Chapter IV: Temperance Hospitals

THE LONDON TEMPERANCE HOSPITAL.

In 1865 Dr. S. Nicholls, medical officer of the Longford Poor-law Union, published a report of the results of non-alcoholic treatment of disease as practiced by him for sixteen years in the institutions under his control. The figures for 1865 were:--

ADMITTED. RECOVERED. DIED.

Fever, 142 135 7
Scarlatina, 33 30 3
Small-pox, 48 47 1
Measles, 8 8 0
--- --- ---
231 220 11

_The treatment was altogether without wines, spirits or alcohol in any form._

The death-rate reported by Dr. Nicholls was so small that some of the more observing and progressive physicians were led by it to begin similar experiments in the disuse of alcohol in other hospitals. Among these was Dr. James Edmunds, senior physician at the Lying-In Hospital, London. The experiments continued a year with a reduced death-rate among both mothers and children. But the great brewers of London, who contributed largely to the support of this hospital raised such a storm of opposition to the discontinuance of alcoholic liquors that the experiments had to be abandoned.

The establishment of a temperance hospital was now suggested, and in October, 1873, a temporary institution was opened in Gower Street, accommodating only seventeen in-patients at one time. Later a fine site was secured on Hampstead Road, and in 1881 the east wing and centre were opened by the Lord Mayor of London. In 1885 the west wing was finished, and the opening ceremonies conducted by the Bishop of London.

At the time of the launching of this enterprise, wine and spirits were literally "poured into" sick persons, with frightful results. Death-rates were enormous. The success of the Temperance Hospital has no doubt had much to do in modifying this abuse. Its death-rate, on an average, has been only 6 per cent. throughout the years since its beginning. This is lower than that of any other general hospital in London, and certainly proves conclusively that alcohol is not necessary in the treatment of disease. The physicians connected with it have been men of eminence in the profession, such as Dr. James Edmunds, Dr. J. J. Ridge and Sir B. W. Richardson.

The visiting staff is not compelled to pledge disuse of alcohol, but is required to report if it is used. During all these years it has been given only seventeen times, then almost entirely in surgical cases, and in nearly all of these a fatal result proved it to be useless. The patients who are restored to health leave without having had aroused or implanted in them a desire for alcoholic liquors, neither have they been taught to regard them as valuable aids to the recovery of health and strength. On the contrary, there have been many who have come in, suffering from this delusion, who have had it thoroughly dispelled, both by their own experience and the experience of their fellow patients.

Sir B. W. Richardson took charge of this hospital from 1892 until his death in 1897. In his report in 1893 he said:--

"I remember quite well when according to custom, I should have
prescribed alcohol in all those cases that were not actually
inflammatory (speaking of diseases of the alimentary system);
but I never remember having seen such quick and sound recoveries
as those which have followed the non-alcoholic method."

The following selection showing points of practice in this hospital is taken from the same report:

"For medicinal purposes, we are as free as possible from all
complexity. We use glycerine for making what may be called our
tinctures, and in my clinique I am introducing a series of
'waters'--aqua ferri, aqua chloroformi, aqua opii, aqua quinae,
and so on--to form the menstruums of other active drugs when
they are called for. I also follow the plan of having the
medicines administered with a free quantity of water, and with
as accurate a dosage as can be obtained, for I agree with Mr.
Spender's original proposition that the administration of
medicines in comparatively small and frequent doses is more
effective and useful than the more common plan of large doses
given at long intervals.

