The so-called periodic drinkers (dipsomaniacs) constitute a group by themselves. Sleeplessness, restlessness, headaches, etc., are the preliminary symptoms which stimulate a craving for alcoholic beverages, which they cannot resist and which must be satisfied at any cost. They care less for the kind or quality than they do for the quantity consumed. As soon as the attack is over, little or nothing is taken, until the craving again comes on, which may be after an interval of week or months. Periodic alcoholic indulgence of this kind is usually a part of a periodically appearing mental disturbance, periodic mania or melancholia, or sometimes of acute exacer bations of nervous diseases, in which the patient employs the alcohol as a narcotic medium. Repeated or long-continued attacks may be followed by delirium, and occasionally they may end fatally.
The consumption of alcoholic beverages is steadily increasing, in spite of the undoubted harmful influences Nvhich they exert. The gigantic establish ments for their production are the developments of the last few decades, and their growth depended on this fact. The consumption of beer particularly has markedly increased in all countries. Statistics are unnecessary here. They show, however, that the consumption of Nwhisky has diminished during late years, whereas that of beer has largely increased. Many look upon this as a favourable sign, because whisky, being considered a stronger drink, is believed to be more unhealthy than the lighter beer. It must not be for gotten, however, that beer is consumed in much larger amounts than whisky, so that in the end the same quantities of alcohol are taken. As a whole, it is immaterial whether one favours beer or Nvhisky. Whisky drinkers are more apt to develop delirium tremens' and gastric and hepatic troubles than are beer drinkers, but the latter, asidC from the effects due to the alcohol itself, endanger their heart and kidneys. The heart is affected by the increased quantity of fluid it must pump, and the kidneys by the larger amounts of fluid which they are compelled to filter. It is impossible, there fore, to group alcoholic beverages on the score of their comparative harm lessness ; all of them act as poisons to the human organism, and are harmful.
In passing, attention should also be directed to the chronic intoxications due to the consumption of ether, eau de cologne, and absinthe. Ether drinking which is particularly prevalent in Ireland, brings on a condition of transi tory intoxication without any after-effects. Many subject themselves to this intoxication several times daily ; and long-continued adherence to the habit affects both body and mind in a manner similar to that associated with chronic alcoholism. The use of eau-de-Cologne is attended by like effects, and the habit is particularly prevalent in Russia, England, and America. Chronic absinthe poisoning differs slightly from that caused by alcohol, the effects being due to the contained ethereal oils. The consumption of absinthe is limited mainly to France, and its continued use leads to severe nervous disturbances, extreme sensitiveness of the skin, pains, epileptic convulsions, and finally, in many, to insanity.
Until very recently, the drinking habit was looked upon as an incurable evil. Efforts were confined to exhortations which usually went unheeded.
great advance was made when it came to be realised that complete abstinence could alone free the individual from his desire for alcoholic beverages. The damage done to the various organs cannot be rectified, but the drinker can be warned of further inroads on his health which are liable to occur. He again becomes the support of his family and a useful member of society. There is no medicine or secret remedy which, taken alone or with the alcoholic beverage, will cure the disease, and such claims are fraudulent.
The elementary principles for correcting the habit are about as follows. The individual must practise complete and total abstinence. In order to accomplish this, it is wise to commit him to a sanatorium specially devised for this purpose. "When he is returned to his family, the latter must also lead an abstemious life. A change of occupation is advisable, especially if the person has been engaged in one which would lead or tempt him to indulgence. Furthermore, it is essential for him to associate with people who are also abstainers, and he should be encouraged to become a member of an organisation which has for its main object the redemption of drinkers.
These societies, a number of which exist in Great Britain, can be divided into those which counsel total abstinence, and those which permit moderate indulgence ; there are, besides, other organisations which combine both of these principles. This brings about a paradoxical situation in the practical treatment of the alcohol question ; whether the evil had better be combated by abstinence or by temperance. Our views are as follows : Any person who is made ill by alcohol, or is in any way harmed, must undoubtedly practise total abstinence. This also applies to anyone who cannot resist the tempta tion to drink more than is good for him, or who numbers among near or distant relatives any who are subjects of this habit. The danger lies in the fact that a slumbering predisposition to alcoholic over-indulgence may be present, which, under appropriate circumstances, may be stimulated to its full development. Every drinker claims to have been moderate at some time in the past ! An abstemious life should also be led by anyone who wishes to make life an example for those about him. It is only by complete denial that the tide may be stemmed. The example of moderate indul gence is of less value for the cause, because the conception of moderation may be interpreted to suit the individual caprice. He who believes that he cannot get along without alcoholic beverages should limit himself to small quantities, and then not fail to admit that he,takes them, not for any bene ficial properties supposed to be present in the alcohol, but merely to satisfy a taste as distinguished from a craving. But he must beware of drinking daily as a matter of custom, remembering that amounts which arc ordinarily considered harmless have been shown by physicians to create a great deal of damage when taken clay after day. This even applies to three or four glasses of beer per day. Many who believe themselves moderate cannot, as a matter of fact, be included under this designation.