a Physician’s Point of View
1876 — Temperance Meeting, Lake Bluff IL
The question of appetite is altogether the greatest paradox of life. Self-regulating, or, as we term it, governed by instinct, in the lower orders it subserves the preservation and perpetuation of life. Regulated by himself or by reason in man, it may become a destroyer instead of a preserver. It is the paradox of unreasonable reason the power most to be dreaded of all human or natural powers — the most prolific source of evil to the race. Well may we tremble at the winds and the waves when perverted reason is at the helm. Intemperance is no fungus growth. It is as old as the race, and has its roots down deep in the soil of man’s necessities, not the necessities of the ideal man or the possible man, but of the present man, whose body is physiologically depraved, every atom crying out for some abnormal stimulant, something to quiet the vague unrest and apprehension that pervade the whole.
Physical life is expressed by infinite motion; no living thing is at rest. Superadded to this animal life in man is his mental or spiritual life, which even in sleep is still active, like a night-watch on guard. This life, so delicately poised that no philosopher has ever been able to measure the adjustment thereof, be the balance lost never so slightly, things go wrong; but we know not where, and we cover our ignorance with the mantle of a word, nervousness. This unbalanced condition is handed down from parent to child under a thousand forms. Some of the signs are simply meaningless habits to the ordinary observer; the women of a household may “borrow trouble and bite their finger nails,” while the men “take to drinking.” The record goes no further; but who shall trace the subtle initial cause of that “borrowing trouble,” and “taking to drink.” These things have a far deeper meaning than we have been wise enough to discern.
The perfection of the race demands that man shall be at one with himself and his surroundings, which in its fullest sense means at one with God. But if vice and misery are necessary outgrowths of the social body, the perfection of that body is but an idle dream. Is it possible that the world, not here and there one man, or one community, but is it possible that the great world ever shall be emancipated from its moral slavery? That it is slowly but surely breaking the shackles of political bondage, makes us hope for moral freedom.
Malthus, though a benevolent Christian himself, discovered and made known a cruel, inexorable law, which seemed to close forever the door of hope to the race at large. He demonstrated that while the products of the earth can be made to increase in only an arithmetical ratio, population may increase in a geometrical ratio; hence a part of the human family is doomed to starvation — a simple question of mathematics. If in the very nature of things there are more mouths than there is bread, some must go hungry.
While this law is theoretically true it is not actually true, for though it is possible for the race to multiply beyond the power of the earth to support, it does not so multiply. Along with the growth there is developed a conservative power. There is in civilization what the physiologist would call an inhibitory or restraining force upon the undue increase of population, so that the problem becomes in a measure self-adjusting.
If, then, the overcrowding of population, with its consequent vice and misery, is not a necessity in the constitution of things, the reformer can stand upon bed-rock, and not upon thin air. If this wide-spread disease, human misery, is of human origin, and not the result of Almighty decree, then it is within human power to find remedies. The fruitful source of intemperance in the lowest classes is constitutional depravity, the want of fresh air, nutritious food, and occupation.
There is abundance of air. It encircles our globe to the depth of forty-five miles, but how successfully we plan to shut it out of human habitations! The food of the earth has never yet been measured, much less exhausted, and yet the cry of the hungry ever ascends to heaven. There is work waiting for hands to do it, but the poor hands grow weary and die before they find it. Here are the supplies; here are the people dying for want of them, but where is the adjustment? Our social reformers try to make these people better without change of condition, whereas angels would become degenerate with such surroundings. It is notorious that our systems of charity encourage and perpetuate the misery they intend to relieve.
It is only when some great calamity or crime startles the public that we begin to realize how and where the poor are living.
The sun, from a distance of ninety-five millions of miles, is finding out these places of festering humanity, and marking them from day to day through the long summer with the awful sign of a thousand dead children! We read in the daily papers such paragraphs as the following: “The authorities are waking up to the necessity of immediate action to prevent the spread of disease; the increased death rate among children has created a panic among parents. A general overhauling of the quarters where thousands of families are huddled together, like so many pigs, in small and ill-ventilated apartments, has been ordered.”
We stand here to-day surrounded by nature’s best, and wonder why the world is not religious and temperate. Let us put ourselves in their places, in order to know why our fine speeches never reach the world; and if they did, what do words mean when the body is burning, freezing or starving?