"I treat many cases by inhalation, and for this end I use oxygen
in a new and, I hope, efficient manner. I make oxygen gas a
medium for carrying other volatile substances that admit of
being inhaled with it. The mode is very simple. * * * * * In the
pneumonic and bronchial cases the treatment has been of the
simple and sustaining kind. The medicines that have been given
during the acute febrile stages have been chiefly liquor ammoniae
acetatis and carbonate of ammonia in small and frequently
repeated doses. The patients have all been well and carefully
fed on the milk and middle diet until convalescence was
declared. In some of the more extreme instances, where there was
fear of collapse from separation of fibrine in the heart or
pulmonary artery, ammonia has been given freely according to the
method I have for so many years inculcated. I have also in cases
of depression under which fibrinous separation is so easily
developed, lighted on a mode of administering ammonia which
combines feeding with the medicine. I direct that a three or
five-grain tabloid of bicarbonate of ammonia shall be dissolved
in a cup of coffee or of coffee with milk, and be taken by the
patient in that manner. The coffee can be sweetened with sugar
if that is desired by the patient, and the ammonia can be so
administered without any objectionable taste to the beverage.
After what is called the crisis in acute pneumonia, I administer
very little medicine of any kind; I trust rather to careful
feeding with an occasional alterative or expectorant, as may be
required. * * * * * I am satisfied that no aid I could have
derived from alcoholic stimulants, as they are called, could
have bettered my results. I feel sure any candid medical brother
who will have the steady courage to put aside many old and
unproven, though much-practiced, methods, based only on
unquestioning and unquestioned experience, and to move into
these new fields of observation and experience, will, in the
end, find no fault with me for leaving a track which, though it
be beaten very firmly and be very wide and smooth to traverse,
may not, after all, be the surest and soundest path to the
golden gate of cure."

THE FRANCES E. WILLARD NATIONAL TEMPERANCE HOSPITAL.

This hospital is situated at 343-349 South Lincoln Street, Chicago, in a handsome and well-equipped building. It is connected with a medical school. The history of its origin is best told in the words of the woman to whom the conception of such an institution first came, Dr. Mary Weeks Burnett, for several years the physician in charge:--

"In the fall of 1883 there came to a few of us the thought that
there was a point of weakness in the temperance pledge. It
reads, 'We promise to abstain from all liquors--_as a
beverage_.' We had found in many instances in reform work that
pledging to abstain from liquor 'as a beverage,' and leaving the
victim to the unlimited use of it in physicians' prescriptions,
was simply a skirmish with the devil's outposts, that the
conflict, based upon these grounds, was short, and defeat almost
sure; and the great fact remained that the innermost recesses of
evil force and power were by this pledge still left unassailed.
We found that this power of evil had largely entered the homes
of our land through the family physicians, and that willingly or
not, the physicians were being used to bring in even our
innocent children as recruits to this unrighteous warfare.

"Now, how could we hope to eliminate those three little words
'as a beverage' from our pledge?

"In some way we must bring about an arrest of thought in the
minds of 100,000 men and women physicians whose medical
education warranted them in supposing that they knew that of
alcohol which justified them in its full and free use in medical
practice. Nothing short of a great national object lesson could
ever convict and convert this broad constituency through which
the power of darkness is doing his deadliest work.

"In January, 1884, four of us met and organized under the name
of the National Temperance Hospital. To have our sick properly
cared for in our hospital we found that we should be obliged to
train our own nurses. The nurse who has always been accustomed
to administering alcohol under the physician's prescription at
all times and under all circumstances, and to administering it
herself at her own discretion if the physician is not at hand,
is a terror to the temperance physician. So we included in our
charter a Training School for Nurses. It is now open, and we
expect, as the years go by, to send out armed with our training
school diplomas, grand, noble women and men thoroughly trained
in true temperance methods for relieving the sick.

"Our organization lived on paper, and was sustained in purpose
by prayer and planning for two years. In September, 1885, Mr. R.
G. Peters, of Manistee, Michigan, signified to us his intention
to give $50,000 toward our buildings whenever we had
satisfactorily materialized. About the same time a good old
gentleman in Michigan placed in his will for us $2,500. The dear
man is still living, and we hope will live many years. Even the
money when it comes can never be of greater service to us than
was the knowledge at that time that the Lord was our leader and
was raising up helpers in the work.

