WHAT SHALL WE DO WITH THE INEBRIATES?
Synopsis of a lecture delivered on Saturday, April 12, in the National Museum, at Washington, D. C., by Dr. W. W. Godding, in charge of the Government Hospital for the Insane at Washington, D. C.
The profound interest which I feel for this subject is in sympathy with certain words of Terence: “I am a man, and nothing that concerns a man do I deem a matter of indifference to me.” This sentiment is to be commended to the scientists of the Christian era. Entitled, then, to the grave consideration of humanity, is the miserable inebriate. The study of this subject has both a biological and anthropological bearing. The former defines the protoplasm—the wonderful beginning of existence—the subject in hand demonstrates the destructive oxidation of the soul in the presence of alcohol, the deterioration of vital energy, and a misspent life. Again, the anthropologist studies man in his present and primeval existence, delving into burial mounds and bone cases to spell out the lessons learned by each succeeding generation in the great struggle for existence.
Of man it has been written: “How noble in reason! how infinite in faculties! in form and moving, how express and admirable! in action, how like an angel! in apprehension, how like a God!” But by saturating his brain with whiskey, how soon would the godlike man become debased lower than the meanest brute. Truly here in the nineteenth century—not in the old red sandstone or in the silurian beds—but right here in this day appears what might be called the “missing link” in anthropological studies.
What is to be done with the inebriate? Prohibition, total abstinence, and women’s crusades have struggled with the demon of drunkenness, but its throne has not yet been demolished. Its dominion was set up among men long before the Macedonian conqueror, with heel planted upon the neck of a prostrate world, was vanquished by it, and its temples were already hoary when the old Roman worshiped Bacchus under the vines. In the history of the world it has been more potent than Christianity in winning the savage tribes, and at the same time has done more to depauperize Christian nations than all other calamities put together. The subject of intemperance and its cure present the most important social problem of the day for both philanthropist and legislator. However, much good has been brought about by the moral forces of society and the benevolent organizations, toward the extinction of the vice, yet it seems that its utter annihilation is entirely beyond the reach of all influences. Shakspere well described this lurking remnant of a vice not wholly to be controlled, when he said, “I have lost the immortal part, sir, of myself, and what remains is bestial.” There has been too much nonsense in dealing with the inebriate. The world has laughed too long at the noisy, reeling comedy daily enacted on our streets, and is unmindful too often of the corresponding silent tragedy taking place at home. Patient women are not unfrequently found wearing away in gloom what might have been a happy life, looking for the daily return of a drunken husband. Many a death is attributed in the obituary columns of our papers to Bright’s disease, or pneumonia, when in reality whiskey should take all the blame.
The indiscriminate commitment of the inebriate to the hospital for the insane is a grievous wrong. Genuine cases of a real insanity, resulting from dipsomania, are indeed to be found, but it is absurd to class any considerable portion of the inebriates in this category. The hospital for the insane is, however, preferred to the workhouse, as announcing less publicly the disgrace of the victim, and therefore it is that dipsomania is so often stretched into insanity. With some physicians inebriety is confounded with insanity, while others deny the existence of an insanity whose sign is a passion for drink, and accordingly fail to distinguish dipsomania from drunkenness or crime. These points need not, however, be discussed in a lecture intended to treat the subject socially. Social science asks whether this inebriety is a crime or a disease. The law classes drunkenness among crimes, and sends the offenders to penal institutions; but how often do friends, unwilling to see the victims of intemperance committed with the felons, bring to bear on the case powerful arguments to show that the mind is diseased, and thus have him transferred from the gaol to the lunatic asylum, where he is evidently out of place as soon as the fumes of alcohol have left the brain. Inebriety is both a crime and a disease, and owing to a want of recognition of this truth on the part of philanthropists, much work and intended good have been wasted. When it is regarded by the law as an iniquitous disease, and provided for by the law with a curative punishment, then will the community at large be afforded a relief which might also effect the recovery of the victim.
As to the vices of drunkenness and opium consumption, women are probably as much addicted to the latter as men, while drunkenness counts many more victims among the males. The former is a social vice, the latter a solitary evil. The latter injures none but the consumer, leaving out of consideration its power to unfit the mind for business, and thus injure the other members of the family. Through persistent indulgence in opium the mind at last suffers more surely than from alcohol. The love of opium often originates in a physician’s prescription of an opiate for the relief of pain. That is a grave responsibility, but it is inexcusable that the patient is allowed to renew the prescription at will, and long after the immediate necessity for its use has passed away. The antidotes so commonly used as “opium cures” are nothing but disguised morphine, and the poor wretch instead of conquering his love for opiates allows them to get a firmer and surer hold upon him. Such nostrums as “Collins’s cure” and “Hoffman’s antidote” should be analyzed by a chemist directed by state authorities, and the amount of morphine contained in them be published to the world. Prolonged treatment in proper homes, where the victims of opium can be protected against themselves, is the only radical cure.
