September 17, 1891] 



NATURE 



485 



events, the statistical data sufficiently show that a great part of 

 the civilized world is suffering greatly from the effects of alco- 

 holism. The investigations of the Harveian Society make it 

 probable that in London one-seventh of all adult deaths (males 

 and females) is directly or indirectly due to the consequences of 

 alcoholic excess. The mortality in England from alcoholism in 

 1871-80 among males 25 to 65 years old was about i per 

 cent, of all deaths — nearly 800 yearly. What an amount of 

 disease and poverty, of moral and physical degradation, is 

 represented by these 800 deaths ! In Belgium the yearly loss 

 of life from delirium tremens among males was 330 in 1870-89. 

 Still greater have been the devastations of drinking in Switzer- 

 land. Prussia has a yearly loss of iioo males from delirium 

 tremens. Undoubtedly we should find, if trustworthy data 

 could be had, that chronic alcoholism and delirium tremens 

 alone kill many thousands of men every year. What is to 

 be done? High excises are generally looked upon as an 

 excellent weapon against alcoholism. But we must not forget 

 that even a very high excise, as in England, does not prevent 

 spirituous liquors from coming within the reach of anybody, so 

 long as the number of public-houses is so exceedingly large as 

 in this country. If a person has to go a long way to get drunk, 

 and if he has in addition to pay a good sum for it, he will stop to 

 think before going. Still, high excises seem to have some effect ; 

 the German law of 1887 has, for instance, reduced the con- 

 sumption of spirits to a certain extent. But generally the 

 reduction of the consumed quantity does not seem to correspond 

 with the increase of the excise. An interesting expedient is the 

 new State monopoly in Switzerland. Ten per cent, of the 

 surplus are left to the cantons for counteracting alcoholism. By 

 regulating the price the monopoly acts like an excise, and the 

 Government takes care that only unadulterated liquors are sold. 

 The monopoly is reported to have had a good sanitary effect, 

 and it has caused some decrease in the consumption of liquors. 

 In connection with excise and duties every effort is to be com- 

 mended which tends to render the access to intoxicating liquors 

 more difficult. Among these measures, the three popular 

 American systems deserve our attention — viz. the Maine laws, 

 local option, and the high-licence system. The first of these 

 expedients — the prohibitory system — has been tried in Maine 

 and some other American States. According to this system, it 

 is prohibited to manufacture and sell intoxicating liquors, the 

 only exception commonly being that liquors of " foreign produc- 

 tion " may be imported and sold in the original packages. But 

 this exception is unjust, permitting the man who can afford it to 

 order as much liquor as he likes, and nearly all reports agree in 

 testifying to the perpetual violation of these laws. One curious 

 fact from Maine, where the system was adopted in 188 1 may 

 be mentioned. During the years 1867-86, 8412 divorces of 

 marriages took place, being probably several per cent, of the 

 yearly number of celebrated marriages. Of these no less than 

 960, or II per cent., were caused by intemperance, combined or 

 not with other causes. It thus seems that intemperate habits 

 are rather frequent in this State. Curiously enough, the State 

 of Massachusetts (where there is a considerable revenue for 

 licences) shows, under nearly the same regulations concerning 

 divorces as in Maine, the same proportion — viz. 1054 out 

 of 9853. It seems impossible to suppress the liquor traffic 

 in the larger towns. Between the Maine laws and the 

 high-licence system is an intermediate system — local option. 

 According to this, it is left to the citizens of a village, 

 town, city, or a larger district, to vote for local prohibi- 

 tion. This system seems to work somewhat better than the 

 Maine laws, and it may prove useful in rural districts, the con- 

 trol in small communities being more easily carried through ; 

 but in larger towns it is probably ineffective, tempting as it does 

 to a surreptitious liquor traffic. The third system— high licences 

 — has been introduced in several States. Under this system 

 licences for the sale of liquors can be taken out, but the fees are 

 so considerable (for instance, 500 or looo dollars yearly) that 

 many small saloons disappear. In some cases the sale of liquors 

 through grocery stores is entirely stopped (Illinois). This sys- 

 tem is reported to work well by reducing the number of drinking 

 saloons, thus lessening the opportunity for drinking. It is main- 

 tained that "the high-licence system has thrown the liquor 

 traffic into the hands of a more respectable class of dealers," 

