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TEMPERANCE HOSPITALS.

THE LONDON TEMPERANCE HOSPITAL.

In 1865 Dr. S. Nicholls, medical officer of the Longford Poor-law Union, published a report of the results of non-alcoholic treatment of disease as practiced by him for sixteen years in the institutions under his control. The figures for 1865 were:--

ADMITTED. RECOVERED. DIED.

The death-rate reported by Dr. Nicholls was so small that some of the more observing and progressive physicians were led by it to begin similar experiments in the disuse of alcohol in other hospitals. Among these was Dr. James Edmunds, senior physician at the Lying-In Hospital, London. The experiments continued a year with a reduced death-rate among both mothers and children. But the great brewers of London, who contributed largely to the support of this hospital raised such a storm of opposition to the discontinuance of alcoholic liquors that the experiments had to be abandoned.

The establishment of a temperance hospital was now suggested, and in October, 1873, a temporary institution was opened in Gower Street, accommodating only seventeen in-patients at one time. Later a fine site was secured on Hampstead Road, and in 1881 the east wing and centre were opened by the Lord Mayor of London. In 1885 the west wing was finished, and the opening ceremonies conducted by the Bishop of London.

At the time of the launching of this enterprise, wine and spirits were literally "poured into" sick persons, with frightful results. Death-rates were enormous. The success of the Temperance Hospital has no doubt had much to do in modifying this abuse. Its death-rate, on an average, has been only 6 per cent. throughout the years since its beginning. This is lower than that of any other general hospital in London, and certainly proves conclusively that alcohol is not necessary in the treatment of disease. The physicians connected with it have been men of eminence in the profession, such as Dr. James Edmunds, Dr. J. J. Ridge and Sir B. W. Richardson.

The visiting staff is not compelled to pledge disuse of alcohol, but is required to report if it is used. During all these years it has been given only seventeen times, then almost entirely in surgical cases, and in nearly all of these a fatal result proved it to be useless. The patients who are restored to health leave without having had aroused or implanted in them a desire for alcoholic liquors, neither have they been taught to regard them as valuable aids to the recovery of health and strength. On the contrary, there have been many who have come in, suffering from this delusion, who have had it thoroughly dispelled, both by their own experience and the experience of their fellow patients.

Sir B. W. Richardson took charge of this hospital from 1892 until his death in 1897. In his report in 1893 he said:--

"I remember quite well when according to custom, I should have prescribed alcohol in all those cases that were not actually inflammatory ; but I never remember having seen such quick and sound recoveries as those which have followed the non-alcoholic method."

The following selection showing points of practice in this hospital is taken from the same report:

"For medicinal purposes, we are as free as possible from all complexity. We use glycerine for making what may be called our tinctures, and in my clinique I am introducing a series of 'waters'--aqua ferri, aqua chloroformi, aqua opii, aqua quinae, and so on--to form the menstruums of other active drugs when they are called for. I also follow the plan of having the medicines administered with a free quantity of water, and with as accurate a dosage as can be obtained, for I agree with Mr. Spender's original proposition that the administration of medicines in comparatively small and frequent doses is more effective and useful than the more common plan of large doses given at long intervals.

THE FRANCES E. WILLARD NATIONAL TEMPERANCE HOSPITAL.

This hospital is situated at 343-349 South Lincoln Street, Chicago, in a handsome and well-equipped building. It is connected with a medical school. The history of its origin is best told in the words of the woman to whom the conception of such an institution first came, Dr. Mary Weeks Burnett, for several years the physician in charge:--

"Now, how could we hope to eliminate those three little words 'as a beverage' from our pledge?

"In some way we must bring about an arrest of thought in the minds of 100,000 men and women physicians whose medical education warranted them in supposing that they knew that of alcohol which justified them in its full and free use in medical practice. Nothing short of a great national object lesson could ever convict and convert this broad constituency through which the power of darkness is doing his deadliest work.

"In January, 1884, four of us met and organized under the name of the National Temperance Hospital. To have our sick properly cared for in our hospital we found that we should be obliged to train our own nurses. The nurse who has always been accustomed to administering alcohol under the physician's prescription at all times and under all circumstances, and to administering it herself at her own discretion if the physician is not at hand, is a terror to the temperance physician. So we included in our charter a Training School for Nurses. It is now open, and we expect, as the years go by, to send out armed with our training school diplomas, grand, noble women and men thoroughly trained in true temperance methods for relieving the sick.

"Our organization lived on paper, and was sustained in purpose by prayer and planning for two years. In September, 1885, Mr. R. G. Peters, of Manistee, Michigan, signified to us his intention to give ,000 toward our buildings whenever we had satisfactorily materialized. About the same time a good old gentleman in Michigan placed in his will for us ,500. The dear man is still living, and we hope will live many years. Even the money when it comes can never be of greater service to us than was the knowledge at that time that the Lord was our leader and was raising up helpers in the work.

