RELATION OF BOARDS OF HEALTH INTEMPERANCE. READ I!EFORK THE NATIONAL CONVENTION OF HEALTH BOARDS ASSEM- BLED IN WASHINGTON CITY," JANUARY 2 I-23, I 874, BY PROF. MILO P. JEWETT, LL. ])., LATE PRESIDENT OF THE HOARD OF HEALTH OF THE CITY OF MILWAUKEE. MILWAUKEE: MILWAUKEE NEWS COMPANY, PRINTERS. 1874. REL ATI ON OF BOARDS OF HEALTH TO INTEMPERANCE. A. T=A.TP3IiIA. RF.AP BEFORE THE NATIONAL CONVENTION OF HEALTH BOARDS ASSEM- BLED IN WASHINGTON CITY, JANUARY 21-23, 1874. BY PROF. MILO P. JEWETT, LL. ])., LATE PRESIDENT OF THE BOARD OF HEALTH OF THE CITY OF MILWAUKEE. MILWAUKEE NEWS COMPANY, PRINTERS. 1874. RELATION OF BOARDS OF HEALTH TO INTEMPERANCE. For nearly fifty years past the friends of humanity in this country have been engaged in efforts to stop the use ot alcoholic liquors as a common drink. The first half century from the declaration of our national independence had just closed when President Nott, Ly- man Beecher, the Rev. Dr. Plewitt, and a host of others, true men and mighty men all, sent through the land a cry of warning against the tyranny of an appetite which sought to impose upon our people a slavery more galling than that which aroused our fathers to arms in the war of the revolution. From that date to the present hour the agitation against the use of intoxicating beverages has never ceased. Multitudes of persons of either sex, moved by a generous pity, ani- mated by the purest philanthropy and the loftiest patriotism have banded themselves together to stay the ravages of the destroyer. The pulpit and the press have directed their potent energies to the same end. The medical faculty have unanimously declared the abuse of alcoholic stimulants to be a prolific source of disease and death. The highest judicial authorities have pronounced sentence on this practice, and drunkenness is punished as a criminal offense. Yet, after all that has been done we are compelled to admit that this giant evil still remains strongly intrenched in the customs and habits of the American People—the destroyer of individual lives, the bane of the family, the curse of society, the shame of our civili- zation. And now, since the law requires Boards of FTealth “to examine into and consider all measures necessary to the preservation of the public health, and to see that all ordinances and regulations in rela- tion thereto be observed and enforced,” it would appear to be in hai- mony with the purposes of this meeting to discuss the question: 4 What relation have these boards to the subject of intemperance? Have they any responsibility for the evils inflicted by it on their constituents? If this be affirmed how can they meet this responsi- bility? The writer of this paper is impressed with the conviction that this subject has not received from Boards of Health that considera- tion which its importance demands. Of all their annual reports which have come under his notice only two or three have given the subject any prominence. A single one, only—the report of the State Board of Massachusetts for 1871 — shows an appreciation of the vital issues involved, and an earnest purpose to press these home on the people of that Commonwealth. There seems to be no good reason why every health board in the country, acting in the same intelligent and fearless spirit, should not investigate the facts connected with the popular use or abuse of in- toxicating liquors. Should it be found that these are inflicting in- calculable injury on society, it will then become the duty of these conservators of the public weal to devise plans for the speediest re- moval of existing evils. First. The first pregnant fact presented in the inquiry is this: Al- cohol is a poison, and all intoxicating liquors taken into a healthy human organism are deleterious just in proportion to the quantity of alcohol present. Such is the decision of the most eminent chemists and toxicologists of Europe and America. Sir Astley Cooper says: “spirits and poisons are synonymous terms. Dr. Munroe says: “alcohol is a powerful narcotic poison, and if a large dose be taken no antidote is known. ” Forty-five physicians of Cincinnati testify that alcohol “is equally poisonous with arsenic.” Pereira, Orfila, Dr. Taylor, and Professor Christison rank it among the tiarcoiic-acrid poisons. Dr. Percy, speaking of a case of instant death produced by this powerful agent, adds: “The mode in which death occurred was almost precisely identical with that of poisoning by a strong dose of prussic acid. ” Dr Wilson, in his “Pathology of Drunkenness,” writes: “All these diversified proofs have pointed unchallengeably to the conclu- sion that alcohol is the most widely and intensely destructive of poisons. In large and concentrated doses there are few which are more promptly and inevitably fatal. In more moderate and diluted potions, continuously repeated, it is, with its own peculiar modifica- tions of action, obviously one of those so-called cumulative poisons of which science possesses other well-known examples in corrosive sublimate, foxglove, and arsenic.”