"In January, 1886, we found, according to the law under which
our charter was obtained, that we must commence active
operations at once, or obtain a new charter. After a blessed
season of prayer and counseling together in the board meeting
held January 29, there being present only the members of the
board at that time, Mrs. Plumb offered to advance $3,500, if
necessary, toward the expenses for the first year. We accepted
it with great thankfulness, rented a building the 15th of
March, 1886, and formally opened the National Temperance
Hospital on the 4th of May, 1886.

"In April, 1886, we took a firm stand upon the alcohol question,
and decided to eliminate it entirely from our list of
therapeutics, as we had become convinced that there were better
and more reliable remedies as stimulants and tonics.

"In September, 1886, at our annual meeting, we reaffirmed this
decision, and we now have the following as one of the articles
of our constitution: 'All medicines used in the hospital must be
prepared without alcohol, and all physicians accepting positions
on the medical staff of the hospital or dispensary must pledge
themselves not to administer alcohol in any form to any patient
in hospital or dispensary, nor to call in counsel for such
patients any physician who will advise the use of alcohol.

"Any physician of pure character, and in good standing, who is a
total abstainer from liquor and tobacco can, by subscribing to
this pledge, become a member of our physicians' association, and
if so desired, be placed upon the visiting and consulting staff
of the hospital.

"The cases treated in the hospital include many of the serious
medical and surgical maladies. In no case has any particle of
alcohol been used, and the usual inflammatory secondary symptoms
resulting when alcohol is used have been entirely avoided.

"Our course of building-up treatment is, we believe, unique in
hospital practice. It consists of treatment by massage, heat,
rest, passive exercise, etc., together with proper medication
and a thoroughly nutritious diet adapted to the individual needs
of the patient.

"To alleviate, and, if possible, cure disease, is the design of
all hospital treatment. In our hospital we seek to gain this
result by means which the highest science of the day approves,
and in addition to this we have especially at heart the
advancement of the temperance reform. There are, we believe,
thousands of temperance adherents, who do not yet fully
apprehend the importance of this hospital to the permanent
extension and progress of temperance principles. Although
prohibition as a _principle_ has been accepted by many, yet in
its _practical application_ in the home in serious illness, it
is still feared by the immense majority of even our strongest
prohibitionists. We are organized upon the basis _no alcohol in
medicine_, and we are preparing to demonstrate fully and
scientifically, so he who runs may read, that as in health, so
in disease and accident, alcohol in any form works to the
hindrance and injury of the vital forces, and prevents the
establishment and advancement of health processes in the
system."

At the opening of the hospital, May 4, 1886, Miss Frances E. Willard, the president of the National W. C. T. U., gave the following address:

"Nothing is changeless except change. The conservatives of one
epoch are the madmen of the next, even as the radicals of to-day
would have been the lunatics of yesterday. To prove this, just
imagine the founders of this hospital declaring to my
great-grandfather that because he had taken a cold was no reason
why he should take a toddy; and _per contra_, imagine my
great-grandfather's doctor marching into our presence here and
now, with saddle-bags on arm, and after treating us each to a
glass of grog for our stomach's sake, giving us a scientific
disquisition on the sovereign virtues of the blue pill, and
informing us that bleeding, cupping and starvation were the
surest methods of cure!

"That the story of Evolution is true I am by no means certain,
but that 'We, Us, and Company,' are 'evoluting' with electric
speed ourselves it is useless to deny. This very hospital is the
latest mile-stone on the highway of progress in the American
temperance reform. The conditions that have made its existence
possible have developed in this country within about twelve
years.

"Public opinion, that mightiest of magicians, has within that
time been educated up to this level and has said in its
omnipotence: 'Hospital, be!' and, behold, the hospital _is_.

"When I joined the ranks of temperance workers in 1874, a
thought so adventurous as that alcoholics in relation to
medicine were a curse and not a blessing had never lodged within
my cranium. But, as in duty bound, I studied the subject from
the practical, which is the nineteenth century standpoint.

