Sunday, January 8, 2012

Alcohol, Tobacco and Suggestion.

By John D. Quackenbos, A.M., M.D., Emeritus Professor in Columbia University; Member of the London Society for Psychical Research; Fellow of the New York Academy of Medicine, of the New Hampshire Medical Society and the New Hampshire Society for the Prevention of Tuberculosis; Member of the New York Medical Association; Member of the American Medical Association; Member of the American Association for the Advancement of Science.

* Delivered at Washington, December 15, 1916, before the American Society for the Study of Alcohol and Narcotic Drugs.
Bits and Bites

By way of introduction to the theme that has been assigned me, I beg your leave briefly to describe the weapon with which I strike at the physio-psychic complex involved in every case of alcoholism.

There exists in human beings a mass of latent unused power — a reserve fund of energy, or capacity for performing work, which is applicable to emergencies, to extraordinary demands on the fortitude, exalted control, innate aptitude, or regenerating faculty of the individual. It is this power that may be incited to control the psychic elements in all diseases, and so affect the cure of those that are functional and the alleviation of suffering in those that are organic. It is this power that commands the output of thought, the projection of genius, the material expression of all that is best in the man. It is this power which, dynamically directed and applied, regenerates the outcast, sobers the drunkard, rescues the drug-fiend, restores to normal thought and feeling the distraught and suicidal, the perverted and the obsessed.
. . .

There is no suggestion to the will of another in psycho-therapy. Nobody but a fool would submit to such treatment, were this possible; and nobody but an unprincipled operator would practice; even for the relief of suffering, a method that makes a fellow being his automaton. My subjects do what I urge them to do, not because I urge them, but because they are made clearly to see that the course suggested conjugates with right, truth, expediency, necessity.

One of the most important applications of psycho-dynamics is its combination with rational physical attention in the treatment of drink and drug habits. The results here obtained are without parallel, dependent as they are on the automatic operation of a super-physical control rendered active by a resistless appeal. The drink and drug cures so extensively advertised fail utterly to impart the great essential to radical regeneration and lasting abstinence — viz., spontaneous unresisting moral sway. They evoke not those forces of the soul that are a thousand times stronger than appetite or desire. Hence about 70 per cent of drinkers who seek relief at the sanatoriums are sobered only for a time and sooner or later relapse. The drink habit cannot be cured by nauseating the victim with lobelia, purging him with drastic cathartics, blinding him with belladonna, or vomiting him with apomorphia. Such treatment creates revulsion in the patient. He soon recovers from the effect of the physic used to find his craving unchanged and his powers of resistance as poisonless as ever. Drug cures leave the moral nature uninfluenced. Dr. Partridge of Clark University convincingly contends that no drug can reach the heart of the intoxication impulse.
. . .

The drink habit is growing, especially among our women, from shop maid and nymph du pave to the pampered dames of upper society. The punch bowl figures at functions, and proud-pied belles dip freely therein. Cocktails and highballs are everywhere on dress parade, and the wanton cordax[1] has been revived by dancemad, up-to-date Bacchantes [2] amid the hocktide familiarity of the roof-garden and the misnamed "the dansant." Girls representing good families, conspicuously made-up, are not missing from the throng. Debutantes, not necessarily of the fast set, unblushingly assert a right to drink wine and smoke cigarettes at luncheons and levees, at high-priced cafes and in the corridors of the hotels; and not a few of this class, as well as young married women, have been brought to the writer's office in a state of intoxication. Such has become the vogue; and, worse than this, girls in their teens see no impropriety in drinking publicly with men companions. A few years ago, a woman with a cocktail before her, amid much surroundings, the air polluted with tobacco smoke, would have been set down as a Cyprian (Licentious or Wanton). The abstinent, unobtrusive young lady of the past generation is giving place to a coarse, boisterous, immodestly attired bon-vivant, controlled by unworthy impulses, and wholly unfit to fulfill her function in the community as an inspirer to meritorious action, or her function in the home as a character-former, a wife and a mother. Verily, the beaumonde reflects a piteous state of preparedness for combat with the forces of evil that threaten to disrupt society. Verily, the national force that is wasting today in America is woman; and she who prostitutes her obligation to her sex in I, life of self-indulgence and demoralizing example should be brought to her senses by the thought that no nation can be truly great in which the rights of woman are not deservedly upheld, and her refined intellect is not respected as a directing agency and an impelling power.