. Dr. William B. Carpenter and Dr. Edward Smith have expressed the same opinion in terms equally explicit. Second. We next consider the effects produced by alcoholic drinks on persons in health. The immoderate use of this poisonous drug generates a train of diseases which have no parallel in the cata- logue of ills that flesh is heir to. Among these Dr. Sewell enumer- ates dyspepsia, jaundice, dropsy, rheumatism, gout, palpitation, hys- 5 teria, epilepsy, palsy, apoplexy, melancholy, madness, delirium tre- mens. To this list I)rs. Trotter and Carpenter add forty-one others —all induced by the use of alcoholic liquors. In his prize essay on the “Use and Abuse of Alcoholic Liquors in Health and Disease,” Dr. Carpenter gives the recorded opinion of over two thousand medical men in Great Britain who have signed the following: “We, the undersigned, are of opinion that a very large proportion of hu- man misery, including poverty, disease and crime, is induced by the use of alcoholic or fermented liquors as beverages.” It may be added that the effects of intemperance are not confined to the person of the inebriate himself, but re-appear in his children. If a woman indulges in spirituous potations, her babe will imbibe the poison with its mother’s milk. If the father alone is intemperate his offspring receive the taint in their blood and transmit it to their descendants. Says Dr. Bowditch, chairman of the Massachusetts State Board: “The sin of the intemperate use of ardent spirits is visited not only upon the third and fourth generation, but must act in all time unless radical reform be instituted. ” Third. Look at the crime and pauperism for which intoxicating drinks are responsible. Judge Cady, of New York, after being about forty years on the bench, declared that “the greater portion of the trials for murders and assaults and batteries that were brought into court before him originated in drunkenness.” In 1867, the police of New York and Brooklyn made nearly 70,- 000 arrests, of which liquor was the producing cause. In Philadelphia in the same year, 41,000 arrests were made, and the records show that three-fourths were cases arising solely from the use of liquor. In the same year there were in Chicago 23,000 arrests, more than 20,000 of them occasioned by liquor. Milwaukee claims to be the most moral and orderly city in the Union, its people drinking chiefly the lager beer for which it is so famous; yet of the arrests made by the police for the year ending March 31, 1872, nearly four-fifths of the whole were for offenses committed under the influence of intoxicating drinks. In regard to Pauperism, we have very strong evidence that fully three-fourths of it is produced by drinking. The Secretary of State of New York in 1863, reports that the whole number of paupers re- lieved during the year was 261,252—one in twenty of the entire population. A committee, who examined into the facts, say that seven-eighths of these were made paupers by alcohol. That multi- tudes of individuals are reduced to beggary, and the nation is im- poverished by the use of intoxicating liquors, is evident from the vast sums of money expended in the production and distribution of an article which returns no equivalent therefor. An editorial in the New York Evening Post on “what our drinks cost us,” presents some very suggestive statements on this topic. “In 1871, 3,524 dis- tillers were employed in producing domestic spirits, and 153,522 licensed vendors made the whole into sherry cobblers, brandy 6 smashes, mint juleps, gin slings, and cocktails; and, of course, we paid for them with princely liberality, giving live, ten, twenty-five, and fifty cents a glass for that which costs only from a tenth to a twentieth part of these amounts, thus putting into the pockets of our obliging friends, the dealers, the exceedingly handsome sum of more than $500,000,000—the clear profits of the licensed dealers over and above all expenses! In this way we are spending half a billion annually on drinks, while we are thus supporting in ease and affluence from three to four hundred thousand able-bodied men be- hind counters to minister to our pleasures in bibification. ” “Nor,” continues the writer, “is the actual money expenditure on these drinks the whole of their cost to the nation. The vendors, with their attendants, make up an army of 300,000 to 400,000 per- sons, who, if they were not thus employed, might be at useful work, earning an average of $500 to $1,000 a year each. Thus withheld from remunerative work, the nation loses thereby from $200,000,000 to $400,000,000, which, added to the first cost of the liquors and the profits of the dealers, makes a total of $800,000,000 to $1,000,000, 000 annually, as the cost to the nation of the drinks in which our people indulge; an immense outlay, exceeding by many times our expenditures on churches, colleges, and schools.” If we could add to these figures the amount by which the results of drinking increase the expenses of our courts, and jails, and pris- ons, our poor-houses, hospitals and insane asylums, the grand aggre- gate would be incredible, if not incomprehensible. Fourth. The waste of mind, and the consequent loss of intellec- tual power to the nation, is one of the most deplorable effects of the intemperate habits of the people. In our halls of Congress, in the seats of our judiciary, in our gubernatorial chairs, and in our State Legislatures how often have the brightest intellects been veiled in perpetual eclipse, under the sorcery of the Circean cup. How often, in the morning of life, has the fatal