15

H.—22a

parable for the alcoholic, to the extent to which it is irreparable, and I fail to see how human beings can logically expect a special intervention and departure from the laws of nature in favour of the man who brings upon himself the disability of alcoholic degeneration, and yet accept with comparative resignation the bodily and mental limitations imposed upon the victims of pure accident and misfortune.* How far the drinking habit is to be regarded as a misfortune and how far as a vice is a matter so inextricably bound up with the ultimate question of human responsibility and free will that it cannot profitably be discussed here. It is of vital importance, however, that the plea of hereditary tendency should not continue to be generally advanced by the public as an excuse for failing to exercise the will-power in regard to drinking. The cases in which alcoholism is comparable to kleptomania or any other form of impulsive insanity are so comparatively rare as not to affect the main question. One might as well advance the existence of kleptomania as evidence that no one is responsible for theft ; or of pyromania that no one is responsible for arson. Even where a marked hereditary predisposition exists in regard to insanity itself, the individual can, in a large proportion of cases, ward off actual mental disease by a wise regulation of his life. There is, as Dr. Clouston says, no reason why " potentialities should be allowed to become actualities." I quote the following from Dr. George Wilson's emphatic protest against the " Plea of Heredity " : " One excuse we have given the drunkard by our too indiscriminate belief in the importance of heredity Granting for the sake of argument that a tendency to drunkenness is inborn in the offspring of drunkards much more than in the children of the sober, what has society gained by the information ? The drunkard has learned his part of the lesson aptly ; he has readily grasped the fact, and makes use of it, that this teaching gives him an excuse for his vice. From the time that he learns that some one of his forebears was a drunkard he begins to regard himself as a victim of an unfortunate law of nature —an object of pity rather than, as he ought to be, an object of scorn. Also our teaching has done considerable harm in its suggestion to the sons and daughters of drunkards. I speak from observation, and not at random. Several cases occur to me which prove that young people who have a drunken family history are, to their hurt, taught to expect that they will likewise become drunken Our teaching should be all the other way. A bad family history is a good excuse for total abstinence ; it is no excuse at all for promiscuous drinking. It would be quite as sensible if a man who slept in a ditch explained his illness by a reference to a rheumatic or a phthisical family history. A person who has any such idiosyncrasy should be guided and corrected with greater severity, and not with less than the normal individual. Let us impress on such an one as strongly as we can how important this matter is for him. Let us warn him that there is no excuse for him, but let us not be so misguided as to tell him that he is likely to become what his father became, because there is something in his nature which makes for drinking." But in the majority of cases nothing special can be reasonably advanced as to heredity, and we must look for the causes of inebriety elsewhere. The most fundamental reason for drinking, apart from the question of custom and company, is, of course, the feeling of elation and pleasurable well-being which ensues, and the sense of detachment from the ordinary cares and responsibilities of life. The drunkard on the whole falls back into a more primitive and a lower phase of existence, in which he is less trammelled by the restrictions of civilisation and conscience. The attaining of this result we may assume will always have its attractions. Alcoholic drinks, per se, offer practically very little temptation ; many of them are, indeed, repellant to the natural sense of taste, and only the man who seeks for a drug to kill the " crave " is shallow enough to suppose that by making a man dislike whisky he could be prevented from intoxicating himself by other means such as methylated spirit if nothing else were procurable. Among the causes apt to pave the way to excessive drinking which I believe we are most called upon to counteract are tradition and ignorance. It has been handed down to us, especially through literature, that to be able to take an excessive amount of alcohol without becoming insensible is an evidence of strength and manliness. The glamour of romance still clings to the feat of drinking one's fellows under the table, though Seneca said nearly two thousand years ago, " Is it not a magnificent virtue to swallow more wine than the rest and yet at last to be outdone by a hogshead? " Sir Dyce Duckworth, writing on "The Eelation of Alcohol to Public Health," says, '-It is to be hoped and expected that with the spread of knowledge and education alcoholic intemperance may come to be regarded always and everywhere as vicious and reprehensible. It is a grievous matter that it should be regarded in any quarter as a venial offence." That it still is so regarded, that there still is no conception in the public mind of the irreparable degeneration of the brain brought about by alcohol, is frequently borne in upon me by the way in which reclaimed drunkards are offered drink by their acquaintances. The knowledge that a man has been for months in an asylum on account of inebriety does not safeguard him from being offered liquor,

• It must be understood that I am trying to convey to the authorities the gravity of alcoholism regarded as a disease, and that lam not addressing alcoholic patients. No patient at Orokonui has been told by us that he has already done irreparable injury to his brain, though that fact might be inferred from our having to impress on every inmate that any further drinking would certainly bring about permanent structural changes. However, it is imperatively necessary that the public should know the facts, and there is no special objection to letting the inebriate himself know that long-continued abuse of alcohol entails organic degeneration and certain permanent disabilities. There is no harm in his even coming to realise that some such change is already in progress in his own case, and that he has lowered his mental and moral stature, reduced his range of potential development, and in that sense done himself irreparable injury. He has every reason to be thankful that the way to reform is still open to him, and that though he cannot expect to attain the highest and widest development of which he was originally capable, he may even yet do excellent work in the world. In one direction, indeed, the fact of having been an inebriate is recognised as giving a man a special power for good—viz., in the direction of inducing temperance in others. The fact that reformers of this origin usually take a somewhat narrow view of the situation, and tend to be fanatical and filled with the one subject, is no doubt an expression of the limitation of range imposed by organic brain-changes; but this does not prevent their exercising a very potent influence over their fellows.