The careful observation and study of inebriety by medical men, during the past twenty-five or thirty years, as well in private practice as in hospitals and prisons, has led them to regard it as, in many of its phases, a disease needing wise and careful treatment. To secure such treatment was seen to be almost impossible unless the subject of intemperance could be removed from old a.s.sociations and influences, and placed under new conditions, in which there would be no enticement to drink, and where the means of moral and physical recovery could be judiciously applied. It was felt that, as a disease, the treatment of drunkenness, while its subject remained in the old atmosphere of temptation, was as difficult, if not impossible, as the treatment of a malarious fever in a miasmatic district. The result of this view was the establishment of Inebriate Asylums for voluntary or enforced seclusion, first in the United States, and afterwards in England and some of her dependencies.
In the beginning, these inst.i.tutions did not have much favor with the public; and, as the earlier methods of treatment pursued therein were, for the most part, experimental, and based on a limited knowledge of the pathology of drunkenness, the beneficial results were not large.
Still, the work went on, and the reports of cures made by the New York State Asylum, at Binghampton, the pioneer of these inst.i.tutions, were sufficiently encouraging to lead to their establishment in other places; and there are now in this country as many as from twelve to fifteen public and private inst.i.tutions for the treatment of drunkenness. Of these, the New York State Inebriate Asylum, at Binghampton; the Inebriate Home, at Fort Hamilton, Long Island; and the Home for Incurables, San Francisco, Cal., are the most prominent. At Hartford, Conn., the Walnut Hill Asylum has recently been opened for the treatment of inebriate and opium cases, under the care of Dr. T.D. Crothers. The Pinel Hospital, at Richmond, Va., chartered by the State, in 1876, is for the treatment of nervous and mental diseases, and for the reclamation of inebriates and opium-eaters. In Needham, Ma.s.s., is the Appleton Temporary Home, where a considerable number of inebriates are received every year.
Besides these, there are private inst.i.tutions, in which dypsomaniac patients are received. The methods of treatment differ according to the views and experience of those having charge of these inst.i.tutions. Up to this time a great deal of the treatment has been experimental; and there is still much difference of opinion among physicians and superintendents in regard to the best means of cure. But, on two important points, all are nearly in agreement. The first is in the necessity for an immediate and
ABSOLUTE WITHDRAWAL OF ALL INTOXICANTS FROM THE PATIENT,
no matter how long he may have used them; and the second in the necessity of his entire abstinence therefrom after leaving the inst.i.tution. _The cure never places a man back where he was before he became subject to the disease; and he can never, after his recovery, taste even the milder forms of alcoholic beverage without being exposed to the most imminent danger of relapse._
The great value of an asylum where the victim of intemperance can be placed for a time beyond the reach of alcohol is thus stated by Dr.
Carpenter: "Vain is it to recall the motives for a better course of conduct, to one who is already familiar with them all, but is dest.i.tute of the will to act upon them; the seclusion of such persons from the reach of alcoholic liquors, for a sufficient length of time to _free the blood from its contamination, to restore the healthful nutrition of the brain and to enable the recovered mental vigor to be wisely directed, seems to afford the only prospect of reformation:_ and this cannot be expected to be permanent, unless the patient determinately adopts and steadily acts on the resolution to abstain from that which, _if again indulged in, will be poison, alike to his body and to his mind_."
In the study of inebriety and the causes leading thereto, much important information has been gathered by the superintendents and physicians connected with these establishments. Dr. D.G. Dodge, late Superintendent of the New York State Inebriate Asylum, read a paper before the American a.s.sociation for the Cure of Inebriates, in 1876, on "Inebriate Asylums and their Management," in which are given the results of many years of study, observation and experience. Speaking of the causes leading to drunkenness, he says:
"Occupation has a powerful controlling influence in developing or warding off the disease. In-door life in all kinds of business, is a predisposing cause, from the fact that nearly the whole force of the stimulant is concentrated and expended upon the brain and nervous system. A proper amount of out-door exercise, or labor, tends to throw off the stimulus more rapidly through the various functional operations of the system. Occupation of all kinds, mental or muscular, a.s.sist the nervous system to r.e.t.a.r.d or resist the action of stimulants--other conditions being equal. Want of employment, or voluntary idleness is the great nursery of this disease."
TOBACCO.
"_The use of tobacco predisposes the system to alcoholism,_ and it has an effect upon the brain and nervous system similar to that of alcohol.
The use of tobacco, if not prohibited, should be discouraged. The treatment of inebriates can never be wholly successful until the use of tobacco in all forms is absolutely dispensed with.
