marized most of his chapters so that the extracts appearing below are careful translations of the original text, with omission here and there of detail or matter of subordinate importance and interest. Only the matter in parentheses is by the translator, and purely in the nature of necessary explanations in order to carry the thread of the exposition or argument.

INTRODUCTION

It is exclusively the medical aspects of the alcohol problem which will be considered in the present work. They have attained a very prominent place in the popular educational efforts relative to the temperance question, although now increasing emphasis is being laid on the social aspects as reasons for the desired practical reforms. It is thus found that even very complicated physiological and medical questions have been made the subject of popular, but too frequently one-sided and colored expositions; and purely special questions in medicine have been given such weight that they are incorporated in the most elementary public school instruction, in which, for example, the poisoning of the protoplasm, cirrhosis of the liver, hardening of the arteries, occupy the attention of school children. The text-books of the so-called 'Alcohology' are in part almost compendiums in pathological anatomy, a subject whose educational value to children seems to me doubtful, to say the least, besides being one in which even teachers are incapable of giving instruction.

"On account of the weight given to the medical side of the alcohol question and because the popular expositions at hand are often less reliable-of which the text-books used in our country provide many examples-I have thought it possible to help those, particularly physicians and teachers, who wish to gain an insight into this important matter by a critical inquiry on a strictly scientific basis. If this results in showing that certain doctrines which many regard as finally fixed are not so according to my opinion, and that we must exercise greater caution in pronouncing upon a number of special questions, it does not follow on this account that practical temperance efforts must suffer. . . . That the abuse of alcohol is fraught with great dangers and brings with it injurious consequences of many kinds, both to the individual and society, is the principal fact established by all experience and the point of departure of the whole alcohol question and alcohol investigation.

Upon this all are agreed, as well as upon the necessity of combating this abuse with energy. But here agreement ceases and beyond it one encounters almost wholly conflicting opinions. Relative to the temperance agitation which is engaged in searching for means to fight alcoholism, there is strife between absolutists and moderates, between prohibitionists and their opponents. These sharp contrasts seem in a certain measure to be typical when anything is brought up connected with the burning subject of alcohol, and even when scientific consideration of matters for specialists is concerned. It seems as if in this field many find it particularly difficult to escape subjective valuations which spring from a personal attitude toward one or the other standpoint in regard to practical temperance endeavors. One even observes that when the results of earnest investigations are discomforting to a certain leaning, they are suspected as if springing from opinions wholly foreign to scientific truth-seeking.

"In spite of the actuality of the alcohol question, in spite of ail work done to explore the effects of alcohol upon the human organism, in spite of the unusually rich literature on the subject, much still remains obscure and unexplored. In order to gain from the shifting opinions a sufficient concept of what science has determined in regard to the effects of alcohol, it is not enough, as is frequently done in the popular temperance literature, to bring forward and emphasize in a partial manner what the champions of one side would teach or seek to weld into a whole-opinions on the different points that all tend in one direction-for in the literature one can find support for widely different views. We should test everything bearing the stamp of exact investigation-regardless of the value of the results from this or that practical point of view-weigh the various results of investigations against each other according to their inherent worth which must be estimated solely according to the integrity and reliability of the investigation and the significance of the conclusions."

(Having referred to the wide medical field touched by the alcohol question and the difficulty of surveying it as a whole, the author continues:)

"... Thus, the chief aim of my investigations is to delimit our present knowledge of the pathology of alcoholism. The present condition may be said to be in large measure that (in regard to the pathology of alcoholism) science has on some points

reached conclusive or almost conclusive results; in regard to other points one can only infer the facts with greater or less probability, because much is still obscure, so that for the present we can only discuss possibilities and bring forward more or less well grounded hypotheses-working hypotheses which may serve as points of departure for further investigations."

