in the accident. The labor classes are alive to-day to the false position the prohibition advocates have given them as users of alcohol. It is clearly evident to all impartial students of the problem of alcohol and the industries that the over-speeding, high tension, modern inventions, and keen competition of the industries so irritate, excite and deplete the nervous system of workers to-day that the mass of society has found it necessary to pitch its recreation, pleasure, business, home life and even its vacation periods in the same key. When to this are added low wages, unsanitary working places, poor food, and overcrowded living quarters the wonder is that so many workers retain sufficient self-control to keep in check the desires and cravings of an overworked and much weakened nervous system. Alcohol cannot be held accountable for the poverty, pauperism, mental defectives, infantile debility and mortality, etc., when everyday experience teaches that alcoholism is almost exclusively the result of modern industrial and social life plus an inherited weakened nervous system, the result often of the occupational life of women. Labor legislation on the conservation of health and life of the industrial classes, especially women and children, is an acknowledgment by society that modern industries contain both the cause and the remedy for many of our social and economic evils. Alcoholism is one of the by-products incidental to the grinding and crushing processes of modern life. Dr. W. Gilman Thompson, the great authority on occupational diseases, has this to say on this subject in his recent book: "It is not to be supposed that the occupational poisons themselves develop any special craving for alcoholic beverages. Alcoholism in such cases is due rather to a general lowering of vitality, often combined with gloomy surroundings, where the victim works in dark, damp or overheated rooms, has long hours of work, and depressing home surroundings, and is subjected to a dull, unvarying routine of life from which the saloon affords him the only refuge. No doubt, also, the fatigue induced by heavy muscular effort in these grosser industries meets with temporary abatement by drink. In a word, the relationship of alcohol to industrial disease is a question of environment, and often a social one rather than a physiologic one. Hence any well-directed effort to ameliorate chronic alcoholism (for apparently it can rarely wholly be prevented) must deal with questions of wages, food supply and cooking, housing, wholesome diversion, cleanliness and personal hygiene, which are usually more potent than the influence of any particular trade apart from environment." Alcohol and its influence on longevity is one of the more active factors of the problem now being presented. Statistics and data are graphically arranged so as to show that certain diseases are markedly increasing in this country, while the same diseases show a decrease in the mortality tables of England. Without entering into the question of differences in social life, temperament, occupational life, etc., between the people of this country and those of England, we have in these tables again a representation of false reasoning concerning the real causation of these diseases, i. e., whether the diseases are due to specific germs or result from complex chemical processes of metabolism, and finally the unreliability of morbidity statistics in this country. The fact that these data are based upon replies to questions put to applicants for life insurance weakens their value greatly. Scientific medicine to-day demands an impartial consideration of these various questions before either alcohol or any other single factor can be accepted as the cause of this alleged increase in mortality from these diseases. The medical profession alone is competent to interpret the clinical manifestations and pathological findings upon which such tables must rest. There are no such data available to-day that can stand successfully the test of truth and of fact of modern medicine. THE CLINICAL USE OF ALCOHOL (From an address by H. A. Hare, M.D., Professor of Therapeutics and Diagnosis, Jefferson Medical College of Philadelphia. Read before the Philadelphia County Medical Society, April 14, 1915.) ‘. . . The view has been brought forward, although held by certain investigators for many years, that alcohol in moderate amounts is burnt up in the body and in the process of this combustion gives force to the organism, and in certain instances, because of its easy combustion or oxidation, distinctly aids in the conservation of tissue. Not only does it do this by giving force but it saves the tissues, in that it is burnt up so readily that the less easily burnt-up tissues escape. "This being the case it is not difficult to reach the conclusion that alcohol, properly used, has a very definite position in the materia medica list, and can be used with advantage in certain cases of diseases which are characterized by great tissue wastes, notably diabetes mellitus, typhoid fever, and certain cases of tuberculosis, and in certain stages of other maladies. I believe that it may be fairly stated that these are facts, and that those who are sweeping in their condemnation of alcohol as a remedial agent are, at this time, unable to present any evidence which can satisfactorily controvert these views; always bearing in mind, however, that this drug, like others, must be administered in doses which suit the needs of the patient in the particular stage of the disease, and the particular time of the day when he needs the drug. All drugs are given too much by routine and too little by careful adjustment to daily or hourly need, and alcohol does not escape from this abuse any more than its sister remedies. To make the bald statement that alcohol is useful in diabetes or valuable in the treatment of typhoid fever is almost as much of an error as to state that it is useless in these diseases. Such positive statements must be qualified by the additional information that it is useful if the proper |