INEBRIETY AND ITS CURE, A PAPER READ BEFORE THE Suffolk District Medical Society, DECEMBER 30, 1876, BY ALBERT DAY, M. D. SUPERINTENDENT AND PHYSICIAN OF THE WASHINGTONIAN HOME 41 Waltham Street. B O S T O N : C. VV. Calkins & Co., Printers, 2S6 Washington Street. 18 7 7 • INEBRIETY AND ITS CURE, A PAPER READ BEFORE THE Suffolk District Medical Society, DECEMBER 30, 1876, — by — ALBERT DAY, M. D. SUPERINTENDENT AND PHYSICIAN OF THE WASHINGTONIAN HOME. 41 Waltham Street. BOSTON: C. W. Calkins &. Co., Printers, 286 Washington Street. i877- INEBRIETY AND ITS CURE. “ Is there satisfactory proof of the existence of a disease characterized by distinctive symptoms or diagnosis, indicative of its nature, and distinguishing it from all others, called Dipso- mania, or (Enomania ?" “ If so, can it be cured.”? So important are these inquiries in their moral bearings, that any physician venturing an opinion on them assumes a great responsibility; nevertheless I give an unhesitating answer in the affirmative to both questions. The enlightened philanthropy of the nineteenth century, must have the credit of assuming intemperance to he a disease of a complex and obscure character ; involving abnormal conditions of mind and body, and varying in every case with individual temperament and idiosyncrasies. If the phenom/na of habitual drunkenness he not the result of an abnormal condition, either mental or physical, or both com- bined. rather than a willful and determined submission to a de- praved and criminal appetite, the fundamental basis upon which all hopeful treatment of the inebriate rests, is at once and for- ever ignored and the victim must submit to the slavery that enthralls him with no prospect of escape. If the drunkard does not present a fearful specimen of the ravages of disease, where shall we look for such a specimen ? Think of the numberless diseases, aches and pains to which he is subject. Contemplate his unsteady gait; his uncertain tread ; his broken utterances; his bloodshot eyes, livid lips and the insane workings of his frenzied brain. Go to our prisons ; hos- pitals and madhouses, and you will search in vain for a more deplorable and apparently hopeless subject of disease than the victims of intemperance afford. Thousands of such broken, paralyzed, death stricken forms are scattered all along the path- way of life, giving powerful evidence of this fact. 4 A generation ago, public sentiment in this country regarded the drunkard as incurable ; he was excluded from the pale of human sympathy, and any attempt to save was considered useless. Drunkenness was a vice only, and its victim was left to meet his fate, escape from which was deemed impossible. Now, however, under the healthful influences of enlightened and liberal education, the complete recovery of the drunkard is acknowledged to be not only possible but probable. Intelligent men are convinced that intemperance is not always, or often the result of that wilful preference for evil which con- stitutes criminality and justifies punishment, but is a disease ; an abnormal condition of the nerve matter, and demands remedial, rather than coercive treatment. Accordingly wherever we find these views have been obtained, we observe that drunkards are being reclaimed ; and when they are universally adopted and acted upon, drunkenness will be very much narrowed and restricted, if not entirely obliterated from our land. But it should be remembered that intemperance does not always mean absolute drunkenness. While doing our best to cure old drunkards, we should not forget to adopt suitable measures to prevent the making of new ones. We should treat the disease in its earlier stages; even the so-called moderate drinker, who takes his wine, his ale or whiskey regularly every day, and who cannot, as he thinks, work or live comfortably without it, should be looked upon as a sick man and treated as such, else he will sooner or later be developed into a full blown drunkard ; for from the ranks of moderate drinkers all drunkards are produced. I will now proceed to give explicit answers to the questions at the beginning of this chapter. The term Dipsomania (or CEnomania), is applied by certain writers on diseases of the mind, to a peculiar form of insanity. The term is intended to designate that uncontrolable impulse towards the use of intoxi- cating liquors which is known to rise suddenly in some persons at periods remote from each other, in contradistinction to that crav- ing which in others is gradually established through the influence of habit, and which continues with unbroken and undisturbed regularity. The former are called periodical, and the latter con- stant drinkers. The impulse of the first has been considered a malady from the beginning, and I am forced to believe that the craving of the latter is equally as much so. The daily drinker has deliberately cultivated his propensity until it has gained