What has been said is germane to the attitude of the well-do-do classes for with the great mass of working people in the cities, the habit of drink is noticeably on the wane; and the saloon-keepers who have long absorbed a generous fraction of the laborer's hard-earned wage fear for the future of their nefarious business of "swapping the souls of men" for mammon [3]. The poor or moderately salaried man is not only developing a knowledge of the perils of alcoholic indulgence through the strenuous efforts of both Catholic and Protestant educators, but he recognizes the necessity of economy, and has come to appreciate the superior attractions of the photo-drama. The moving picture-show is the great adversary of the saloon. In its comfortable parterre, a man may be entertained with his family an hour or two for less money than he would naturally spend in the card rooms that figure at the rear of every bar. These clubs of the poor, where a man of labor and the youth of the store pass their evenings in drinking and card-playing, are dehumanizing our brothers of the tenement, aiming to destroy their capacity both for conferring and enjoying domestic happiness. The moving picture-show offers a form of instructive entertainment that is cheap enough to be within the reach of all working people, and popular enough to drain the lounging-rooms of the cabarets. The saloon is out of step with the times.
. . .

What these persons drink to reinforce nervous energy is itself a most dangerous compound mad of crude grain or potato spirits, or fusel oil, and various "essences" manufactured in laboratories — a compound sixteen times as deadly in its effects on the brain and other organs as is ethyl alcohol in pure whiskey. And the beer and ale of this country all contain sulphurous acid and other adulterants, much of it preservatives, rendering it antagonistic to digestion which is a form of fermentation, and, constituting it a kidney and liver irritant which has to. be reckoned with by the doctor and is taken into serious, consideration by life insurance companies.

In spite of these accepted facts, drinking goes madly on. A discussion of the psychology of the habit would, seem to imply a presentation of the various reasons advanced by intemperants for their addiction to "the juice divine" (Rubaiyat.[4])

Some drink to hide conditions that mortify, worry, depress, or agonize — business entanglements, loss of wife or fiancee, blood-guilt. Like Omar Kaiyam[4], they drink inconsolate, not for pleasure or profligacy, nor to renege religion and good morals, but solely to drown care and escape from themselves. How often it has to be demonstrated to these deluded patients that obscuring conditions does not alter them, but merely renders the dupe less capable of coping with them. "To drink my wine and take my pleasure," said the Persian poet, "that is how I live. To care no jot for heresy or orthodoxy, that is my creed." Yet heresy and orthodoxy continue to exist, and the man's responsibility is none the less. Many men drink exclusively from habit and not from desire for intoxicating effects. Many again plead business necessity; others, lowered nerve tone, and whip themselves to greater effort, forgetting that in the lash of the whip is hidden a scorpion's sting. And some fools who have been cured touch, handle and taste in cold blood to see whether they really are cured, often with disastrous consequences that are likely to follow playing with fire.

A popular fallacy with the alcoholic is the progressive conviction that, in consequence of a long period of good behavior he is entitled to a spree. This applies to patients who are willing to take a six months' voyage on a sailing vessel innocent of liquor, or be interned in a sanatorium, perfectly happy and apparently without desire, but living on the expectation of "going on another whizzer," as one patient denominated it, as soon as the ship docks or the sanatorium doors are unbarred.
. . .

It has been shown that abundant adequacy exists in the man to destroy any and all abnormal craving of his objective nature, and that this dormant power may be awakened and exploited by suggestional appeal. The suggestions given in drink habit cases must be iconoclastic and uncompromising, for radical cure depends on change in the mental state.
. . .

Your speaker has treated in this way persons who came to him unwillingly, who entered the sleep reluctantly with pronounced mental reservation, even men who defiantly sneered at his proffers of help. In many such cases, he has overridden a righteous impulse to eject them from the office, placing love for the sinner before hatred of the sin, has brought the subject into his own presence, made him aware of his obligations with his power to meet them and disclosed to him an earnestness and sincerity of purpose in the effort at reclamation. Such a patient generally emerges from the first sleep, always from the second, a changed being and happy in the change. The surly ruffian who had to be handled with the utmost finesse, is transformed into an affable and appreciative gentleman.
. . .

The rational treatment of alcoholic addicts has been characterized as physio-psychic. This means that it does not lose sight of the necessity for physical repair. It recognizes the interdependence of brain and psychic offices, for in the light of modem science, "bodily and psychic functions are only different forms of the same brain and nerve activity." The successful carriage of the suggestions offered depends then on the integrity of these organs.
. . .

The psychological cause for alcoholic excess is not infrequently emphasized by the depression and nervous irritation resulting from the abuse of tobacco.

