Alcohol, a Dangerous and Unnecessary Medicine/Chapter 10
CHAPTER X.
COMPARATIVE DEATH-RATES WITH AND WITHOUT THE USE OF ALCOHOL AS A REMEDY.
A study of statistics relating to the difference in results of the treatment of disease with and without the use of alcohol, cannot but be of great interest to all students of the alcohol question. The appended statistics are culled mainly from the Medical Pioneer of England, now, Medical Temperance Review, the journal of the British Medical Temperance Association, and from the Bulletin of the American Medical Temperance Association.
A paragraph in the British Medical Journal, for Dec. 2, 1893, says:—
"An interesting fact has been noted by Dr. Claye Shaw, at the London County Asylum, Banstead, for the Insane. Since the withdrawal of beer from the dietary, the rate of recovery has gone up. During the past year, for example, the recoveries reached 46.97 per cent. Nearly one half of the patients had thus recovered during the period stated. The inmates take their food better without the liquor, and they are thus taught that intoxicants are not a necessity of ordinary health."
In the Medical Pioneer for January, 1894, Dr. John Mois, medical superintendent of West Haven infectious Diseases Hospital, states that prior to 1885 he had treated 2,148 cases of smallpox "in the usual routine method, with the use of alcohol when the heart's action seemed to indicate it;" resulting in a mortality of 17 per cent. But since 1885 he has treated 700 additional cases under similar circumstances except that the use of alcoholic preparations was entirely omitted, and the resulting mortality was only 11 per cent.
In the same journal, Dr. J. J. Ridge states that he had treated the 200 cases of scarlet fever admitted into the Enfield Isolation Hospital during the years 1892 and 1893, without alcohol in any form, with a mortality of only 2.5 per cent.; while the mortality in the hospitals under the Metropolitan Asylums Board in 1893, in which alcohol was used in accordance with the usual practice in scarlet fever, was 6.3 per cent.
Dr. J. J. Ridge says later:—
"In January, 1894, I published the result of the treatment of the first 200 cases of scarlatina admitted into the temporary wards of the Enfield Isolation Hospital during 1892 and 1893. I stated that there had been five fatal cases, but that one was dying when admitted and only lived a few hours. The mortality was 2 per cent., or 2.5 if the later case is included.
"Since then 300 more cases have been admitted and discharged and among these there have been 7 fatal. Hence there have been 14 deaths in 500 consecutive cases extending over a period of a little more than four years. One of these ought to be excluded, no time having been given for treatment. Hence the mortality has been just 2.6 per cent. This, I think it will be admitted, is a low mortality, although it is possible it may be even lower when the cases are treated in a permanent hospital about to be erected.
"It may be interesting to state that 4 of the cases died on the third day after admission; 1 on the fourth; 1 on the sixth; 1 on the tenth, with pneumonia; 1 on the thirteenth; 1 on the fifteenth; 1 on the sixteenth; 1 on the eighteenth; 1 on the thirty-sixth, with nephritis and pleuropneumonia; and 1 on the forty-sixth, with otitis and meningitis.
"All the cases have been treated without alcohol either as food or drug, although many have been of great severity with various complications. It is certain that the absence of alcohol has not been detrimental, since the mortality is less than three-fourths of that of the mortality among all notified cases in England and Wales. I am bound to say that it is my firm conviction that had alcohol been given in the usual fashion, the death-rate would have been higher. Cases have been admitted to which alcohol has been given previous to admission, apparently with harm, as they have improved without it. One case was particularly noticeable in this respect. A child, aged 6, had had a good deal of whisky, and was supposed to be dying when admitted on the fourth day of the disease, so that the doctor who had seen it was surprised, when he called the following day to inquire, to find it was still alive. Without a drop of alcohol it began to improve and made a good recovery. I may say that delirium is very rare, even in the worst cases treated non-alcoholically."
Dr. Norman Kerr says:—
"In my paper on 'The Medical Administration of Alcohol,' read to the section of medicine at the Sheffield meeting in 1876, I cited several medical testimonies in favor of non-alcoholic treatment of fevers, notably that of my friend, the late Dr. Simon Nicolls, who had a mortality of less than 5 per cent, in 230 cases.
"The record of the results of a greatly lessened administration of alcohol in the treatment of smallpox in the London hospital ships, is of deep interest. Having been requested to inquire into the effects of this diminished alcoholic stimulation on mortality and convalescence, Dr. Birdwood stated that though the gravity of the cases had increased, with a mortality of 15 per 100 in the metropolis, the ship's death-rate had remained at less than 7 per 100. Convalescence had been more rapid, and there had been fewer and less serious complications from abscesses and inflammatory boils. Other causes had contributed to this improvement, but the medical officers attributed a considerable share in the amelioration to a greatly diminished prescription of alcohol."