complete ascendency over him, and his will is made entirely subservient to his unconquerable longings. In fact he learns to be a drunkard, and is his own schoolmaster. But the periodical dipsomaniac leaps at one bound from com- plete sobriety into excesses of the most fearful character, with a full conciousness of the foul debasement that awaits him, but to which ne is impelled by an impulse he cannot control. Though for a long time he may have been free from stimulants, he sud- denly feels a craving for alcoholic drinks, the same in kind and degree that all constant drinkers experience after a protracted debauch. This condition of disease is by no means rare; many such cases are reported in the medical journals of England, France and Germany. Men of experience in this country have reported similar cases, and certainly more than a hundred have come under my own observation. The exciting cause may be either physical uneasiness, some condition of mental depression, or perhaps both. Those who are liable to nervous excitement seem to be the most ungovernable and reckless. It may therefore be concluded that this disease may be con- nected with temperament and constitution ; yet in some instances it has seemed to be hereditary. A young man thus afflicted may go on for years before his disease manifests itself. lie .suffers from depression of spirits, gloomy forebodings, and feels discontented and dissatisfied, though all the ordinary com- forts and even luxuries of life are within his reach. He experi- ences an “aching void” that must be filled before he can find rest. He has a burning, gnawing desire for something, without knowing what that something is. Thus he goes on without hope and refusing to be comforted until at a marriage feast, a social gathering or perhaps on his own sick bed, he is presented 6 with his first glass of stimulants. In a moment he is electrified. The subtle fumes of alcohol dart with the velocity of lightning to his sensitive brain, and he thinks, if he does not exclaim, Eureka! i As the hungry tiger thirsts for more blood after his first taste, so does this poor diseased one thirst for more liquor after the first draught, and will have it at any cost, and gorge himself with it as long as his system can possibly bear it. His unnatural thirst is seldom subdued until the body becomes so enfeebled as to refuse further portions of the nauseating mix- ture, and the paroxysm terminates by the “statute of limitations” — in complete nervous prostration or death. The suddenness of this impulse maybe safely received as an indication of its morbid origin. On awaking from this first debauch the patient is filled with remorse, and for a time loathes the smell, sight, or even the mention of intoxicating drinks, and he equally loathes himself for having indulged in them. A few weeks of careful nursing brings him to his feet restored to a tolerable degree of health, when he honestly repents and vows never again to disgrace him- self. He resumes his usual avocations and in a few months con- gratulates himself that he is safe from another attack ; when again and without any apparent provocation, he is impelled by a burning desire that causes him to rush to the bottle without hesi- tancy or a moment’s reflection ; and while the paroxysm is on him, his health, reputation, the claims of affection and all the ties that bind him to honor and to life itself, are totally disregarded. Is such a person a responsible being? Only so far as he may have directly or indirectly brought this disease upon himself; but the responsibility ceases the moment he comes under the influence of the malady. With this faint description of a man who is afflicted with dipsomania through predisposing causes entailed upon him perhaps by his progeni- tors, let me consider the case of a self-made victim to this terri- ble disease. A young man has good health and what appears to be a sound constitution, and brought up under correct moral influences. 7 lie despises drunkenness and looks with disfavor upon excess of every kind. He may be what is called “an evenly balanced man.” lie believes it is the abuse and not the use of alcoholic liquors that is sinful, and his motto is, “temperance in all things.” lie takes his first glass of wine or cordial; the taste is agreeable, the fumes ascend to his healthy brain and produce a very pleasant sensation. II is heart is cheered, his blood is warmed, and shoot- ing through his veins creates delightful emotions. He has dis- covered a new source of pleasure. If this person be of a dull stolid phlegmatic disposition, is sor- did and unsocial, and thinks twice or thrice before acting once, he may for a long time,— perhaps for life — hold the reins of appe- tite very taught, and seldom transgress the rules of moderation ; but if he be of a nervous, sanguine temperament, is hospitable and generous, impulsive and ardent, loves society and