 and that those who pay high licences " help the authorities in 

 the conviction of breakers of the law, under the fundamental 

 principle of self-preservation." It is also to be recommended to 



limit the numbers of licences that may be taken out. This is 

 the case with the Dutch law of 1881. Still more effective have 

 been the efforts in Sweden, Norway, and Finland. The numbers 

 of bars have been gradually greatly reduced, especially in the 

 rural districts ; and in most of the towns the so-called " Gothen- 

 burg system " has been introduced. According to this system, 

 adopted since 1865 in Gothenburg, all or most of the licences in 

 a town are given to a company which is not allowed to pay more 

 than a fixed rate of interest to the shareholders, the surplus 

 being spent for the benefit of charitable institutions or forming 

 part of the municipal income. The result has been a great re- 

 duction of the number of bars. In Gothenburg the company in 

 1865 took out 40 licenses, but at once reduced the number 

 of saloons to 23. The persons who manage the saloons 

 get a fixed salary for the sale of spirits, and are there- 

 fore not tempted to encourage the customers to drink- 

 ing. Moreover, there is a limitation of the hours during 

 which the saloons are open, and other steps have been taken to 

 prevent abuses. Undoubtedly this system — in connection with 

 the great diminution of the number of bars in the rural districts 

 of the country — has contributed very much to the conspicuous 

 reduction of the alcoholism in the three countries before-men- 

 tioned. A very practical expedient is also the prohibition of 

 sale of intoxicating liquors at groceries and similar shops, and 

 this provision ought never to be omitted where steps are taken 

 to limit the number of saloons. And last, not least, it is highly 

 desirable to regulate the opening hours of the saloons. 



Dr. Isambard Owen, of London, said he took part in the 

 discussion solely to correct the numerous misquotations current 

 of the " Collective Investigation Report on Intemperance of 

 the British Medical Association," of which Report he was the 

 author. A certain table of figures contained in the Report 

 had been quoted apart from the context in such a manner as 

 to lead the public to believe that, in the view of the author 

 of the Report, the longevity of abstainers fell below that, 

 not only of moderate drinkers, but even of the decidedly intem- 

 perate. The conclusions of the Report, as far as concerned the 

 general health of the public, were the following: — (i) That 

 habitual indulgence in alcoholic liquors, beyond the most 

 moderate amounts, has a distinct tendency to shorten life, the 

 average shortening being roughly proportional to the degree of 

 indulgence. (2) That of men who have passed the age of 25, 

 the strictly temperate live, on the average, at least ten years 

 longer than those who become decidedly intemperate. (3) That 

 in the production of cirrhosis and gout.alcoholic excess plays the 

 very marked part which it has long been recognized as playing, 

 and that there are no other diseases anything like so distinctly 

 traceable to the effects of alcoholic liquors. (4) That, cirrhosis 

 and gout apart, the effect of alcoholic liquors is rather to predis- 

 pose the body towards the attacks of disease generally than to 

 induce any special pathological lesion. 



M. Milliet, of Berne, Dr. Norman Kerr, of London, Mr. J. 

 Phillips, of London, Sir V. Barrington, L.C.C., Dr. Robinson, 

 of Maine, U.S.A., Sir Joseph Fayrer, Prof. E, Alglave, of Paris, 

 Dr. Kinkead, of Galway, Dr. Arthur, of London, Prof. Bohmert, 

 of Dresden, and Dr. Sonsino, of Pisa, also took part in the 

 discussion. 



On Thursday afternoon. Dr. W. O. Priestley read a paper "On 

 the Improved Hygienic Condition of Maternity Hospitals," of 

 which the following is an abstract : — 



During the end of the last century and the first half of the 

 present one, the mortality in maternity hospitals was very large, 

 both on the Continent and in Great Britain. According to Le 

 Fort, it was at the rate of 34 per 1000, while, according to Miss 

 Nightingale, it was only 47 per 1000 when patients were confined 

 at their own homes ; or, according to Dr. Matthews Duncan, 8 

 per 1000, equal to i in 125. The cause of the increased 

 mortality in lying-in hospitals was the prevalence in these insti- 

 tutions of puerperal fever, 75 per cent, being due to this cause. 

 The infectiousness of puerperal fever, long doubted, was at 

 length established, and also the fact that various poisons, brought 

 from the dissecting room — from patients suffering from erysipelas, 

 eruptive fevers, and the like — became the germs of infection 

 which might cost the lives of many patients. The researches of 

 Pasteur, Koch, Lister, and others have shown that these poisons 

 owed their virulence to the presence of microscopic germs which 

 multiply in the body of patients and produce the deleterious 



NO. II 42, VOL. 44] 



