Inebriate Asylums

Mr. Editor: - Whon you have space in your paper, may I ask tho iublication of the markod portions of the Report of thu N. Y. State Inobriato Asylum for 1-871. Inebríate Asylums aro attracting a good doal of atteKtio'h in tuis country and abroad. A valuablo pamphlet has lately been issued, " Proceodings of the Second Jloeling of tho American Assooiation for tho cure of Inebríate." Ib additicn ta tho proceediiif s proper it eontains a number of essays oïi the stibjoct from eminent physicians. boine foreign power hos lately sont a commissioner to this country to inquiro into tho working of these asy lums. Whatever may be dono to prevent the f roe sale and use of intoxicating liquors, thero are among us those who aro too far gono through the excesses of the past to bu recoTèred by any efforts of their own. For this class these institutions are intended. Ihuse in charge of them claim very marked guccess in potmatíent rocovery. Dr. Parker, the President of the American AsBOciatioñ, inhis opening remarks a.t the meeting, expressed tho sentimenten tbat to him " the subject of tho reclamation of tho inebríate was tho great subect of the day. It was one tbat ought to come undor the notice of tho medical pro:ossion, and secure their earnest support. [nebnety, he feit, was as much a disoasa as soarlatinu, or small-pox. Yellow fover was harmleS8 compared with ineoriety.Thirty-threo and a third per cent of all the in N(.v York City were the lirect or indirect result of the uso of alcohol." G. D. G. From the roport of Dr. D. G. Dodge Superintendent and Physician of the N. Y. Stuto Inebríate Asylum; at Bingham,011, we quote as suggestod by our correspondent: I will now consider inebriety or alchoïolism from a medioal stendpoint, ia thö ight of an actual diaeaee. AVlion taken, tin: iir.it aotion or pei-ceptible effect of alcohol is, Undcnbtêdly, upon the mucous ;! iilnane of the stomach ; secondly, on the great synipathetic üerve, and finally on the whole nervoua system and brain, expending nearly all its whole force upori ;ho two laiter, and ciusing lesions in these vit;il orgaus. What theee ]n-':ise lesions ire pathologiats have thus f.ir been unajle to determine; but are ready and willng to concede thut there is an organio chungo ur defect in thoso centres of hought and yitality, oaused by the exuse of alcoholio stimulants, which "in only bu relieved andoured by removng the cause, umi ftllowing nature the pportunity to repair the disestsed organs ;o saeh in extent that stiinulants will not 5e required to sustain and support the systcm, and finally teaching and eonvinciug the patiënt that even their moderate usej (if that were possible) in tho futura will b; not only injurious, but dangerous, and iinully disastrous. Ever after in total abstiueneu lies his only hope and only safoty. With tho genneral admission that alcohol is im irritant-narcotic poison; a prominent and leadiiig poison in that class ia ïoxicology, I will not discuss the point, but proceed at once to considor its effects apon tlit! systcm, when used exeessively or interoperately. lts first effect, when so used, is to cause functional disorder; which, if peraisted in, will invariably rej sult in organic disease. The diseases proL u_y - - -i! ■■! ifrrTlTliJ drink.s are . numerou ften fatal. om its direct and sudden action on théuervous system and brain, we have a long list of diseases, such as impairmcnt of all muscular power, muscular tremor, vértigo, hallucinatious, paralasis, ajioplexy, ' delirium tremens, convulsions and insanity. iearly all the foregoirg diseases may bo attributecl to exluiusted functioii in tho brain and nei "ous system. No organ or tissue of tüo body is free frorn its iniluence. The principal organa ujion which it expends its chief force are thebrain, lungs, stomach, bowels, li ver and kidneys ; from the same cause, disease of the huart and arteries may occur separatoly, and may bo found in connection with some other disease. I will only notice a lew of the more prominent and important diseases. Ono evident action of alcohol is to increase tho action of the hoart and arteries, causing congestión of the brain and its membranen, of tn resnlting in serous effusion, as is indicated in the inebríate by a blouted face, etc. We have inflammation of the brain and its membranes from the forogoing cause, and from tho direct influence of tho poison. Besides congestión, inüaiumation and effusion within thu crauium, we have indaratioQ and softening of the cerebral substanco. The symptoms ol those