"Statistics show that inebriety oftenest prevails between the _ages of thirty and forty-five. The habit seldom culminates until thirty_, the subject to this age generally being a _moderate drinker; later in life the system is unable to endure the strain of a continued course of dissipation._
"Like all hereditary diseases, intemperance is transmitted from parent to child as much as scrofula, gout or consumption. It observes all the laws in transmitting disease. It sometimes overleaps one generation and appears in the succeeding, or it will miss even the third generation, and then reappear in all its former activity and violence. Hereditary inebriety, like all transmissible diseases, gives the least hope of permanent cure, and temporary relief is all that can generally be reasonably expected.
"Another cla.s.s possesses an organization which may be termed an alcoholic idiosyncrasy; with them the latent desire for stimulants, if indulged, soon leads to habits of intemperance, and eventually to a morbid appet.i.te, which has all the characteristics of a diseased condition of the system, which the patient, una.s.sisted, is powerless to relieve, since the weakness of will that led to the disease obstructs its removal.
"The second cla.s.s may be subdivided as follows: First, those who have had healthy and temperate parents, and have been educated and accustomed to good influences, moral and social, but whose temperament and physical const.i.tution are such _that when they once indulge in the use of stimulants, which they find pleasurable, they continue to habitually indulge till they cease to be moderate, and become excessive drinkers. A depraved appet.i.te is established that leads them on slowly, but surely, to destruction._
"Temperaments have much to do with the formation of the habit of excessive drinking. Those of a nervous temperament are less likely to contract the habit, from the fact that they are acutely sensitive to danger, and avoid it while they have the power of self-control. On the other hand, those of a bilious, sanguine and lymphatic temperament, rush on, unmindful of the present, and soon become slaves to a depraved and morbid appet.i.te, powerless to stay, or even to check their downward course."
As we cannot speak of the treatment pursued in inebriate asylums from personal observation, we know of no better way to give our readers correct impressions on the subject, than to quote still farther from Dr.
Dodge. "For a better understanding," he says, "of the requisite discipline demanded in the way of remedial restraint of inebriates, we notice some of the results of chronic inebriation affecting more particularly the brain and nervous system--which, in addition to the necessary medical treatment, necessitates strict discipline to the successful management of these cases."
RESULTS OF CHRONIC INEBRIATION.
"We have _alcoholic epilepsy, alcoholic mania, delirium tremens, tremors, hallucinations, insomnia, vertigo, mental and muscular debility, impairment of vision, mental depression, paralysis, a partial or total loss of self-respect and a departure of the power of self-control._ Many minor difficulties arise from mere functional derangement of the brain and nervous system, which surely and rapidly disappear when the cause is removed."
The general rule, on the reception of a patient, is to cut off at once and altogether the use of alcohol in every form. "More," says the doctor, "can be done by diet and medicine, than can be obtained by a compromise in the moderate use of stimulants for a limited period." It is a mistake, he adds, to suppose "that any special danger arises from stopping the accustomed stimulus. Alcohol is a poison, and we should discontinue its use at once, as it can be done with safety and perfect impunity, except in rare cases."
To secure all the benefits to be derived from medical treatment, "we should have," says Dr. Dodge, "inst.i.tutions for the reception of inebriates, where total abstinence can be rigidly, but judiciously enforced for a sufficient length of time, to test the curative powers of absolute restraint from all intoxicating drinks. When the craving for stimulants is irresistible, it is useless to make an attempt to reclaim and cure the drunkard, _unless the detention is compulsory_, and there is complete restraint from all spirituous or alcoholic stimulants."
REMOVAL FROM TEMPTATION.
In regard to the compulsory power that should inhere in asylums for the cure of drunkenness, there is little difference of opinion among those who have had experience in their management. They have more faith in time than in medicine, and think it as much the duty of the State to establish asylums for the treatment of drunkenness as for the treatment of insanity. "The length of time necessary to cure inebriation," says Dr. Dodge, "is a very important consideration. A habit covering five, ten, fifteen or twenty years, cannot be expected to be permanently eradicated in a week or a month. The fact that the excessive use of stimulants for a long period of time has caused a radical change, physically, mentally and morally, is not only the strongest possible proof that its entire absence is necessary, but, also, that it requires a liberal allowance of time to effect a return to a normal condition.
The shortest period of continuous restraint and treatment, as a general rule, should not be less than six months in the most hopeful cases, and extending from one to two years with the less hopeful, and more especially for the cla.s.s of periodical drinkers, and those with an hereditary tendency."
