ADDRESS; DELIVERED BEFORE THE TEMPERANCE SOCIETY MEDICAL CLASS DARTMOUTH OOLLE&E. OCT. SI, 1832. By DANIEL OLIVER, M. D. CHRONICLE PRESS......WINDSOR, VT iS&r" ADDRESS. It is a fit subject of rejoicing, to see another association formed by the young, just entering on the active business of life, to oppose, by their example and their precepts, a vice which has brought so much misery into the world. Youth is the time best suited to such an object, on many accounts. The young, from the ardor of their passions, and from not having as yet settled down into habits of calm reflection, are much more exposed to fall into practices, which, though perhaps not vicious in them- selves, may lead by insensible degrees into the depths of profli- gacy and vice. Youth is the time for the formation of habits which exert so much influence for good or for evil, upon the fu- ture character and destiny of the individual. The lights and shadows of character which are so intermingled, and which threw so indistinct but so interesting a grace over childhood and early youth, begin then to part, and each to assume the place and proportion which it is destined to preserve in after life. The outlines of mankind begin to show themselves in stronger relief, and the character to take the shape and direction it is ever after to preserve. In this forming state, habits insensibly take their rise. Originating more frequently in accidental circumstances, particularly the influence of example, than in temperament or natural disposition, they soon fall in with some principle in the character congenial to themselves; and attaching themselves to this, and thus obtaining a foot-hold in the character, they extend the sphere of their influence in every direction, until they fall in with some less congenial or less flexible principle, or reach the I limits which bound the jurisdiction of some other habit. In this way are formed habits of various kinds, which gradually acquire strength and extend their influence over the mind, until the whole character is parcelled out, as it were, between them. In- deed, the character itself may be said to be made up of habits resulting from the influences to which the young are exposed, operating upon the principles which nature has implanted in them. In mature age, the time for habits to be formed or re- formed, is for the most part passed. The character has received its shape and bias; and though there may be some neglected parts of it, which are not yet in the legitimate occupancy of any habit, there is none in which the influence of those already form- ed will not be felt, and where, consequently, it will not be diffi- cult to establish others, which shall not harmonize with them. Since, therefore, the habits formed in youth are those by which the future character will receive its lasting shape and propor- tions, and the destinies of the individual be in a great measure determined, it is of immense consequence to the young, that on- ly such should be formed as will exert an auspicious influence over their future respectability and happiness. But besides the considerations, that the young are so suscep- tible of the influence of example, that from want of reflection and the warmth of passion, they are so prone to fall into practi- ces which may strengthen into the most destructive vices, and that habits are formed in youth by which the whole future char- acter is determined, there is another reason why it is important for a work of reform to be adopted by them, and this is, that they are the forerunners, the advanced guard, as it were, of another generation; and whither they lead, those who come after them will pretty certainly follow. Their successors, in selecting their own models for imitation, will not be apt to leap over ihose who are immediately before them, with whose feelings they sympa- thize, whose opinions they are ambitious to adopt, whose exam- ples they are proud to imitate, in order to take for their patterns manners and opinions which they are apt to despise as antiqua- ted, and as soon to pass away with those who entertain them. Such is not the course of human nature. The young sympathize with the young, and not with the old. The ardent and impetu- ous feelings of youth have little sympathy with the cautious pru- dence and the calculating forecast of age. And the wisdom and 8 experience of age, before they can be made available to the benciit of the world, must be made acceptable to that class who are to direct the opinions and the manners of the coming generation. No plan of reform, no innovation in manners, whether for good or for evil, can be successfully executed, until it is first adopted and cherished by the young. Their ardor and energy, also, are qualities of inestimable value in carrying into successful opera- tion enterprises and schemes of improvement for the benefit of the world. Another circumstance in the present case, auspicious to the cause in which you have embarked, is that you belong to a pro- fession to which is confided the health of the community. As members of the healing art, your opinions and your example Avill exert a powerful influence upon those with whom you have in- tercourse, on all subjects connected with health; and in no way can you better repay their confidence who entrust their health to your keeping, and the respect which society pays the profes- sion to which you belong, than by employing this influence in counteracting and destroying the grand enemy of health and