various f unctional and organic cbanges or losioTis in the brain aro shown in the inebríate by a weakened intellect, a general debility of the mental faculties, impairment ot' visión, a partial or total losS of self-respcct, and a perfect departure of the power of self-control ; all of which, aoting togother, he is utterly unable tb cure or relieve by bis own unaided efforts and which will inevitably destroy hint unless timely tiid comes to his relief. Wé have ohronio gastritis and enteritis (inHainmation of the stomaeh and bowels) is the result of the inordinato use of alcoholic baverages, and dyspeptic comi)laints are seldom absent in tliese subjects, We frequently have organic diseases of the liver and kidnoys, resulting from intemperate habite, such as cirrhosis, fatty Üegeneration and chronio inrlammation. of the liver, acute and chronic albuminuria (cominonly known as Bright's diséasé of tlu? kidneys), which are common among incbriates, and often fatal These various diseases, v.iih their lrsions, have ná oonnection with the delirium tremen or convulsiona, whic'u, bo fat as dissection throws no special light upon these particular d which must be regáis Sed as stiictly funoiiouai. Many ther coraplaints and diseaïea of a señeras and even fatal oharacter iniglit be adduced a,8 the result of intempwrtiiee, but. cnougE havo alroady be;;i fco wam the anfortuna.te man in liis career of sill-deRtruotíon. Bafore closing this parugrëpa I desir ■ to all tha rea l i's attention lö 3 few other Eaota in 1 o n ction with t)i intemperate use of alobolio drinks. It predispo item to nearly every forni of acate disaase- 1 1 those espeoially of au nflammatory nature, and to thosé ansingf from an impar id nntrition. Por tlie ceasou it pred;spo8e8 the system trt attacks of an epidemie, and when the predisposition to uuy disease, from aiiy othei cause, is moderate and limited, and. may bo eaeily arrested, the eziBtehoe oí this habit, alone, will insure its devolop-1 inent and lossen the ohanoesfor reeovery; and the fact is recogniaed by all medical i inon of experience, that when tha intein. perate habit is associatcd willi the disI sabjeot, the prognosis of the case is nade invariably moni unfavorabloi ín his conncetion I do not wisH ov caro to Liscard the uso of alcohol as a réttetlial m'.nt in tbc treatmont of diseaseSi Iü somu cases it may be s:iiil to be i vahiaili remedy (likeall kuown poisons) wÍÍbü judiciously prescribed by :i oompBtüti jhysioian ; yat 1here is rsallv not hing OtiN ative in alooholio liquore. Their use iti i-ert;iin oasis niul stares 08 disdase is raloulated only tosustain an suppott the exbaosted powers of -. in othor words, to keep the patiënt ulive for A certain longth of timo, cr until tbo roparatory proucsses como to his rcü-f. Then the stiimiliis will no longer be i ed and mav boounie Lpturiotie. T cartrtofc avoid remaikiiiir, ín Ihis connectidn; t!'at Iamot' Öw opinión that the tluleíerióus tind disastroua éffeotg airifing from .the intemperate nsi oí' aloobolio driiiks more than oounterbajanee :i bundred foM tha good accoinpli.shed by tliat a;ent. Now, siuce the forogoing facts aré vrell establiahed iu medical science; niaco thst the inebríate is affected with a po umeaso whu-ti ha is poweriees I uuuided, l accepted na a unit by the medical profossion, and oonfirmed in evary caso by the Inobriafe himself ; siaoo, bythatssmc profession, the-proper and oñly remedies aro prescribid whioh uiv intendedaod oaloulated torslievn tod restore the patiënt to a norm ü conditioii, physiealiy and mentally, why_ should the public at largo ïvt'uso or '■■. ■ aucopt the result ut the oombined wisdom and oxperionoo of a profession that stands pre-emincntly high i" all matters in which our physical well-being is interestsd? Why" should we be indifferent to or negleot to avail öurselvea of the advantages which medical men assure ua are our only hope andsafcty? Fortonately for "the unhappy inebríate, lus friends, society and the world, alcoholiam and its treatnient bas taken its place in the list or family of diseases ; and I fully believe thatthe time hasoome when the inebríate asylums are as neces andaru becomingsorecognizcd, to i and reelaiin the inebríate to health and usefuluess to themselves and othet our ordinary hosjAtals and insano asyluins aro to relieve and cure fhose who seok admission at their door.;, for the Bpecial objects for which they were intonded. To what more worthy and noblo object ban mankind turn their thoughts and direct their enorgies tlmn tho i ing of thoir