"I investigated the cause of inebriety, and found the medical
use of alcoholic stimulants a prominent factor in this horrible
result; I sought for expert testimony, and found Dr. N. S.
Davis, ex-President American Medical Association, saying 'that
in his ample clinical practice he had for over thirty years
tested the medical uses of alcoholics, and had _found no case of
disease and no emergency arising from accident that he could not
treat more successfully without any form of fermented or
distilled liquors than with_'; found Dr. James R. Nichols, of
Boston, so long editor of _The Journal of Chemistry_, declaring
as his deliberate scientific opinion that the entire banishment
of these liquors 'would not deprive us of a single one of the
indispensable agents which modern civilization demands'; found
Dr. Green, of Boston, saying before the physicians of that city
that it is upon the members of the medical profession and the
exceptional laws which it has always demanded, that the whole
liquor fraternity depends more than upon anything else to screen
it from opprobrium and just punishment for the evils it entails,
and that after thirty years of professional experience he felt
assured that alcoholic stimulants are not required as medicines,
and that many, if not a majority of the best physicians, now
believe them _to be worse than useless_. Meanwhile I learned
that across the sea such great physicians as Dr. Benjamin Ward
Richardson, Sir Andrew Clark, Sir Henry Thompson and Sir William
Gull held views which for their latitude were almost equally
radical; and Dr. James Edmunds, founder of the London Temperance
Hospital had demonstrated publicly and on a grand scale the more
excellent way, his hospital having 4-1/2 per cent. fewer deaths
than any other in London, taking the same run of cases, and that
the Royal Infirmary at Manchester reported the medicinal use of
alcohol fallen off 87 per cent. in recent years, with a decrease
in its death-rate of over one-third. Besides all this, and
independent of any such investigation, the 'intuitions' of our
most earnest women were leading them out of the wilderness. As
is their custom, they determined to put this matter to the test
of that 'experience which one experiences when he experiences
his own experience,' and a whole body of divinity upon the
advantages of non-alcoholic treatment could be furnished from
their evidence. I was not able personally to pursue this method,
my own condition of good health having become chronic. Away back
in 1875, in executive committee, one of our leading officers was
stricken with _angina pectoris_. A physician was promptly
summoned. 'Give her brandy,' he said, and insisted so stoutly
upon it as vital to her recovery that we should probably have
sent for it, but the dear woman gasped out faintly, 'I can die,
but I can't touch brandy.' She is alive and flourishing to-day.
Another national officer absolutely refused whisky for a violent
attack of a very different character, the physician telling her
that she could not live through the night without it; but she is
still an active worker--a living witness that doctors are not
infallible. Instances like these have multiplied by hundreds and
thousands in our Woman's Christian Unions and Bands of Hope.
'No, mamma I can't touch liquor; I've signed the pledge,' is a
protest 'familiar as household words.' Meanwhile, I beg you to
contemplate something else that has happened. Behold, our own
beloved beverage itself,

'Sparkling and bright,
In its liquid light,'

has come grandly to our rescue in this crusade against alcohol
in the sick room. Water has become a favorite--nay, even a
fashionable--medicine! The most conservative physicians freely
prescribe it in the very cases where some form of alcohol was
the specific so long. To be sure, they give it hot, but we do
not object to that, since 'water hot ne'er made a sot,' and it
cures dyspepsia and all forms of indigestion as whisky never
did, but only made believe to; while its external use as a
fomentation is banishing alcohol even for old folks' 'rheumatiz'
where, as a remedy, it would be likely to make its final stand.

"Farewell, thou cloven-foot, Alcohol! Thou canst no longer hide
away in the home-like old camphor bottle, paregoric bottle,
peppermint bottle or Jamaica-ginger bottle; and a tender
good-by, Mrs. Winslow's Soothing Syrup, for be it known to you
that the wonderful discovery stumbled over for six thousand
years has in our day been made, namely, that hot water will
soothe the baby's stomach-aches and the grown people's pains,
and drive out a cold when all else fails. _Jubilate!_ Clear out
the cupboard and top shelf of the closet now that the sideboard
has gone. Let great Nature have a glance to 'mother up' humanity
with the medicine, as well as the beverage, brewed in Heaven."