spell mocked the promise of a radiant manhood, and extinguished it in darkness and despair, robbing the nation of her dower of genius and taste, learning and eloquence, piety and patriotism. But far more destructive of na- tional mental force and vigor, though less conspicious, is the stupe- fying, besotting effect of inebriety on the masses which constitute the body of citizens controlling the destinies of this Republic. Our limits forbid enlarging on a theme at once so fruitful and so prophetic of disaster. Fifth. The blinding of the judgment, the perversion of conscience, the enervation of the will, the crushing out of all pure and tender affections are the inevitable sequence of habitual intoxication. Sixth. The baleful effects of our drinking usages pervade every section, reach every corner of our broad land. They are not con fined to particular localities, or bounded by any parallels of latitude, or limited by isothermal lines. The great mass of our male popula- tion practice the occasional drinking of spirituous liquors, and large numbers of o'Ur women not infrequently partake of the lighter in- 7 toxicating beverages. But excluding the multitudes who claim that they never drink enough to hurt them, carefully prepared statistics show there are in the United States one million drunkards. Of these the greater portion live in the 'miserable hovels called their homes— the terror of broken-hearted wives and starving children; but many thousands of them are supported in our charitable, penal and refor- matory institutions, and 60,000 of them die every year. Seventh. To sum up: Intemperance is producing among our peo- ple a degree of physical weakness, mental imbecility and moral deg- radation which seriously impairs the vitality of the nation, and threat- ens to drag it down from the pedestal of power and grandeur on which our fathers placed it. That this conclusion is logical and just appears from the opinions of eminent physicians, scientists and statesmen, mostly derived from the Massachusetts State Report above quoted. The world-renowned Liebig says of ardent spirits: “He who drinks them draws a bill, so to speak, on his health, which must always be renewed, because for want of means he can not take it up. He consumes his capital instead of his interest, and the result is the bankruptcy of his body.” Professors Tilanus and Swingar, of Holland, write in favor of abolishing even the moderate use of strong drinks as “always un- healthy,” “the greatest underminer of the actual welfare of man- kind. ” The secretary of the Netherlands Society for the abolition of strong drinks writes: “Gin is the beverage of the people, and to such an extent as to create a general anxiety about the future of the nation. ” Hon. John Jay, Minister to Austria, says: “The degeneracy of the race in Gallicia is to be sought mainly in the excessive use of corn brandy. Of the men called to military duty, thirty-eight per cent, are rejected on account of physical disability and infirmity. ” Thomas Jefferson, in a letter written in 1818, speaks of “the poison of whisky which is desolating the homes of our citizens. ” The physicians of France, after various discussions of the evils resulting from the use of strong liquors, “feel called on solemnly to warn their countrymen against them. ” Dr. Bowditch says: “We get from our correspondents a most shocking array of evidence, proving that the free and intemperate use of ardent spirits not only crushes out manliness in a man or woman, but actually dwarfs the offspring. The sin of intemperate use of ardent spirits is visited not only upon the third and fourth generation, but must act in all time unless radical reform be institu- ted. Even if a reform be begun several generations will be needed to redeem the progeny of such a degenerate race. What a warning this to our country in regard to the use and abuse of ardent spirits!” That profound thinker, Professor Goldwin Smith, speaks of in- temperance “as threatening the very life of the community; it is producing a physical and moral pestilence more deadly in the deepest 8 sense than any other plague which stalks the infected cities of the East. ” In view of the facts here presented can there be any doubt as to the duty of our Boards of Health in the premises? They surely cannot plead the want of power to act. The legislation which cre- ates these Boards assumes that the State is prosperous only in the physical vigor, the clear intelligence and the moral elevation of its people. All causes of disease are proper subjects of investigation, and it is the duty of Health Boards to expose these public enemies, to anticipate and prevent the developenrent of disease, and to arrest its progress, disarm it of its terrors, and utterly defeat and destroy it. So valuable to society is human life, so important are sound, hygienic conditions, that in great emergencies the State arms its Boards of Health with despotic power. When small-pox, cholera or yellow fever invades one of our cities, the law clothes the Board of Health with an authority scarcely exceeded by that of the mili- tary chieftain in time of war, when he proclaims a district under martial law. lake the decree of the Roman Senate ordering the consuls to take care that the Republic suffer no detriment, the law says to the Board: