,andquo ted by Dr. Carpenter, and feel that I can give nobetter idea of it than is given in that description The

individual,” says Dr. Hutcheson, thus affected ab stalnsfor weeks or months from all stimulants, and fre

quently‘

loathes them for the whole period . By d egreeshe becomes uneasy,listless and d epressed,feels incapableof application, and restless,

‘

aband ons business, and

begins to d rink and continues to till he is intoxicated .

This he continues till sleep ensues, which he awakesfrom only to seek again the intoxicating d ose,and so hecontinues on for -aweek o r more . Then a feeling of disgust and positive ‘ loathing for his intoxicating drinkscomes o n,attended generally by anorexia and vomiting,a feeling of apathy and d epression follows, he is theprey of remorse,regrets bitterly his infirmity,often contemplates, and even commits suicide to terminate hismisery .

”

“ His vigor,however, returns,he goes with reneweddiligence to business,and freshly determ lnes never againto yield to his malady . But,alas, sooner or later

‘

the

paroxysm recurs,and the same scene is re enacted, tillultimately,unless the disease be checked,he falls a victim to the physical effects o f intemperance, becomesmaniacal or imbecile,or the intervals becoming shorterand Shorter till none takes place between them, and hefalls into the deplorable State o f chronic or continual

BUS I NESS AND CR I M I NAL RESPONS I B ILI TY 159

methoman ia,astate in which the patient is incl

essantlyund er the m ost overwhelming desI re for stimulants .

N o exhibitions of the maniac can be more ind icativeof insanity than are the ungovernable impulses to intoxication that move these persons . I n all the forms of thed isease, the patient is totally incapable of self-control .There is no motive of business that has any weightagainst it ; there is no consideration of family, or tie offriendship, that in the least influences him to resistand even physical mutilation and the vilest personal debasement are at times gladly submitted to for the purpose Of getting th e means to appease this d evouringimpulse . An account illustrative of the strength and

danger of this diseased impulse,is given by Dr. Mussy,of a m ethomaniac of the chronic variety,who was pu tinto an almshouse . A fter making many unsuccessfuleffort s to procure rum,he at length hit upon the following d evice,which was successfulHe went into the wood -yard, seized an axe,and placing his hand upon a block, cut ,

it from the arm at aS ingle blow . With the bleeding stump raised, he raninto the house,crying,

“ My hand is Get somerum get some rumI n the confusion of the moment, a bowl of rum wasbrought

,and plunging the bleeding member of his body

into the fluid,he raised the bowl to his mouth, d rankfreely

,and then exultingly exclaimed, N ow, L am

satisfied ! ”

What maniac could be more regardless o f t siCu I


pain ! Truly d id Dr. Hutcheson say that such a person“ is dangerous to himself and others, and howeverresponsible he may have been for bringing the d iseaseupon himself, his responsibility ceases as soon as hecomes und er its influence .” Another peculiarity of thisd isease is that it seeks solitary gratification,and in thisrespect it resembles some form of recognized mental d erangements . Dr. Anstie says, in his article on A lcoholism, Reynold s’ System of M ed icine,” that acute melanch oly is seen in this d isease presenting the usual fOrm of .

this mental affection, “ but it is . marked by a specialtendency to suicidal acts . ” Dr. Hutcheson allud es tothis change in social character and sentiment, sayingthat the patient derives n’ o pleasure from society, for hegenerally avoid s it .The motive for the secret gratification

,of this impulse

has appeared to me to be a d esire to keep the fact hiddenfrom the world . The positiveness and the persistencewith which these victims will often deny having takenany stimu lants, and much more, having . been intox

icated, are as strong an evidence of their moral; ifnot general insanity,as can be presented . Their cunning and ingenuity in explaining their symptoms

,taking

care to make no allusion to the true cause, have nocounterpart except in the cunning and deceit Oftenfound in the truly insane . Dr. Tyler very truly remarksupon the deadening influence of this disease upon themoral sensibilities of large numbers of its victims

, that“ they turn to whatever breeze is blowing,and change


but as a rule it is still solitary indulgence .

“

I t is not tobe confounded with convivial drunkenness, and it isgreatly d oubted by some whether the occasional intoxication at the festive board ever lead s to methomania, inpersons who do not inherit, o r accid entally possess, ad ecid ed pred isposition to the disease . There can be nod oubt that we constantly meet with persons who consume more alcohol annually than many m ethomaniacs,

but who are never intoxicated,and who can stop the useof it at any moment without much, if any, inconvenience . While some become intoxicated at every d inner-party, they eat their d inner quite as well withoutwine . This, it is easily seen,is an entirely different condition from methomania . The habits which I regard asind icating methomania are : 1. Period ic secret d rinkingto intoxication,attended by stud ied secrecy regarding it,and persistent denial of the act . 2 . Period ic solitaryd rinking to d runkenness, though not in secret,attend edby the same determined d enial of the act . 3 . Gulpingdown alcoholic liquors on all possible occasions to drunkenness W ithout regard to taste or quality .