THE RED CROSS HOSPITAL.

A philanthropic young woman, Miss Bettina A. Hofker, entered Mount Sinai Training School for Nurses in 1891. Her desire was to fit herself as a nurse for the poor. After her graduation in 1893, she met Mrs. Charles A. Raymond, a benevolent lady, who offered her pecuniary assistance in her work. Miss Hofker suggested that she would like to institute a Red Cross Hospital and Training School for Nurses. Mrs. Raymond succeeded in interesting others in the proposition. The name of Red Cross however could not be used without permission of the officers of the society bearing that name, but after consultation with Miss Barton, permission was granted. Several years previous to this, Dr. A. Monae Lesser, Dr. Thomas McNicholl and Dr. Gottlieb Steger had opened a small hospital under the name of St. John's Institute. This was now amalgamated with the Red Cross, and Dr. George F. Shrady and Dr. T. Gaillard Thomas, two of New York's leading physicians, were requested to act as consulting physicians.

The hospital does not confine itself to service in its building alone, but sends its workers wherever called, to mansion or tenement. The "Sisters" are trained for field service or for any national calamity such as floods, earthquakes, forest fires, epidemics, etc. When neither war nor calamities require their presence, they devote themselves to the service of the needy poor, or wait upon the rich, if called. The heroic service rendered by the surgeons and nurses from this hospital in the Cuban War, brought their work into great prominence.

At the suggestion of Miss Barton, the medical department of the hospital was commissioned to treat diseases without the use of alcoholic liquids.

Dr. Lesser, the executive surgeon, is a German, and of German education, having received his medical education in the Universities of Berlin and Leipsic. In a conversation with a press representative, Dr. Lesser said some time ago:--

"We have been convinced that the use of alcohol can be entirely
eliminated from our medical practice, and this has been
practically accomplished at the Red Cross Hospital. We find that
where stimulants are required, such remedies as caffeine,
nitro-glycerine and kolafra take the place of alcohol, and are
even more satisfactory. The main use of alcohol is to stimulate
the action of the heart in various ailments. The blood is thus
forced to the remote parts of the system, and poisonous
substances carried away. But, besides serving this good purpose,
the drug tears down and ultimately destroys the cellular tissues
of the body. A relapse is certain to follow the application. The
drugs that I have mentioned serve exactly the same purpose
without the disastrous results. We are proving this every day at
the Red Cross Hospital.

"Only a few days ago a boy was brought in, apparently at the
point of death. He was put into bed and watched by the nurse.
After a little ammonia had been given to him as a stimulant, he
unconsciously expressed himself to the effect that it was not
the same as they gave him in another place, and gradually when
it dawned upon him that no alcohol was administered by the Red
Cross, he said, 'Gin has allers made me better.' The doctor in
charge, who already suspected that the boy was pretending
illness for the sake of the drink, was not surprised an hour or
two afterwards to learn that he had demanded his clothes,
dressed himself, and left the hospital most ungratefully, but
apparently quite well."

Dr. George F. Shrady, one of the consulting physicians, is famous as having been in attendance upon both President Garfield and President Grant. He is the editor of the _Medical Record_, one of the most important medical journals published in America. While not a non-alcoholic physician, he says of the medical use of intoxicants:--

"There is altogether too much looseness among physicians in
prescribing alcohol. It is a dangerous drug. There is much more
alcohol used by physicians than is necessary, and it does great
harm. Whisky is not a preventive; it prevents no disease
whatever, contrary to a current notion. Another thing, we
physicians get blamed wrongfully in many cases. People who want
to drink, and do drink, often lay it on to the physician who
prescribed it. * * * * * I think that in most cases where
alcohol is now used, other drugs with which we are familiar
could be used with far better effect, and with no harmful
results."

