Alcohol: A Dangerous and Unnecessary Medicine, How and Why

In a clinical lecture delivered before the Senior Class in the Northwestern University Medical School, Dr. Davis told of a case similar to the preceding: —

“The flow of milk in her breasts has also diminished to such a degree that she does not have half enough for her baby. Yet she says the beer makes her feel better after each drink, and that the gin helps to relieve the severe attacks of pain, and consequently she thinks she could not do without them. It is undoubtedly true that the patient feels temporary relief from the anæsthetic effect of the alcohol in her beer and gin, just as she would from any anæsthetic or narcotic. And it is equally true that so long as the alcohol is present in her blood it so modifies the hemoglobin and albuminous constituents, as to diminish the reception and internal distribution of oxygen, and thereby retards metabolic changes. But the combined influence of the alcohol in retarding the internal distribution of oxygen and the drain upon the nutritive elements of her blood, in furnishing milk for her baby, led to rapid impoverishment of the blood and tissues, and the early establishment of a sufficient grade of gastritis to cause indigestion, frequent vomiting, and, later, paroxysms of severe gastralgia, with general emaciation, and loss of strength.

“In accordance with the present popular ideas, both in and out of the profession, this patient tells me she has tried a great variety of foods, peptonized, sterilized, and predigested, but all to no purpose. And why? – Simply because her troubles are not in the kind of food she takes, but in the morbid condition of her blood, and of the mucous membrane and nerves of her stomach. Consequently the rational indications for treatment are: (a) to get her stomach and blood free from the alcohol of beer and gin; (b) to encourage the reception and internal distribution of oxygen by plenty of fresh air; (c) to give her the most bland, or unirritating food in small, and frequently repeated doses, of which good milk with lime-water, and milk and wheat-flour gruel are the best; (d) such medicines as possess sufficient antiseptic, and anodyne properties to allay the irritability of the gastric mucous membrane, and lessen fermentation.”

CHAPTER X.

COMPARATIVE DEATH-RATES WITH AND WITHOUT THE USE OF ALCOHOL AS A REMEDY

A study of statistics relating to the difference in results of the treatment of disease with and without the use of alcohol, cannot but be of great interest to all students of the alcohol question. The appended statistics are culled mainly from the Medical Pioneer of England, now, Medical Temperance Review, the journal of the British Medical Temperance Association, and from the Bulletin of the American Medical Temperance Association.

A paragraph in the British Medical Journal, for Dec. 2, 1893, says: —

“An interesting fact has been noted by Dr. Claye Shaw, at the London County Asylum, Banstead, for the Insane. Since the withdrawal of beer from the dietary, the rate of recovery has gone up. During the past year, for example, the recoveries reached 46.97 per cent. Nearly one half of the patients had thus recovered during the period stated. The inmates take their food better without the liquor, and they are thus taught that intoxicants are not a necessity of ordinary health.”

In the Medical Pioneer for January, 1894, Dr. John Mois, medical superintendent of West Haven Infectious Diseases Hospital, states that prior to 1885 he had treated 2,148 cases of smallpox “in the usual routine method, with the use of alcohol when the heart’s action seemed to indicate it;” resulting in a mortality of 17 per cent. But since 1885 he has treated 700 additional cases under similar circumstances except that the use of alcoholic preparations was entirely omitted, and the resulting mortality was only 11 per cent.

In the same journal, Dr. J. J. Ridge states that he had treated the 200 cases of scarlet fever admitted into the Enfield Isolation Hospital during the years 1892 and 1893, without alcohol in any form, with a mortality of only 2.5 per cent.; while the mortality in the hospitals under the Metropolitan Asylums Board in 1893, in which alcohol was used in accordance with the usual practice in scarlet fever, was 6.3 per cent.

Dr. J. J. Ridge says later: —

“In January, 1894, I published the result of the treatment of the first 200 cases of scarlatina admitted into the temporary wards of the Enfield Isolation Hospital during 1892 and 1893. I stated that there had been five fatal cases, but that one was dying when admitted and only lived a few hours. The mortality was 2 per cent., or 2.5 if the later case is included.

“Since then 300 more cases have been admitted and discharged and among these there have been 7 fatal. Hence there have been 14 deaths in 500 consecutive cases extending over a period of a little more than four years. One of these ought to be excluded, no time having been given for treatment. Hence the mortality has been just 2.6 per cent. This, I think it will be admitted, is a low mortality, although it is possible it may be even lower when the cases are treated in a permanent hospital about to be erected.