I t would be an error to suppose that all cases of methom ania refuse to confess their affliction . M ost of themsooner or later have confidan ts to whom they unbosomtheir afflictions, but as to general confession the rulehere stated' is true . During the paroxysm the patientabandons the most urgent b usiness, and, to get themeans o f gratifying his craving d esire,d isposes o f clothing and jewelry,and even pledges estates and beggars

BUS I NESS AND CRI M I NAL RESPONS I B I LI TY . 163

his family . I have Often noticed that the very fact ofhaving extraord inary or unusually important or d ifficultbusiness to transact, seemed to overwhelm the will andcourage of these persons,and to bring on prematurelyan attack . So common is this that the unreliability ofthe m eth omaniac for any urgent and important work isproverbial, they always being nearly sure to d isappointwhen most needed . This is,no d oubt, to be accountedfor by the fact that the mental as well as physical vigoris more or less greatly impaired by the d isease, SOthatthe patient is really unequal to the application requiredfor him,and feels himself so .

Dr. Carpenter alludes to this subject by saying that,besid es the positive d iseases,a premature exhaustion‘

of nervous power, manifest in the d ecline of mentalvigor, and of nervo muscular energy, are ranked ,by

common consent among th e consequ ences of habitualexcess I n the use of alcoholic liquors . ” Th e find ing of aman drunk,and absent from business that he knows tobe important, I , therefore, should at once regard as evid ence of the existence of methomania in his caseI have purposely deferred to the close of these re

marks,the consideration Of the personal danger which

the family or associates of the m eth om aniac are exposedto during different periods of his paroxysms . I mpelledby some insane hallucination, or by the frenzy of torm enting desire, during the maniacal excitement ofintoxication

,or the terrors of delirium which succeed

it,the inebriate who would dismember his own body


would just as soon destroy the life of his dearest friendor relative . Of all the d iseases . of humanity,none is SOd readful as the insanity of the m ethomaniac .

Says Dr. Turner, in his graphicdescription of the victim of this disease Extreme poverty,

_

hideou s d eformity,mutilation Of limbs, d eafness, blindness, all those,sad as they are, leave alive the human affections,andadmit the consolation Of sympathy and love but thismalady so entirely changes the heart that no affectioncan grow 'upon it,and the unhappy victim S inks andd ies, or is SO excited as to crush the life out of themother that bore him, as coolly as he would trampleupon a serpent .

”Then the d octor relates that most

awful case which occurred in Mad ison county, in thisS tate, a few years ago, to illustrate his statement . A

young man,during the delirium of a paroxysm of methomania,murd ered both his father and mother,and cu t

ou t their hearts which he roasted and ate . He wasbrought into court for trial,but Judge Gray declined totry thecase,on theground that his court had no jurisd iction in the case of a crime for the commission ofwhich there could be no motive in the human heart . I t

was, ind eed , an unequivocal admission,by high jud icialauthority, that m ethomaniacs may be irresponsible fortheir acts . These morbid perversions of feelings and

desires, SO frequently seen in the insane from any cause,are peculiarly liable to appear in the m ethomaniac, andliable to impel the victim to acts of an appalling character .

METHOMAN I A .

BY JAM E S J . O’DEA, M .D .

*

Madam, said Dr. Samuel Johnson, to a lady withwhom he was once

,conversing on the subject of intem

perance .

“I can be abstinent but I cannot be moder

ate .

”Such is an admirably terse statement of the case

of many living men and women, who,though stronglytempted to indulge their propensity for ardent ‘

Spirits,are fortunate in possessing a ,self—control as rigid anduncompromising as that of the illustrious man abovequoted . But there are others not SO happily endowed .

As a matter of every-day experience we meetwith m anyShades of distinction among mankind, in regard to theappetite for alcoholic d rinks, from the few who positively d islike them,or the very large number who use themin moderation, to the many whose lives are little elsethan a repetition of drunken debauches,and who haveonly too much reason to exclaim with the great dramat

istOh ! thou invisible spirit of wine, if thou hast ' no

name to be known by, let us call thee d evilFrom among the latter we may S ingle out a class having a peculiar character and physiognomy of its own .

‘Read b efore th e N ew Y ork Med ico -Legal S o ciety, 1868 .

M ETHOMAN I A . 167

I t has probably happened to every one of us to knowpeople—acquaintances, friend s, relatives—who are, toall appearances, hopeless drunkards . They are eitherconstantly intoxicated, or they abstain only when thereis no temptation to d rink but let them indulge ever solittle and their propensity, assails themwith a forcewhich no consid eration is able to restrain. Such peopleare the d espair of their friend s,'the torment or ruin oftheir families,the scandal Of their c ommunity . Seventytimes seven they fall and are lovingly raised up . Theyexpress contrition, they make firm promises,of amendment, and, for a little while, seem to have masteredtheir propensity,but, sooner or later, it renews its as

saults, and obtain an easy victory over them . What isthe meaning of this phenomenon ! I s it simply an ind ication o f moral obliquity, or d oes it point to somethingradically wrong in the physical organization Of the ind ividual, to a d iseased or d isordered state of his nervoussystem obedient to the well -known laws of all the neuroses, hé ré d ité ,period icity, and interchangeability ! I n

a word,can we pronounce it to be a form of insanity !Such is the question submitted to our consideration butbefore entering upon it, I think it will be advisable totake a rapid survey of the recent progress o f opinion re

specting the action Of alcohol on the human system .