If the authorities have the right to overhaul tenement houses, why not by statute compel landlords to furnish so much space to each individual, twenty cubic feet per minute, and thus prevent these terrible results? Cheap, comfortable homes for the poor would be a practical work for the temperance reform, and the possibility is within the reach of every city. The cases are exceptional where a man would prefer the saloon to his home, if he had one. We are glad to read the authorities are waking up, but it is sad to remember that the authorities too frequently wake up too late. And we fear our own fair city will only add to the long list of blunders, deliberately preferring cure to prevention, though at ten-fold greater cost. Now, in the days of her youth, is the time for her to kill the growth of a western Seven Dials, or Five Points, and they already have a good beginning in Goose Island, the Patch, and other places. Nature has done wonders by way of situation. Ours is pre-eminently the summer-city of the United States, if not of the world. No city of its size in the world is so free from epidemics, ever freshened as it is by the breezes of the lake and the prairies. Nothing but our own stupidity can ever make it unhealthy. But the persistence with which the authorities are preventing the people from taking advantage of the great baptism which nature has provided, in the clear, health-giving waters of Lake Michigan- this is ominous of our future. If the city treasury is in need of funds, better the fines be imposed upon those who do not, instead of those who do, bathe.
Were I consulted medically as how best to promote the temperance cause in Chicago, I should say, first, let the people be washed in Lake Michigan.
This feverish, insatiable thirst that comes upon the system in hot weather is always relieved by the bath. Thus the saloons might be cheated of many a patron.
In general we would say that if a few of this city’s disappearing thousands were thrown into free baths, and parks, drinking fountains and shade trees provided for the poor, not boulevards and distant parks for the rich, Chicago would lay a sure mortgage of health and morals upon the future. Here is a chance for some ambitious mayor-free bathing-houses for the people.
The intemperance of the working classes, the day laborers, is traceable to about the same causes, except that in this class overwork takes the place of the pauper’s idleness. That is to say, the labor demanded is beyond the force which the innutritious
This is especially true of working women, who, in addition to the day’s work, must care for their children — thus one person doing the work of two, upon food sufficient for about half a person. These women tell me that by working early and late they are able to pay rent, buy fuel, etc., but can not afford to eat meat. No constitution could endure such a strain upon such a diet; consequently I find them in the hospital. [I should like to convert one end of my hospital into a bath-house, and the other into a good market.] What wonder, then, that the working man should seek some substitute for the food that is denied him, something that shall at least seem to take the place of real nourishment? And here the instincts of the man have anticipated the discoveries of science. The poor laborer has found out that his meagre fare goes farther — or what is the same in effect, seems to go farther, for it is a grand delusion — is more satisfying, when it is mixed with alcohol.
This substance stands at the head of a class which are known to the physiologist as reserve or economic aliments. It is not itself a food; it is not consumed in the system, but its presence retards the combustion of the real alimentary substances, and thereby, it is thought, promotes the transformation of heat into force. “We can understand, then, that alcoholic drinks may be indispensable, in some degree, to a man who is obliged to perform severe labor with insufficient nourishment. As to the fatal excess which 80 often succeeds a moderate use of these drinks, physiology shows us that our efforts should be directed less against this than against the conditions which make the use of alcohol an imperious and fatal necessity for the working man.”
In other words, let the temperance reformer see to it that beefsteak and bread are cheaper than whisky and beer; that is practical work. Cheap, wholesome food for the poor would close half the saloons in the land. Alcohol certainly does, in a certain sense, economize combustion; but it does it, as we believe, at the expense of the nervous system, for in its passage through the body it is found again principally in the nervous tissue, where it takes up its abode for some time, while some maintain that a part of it is retained. This sometime residence in the nervous tissue explains the mystery which has always surrounded the question of the effect of alcohol upon the system. The temperature of the body depends upon the oxidation of tissue, and this oxidation is regulated by the nerve centres. Alcohol, by acting upon the nerve centres, retards the oxidation, hence lowers the temperature, and this theory has been verified by direct experiment. There are those who maintain that what is thus lost in heat is gained in power. It is well known that the strength of the body depends upon the transformation of its heat into force. It would seem that whatever lowers the temperature must ultimately lower the force, and the facts in the case support the theory. Everybody has observed that the muscular force though so violent in its manifestations under alcohol, is not real; the actual condition of the drunken man is one of weakness, and this weakness is in proportion to the degree of intoxication. We have exalted motion with decreased strength. There is a theory to the effect that alcohol acts upon only the surface of the brain, exciting the ideas of motion, not upon the actual motor centers themselves; hence the motion is of a powerless kind.