Dr. Steger, another physician of the staff, says:--

"I don't use alcohol at all in my practice. I used to use it,
but my observation has been that other drugs do the same work
without the harmful results. Alcohol over-stimulates the heart,
and tears down the cellular tissues of the system, besides
causing other deleterious effects. The use of alcohol is simply
a superstition among physicians. They have used it so long that
they think they always must. I am not a total abstainer, but
that only shows that I take better care of my patients than I do
of myself. It is not good for a healthy man to drink, but
sometimes folks like myself do things which had better be left
undone. I have seen patients in hospitals made absolutely drunk
by their physicians."

The following interesting items in regard to practice in this hospital are culled from the report of 1897:--

"Temperature was never reduced by active drugs known as
antipyretics.

"Water was allowed freely after all kinds of surgical operations
and in fevers.

"Alcohol was never used as an internal medicine.

"The free use of water in saline solutions directly injected
into the tissues was found of great service. Quarts have been
injected that way with most satisfactory results.

"Antipyretics were altogether discarded as it is well known that
their action diminishes the tone of the heart. Artificial
reduction of temperature only deludes one into the belief that
the drug has improved the condition of the patient, while in
reality, it has no beneficial influence on the disease, and has
reduced the vital resistance of the patient. In no case has high
temperature harmed a patient and there was every evidence that
in some instances a high temperature was preferable to a low
one.

"Special attention has been given to the use of alcohol in
disease, not with any desire to approve or disapprove it, but
solely for the purpose of discovering the truth, for nothing
seems of greater public interest from a medical standpoint than
the truth regarding a subject for which so many virtues are
claimed on the one hand, and so many destructive elements proven
on the other. * * * * *

"We criticise the treatment of no institution, antagonize no
school of medicine, claim no unusual or peculiar scientific
virtue, but what we do maintain and insist upon is this: that
the human body may be ever so afflicted, ever so reduced, the
heart ever so feeble, and the spark of life ever so dim, the
conscientious student of medicine can secure as good results
without as with administration of antipyretics, sparkling wines,
beers or liquors.

"Experience teaches that true science does not antagonize
nature. In surgical cases, in septicaemia, in pneumonia, or in
any of the fevers, water freely administered has proven to be a
real source of comfort, and an aid to recovery. It is amazing
how favorably diseases terminate under this beneficent beverage.
The withholding of food does not retard, but rather hastens
convalescence.

"In the conduct of our Red Cross patients, irrespective of their
condition when admitted, it can be truly said that after
treatment began, delirium has not been witnessed in a single
instance, and as our hospital reports indicate, our mortality
has been unusually small.

"Alcohol has not figured as a life-saver in our institution.
Cases of extreme collapse following major operations, cases of
pneumonia, where the pulse ranged from 160 to 220, patients
suffering from pernicious anaemia, septicaemia, pyaemia, cholera
infantum and typhoid fever, some of whom when first seen were in
the worst stages of delirium and collapse have without alcohol
regained consciousness, overcome delirium and made excellent
recoveries.

"The following cases very forcibly illustrate the results of
non-alcoholic treatment:--

"Case No. 1. A child, aged nine months, under treatment for six
days for pneumonia, came under our notice on the seventh day.
The temperature was 106 5-10; pulse was 220; respirations 90.
Whisky, which had been given previously to the extent of two
ounces daily, was stopped. Carbonate of ammonia, caffeine
salicylate, nitro-glycerine and 1-10 of a drop of aconite were
given internally; camphorated lard applied externally; with the
result that on the ninth day temperature stood 99; pulse 100;
respiration 20. The child made a complete recovery.

"Case No. 2. L. was a child aged eight months, suffering from a
very violent attack of entero-colitis. For three weeks previous
to coming under our notice the patient received brandy,
stimulating foods and alkaline mixtures. Fearfully emaciated,
temperature 106, feeble pulse 182, frequent bloody discharges
from the bowels, numbering as much as thirty in a day and
constant vomiting, the child was considered beyond hope. Under
these circumstances, and at this time we first saw her. Brandy
and all foods were stopped; bowel flushings were given, 1-12 of
a drop of tincture of aconite was administered every half hour
and salicylate of caffeine every two hours. In twenty-four hours
the temperature was 105 and the pulse 160. In two days,
temperature was 102 and the pulse 140. In one week, temperature
was 99 5-10, pulse 110. In three weeks, the patient was
discharged cured.