Speaking in a general way, it may be declared thatthe total abstainer is a healthier man than the tippler,and

,further,that the d ifference between the consumem

of a very little alcohol,and the consumer of a good deal,

168 METHOMANI A .

is mainly one Of degree . The steady use of alcoholicdrinks, for even a comparatively short time, lessens thevigor and elasticity of the body, impend ing both its neutrition and th ) play of its faculties . As a consequenceof its depressing effect on the lungs, skin and kidneys,less carbonic acid,water, and urea are eliminated, andthe system becomes changed with an accumulation ofimperfectly Oxidized substances, such as uric and oxalicacids . The eff ect of alcohol in inducing chirl

'

o s1s Of theliver is long familiar to the profession, and recently,Dr .

Fox has drawn attention to an analagous change in" thestomach of inebriates,marked by chronic inflammationof the mucous membrane and '

its conseql'

I ents,hypertro

phy of interglandular connective tissues and obliterationOf glandular structure . Owing to this initative actionon the structures of the stomach, and also to the oh

struction of healthy tissues metamorphosis occasionedby the same agent, there is a d im inishing appetite forfood,and a gradual d ecline in the enduring powers ofthe body . An employer in Scotland tested this latterfact in the case of a workman who abstained from alcoholic beverages for eight weeks . On subsequently referring to

'

the wages -book, it was seen that during thistime he had earned about sixty - eight dollars

,gold, as

against fifty- three d ollars, gold,which was all he hadmad e in the eight preced ing weeks during which he indulged. As a teetotaler ” he earned fifteen d ollarsmore than as a moderate d rinker . *

Frazer’

s Magazine, September, 1868 .

170 METHOMAN IA.

A lcohol is not food .

I n a feeble dose it excites,in a large d ose it stupefies .

I t is never transformed in‘the organism .

I t accumulates in the brain and liver .I t I S ejected entire and pure by the lungs,by th e

skin,and especially by the kidneys .6 . I t I S a pathogenic, causing functional disturbanceand organic alterations in the brain, liver and kidneys .

Lastly, these influences of the commission are in theirturnd isputed by M . Edmond Baud ot,in the Union M ed i

cale for September and November, 1863 . I n regard toNO . 3,he remarks that, though th ere is no d irect proofof the transformation of alcohol in the system, there isstrong presumption that some is really there transformed . He hasconvinced him self

l

by experiments thatvery little alcohol is eliminated by the kidneys,and onlyenough by the lungs to give it faint reaction with thebichromate of potash test . He hold s that only the portion of which the organism is intolerant,as being morethan it can safely bear, is eliminated as alcohol, andthat the rest rem ains in the body,and und ergoes transformation into aldehyde,acetic, and oxalic acid sThe last year or two has witnessed a renewed interestin this important question . All the more recent authorities agree that

.

alcohol has no histogenetic propertieswhatever,but there is still a d ecided difference of opinion as to whether it is a force producer . Dr. Anstie

seems to favor the theory propounded by L iebig . He

hold s that it is oxid ized in the organism,and undergoes

9

.»

n

METHOMANI A . 171

a change into carbonic acid and water that,in so beingacted upon, it contributes useful force to the body,and,consequently,that it has an absolute dietetic value . Dr.

Parks, on the other hand,while admitting the d estruotion Of alcohol as above indicated, refuses to see inthis fact alone any reliable proof of its d ietetic value .To pursue this interesting controversy any furtherwould lead u S too far away from our present purpose .

Whatevermay be the ultimate d ecision of scientificmen, to Dr. Anstie belongs the great merit of havingcontributed one positive truth to what knowledge wepossess upon the subject —the important fact that theh ealthy human frame can safely d ispose of one ounceand a half of alcoh ol in'the twenty - four hours,which isthe limit of healthy indulgence ; all indulgence beyondthat amount being not only excessive, but d iseaseproducing .

Now,with regard to one of the consequences of excess,statistics and pathological observations both go

.

to provethat the habit of frequent indulgence in alcohol is reallya potent cause of many d iseased conditions of the nervous system highly favorable to insanity”First, of statistics . M ost systematic writers on insanity give aproximate estimate of the percentage ofcases of mental alienation attributable to the abuse ofardent spirits

. Bu cknill and Tuke tell us in their workon Psychological M ed icine that the report of t he commission in lunacy, for 1844,gave eighteen out of everyhundred as the number o f insane from this cause,and

172 M ETHOMAN I A .

ad d that “ in America the proportion is stated to be verymuch higher among the patients admitted into

.

Stateasylums . Bu t,we believe, that all these figures fall farshort of presenting a true picture of the complex influence of intemperance in indulging,d irectly Or ind irectly,d erangement of the mental faculties .