See that the plague touch not my people. In obeying this mandate the Board is invested with more than kingly prerogatives. The persons, the property, and, indirectly the lives of the inhabitants are at its absolute disposal. The lowest pauper in his filth and squalor is not beneath its notice. The millionaire in his palatial mansion is not above its reach. The whole police force of the city is placed under its orders, and the treasury throws open its coffers at its bidding. The sanitary board represents the sover- eignty of the people, all the powers which the instinct of self-preser- vation would summon to the rescue being delegated to this supreme committee of public safety. Arrayed in this royal investiture of power these Boards must bear a regal burden of responsibility. We have stated the facts which challenge their attention, and demand prompt and earnest action. It has been demonstrated that intemperance is making havoc of the health, the corporeal vigor, the mental energy, the labor and capital, the virtue and happiness of the nation. It is sapping the foundations of national life and extending its leprous taint through all classes, threatening the disintegration and destruc- tion of society. It is a greater foe to civilization than was the plague of two hundred years ago, which desolated Europe. In every town and village in the land it is a perpetual plague, an abiding pes- tilence. It is the most stupendous nuisance of the age and the country. If ever contagious disease or baleful infection called for radical and summary measures the present exigency justifies them. Is it asked what sanitary measures our Boards of Health can adopt in order to stay the ravages of intemperance? It may be said in reply, negatively: Eirst. In any action taken they should not enlist under any par- tisan banner, or affiliate with associations favoring or opposing what is termed “ class legislation. ” 9 Second. They will not, necessarily, accept the dictum, “Alcohol is always, everywhere, and under all circumstances, injurious.” Third. They will not place light wines, ale, and beer in the same category with strong liquors. Fourth. They will not make war on any worthy industry, or on capital invested in products which benefit the community. Fifth. They will not be obliged to take sides on the disputed point as to the expediency of using alcohol as a medicine. In short, our Boards would be governed solely by the principles of sanitary science, without reference to the theories of individuals, or the views of organizations, disregarding all considerations, other than those which should control them as the legally-constituted health police of their respective municipalities. Affirmatively, the above inquiry may be answered as follows: First. Our Boards ought to shut up at once and forever all places where ardent spirits are sold as a beverage. These tippling-shops are the occasion, if not the origin and cause, of nine-tenths of all the drunkenness that afflicts our country. They are the generators and propagators of idiocy, insanity, disease, and death, and ought to be instantly suppressed. Of course, this measure would encounter the most determined op- position. The manufacturers and vendors of intoxicating drinks, with a host of patrons, dependents, and flatterers, and with an enor- mous capital at their command, will denounce every attempt to abate these most outrageous of all nuisances as an attack on the rights of property, an invasion of personal liberty. “Personal liberty leagues” wrould be formed, and organized resistance to the sanitary police would stop short of nothing but mob-violence in their hostility to the proposed action. But these Boards, composed of intelligent, honorable, and public- spirited citizens, actuated by nothing but a disinterested concern for the public good, should not be intimidated by the threats of a class of men who are governed solely by self-interest; who enrich them- selves by bringing others to poverty; who flourish most wThen most they scatter abroad firebrands, arrows, and death. In the case un- der consideration the boards have only to exercise their power as they are accustomed to use it, where the danger is less imminent and appalling. The cholera breaks out in one of our cities. Hundreds of homeless, houseless denizens are struck down. The hospitals can not contain them. The Health Board seizes on any public hall, warehouse, or church, or on a sufficient number of private dwellings, and fills them with patients. Again, a certain quarter of the city is crowded with dense masses of human beings, packed in underground cellars, reeking in filth, gasping for breath in the fetid atmosphere, dying by hundreds. Here the plague originated, and from this focus of contagion is spreading throughout the city. By a summary pro- cess, the Board of Health removes the wretched inmates, tears down the infected tenements, or applies the torch and burns up wfflole blocks. Once more, suppose, instead of the 8,000 dram-shops in 10 Philadelphia, which are dealing out “liquid poison,” there were 8,000 butcher-shops which sold pork charged with trichina, and that thou- sands of citizens, under the cravings of a morbid appetite, purchased and ate the diseased meat, and multitudes were dying from this •cause, would the Philadelphia Board