"In January, 1886, we found, according to the law under which our charter was obtained, that we must commence active operations at once, or obtain a new charter. After a blessed season of prayer and counseling together in the board meeting held January 29, there being present only the members of the board at that time, Mrs. Plumb offered to advance ,500, if necessary, toward the expenses for the first year. We accepted it with great thankfulness, rented a building the 15th of March, 1886, and formally opened the National Temperance Hospital on the 4th of May, 1886.

"In April, 1886, we took a firm stand upon the alcohol question, and decided to eliminate it entirely from our list of therapeutics, as we had become convinced that there were better and more reliable remedies as stimulants and tonics.

"In September, 1886, at our annual meeting, we reaffirmed this decision, and we now have the following as one of the articles of our constitution: 'All medicines used in the hospital must be prepared without alcohol, and all physicians accepting positions on the medical staff of the hospital or dispensary must pledge themselves not to administer alcohol in any form to any patient in hospital or dispensary, nor to call in counsel for such patients any physician who will advise the use of alcohol.

"Any physician of pure character, and in good standing, who is a total abstainer from liquor and tobacco can, by subscribing to this pledge, become a member of our physicians' association, and if so desired, be placed upon the visiting and consulting staff of the hospital.

"The cases treated in the hospital include many of the serious medical and surgical maladies. In no case has any particle of alcohol been used, and the usual inflammatory secondary symptoms resulting when alcohol is used have been entirely avoided.

"Our course of building-up treatment is, we believe, unique in hospital practice. It consists of treatment by massage, heat, rest, passive exercise, etc., together with proper medication and a thoroughly nutritious diet adapted to the individual needs of the patient.

At the opening of the hospital, May 4, 1886, Miss Frances E. Willard, the president of the National W. C. T. U., gave the following address:

"That the story of Evolution is true I am by no means certain, but that 'We, Us, and Company,' are 'evoluting' with electric speed ourselves it is useless to deny. This very hospital is the latest mile-stone on the highway of progress in the American temperance reform. The conditions that have made its existence possible have developed in this country within about twelve years.

"When I joined the ranks of temperance workers in 1874, a thought so adventurous as that alcoholics in relation to medicine were a curse and not a blessing had never lodged within my cranium. But, as in duty bound, I studied the subject from the practical, which is the nineteenth century standpoint.

'Sparkling and bright, In its liquid light,'

has come grandly to our rescue in this crusade against alcohol in the sick room. Water has become a favorite--nay, even a fashionable--medicine! The most conservative physicians freely prescribe it in the very cases where some form of alcohol was the specific so long. To be sure, they give it hot, but we do not object to that, since 'water hot ne'er made a sot,' and it cures dyspepsia and all forms of indigestion as whisky never did, but only made believe to; while its external use as a fomentation is banishing alcohol even for old folks' 'rheumatiz' where, as a remedy, it would be likely to make its final stand.

THE RED CROSS HOSPITAL.

A philanthropic young woman, Miss Bettina A. Hofker, entered Mount Sinai Training School for Nurses in 1891. Her desire was to fit herself as a nurse for the poor. After her graduation in 1893, she met Mrs. Charles A. Raymond, a benevolent lady, who offered her pecuniary assistance in her work. Miss Hofker suggested that she would like to institute a Red Cross Hospital and Training School for Nurses. Mrs. Raymond succeeded in interesting others in the proposition. The name of Red Cross however could not be used without permission of the officers of the society bearing that name, but after consultation with Miss Barton, permission was granted. Several years previous to this, Dr. A. Monae Lesser, Dr. Thomas McNicholl and Dr. Gottlieb Steger had opened a small hospital under the name of St. John's Institute. This was now amalgamated with the Red Cross, and Dr. George F. Shrady and Dr. T. Gaillard Thomas, two of New York's leading physicians, were requested to act as consulting physicians.

The hospital does not confine itself to service in its building alone, but sends its workers wherever called, to mansion or tenement. The "Sisters" are trained for field service or for any national calamity such as floods, earthquakes, forest fires, epidemics, etc. When neither war nor calamities require their presence, they devote themselves to the service of the needy poor, or wait upon the rich, if called. The heroic service rendered by the surgeons and nurses from this hospital in the Cuban War, brought their work into great prominence.

At the suggestion of Miss Barton, the medical department of the hospital was commissioned to treat diseases without the use of alcoholic liquids.

Dr. Lesser, the executive surgeon, is a German, and of German education, having received his medical education in the Universities of Berlin and Leipsic. In a conversation with a press representative, Dr. Lesser said some time ago:--

"We have been convinced that the use of alcohol can be entirely eliminated from our medical practice, and this has been practically accomplished at the Red Cross Hospital. We find that where stimulants are required, such remedies as caffeine, nitro-glycerine and kolafra take the place of alcohol, and are even more satisfactory. The main use of alcohol is to stimulate the action of the heart in various ailments. The blood is thus forced to the remote parts of the system, and poisonous substances carried away. But, besides serving this good purpose, the drug tears down and ultimately destroys the cellular tissues of the body. A relapse is certain to follow the application. The drugs that I have mentioned serve exactly the same purpose without the disastrous results. We are proving this every day at the Red Cross Hospital.