life. We owe this to society, also, as a matter of retribution. We have been reproached, and not without reason, with having con- tributed in no inconsiderable degree to the prevalence of drink- ing. False theories in medicine, until a very recent period, led to the common practice of prescribing diffusible stimulants in ma- ny diseases in which they are now considered as useless, or worse; and many a victim of intemperance might date the origin of his ruinous vice from a prescription of his physician. Let all of us beware that we do not partake in this deep sin; and let it be one of our first objects, to wipe off so foul a stain from our beneficent profession. Too often have we to lament (were not such the will of Heaven) that our utmost skill and exertions are unavailing to save human life. Too often, let us confess it with shame and sorrow, life is lost, not because it was beyond the power of medicine to save it, but because we had not been dili- gent to furnish ourselves with its resources, or had failed to ap- ply them with the requisite attention and judgment. For such errors let our pride be humbled, and let us make what retribution we can to society, by greater fidelity and diligence in future. But in our endeavors to relieve the sufferings of our fellow creatures, let us not hazard the chance of doing infinitely more 6 evil than we can possibly do good. Let us be careful in our anxiety to save life, or restore the bodily health, that Ave do not incautiously sow the seeds of an incurable moral disease, which may render the life we have preserved, a burden and a curse. We also, better know the effects of drinking upon the animal economy, than others, and we are therefore, more inexcusable, if we in any way, contribute to give encouragement to the prac- tice. It will, perhaps, be expected that I should go into the general argument of the advocates of temperance, on this occasion. This, however, I would willingly avoid; because I know of no- thing on the subject which has not been urged with far greater force than I can pretend to, myself. The subject indeed, as to its essential features, is wholly exhausted. The evils of drinking are of so obvious and undeniable a kind, and have been so fre- quently and so fully described, that it seems impossible to pre- sent the subject in any point of view, in which it has not already been considered; and it seems equally impossible for any man of common sense, who has not received a secret bribe from his own inclinations, or has not certain ends in view, different from the good of society, to oppose the cause in whieh we are enga- ged. The practical opposers of temperance, however, strange as it may justly appear, are still numerous and powerful. I speak not of those who, having forfeited all claim to the character and privileges of temperance themselves, may be regarded, perhaps, as its natural enemies. With such we have nothing to do, ex- cept to make use of them as a warning to others. We leave them to themselves and to all the benefit of the habit to which they cleave. To the cause of temperance they would be enemies if they could, but in truth they are enemies to none but them- selves, and such as unfortunately take pattern instead of warn- ing from their example. To the cause of temperance, do and say what they will, they are in truth the most eloquent advo- cates, the very best friends. As long as a single drunkard exists upon earth, the friends of temperance have only to point him out, as a living and unanswerable argument of the truth and jus- tice of their cause. If they Avish to ruin the temperance socie- ties, they have only to reform and the work is done. 7 But the contest, in truth, is with those who admit and per- haps deplore the evils of intemperance, and yet refuse to aid, and perhaps oppose the systematic efforts which are now making to remove them. To myself this conduct seems strangely inconsist- ent and unaccountable. The evils which flow from the use of distilled spirits are so obvious, so undeniable, and so excessive in amount, that it is difficult to conceive what plausible reasons can be given for opposing, or refusing to aid the efforts to re- move them. What harm can possibly result from persuading a man to relinquish a practice, which, to say the least, is an un- necessary and a very expensive one ; but more than this, is preg- nant with danger of the most ruinous consequences, and is in fact exerting the most pernicious influence upon society ? Will the drinker of spirits sustain any injury in his purse, in his health, in his morals, in his rational enjoyments, in his capacity for bu- siness, in his standing and influence in society, in the respect and affection of his friends and family, in his temporal prosperity, and in his hopes and prospects as a Christian, by being persuad- ed to renounce the practice of drinking ? Will his children, who naturally look up to him for example, receive any injury by no longer seeing him indulging in a practice, which experience shows they are so ready to imitate themselves, especially Avhen recommended by a parent's example ? Will the interests of so- ciety suffer, if its members are universally prevailed upon to re- linquish a habit, from which it suffers more evils, and incurs more expense than from any other moral cause in operation ? There are a few classes of society, it must be confessed, who would suffer a temporary injury, by a sudden and universal re- nunciation of the use of distilled