The Medical Pioneer says :—
"In 1872 there appeared in the Saturday Review an article in which the medical practitioners of this country were accused of inciting their patients to free drinking, and in the discussion which this article called forth, Dr. Gairdner, of Glasgow, said that fever patients in that city, when treated with milk and without alcohol, did much better than those reported as having been treated by Dr. Todd with large doses of alcohol; the latter resulting in a mortality of about 25 per cent., while those treated by Dr. Gairdner with' milk had had a death-rate of only 12 per cent. About this time the British Medical Temperance Association was founded, owing to the exertions of Dr. Ridge, of Enfield, and in 1876 it was enrolled, under the presidency of Sir B. W. Richardson. It now contains 269 members in England and Wales, 53 in Scotland and 80 in Ireland, or more than 400 altogether, all professional men and women. This, I think, is but a sign of the change of opinion on the use of alcoholic fluids in medical practice, for all who remember what medical practice was in London thirty years ago know that the use of wine and brandy in hospital practice was so common that it was quite a rarity in some hospitals to find a patient who was not ordered, by some of the staff, from three to four ounces of brandy or six to eight fluid ounces of wine. The expense caused to the hospitals by this practice was, of course, great, and increased notably between 1852 and 1872, owing to the prevalence of the views of Liebig and his follower, Dr. Todd. The writings of Parkes, Gairdner, Dr. Norman Kerr and of Sir B. Ward Richardson, Dr. Morton and others, gradually lessened this predilection for treating diseases by alcohol, and accordingly between 1872 and 1882 a great change came over the practice of London hospitals. Thus the sum paid for milk in 1852 in Saint Bartholomew's Hospital was £684, and in 1882 it was £2,012; whilst alcohol in that hospital cost in 1852, £406; in 1862, £1,446; in 1872, £1,446; and in 1882 only £653. Westminster Hospital in 1882 spent £137 on alcohol and £500 on milk. One hospital, St. George's, long continued to use large quantities of alcohol. That hospital in 1872 had the high mortality among its typhoid fever patients of 24 per cent., which was twice as high as that noted by Dr. Gairdner as occurring in Glasgow, when alcohol was abandoned and milk used instead. Dr. Meyer, who reported these cases of typhoid treated in Saint George's Hospital at that time, mentioned that alcohol in large doses was given to 87 per cent, of the patients. Three-fifths of these patients took daily eight ounces of brandy when there was danger of sinking from failure of the heart's action. One-fourth of the number took sixteen fluid ounces of brandy in the 24 hours."
"In 230 typhoid cases in St. Mary's Hospital, Dr. Chambers reduced the ratio of deaths from 1 in 5 with alcohol to 1 in 40 without it. Dr. Perry, of Glasgow, found that of 534 cases treated with alcohol, 138 died, while of 491 treated without alcohol, only 9 died."
In a recent text-book on medicine occurs the following:—
"English physicians use spirits in fevers, and all experience sustains the conviction that no substitute has been found for them."
In a late number of the Temperance Record, Dr. Smith gives a different view of the experience of English physicians:—
"When Bentley Todd was at King's College, and leading his profession, brandy was the rule in febrile cases. Then the mortality varied from twenty-five to thirty-five per cent. That the treatment was as fatal as the disease, experience demonstrates:—
"1. Professor W. T. Gairdner, of Glasgow, writing to the Lancet (1864), gave his experience as follows :—
| Fever cases treated. | Average of wine and spirits. | Mortality. |
| 1,829 | 34 oz. to each | 17.69 per cent. |
| 595 | 2½ oz. to each | 11.93 per cent. |
| 212 | none | 1 death only. |
| (young lives) |
"These were mostly typhus cases, but the rationale, so far as alcohol is concerned, is the same as in typhoid.
"2. At the British Medical Association in 1879, Professor H. MacNaughton Jones gave particulars of 340 cases of typhus, typhoid and simple fever. I append a summary :—
| Cases. | Deaths. | Mortality per cent | |
| Given brandy | 58 | 19 | 32.7 |
| Given claret | 51 | 2 | 3.8 |
| Given no alcohol | 231 | 4 | 1.7 |
"3. Dr. J. C. Pearson writes to the Lancet (Dec. 5 and 26, 1891), giving his experience of typhoid. He had treated several hundreds of cases without a single death, and never prescribed stimulants in any shape or form in the disease.