"Only a few days ago a boy was brought in, apparently at the point of death. He was put into bed and watched by the nurse. After a little ammonia had been given to him as a stimulant, he unconsciously expressed himself to the effect that it was not the same as they gave him in another place, and gradually when it dawned upon him that no alcohol was administered by the Red Cross, he said, 'Gin has allers made me better.' The doctor in charge, who already suspected that the boy was pretending illness for the sake of the drink, was not surprised an hour or two afterwards to learn that he had demanded his clothes, dressed himself, and left the hospital most ungratefully, but apparently quite well."

Dr. Steger, another physician of the staff, says:--

"I don't use alcohol at all in my practice. I used to use it, but my observation has been that other drugs do the same work without the harmful results. Alcohol over-stimulates the heart, and tears down the cellular tissues of the system, besides causing other deleterious effects. The use of alcohol is simply a superstition among physicians. They have used it so long that they think they always must. I am not a total abstainer, but that only shows that I take better care of my patients than I do of myself. It is not good for a healthy man to drink, but sometimes folks like myself do things which had better be left undone. I have seen patients in hospitals made absolutely drunk by their physicians."

The following interesting items in regard to practice in this hospital are culled from the report of 1897:--

"Temperature was never reduced by active drugs known as antipyretics.

"Water was allowed freely after all kinds of surgical operations and in fevers.

"Alcohol was never used as an internal medicine.

"The free use of water in saline solutions directly injected into the tissues was found of great service. Quarts have been injected that way with most satisfactory results.

"Antipyretics were altogether discarded as it is well known that their action diminishes the tone of the heart. Artificial reduction of temperature only deludes one into the belief that the drug has improved the condition of the patient, while in reality, it has no beneficial influence on the disease, and has reduced the vital resistance of the patient. In no case has high temperature harmed a patient and there was every evidence that in some instances a high temperature was preferable to a low one.

"We criticise the treatment of no institution, antagonize no school of medicine, claim no unusual or peculiar scientific virtue, but what we do maintain and insist upon is this: that the human body may be ever so afflicted, ever so reduced, the heart ever so feeble, and the spark of life ever so dim, the conscientious student of medicine can secure as good results without as with administration of antipyretics, sparkling wines, beers or liquors.

"Experience teaches that true science does not antagonize nature. In surgical cases, in septicaemia, in pneumonia, or in any of the fevers, water freely administered has proven to be a real source of comfort, and an aid to recovery. It is amazing how favorably diseases terminate under this beneficent beverage. The withholding of food does not retard, but rather hastens convalescence.

"In the conduct of our Red Cross patients, irrespective of their condition when admitted, it can be truly said that after treatment began, delirium has not been witnessed in a single instance, and as our hospital reports indicate, our mortality has been unusually small.

"Alcohol has not figured as a life-saver in our institution. Cases of extreme collapse following major operations, cases of pneumonia, where the pulse ranged from 160 to 220, patients suffering from pernicious anaemia, septicaemia, pyaemia, cholera infantum and typhoid fever, some of whom when first seen were in the worst stages of delirium and collapse have without alcohol regained consciousness, overcome delirium and made excellent recoveries.

"The following cases very forcibly illustrate the results of non-alcoholic treatment:--

"Case No. 1. A child, aged nine months, under treatment for six days for pneumonia, came under our notice on the seventh day. The temperature was 106 5-10; pulse was 220; respirations 90. Whisky, which had been given previously to the extent of two ounces daily, was stopped. Carbonate of ammonia, caffeine salicylate, nitro-glycerine and 1-10 of a drop of aconite were given internally; camphorated lard applied externally; with the result that on the ninth day temperature stood 99; pulse 100; respiration 20. The child made a complete recovery.

"Case No. 2. L. was a child aged eight months, suffering from a very violent attack of entero-colitis. For three weeks previous to coming under our notice the patient received brandy, stimulating foods and alkaline mixtures. Fearfully emaciated, temperature 106, feeble pulse 182, frequent bloody discharges from the bowels, numbering as much as thirty in a day and constant vomiting, the child was considered beyond hope. Under these circumstances, and at this time we first saw her. Brandy and all foods were stopped; bowel flushings were given, 1-12 of a drop of tincture of aconite was administered every half hour and salicylate of caffeine every two hours. In twenty-four hours the temperature was 105 and the pulse 160. In two days, temperature was 102 and the pulse 140. In one week, temperature was 99 5-10, pulse 110. In three weeks, the patient was discharged cured.

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