spirits. These are, besides those whose proper business is the manufacture of spirits, the professions of law and physic, and the officers of civil and crim- inal justice. Our own profession, and that of the law, are some- times regarded, I believe, as necessary and unavoidable evils in society. If they are evils, however, they become necessary, as much by the vices, as by the inevitable misfortunes of mankind. For if men could be persuaded to dispense with their vices, they might dispense with much of the services of these obnoxious professions. The income of the physician, as well as that of the lawyer, is derived, in no small degree, eventually from the distil- lery. And if these buildings were universally shut up, or burnt 8 to the ground, on the same day throughout the country, no small portion of these two classes of society would be obli- ged to emigrate or betake themselves to other occupations. They live upon taxes which the people are compelled to pay, in consequence of previous taxes Avhich they have voluntari- ly paid for the purchase of spirits. For if the people did not impose a tax upon themselves in the first place to purchase liquor, they would avoid the necessity, in many instances, of raising a second tax to pay the physician or attorney. In this way people subject themselves to a double and very burden- some taxation, and all for the trifling and momentary gratifica- tion derived from tickling their throats and inflaming their blood with ardent spirit. Let not the physician, however, hesitate to employ all his influence and all his exertions to discountenance the use of spirits among his patients, and the public. The pro- gress of reform is too slow to affect, in any sensible degree, the emoluments of the profession; and while it is going on, and producing a beneficial change upon the public health, the effect will be felt, not in the decreasing profit of the actual members of the profession, but in the diminished number of those who will enter it. No motive, therefore, even of a selfish kind, can exist to deter the members of our profession from exerting their utmost power and influence in extirpating this destructive prac- tice from society. As guardians of the public health, it falls within the proper scope of their professional duties. It is a sa- cred debt which they owe to society for the respect Avhich is paid, and confidence which is reposed in the profession to which they belong ; and the successful exertions of other classes of the com- munity in the cause of temperance, are a loud call upon them to discharge it. There are many, however, who readily admit the evils which flow from the abuse of distilled spirits, but who contend that when used in moderation, they are harmless, and sometimes even beneficial. Admitting, for the sake of argument, the correctness of this opinion, what does it amount to ? Evidently only to this, that the practice is safe as long as the bounds of moderation are not transgressed, but no longer. But what guarantee can alco- hol furnish that this will always be the case ? Is there any thino- in the nature of this poison, to secure those who use it against the possibility of exceeding the safe and salutary limit ? It is 9 not usually the nature of our animal inclinations to prescribe limits to their own indulgence, and we have yet to learn that al- cohol enjoys the extraordinary prerogative over all other objects of physical desire, of suggesting to its votaries moderation and caution against its own abuse. Indeed, one of the principal causes of its pre-eminence in evil is, its natural tendency to cre- ate an appetite which is perpetually calling for increased liba- tions, and which must and will be gratified at any expense ; while by stupifying the moral sensibility, and clouding the rea- son and understanding, it removes the only obstacles to its ob- taining the absolute control over the man. No one, therefore, who indulges in the moderate use of spirit, can be certain that he shall never be tempted to transgress the bounds of temper- ance. From the very nature of the case, and from the qualities of this poison in particular, such confidence is in the highest de- gree presumptuous and absurd. No man, whoever and whatev- er he may be, is secure against the danger of falling into con- firmed habits of intemperance, so long as he indulges in the practice of moderate drinking. No strength of principle, no force of intellect, no power of virtue is proof against the insidi- ous and imperceptible encroachments of the habit; and when it is once formed, there is no redeeming power in man to save him from destruction. Many among the wisest, the most en- lightened, and but for this, the most virtuous of mankind, have fallen before it, and they have gone sloAvly and deliberately to ruin, with their eyes open to the destruction before them. What then shall we think of the giddy and thoughtless multi- tude, of the young and inconsiderate, who, with less restraint from reason and reflection, and with stronger temptation from the warmth and ardour of their feelings—what shall we think of the prudence or safety of their playing with this gilded serpent? This practice, I repeat it, has raised its trophies on the ruins of whatever is respectable in character, venerable for virtue, and splendid in intellect. Many, it is true, escape, as many escape a wide-spreading pestilence, but no one is safe—no one has any just ground for confidence in his own security, so long as he in- dulges