The dipsomaniac is often to be found in the full vigor of youth; a man rejoicing in a magnificent physique, and showing no external signs of impairment. He may have talent and wit, and be high in the social scale. But behind the mask something is found to be lacking. His liver, clogged with fatty deposit, is disordered, the coats of the stomach are more or less burnt out, dyspeptic symptoms are apparent. The man becomes moody and irritable if deprived of his stimulant, while gout and neuralgia perhaps add themselves to the list of symptoms. The most marked result probably is the utter absence of the natural instincts of rectitude and morality. His whole confession of faith might be summed up in the words of Byron: “Man, being reasonable, must get drunk; the best of life is but intoxication.”
If the dipsomaniac be sent to the hospital, it is noticed that, while recovering from the immediate effects of his revels there is a condition of unstrung nerves, with marked depression of mind. As his normal activity is restored through rest, proper food and abstinence from stimulants, there appear peculiar intellectual and moral phases characteristic of the inebriate. He speaks of his indulgence as a thing of the past; blames everybody but himself for his excess; declares that it is the result of a dose of Plantation Bitters (perhaps) taken as a cure for an attack of cholera morbus, at the suggestion of a friend who declared they contained no alcohol; treats the matter as something which could never possibly happen again—in fact, regards it as an unfortunate mistake. He declares that the idea of being detained as a lunatic is absurd, and repugnant to his feelings, and probably will soon actually have the effect of converting him into a lunatic; that it is absolutely necessary for him to go and attend to his business. He will never forget the physician’s kindness, and departs apparently cured. His actions remind me of the poor Indian who came to the missionary and began repeating the names of the twelve apostles, adding those of the patriarchs and Old Testament worthies, and anxious to enlarge upon Biblical literature; but when the astounded missionary exclaimed, “What does all this mean?” the Indian promptly replied “Whiskey.”
I have pictured the dipsomaniac as I myself have known him. There are, of course, cases in which the victim is thoroughly convinced of his folly and sin, and radically cured. That is the exception, however, and not the rule. The grave question then has to be considered—“What shall we do with the inebriates?” Are they to be sent back to their families, because the law allows a man’s house to be his castle, in which he has a right to do as he pleases? The inebriate has no such right. Whether sick or criminal, such a man is a nuisance, and should be put down. The law should confine him, however, not as a disturber of the peace, not as a terror to wife and children, nor as a dangerous man to the community, but he should be restrained and punished because he is a confirmed inebriate, with the hope that the punishment will cure his disease and depravity. If sent to the insane hospital it should be as an inebriate, not as a lunatic, and a separate building and enclosed grounds should be provided for this class. The law should provide for his prolonged detention and compulsory labor. The victim, if a minor, should be sentenced for the remainder of his minority. It is an open question whether the will power of a drunkard ever, indeed, attained its majority. If over twenty-one years of age, the first offense should be limited to perhaps one year; but should a second commitment be necessary, then for a term of years, discretionary power being left with the court, under the advice of the authorities of the institution.
Insufficient period of detention, lack of legal power to detain, and absence of authority to inflict compulsory labor, has prevented much good being done by inebriate asylums. It is the province of legislation to invest the court and authorities of inebriate asylums with these powers. Unfortunately, there is a fourth drawback to the permanent cure of the inebriate—one which is outside of the control of legislation—namely: a general indisposition to reform, a perfect atrophy of moral sense, an instinctive return, like “the dog to his own vomit,” of the inebriate to his cups. After the law has endued the authorities of inebriate asylums with all desired power, the essential element of their cure then comes in, and that is sound medical treatment. Asylums conducted in this manner would be able to record quite as large a proportion of good recoveries as the insane hospitals. Would there be anything cruel in subjecting the patient to compulsory labor, or in detaining him for a long period? Surely not; his freedom before the right time would only mean a return to vice and sloth, while his labor could probably be made to pay for his maintenance in the asylum. Not until savants take an interest in this subject will public sentiment be gained, legislation in its behalf enacted and, in fine, a glad release from this state of bondage be attained.
It is a foe invisible which I fear—an enemy in the human breast which opposes me—by its coward fear alone made fearful to me; not that which, full of life, instinct with power, makes known its present being; that is not the perilously formidable. Oh, no! it is the common, the quite common, the thing of an eternal yesterday, which ever was and evermore returns—sterling to-morrow for it was sterling to-day; for man is made of the wholly common, and custom is his nurse. Woe then to them who lay irreverent hands on his old house furniture, the dear inheritance from his forefathers! For time consecrates, and what is gray with age becomes religion. Be in possession, and thou hast the right, and sacred will the many guard it for thee.—Schiller.