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THE

DIETETIC AND HYGIENIC GAZETTE

A MONTHLY JOURNAL OF PHYSIOLOGICAL MEDICINE

Vol. XVIII.

NEW YORK, AUGUST, 1902.

No. 8.

THE RELATION OF ALCOHOLISM TO INSANITY, PAUPERISM AND CRIME.

BY DANIEL R. BROWER, M.D., LL.D.,

Chicago.

Professor of Nervous and Mental Diseases, Rush Medical College, etc.*

In order to approach this question scientifically, we must consider the primary effects of alcohol on the human organization. We have stated elsewheret "alcohol is classed popularly as a stimulant, and it does have this action in a transitory way, but its most striking effect is as an anesthetic, and a vaso-motor depressant, producing degenerative changes in the neurons and connective tissue of the brain, and in the heart, arteries, liver and kidneys. The gross changes found in the nerve centers consist largely of neuritis, atheroma, fatty degeneration of blood vessels, thickening of the membranes, inflammatory adhesions of the cortex and meninges, hemorrhagic foci, effusions into the ventricles, etc."

The profession is still disputing as to the therapeutic value of alcohol. Its use to-day is very limited, as compared with twenty years ago. Then it was considered impossible to carry to successful termination a case of typhoid fever, pneumonia, and some other diseases without the use of alcoholics; now we frequently find in the practice of our leading physicians these and other cases successfully treated without the administration of a single dose of alcohol. That alcohol does stimulate the heart as a * Read before the Georgia Sociological Society, June 24.

primary effect is admitted, and this stimulation forces blood to the brain out of proportion for its immediate necessities, and this undue and unnecessary increase of blood supply to the brain must sometimes interfere with its proper functional activity, and may lay the foundation of pathological processes.

Now, we know that the brain requires for its proper functioning more blood than any other organ not engaged in blood-making and blood purification, and the most delicate anatomical mechanism that the body possesses anywhere has been devised to keep the blood pressure in the brain uniform, and to properly distribute the blood to meet its varying requirements. These blood vessels of the brain are surrounded by perivascular spaces, the function of which is to promptly remove from the cerebral tissue the waste material of cerebral activity, and the effect of alcohol is not only to increase the heart's action, but also to dilate the arterioles, and this increase in heart's action, and this dilatation of the arterioles must interfere with the regularity of the blood supply, and, therefore, with the normal discharge of the cerebral neurons, and this is further intensified by the interference of the unduly dilated arterioles

with the functions of the perivascular spaces.

Then, again, the brain requires a pabulum, the most perfect that can be elaborated. The alcohol lessens the absorption of oxygen by the blood corpuscles, and the exhalation of carbon dioxide, it diminishes the activity of the respiratory process in the lungs, and produces degenerative changes in the liver and kidneys, in consequence of which the waste products of the body do not undergo normal metabolism, hence the blood is not properly purified, and the brain is supplied with blood below the normal standard, and the result is malnutrition.

Dr. H. J. Berkley writes as follows of the manner in which the pathological lesions and the symptoms correspond one with another: "The sensory disorders, the exaggeration of the sensibility of the skin, the anesthetic troubles, and the ocular and auditory disorders would correspond to the beginning of the vascular disorders, when the nerve cells, irritated by an insufficient supply of proper nutriment and excited by the presence of a poisonous stimulus, overact for the time, and then as nutriment is still withheld from them, altered metabolism results. The beginning swelling of the dendrites of the sensory motor organs is marked by paresthetic symptoms, those of the purer sensory organs by visual and ocular troubles, and some amnesia, especially for recent events; or, in other words, cells that have the function of evolving and transmitting thought cannot work properly, and defective memory results. Later, as the motor cells are more and more involved, and nuclear changes begin, continuous tremor becomes apparent, the muscles no longer co-ordinate perfectly, unless for a moment under the direct influence of the will. Still later, when a portion of the celi structures have become highly degenerated, and the altered cells have become more numerous, the already tottering will power becomes more and more deadened, memory and judgment fail, and when the degenerative process is far advanced an incomplete dementia is the final result."

These several effects of alcohol, especially if accompanied with a bad heredity and a bad environment, lead unerringly to insanity, pauperism and crime.