in the habit of even tasting spirit. He may escape many years, and yet be overtaken at last. For the truth of the asser- tion, I may appeal, not to theory, but to the common experi- ence of mankind. Indeed, whjtfjyfiij.smore familiar from its 10 frequency, than that temperate drinkers of spirit often sink by in- sensible degrees into confirmed and incurable sots. They use spirituous liquors in moderation perhaps, for years, and are consid- ered by their friends, and by the Avorld, as temperate men. But, sooner or later, according to the progress of the habit, Avhispers and surmises begin to be heard that they drink too much. The story at first is variously received. The kind hearted and benevo- lent, reject it as slander; some, with a deeper knowledge of hu- man nature, fear it may be true ; and some perhaps, for such alas, is man, with an air of deep but feigned concern, secretly hope that it may—until at length, the red and watery eye, the deep carnation of the face, the fiery hue which begins to gild the nose, the loathsome breath, the bloated face, the stupid and sensual expression of the countenance, and the consciousness of self-degradation so conspicuous in the whole aspect, reveal the melancholy truth; and the temperate drinker of spirit be- comes a vagabond, and dies a sot. These deplorable exam- ples of the effects of temperate drinking are so frequent, that it is truly astonishing they do not alarm those who indulge in the habit. Undoubtedly every one supposes, that however it may fare with others, he himself shall escape. This is one of those common cases in which men are led blindfold to destruc- tion, by pride and self-love. Every temperate drinker of spirit has such confidence in the strength of his own resolution, as to feel no apprehension of becoming enslaved to habit. He does not perceive that he is a slave to it already, as soon as the habit itself is formed. His fetters are already forged and placed upon his limbs. Every act of indulgence is driving a bolt, or fasten- ing a rivet; and the depth of his degradation and servitude will depend far less on his oAvn resolution, than on the caprice and humor of his inexorable master. It signifies nothing that he is aware of his danger, and on his guard against it. For no vigil- ance can afford any security. Vigilance, in this case, implies a distrust in the moral power of the mind to resist the force of the habit. It foresees the danger, but makes no provision to avert it. Undoubtedly, he who is aAvare of his danger, is safer than he who disbelieves, or despises it, or trusts in the strength of his resolution to resist it. But he is safer, not because his vigil- ance, or his consciousness of danger, gives him any greater power of resistance ; but because^what power he does possess \ tl he will be likely to oppose to the encroachment of the habit. And it may possibly happen, that by the exercise of incessant caution, his moral strength will be sufficient to prevent the ene- my from getting the mastery. But no drinker of spirit can be certain that such will be his own good fortune. With all his vi- gilance, he perhaps will find that his power of resistance is gradually becoming weaker, before the increasing strength of his habit; and in this state of things, his consciousness of dan- ger is of little avail to his safety. He will probably struggle against the force of his propensity, but perhaps will find that he struggles in vain. In yielding to the temptation, he will en- deavor to still the clamor of his conscience, by resolving to exert more firmness in future, and thus opposing his present resolution to a future temptation ; and proroguing his resistance to a future assault, he leaves his enemy, in the mean time, all the advantage of uncontrolled and unresisted attack. In this manner, he soothes his conscience with the hollow and delusive idea of fu- ture resistance, and with his eyes wide open to the danger, he plunges, as it were, still farther into a stream, which, every moment becoming broader, deeper, and more irresistible, at length sweeps him and his virtuous resolutions to destruction. It is, however, a mistake to suppose that the habitual use of spirits, even in moderate quantities, is not injurious to health. Ardent spirit is a powerful stimulant to the animal economy ; i. e. it excites the actions of the human system to a degree of ac- tivity beyond that which is natural to them, and which is most favorable to health and long life. It hurries on the wheels of life to a speed at which it may be highly animating to the young and inconsiderate to be whirled along, but which sooner wears the machinery out, besides exposing it to many dangerous and even fatal accidents on the road. It is plying the bellows, when the fire is already kindled, and burning with a steady flame. The burning mass will be excited to a brighter glow and intenser heat, and perhaps throw up volumes of brilliant and crackling sparks ; but the fuel will sooner be consumed, and the fire go out. One who habitually drinks spirituous liquors may enjoy good health, and may laugh at the grave admonitions of a physi- cian or friend who tells him to beware. But his consciousness of health and vigor may arise from the machinery of his sys- tem moving with a velocity beyond its natural rate. He may 13 sweep down the current of life like one of those beautiful boats, which, impelled by hidden fire, skim like birds over the bosom of our Avaters, and be enchanted with the ease