enjoys mirth and hilarity, the chances are ten to one that he becomes as confirmed a victim of dipsomania as the one who inherits it. He has acquired gradually by his own acts what the other in- herited. Both are in the same condition and require precisely the same treatment in order that the will power may he stimu- lated so as to hold in check the strength of appetite. As there are many exciting causes of intemperance besides consti- tutional predisposition and hereditary taint, I will endeavor to specify them in the order in which I have traced and defined them in my practice. Let it he understood that there are some men who are constitutionally protected against excessive drink- ing ; men whose natural dispositions hold their appetite in con- stant check. They are moderate in everything. They are men who always want a joke explained to them before they can appre- ciate it, and even then are seemingly unconcious of where the laugh comes in. Such dull creatures are compared by a dis- tinguished advocate of temperance to a “ lot of tunes boxed up in a barrel organ ; on turning the handle or crank the same tunes will he played for twenty years or during life.” ist. Show me a man of lively and excitable disposition with a vigorous imagination and generous impulses, who is fond of society and fashionable amusements, is the life of the social circle, can tell a good story and create a laugh by his gaieties and grav- ities, and I will show you a man who with all his manliness, pride of character and culture, is most likely to fall into the snares of intemperance. Individuals of this character are usually possessed of strong abnormal propensities and subject to great contrasts of mental and moral condition, alternating between the base and brow of sensibility ; subject at one hour to great exaltation, and at an- other to deep depression. Such men can never drink in moderation. If they touch even the outer circle of indulgence they are certain sooner or later to be engulfed in the fatal whirlpool of gross intemperance. 2d. An original, nervous, excitable constitution, predisposed to excessive indulgence. The operation upon this class was everywhere apparent during the late civil war. The constant excitement to which the whole country was subjected for four or five years, the recruiting of men for the army and navy, their thrilling deeds upon land and sea, their fatigues and exposure to summer’s heat and winter’s cold, the breaking up of families, the scattering of households, disrup- tion of business relations, and the numerous other exciting influ- ences that attend the pomp and circumstances of war, developed a propensity and created a demand for stimulants, the physical, to say nothing of the moral effects of which will scarcely be eradi- cated for generations to come. The close connection between a season of general excitement and the craving for intoxicants can be seen in any community on the advent of a circus, the arrival of a menagerie, the visit of a company of strolling players, or on election days. Also, on all public holidays, which custom has recognized as fit seasons for the gathering of crowds of pleasure seekers for the purpose of hilarity and sport. In thousands of instances the first glass of intoxicating drink has been swallowed on such occasions and the foundation laid for after excesses and ultimate destruction. 3d. It is well known to those who have studied this subject that there is a tendency in some occupations to create a desire for stimulants. 9 Among those most liable are tailors, hatters, printers, shoe- makers, bookbinders, paper box makers, jewellers, and all others whose occupations are sedentary, and which when pursued under the most favorable circumstances, exert from the necessary con- finement which they require, a depressing effect upon the nervous system. And farther, when these avocations are fol- lowed in crowded and badly ventilated rooms, nervous debility follows, and the workmen feeling fretful and uneasy, resort to ardent spirits in order to temporarily relieve them from the mo- notony and listlessness of their pent up lives. It is not strange that intemperance is very prevalent among such, or that it is a difficult matter to cure them of their habits. Whenever I find a man who has evidently fallen below a certain point in material comfort, I note that he is not only incapable of intellectual improvement or of enjoying social intercourse of an elevated character, but that he is prone to seek sensual enjoyment, and finds in the excitement of the wine cup his chief delight. 