“It may be interesting to state that 4 of the cases died on the third day after admission; 1 on the fourth; 1 on the sixth; 1 on the tenth, with pneumonia; 1 on the thirteenth; 1 on the fifteenth; 1 on the sixteenth; 1 on the eighteenth; 1 on the thirty-sixth, with nephritis and pleuropneumonia; and 1 on the forty-sixth, with otitis and meningitis.

“All the cases have been treated without alcohol either as food or drug, although many have been of great severity with various complications. It is certain that the absence of alcohol has not been detrimental, since the mortality is less than three-fourths of that of the mortality among all notified cases in England and Wales. I am bound to say that it is my firm conviction that had alcohol been given in the usual fashion, the death-rate would have been higher. Cases have been admitted to which alcohol has been given previous to admission, apparently with harm, as they have improved without it. One case was particularly noticeable in this respect. A child, aged 6, had had a good deal of whisky, and was supposed to be dying when admitted on the fourth day of the disease, so that the doctor who had seen it was surprised, when he called the following day to inquire, to find it was still alive. Without a drop of alcohol it began to improve and made a good recovery. I may say that delirium is very rare, even in the worst cases treated non-alcoholically.”

Dr. Norman Kerr says: —

“In my paper on ‘The Medical Administration of Alcohol,’ read to the section of medicine at the Sheffield meeting in 1876, I cited several medical testimonies in favor of non-alcoholic treatment of fevers, notably that of my friend, the late Dr. Simon Nicolls, who had a mortality of less than 5 per cent. in 230 cases.

“The record of the results of a greatly lessened administration of alcohol in the treatment of smallpox in the London hospital ships, is of deep interest. Having been requested to inquire into the effects of this diminished alcoholic stimulation on mortality and convalescence, Dr. Birdwood stated that though the gravity of the cases had increased, with a mortality of 15 per 100 in the metropolis, the ship’s death-rate had remained at less than 7 per 100. Convalescence had been more rapid, and there had been fewer and less serious complications from abscesses and inflammatory boils. Other causes had contributed to this improvement, but the medical officers attributed a considerable share in the amelioration to a greatly diminished prescription of alcohol.”

The Medical Pioneer says: —

“In 1872 there appeared in the Saturday Review an article in which the medical practitioners of this country were accused of inciting their patients to free drinking, and in the discussion which this article called forth, Dr. Gairdner, of Glasgow, said that fever patients in that city, when treated with milk and without alcohol, did much better than those reported as having been treated by Dr. Todd with large doses of alcohol; the latter resulting in a mortality of about 25 per cent., while those treated by Dr. Gairdner with milk had had a death-rate of only 12 per cent. About this time the British Medical Temperance Association was founded, owing to the exertions of Dr. Ridge, of Enfield, and in 1876 it was enrolled, under the presidency of Sir B. W. Richardson. It now contains 269 members in England and Wales, 53 in Scotland and 80 in Ireland, or more than 400 altogether, all professional men and women. This, I think, is but a sign of the change of opinion on the use of alcoholic fluids in medical practice, for all who remember what medical practice was in London thirty years ago know that the use of wine and brandy in hospital practice was so common that it was quite a rarity in some hospitals to find a patient who was not ordered, by some of the staff, from three to four ounces of brandy or six to eight fluid ounces of wine. The expense caused to the hospitals by this practice was, of course, great, and increased notably between 1852 and 1872, owing to the prevalence of the views of Liebig and his follower, Dr. Todd. The writings of Parkes, Gairdner, Dr. Norman Kerr and of Sir B. Ward Richardson, Dr. Morton and others, gradually lessened this predilection for treating diseases by alcohol, and accordingly between 1872 and 1882 a great change came over the practice of London hospitals. Thus the sum paid for milk in 1852 in Saint Bartholomew’s Hospital was £684, and in 1882 it was £2,012; whilst alcohol in that hospital cost in 1852, £406; in 1862, £1,446; in 1872, £1,446; and in 1882 only £653. Westminster Hospital in 1882 spent £137 on alcohol and £500 on milk. One hospital, St. George’s, long continued to use large quantities of alcohol. That hospital in 1872 had the high mortality among its typhoid fever patients of 24 per cent., which was twice as high as that noted by Dr. Gairdner as occurring in Glasgow, when alcohol was abandoned and milk used instead. Dr. Meyer, who reported these cases of typhoid treated in Saint George’s Hospital at that time, mentioned that alcohol in large doses was given to 87 per cent. of the patients. Three-fifths of these patients took daily eight ounces of brandy when there was danger of sinking from failure of the heart’s action. One-fourth of the number took sixteen fluid ounces of brandy in the 24 hours.”