and rapidity of his flight; little suspecting that the fire which impels his bark, and which he is incautiously urging to an intenser glow, is cor- roding the machinery on which it acts, and that he may in an instant be hurled to destruction, when least suspicious that dan- ger exists. No one Avho has studied the physiology of life, can entertain a doubt of the injurious effects of artificial stimulants, and par- ticularly alcoholic drinks, upon health and long life. The ac- tions of life result from two causes : one, a certain principle with which organized matter is endued ; the other, certain properties belonging to those agents by Avhich life is supported. These agents consist chiefly of the air we breathe, and the substances we use as food; and the properties they possess are such, that when applied in certain modes to living matter, they excite the principle of vitality in the different organs, to the various actions of which the phenomena of life consist. The actions of the ani- mal frame, then, result from the mutual operation of the quali- ties of the air and food, and the principle of animal life, and healthy action from the harmonious relation of these two to each other. In the ordinary state of health, nourishing food alone is all the stimulus that is necessary to support the frame in a state of healthy action. All beyond this is hurtful; for it tends to ex- cite a higher degree of action than the system can support with- out injury, either immediate or remote ; and its inevitable conse- quence is some derangement of its healthy condition. A certain stock of vital power is bestowed upon the system with its original organization, and distributed among the various organs of which it is composed. By this the possible duration of human life is measured and limited. It is slowly expended by the healthy ac- tions of life; and were it carefully husbanded, and if the human race were not exposed to inevitable causes of disease and death, it would hold out in many individuals of the race, to the extreme natural limit of human existence. The machine would continue in motion as long as it was intended by nature ; and would then stop, not from any external or accidental necessity, but because it had fully accomplished the purposes of its construction. What a waste of life, then, is occasioned by the use of artificial stimu- 13 lants! Every draught of intoxicating liquor which a young man swallows, as well as every act of intemperance or excess which he commits, is expending in a minute or in an hour a portion of vi- tal power, which, if prudently and temperately used, might give to his old age, should he ever attain it, another day or perhaps another week of comfortable existence. The loss is not felt, or not thought of, while the treasury of life is full.. But in the day of his penury, when a scanty remnant is all that is left of life's abundant store, he will look back with bitter regret and remorse on this thoughtless and irretrievable waste. Nature certainly never intended that man, while in health, should make use of artificial stimulants. Health and strength do not require them ; and though they excite for a time a certain feeling of increased animation and vigor, this is always followed by an equal degree of lassitude and exhaustion. The appetite for them is artificial, for they are almost always distasteful at first. It will perhaps be asked, if these substances were not de- signed to be used by man, why are they placed within his reach, and why is a taste for them so easily acquired ? To this it may be replied, that diffusible stimulants are sometimes useful as med- icines, and for certain other purposes. But to take them habitual- ly, or for food or drink, is to pervert them from their proper use. The very fact that they may be useful as medicines proves, of it- self, that they were never designed for common use. It may be assumed as a general principle, that no substance possessed of medicinal properties, was ever intended by nature to be used as food or drink. But it must also be remembered, that we live un- der a moral government, and that these objects of physical desire are placed within our reach, partly to exercise our self-denial, and to prove our obedience to the laws of our nature, and the commands of its great Author. But here, as in other cases, it is graciously ordered that our duty should coincide with our hap- piness, even in its lowest and grossest form, mere physical enjoy- ment. The true philosophy of pleasure, the hidden essence of epicurism, which has constantly eluded the professed pursuers after pleasure, is to make a temperate use of life and its enjoy- ments ; and not to lavish a fund which was given us to be used with a wise moderation, and the sum of which, being unalterably fixed by the laws of our nature, we may squander as we please, but it is not in our power to add to. 14 But, besides its natural tendency to shorten life, the use of alcoholic stimulant renders the system more liable to many dis- eases, by which life may be suddenly cut short. Many a temper- ate drinker has fallen a victim to disease, in whom the malady owed its power to the state of the constitution produced by the stimulus of spirit. Many persons die, as is supposed, of fever, inflammation, dropsy, apoplexy, and other diseases, Avhen in truth, they owe their deaths to the habit of temperate drinking. They perhaps consider themselves, and are considered by others, as temperate men, because they use ardent