The only case where alcohol could possibly do good in the way of economizing force is where disintegration is out of proportion to assimilation, the waste greater than the supply; and even in this case it is a questionable policy to decrease the waste if it is possible to increase the supply. Even though the immediate action of moderate doses of alcohol has this sustaining or economizing effect that is claimed, the economy in the long run proves to be waste.
The effect of the drug is not accumulative. That is to say it takes more and more to bring about the same impression upon the system from day to day. The long continued contact with the tissues, especially the nervous, for which it has a peculiar affinity probably owing to its great affinity for albumen gradually changes their chemical composition, and the inevitable result is impaired health, both mental and physical, of the individual, to say nothing of the hereditary influence on his children, which shows itself in epilepsy, insanity, criminal tendency, etc.; so that, while alcohol has the semblance of a tonic and restorer, and as such has taken a great hold upon the physician’s prescription list, and upon public sentiment, it is really a narcotic, irritant poison, yet, like arsenic and opium, may sometimes be used through a long life-time. And upon precisely the same reasoning should we encourage the intemperate use of all these poisons. But science and reason preach in vain while the working man is hungry. He will satisfy his present necessity, and he finds that a glass of beer moistens his dry bread, producing a more exhilarating effect than tea or coffee, while it is cheaper than either.
In my walks through this and other cities, I have often stopped to look at a party of working men at their noon-day meal, purposely to satisfy myself as to what kind of food they were eating, and I must say that in but very few instances did meat constitute a part of their meagre bill of fare.
The drunkenness of the higher classes has two specially predisposing causes, the want of occupation and the want of rest. The tragic story of the want of occupation is incomparably told in the New Testament. The evil spirit that had departed from the man returned and found the man’s heart empty, unoccupied; then the spirit took with him seven others more wicked than himself, and they entered in and dwelt there. Doubtless, intemperance in some form, was the ringleader. Temperance has not done its work when it has taken the bottle away; its place must be occupied by some all-absorbing good, else the last estate will be worse than the first.
Here is one of the great missions of the parent, to see to it that every child has an occupation; to discover and expand the natural inclination, if there be one; if not, then to choose something for the child to do, so that it be not left to drift according to the wind and tide, so that the mind and heart shall be full; then the spirit of intemperance and its legion companions shall find no room to enter and dwell therein.
Through all our country towns, who are the drunkards? For the most part the unemployed. Young men whose fathers have let them drift into manhood with nothing to do, and the sea of life has bewildered them; they know not which course to take, and so they are left to the merciless waves of instinct and appetite. The hangers-on, the time-killers, the barroom loafers — many a one had the making of a man within him, but the germ, finding no nourishment, has died.
Inebriate asylums are finding are the sanitary power of employment, and we quote from one of their late records: “An inebriate who is allowed to idle away his time will never acquire that mental and physical stamina which is requisite for his reformation and cure. Employment bureaus and industrial schools, then, are grand allies of the temperance cause.”
As to the drunkenness caused by over-work among the higher classes, the facts are too well known to need detail. Professional and political men are falling every day victims of ambition, which goads them on to undertake more than they can perform, and when the tired brain and muscle flag, they are scorched to renewed efforts in the flames of alcohol.
And so we find all classes, from lowest to highest, yielding to this craving for stimulants. The appetite is universal, belonging to all time and all nations; hence we may call it natural in the same sense that tendency to evil is natural. We imagine that as long as man shall live he will be tempted to sin. The most sanguine do not hope to kill out the tendency, that is a part of us, but we do expect to keep this tendency under control; that is what makes strength of character. To be victorious we must have something to conquer, and so nature supplies us with this omnipresent foe, of which intemperance, or in its broader sense, appetite, is the strong right arm. How shall we control it? Not by introducing light wines and beer. Fermented liquors may do for the Italian or the German, but not for the Englishman or the American; they only whet his appetite for more. The Duke of Wellington’s beer-act has increased England’s drunkenness. The people, thinking it harmless because sanctioned by the government, have through it developed an appetite for stronger drink; and so we find it in the wine districts of the United States. The northern races, especially the Anglo Saxon, owing to more stimulating climate and greater development of nerve, will not be satisfied with fermented drunkenness; they never stop short of the strongest distillation. Criminal statistics of intemperance will bear out this statement. Those who believe in substituting beer for intemperance, had better study up the relation of certain forms of kidney and liver diseases to beer drinking.
