Alcoholism

The most trustworthy experimental data that are available, among which may be mentioned those of Schneider,2 Hellsten,3 Mayer,4 Aschaffenburg,5 Smith,6 Kurz and Kraepelin,7 seem to show that even moderate indulgence in alcohol, though producing in the subject a sense of well-being and of increased physical and mental ability, in reality causes impairment of muscular power and coordination and of mental efficiency.

Excessive indulgence produces the sufficiently familiar picture of drunkenness, and such excesses, if frequently repeated, are apt sooner or later to produce one or another of the alcoholic psychoses, of which the more important are: delirium tremens, acute hallucinosis, a fairly characteristic chronic delusional state, the polyneuritic psychosis, and alcoholic dementia. During the year ending June 30, 1918, 7.1% of all male admissions and 2.6% of all female admissions to the New York state hospitals were cases of alcoholic psychoses.8 This does not include cases which were not specifically alcoholic but in which intemperance was given as a contributing cause.

1 Thirtieth Annual Report of the State Hospital Commission, Albany, N. Y., 1919.

2 Pflueger's Archiv. f. d. gesamte Physiologie, Vol. XCIII, p. 451.

3 Abstracted in Muenchener medicinische Wochenschrift, 1904, p. 1894.

4 M. Mayer. Ueber die Beeinflussung der Schrift durch den Alkohol. Kraepelin's Psychol. Arb., Vol. Ill, p. 535.

5 G. Aschaffenburg. Praktische Arbeit unter Alkoholwirkung. Kraepelin's Psychol. Arb., Vol. I, p. 608.

6 A. Smith. Ueber die Beeinflussung einfacher psychischer Vor-gdnge durch chronische Alkoholvergiftung. Br. ueber d. V. intern. Kongr. z. Bekampf. d. Missbr. geist. Getranke, Basel, 1896, p. 341.

7 Kurz and Kraepelin. Ueber die Beeinflussung psychischer Vor-gange durch regelmdssigen Alkoholismus. Kraepelin's Psychol. Arb., Vol. Ill, p. 417.

8 Thirtieth Annual Report of the State Hospital Commission, Albany, N. Y., 1919.

Drug Addictions

In March, 1918, a special committee was appointed by the Secretary of the Treasury of the United States to investigate the traffic in narcotic drugs. This committee rendered an official report of its investigation in June, 1919. The report states that the per capita consumption of opium in the United States amounts to 36 grains annually, the consumption in some other countries being as follows: Austria 1/2 to 3/5 grain; Italy 1 grain; Germany 2 grains; Portugal 2 1/2 grains; France 3 grains; Holland 3 1/2 grains. "When it is considered that the greater portion of our citizens do not take a single dose of opium year after year, it is manifest that this enormous per capita consumption is the result of its use for the satisfaction of addiction."

The situation as regards cocaine is somewhat similar: "112,500 ounces of cocaine, which is manufactured in this country, is used for illicit purposes, and this does not include that quantity which is smuggled into this country, of which no estimate can be made."

"The committee is of the opinion that the total number of addicts in this country probably exceeds 1,000,000 at the present time."

Hundreds of cases came to light in drafted men between the ages of 21 and 31 in the National Army cantonments. The drugs used in 100 consecutive cases observed in the Base Hospital at Camp Upton, N. Y., were as follows:

Table 2

Heroin...

84 cases

Morphine and heroin...

5 "

Morphine...

4 "

Opium and heroin...................

2 "

Cocaine, morphine and heroin........

2 "

Cocaine and heroin...

1 case

Morphine, opium and heroin.........

1 "

Opium and morphine....

1 "

Syphilis

Syphilis appears as the essential cause of all cases of general paralysis and of cerebral syphilis (gummata, meningitides, etc.), and of a large proportion of the cases of cerebral arteriosclerosis. Not counting cases of the latter condition, which are not always of syphilitic origin, 21.2% of all male first admissions and 6.5% of all female first admissions to the New York state hospitals during the year ending June 30, 1918, occurred on the basis of syphilis as an essential cause.1

Head Injuries

The more important mental disorders occurring as result of head injuries are: traumatic delirium, traumatic constitution, traumatic epilepsy, and traumatic dementia. These cases are far more often brought to general hospitals than to hospitals for the insane for reasons that are sufficiently obvious. Thus only 0.3% of all first admissions to the New York state hospitals during the year ending June 30, 1917, were cases of traumatic psychoses.1