“In 230 typhoid cases in St. Mary’s Hospital, Dr. Chambers reduced the ratio of deaths from 1 in 5 with alcohol to 1 in 40 without it. Dr. Perry, of Glasgow, found that of 534 cases treated with alcohol, 138 died, while of 491 treated without alcohol, only 9 died.”

In a recent text-book on medicine occurs the following: —

“English physicians use spirits in fevers, and all experience sustains the conviction that no substitute has been found for them.”

In a late number of the Temperance Record, Dr. Smith gives a different view of the experience of English physicians: —

“When Bentley Todd was at King’s College, and leading his profession, brandy was the rule in febrile cases. Then the mortality varied from twenty-five to thirty-five per cent. That the treatment was as fatal as the disease, experience demonstrates: —

“1. Professor W. T. Gairdner, of Glasgow, writing to the Lancet (1864), gave his experience as follows: —

“These were mostly typhus cases, but the rationale, so far as alcohol is concerned, is the same as in typhoid.

“2. At the British Medical Association in 1879, Professor H. MacNaughton Jones gave particulars of 340 cases of typhus, typhoid and simple fever. I append a summary: —

“3. Dr. J. C. Pearson writes to the Lancet (Dec. 5 and 26, 1891), giving his experience of typhoid. He had treated several hundreds of cases without a single death, and never prescribed stimulants in any shape or form in the disease.

“4. Dr. Knox Bond writes to the Lancet (Nov. 25, 1893), giving his experience of typhoid at the Liverpool Fever Hospital. He says: ‘As a resident for some years in the fever hospitals, my views of the value of alcohol in fever underwent, solely as a result of the experience there gained, entire modification. The conviction became forced upon my mind that in no case in which it was used did benefit to the patient ensue; that in a proportion of cases its use was distinctly hurtful; and that in a small but appreciable number of cases the resultant harm was sufficient to tilt the balance as against the recovery of the patient.’

“In plain terms, alcohol tended to the destruction of the patients. Dr. Bond’s figures are: —

In May, 1890, Dr. Nathan S. Davis, read a paper before the American Medical Association upon the use of certain drugs in disease. Among the drugs mentioned was alcohol, and comparative death-rates were given in typhoid fever and pneumonia, between Mercy Hospital, Chicago, during a term of years when no alcohol was used in the medical wards, Dr. Davis being in charge of them, and some of the large metropolitan hospitals using alcohol. In Mercy Hospital without alcohol, the death-rate in typhoid fever was only five per cent.; in pneumonia only twelve per cent.

“Of 161 cases of typhoid fever treated in Cook County Hospital during 1889, 27 died, or one in six – nearly 17 per cent.

“According to the annual report of the Cincinnati Hospital for 1886, 47 cases of typhoid fever were treated during that year, with seven deaths, a mortality rate of 16 per cent.

“The Garfield Memorial Hospital, at Washington, reported for the year 1889, 22 cases of typhoid fever, with 5 deaths – or 22 per cent.

“In the Pennsylvania Hospital the mortality rate in pneumonia for the years 1884-1886, was 34 per cent.

“The mortality of pneumonia in the Massachusetts General Hospital, between the years 1822 and 1889, comprising 1,000 cases, was 25 per cent.; but a gradual increase in mortality had been noted from 10 per cent. in the first decade of the seventy years represented by this report, to 28 per cent. in the last decade.

“According to the report of the Supervising Surgeon General of the U.S. Marine Hospital Service for 1888, the number of cases of pneumonia treated between 1880 and 1887 was 1,649, with 311 deaths – nearly 19 per cent.

“The Cincinnati Hospital reported for 1886 a mortality rate in pneumonia of 38 per cent.

