tured to discriminate between liquors according to their contents; that is to say, in conformity with their injurious or non-injurious properties. If the question has been one of taxation or the imposition of license fees, the guiding principle has not been how light wholesome beverages may be substituted for the manifestly dangerous or outright injurious, but what the traffic will stand. Thus far this unenlightened, one might almost say unmoral, attitude, has been as characteristic of the national as of State law-making powers. Here and there some half-hearted attempt to lessen the financial burden to the vendor of light alcoholic beverages may have been made, but the laws have absolutely failed directly to encourage the substitution of beer and light wines for distilled liquors, whether the aim has been one of manufacture or sale. This is only another way of saying that the motive of legislation has been purely fiscal or one of suppression without a proper distinction as to what is being repressed or suppressed.

Of course, uncompromising prohibitionists who regard all beverages containing alcohol as equally injurious, and of the evil one, will bitterly oppose any legislative effort to encourage the substitution of the harmless for the harmful or to affirm in any way the underlying principle. They insist upon their universal remedy-first local, then state prohibition, eventually to be translated into national prohibition. That hitherto, so far as recorded experience goes, the effect of such sumptuary legislation has not only been negative but largely to drive out the use of the least alcoholic beverages and substitute the admittedly harmful, goes for naught. To say that national prohibition will remedy this is but to leave one will-o'-the-wisp to chase another.

Persons who really have it at heart to make the nation more sober, may well question how long this tyranny of unenlightened opinion shall prevail. They should study carefully the eminently practical and direct steps towards temperance which the Norwegian legislation exemplifies. To answer that it is not practicable in this time is merely begging the question. There is no fundamental difficulty in so fashioning our revenue laws that the more alcoholic beverages are made to bear the greater tax burden, unless we confess that moral considerations must have no place in fiscal regulations. State and local laws affecting the manufacture and sale of liquors can likewise be adjusted upon the principle that the use of the more harmful should be discriminated against, primarily through

the simple expedient of progressive taxation, which in this instance must be clearly reflected in the imposition of license fees.

This is not the place to suggest a scheme of legislation in detail but to ask the question, Has not the time come for legislation after the Norwegian model as described above? Perhaps all the desired advance could not be taken at one step, but a little progress is better than standing still while other parts of the world move forward in temperance legislation. It is not a question of compromise or of meeting the threats of general prohibition, but of doing that wherein prohibition signally fails-promoting actual sobriety. At the same time, it must be confessed that until rational measures are taken to reduce the drink evil, one cannot wonder that so many hanker after the unattainable-absolute prohibition.

THE ALCOHOL QUESTION FROM A MEDICAL VIEWPOINT STUDIES IN THE PATHOLOGY OF ALCOHOLISM

By ULRIK QUENSEL

Professor of Pathology and General Hygiene of the University of Upsala (Sweden)

"A renowned Swedish scientist presents here the result of years of intensive study of the literature of the alcohol question and of his own pathologic, anatomical and experimental investigations, carried on in a thoroughly objective manner and stamped with a spirit of scientific inquiry, a comprehensive, work in two volumes of 941 pages. The work was completed through pecuniary assistance on the part of the Swedish Government, and has already created attention in the home-land of the author, as well as in foreign parts. It may in one word be characterized as a standard work in the great literature of the alcohol question, being much more comprehensive and especially much more critical than most of the existing publications on this subject."

Thus writes Dr. Scharffenberg, who is himself an ardent absolutist, and although he does not agree with Dr. Quensel on many points, concedes the absolute fairness and conservatism of his conclusions.

The work may be regarded as a scientific companion piece of a more popular publication, "Alcohol and Society," issued by a committee of the Swedish Medical Society. The volume derives particular value from the fact that the author has subjected the vast material at hand to rigid examination, no matter what point of view it follows. He may be said to have searched the whole alcoholic literature, so far as it bears upon the medical point of view, weighed its evidence, and stated the conclusions with a freedom from abuse and exaggeration which as a rule does not distinguish books upon this controversial subject.

Unfortunately, Dr. Quensel's studies are not accessible in English, nor is his work as a whole adapted for popular reading. In the following pages certain portions of the two volumes are summarized, those being selected that can most easily be understood and that deal with aspects concerning which there is especially need of greater understanding. Happily, the author has himself sum

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