” Dr. N ichols, illsome recent remarks on the Gov ernment Hospitalfo r th eI nsane,says “

The reports of the institutions for theI nsane, both I n this country and Europe, Show thatintemperance is a common sense of insanity in its ord inary forms . The authorities also almost unanimouslyagree that inebriety sometimes becomes an insanity

characterized by a total aband onment to extremeindulgence, regard less of the most sacred claims and

pledges,and by no more less impairment of the m oraland intellectual powers Of the ind ividual . ” 6

“Of the physical causes of insanity, says Dr.

Maud sley, “ intemperance occupies th e first place ; acting not only as a d irect cause,but ind irectly through theemotional agitations incident to an irregular ‘life ofd issipation and excess .

”And Dr. Ho od )

L places alcoholicexcesses next after Old age,as the most potent, physicalcause of

‘insanity .

Secondly,of pathological observations . Th e experi

ments Of Percy and others have established the greatrapidity of the absorption of alcohol from the stomachand its strong affinity for the nerve centers . N ow, al

*Am erican Jo urnal of M ed ical S ciences,J anuary, 1869 .

!Qu o ted in Aitkin’s Practice o f Med icine .

”

174 METHOMAN I A .

ject o f this paper, I shall divide m ethomaniacs into twoclasses : Methomaniacs in consequence of a longseries o f debauches Me th omaniacs by inheritance .

HOW long a course of immoderate tippling maybe continued before the d evelopment of methomania, itwould be impossible to say . I n endeavoring to form anOpinion on the subject at all approximating to cor e

rectness,a variety of circumstances would have to betaken into account . Doubtless, in some abnormally constituted ind ividuals,with an hereditary tendency to nervous disease,

‘

a very limited number Of debauches mightbe sufficient to develop it " ; while other persons withrobust constitutions,and no special tendency to any formof neurosis,might indulge to excess for a lifetime withou t manifesting a single S ign of insanity . This is all Ifeel justified in saying at present on methomania as adisease developed in consequence of frequent excessiveindulgence in alcoholicstimulants .

The hereditary transmission of a propensity todrunkardness (hereditary methomania), is a subject ofconsiderable so cial and medico - legal importance . Few

allied questions are more fully supported by evid encethan the transmissibility,not m erely

'

of the drunkard ’sdegenerate constitution,but even o f his appetite for ihtoxicating drinks . The well-known instance recordedby Gall,of a drunken Russian family whose son, onlyfive years of age,was already on the high road

'

to inebriety, is but one of the many examples of a like naturewhich might be cited . I must not, however, omit the

METHOMAN I A . 175

striking picture given by M orel, of the afflictions offour generations of a family in consequence of alcoholicabuses in the first, for nothing more startling and conclusive can be found anywhere upon the subject . The

great grandfather of the family was a dipsomaniac,andand so complete was the transmission Of the disease thatthe race became totally extinct under the well-markedphenomena Of alcoholic poisoning and degeneracy . The

effects entailed were in the first.

generation, alcoholic excesses,immorality d epravity,bru tish d ispositionin the second generation,heredity d runkenness,attafi s

of mania,general paralysis in the third generation, SObriety prevailed,but hypochondriasis,lympemania,persistent ideas Of persecution,homicidal tendencies, wereexpressed ; in the fourth generation, intelligence wasbut feeble,man ia became developed at sixteen years ofage, stupidity,running on to idiocy,and a condition involving extinction of the race .

*

Very few, I think,will venture to deny our right toclassify methomania among the forms of insanity . Thisbeing admitted, the query arises,whether the progenitors o f the generation in which it is manifested mu stnecessarily have been drunkard s . This question ih

volves a consideration of the heredity transmission ofdisease

,a subject which, though demanding some of

our attention,is much too large and secondite to be satis

factorily treated at present . Those who may wish to

Mo rel ;qu o ted in Aitkin ’

s Practice o f M ed icin e, v o l. 1. pp . 145, 146

176 METHOMA YI A .

pursue the topic further will find it very fairly d iscussedin the American J ournal of M ed ical S cience for April,1868, in a review of Dr. Griesinger’s M ental Pathologyand Therapeutics .

” Here, however,we are obliged toconfine ourselves to the few following ObservationsBy some authorities no case of d isease is consid eredhered itary unless it has already appeared fully d evelopedin a parent or grand -parent . By others a case is d eemedto be also hereditary if the d isease has Shown itself ill anuncle,aunt or cousin . I n otherword s,the latter conced ethat the transmis sion may be along the collateralas wellas the direct line . Again, in regard to the form in whichthe hered itary taint is transmitted there are d iff erencesof opinion,some maintaining that the full -blown ailmentof the parent is inherited,while others hold that mostcomm only the Off spring receives only a morbid cond itionof organism ; having a strong tend ency to repeat theparental variation from health . For m y own part, Ibelieve what the offspring most commonly inherits is acertain condition of organism very'prone to take theshape of the parental disease . Thus, the consumptiveor epileptic parent more frequently transmits the tubercnlar or nervous diathesis than the concrete d iseasesconsumption and epilepsy . I n this view,t h e insane mand oes not bequeath to his descendants any particular formof insanity so frequently as a general morbid,nervouscondition very prone to develop into some definite formof madness . Coincid ing with this law,and confirming it,is the fact, amply attested by experience, that diseases

178 METHOMANIA .

Y ou may infer from what I have now been saying,that m ethomaniacs are not always steady,hard d rinkers .