"4. Dr. Knox Bond writes to the Lancet (Nov. 25, 1893), giving his experience of typhoid at the Liverpool Fever Hospital. He says : 'As a resident for some years in the fever hospitals, my views of the value of alcohol in fever underwent, solely as a result of the experience there gained, entire modification. The conviction became forced upon my mind that in no case in which it was used did benefit to the patient ensue; that in a proportion of cases its use was distinctly hurtful; and that in a small but appreciable number of cases the resultant harm was sufficient to tilt the balance as against the recovery of the patient.'
"In plain terms, alcohol tended to the destruction of the patients. Dr. Bond's figures are :—
| No. of cases. | No. of deaths. | |
| Given alcohol | 71 | 18 |
| Given no alcohol | 309 | 15 |
| 380 | 33 |
In May, 1890, Dr. Nathan S. Davis, read a paper before the American Medical Association upon the use of certain drugs in disease. Among the drugs mentioned was alcohol, and comparative death-rates were given in typhoid fever and pneumonia, between Mercy Hospital, Chicago, during a term of years when no alcohol was used in the medical wards, Dr. Davis being in charge of them, and some of the large metropolitan hospitals using alcohol. In Mercy Hospital without alcohol, the death-rate in typhoid fever was only five per cent.; in pneumonia only twelve per cent.
"Of 161 cases of typhoid fever treated in Cook County Hospital during 1889, 27 died, or one in six—nearly 17 per cent.
"According to the annual report of the Cincinnati Hospital for 1886, 47 cases of typhoid fever were treated during that year, with seven deaths, a mortality rate of 16 per cent. "The Garfield Memorial Hospital, at Washington, reported for the year 1889, 22 cases of typhoid fever, with 5 deaths or—22 per cent.
"In the Pennsylvania Hospital the mortality rate in pneumonia for the years 1884-1886, was 34 per cent.
"The mortality of pneumonia in the Massachusetts General Hospital, between the years 1822 and 1889, comprising 1,000 cases, was 25 per cent.; but a gradual increase in mortality had been noted from 10 per cent, in the first decade of the seventy years represented by this report, to 28 per cent, in the last decade.
"According to the report of the Supervising Surgeon General of the U. S. Marine Hospital Service for 1888, the number of cases of pneumonia treated between 1880 and 1887 was 1,649, with 311—deaths nearly 19 percent.
"The Cincinnati Hospital reported for 1886 a mortality rate in pneumonia of 38 per cent.
"The mortality rate in the Cook County Hospital, Chicago, for 1889, according to Dr. Heltoin, relating to 80 cases of pneumonia, was 36 per cent."
Only a five per cent, death-rate in typhoid fever without alcohol, and from sixteen to twenty-two per cent, with alcohol; only a twelve per cent, death-rate in pneumonia without alcohol, and from 19 to as high as 38 per cent, with alcohol. Such are the comparative death-rates given by Dr. Davis. They should be committed to memory by every opposer of the use of alcohol, as they show clearly that people have many more chances for recovery, other things being equal, in the diseases mentioned, if alcohol is not used than if it is.
It is worthy of mention in this connection that Cook County Hospital contains in its report for 1897 the following items: Number of patients 19,536; cost of liquors $80.00; per cent, of deaths from all causes, 5.7. The cost of liquors is only .004 for each patient. This shows a decided advance in the disuse of alcohol, when so very little is used in a great hospital, with so large a number of patients.
Dr. A. L. Loomis, in the treatmemt of 600 typhus fever cases on Blackwell's Island in 1864, excluded alcoholics, with the result of reducing the mortality rate to only six per cent, whereas it had previously been twenty-two per cent., in Bellevue Hospital from which the patients had been removed.
In Battle Creek Sanitarium no alcohol is used in any disease, simply because the management believe better results are obtained by the use of other agencies. In the October, (1893) number of the American Medical Temperance Quarterly now Bulletin of the A. M. T. A., Dr. J. H. Kellogg gives statistics of deaths from various diseases in the Battle Creek Sanitarium. The total of these statistics is as follows: la grippe, 827 cases, 4 deaths—or two per cent.; scarlet fever, 83 cases, 2 deaths—less than three per cent.; 333 cases of typhoid fever, 9 deaths—or 2.7 per cent.; 82 cases of pneumonia, 4 deaths—or 4.9 per cent. These exceptional results are not attributed solely to the non-use of alcohol. The nursing and surroundings were of the best. But these results certainly show that the use of alcohol as a remedy in acute diseases is not necessary, and that patients have a much better chance for life, other things being equal, where alcohol is not used than where it is.