4th. Cold and damp are also incentives to intemperance. The stomach is a quick, though short-sighted guide, and when the atmosphere is wet and chilly, it issues orders for carbon, of which distilled liquors affords the largest supply. The owner of the stomach gratifies its longings, but does not reflect that though the demand may be measurably proper at the outset, indulgence with rapidity turns it into a constant craving for stimulants when the necessity for them no longer exists. It is this desire for heat which alcohol furnishes, that accounts for the prevailing drunkenness in northern latitudes. This principle may be seen every day. Cold and exposure send crowds of cus- tomers to the rum shops. The driver of the horse car or the omnibus, yearns for his glass of bourbon more than the salesman at the counter, or the clerk at his desk ; and more in a cold stormy day in January, than when a July sun shines upon his head. It is a well authenticated fact that the trade in beer falls off' more than one half in cold sharp weather, and the ascertained reason is, that the drinking class betake themselves to distilled liquors at such seasons in preference to the lighter drinks which contain less carbon. 5th. Excessive fatigue of body or mind or of both, creates a desire for stimulants. Exhaustion is often produced by excit- ing amusements; by spending several hours in over crowded rooms ; by keeping late hours ; by travelling in badly ventilated cars and steamboats; by late suppers and consequent indigestion, and by remaining too long in hot baths. All of these produce a debility that seeks relief in the intoxicating cup. 6th. There are unhealthy habits which are sure incentives to intemperance ; such as overworking the brain, studying at un- seasonable hours and neglecting proper exercise ; irregular meals, unpalatable and badly cooked food ; too much or not enough of good food ; in fact any style of living that throws the system out of order. To these inducing causes may be added uncon- genial employment, the want of any occupation or its opposites ; it being found that extremes of any sort are always followed by reaction and exert an unfavorable influence. 7th. There are certain states of mind which lead men to in- dulge in alcoholic stimulants. Any strong desire ungratified, or disturbed domestic relations will often result in a debauch. A refusal of substantial aid when honestly sought for and needed ; neglect of real or fancied friends ; suspicions of deceit or treachery'; meeting with, or separating from old friends; the completion of a long and tedious job of work ; a disastrous ter- mination of a business enterprise; sudden prosperity or un- looked for adversity, and all other abrupt changes of outward condition produce a state of mind in which men indulge. 8th. The inordinate use of tobacco strongly predisposes men to drink. That it creates a morbid thirst and an undue excite- ment of the nervous system none can doubt; but my chief ob- jection to its use by men who are striving to renounce their drinking habits, arises from the fact that it impairs the appetite for-food, weakens the power of digestion, and thus indirectly encourages those who use it to seek alcoholic stimulants for that strength and vigor which nutricious food alone gan furnish. I have found that when a man can subdue the appetite for tobacco, the love for intoxicating drinks is nearly sure to cease. 9th I name as another cause of intemperance the indiscrimi- 11 nate use of alcohol by physicians as a remedy in all kinds of diseases, without consideration of its necessity or results. That it is one of the most powerful agents we possess to rouse the dormant nervous forces cannot be denied. But it should not on that account, be assumed to be a tonic that must necessarily be administered because the patient is weak, for that very weakness may be due to the long continued abuse of the same stimulant. I believe that the employment of alcohol as the great panacea for all bodily ills, has shortened more lives and made more drunkards and vagabonds than any other agency, or than all other causes combined. Happily, this subject is now attracting the attention of some of the most able minds of the medical profession, and upon them devolves to a great extent the duty of bringing the light of truth and scientific investigation to bear on the greatest barrier to hu- man progress, and to determine once for all the real value, or lack of value of alcohol as a remedial agent. It is very common to cast blame and even odium upon the medical profession for this reckless use of alcohol as a remedial agent, but the jtruth is, while there may be those who are not careful in this respect, the much larger number of physicians do recognize the danger of promiscuously prescribing alcoholic stimulants in cases of sickness. The trouble comes not so much from the medical prescriptions, as from the people prescribing for themselves. This will appear to us more palpable when we consider the vast amount of quack nostrums which are swallowed by the people. All the newspapers of the day are loaded with advertisements, most ingeniously worded and often times recommended by cler- gymen and others, all calculated to mislead the people and capture