fellow man's oondition f La what botter pursuit can they be enipl yed than in roseuing from destructioi recovering to usefulness this unfortunata class of mun 't ïhis subject oalls for and domauds onr unit. d energiea a';d Bttppoi t while there is u singlo inebríate in the land who is willing and anxious to secure hi8 own rastoration, and will co O] with tho mea::s and appliances p within his roach to enable him, in due time to go forth into the world era j eert and maintain his ïuanhuod and independence. For, by so doing, that one man is not only cured ; he not only, ia his own family, replacea Borrow, tears, poverty and despair, with joy, peace, energy and prosperity ; he not only o to exurt even a passive influence, which unseeu and cold and snakelike, ere ipa in a thousand directions into tho minds of friends and associates, and draga them, too, to ruin ; Uut, uu ' band, he will oxert now and in the future, and all through life, an activ , untiring inihienee, open and bright and warm as truth itself; a saving, all-embracing infli ever ready to support the falhng and n boue tho fallen, íor ho has Been and fel and reolized the n ■, r-ending, ever-incroasiug accumulative horrors of inebriety, and has trodden back Btep by step, the only sure path t; raanhood. Hla whole soul glows with the I he i-; cured and saved, and ovcrüows with for all who ace tending toward the sanio condition which he has just etcaped; and Buch a pity as none c:m icol who have not, like him, suffered and fonght and conquerod. I will now consider, Srst, what is meant by an iuobiiato ; secondlj', how and by what ïnoans a cure can be efiucted. There isa class of persons in our raidst whose teiuperáment and physical constitntion are such that when oneo they indulge in the use of intozisating drink:! they not only reoognize what to them appears a pleasure, but an actual i sity. A man of this peculiar habit and dia ■ position takes hií ürst social glass, and ; gradually and unconsciously Becomea a moderato drinker. Tho point oí time when he ceases to be a moderato drinker and becomes an excossivo drinker he is unable to see or determine. He roalizes the fact that he has at last becomo tho slave to a despotic appetitc - his whole organization is ehanged, his moral nature is perverted, his intellectual I ties are blunted, and he finally succuinbs i " a mnrbid aüDetite aji4 a ' ; ib rapidly destroymg mmd and body. In this state his stomach, nervous sysjjpi and brain demand und continually cry out for their aecustomod stimulanl, a ! admit of no denial. In lus oase there is a constant increaso iu the quantity of stimulus taken, and it is a pathologieal truth that there is a proportional diminution in its effect, until the time will linally arrive when the oonfirmed inebríate, cachoctic physically, and dementud and imbruted mentally, has but ono single object to live for, viz. : to satisfy a morbid appetite and craving for alcohol, when euough cannot be taken to support an exhaustod sjstem. This class of inebriatcs illustrates a form of mental derangemcut known as dipsomanía, from which but few, ii' any, ever recover. Fortunately this hopeless class are oomparatively few in number. That man is truly 8uffering from a weakness, and tliai wealmess is both a functíonal and organic disease which he is absolutuly erless to relieve and curo unassistecí, sinoo ín addition to the habit, tho samo weakness of will led to tho disease, ob-. struets its removal. These cases evidently possess a pocujiarity oi constitution or temperament which may, wih proprioty, be termed an alcoholic idiosyncrasy. Another peculiar feature, in OOnnoction with one class of inebriates, is an alcoholic diathesis, or hereditary predispositiou to drunkennoss. This is not only evident, but well marked in a goodly number of patients admitted to this asylum. The atatistics show a large percentage who have intPinperate or havo had intemperate parents or ancestors. I íind, bv ro ferring to tho record, that out of throe hundred and Beventy-nine, the wbole number admitted during the yast twenty nonths, one hundred and eighty niño have inhoritedlhe disease from intemporate paronti or ajicestors, and tlu.se mep are ueai-ly all periodioal drinkers. It is a well establi&li'.'l fact that of those who inherit th predispoeition to alooholiam. by far-tke laegest proportion load a miser able exísleace aud ígw escape being afflictwl with djüeaeo or phyaioal and frcquontly v. it h both oombin ono; ad it is a notorions fact, that of all the crimes eommitted