VIII
SOME ASPECTS OF INTOXICATION
There are various drugs that, through acute or chronic poisoning from their use, cause mental disturbance,—alcohol, chloral, cannabis indica, somnal, sulphonal, paraldehyde, ether, chloroform, antipyrin, phenacetin, trional, chloralamid, iodoform, atropine, hyoscyamus, salicylic acid, quinine, lead, arsenic, mercury, opium and morphine, the bromides, cocaine, and others. Of these intoxicants alcohol always has been most commonly used by western nations, but the moral aspects of alcoholism have not been shown with sufficient insistence. There are many sots in human society much less reprehensible than to the unskilled observer they appear to be; others are more blameworthy.
Morality, as far as the agent is concerned, apart from the nature and circumstances of the deed, supposes, first, voluntary acts, or acts that proceed from the will with a knowledge of the end toward which the acts tend; and, secondly, free acts, or acts that under given conditions may or may not be willed. If by unavoidable chance one stumbles against a man standing at the edge of a wharf, knocks him into the water, and drowns him, the act has no element of morality in it, because it is not voluntary and free. If a mind is diseased, and, impelled by a mad notion of persecution, it brings about a like killing, there is no question of morality, because the agent is not free, and when fully analysed his action is not voluntary.
An act is more or less voluntary and free, and therefore more or less moral, as the agent is affected by ignorance, passionate desire, fear, or disease. Ignorance, fear, and disease may be such as to remove all quality of morality from an act. [{106}] Certain diseases or pathological conditions, especially of the nervous system, can take out of an act the elements of voluntariness and freedom that are necessary to make the act moral or immoral, provided, however, these pathological conditions are not brought on through the fault of the subject in which they exist. If a man voluntarily becomes drunk with alcohol, or some other drug, he is, of course, accountable for the evil he may unconsciously do while under the influence of that drug, and if he begets an idiot or a criminal imbecile in his drunkenness, he must atone somewhere for the blinded soul of his child. Here, again, there are certain extenuating circumstances, because very few drunkards are fully conscious of the extent of the evil in alcoholism.
Apart from the other requirements that go to make an act moral, the agent must be sane; that the act be immoral, he must be sane or insane, either temporarily or permanently, through his own fault; that it be devoid of morality an act must be a mere actus hominis, or it must be the act of a person blamelessly insane. If a man knows that an alcoholic is liable to beget a criminal imbecile solely because of the alcoholism,—and most men are aware of that fact,—this father or grandfather is more or less accountable for every larceny, rape, and murder done by the imbecile. The law, therefore, should put the imbecile into safe keeping, then seek out the father and hang him.
Insanity is a common condition, but it has not been satisfactorily defined. It supposes an appreciable unsoundness of the will, memory, and understanding, or of one or two of these faculties, but no alienist has given a short differentiation of that unsoundness. Where shall we draw the line between the weak but responsible will and the insane will? What degree of opacity between intellect and the world separates the ignorant man from the lunatic? The extremes of sanity and insanity are readily recognisable, but the intermediate degrees are not clear. There is no test to apply to all cases; each must be diagnosed from its peculiar symptoms, but the will of an insane man is always weak. It can not deny or defer the gratification of a desire, nor can it keep up an effort. Even in its lightest forms insanity is selfish and [{107}] impolite, because it lacks the force of will necessary to take trouble. It foregoes great future benefit for slight present gratification. The insane man is idle, or busy only in work that he likes, in pleasurable activity. A marked quality of sanity is the capacity for sustained work, and the man that shirks work merely because he does not like it is gratifying himself dangerously.
These defects are found commonly in sane persons, but the lunatic can not rise from them, and he adds to the defects of will a warped intellect. He can not adjust himself to his surroundings, and the fault is in himself, not in the circumstances. His intellect may be brilliant, but it sooner or later shows a taint. The insane man is not a free, rational agent.
Alcoholism readily passes over into unmistakable insanity, and it almost always is the cause of nervous degeneration in the children born within its influence. This, is a phase of the evil not sufficiently insisted upon by those that plead for total abstinence.
Chronic poisoning by alcohol induces hardening and calcification in the walls of the arteries, degeneration of the nerve cells and dendrites, wasting or overgrowth of the heart muscle, and fatty degeneration of the liver and kidneys. The nerve centres that control the circulation of the blood are paralysed by it, and, as a sequence, the arteries and capillaries are diminished in calibre. This state in turn obstructs the flow of the blood, and the body is not nourished, nor are the waste and poisonous results of metabolism carried off as they should be. Alcohol prevents the haemoglobin of the blood from doing its office, which is to supply oxygen and remove carbon dioxid. It absorbs the necessary water from the tissues, and thus it acts as a corroding poison. It is also a functional toxin, because it depresses the activity of organs by injuring the innervation. The poison affects the brain, and as the cerebral gray matter, especially its pyramidal cells, are the physical instruments of thought, will, and memory, or the means of communication between the soul and the outer world, the exercise of these spiritual functions is checked or inhibited by it.
A tendency to excess in the use of alcohol commonly [{108}] manifests itself before the thirtieth year, and in some cases it may be removed at the alcoholic climacteric, which is from the fortieth to the sixty-fifth year. Those that become drunkards are usually of a neuropathic constitution, through inheritance or abuse. Severe diseases, like influenza, syphilis, typhoid; injuries to the head, sunstroke, shock, worry; the disturbance that may accompany puberty, pregnancy, lactation, and so on,—cause a nervous depression which is soothed by alcohol, and thus a habit is fixed. The reckless prescription of alcohol by some physicians is another cause of the habit, and the use of proprietary medicines is a still more prolific source of drunkenness and the consequent misfortune.