I n fact, the impression seems to be, that those whoinherit the disease are commonly given to periodicd rinking . At all events,the period ic form of the malady is that bestsuited for study,both in consequence Ofits saliency and S implicity . I n the course of our experience we meet every now and again with a person whosecase answers to the following description The inheritorof a nervous organization, whose tend ency may haveculminated in some one Or other of the neuroses— epilepsy,chorea, neuralgia - for a while sober,and attentive to busine ss,becomes restless,moody and thoughtful . His d isposition, in fact,changes,he loses his relishfor society,and his accustomed appetite for food . A fterth is state has lasted a little while,he sudd enly abandonsall his duties, and addicts him self to drink . His wholenature,(as I have just remarked,und ergoes a most surprising change . There is scarcely an action,h oweverimproper or subterfuge,however cunning, of which hewill . not be guilty in his all - absorbing desire to gratifyhis craving for d rink . At tim es he may make a publicexhibition of his weakness, but more commonly heretires into solitude, that he may enjoy his propensityto 'its fullest extent . I t may be that,as he drinks, allpower of self- control wanes, and his emotions Obtaincomplete sway over him . I f, now, he is possessed bysome hallucination or illusion,he may commit acts ofviolence, even to bloodshed . After indulging for a

METHOMANI A . 179

length of time, variable according to the violence of hisdisease, or the strength of his constitution, the attacksubsides, leaving him in a state of extreme physical andmental prostration .

I n his Anatomy of Drunkenness, Dr. Macnish has

recorded a striking example of the unrelenting temptation which assails the m eth omaniac . One of this unfortunate class makes the following reply to the urgentremonstrances of his friends

“Y our remarks are just ; they are, ind eed too true,

but I can no longer resist temptation . I f a bottle ofbrandy stood at one hand and the pit of hell yawned atthe other, and I were convinced that I would be pushedin as sure as I took a glass,I could not refrain . Y ouare

very kind,good friends,but you may spare yourselvesthe trouble o f trying to reform me ; the thing is out Ofthe question .

Obviously this is the language of d espair,but it is alsothe - language of a man who has struggled many a timeagainst his besetting sin,and who only throws downhisarms when, at last,he finds how utterly hopeless thecombat is,and how completely he isworsted every timehe engages with his unseen antagonist . Not that Slich aman ’s condition is really hopeless . Our inebriate asylums demonstrate quite conclusively how much temporary

,nay, sometimes permanent benefit, may be

“

conferred on this unfortunate class by seclusion and medical care .

The disease under which the m ethomaniac labors de

180 METHOMAN I A .

prives him, therefore, of his power of self-control . On

this poin t Dr. Hutchinson has well remarked that“those afflicted with the disease cannot abstain,however convinced they may be of the impropriety of yielding to their propensity,or however desirous they may beto subdue it . ” With the m eth omaniac there is no premeditated drinking ; on the contrary, he deplores hispropensity,he evens warns . his friends of the approachof the craving,and may entreat their help to escape it .This fact is of primary importance

'

in the diagnosis ofmethomania, and assists materially in distinguishingbetween it and the ordinary forms o f . inebriety .

Another feature met,

with among people prone to outbreaks o f this d isease is the great mental excitementthey sometimes experience after taking only a smallquantity of ardent Spirits . The sane toper drinks andgrows merry and bright, or stupid and sentiment al,accord ing to , his temperament ; but persons prone tomethomania get often wild and uncontrollable after

'

aglass or two . Last Christmas night, for example, oneof this class took two “ glasses ” of whisky in a saloon,and returned home in a state of such wild excitementthat it required the united strength Of six men to holdhim . Being o “ ered a thick porcelain cup with water todrink,he drove his teeth quite through it,and bit out apiece as large as his mouth could hold .

The diseasewhich we have thus been considering is atransitory form of mania . I t has its period s of access

,

of exacerbation and of decline . I ts subject often feels

182 METHOMAN I A .

connected therewith . Here we have the physiologicalbasis of the inevitable struggle which every one experiences between the two opposing forces of the organismon the one hand, the passions as they proceed fromthelower,and,on the other, conscience,or the sum of thefaculties of the higher nature . St . Paul expressed thewhole idea in his words to the Galatians For the fleshlusteth against the spirit,and the spirit against the flesh ;and they are contrary the one to the other so that yecannot do the things that ye would .

” Now the methomaniac is pre - eminently in this unfortunate position .

Owing either to an inherent feebleness o fwill,or to theextraordinary force o f his one passion it refuses to begoverned periodically it gets the bit between its teeth,and carries him where it will . This state of the case fitsexactly into our idea of moral insanity,and we are constantly led to the evident conclusion that m eth omaniacs

are insane . We see nowwhere Our subj ect touches thequestion of legal responsibility . This point, however,would require a separate treatise to do it justice for thepresent, I must limit myself to one o r two observations .I t will be remembered that our courts of law do no tallow intoxication to be paraded as an excuse for crlm e .