A well-directed inebriate asylum not only affords, says the same authority, "effectual removal of the patient from temptations and a.s.sociations which surrounded him in the outer world, but by precept and example it teaches him that he can gain by his reformation, not the ability to drink moderately and with the least safety, _but the power to abstain altogether_. With the restraint imposed by the inst.i.tution, and the self-restraint accepted on the part of the patient, are remedial agents from the moment he enters the asylum, growing stronger and more effective day by day, until finally he finds _total abstinence not only possible, but permanent_. With this much gained in the beginning, the asylum is prepared to a.s.sist in the cure by all the means and appliances at its command. With the co-operation of the patient, and such medicinal remedies and hygienic and sanitary measures as may be required, the most hopeful results may be confidently looked for.
"THE HYGIENIC AND SANITARY MEASURES
"consist in total abstinence from all alcoholic beverages; good nourishing diet; well ventilated rooms; pure, bracing air; mental rest, and proper bodily exercise. * * * Every patient should be required to conform to all rules and regulations which have for their object the improvement of his social, moral and religious condition. He must begin a different mode of life, by breaking up former habits and a.s.sociations; driving from the mind the old companions of an intemperate life; forming new thoughts, new ideas and new and better habits, which necessitates a new life in every respect. This is the aim and object of the rules for the control and government of inebriates. To a.s.sist in this work, inebriate inst.i.tutions should have stated religious services, and all the patients and officers should be required to attend them, unless excused by the medical officer in charge, for sickness, or other sufficient cause."
THE BINGHAMPTON ASYLUM.
Of all the inebriate asylums yet established, the one at Binghampton, New York, has been, so far, the most prominent. It is here that a large part of the experimental work has been done; and here, we believe, that the best results have been obtained. This asylum is a State Inst.i.tution, and will accommodate one hundred and twenty patients. In all cases preference must be given to "indigent inebriates," who may be sent to the asylum by county officers, who are required to pay seven dollars a week for the medical attendance, board and washing, of each patient so sent. Whenever there are vacancies in the asylum, the superintendent can admit, under special agreement, such private patients as may seek admission, and who, in his opinion, promise reformation.
The building is situated on an eminence two hundred and fifty feet above the Susquehanna River, the scenery stretching far up and down the valley, having features of uncommon beauty and grandeur. Each patient has a thoroughly warmed and ventilated room, which, from the peculiar situation of the house, commands a wide view of the adjoining country.
The tables are supplied with a variety and abundance of good food, suitable in every respect to the wants of the patients, whose tastes and needs are carefully considered. Amus.e.m.e.nts of various kinds, including billiards, etc., are provided within the building, which afford pleasure and profit to the patients. Out-door pastimes, such as games of ball and croquet, and other invigorating sports, are encouraged and practised.
The asylum grounds embrace over four hundred acres, part of which are in a state of cultivation. The remainder diversified in character, and partly consisting of forest.
Gentlemen who desire to place themselves under the care of the asylum, may enter it without any other formality than a compliance with such conditions as may be agreed upon between themselves and the superintendent. The price of admission varies according to location of rooms and attention required. Persons differ so widely in their circ.u.mstances and desires, that the scale of prices has been fixed at from ten to twenty-five dollars per week, which includes board, medical attendance, washing, etc. In all cases the price of board for three months must be paid in advance.
From one of the annual reports of this inst.i.tution now before us, we learn that the number of patients treated during the year was three hundred and thirty-six, of whom one hundred and ninety-eight "were discharged with great hopes of permanent reformation." Fifty-eight were discharged unimproved. The largest number of patients in the asylum at one time was a hundred and five.
SAVING AND REFORMING INFLUENCES.
Of those discharged--two hundred and fifty-six in number--eighty-six were of a nervous temperament, ninety-eight sanguine and seventy-two bilious. In their habits, two hundred and thirty-four were social and twenty-two solitary. Out of the whole number, two hundred and forty-four used tobacco--only twelve being free from its use. Of these, one hundred and sixty had been constant and ninety-six periodical drinkers. Serious affliction, being unfortunate in business, love matters, prosperity, etc., were given as reasons for drinking by one hundred and two of the patients. One hundred and twenty-two had intemperate parents or ancestors. One hundred and forty were married men and one hundred and sixteen single. Their occupations were varied. Merchants, fifty-eight; clerks, thirty-five; lawyers, seventeen; book-keepers, sixteen; manufacturers, eight; bankers and brokers, eight; machinists, seven; mechanics, six; farmers, six; clergymen, five; editors and reporters, five, etc.
In regard to some of the special influences brought to bear upon the patients in this inst.i.tution, we have the following. It is from a communication (in answer to a letter of inquiry) received by us from Dr.
