# Alcohol, a Dangerous and Unnecessary Medicine/Chapter 12

CHAPTER XII.
WHY DOCTORS STILL PRESCRIBE ALCOHOLICS.
Workers in the department of Medical Temperance of the Woman's Christian Temperance Union are told repeatedly by the better class of physicians that they would be glad often not to prescribe alcohol if patients and their friends would not insist upon its use. There is a deep-rooted prejudice in favor of alcohol as a remedy in the minds of the great multitude of people, and they are ready to distrust as fanatical, or incompetent, any physician who does not use it. Dr. Norman Kerr, a well-known physician of England, says, that during a ten years' residence in America, he found people unwilling to pay him as much for his services as they were willing to pay one who prescribed alcoholics. Even those who were abstainers from liquors as beverages distrusted him for not using these things as medicines. Indeed, this prejudice goes so far with many that they will refuse to employ a non-alcoholic physician, if they know him to be such. In consequence of this latter fact, there are great numbers of skilful physicians who say nothing about alcohol lest they be ​considered "faddists," and lose practice, but who never prescribe it unless it is asked for by the patient or his friends.
Again, consulting physicians will sometimes insist upon the use of alcohol, and thus seeds of distrust of the non-alcoholic physician will be sown.
Dr. J. J. Ridge says of medical prescriptions:—
"Hundreds of medical men order alcoholic liquors from habit, from ignorance of their real effect, from fashion, or from a desire to please, or not to offend, their patients. Port-wine is constantly being ordered when persons are recovering from various diseases; day by day they regain their strength, and the port-wine gets all the credit of it, especially since each glass seems to diffuse a comfortable glow over the whole body. They forget that the process of recovery would have gone on without the port, and that hundreds and thousands of people do get well without it. They often ignore the fact that they are taking real tonics in addition. They are misled by the sensations which the alcohol causes; they do not know that it relaxes the blood-vessels instead of improving their tone; that it exhausts the heart by making it beat away more rapidly to no profit. Hence the convalescence is actually more prolonged than it would otherwise be. Gentle exercise, regulated baths, good food, balmy sleep, these are the true restoratives of the exhausted system, and no jugglery with sedatives, such as alcohol, can produce the desired result.
"It is by its sedative action that alcohol has obtained its position in public opinion. It will render persons insensible to various uneasy sensations, and the majority prefer to continue the bad habits which produce the uneasy sensations, and then to take them away by a dose or two of some alcoholic liquor, or, indeed, to take this before the uneasy sensations come on. In this way they do themselves injury and make themselves ​unconscious of it. Dr. Beaumont, who had the opportunity of examining the interior of Alexis St. Martin's stomach, and of seeing how digestion went on, was astonished to see how inflamed the mucous membrane could be without any consciousness of it. He observed, as a matter of fact, that alcoholic drinks of all kinds hindered the process of digestion, and produced this morbid condition of the mucous membrane. The relief, therefore, which can be obtained by alcohol is delusive and dangerous.
"But some persons say they are afraid to abandon the use of alcohol because they have been in the habit of taking it for a long period. This fear is entirely groundless. The alcohol will be missed for a time, just as a person who has been using crutches would miss them if thrown away; but they will do better without both after a little while. There is no kind of constitution which renders a person unable to do without alcohol. The prisoners in all our jails have to leave off their drink at once, and altogether, on entering there, and no harm ever ensues in consequence. But some say that this is because their diet is so carefully arranged, and the hygienic condition of the prison so perfect. Quite so. This shows us clearly that when total abstainers become ill outside the prison, their illness is to be attributed to some error in diet or hygiene, or to some accidental circumstance. It is absurd to think that the infraction of one law of health can be nullified by breaking another; that if you eat too much, or too fast, or too often, or what is not good for you, you can escape the consequences by injuring yourself with alcohol."
Dr. N. S. Davis was for many years openly sneered at by many of his professional brethren as "a cold-water fanatic." Since his views are now being rapidly adopted by progressive medical men all over the civilized world, it may be that soon those ​physicians who cling to alcohol will deserve the soubriquet of "alcohol fanatics." Dr. Davis said:—
"If I am asked why the profession continues to prescribe these drinks, I answer; simply from the force of habit and traditional education, coupled with a reluctance to risk the experiment of omitting them while the general popular notions sanction their use. Nothing is easier than self-deception in this matter. A patient is suddenly taken with syncope, or nervous weakness, from which abundant experience has shown that a speedy recovery would take place by simple rest and fresh air. But in the alarm of friends something must be done. A little wine or brandy is given, and as it is not sufficient to positively prevent, the patient in due time revives just as would have been the case if neither wine nor brandy had been used.
"Of course both doctor and friends will regard the so-called stimulant as the cause of the recovery. So, too, when patients are getting weak, in the advanced stage of fever, or some other self-limited disease, an abundance of nourishment is regularly administered, in the greater part of which is mixed some kind of alcoholic drink. The latter will always occupy the chief attention, and if, after a severe run, the fever, or disease, finally disappears, it will be said that the patient was sustained or 'kept alive' for over two or three weeks, as the case may be, 'solely by the stimulants,' when, in fact, if the same nourishment and care had been given without a drop of alcohol, he would have convalesced sooner, and more perfectly, as I have seen demonstrated a thousand times in my experience."