Dr. Kellogg says of the surgical cases:—
"In a hospital of 100 beds, connected with the institution, more than 2,000 surgical cases have been treated, to whom alcohol has never been administered except in connection with chloroform anæsthesia; my uniform custom being to administer an ounce of brandy or whisky five minutes before beginning the administration of the anæsthetic, when chloroform is used.
"The surgical cases include more than 300 cases of ovariotomy, and over 300 other cases involving the peritoneal cavity, such as operations for strangulated hernia, the radical cure of hernia, etc. The statistics of death and recoveries are certainly as good as can be produced by any hospital in the world, dealing with the same class of cases. The total mortality from the operation of ovariotomy, including nearly 300 cases, is less than three per cent., and for the last few years, in which the antiseptic measures have been perfected, the record is still better, showing a succession of 172 cases of laparotomy for the removal of ovarian tumors, or diseased uterus and ovaries, without a death. These cases include a number of hyterectomies, and many cases so desperate that those who trust in alcohol as a heart stimulant, and as a means of supporting the vital energies, would certainly have considered it necessary to resort to the use of this drug. Nevertheless, it was not administered in a single case, and I have seen no reason to regret its non-use in a single instance."
Dr. T. D. Crothers, of Hartford, Conn., tells the following:—
"In a large hospital a study of the mortality of pneumonia indicated a greater fatality at intervals of six months. There were five per cent, more deaths during periods of two months at a time, twice during the year. This extended back for two years, and was finally narrowed down to the service of an eminent physician who gave spirits freely in all cases of pneumonia from their entrance to the hospital. The other visiting physicians gave very little spirits, and only in the later stages. The physician was skeptical of these statistics, but finally consented to test them by giving up spirits practically in all cases of pneumonia. This was continued for a year, and the mortality went back to the average statistics. That physician has abandoned alcohol as a food and a medicine, only in very limited degree. He writes, 'My stupidity in accepting theories and statements of others, concerning spirits, which I could have tested personally, is a source of deep sorrow, and I do not know but it could be called criminal. I certainly feel that punishment would be just."
Brandy has been considered the great necessity in cholera, yet the use of it and other alcoholics are known to expose people to greater danger when this disease prevails.
The Bulletin of the A. M. T. A. is authority for the following :—
"During the epidemic of 1832, Dr. Bronson said: 'In Montreal 1,000 persons have died of cholera, only two of whom were teetotalers.' A Montreal paper said: 'Not a drunkard who has been attacked has recovered from the disease, and almost all the victims have been at least moderate drinkers.'
"In Albany, N. Y., the same year, cholera carried off 366 persons above sixteen years of age, all but four of whom belonged to the drinking classes. Packer, Prentice & Co., large furriers in Albany, employed 400 persons, none of whom used ardent spirits, and there were only two cases of cholera among them. Mr. Delevan, a contractor, said : ' I was engaged at the time in erecting a large block of buildings. The laborers were much alarmed, and were on the point of abandoning the work. They were advised to stay and give up strong drink. They all remained, and all quit the use of strong drink except one, and he fell a victim to the disease.' He says also: 'I had a gang of diggers in a clay bank, to whom the same proposition was made; they all agreed to it, and not one died. On the opposite side of the same clay bank were other diggers who continued their regular rations of whisky, and one third of them died.'
"In New York City there were 204 cases in the park, only six of whom were temperate, and these recovered, while 122 of the others died. In many parts of the city the saloon keepers saw and acknowledged the terrible connection between their business and the spread of the disease, and, becoming alarmed for their own safety, shut up their saloons and fled, saying: 'The way from the saloon to hell is too short.'
"In Washington the Board of Health was so impressed with the terrible facts that they declared the grog shops nuisances, ordered them closed, and they remained closed for three months.
"A prominent physician of Glasgow reported: 'Only nineteen per cent, of the temperate perished, while ninety-one and two-tenths per cent, of the intemperate died.' One extensive liquor dealer of Glasgow, said, 'Cholera has carried off half of my customers.'
"In Warsaw ninety per cent, of those who died from cholera were wine drinkers.
