Essays In Pastoral Medicine

by Austin O'Malley; James J. Walsh

Dipsomania is a form of impulsive degenerative insanity, and it is probably epileptic in origin. After a few days of insomnia and loss of appetite for food, there is an irresistible impulse to drink alcoholic liquor and to indulge in other excess. The patient drinks until all means of getting alcohol are exhausted. He will take crude alcohol, bay rum, cologne, the alcohol that is about pathologic specimens in a hospital museum. The attack lasts from one to two weeks, and is followed by depression and a feeling of remorse. The onsets are irregular in occurrence, and between them the patient may [{111}] be temperate or have even an extreme distaste for alcohol. This form of disease is not infrequent among professional men and clergymen, and it is impossible to find out just how far the patient is responsible for his condition. If bishops would investigate the alcoholic tendencies of the families of candidates for seminaries, and reject all that have this taint, there would be much less scandal. It is a serious error of judgment to ordain a seminarian that has even once been under the influence of alcohol, and those seminarians that cover up the tippling of a companion, because he is a good fellow, are guilty of far-reaching crime. The fact is worth investigation whether or not a liquor dealer who never drinks alcohol, but who lives for years in the presence of volatilised alcohol, has much of the alcoholic degeneracy and a tendency to beget neurotic children. Certainly the fumes of wood alcohol have killed workmen that went down only once into a vat containing these fumes, and other alcohols in the form of vapour should have deleterious effects. Féré produced monsters in chickens by exposing eggs to the vapour of alcohol.

In judging a drunkard, it must be remembered that in many forms of alcoholism, after the condition is well established, the patient has little more freedom of will than a brute has. If he is accountable for the habit, he is blamable for the crime that follows. If he is not accountable, and it is often very difficult to prove that he is, he is to be treated as a blamelessly insane man. In proper surroundings, and with skilful direction, a child born with a tendency, or more exactly a temptation, to dipsomania or other alcoholic neurosis can be saved, but commonly the circumstances of such a child's life are the worst imaginable. These children must never take alcohol, even as a medicine, and they must not be pushed in school to nervous exhaustion. A tendency to unchastity can "run in families," like a disposition toward alcoholism, but the disgrace in yielding to this vicious bias keeps many such unfortunates clean. It is to be regretted that public opinion can not give the same aid in alcoholic predisposition.

A confirmed alcoholic should be prevented, if possible, from marriage, because his sins will be visited upon his posterity. [{112}] The first children of an alcoholic may be mentally sound, the younger children are more or less mentally weak, the youngest are not uncommonly imbeciles, or idiots, or under shock they grow insane. Fortunately many of the children of alcoholics die at an early age, and the family of a drunkard very seldom lasts beyond four generations. In the first generation moral depravity and alcoholic excess are found; in the second, chronic drunkenness and mania; in the third, melancholia, hypochondria, impulsive and homicidal ideas; in the fourth, idiocy, imbecility, and extinction of the family. The lower the social caste of the drunkard, the greater the liability of meeting these blights.

Priests should take a deep interest in societies established for the promotion of temperance, and the only temperance for most persons is total abstinence. No man knows what latent tendency to alcoholism he may have, especially in America, where great grandfathers are unknown and the climate and life are trying on the nervous system. The adulterated liquors sold everywhere at present make the danger greater than it ever was. Whatever may be the truth as regards heredity, there is no doubt concerning the strong influence of environment; therefore get into the temperance societies the children of alcoholic parents, of parents that are shiftless, hysterical, irritable. If a man has a violent temper or if he is unchaste, get him and his children into the society to check the downward drift. A bad temper is a neurotic taint, and it commonly is a first step toward alcoholism. Do not forget to warn the people against patent medicines that contain alcohol.

If you go over the list of the families in a parish, it is startling to find how few there are without one or more "black sheep." The human black sheep, in a good environment, is always physically imperfect, and never so black as the gossips paint him. He may be a powerful football player, but there is something wrong with his gray matter. He is morally deaf, he was born so, and he is to be excused if he can not always hear the still, small voice. This may sound like lax doctrine, but it is true, nevertheless.

We must recognise that moral weakness is very often, [{113}] partly at least, a physical defect, and there is no such state as "moral insanity" where the intellect is normal. Now, I do not wish to be quoted as holding that all moral depravity has a physical basis; most of it is the unalloyed stuff; the Lombroso criminal is not a scientific fact; but there is a moral condition very frequently met with which is largely physical in origin. Given so many grains of cocaine or morphine or so many ounces of alcohol, and you can make a liar of a man once on the way toward sanctity. Given an attack of hysteria in a holy nun, and she at once becomes a liar, an altogether blameless liar, but no influence that does not remove the physical cause will cure the lying.

The morally weak do not at present obtain enough religious instruction. Their religion is more a matter of inheritance and habit than of positive energy. It is "in the bones," sometimes in the fists, rather than in the soul. They prefer the Sunday newspaper to the Sunday sermon. The remedy here seems to be in making the Sunday school solidly interesting and its teaching impressive.

Alcoholism in the parents, especially drunkenness at the moment of conception, is one of the chief causes of idiocy in children. Féré, as was said before, by injecting a few drops of alcohol beneath the shell of hens' eggs, or by exposing the eggs to the vapour of alcohol, could produce monsters almost invariably. In 1000 cases of idiocy at the Bicétre, Bourneville found a history of alcoholism in 620, or 62 per centum: in the fathers of 471, in the mothers of 84, in both parents of 65; and in one-half of the remaining 38 per centum no history was obtainable—probably most of these also had the alcoholic taint. The administration of alcohol to infants, of gin and whiskey, of essences of peppermint and anise, to relieve colic or induce sleep, and the dosing with opiates like paregoric, are also well-established causes of idiocy.

The idiot is practically dead, except for the trouble he gives in caring for him; but another unfortunate, the imbecile, most commonly the offspring of alcoholics, is often capable of great mischief. The higher grades of imbeciles, those nearest the normal, are almost invariably criminals. Not all criminals, of course, are imbeciles, but a vast number of petty and brutal [{114}] criminals are imbeciles. We keep these unfortunates most of their lives in jail, while we fine their drunken fathers, the cause of the imbecility, "five dollars and costs."

Imbecility has grades,—from marked lack of intellectual power, a stage little beyond idiocy, up to the presence of a mind capable of fair education,—but in all cases there is real defect, either of intellect or of will. Sometimes, where the will is so weak that the patient becomes a criminal in spite of all training, the intellect is practically normal to the superficial observer.