Physicians who have had much to do with alcoholic inebriates realize that there is a direct relationship between alcohol addiction and such abuse. The first effect of tobacco smoking is stimulating, with a rise of blood pressure; a sedative effect follows, with a fall of blood pressure; and if the smoking be continued, the nerve cells are depressed. The depression is cumulative in the system of the smoker, and after a varying interval (of days, weeks or months) it creates an instinctive demand for the antidote to tobacco poisoning — and that is alcohol. The intemperate use of tobacco thus explains 75 per cent of all drink habit cases. The alcoholic thirst is engendered and inflamed by smoke.

The real danger in smoking consists largely in the habit of inhalation, whereby the volatilized poisons are brought into immediate contact with at least 1000 square feet of vascular air-sac walls in the lungs, and are thus promptly and fully absorbed, to be diffused into the blood and carried on their disastrous errand to the several organs of the body.
. . .
Inhalers of tobacco smoke are listless, forgetful, independable, backward in study, and conspicuously lacking in power of attention and application. A patient who began to smoke at seven and smoked all the time he was awake until, as he described it, he "got a jag on the smoke," at 35 could not "pin himself down to any business." As the habit is pushed, the habitué becomes excessively nervous, suffers from shortness of breath, muscular cramps and tremblings, rapid and irregular heart, nausea, giddiness, insomnia, irritable throat ("cigarette cough"), impaired digestion, and often from dimness of vision which has been known to culminate in blindness (tobacco amaurosis[is vision loss or weakness]) — all of which disappear with discontinuance of the habit.
. . .
The government has begun a most meritorious campaign against drug-taking in the enforcement of the Harrison law. But it has left unnoticed two habits that are doing infinitely more damage to the brains and physical constitutions of the people of the United States than all the drugs put many times together, viz., the drink and cigarette habits. Three times the amount of our national debt (about $3,000,000,000) is spent annually in the country on alcoholic drinks and tobacco. Twenty billion cigarettes, it is estimated, are smoked every year in the United States. Boys and girls, men and women, are permitted without protest from high quarters to destroy their mental faculties and moral propensities by this practice. Physicians have come to realize that those who abandon themselves to the double indulgence in tobacco and alcohol are practically committing suicide on the installment plan. They can never be at their best, and a cigarette smoker represents as hazardous a risk from the viewpoint of life insurance as a consumer of liquor.

In closing, let me insist on one fact, viz.: The ill-success of a given suggestionist in the treatment of an alcoholic or drug addict, does not imply that such a subject is incurable through psycho-dynamic influence. The sufferer should make trial of another personality. Especially is this to be considered in the failures of Emmanuelism, so noble in its conception and so successful in the hands of its founder, where cures are attempted by unqualified clergymen who are ignorant of the mental states in which receptivity is at its height, and apply extremely crude methods with faith in their efficacy. The same criticism applies to the quixotic efforts of the therapy and the tedious procedures of psycho-analysis.
THE Alienist and Neurologist
A JOURNAL OF Scientific, Clinical and Forensic
[1] The cordax was a provocative, licentious, and often obscene mask dance of ancient Greek comedy. Modern philologists maintain that the cordax later became the fandango. This amatory dancing with undulations of the loins and buttocks was called cordax.
[2] A Bacchante in Roman mythology is a female follower of Bacchus, god of wine and intoxication.
[3] Riches, avarice, material wealth or greed from the New Testament
[4] The Rubáiyát of Omar Khayyám (is the title that Edward FitzGerald gave to his translation of a selection of poems, originally written in Persian and of which there are about a thousand, attributed to Omar Khayyám (1048–1131), a Persian poet, mathematician and astronomer. A ruba'i is a two-line stanza with two parts (or hemistichs) per line, hence the word rubáiyát (derived from the Arabic language root for "four"), meaning "quatrains".

In 1988, for the very first time, the Rubaiyat were translated by a Persian translator. Karim Emami's [5] translation of the Rubaiyat was published under the title The Wine of Nishapour in Paris. The Wine of Nishapour is the collection of Khayyam's poetry by Shahrokh Golestan, including Golestan's pictures in front of each poem.

Illustration by Edmund Joseph Sullivan for Quatrain 11 of Fitzgerard's 1st Version.

Karim Emami(1930, Calcutta, India – 2005, Tehran, Iran) was a highly regarded Iranian translator, editor, lexicographer, and literary critic.

Prof. John D. Quackenbos, the eminent New York scientist, says:
"The time has indeed come, as Maeterlinck predicted it would, when souls may know of each other without the intermediary of the senses."
[The Science of Psychic Healing By Yogi Ramacharaka 1909]


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