the gullable. Indeed, it does not seem necessary that any one should die, that the long sought for art is found at last, how to live forever; that the old proverb, mors omnibus com- munis is no longer to be remembered. I was called upon a short time since to see a man suffering from a long continued alcoholic debauch. I found that for a long time he had been in his room drunk, not from ordinary liquors, but from the use of a well known and well advertised nostrum. As I was informed he had been in the habit of con- suming from one to three bottles of stuff' called “ Vegetine” per day; but on his abandoning the use of this cure all, he very soon recovered. To charge any considerable part of drunkenness upon the medical profession is simply absurd, and is only done by those who know but very little concerning this or any other subject connected with the temperance reform. I now come to the most difficult part of my task, in endeavor- ing to throw light upon a subject which is so important to the hu- man race, viz. : THE CURE OF INTEMPERANCE. Often times the cure in individual cases has been effected by a very simple method. A man may go on from one year to another growing all the time more intemperate in his habits; loosing property, char- acter, and indeed everything worth living for ; at the same time resisting all the kind admonitions of friends, repels and despises their entreaties, or those of a loving wife or parents. Not only resisting all their efforts to induce him to abandon such a reck- less life, but repaying their kindness by drinking deeper and deeper of the maddening cup, until his whole circle of friends and acquaintances become discouraged, and leave him to his fate. He is now left alone to sink himself deeper in the vortex of misery and wretchedness. It may be that while thus wandering, he knows himself not whither, his attention is arrested by the melodious sound of human voices singing the sweet hymn— “ God of mercy can there be, Mercy still reserved forme.” He stops and listens as the sound grows sweeter, and feels that it applies to his own case. He then asks himself the question, “ Is there mercy still for me?” A gleam of hope seems to enter his mind, and he at once seeks a place of refuge ; the hand of kindness ministers to his bodily wants, he is restored to a normal condition of health, and instructed in the sure method of keeping sober, viz. : Total abstinence from all intoxicants now and forever. He gladly accepts tbe conditions, and at once enters upon a new life, becoming a good citizen, husband and father. This is no fancy sketch, for 1 have known a considerable number of cases that have been cured as above related. Some persons will say that such treatment is not “ scientific.” I will not attempt to decide that question, I only give the facts. A few months since a preacher in one of the city pulpits related his experience with an inebriate, which was substantially as follows: lie informed his hearers that he had visited the home of a drunkard, and at the bedside saw the victim of in- temperance prostrate and helpless from the excessive use of in- toxicants ; he whispered in his ear saving, ‘‘God loves you,” and from that time to the present this poor man has had no desire for intoxicating drinks.”—While this case was being related to me, one of the patients in the Washingtonian Home came to my side and said, pointing to the stairs leading up to the main hall, “ Since I first came up those stairs and took you by the hand, I have had no desire for intoxicating drinks, and ten minutes before I came into that door I would have given a fortune for just one drink.” Now in the two named cases what removed the appetite for strong drink. The person in one case was assured that “God loved him ;” the other come into the “ Home” with no well fixed pur- pose in his mind (for he was led there by a friend), and he in- forms me that all desire for stimulants is gone, and indeed up to this time (more than a year), he has remained perfectly sober. W as the treatment in either case “ scientific?” One man enters upon a new life on being admonished by a friend, while another dates his life of sobriety from the time he was kicked out of a grog shop by the keeper for refusing to pay for his drinks ; and he avers that from the time he picked himself up from the sidewalk, he has had no desire for strong drink. These are exceptional cases, however, and the means which were employed to effect a cure are within the dominion of science. They are subject to physical laws which guide and control the mind. We see its manifestations, and hear the sound thereof, hut cannot tell “whence it cometh, or whither it goeth.” It is the echo and re-echo of the soul, like the electric element which is present in all space, and in some form pervades all matter. At times we see its manifestations in the vivid lightning; but our knowledge of the laws which govern