"At Tifels, Prussia, a town of 20,000 inhabitants, every drunkard died of cholera.",
The St. Paul Medical Journal, of September, 1899, gives the following report of a railway surgeon, Dr. Kane:—
"From June 1 1898, to June 1, 1899, the author performed a few more than four hundred operations. Forty-nine abdominal sections, fifty odd more operations of a graver sort, one hundred miscellaneous of less gravity than above, over one hundred operations upon female perineum and uterus. Of the four hundred, more than three hundred demanded anæsthesia. There were but three deaths, making the mortality a little less than one per cent.
"The author does not claim a phenomenally low mortality, nor does he claim specially brilliant results. He has to contend with unreasoning fear on the part of the patients for hospital surgeons, and also most of his cases had been in the hands of quacks, and had subjected themselves to remedies prescribed by old women. Many cases came after the family physician had exhausted his resources. He thinks his results are considerably better than the average in hospitals and in country districts. Alcohol medication was dispensed with entirely after the patients came under his care, and to this he attributes much of his success. He does not believe that alcohol is a stimulant, or a tonic. On the contrary, he believes that it retards digestion, arrests secretion, and hinders excretion. The courage and fortitude of his patients were lessened instead of increased by the use of alcoholic medication.
"Pain is better borne, endured longer and more patiently when alcohol is not used.
"He urges the practical surgeon to carefully weigh the subject of alcohol, and verify for himself the expediency of its use."
Dr. B. W. Richardson in the report of his practice for 1895 in the London Temperance Hospital refers to non-alcoholic treatment of rheumatism. He said:—
"Out of seventy-one cases of acute or subacute rheumatism—the large majority acute, and attended with temperatures moving up to 104 F.—sixty-nine recovered, and two, although they were discharged without being put on the recovery list, were so far relieved that a few days' change in country air seemed all that was required to induce full restoration. Comparing the experience of the treatment of acute rheumatic disease without alcohol with that which I have previously observed with alcohol, I can have no hesitation in declaring that it is of the greatest advantage to follow total abstinence absolutely in this disease. The pain and swelling of joints is more quickly relieved under abstinence, the fever falls more rapidly, there is less frequent relapse, and there is quicker recovery. In brief, the experience of treament of rheumatic fever minus alcohol, presents to me as much novelty as it does pleasure, and I am convinced that if any candid member of the profession could have witnessed what I have witnessed in this matter, he would agree with me that alcohol in rheumatic fever, however acute, is altogether out of place. I am also under the conviction, though I express it with great reserve, that in acute rheumatism, treated without alcohol, the cardiac complications, endocardial and pericardial, are much less frequently developed than where alcohol is supplied."
Dr. Pechuman in Alcohol—Is It a Medicine; published in 1891, says:—
"There is no disputing that many deaths occur each day as the result of the administration of alcohol in acute diseases, to say nothing of the deaths caused by its habitual use; and those who give it ignore the very fundamental principles of physiology and the many published statistics. The Boston Hospital report tells a sad story in this connection; it shows that out of 1,042 cases treated with alcoholics 386 died, while out of the same number treated without alcohol only 81 died. Using plain English 305 were actually killed by it."
Dr. T. D. Crothers, in the January, 1899, Bulletin of the American Medical Temperance Association, gave the following Hospital Statistics, showing a decline in the use of spirits in hospitals:—
"Evidently a great change is going on in the use of alcohol as a remedy in large hospitals. The annual reports of ten hospitals in the New England and the Middle States show the following widely varying figures. The spirits used include beers, wines, whiskies and brandies, and vary from eleven to sixty-one cents a person for all the cases treated. These hospitals treat from eighty to seven hundred cases a year, both surgical and medical, and the medical staff are the leading physicians of the towns and cities where they are located. The hospital where the largest amount of spirits was used is not different from others, nor is the one where the lowest amount is reported. The conclusion is that this difference is due entirely to the judgment of the medical men. The lowest rate (eleven cents each) was in a hospital where one hundred and twenty-one cases had been under treatment. The highest rate (sixty-one cents) was in a hospital of five hundred and forty cases. The mortality from typhoid fever and pneumonia was eight per cent, higher in this hospital than in the one where only eleven cents a head had been expended for spirits. The general mortality did not vary greatly in any of these hospitals, and the records of one year could not be expected to show this. In the remaining hospitals the mortality of the fever and the septic cases was about the same. The free use of spirits did not show any improvement, but rather an increase of the death-rate, while the same amount of spirits used showed but little change, and that in the line of improvement of death-rate. These are only the figures of one year, but they indicate a change of practice, and show the passing of alcohol as a remedy."