Chapter XXI.

Personal Pathologic-Anatomical and Experimental Investigations (Being a solely technical statement, this chapter is not adapted for a summary reproduction).

Chapter XXII.

Summary of the Principal Traits of the Special and General Pathological Anatomy of Chronic Alcoholism

(Necessarily the author repeats much that has been set forth in detail in previous chapters. It is enough to give the closing paragraphs :)

"We cannot as yet give an exhaustive explanation of the action of alcohol on the organism nor form a theory of general validity in regard to the pathology of alcoholism, as there is still so much, even as regards fundamental questions, which is unexplained. Much remains to be done before we can gain a clear picture of this difficult question.

"But when in the course of my studies I have found much conflicting with many of the current conceptions of the nature of the pathological effects of alcohol, I have expressed my doubts in regard to their correctness. At the same time I have adhered to another method of explaining some of the peculiar phenomena which are bound up with this interesting and difficult problem; the pathology of alcoholism.

"The attempts which have been made were founded upon the known investigations of the action of alcohol as a narcotic substance. In this property of alcohol we should, according to my opinion, seek the point of departure and we should not in pathology look away from the fundamental principles of the modern theory of narcotics, nor from the data which modern investigation has yielded in regard to the significance of the liquid substances in physiology and pathology. Much seems to indicate that alcohol with its natural attraction for these substances may act in the first instance upon these and not only in the acute but also in the case of chronic poisoning. And a further exposition of this question seems to me well adapted to furnish us the key to the explanation of the important question of the primary effects of alcohol on the cells which fundamentally is very important to the doctrine of the pathology of alcoholism.

"The opinion has been advanced that even moderate or small quantities of alcohol have an injurious action upon the organism, even upon the offspring. Meanwhile, the pathology does not yield us any proof of this assumption, and from a theoretical point of view it does not seem to me to be probable. We must regard the demonstrated fact that smaller doses quickly oxidize and that the energy thus generated is placed in the service of the organism as an effective protective measure of nature. Alcohol in this case assumes clearly the same relation as other nutritious substances. The poisonous action occurs first when a certain amount is exceeded. Where this limit for alcohol lies cannot be stated with exactness and must differ in the case of different individuals.

"In conclusion I wish to speak a few words about temperance education in schools.

"I have shown that the customary text-books in the so-called 'Alcohology' contain many incorrect and unreliable statements and assertions in regard to the pathology of alcoholism, and I therefore regard them as unsuitable as text-books; they should as soon as possible be supplemented by others. Here, as in other questions of enlightenment, one is justified in demanding that the statements in regard to the temperance question which are placed in the hands of teachers and children shall contain as correct and reliable data as possible and avoid all which can mislead.

"I wish to express it as my firm conviction that all pathologicanatomical special questions should be excluded from the temperance instruction. As a rule they are far too complicated and undetermined to be studied in the schematic and dogmatic manner which is now customary. Besides, they can hardly play a notable part in the conception of the social hygienic temperance question which is the most important part of the alcohol question to the general public. To me the extreme pathologic-anatomical sketches which occupy a prominent place in the text-books, together with diagrams and figures, which are used to illustrate this part of the temperance instruction, seem to be exhibitions of a misdirected. method of teaching. It is not necessary to seek after any anatomical bogy, there are sufficiently many such in actual life which show the unhappy consequences of a misuse of spirits.

"I cannot imagine a more unsuitable subject of instruction for

children than pathological anatomy. It would also be a relief to all school teachers to be exempted from the duty of instructing in questions relating to this which they themselves lack the necessary qualifications for handling in a competent manner. Both pupils and teachers have other subjects to devote their time to which are more useful and important to them. Aside from this it does not seem to me to be right that the so-called Alcohology is treated in the schools as a separate subject. It is a part of and belongs to general hygiene and should be considered as a part of it, as is done in some text-books. If one takes away the unnecessary parts of 'Alcohology,' which are as unsuitable for the instruction of children as for popular instruction generally, more time would be left for the other questions belonging to general hygiene. What it is important to impart is a knowledge in regard to the means of promoting popular hygiene as a whole. However far the misuse of alcohol reaches into the life of society at the present time, it is nevertheless not the only menace to public health. But there are alongside of it many other questions of hygiene which are worthy of attention and instruction."