spirit in moderation ; and they go to their graves, as their friends suppose, in the common course of nature and of providence, by a stroke of disease ; when in truth, they die of a secret wound which they have inflicted upon themselves. It is, therefore, a mistake for people to sup- pose, that so long as they keep within the bounds of moderation in the use of spirit, they are doing themselves no injury. They are, by slow and insensible degrees, wearing out the springs of life, and they are pointing Avith their own hands the shaft of dis- ease, Avhich is to pierce their oAvn bowels. Temperate drinking is in the secret pay of many of the mortal diseases of mankind. We receive it, Avithout suspicion, into our favor and affection, and it repays our confidence by unbarring the gates of life to the de- stroyer. Let the advocates of ardent spirit ponder well the ar- guments Avhich a single disease, the Cholera, has furnished in favor of the cause of temperance. But, the great evil of moderate drinking is, that it is the prin- cipal cause of drinking intemperately. Let all those who in- dulge in the moderate use of spirit, relinquish it altogether, and the vice of intoxication, with its numberless and indescribable evils, would soon disappear. It would not, it is true, reclaim the drunkard; but it would very certainly prevent others from falling victims, because, let it be remembered, every drunkard was once a moderate drinker. No man can become a sot at once. Nemo repente fuit turpissimus. Men may pass, by more or less rapid steps, from the first taste of spirit, to the confirmed habit of ex- cessive drinking, but they must all pass through the intermedi- ate stage of drinking moderately. The taste is not a natural, but an acquired one ; and it is acquired only by repeated trials. Let every one, then, who makes a temperate use of spirit, re- 15 nounce it altogether, and the vice of intoxication is cut up by the roots. Let temperate drinkers, then, consider that with them it rests, whether society shall any longer be disgraced by the loathsome and unnatural vice of drunkenness. I do not say that their example, should they renounce the habit, would reclaim those miserable beings, whose souls, as well as bodies, are drenched with this stupifying poison. They must go to their graves in misery and shame. The remembrance of their former virtues, forever blasted by this destroyer, may gain them a tear ; but they depart unlamented, and leave a world which they have burdened and disgraced, purer and happier by their death. We would indeed rejoice to believe that such an example, aided by the powerful impulse of public opinion, might have the effect of aAvakening the slumbering consciences of some of these unhappy victims, and rousing them to an effectual effort to break the chain which fetters them. Could such effects be reasonably expected, what an inducement would they not offer to the temperate drink- ers of spirit to renounce it forever. But, alas, alcohol makes sure of its victims. We all have witnessed how ineffectual are the struggles of those who have once placed themselves in its power, and at length are awakened to the horrors of their situa- tion, to escape from its toils. Let the temperate drinkers of spirit remember that they con- stitute the body out of which the ranks of the intemperate are recruited. The lot, of course, will not fall on all of them, but on some it inevitably Avill, while they fall within the conditions which render them liable to this conscription. Out of the body which they form, will be annually draughted a certain propor- tion, to fill up the ranks of that army of drunkards who are black- ening over the face of society, and threatening its political lib- erties, no less than its religion and morals. It is a hard service, and kills off its men much faster than the sword, yet its ranks are always full; and of those out of whom it is destined to be re- cruited, it will depend on causes very different from their own individual determination, on whom the lot shall fall. No moral certainty is greater than this, that out of a certain number of temperate drinkers of spirit, some in the course of time will be- come victims of intemperance. It signifies nothing for them to say and to believe, that they themselves are in no danger. If 16 they all really believe so, the event will infallibly teach them that some are mistaken. For as long as they indulge in the ha- bit of drinking spirit, no cause whatever can be imagined to ex- ist, why the community which they form should not furnish the usual proportion of intemperate men.. While human nature re- mains the same, and men make use of intoxicating drinks, it is morally certain that drunkards will exist; and they will very cer- tainly be formed out of those who make use of these drinks, and not out of such, as never taste them. Whatever confidence, therefore, temperate drinkers of spirit may individually possess in the strength of their own virtue and resolution, they have no reason, as a class of men, to claim an exemption from the inva- riable laws of human nature. In conclusion, let me exhort the members of this society to go resolutely and steadily forward in the course on which they have now so laudably entered. Perhaps there is no other way in which it is in their power to do an equal amount of good to their fellow creatures; and few others, in which they can so surely earn for themselves the blessings of an approving con- science. NLM032037009