eeventy-fi" cent, ischargoablo to wtsmperance alono, It furnishes a large uijaoiity of su ' for our poorhouses, insane asylums, work-housos, Denitentiarios and pi What is equally well knou'n to medical men is tho pathologieal fact or facts that intempcrance is a frequent causo of scrofula, and may be held rcspunsiblo for more than fifty por cent. of all the cases of insanity ; and when we add to disease and dementia that intemperanre is tb father of allcrime, how necessary, how imperativa, that the S(:Ao should come to the relief of the publio by providing snitableaeyluma for the inebnate, where he may resort for our and re; forination, thus lesscninjz the temptation to inebriety and dccreis'"iic the number of its victims. Admitting th fact that we cannot entirely remove tho o."'o graat cause ofdiseaee anil crime, it is none the )"or our duty todo all in ikiw.i1 b ten; the temptalit n to intemperan e uncí to i -..ieliorato the condition 01 bha unfortunttto inobriatf.', and the -viï COC faUowing in the wake of his depli babii. iiy suoh a courne we shall merit thanks and blessings of direetly int ted partic?, and at tho samethne peiform excellent service to the S' Secondly, How and by what raèaas a ure is effected. Neariy all patients on their admission, requiro modieal t ment. Stimulant, sedaüve and nai remedies aro usurlly adrainistwed at the outset, followed by alterativo medicines to improve and currect the secretiont ; after which tonics, botli V( g ■ mineral, are givcn, calcuhtted to i the sj'stem. When wo havo organii: (!!■- ease, appropriato remedips, adapted to each particular caso, are adminiatered to relieveandaKsisfcjMit.il!' in renutvingthe samo. Outóde of thwa Luoctional :m organic diiriculties very little mi treatment is domandod or requirod. Oui miiin reliance is upon ganitary n easoresg remedial rather than inodicinal, and es sential to improve and iavigorate tha pbjí8ical orgflnizati-n, and as a result ad diag-stnength in the same ratio to the mental' facultios. thus enabUng (he patiënt in the future to aesert and maintain hie Belf-renrect and scif-oontrol. Tn tbi oonnection it may bo wt;ll to state that, M woon ns OW ' - followingsa ;;;ci;: retirement from businew and the busy . of every-day lifo, quiet, reading, writing, pura air, well vut.il -' good nourahing diet, regular honra for . riaing and retiringi proper pbysi. iinj; and suoh ineohanio i iu tnay di opportunity afford. Ihe Btrougly re hi althful oondition of miad and Lsting materially in breaking up formi r h ' ';'i;lringfiomthe tnind those old coinpanions oï an intempesta lii.-. fonn; thought?, uuw ideaa and new and botter babüa, necessicatiog new bu- A ;i new lite in every res] . Bnally coTivincing all v "l: " . v.' been use of ■ uluut.s irc not only uaèless, but absoíately iiijurious. 1 will state, for the informal ion ol ' intereted, that we have no speoifio whlch to deetroy the mving s alooholioatimulonts, whetfeeraoquir tluntary ewt of the subjeci or h nú ed down a"an hei lal agenta and ■:■. powerless to 8ïdio ite rt habit that has by practii ''!':-- irt of one's vory tixi and o;. '■■ There is on n ■ nabit and i ry ae com permanent aa i t is possible ioi It. is n physiológicalfaot, '. ;;}t. whore n. hsbit has an absolttte remövalot'the :::-n: '.;;: produoed the habit ie things in ■. ible. Pla übcral sujip'.y of ti'mjiiing, dolioious foo 1, and ;isk him to Btarve , :ath ; :: ur ■ i i strong it than the witl : it ia m im] osd ólity. Place ilcoholwithin h ' inebtiftte to euro himself graduaHy : it isequally :nx injpoísibility Thefaot thftt exoessive, oontinuod uro of alooholio drinks iws oaüsed a oom ireni orgnnization, physioally and i dence ïy necess&ry in allow the now lorbid stule graduaHy to an I fin '■ tnrn to normal a. A.nd i ment, ' imple, thfti total absti■ i the only sdfa and sure rond to ntanhood, honot and nsefulness, bealth, rity au i . and make the men themse rts hving exotaples of fuitheory and praotioe; a living, all-convinroof that they ':ni gwn by total abstin ' by that only, not the y v.iih tho loast s ifety, but the power never to indulge at all; and this self-restraint is a rem agent from tho moment I öniou, growi i - r and .; -V I y d :y, unlii ti he finds total al not only po.=siuently suoceösful in the future Ihe same trnths pply eqnally to the treatment of the opium habit. 1 had Bon to say in my report las ■ 'h:s had been m ■ ■■' Asylum, with the i irked and gratifying ï'usults. I am happy to state that an . eo i '::■!. these -, but in a majority of cases rendéis them still more favorable.