KANSAS

William Allen White, of the Emporia Gazette, contributed to the Saturday Evening Post for July 11, 1914, an article entitled "How Kansas Boarded the Water-Wagon." In it he proved, by his own figures, that Kansas had found happiness and prosperity as a result of her prohibitory laws.

On October 24th the same publication gave space to a reply by Hugh F. Fox, Secretary of the United States Brewers' Association, and on November 12th a further reply by the Hon. Royal E. Cabell, former United States Commissioner of Internal Revenue, was published in Leslie's Weekly. As Mr. White's claims are made evident by Mr. Fox's reply, it is unnecessary to repeat them here.

That a trained newspaper man should fill an article with State statistics and deliberately avoid the Census Bulletins is at least disingenuous, if not willfully misleading. Mr. White quotes none of his authorities; and yet, whatever they are, they bear out his contentions better than official figures. Let us take his statements in order, and answer them categorically.

I-Mr. White states: "The prohibitory law is now enforced in one hundred of the one hundred and five counties of the State”— in all the counties, in fact, except Leavenworth, Atchison, Sedgwick, Crawford and Cherokee. Yet Mr. White's own paper, the Emporia Gazette, February 7, 1914, contains an article headed: "Plenty of Booze in Emporia"; March 2, "Emporia, Kansas, Not a Dry Town!-Prohibition Only Keeps Liquor Out About a Month at a Time"; March 4, "Booze and Cards for Kansas Women-Society in Prohibition State Mixes Bridge and Booze"-an article by Mr. White himself.

2—Mr. White states: "The brewery has been a crumbling ruin for twenty years." And 3-"The wholesale liquor house has vanished."

Page 185 of the Report of the Commissioner of Internal Revenue for 1912 shows that Kansas had in that year one brewery, five hundred and thirty-one retail liquor dealers, seven wholesale liquor dealers, seventy-six retail dealers in malt liquors and twentyfour wholesale dealers in malt liquors-a total of one brewery and six hundred and thirty-eight licensed dealers in various kinds of

liquor, all in a prohibition State, under whose laws the possession of a Federal license is prima facie evidence of liquor selling. That they are there the United States knows; but Kansas cannot catch them.

4-Mr. White states: "There is not a great difference in population between Cook County, Illinois, and the State of Kansas." One, however, is made up of the city of Chicago and its suburbs, covering 993 square miles, and the other is made up of agricultural communities covering 81,700 square miles. The comparison, in any case, is not a proper one; but Mr. White states there are more inmates in insane asylums in Cook County than in all the insane hospitals, penitentiaries, jails and institutions for the feeble-minded, combined, in the State of Kansas.

According to Bulletin 119, Bureau of the Census, page 10, the total number of insane in Kansas enumerated January 1, 1910, was 2,912. The total insane in Cook County on the same date was 2,174. Kansas population was 1,690,949; Cook County population, 2,405,949. See pages 35 and 37, Abstract of Census, 1910.

5-Mr. White states that the murder, homicide and accidental death rate of Kansas is 4.5 to a hundred thousand. How Mr. White secured his figures one cannot say. No figures of an official character exist. Kansas is a non-registration State, so that mortality statistics are not available. Covering the year 1912, a few places in Kansas were included within the registration area. There are no figures covering murders, homicides and accidental deaths for those places, but there are figures covering violent deaths and suicides.

The total population of Kansas cities in the registration area, given for the first time in 1912, was 289,000. The number of violent deaths and suicides registered in these places in 1912 was 369 -or 127.6 to a hundred thousand, instead of 4.5, as Mr. White claims. See page 56, Mortality Statistics for 1912, U. S. Census Bureau.

6-Mr. White states: "Kansas has fewer deaths from kidney diseases than any other State." Since about one-half of the United States, Kansas among them, are outside of the registration area, Mr. White cannot know whereof he speaks, and therefore lays himself open to the charge of manufacturing evidence.

7-Mr. White states: "Forty-eight Kansas counties sent no persons to the penitentiary in 1913; eighty-seven Kansas counties sent no insane to asylums in 1913; in fourteen Kansas counties no