(The author emphasizes that in order to gain a clear conception of the pathological effects it is necessary to have a thorough knowledge of the physiological that is pharmacological effects. While the latter are outside the real field of the author's inquiry, he found it necessary to survey the most important. His work therefore falls into two main divisions: The first dealing with the general physiological effects of alcohol upon organism, and the second giving a survey of our present knowledge in regard to the general and specific pathology of alcoholism. He concludes the introduction as follows:)

"It is not a spirit of fault-finding which leads me to examine during the progress of my exposition several declarations contained in our popular text-books on 'Alcohology.' I do it because it seems. to me timely to point out evident untruths which have sneaked into them and thereby helped on their removal from the text-book literature. Aside from this, the text-books seem to me of interest and must be given attention in an exposition like the present, since several other countries have them of the same kind and they thus have assumed an international aspect; also because they express the conception most generally adhered to by the great public, although apparently held also by a number of physicians. That the latter is the case is shown by the fact that two of our popular text-books are written by physicians, while two have been tested by physicians. In a preface to the 'Text-Book on Alcohol,' by Helenius, Professor Curt Wallis says that it is a deserving compilation of the most important knowledge which science hitherto has brought together relative to this question.' Under such circumstances it is quite natural that the text-books are regarded by a large part of the public as an expression of the standpoint of medical science."

Chapter I

Some Words About the Formation and Occurrence of Alcohol in Nature

(The author refers to the universality of alcohol as an article of consumption and cites Hartwitch, who states that at the present

time the peoples who can be regarded as “alcohol free" are only certain remnants of the original population of Ceylon, Malacha and some Indians of South America. He describes the formation of ethyl-alcohol, the qualities and effects of which are the subject of his study. He refers to the occurrence of alcohol in healthy, normal organs, and the conclusion drawn by some investigators that alcohol is a substance which is regularly formed in the body (human) and therefore constitutes a substance not really foreign to the normal organism and its functions. He remarks, however:)

"Meanwhile, it is evident that even if the organism is able to consume and take into its service the alcohol formed under the normal processes of digestion, nothing is thereby decided in regard to the question whether and to what extent the body is able to render harmless the alcohol brought into the body from outside. How this matter stands, how the human organism reacts to the alcohol brought in from outside in larger or smaller quantities, belongs to the complex problem of the medical alcohol question, which again is conditioned upon a multitude of different questions belonging to the wide domain of medical science, and which I, in the following exposition, will try to illustrate from different points of view."

Chapter II

The Absorption of Alcohol by the Body and Its Circulation in the Organs (This is a solely technical exposition.)

Chapter III

The Consumption of Alcohol Within the Body and Its Influence Upon the Process of Digestion

"In the previous chapter we have learned that the alcohol taken. is quickly absorbed sucked into the blood and thereby brought to all parts of the body, and that after several or few hours according to the size of the dose- it has disappeared from the body. When large intoxicating doses have been taken the blood seems to become free from alcohol in the course of about twenty-four hours.

"We shall now in what follows study the relations of alcohol to the body and step by step follow the effects upon it which are peculiar to alcohol."

(Having examined a number of the more important investigations the author says:)

"From the above named explanations we thus conclude that alcohol is oxidized within the body in different quantities and under different conditions. As high as 98 per cent of the alcohol taken, or even more, can be oxidized when the dose has not been too great and additional circumstances have not been effective. But from this fact it does not follow that it has a nutritive value, for it may be assumed that digestion can take place to the same extent with, as without, alcohol, and that thus alcohol may be consumed without any use. In order to make this clear, experiments in digestion have been made, yielding results which I will briefly account for."

(The concept of the importance of alcohol as a nutritive substance has passed through many stages of development marked by the most contradictory views. What is "known" about the subject. the author sums up in two sentences:)

"For the greater part alcohol oxidizes in the body.

"In the process of oxidation in the body alcohol is capable of conserving both fat and carbo-hydrate as well as albumen, and must therefore be regarded as a nutritive substance."

(After a thorough examination of the various investigations made of the subject, the author re-states the case as follows:)

". . . The physiologists of our day thus regard themselves as bound from the physiological point of view to regard alcohol as a nutritive substance, and, more definitely stated, as a substance having a conserving value in relation to fat and carbohydrates as well as to albumen.

"Kassowitz has controverted this view, and as his formula of the view 'Alcohol is a poison, therefore not a nutritive substance,' has won many imitators in the popular temperance text-book literature, I wish to touch upon it in a few words. First and foremost it should be noted that the standpoint of Kassowitz is not determined by any new and experimental investigations undertaken by himself which disprove others, but so far as I have been able to discover his standpoint is fixed by the fact that he explains older experiments in a different way from other investigators, and by the fact that he starts with a definition of nutritious substances peculiar to himself. He believes that certain earlier experiments show that alcohol is a poison to albumen and, furthermore, he holds that only such substances are nutritious as are adapted to the formation of protoplasm or at least as