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American Life as Related to Inebriety By Edward P. Thwing, -.M.D. Quarterly Journal of Inebriety, Vol. 10 (January, 1888) 7 43-50. Although there are abiding factors the world over, in America we have elements to study which are peculiar and unique. By America is meant the American Republic, the States and Territories bounded by the seas, the lakes, and the gulf. It evil be my aim to show that the sixty millions of this vast country are placed under those physical, psychic, political. and social conditions which combine to make life more vividly intense and exacting than anywhere else on this planet, and therefore are more susceptible to the malady of inebriism. This region has been called "the intemperate belt," because, as my lamented friend, the late Dr. George M. Beard of New York, has said, "Inebriety, as distinguished from the vice or habit of drunkenness, may be said to have been born in America; has developed sooner and far more rapidly than elsewhere; like other nerve maladies is especially frequent here. It is for this reason, mainly, that asylums for inebriates were first organized here." Here also the total abstinence societies of modern days began. Why? because of the abnormal nerve sensibility which the feverish rush of life here has developed, a physiological condition, that will not tolerate stimulants. Dr. Beard says that it is a greater sight than Niagara, which is presented to a European coming to this land, to behold an immense body of intelligent citizens, voluntarily and habitually abstaining from alcoholic beverages. "There is perhaps no single fact in sociology more instructive and far reaching than this; and this is but a fraction of the general and sweeping fact that the heightened sensitiveness of Americans forces them to abstain entirely, or to use in incredible and amusing moderation, not only the stronger alcoholic liquors, but the milder wines, ales, and beers, and even tea and coffee. Half my nervous patients give up coffee before I see them, and very many abandon tea. Less than a century ago, a man who could not carry many bottles of wine, was thought effeminate. Fifty years ago opium produced sleep, now the same dose keeps us awake, like coffee and tea. Susceptibility to this drug is revolutionized." Dr. Beard makes the ability to bear stimulants a measure of nerves, and asserts that the English are of "more bottle-power than the Americans"; that it is worth an ocean-voyage to see how they can drink. A steamer seat-mate poured down, almost at a swallow, a half tumblerful of whisky with some water added. He was a prominent minister in the Established Church, advanced in years, yet robust. He replied to the query, "How can you stand that?" that he had been a drinker all his life and felt no harm. The same relative sensitiveness is shown in regard to opium, tobacco, and other narcotic poisons. The stolid Turk begins to smoke in early childhood, when seven or eight; everybody smokes, men, women, and little ones, yet the chief oculist in Constantinople says that cases of amaurosis are very few. A surgeon whom I have known, Dr. Sewny of Aintab, after years of extensive practice in Asia Minor, has yet to see the first case of amaurosis or amblyopia due solely to tobacco. But Americans cannot imitate Turk, Hollander, and Chinese. Heart and brain, eyes, teeth, muscle, and nerve are ruined by these vices, yet the frightful fact remains that latterly the importation of opium has increased 500 per cent.! The "tobacco heart" and other fatal effects of cigarette smoking are attracting the attention of legislators as well as physicians, and the giving or selling this diminutive demon to youth is made in some places a punishable offense. Physical, psychic, political, and social conditions combine in the evolution of this phenomenal susceptibility. Nowhere, for instance, are such extremes in thermal changes. I have seen in New England a range of 125', from 25' below to 100' above, in the shade. The years record at 'Minnesota has read from 39' below to 990 above, a range of 138'. Even within twenty-four hours, and in balmy rearions like Florida, the glass has shown a leap from torrid heat to frosty chill. No wonder then the greatest fear of some is the atmospherel They dread to go out to face Arctic rigor or tropic fire, and so get in the way of staying in doors even in exquisite weather of June and October. They make rooms small, put on double windows, with list on the doors, and build a roaring furnace fire in the cellar, adding another of bright anthracite in the grate. The difference between this hot, dry, baked air within, and the wintry air without, is sometimes 80'. It is estimated that the difference of temperature inside and outside an English home averages 20', and that within and without an American dwelling is 60'. The relation of this to the nervousness of the people is apparent. The uniform brightness of American skies favors evaporation. The Yankee is not plump and ruddy like his moist, solid British brother, but lean, angular, wiry, with a dry, electrical skin. He lights the gas with his fingers, and foretells, with certainty, the coming storm by his neuralgic bones. Hourly observations were conducted for five years with Captain Catlin, U. S. A., a sufferer from traumatic neuralgia in care of Dr. Mitchell. The relation of these prognostic pains to barometric depression and the earth's magnetism was certified beyond doubt, and was reported to the National Academy of Science, April, 1879. Even animals in the Sacramento valley and on the Pacific coast are unwontedly irritable while the north desert winds are blowing, and electricity seeking equilibrium, going to and from the earth. Fruits, foliage, and grass, towards the wind, shrivel. jets of lightning appear on the rocks and sometimes on one's walking stick. But psychic and social factors cannot be ignored. Someone has said that insanity is the price we pay for civilization. Barbarians are not nervous. They may say with the Duchess of -.NLIarlborough that they were born before nerves were invented. They take no thought of the morrow. Market returns and stock quotations are unknown; telephones and telegraphs; daily newspapers, with all their crowded columns of horror and crimes, are not thrust upon them; and the shriek of the steam engine does not disturb their mid-day or their midnight sleep. Once a day they may look at the sun, but they never carry watches. This bad habit of carrying watches is rebuked by a distinguished alienist, who says that a look at one's watch, when an appointment is near, sensibly accelerates the heart's action and is correlated to a definite loss of nervous energy. Every advance of refinement brings conflict and conquest that are to be paid for in blood and nerve and life. Now, it is true, that watches are occasionally seen in England. Sun-dials are not in common use in Germany and Switzerland. But the "American Watch" is an institution. Not the Elgin, the Waterbury, or any particular watch, but the worry and haste and incessant strain to accomplish much in a little time-all this symbolized in the pocket-time piece, is peculiarly American. It