T.D. Crothers, formerly of Binghampton, but now superintendent of the new Walnut Hill Asylum, at Hartford, Connecticut: "You have failed to do us credit," he says, "in supposing that we do not use the spiritual forces in our treatment. We depend largely upon them. We have a regularly-appointed chaplain who lives in the building;, and gives his entire time to the religious culture of the patients. Rev. Dr. Bush was with us eight years. He died a few months ago. He was very devoted to his work, and the good he did, both apparent to us and unknown, was beyond estimate. His correspondence was very extensive, and continued for years with patients and their families. He was the counselor and adviser of many persons who did not know him personally, but through patients. I have seen letters to him from patients in all conditions asking counsel, both on secular and spiritual matters; also the most heart-rending appeals and statements of fathers, mothers, wives and children, all of which he religiously answered. He urged that the great duty and obligation of every drunkard was to take care of his body; to build up all the physical, to avoid all danger, and take no risks or perils; that his only help and reliance were on _G.o.d and good health_; that with regular living and healthy surroundings, and a mind full of faith and hope in spiritual realities, the disorder would die out. Our new chaplain holds daily service, as usual, and spends much of his time among the patients. He lives in the building, p.r.o.nounces grace at the table and is personally identified as a power to help men towards recovery. Quite a large number of patients become religious men here.
Our work and its influences have a strong tendency this way. I believe in the force of a chaplain whose daily walk is with us; who, by example and precept, can win men to higher thoughts. He is the receptacle of secrets and much of the inner life of patients that physicians do not reach."
In another letter to us, Dr. Crothers says: "Every asylum that I know of is doing good work, and should be aided and encouraged by all means. The time has not come yet, nor the experience or study to any one man or asylum, necessary to build up a system of treatment to the exclusion of all others. We want many years of study by competent men, and the acc.u.mulated experience of many asylums before we can understand the first principles of that moral and physical disorder we call drunkenness."
TREATMENT.
"As to the treatment and the agents governing it, we recognize in every drunkard general debility and conditions of nerve and brain exhaustion, and a certain train of exciting causes which always end in drinking.
Now, if we can teach these men the "sources of danger," and pledge them and point them to a higher power for help, we combine both spiritual and physical means. We believe that little can be expected from spiritual aids, or pledges, or resolves, unless the patient can so build up his physical as to sustain them. Give a man a healthy body and brainpower, and you can build up his spiritual life; but all attempts to cultivate a power that is crushed by diseased forces will be practically useless. Call it a vice or a disease, it matters not, the return to health must be along _the line of natural laws and means_. Some men will not feel any longing for drink unless they get in the centre of excitement, or violate some natural law, or neglect the common means of health. Now, teach them these exciting causes, and build up their health, and the pledge will not be difficult to keep. This asylum is a marvel. It is, to-day, successful. Other asylums are the same, and we feel that we are working in the line of laws that are fixed, though obscure."
DEEPLY INTERESTING CASES.
The records of this inst.i.tution furnish cases of reform of the most deeply interesting character. Here are a few of them:
CASE No. 1. A Southern planter who had become a drunkard was brought to this asylum by his faithful colored man. In his fits of intoxication he fell into the extraordinary delusion that his devoted wife was unfaithful; and so exasperated did he become when seized by this insane delusion, that he often attempted her life. She was at last obliged to keep out of his way whenever he came under the influence of liquor. When sober, his memory of these hallucinations was sufficiently distinct to fill him with sorrow, shame and fear; for he sincerely loved his wife and knew her to be above reproach. After the war, during which he held the position of a general in the Southern army, he became very much reduced in his circ.u.mstances, lost heart and gave himself up to drink.
The friends of his wife tried to prevail on her to abandon him; but she still clung to her husband, though her life was often in danger from his insane pa.s.sion. Four years of this dreadful experience, in which she three times received serious personal injuries from his hands, and then the old home was broken up, and he went drifting from place to place, a human ship without a rudder on temptation"s stormy sea; his unhappy wife following him, more or less, in secret, and often doing him service and securing his protection. In the spring of 1874, his faithful colored man brought him to the asylum at Binghampton, a perfect wreck. His wife came, also, and for three months boarded near the inst.i.tution, and, without his knowledge, watched and prayed for him. After a few weeks"
residence, the chaplain was able to lead his mind to the consideration of spiritual subjects, and to impress him with the value of religious faith and the power of prayer. He became, at length, deeply interested; read many religious books, and particularly the Bible. At the end of three months his wife came to see him, and their meeting was of a most affecting character. A year later, he left the asylum and went to a Western city, where he now resides--a prosperous and happy man.