We know of but two methods — education and legislation; indeed, both may be included in one, for right legislation must follow right instruction. In education religion also is included. The higher the moral standard, the purer the thought, the better the man, always. That the particular kind of religious belief does not lie at the bottom of this question, we have but to compare Catholic Italy with Protestant Scotland. Spending about the saine time in both countries, with about the same opportunities for observation, I do not remember to have seen a genuine case of drunkenness in Italy, while the number I saw in Scotland outnumbered all I had ever seen before in life. And when the good family with whom I was staying arose from their knees after evening worship, and asked me to take a hot toddy, or “night-cap,” I confess religion and temperance took on a new phase of meaning to me.
We would especially educate women. The mothers of children should fully understand the fearful possibilities of the child. Beside the open Bible we would place the open physiology. To most people that book means only horrible bones and blood, whereas it is a gospel second only to that of Christ. An eminent American divine once said he did not believe in educating women, and as I looked at his dyspeptic countenance I thought it might have been better for him if his mother had known more.
If we could reach the poor women of our country, and teach them how to select their meagre food, and then how to prepare it in the most nourishing manner, this would be a wondrous gain to the temperance cause.
I believe, too, that the habit of drinking, per se, is most pernicious. In the families I know, I see the children drinking far greater quantities of liquid than their systems require. Thus the tone of the digestive organs is impaired; especially is this true of the effect of the great American drink, ice-water, of which our people, old and young, take such quantities with their food. This sudden lowering of the temperature of the digestive organs is very dangerous, and we believe a great cause of sun-stroke. Bad as we believe beer and wine to be, their effect upon the digestive organs is not so pernicious as these great draughts of ice-water. If mothers knew the maximum amount of liquid which the system requires per day, and the normal temperature required for digestion, they might even in the infancy of the child teach it self. control instead of unbounded indulgence. Three pints of fluid in twenty-four hours, and two and a half pounds of solid food are all that are essential to the strength of a working man. One of our strongest grounds of hope for our own country is the great fact that ours is the only land on the face of the globe in which the women do not use alcohol as a beverage. This means a great deal for America.
To legislation we must look for the regulating of the sale of alcohol, just as the sale of arsenic and opium are now regulated. Both are used as tonics, yet both are deadly poisons, and as such are recognized by the law, yet neither is more deadly than alcohol. There are people in the Austrian Alps that eat marvelous quantities of arsenic. Why not, then, call it a food?, No. When public sentiment is sufficiently educated legislation will discover that it has the right to control the sale of this as of every other poison with which people are daily committing suicide. The drinking of alcohol is only one form of suicide, the most deceiving and therefore the most dangerous of all forms.
To legislation we must look for the control of predisposing causes, such as crowded tenement houses, bad food and water supplies, the whole class of causes belonging to state medicine.
As to the existence of a specific remedy for drunkenness, my observation leads me to say that we have in our materia medica several very powerful sedatives and tonics, sedatives which control the stage of alcoholic excitement, and tonics that relieve the other extreme of depression; but the difficulty lies in prevailing upon the drunkard to avail himself of either. I have myself seen men refuse to take the cinchona which was right at hand, and go a long distance for another drink; that too, after having taken the tonic — deliberately preferring the liquor. This is a clear case of choice, and I know of nothing but the grace of God that is an antidote to a drunken will.
I have thus taken a very inadequate view of what may be called the physical side of this question. I have left the spiritual part for those who are better able than I to deal with spiritual things. Among all our eminent Christians, this side has surely been well maintained. I have strong hope for the future, but I confess my hope is based largely upon a better flesh and blood. I have no acquaintance with disembodied spirits. I say this at the risk of being called materialistic. I accept the name, but not in its common interpretation. I am materialistic, but only in the sense that Christ meant when he said to the fault-finding Jews, right under the shadow of his wondrous miracle, “Whether is it easier to say thy sins be forgiven thee, or arise, take up thy bed and walk!” The first may be your preference, but I feel that I have the divine sanction, and if I could I would speak to this great world to-day, and say to every soul sick with the palsy of intemperance, “ Arise, take up thy bed and walk.”
Source: The Physiology of Woman, Embracing Girlhood, Maternity and Mature Age, by Sarah Hackett Stevenson (Chicago: Fairbanks, Palmer & Co., 1883), pp. 196-212.