"Case No. 3. Mrs. C., aged forty-three, who had been under
treatment for seven weeks for metrorrhagia, nietortes and
peritonitis came under our notice. Brandy which had been
previously given in large quantities had proved of no avail and
the patient was considered beyond recovery. We found her
completely prostrated, temperature 102, pulse 170, and
unconscious. The heart very weak and irregular. The brandy was
discontinued, salicylate of caffeine and nitrate of strychnia
were given with the result that in a short time the patient was
convalescent and finally recovered.

"Each case in our hospital is an additional proof that whether
found in wines, spirits or beers, alcohol can claim no right as
an indispensable medicine."

Dr. Lesser, who was Surgeon-General of the American Red Cross in the Cuban War said after his return from his first visit to Cuba that four out of six of his patients, to whom he allowed liquor to be given as a concession to the popular idea that it was necessary, died; while subsequently in treating absolutely without alcohol sixty-three similar cases, only one died, and he upon the day on which he was received at the hospital.

ALCOHOL IN OTHER HOSPITALS.

In the spring of 1909 a circular letter was sent to some of the best known hospitals throughout the country asking if the use of alcoholic liquors had decreased in those institutions during the past ten years. From the replies received the following statements are taken:

Cook County Hospital, Chicago, sent figures for two years only, 1907, and 1908. With 28,932 patients treated in 1907, the bill for wines and liquors amounted to only $719.40. In 1908 with 31,202 patients the bill for liquors amounted to $970.65. This makes a _per capita_ expenditure for liquors for 1907 of .024 cents, and for 1908 a _per capita_ expenditure of .031 cents. The _per capita_ expenditure for liquors during the same years in Bellevue and Allied Hospitals of New York city, with from 30,000 to 40,000 patients treated was .0246 and .029. Two or three cents as the yearly _per capita_ expenditure for alcoholic liquors in the two largest hospitals in America is striking evidence that the physicians practicing there have not large faith in whisky, or other alcoholic liquors as remedial agents.

Long Island, N. Y., State Hospital:--"We are not using more than half the amount of alcohol we used ten years ago."

Manhattan State Hospital, Ward's Island, New York City:--"Our patient population has averaged nearly 4,500 the last four years, and we have had about 750 employees, many of whom are prescribed for by institution physicians. The _per capita_ cost of distilled liquors for the last fiscal year was .0273 at this hospital."

Milwaukee City Hospital:--"No alcoholic liquors are used to any extent in this hospital, or prescribed by the staff. I know of no move against such use of liquors, but venture the assertion that the physicians believe they have more reliable agents at their command for most cases."

Pennsylvania Hospital, Philadelphia:--"We are now using about one-third the amount of liquor that was used in the Pennsylvania Hospital ten years ago."

The Presbyterian Hospital of Philadelphia sent figures for the years from 1900 to 1908. Those for 1900 show the cost of liquors to be $774.20 and for 1908 only $331.48. The number of patients was not given.

Grady Hospital, Atlanta, Georgia:--"That less liquor is now used than formerly is a fact well known to all connected with the institution."

Garfield Memorial, Washington, D. C., sent figures for ten years. For 1899 the cost of liquors was $490.08, with a steady decrease to 1908 when the cost was $274.58. Number of patients in 1899 was 1,171; in 1908, 1,898 patients. The _per capita_ for 1908 was .144 cents.

University Hospital, Ann Arbor, Michigan:--"Very little alcohol is prescribed in this hospital."

Maine General Hospital, Portland:--"Comparatively speaking, we use but little alcohol for the reason that we now have many remedies which, especially for continued use, are superior to alcohol, which twenty years ago we did not have. For the conditions or emergencies in which we think alcohol has a value it is used when required or deemed best."