“The mortality rate in the Cook County Hospital, Chicago, for 1889, according to Dr. Heltoin, relating to 80 cases of pneumonia, was 36 per cent.”

Only a five per cent. death-rate in typhoid fever without alcohol, and from sixteen to twenty-two per cent. with alcohol; only a twelve per cent. death-rate in pneumonia without alcohol, and from 19 to as high as 38 per cent. with alcohol. Such are the comparative death-rates given by Dr. Davis. They should be committed to memory by every opposer of the use of alcohol, as they show clearly that people have many more chances for recovery, other things being equal, in the diseases mentioned, if alcohol is not used than if it is.

It is worthy of mention in this connection that Cook County Hospital contains in its report for 1897 the following items: Number of patients 19,536; cost of liquors $80.00; per cent. of deaths from all causes, 5.7. The cost of liquors is only .004 for each patient. This shows a decided advance in the disuse of alcohol, when so very little is used in a great hospital, with so large a number of patients.

Dr. A. L. Loomis, in the treatment of 600 typhus fever cases on Blackwell’s Island in 1864, excluded alcoholics, with the result of reducing the mortality rate to only six per cent. whereas it had previously been twenty-two per cent., in Bellevue Hospital from which the patients had been removed.

In Battle Creek Sanitarium no alcohol is used in any disease, simply because the management believe better results are obtained by the use of other agencies. In the October, (1893) number of the American Medical Temperance Quarterly now Bulletin of the A. M. T. A., Dr. J. H. Kellogg gives statistics of deaths from various diseases in the Battle Creek Sanitarium. The total of these statistics is as follows: la grippe, 827 cases, 4 deaths – or two per cent.; scarlet fever, 83 cases, 2 deaths – less than three per cent.; 333 cases of typhoid fever, 9 deaths – or 2.7 per cent.; 82 cases of pneumonia, 4 deaths – or 4.9 per cent. These exceptional results are not attributed solely to the non-use of alcohol. The nursing and surroundings were of the best. But these results certainly show that the use of alcohol as a remedy in acute diseases is not necessary, and that patients have a much better chance for life, other things being equal, where alcohol is not used than where it is.

Dr. Kellogg says of the surgical cases: —

“In a hospital of 100 beds, connected with the institution, more than 3,000 surgical cases have been treated, to whom alcohol has never been administered except in connection with chloroform anæsthesia; my uniform custom being to administer an ounce of brandy or whisky five minutes before beginning the administration of the anæsthetic, when chloroform is used.

“The surgical cases include more than 300 cases of ovariotomy, and over 300 other cases involving the peritoneal cavity, such as operations for strangulated hernia, the radical cure of hernia, etc. The statistics of death and recoveries are certainly as good as can be produced by any hospital in the world, dealing with the same class of cases. The total mortality from the operation of ovariotomy, including nearly 300 cases, is less than three per cent., and for the last few years, in which the antiseptic measures have been perfected, the record is still better, showing a succession of 172 cases of laparotomy for the removal of ovarian tumors, or diseased uterus and ovaries, without a death. These cases include a number of hysterectomies, and many cases so desperate that those who trust in alcohol as a heart stimulant, and as a means of supporting the vital energies, would certainly have considered it necessary to resort to the use of this drug. Nevertheless, it was not administered in a single case, and I have seen no reason to regret its non-use in a single instance.”

Dr. T. D. Crothers, of Hartford, Conn., tells the following: —

“In a large hospital a study of the mortality of pneumonia indicated a greater fatality at intervals of six months. There were five per cent. more deaths during periods of two months at a time, twice during the year. This extended back for two years, and was finally narrowed down to the service of an eminent physician who gave spirits freely in all cases of pneumonia from their entrance to the hospital. The other visiting physicians gave very little spirits, and only in the later stages. The physician was skeptical of these statistics, but finally consented to test them by giving up spirits practically in all cases of pneumonia. This was continued for a year, and the mortality went back to the average statistics. That physician has abandoned alcohol as a food and a medicine, only in very limited degree. He writes, ‘My stupidity in accepting theories and statements of others, concerning spirits, which I could have tested personally, is a source of deep sorrow, and I do not know but it could be called criminal. I certainly feel that punishment would be just.

Brandy has been considered the great necessity in cholera, yet the use of it and other alcoholics are known to expose people to greater danger when this disease prevails.