it is as yet limited. I will not further consider the exceptional cases, but refer briefly to the course of treatment to be persued with those of a more severe type. I have before stated that alcohol destroys volition, or the will. It destroys the correlation of forces, and the symetrical laws which the Divine hand has so wonderfully endowed us with. It destroys the higher faculties of the mind, and man retrogrades and becomes an automatic subject; a mere puppet to be pulled by suggesting wires, capable of being pkfyed upon by every one who shall make himself master of the springs of action. In other words the will is lost, and he is the simple creature of habit and impulse. He may treat his friends with silly kindness, or may plunge the dagger to the heart of one he is bound to love. Now by what process shall we restore him to a normal condition of mind ? Can it not be done by bringing him in contact with a superior and normal mind ? one that will with patient kindness Instruct, admon- ish, and with a large stock of facts, and with power to illustrate the true condition of his patient, lead him forth to truthful reflection, point him to the true way of escape from his thraldom, and the* true philosophy of living? or in other words, would not a school adapted to this purpose, with its master well instructed in mental diseases, more especially with this particular be beneficial ? Most cases in asylums are cured only by the most patient, earnest, intelligent effort on the part of those having charge of such institutions; and when this result has been pro- duced, such asylums have been a success. While on the other hand, when poor philosophy and drugs alone have been relied upon, they have died ; and the cause should be written over their closed doors, died from mismanagement and want of requisite ability. It is often said that our observations are too limited to bear out our conclusions. I have had under my care during the last twenty years nearly seven thousand drunkards, and it is from this field of practical experience that I have gathered facts, and after considerable deliberation arrived at positive conclusions upon a few points ; the most important of which is, a strict observance of total abstinence from all intoxicants is the foundation of all cures. Unless this rule of life is implicitly obeyed, any treatment pre- scribed is useless and futile. Some years since, a young man from a neighboring city was placed under my care. lie was of good disposition and consid- erable culture; Ins family wealthy and generous livers. He remained with me several months, and his condition was so much improved that he returned home. His father met him at the dinner table on the day of his arrival and the first words he said to his son were, “ Now Tom, I hope you are cured of drunkenness, and I want you to sit at my table and drink like a gentleman, and not get drunk any more.” The young man drank, and the consequence was in a few hours he was drunk, and in a short time he returned to the Asylum in as deplorable a condition as ever. Poor fellow, he never can be cured with such surroundings and parental advice. The whole history of the life of every drunkard can be summed up in a few words. He tried to drink 7noderatcly. We can safely conclude that any and all treatment whether medicinal or moral, which will establish self respect in the victim, that will inculcate a firm conviction that the use of intoxicating drinks in the smallest quantities is wrong, is omnipotent. It is wrong, and the most fearful consequences will follow a deviation in the least degree from strict integrity in this respect. It is an easy matter for a man to practice total abstinence when he can be brought to a realizing sense of his situation, and ab- stains from principle, and who is convinced that all his trials and sorrows come when he tries to drink moderately. I cannot take leave of this subject without referring to reform from the use of narcotic drugs From individual observation and incontestable sources of information, I find that in many cases as the use of alcohol decreases, the use of narcotics increase. I find that persons who will sign the pledge to ab- stain from the use of alcohol in all its forms, will at once begin to tamper with that insidious, subtle and dangerous drug, 16 opium, in some of its forms. We can truly assert, that in such cases the condition of the man is worse than that produced by alcohol; and to rid himself of this habit, if firmly contracted, he will be compelled to endure the most horrible sufferings im- aginable. Delirium tremens in point of suffering offer no com- parison to the agony a person is subject to in abandoning this terrible enemy of the human race. The person who persists in this course is like the man who, when one devil was cast out of him, took unto himself seven other devils worse than the first; and should he continue the habit, he