Dr. Casgrau, of Dublin, says that physicians who make personal use of alcohol are not able to give an unbiased opinion about its action, as one of its most marked effects is that of a narcotic to the mental powers; such physicians are not so acute to observe the action of this, or any drug.
​Sir B. W. Richardson, M. D., in an address upon the reasons why physicians still prescribe alcoholics, says that the magnetism of public opinion has great weight with professional men.
"All professions are under that subtle influence. All professions whatever their duties, whatever their learning may be, are sensitive and obedient to that influence. In their pride they think they lead public opinion; it is a mistake, they always follow it on every question in which the people, at large, have a voice. They can assist in influencing the public voice, and sometimes, to quote the words of Abbé Purcelle, spoken in the dawn of the great French Revolution, they may prove that 'respect for sovereign power sometimes consists in transgressing its orders,'but as a general rule not merely the orders but the inclinations are obeyed. We have to wait on, and for, public opinion, and in nothing so much as on the subject of alcohol. The use of alcoholic beverages rests not on argument but on habit, custom. To those whom it affects personally it is an absolute monarch. It makes its own empire. By the very action which it has upon the body of those who receive it into themselves it rules and governs. The joke of the inebriate man that when he had taken his potation he was quite another man and that then he felt it his duty to treat that other man, is literally true, a terse and faithful expression of a natural fact. The man or woman born and bred under the influence of alcohol is of the race of alcohol, and as distinct a person as any racial peculiarity can supply. The reason, the judgment, the temper, the senses are attuned by it. It is loved by its lovers like life. The grape to them is no longer a luscious fruit; it is 'the mother of mighty wine,' and he who is bold enough to disown that motherhood must stand apart. How can a profession however strong, march all at once against such an overwhelming influence? Itself born, perchance, under the influence bred under it, how shall it immediately be transformed? Why ​disobey the influence? It is in the interest of the doctor to obey, in a worldly sense of view; but more—it is in his nature to obey. The strong bands of nature and interest go hand in hand. Is it wonderful that the genius of a professional man so situated should, according to the quality of his genius, uphold, root and branch, the role of his nativity? On the contrary the wonder is that he has ever done anything else. It is most natural that he should be amongst the last to take up what revolutionizes all the manners, and customs, and faiths, of society. A lady will ask her physician the question, May I take wine, Sir? As much as you like Madam; it is very bad for you and I take none, but that is your business entirely. Henceforth that gentleman is said to be one who prescribes alcohol in any quantity. In fact, he never prescribes it, for although when forbidding is hopeless, there is all the difference in the world between prescribing and permitting, permitting goes down as if it were prescribing. Often a patient will try to compromise. On an ocean of whisky and water, brandy and soda, or other poisonous mixture, he is floating into fatal paralysis. You tell him so faithfully, and he says he knows it and will drop down to claret. If you assent, he tells his friends you have changed his brandy or whisky to wine; if you dissent, he says you have left your duty as a doctor undone, in order to become an advocate for abstaining temperance, about which he is as competent a judge as you are, and he won't pay fees for that advice. He pays to be cured of his disease, not to be dragooned into a system peculiar in its tenets. In an alcoholic world there is a strong argument in this decision. It rolls splendidly, especially down hill."
After speaking of non-alcoholic physicians, and their opinions of the harmfulness of alcohol, he adds:—
"On the other side, there are practitioners who, under the magnetism of public opinion, as earnestly believe the opposite in relation to alcohol, who declare they could not, , ​conscientiously, practice their profession if they were debarred the use of alcohol, and who look on the advance and the growth of scientific abstaining principles—which they cannot avoid recognizing—with positive dread. The extremists on this side are indeed extreme in their fanaticism. They shut their eyes to the most obvious facts, and do not hesitate in their blindness to misrepresent the most obvious truths. They affirm that under the influence of total abstinence and, by inference, because of total abstinence, the yearly decreasing death-rate of the population is accompanied by reduction of vitality; that people who live long are more enfeebled than those who live short lives and merry; that under abstinence from alcohol fearful diseases are being developed; that the total abstainers have less power for resisting disease than the moderate temperate; and that under the current system of advance towards total abstinence, a very small advance yet by the way, diseases of a low type have developed and extended their ravages."
It is only physicians of large conscientiousness, or of great independence of character, who will dare to go counter to the prejudices of the people.
Consequently, it is necessary to educate the people in the teachings of those physicians, whose eminence in the profession has permitted them, or whose conscientiousness has driven them, to expose the delusions concerning the medical value of alcoholic beverages. When the people cease to believe in alcoholic remedies, physicians will no longer prescribe them. But while the majority desire the "physicians' prescription" as a cover for indulgence, there will be found physicians willing to give such prescriptions.
That the prescription of alcohol by physicians is ​largely a matter of routine may be seen from the following two cases, reported to the writer by county superintendents of the department of Medical Temperance.
In the first case, the physician said to the nurse, "If the patient's heart becomes weak, you might give a little brandy or whisky." Seeing reluctance expressed upon the nurse's countenance, he added hastily, "Or coffee, strong coffee will do just as well." The nurse in reporting this to the writer, said, "Why couldn't he have ordered coffee in the first place if he thought it equally good?"
The second case was that of an aged woman whose physician ordered whisky as a tonic. Her granddaughter ventured to ask, "Would not whisky have a narcotic rather than a tonic effect?" He replied thoughtfully, " Well, tell the truth, I suppose it would."