Some other defense must, therefore,be substituted, andthat of insanity (methomania) i s as likely to be introduced as any other . As this is a plea o pen to greatabuses, it

.

is all the more necessary that the medicalexpert should furnish himself with tests fo r d iscrim inating between thegenuine m ethomaniac and him Who is

METHOMANI A .

asserted to be such on m ere ground s of exped iency . I t

has often occurred to m e of late that the reckless u sen ow so commonly made of the d efense of insanity incrim inal cases is very much calculated in the long run tod im inish its truly great importance,at least with thepublic, and to engender a suspicion of its genuineh esseven when urged in good faith and on strong evid ence .

E ven for this reason alone we should attentively studythe essential points of d ifference between the , ,m etho

maniac and the drunkard . I need hard ly apologize,therefore, if I d irect your attention to the followingpoints which seem of great service f or the purpose ofthis d istinction1. An inherited or acquired tend ency to insanity .

2 . An irresistible d esire to d rink .

The former can exist without the latter,because,aswe have already seen,the tend ency to insanitymay finda vent in various ways ; but I cannot doubt that theind ividual who has the irresistible d esire ford rink isinsane . He is none the less so,be it observed, that Ofttimes it is the result of his own misconduct . Whetherthe desire to d rink is irresistibl e in any given ind ividual,that is to say,whether it predominates in him in such ad egree as to govern his conduct despite the promptingso f conscience and the d ictates of self- interest,will oftenbe a very difficult point to determine,Owing to the impossibility of read ing the secrets of men’s heart

'

s ; yet,when cautiously examined and intelligently applied, itwill furnish a very valuable test for Separating the realfrom the feigned disease .

,THE QUARTERLY JOURNAL OF INEBR IETYThil Journal ll d evo ted to th e scientific study o f I neb riety, Opium M ania, and th e vario u s d is.

ord ers which b o th preced e and fo llow. Th e many fo rm s o f N euro ees wh ich arise from th e ac tion o f

than toxic agents are increasing and b ecom ing m ore complex,requ iring spec ial study,and as ye t

0 0 com tively unknown to th e pro fessio n .

Es ta ahcd in 1876,itwas th e first,and is now th e only Journal pub lished d iscussing th e scientific

aid e o f I NEBRI ETY .

I t occupies a field entirely new,and conflicts with no o th er pub lication,and hence has a circle o f

ra don no t confined to any one class .

Th is Quarterly is amed ium for th e presentation o f investigations and studies in this field also

the omclal organ of the

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All b ook ,magazines,and exchanges,with contrib utions and sub scriptions,sh ould b e ad dre ss to

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Fo r the Special Treatment o f I nebriates and Opium Cases.

Such personaare roco nized as diseased ,requiringab solute rem o val from temptation ; rest,changeo f th ought and living, 171 h legal contro l als o every m eans known to science to b ring ab ou t resto ra

tion. Th en combined with pleasant surround ings, and th e influence o f a true CHR I STI AN HOME . giveassurance o f apermanent cure in m o st cases . th e Lone !: is attractively lo cated in th e sub urb s,wh erea limite d numb er o f patients are received ,all of wh om come und er th e d irect personal care and super

vision o f the physician. Address.

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s e r i e s 3 .

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V e d ico -Legal So ciety o f N ew Y o rk, o f princ ipal papers read b efo re

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'

o c ie ty, 18 74 \

to 18 78 , and co ntains the fo llowingPrinc iples o f Legal R espo nsib ility Applied to the I nsane,

by JAM ES J. O’

DEA,M .D .

M o no m tziia as Effec ting Testamentary Capacity, byEDWARD PATTER SON,E SQ.

The Diagno sis o f Hanging, by AM BROS E TARD I EU,M .D .

The Proper S tatus o f th e I nsane and Feeb le -M ind ed , by

JOHN O RDRONOUX E SQ ,M .D .

M alpractice in S urgery,by FRAN K H . HAM I LTON ,M .D .

Penal Laws o f‘ S uic id e,by R . S . GUERN S EY .

R e tiring Ad d ress o f the‘ Presid ent,CLARK B ELL,E SQ.

Epilepsy with M ania,by A . O . KELLOGG,M .D .

Lo ss o f Co nscio usne ss,by FRAN K H . H AM I LTON ,E SQ.

M ilk in its M ed ico -Legal A spec t, b y R . O . DOREM U S,M .D .

Mysterio us D isappearances and Pre sumptio ns o f Death,by WM . G . D AV I ES,E SQ.

Scho o l R o om Po iso ning in N ew Yo rk . R EPORT OF A

COMM I TTEE .

Railway I njuries o f the Spine, by WM . A . HAM

M OND,M .D .

Progress o f M ed ico -Legal Science in Am erica, b y

JAM ES ! . O’

DEA, M .D

Po rtrait o f D r. Geo rge M . Beard and Sketch o f L ife .

A N ewTheo ry o f Trance, its Bearings o n H uman Testimo ny,by GEO . M . B EARD ,M .D .

Perso nal I d entity,by APPLETON M ORGAN,E SQ.

The Plea o f I nsanity,by A LFRED M . CARROLL,M .D}Unio n o f Public Charities and Co rrectio ns. b y SAM U EL

A . RABORG,M .D .