will at last cry out in the bitterness of his soul, “ Who shall deliver me from the body of this death?” This drug is not used alone by those who were once intemper- ate in the use of alcoholic drinks, but is used by those who, of all others ought to abstain from its use. It has been stated that even among the higher classes, no ladies toilet is complete with- out Morphine, Hydrate of Chloral and other narcotic drugs. If this be true, we need not look further for the cause which is degenerating the race. We need not look far to find out the cause of physical degeneracy among females, for physical and mental degeneracy are sure to follow the use of these drugs. Why all of this neuralgia? Why all the sleeplessness and nerv- ousness which physicians now meet with? My answer will cover the larger part of the questions : the use of narcotic drugs and the only relief to be found is in a little more opium ; a little more chloral. Only a little more drugging will be the cry of these most pitiable victims of appetite. Were it necessary, I could mention individual cases which have been under my treat- ment, to substantiate my assertion in regard to the baneful effects of opium, the intense paroxysms of pain and the difficulties at- tending the cure of such patients ; and were I satisfied that such would prove detrimental to the formation of such pernicious habits, I would do so with pleasure. Any asylum or individual that attempts the work of reforma- tion or cure upon any other basis than that I have indicated, will be building a castle in the air ; a monument with its apex resting on the earth and its base pointing heavenward. We are often told that intemperance is on the increase, and indeed some persons who find pleasure in figures and statistics, tell ns that if matters go on as they have been for the last half- century, that the race will become extinct. As for one, I indulge in no such fears. In the first place, intemperance is not on the increase. In this enlightened age the fearful consequences of over indulgence in the use of intoxicants is brought more prominently to the public view than ever before. The thou- sand and one organizations that now exist to do battle against this foe of our race, are constantly holding up to public gaze (often times in a most exaggerated form), this enemy of so- cial comfort and progress. Hence the enactment of the most stringent laws against the sale of intoxicants. Another fact which may not be recognized, the form of inebriety from year to year is changing, and the great law of evolution, which is present and active in all nature, will ultimately throw out this unclean spirit. The work of elimination is constantly going on. The weak and worthless fall out and are destroyed as the chaff, while the strong will bear up the pillars of human progress, and as time rolls on, intemperance, with other vices which like barnacles fasten themselves upon the ship of life, will, by the laws of evo- lution be cast out. I observe that during the last twenty-five years the form of in- ebriety has changed in one particular at least. I am certain that cases of what is called Delirium Tremens, do not occur so fre- quently as formerly, and if this is the case, why may we not look for a continued improvement in this direction, and in the not far distant period, may we not expect that Dipsomania will be a dream of the past, and as rarely seen as leprosy or any other old time afflictions. Institutional treatment has thus far done some- thing in this direction. Their influence for good has been lim- ited, however, for lack of power to control their patients at just the time when absolute control is necessary; that is, at the com- mencement of the dipsomanial attack ;*also in their power to retain the patient under their control a sufficient length of time to accomplish a cure. All our institutions for the treatment of inebriates are thus far voluntary, and in many respects this is preferable to a plan of legal commitment; especially is the plan better for the class who themselves seek for relief, and vol- untarily submit to treatment. The worst forms of this disease now go on until death ends their madness, or they come within the pale of legal commitment to some institution for the punish- ment of criminals. But for those who have money at their com- mand, even this fails, for the reason that they can comply with the demand of the law, and then they are free to ruin themselves. God grant the time may soon come when the community shall look upon inebriety as a disease, and not a crime, and instead of imprisoning the victim as a criminal, he shall be placed under remedial treatment such as will restore lost manhood and self respect, and lead him forth into the world a redeemed man, honored by the community, and loved by all within the family circle ; a valued man in the commonwealth, and with a bright hope of a glorious immortality.