If prohibition be not adopted, either in the form of a state law or by the exercise of local option in town, city, or county, the remedy which next suggests itself is the prac tice of total abstinence by the individual, fortified, it may be, by a solemn pledge not to partake of alcohol in any form. To the pledge of total abstinence it may be objected that the drunkard who takes it is not likely to keep it, and that one who has not formed the habit is foolish to bind himself unnecessarily. There are many, however, who have been addicted to the use of alcohol to their own in jury and that of others, who take the pledge and keep it, and there are others, how many it is impossible to calculate, but certainly vast numbers, who have taken a pledge as children or in their young manhood and have been deterred by that pledge from forming habits which would have been fatal. It is wrong to extort a promise from one who is not in position to weigh the evidence, on a distorted and ex aggerated presentation of the consequences of the use of alcohol. Nor is there occasion for such exaggeration.
The argument for total abstinence based merely on the chances of injury is quite as valid as that which leads to the practice of life insurance or many other acts which are entirely rational and well advised. Elementary education in the schools regarding the physical effects of alcohol, and popular instruction of adults through lectures, through the press, from the pulpit, and otherwise, are wholly justi fiable and vitally essential. Reform and the taking of a pledge of abstinence often accompany a religious awaken ing, and are among the finest fruits of such appeals to the higher nature. The practice of total abstinence may be accompanied by some sacrifice of social pleasures, and it may be that its universal adoption would result in some subtle injury to the progress of the human race, as has been claimed, but it is certain that it would enormously reduce the number of the dependent poor, and that it would make it possible to help effectively many who in their slavery to the drink habit are beyond human aid.
There are many with whom alcoholism is essentially a disease, and unfortunately very often an incurable dis ease. Life may then come to an early end, or it may be prolonged with periodic debauches at shorter or longer intervals through many years. The unfortunate victim, whatever the circumstances under which the habit was fastened upon him, may become an object of infinite pity in the end. The most heroic attempts for the sake of the family may be in vain, and the most sincere and apparently complete reformation may be succeeded by repeated col lapse. For such diseased persons the most skilful medical care is needed, and often confinement, voluntary or invol untary, for a prolonged period. There are various secret remedies, some of which present credible evidence of cures effected by their instrumentality. It is, however, for the medical profession to test these remedies, and resort to them with the aid of relief funds is rarely advisable, and, if at all, only with the knowledge and consent of a reputable physician. The layman may not be in position to appreci ate all the details of the code of ethics recognized by the medical profession, but with the position that any remedy or preventive of disease known to a physician must be divulged to his brethren of the medical profession, under penalty that one who fails to do this sacrifices his own pro fessional standing, all the world must agree. Homes for
intemperate men—for the reformation of drunkards ; spe cial hospitals or sanatoria for the medical treatment of such as desire to be cured of an appetite beyond voluntary control, are essential parts of a general relief system. The most important single step that could be taken for the eradication of the curse of intemperance would be the early recognition of the symptoms of habitual drunkenness, and the sentence of every person who has reached this stage either to a hospital or to the custody of a competent proba tion officer, until The substitution of this plan for the present utterly useless and absurd fines and short sentences to jail or workhouse would be both humane and scientific. A further step would be the creation of a farm colony, comprising a series of hospitals and institutions for different grades of patients, to which those who need such treatment could be sent, and in which they could be kept until, in the judgment of a competent examining board, they are ready to be restored to their place in society. Within the institution, inmates might, as a rule, during the greater part of their stay be fully self-support ing. This system would be applicable not only to victims of alcohol, but to such as are addicted to opium or other harmful drugs. To this radical policy for the treatment of inebriates, a physician has objected on the ground that it is condemning those who have committed no crime to " experimenters armed with a hyperdermic needle." In reply to this cynical estimate of the present capacity of the medical profession to deal with one of the largest class of those who are undoubtedly afflicted by disease, it is suf ficient to point out that insane patients are similarly intrusted to medical " experimenters " and on the whole with good results.
The giving of aid in the homes of those who are addicted to drink is attended by grave dangers. Relief should always be conditioned upon some definite and radical steps toward the curing of the real evil. It cannot be declared at what point attempts to reform the drunkard should be so far abandoned as is involved in a separation of wife and children from one who, through drink, makes himself in capable of caring for them, and yet this point is reached in extreme cases, and the interests of the family require either a temporary or a final breaking up of the home. This may require a prosecution of the husband for non-support, ac 1 See a paper presented at the Chicago International Conference of Charities and Correction, 1893, by T. D. Crothers, M.D., on the "Problem of Inebriate Pauperism." companied it may be by cruelty or neglect, or only tem porary institutional care of some kind may be needed. Graver still is the situation when it is the mother, or when it is both parents, that are addicted to drink. Reli gious influence; the personal influence of some one who will take a genuinely friendly interest in the family; the withholding of relief except on such conditions as will tend to insure sobriety; medical treatment in appropriate cases ; and custodial care under reformative and educa tional influences, are remedies which may be brought to bear somewhat in the order named, keeping always in mind, especially in considering the young, that the real remedies are the strengthening of character and the removal of temptation from those who are weak.