Maudsley, writing upon this important question, states the case as follows: "Alcohol yields the simplest instance in illustration of the disturbing action on mind of a foreign matter introduced into the blood from without; here, where each phase of an artificially-produced insanity is passed through successively in a brief space of time, we have the abstract and brief chronicle of the history of insanity. Its first effect is to produce an agreeable excitement, a lively flow of ideas, and a general activity of mind-a condition not unlike that which oftentimes precedes an attack of mania; then there follow, as in insanity, sensory and motor troubles and the automatic excitation of ideas which start up and follow one another without order, so that more or less incoherence of thought and speech is exhibited, while, at the same time, passion is easily excited, which takes different forms according to the individual temperament; after this stage has lasted for a time -in some longer, in others shorter-it passes into depression, and maudlin melancholy, as convulsion passes into paralysis; the last scene of all being one of dementia and stupor. The different phases of mental disorder are compressed into a short period of time, because the action of the poison is quick and transitory; but we have only to spread the poisonous action over years, as the regular drunkard does, and we get a chronic and enduring insanity in which the foregoing scenes are more slowly acted. Or, if death, cutting short the career of the individual, puts a stop to the full development of the tragedy in his life, we may still have it played out in the lives of his descendants; since the drunkenness of the parent sometimes becomes the insanity of the offspring."

Dr. Bevan Lewis|| writes: "Alcohol is a fertile source of nervous disease, and its implication of the nervous centers is so general and far-reaching that the resultant

symptoms are of most protean nature; no poison, except the virus of syphilis, plays so extensive a rôle in the morbid affections and degeneration of the tissue, nervous and non-nervous."

The activity of alcohol as a causative factor in insanity is increasing. The thirtyfourth annual report of the Crichton Royal Institute shows a rapid increase in insanity from drink, as follows: 1869, 8 per cent.; 1870, 16 per cent.; 1871, 23 per cent.; 1872, 29 per cent.; 1873, 35 per cent. Dr. Gilchrist remarks that doubtless a more minute analysis would largely increase the proportion of those in whom the excessive use of stimulants by the patients themselves, or by their parents, constitutes an important, if not the primary, factor in the production of mental disturbance.

Casper said that one-third of all patients. in the Berlin pauper asylum were there from drink. At Bicetre, M. Contease found 1,000 cases of alcoholic insanity out of 5,238 cases.

A careful study of the subject in connection with the reports of American hospitals, and our own cases, tells the same sad story.

Alcohol diminishes the keenness of the moral sense; it blunts the acuity of discrimination between right and wrong, and it impairs the will power, the power to do the right, and easily leads its victims into a vicious life.

Mr. Boris** writes: "Alcoholic drink is estimated to be the direct or indirect cause of 75 per cent. of all crimes committed, and of at least 50 per cent. of all the suffering endured on account of poverty in this country, and among civilized nations." And these observations of this eminent student of criminology do not differ from those who have made detailed studies in the same direction.

The increased consumption of alcohol is pari passu with the increase in crime. The number of criminals has increased 54.6 per cent. faster than the population during the last decade, and the increased consumption of alcoholics per capita of population has increased 53.9 per cent.

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STRANGE men, far different from those new living, will walk the earth in the centuries to come. They will be a race of brainy, four-toed giants.

This startling prophecy, based on a lifetime study of nature and evolution, has just been made by Professor Henry L. Bruner, professor of biology in Butler University of Indianapolis. He is one of the most careful scientists in the West.

He sees in the future man a being in whom strange transformations shall have taken place; a being in which brain is master, ruling a body much larger than the body of the present man; a body which has lost its floating ribs, its vermiform appendix, and its little toes, and in which many other changes have taken place.

The following remarks contain a synopsis. of Dr. Bruner's prophesies:

The chest and the upper and lower limbs of the coming man will be larger. And the future man will be much taller than his brother of to-day.

"The limbs of the savage are smaller than those of the civilized man. Many artists fail utterly in their attempts to depict the anatomy of the primitive man. They place upon him limbs based upon the anatomy of Greek art. The legs of the average man to

*From Mind and Body.

day are better than those of the average man in the days of Greek sculptors.

"In the educational institutions of the future physical development will be compulsory, until exercising the body uniformly and making himself a well-rounded specimen of humanity shall become a firmly established habit with every member of the

race.

"Sandow and other athletes of to-day are already better developed than were the best Greek models.

"The automobile and other labor-saving machines will not tend to make the coming man a weakling. The man who will drive an auto rather than walk and will thus store up vitality, will go out into the fresh air to row or play golf, and his son will go to college and become an athlete.

"The man whose bodily energy is saved by labor-killing devices introduced in the workshops will have a surplus of physical energy to be expended in more wholesome exercise than that to be found indoors.

"The future man will live longer. Within a few generations old age will not fall upon men until the century mark is reached. Communicable diseases will have been brought under complete control.

"Insects which carry disease will have been exterminated. Man will get rid of the house-fly when he exterminates the horse; the flea when he drives away the dogs and cats; the plague germs, when the rats and mice have been banished from the earth; and so on through an endless chain of exterminations.

"It is probable that the number of man's ribs will be reduced by the complete loss of the floating ribs, and perhaps also by degeneration at the upper end of the thorax.