Testam entary Capacity,by I SAAC RAY,M .D .

M o ralR espo nsib ility,b y M ORR I S E LL I N GER,E SQ.

Papers by JACOB F. M I LLER,E SQ ,E . C. M AN N,M .D . ,

PROF. JOHN H . PACKARD,CEPHA S BRA I N A RD, E SQ ,

Portraits o f lead ing M ed ico -Legal Jurists and Alienists .

Price,Clo th, Paper,

T I—I E H I GHLA N DS .

FAM I L Y HOM E FOR N E RVOU S A N D

M E N TA L D I S E A S E S .

W I N CH E N D O N , M A S S .

Tats Fam ily Hom e is cond ucted b y Dr . I raRussell and Dr. Fred erick W. Ru ssell,b o th o f wh

have mad e th e stu d y and treatmen t o f m ental and nervo u s d iseases,ph ysical and nervo u s exh au s ti

opium and alcoh olic in eb riety a spe cialty . Th e Hom e is no t an institu tio n o r asylum . I t is to all

tents and purpo ses a Fam ily Hom e,” wh ere everyth ing is mad e as h om elike as po ssib le . Patie

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gentlem en are employed as attendants and companions o f th e male patients,and educated Am eric

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Th e feeling o f so cial d egrad ation that is comm only felt b ypatients in Retreats and Pub lic I nstit

tions,wh o are su b j ected to th e co ntrol o f unc ultivated nurses, is no t experienced h ere . Th e u tm t

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private practice,and wh en need ed th e ab lest m ed ical talent in th e country is called into consultati

Th e Highland s,so called ,is a pleasant m ansion with co ttages annexed , situated in th e m id st

ample ground s, on an em inence o verlo okingth e town o f Winch en d on and th e valley 0 t M iller’

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From th e wind ows a superb range o f b ills and m ountains can b e seen, reaching from Wachusett

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A piano ro om ,b illiard ro om , b owling salo on and ample fstab lingare pro vid ed on th e gro un

Th e d rives in th e vicinity are consid ered d elightful,and for h ealth fulness o f lo cation th e Highlan

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d ressed to h im , or to Dr. F .W. Russell th e assistant superintend ent. For information we are perm it

to refer to th e fo llowinggentlemen

C. F . Fo lsom , M D . , Pro f . M en tal Disease , G . F . Jelly, M .D . ,123 B oylsto n S treet B o stoHarvard Co llege, 15 M arlb o ro S t. ,B o sto n . M ass .

W . C. William son, Esq .,1 Pemb erto n Square , C H . Hugh es , M .D Edito r o f Alienist ax

B o x to n . N eurologis t,S t . L o u is,M o .

J.H. Hard y .Esq . ,23 Court S tree t, B o ston .

3;E C Spi tzka,130E . 5oth S tre e t,

Rev G .J . M agill,D . D . ,Newport,R . I . W. W. Go d d ing,Superintend entNatio x L. I nsw

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Th e 2 8 th A n nu al S tat em e n t

OF THE

Equitable Life Assurance SocietyO F THE U N ITED S TATES .

Sh ows th e S o ciety e xceed s every o th er leading assurance company in th e followingno tab le particulars

THE LARGEST NEW BUS I NESS .

Assu rance written in 1887,

THE LARGEST AMOUNT OF OUTSTAN DI NG ASSURANCE,THE LARGEST SURPLUS .

Assets,

Liab ilities,(4per cent. valuation)

SURPLUS, $18 . 85

THE LARGEST PER CENTAGE OF ASSETS TO LI AB I L I TI E S, 1271}THE LARGEST I N CREASE I N ASSETS .

I ncrease during th e year,

THE LARGEST I NCOME,

THE LARGEST PREMI UM I NCOME,

THE EXCESS OF I NCOME OVER DI SBURSEMENTS,Excess,

Vo l. 3 o f the J o urnal was c o mple te d b y th

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This vo lum e c o ntains th e fo llowing o riginal article s °

Shall we Hang the I nsane wh o commit Hom icid e ! By CLARK BELL, E SQ.

I ncrease o f I nsanity ; Cause s and Rem edy. By I RA RUSSE LL, M . D .

Repo rt o f Committee o n Lunacy L egislatio n I n I LL I N OI S . With 8 111 o f Dr. FRE

H. W I N ES .

Repo rt o f Committee o n Lunacy L egislatio n in WI SCON S I N .

I nsanity as a plea fo r Divo rce o r Nullity. By GEO. H. SAVAGE, M . D

Ab so rptio n o f'

Arsenic by the B rain .

’

By R . H . CH I ’

I‘

TEN DEN and HERBERT E . SM I ’I ‘

Pho tograpy and M ed ical Jurisprud ence . By WM . M . M ATHEW, E SQ.

Case o f L uc ille Dud ley. By W. H . O’

SAN KEY, M . D .

S truc ture and Func tio n o f Gray M atte r o f Brain . By CHARLE S HE I TZ M AN , M .D .

Fraud ulent Dam age s in Railway Accid ent Case s. By C. J. CULL I N GWORTH,M . D .

Po iso ning by Extract o f Co nium . By A . J. PEPPER, M . D .