was an American who, at Buffalo, I think, wanted to wire on to Washington. When told it would take ten minutes, he turned away and said, "I can't wait." He now uses the Edison telephone, and talks mouth to mouth with his friend, Dr. Talmage says, "We were born in a hurry, live in a hurry, die in a hurry, and are driven to Greenwood on a trot!" The little child, instead of quietly saying to its playmate "Come," nervously shouts, "Hurry up! " You cannot approach the door of a street car, or railway carriage, but what you hear the same fidgety cry, "Step lively!" Said a New Yorker to me, "I am growing old five years every year." Can such physical bankrupts, whose brains are on the brink of collapse, bear the added excitement of drink? The gifted Bayard Taylor was but one of thousands who burned a noble brain to ashes in a too eager race of life. Reviewing sixteen months he notes the erection of a dwelling house, with all its multitudinous cares, the issuing of two volumes of his writings, the preparation of fortyeight articles for periodicals, the delivery of 250 lectures, one every other day, and 30,000 miles travel. The same story might be told of other brain-workers who never accepted the "gospel of rest." The emulous rivalries of business life and the speculative character of its venture cannot be paralleled elsewhere. The incessant strain they impose increases mental instability. Bulls and bears, pools, corners, margins, syndicates, and other "words that are dark, and tricks that are vain," represent the omnivorous passion for gambling. Millions may be made or lost in a day. No one is surprised if a Wall Street panic is followed by suicides. Legitimate business may, by its methods, exert a pernicious influence on the nervous system in still other ways, as for example, in the depressing influence from specialization of nerve function, as indicated by Dr. J. S. Jewell, where one keeps doing one petty thing monotonously year after year and so sterilizes mind and muscle in every other direction. Turning to educational systems in America, we see how unphysiological they are, and calculated to exhaust the nervous energy of youth, many of whom have inherited a morbid neurotic diathesis. Of twenty-seven cases of chorea reported by Dr. William A. Hammond of Bellevue Hospital, eight (about one-third) were "induced by intense study at school." Dr. Treichler's investigations as to "Habitual Headache in Children," cover a wide field, and show that continental communities suffer from similar neglect of natural laws. Here it is more notorious. Not to dwell on these points, we may say that the stimulus of liberty is a productive cause of neurasthenia in America. It is stated that insanity has increased in Italy since there has been civil and religious liberty guaranteed. A post hoc is not always a propter hoc. But it is obvious that the sense of responsibility which citizenship brings; the ambitions awakened by the prospect of office, position, power, and influence; the friction and disquiet, bickerings and wranglings, disappointment and chagrin that attend the struggles and agitations of political life do exhaust men, and more in a land where opportunities for advancement are abundant as in America. While writing these words, news is received of the sudden death of a prominent New York politician, comparatively young, directly traceable to disappointment in carrying out a scheme on which his heart was set. Chagrin acted like a virulent poison on a system already unstrung by the severe political struggle in which he was defeated. Multitudes contract the vice of drunkenness or develop the full malady of inebriism under the continued pressure of these political campaigns. The patient of a friend of mine had, for two years, been kept in working order. He was living, however, on a small reserve of nerve force. A few days before election, he was drawn into a five minutes eager discussion, and became entirely prostrated, more exhausted than by months of steady work. Other nations have their measure of liberty and aspirations for social and political eminence to gratify. But nowhere have men the exhilarating possibilities of position, wealth, and influence, that this republican community offers. The history of the last half century, as related to this fact, reads like a romance. But liberty, like beauty, is a perilous possession, and it has been truly said "the experiment attempted on this continent of making every man, every child, every woman an expert in politics and theology is one of the costliest of experiments with living human beings, and has been drawing on our surplus energies for one hundred years." Finally, American life is cosmopolitan. A curious observer noted nine nationalities in a single street car in New York, one day. I repeated the fact to a few of my students who were riding with me through those same streets. Looking over the ten or dozen passengers on board, one of them at once replied, "Well, here are five nationalities represented here." In one aspect, these importations, particularly English, German, and Scandinavian, are compensative and antidotal. We may hope, with the author before quoted, that "the typical American of the highest type will, in the near future, be a union of the coarse and fine organizations; the solidity of the German, the fire of the Saxon, the delicacy of the American, flowing together as one; sensitive, impressible, readily affected through all the avenues of influence, but trained and held by a will of steel; original, idiosyncratic; with more wiriness than excess of strength, and achieving his purpose not so much through the amount of his force as in the wisdom and economy of its use." This hope may be realized in the future and in the highest type of American manhood. It is a bright, optimistic view of things, but we have to do with the present and the evils of society as they exist. We have to face the fact that our civic life is growing at the expense of the rural; that our cities are massing people by the hundreds of thousands, among whom, on the grounds of contiguity, association, and psychic sympathy, evil influences become more potent to undermine the welfare of society; that we have to encounter in America the drink traffic in its belligerent aspects, as nowhere else, not only politically and financially organized most thoroughly, but ready it would seem to use fraud, violence, or assassination if other means fail, and that we have anarchism stirring up discontent and firing the passions of the desperate classes, who understand liberty to mean license, equality to be the abolition of all the diversities of position and property which intelligence, temperance, and industry have made, and will make, to the end of time. We have had a practically unrestricted importation of the refuse population of Europe. Of every 250 emigrants, one is insane, while but one of 662 natives is insane. Add to all these facts the conditions of American life already enumerated as related to the development of neuroses, particularly inebriety, and we have material which makes the study, as was stated at the start, serious and urgent.
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