"The human foot, which has come from a grasping organ, such as we find in some apes, to a mere ambulatory appendage, will probably suffer the loss of the fifth toe, and the man of the future will become a fourtoed animal.

"The future man will not die of appendicitis; even at the present time, in people of sixty years of age, the appendix is closed in

more than 50 per cent. of the cases observed. "This reduction has already begun in embryonic life. In adults about 32 per cent. of the cases examined disclosed the fact that the appendix was wholly or partially closed. These facts point to the total closing of the appendix in future generations.

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In the man of the future the muscles of the face, which are progressively developing in response to the improvement of the intellect will display still greater delicacy of adjustment and better adaption to the expression of the various moods of the mind. Vivacity and diversion of expression, the mirror of the higher psychical activity, will increase with the growth of man.

"In civilized man the various organs of sense have undergone a certain amount of modification, and these will continue to change in the future. The fact that the degree of the development of certain sense organs, which are much more acute in savages than in civilized man, is not absolute to the success of the individual, has already led to a loss of acuteness in these organs in the man of to-day.

"While the sense organs of the present man have lost in certain directions, they have gained greatly in range of usefulness. In the case of the nose, which occupies a subordinate place among the sense organs of man, there has been marked degeneration; but this has been made good by the application of the organ to more varied uses.

"By the advancement from the service of the animal man to the service of the intellectual man, the fragrance of the flower, for instance becomes the means of mental activity and enjoyment.

"In the man of the future range of usefulness of the nose will be greatly increased.

"In the man of the future the ear will have the power of detecting a greater variety of sounds, but at the expense of acuteness of hearing. The future man will hear higher and lower sounds.

"The savage can hear sounds which fail to excite the ear of the civilized man, but his ear fails to arouse mental action as it is aroused in the man of civilization, if he pas

ses outside the range of his savage experi- The future man's teeth will be improved, be

ence.

"The eye of the future man will have a greater range of vision, but it will be less acute. It will become less of a telescope and more of a panoramic camera. "The man of the future will see colors not now perceptible to us, colors above the violet and below the red. He will also perceive more shades, tints, and tones of all the colors.

"The sense of feeling will become more delicate. The future man will suffer more than we of to-day from heat and cold when exposed to either, but his greater sensitiveness in detecting approaching changes of temperature will enable him better to protect himself.

"The man of to-morrow will be much more sensitve in discriminating rough or smooth, moist or dry, soft or hard surfaces. The more highly developed man becomes the more pain he will suffer from shock. This rule will apply so long as every other condition shall remain equal.

"The greater the increase in refinement and sensibility, the greater will be the future. man's ability to feel extreme pain and extreme pleasure; but as in the case of temperature, he will better know how to protect himself from the extremes of pain in such a manner that his sum of pleasures will constantly increase, while on the other hand his sum of pain will constantly diminish.

"No new sense will be developed by the future man. The greater delicacy and refinement of his senses will not make him more sensual in the narrow meaning of the word. He will appreciate his senses better and will educate them to a greater degree. He will enjoy them more. As to the complexion and eyes of the future man, I believe that the ultra blond and the ultra brunette type will constantly decline. Uniformity of the color of the eyes and the hair, however, will never be reached.

"The man of the future will have superior teeth and hair. The lives of savages are shortened by the early decay of their teeth.

cause he will take better care of them. The same is true of the head. There was more baldness in the days of nightcaps than there is now.

"Man will never develop wings, because their use would be too extravagant employment of vitality.

"The future man will not develop into a hairy creature, because it will always cost less vital energy to manufacture and wear clothing than to cultivate natural fur.

"The man of the future will become more and more distinctly human. We may safely assume that the brain will play the greatest part in his development, and that it will undergo great development and evolution.

"Man's improvement will probably affect both the quality of the brain and its size. This latter has constantly increased as man has advanced from lower to higher spheres.

"Corresponding to the increase in the complexity of the brain, there will come a prolongation of the period of infancy for each individual man-that is to say, it will require a much longer time for the brain to reach maturity and to work out the more complicated communication between its different parts.

"The future man will be more inventive and creative. His written and spoken language will be more economical. There will be a language in which there is a term to express each distinctive idea. Men will talk and think as well as write more rapidly. We can write much faster than our ancestors.

"Thought-saving machines will relieve the future man of much of his present routine of brain work. Mathematical calculations and all such drudgery will be performed by machine, and the thought thus saved will be expended in other pursuits.

"The memory of the future man will be of greater range, but less acute as to useless detail. To-day we remember a hundred things to each one thing remembered by the savage, but of that one thing the uncivilized man can remember more details.

"The most stupid man can remember

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