Buffalo, New York, State Hospital sent figures for six years which include cost of alcohol used in the manufacture of pharmaceutical preparations, which, of course, makes a very decided difference. _Per capita_ for 1903 was 22 cents; for 1908 it was 18 cents.

Buffalo, New York, General Hospital:--"The use of alcohol as a drug in this hospital has diminished about one-third in the past ten years, but I wish to add in this connection that the use of all drugs has diminished in this hospital, and to the best of my knowledge in other institutions of a like character. The use of the microscope, and other studies have advanced the science of medicine the same as all other branches of learning, and other methods are coming to be used beside the use of drugs."

Mount Sinai, New York City:--"The use of alcoholic beverages here for medical purposes is the exception rather than the rule. The majority of our cases are surgical cases, and in these alcoholic liquors are rarely prescribed for any purpose whatsoever."

Massachusetts Homeopathic Hospital, Boston, sent figures for five years. For 1904 the cost of alcoholic liquors was $197.69 with 3,720 patients; for 1908, the cost was $69.82 with 4,543 patients. The _per capita_ cost for the five years is as follows: 1904, cost .0531 cents; 1905, cost .0474; 1906, cost .034; 1907, cost .0171; 1908, cost .0153.

In the _Boston Medical and Surgical Journal_ of April 15, 1909, Dr. Richard C. Cabot gave a table showing the decrease in the use of alcoholic liquors, and of other drugs in Massachusetts General Hospital, Boston.

The following is his table:

1898 1899 1900 1901

Ale and Beer $759.00 $793.90 $1,062.00 $723.00 Wines and liquors, 1,563.00 2,209.00 1,348.00 1,063.00 --------- --------- --------- --------- Total for alcoholic drinks, $2,321.00 $3,002.00 $2,410.00 $1,786.00

Total for other medicines, $8,424.00 $10,013.00 $10,132.00 $9,168.00

Number of patients, 5,005 5,203 5,012 5,495 Cost of alcohol per patient, $0.46 $0.57 $0.48 $0.32 Cost of medicine per patient, 1.68 1.92 2.02 1.66

1902 1903 1904 1905

Ale and beer, $605.00 $338.00 $431.00 $301.00 Wines and liquors, 799.00 688.00 904.00 144.00 --------- --------- --------- ------- Total for alcoholic drinks, $1,404.00 $1,026.00 $1,335.00 $445.00

Total for other medicines, $9,772.00 $7,815.00 $9,162.00 $7,018.00

Number of patients, 5,342 5,429 5,709 5,531 Cost of alcohol per patient, $0.26 $0.19 $0.23 $0.09 Cost of medicine per patient, 1.88 1.43 1.60 1.26

1906 1907

Ale and beer, $192.00 $203.00 Wines and liquors, 546.00 610.00 --------- --------- Total for alcoholic drinks, $738.00 $813.00

Total for other medicines, $5,981.00 $5,492.00

Number of patients, 5,513 5,966 Cost of alcohol per patient, $0.13 $0.13 Cost of medicine per patient, 1.00 0.92

Dr. Cabot says:--

"Since there has been no fall in the price of stimulants or
medicine, the diminished expenditure corresponds to a diminution
in the number of doses of medicine and stimulants, and indicates
a rapid and striking change of view among the members of the
staff of the hospital, especially in the past five years, when
it has become generally known that alcohol is not a stimulant
but a narcotic and that drugs can cure only about half a dozen
of the diseases against which we are contending.

"There has been during this period no increase in the proportion
of surgical cases among the whole number treated, so that the
decreased use of medicines and alcoholic beverages has not
resulted from an increased resort to surgical remedies. On the
other hand, there has been a great increase in the utilization
of baths (hydrotherapeutics), of massage, of mechanical
treatment and of psychical treatment, all of which accounts no
doubt for part of the falling off in the use of alcohol and
drugs."