hesitate to abolish these pest- houses? But in all these cases the property-holders would remon- strate; the dealers in trichina spiralis would be furious in their de- nunciation of this arbitrary interference with vested rights, this de- struction of a most respectable business protected by law. The re- ply is at hand: The safety of the State is the supreme law. So in regard to intemperance: Let its manifold and monstrous evils once firmly possess the public mind, and the conservators of the public health would be able to enforce the most stringent requisitions. Second. Ardent spirits should be put on the shelf of the drug- gist, and sold by him as other dangerous drugs are sold, on the order of a physician, for medicinal purposes only, and to responsible per- sons. Third. As a substitute for dram-shops, “Holly Tree” houses should be established where nutritious and palatable food, with tea and coffee, should be supplied at cheap rates. Fourth. Boards of Health should urge on physicians the greatest care in prescribing alcoholic compounds. The medical faculty are not agreed as to the expediency of using alcohol in medicines. It would be out of place, perhaps, to discuss the subject in this paper, but it is pertinent to quote the opinions of some high authorities who support the negative of the question: The great I)r. Rush declared: “No man should be able to say that he made him a drunkard by recommending spirits. ” Forty years ago I)r. Bye Smith said that “the prescriptions of some medical men, too careless of physical and moral results, have given great impulse to spirit-drinking.” Dr. Charles Jewett writes: “I have no doubt but that tens of thousands annually in this country are hurried out of existence by the uncalled-for and mistaken use of wine and brandy,” taken as a medicine. The eminent physician and physi- ologist, Dr. Carpenter, declares: “Nothing in the annals of quack- ery can be more truly empirical than the mode in which fermented liquors are directed or permitted to be taken by a large proportion of medical practitioners.” In 1864, Dr. Higginbottom, the venera- ble surgeon of Nottingham, England, published the following: “For about thirty years I have not once prescribed alcohol as a medicine. I should consider myself criminal if I again recommend alcohol, either as food or medicine. During my long practice I have not known or seen a single disease cured by alcohol; on the contrary, it is the most fertile producer of disease.” In December, 1871, nearly three hundred of the most eminent members of the faculty in Lon- don, headed by Dr. Burrows, president cf the Royal College of Physicians, and Dr. Busk, president of the Royal College of Sur- geons, subscribed the subjoined medical declaration: “As it is be- lieved that the inconsiderate prescription of, large quantities of alco- 11 holic liquids by medical men for their patients has given rise in many instances to the formation of intemperate habits, the undersigned, while unable to abandon the use of alcohol in the treatment of cer- tain cases of disease, are yet of opinion that no medical practitioner should prescribe it without a sense of grave responsibility. They believe that alcohol, in whatever form, should be prescribed with as much care as any powerful drug, and that the directions for its use should be so framed as not to be interpreted as a sanction for excess, or necessarily for the continuance of its use when the occasion is past. ” These citations sufficiently fortify the position that our sanitary boards should endeavor to secure on the part of medical men a greater degree of caution, in view of the danger of stimulating to frenzy an appetite which the prescription may create, or which the patient may have previously acquired. Fifth. Through their annual reports, by frequent communications to the press, and by every available means Boards of Health should strive to arouse the moral sense of the community to the enormity of the outrages committed against the people by the sale of intoxi- cating drinks to be used as a beverage. Sixth. The children and youth of our country should be educa- ted in sound sanitary principles in relation to this matter. They should be trained up to consider the use of alcoholic beverages, in the social circle or the festive hall, as a deadly enemy to their growth and development, bodily and mental, certain to result in the ship- wreck of all that is manly and noble in their natures. In conclusion, the writer is persuaded that the Health Boards of the country have it largely in their power to enfranchise our people from the bondage of evil habits. These Boards are constituted of representative men, distinguished members of the medical profession, and others familiar with various departments of sanitary science—all devoting themselves to the welfare of the community in the broadest spirit of philanthropy and patriotism, and all enjoying the confidence of their fellow-citizens. What class of citizens can more effectively employ moral suasion, or can recommend a wiser and more prac- tical legislation? Let the Boards in all our cities be harmonious in their views and united in their labors, and a few years will witness a revolution in public sentiment through which the nation shall stand forth “redeemed, regenerated, and disenthralled.”