S im ulated I nsanity. B y PROF. W I L LE .

S till B irth s. By H . D . CHAPI N, M . D .

Classificatio n o f M ental Disease s . By PROF. DR . LEFEBVRE o f B elgium .

1

Re tiring Ad d re ss o f Pre sid ent D R . R . O . DOREM US .

I naugural Ad d re ss o f President D R . I SAAC LEW I S PEET.

I neb rie ty and Criminal Re spo nsib ility in M exico . By EN R I QUE A. FR I M ONT,M .

Autopsia Cad averica L egalis. By TH o s. R . BUCKHAM , M . D .

I t also Co ntains, Po rtraits o f

DR . R . SwAvN E TAY LOR, D R . THO S . R . B UCKHAM,TH E STATUE To PINEL . D R . J . L . L I TTLE .

Po rtraits o f R I EL and D R . B EACH,(wh o were exe cu ted,)

With EDI TOR I AL , TOX I COLOG I CAL o riginal m atter, b e sid e s RECENT LEGAL DECI S I o

and reviews o f new b o o ks .

I t has a fu ll ind ex and c o ntains 49 2 pp. o f intere st to e ve

stu d ent o f M e d ical J u rispru d ence o r Fo re n sic M e d ic e n e .

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Vo l. I o u t o f print .

PR I CE

FI GURESFROM THE

FORTY-THIRD'

ANNUAL REPORT

NEW YORK L I FE

I N SURAN CE COM PAN Y

W lLL lAM H . B EERS , Pre s id e nt .

°<lJ A N U A R Y l,

A to tal incomc o f o ve r twenty- two millio n d o llars, anb enefits to po licy ho ld ers o f o ve r nine millio n d o llars.

I nte re st income o verthre e millio n seven hundred tho uand d o llars, b e ing nearly 5 pe r cent . o n ave rage ne t asse ts,

M arke t value o f se curities o ver/thre e millio n d o llars i

exce ss o f the ir co st value o n the Company’

s boo ks .

A surplus, I nclud ing. the To ntine Fund , o f nearly twelv

millio n d o llars by the new S tate standard .

THE REPORTALSO SHOWSAN I NCREASE o f nearly three million d ollars in income, over eigh

millions in net assets, over twenty-one m illions in insurance written, an

o f o ver fifty-four millions of insurance in force—OVER THE FI GURES 0

THE PRECEDI NG YEAR .

ASSETS, J anuary 1, 18 88, over eighty-three million d ollars.

I NSURANCE I N FORCE, J anuary 1, 1888, over three hundred and fift

eight million d ollars.

The N EW YORK L I FE’

S Po licies are special!adapted to the circumstance s o f pro fe ssional m en, furnishin,

F o r t h e y ear e na t ng u ec em o er 6 1 8 t, i 6 6 1 .

$ 1 8 8 .

u n t .

Amount . Amount.

o licies and Annuities I n Policiesand Annu ities info rce,J an . 1st,1887 . 88 f o rce,J an . I sr,1888 . 51

isks Assumed 37 Risks Terminated . 74

25 152 232 $463,23C,671 25

R e v e n u e A c c o u n t .

0 Balan ce from last account 31 By End owm ents,Purchased I nsurPrem iums 62 ances Div i d ends, A nnu itiesI nterest,Rents and Premium and Death Clainis .

on Securities 84 Comm issio ns, Comm u tations,Taxes and all o ther Expen

Balance to new acco unt .

B alan c e S h e e t .

0 Reserve f or Policies in f o rce Bo nd s Secured b y M ortgages onand fo r risks terminated . 430,096 00 teal Estate $49,615,268 06

Premium s received in ad vance 82,314 36 United State s and o ther Bo nd s . 43,439,877 8 1Surplus at fo ur per cent 6, 52 Real Estate and Loans on Co l

late ials . 37Cash in Banks and Trust Companies at inte rest C6

I nterest accru ed ,Premiums d eferred and in transit and Su ndries 93

83

I have carefully exam ined the forego ing statement and find the sam e to b e co rrect.

A . N . WATERHOUSE,A ud itor .

From the Surplus ab o ve state d a d ivid end will b e apportioned as usual.

RisksAssumed . Outstand ing.

1884 8311 5!188518861887

NEW YORK, January 25,1888 .

ROBERT A . GRANN I SS, Vice -Presid ent .

I SAAC F. LLOYD , 2d Vice -President . W I LL I AM J . EASTON, Secretary .

O F T R U S T E E S .

JUL I E»: T . DAV I ES , N I CHOLAS C. M I LLER.

\ OBERT S EWELL, H EN RY H . R OG ERS ,S . VAN R EN S S E LAER CRUG ER, JI O .W .

CHAR I ES R . HEN DERS ON , THEOD ORE M O R I O R O .

GEORGE B L I S S , W I L L I AM BABCOCK,R U FUS W . PECKHAM, PRESTON B . PLUM R,

l. HO BA RT I lI Z RRlCK, WM . D . WA SHBURNWM . P. D I XON

R OBERT A . GRAN N I S S,

-Z, 5' Nebr' Ety

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