word "efficiency," it has got to be a kind of cant, because we cannot now get on two minutes without using one of these two words.

If I were to say what our government and municipalities are committed to most definitely for the next generation or two, I should say it was the regulation of the great economic powers centering about transportation and affiliated corporations. Not only is our government absolutely committed to it in spite of all the raillery of the socialists who tell us that you can't regulate the steel corporation or the railroads, or Alaska, because these big interests own and run the government. We are, however, committed to regulation of foods, weights and measures, railroads and big corporations of every kind, and all dangerous interests, like the liquor interest, which is one of the greatest economic, and at the same time one of the most dangerous, forces in the community. And we have to regulate it. My question is, what kind of regulation shall we aim at?

I suppose every student has been staggered by one fact. The "three fundamental vices" of society, gambling, prostitution and drinking, have been legislated against for hundred of years. Centuries against prostitution alone and what is accomplished? It merely shifts these plagues from one spot to another. It is virtually the same with drink and with gambling. We change the forms-do we change the essence or the total of evil enough to be at all sure of our case? Many students say that gambling has not been diminished by a jot. We have won a little hold upon the drink problem and it has been through regulation and the accompanying education. For years I have had the statistics of drink in Belgium. These statistics are in such shape that you can really do something with them, as you cannot with those in our own country. There is almost no regulation in Belgium. I have been in places where any man with a hundred francs could start a cabaret and sell just as much rum as he pleased. I have seen districts in which there was one saloon for every eleven families, every man picking up profits out of this business without regulation. They have a drink bill in Belgium absolutely paralyzing. The average Belgian laborer pays all he earns during two months in a year for his drink bill. There is only one place worse, and that is France, where they drink the deadliest thing that is made for a drink, absinthe.

It seems to me proved that we must strike for a local politically manageable unit. I believe the county is too large, and much more is the state too large, and yet I would fight against throwing Maine back into a licensed state. My opinion is precisely as Mr. Woods has stated, Maine has not made out her case and yet I would maintain that experiment until we get a great deal more information, and especially until there is far greater unanimity of opinion on the merits of the case. I want it still among the experimental legislation which is to guide us. For every new start, take the manageable unit of local option, and get into the county and state as fast as possible.

What next? This book which I hold in my hand is the most relentless criticism on the method which I believe in, and yet I would advise everybody to read it for that reason. I have known three or four excellent liquor men-men who made their money selling liquor; we may get invaluable instruction from them. We have to learn that it is good politics to co-operate with those men because they are going to teach us things that we must know. As in, the new constructive politics, we have to learn that it is stupid simply to fight the kind of politicians that we dislike. Politics has made little progress further than it has learned to co-operate with the very best opponents so far as they will take one step that is decent toward saner policies. I do not know an intelligent political student that has not come to that conclusion. I know many that began by thinking politicians are merely loathsome beasts. We have learned that a politician may teach us a lot if we approach him right, and we may co-operate with him to the general cleaning up of the community.

The same is true in industry. We have assumed co-operation between the laborer and the employer, and the Socialist's camp is today torn on this issue. The extremists say any co-operation, any active sympathy with the capitalists or politicians is a vice. On the other side is the reformist or the opportunist. The reformist who is willing to co-operate with practical politics is on the winning track in every country known to me where the Socialists fight. We too have to cooperate with every one of those liquor men that will take first steps towards decency and help educate his own crowd. He can do this far more effectively than outsiders.

The next step in my opinion is to develop this co-operation in eliminating the element of private profit from liquor distribution. But it must go beyond the Gothenburg system. We tried here ten years ago to get a permissive bill to introduce this system. We shall never strike the deadliest blow to liquor distribution until we take the private profit principle out of it. You will waste no end of time until you have that which is the essence of the Gothenburg system. Mr., Gordon, in the book cited, has been watching it for years, and he writes the severest piece of literature against it that I have read. He points to the weakness of the whole business. If you take away private profits, what are you going to do with them? They have to go to the city or state, and that is dangerous, unless most carefully guarded in manageable units of population. It is a very real danger, as he says, to substitute this communal pecuniary advantage for the advantage of the private individual. If I thought the profits were going into the pockets of the tax payer, as they do in certain Swedish communities, I should think it just as much of a curse as Mr. Gordon does in this book. We did not propose to try this experiment in a large city, but in a community that had fought license year after year. Wherever a small community has opposed license, our permissive bill asked that the town be allowed to

experiment in this elimination of profit. We came within one vote of this permissive bill, not to cover a large city, but to try this little experiment.

We

What should one do with the profits? In every place where they have taken the profits away from the liquor interests, everybody is amazed to see how huge they are. If we want to make a genuine substitute for the saloon, we need a great communal house with gymnasium, with museum and theater, and then we want to make that an educational center for the teaching of modern science on the real injury that drink does to the race, and to teach the evils of drink generally. I submit to you that an experiment of that sort in a controllable no-license area, carefully watched, could not be very injurious. That was all our claim, and the principle on which we wanted to make that was this. Dr. Hatton said the liquor business ought to pay its own bills. It causes inconceivable wreckage. Why should the general community pay the bill? The liquor interest throws it upon society. We are very feeble-minded if we continue to stand for that. have plenty of examples. The genius of workingmen's compensation is this: It insures the workman against accidents and then makes the trade pay the bill, and it insures different phases of the trade according to the danger of accident. In the hard coal mines where the accident rate is high they pay a heavier insurance, and throw the wreckage upon the trade. What I want to see is to have educational centers where we can have these graphic temperance charts that really instruct you. Profits from liquor should create powerful educational centers. I want the profits of the trade to pay for this education, and I don't want one dollar of it to go into the taxpayers' pocket, so he can say "That's a good way to pay the taxes.'' I wish everybody would read Mr. Gordon's book. It is strongly against what I am saying, it is a bitter attack on the Gothenburg system, but he attacks its avoidable weaknesses, not its strength. It is the argument of an absolutist who will have no compromise with the enemy. I don't know anything more precious in social politics than to get the habit of learning from your opponent, even from your enemy. If I should try to make that into a little phrase. I would say that to learn from your enemy is as intelligent as it is divine to forgive him.

THE EFFECTS OF ALCOHOLISM ON THE HUMAN BODY.

By Harlow Brooks, M. D., Visiting Physician, Montefiore and City Hospitals, New York City.

This subject is almost as old as the study of medicine. In the works of Hippocrates we find an excellent account of certain of the manifestations of alcoholism and practically all the older medical authors, especially those who dealt with pathological studies of the tissues have interested themselves in this disease. Yet there are today few subjects in pathology on which a greater divergence of opinion exists, not only as to the grade of the changes induced but also as to the character of them. The New York Academy of Medicine has recently appointed a Committee of Fifty, the purpose of which is to investigate from a scientific standpoint all aspects of the alcoholic question, not from a biased standpoint, but from that of the pure scientist who searches for truth, merely because it is truth and in order that the results of their investigation may be applied in the furtherance of Public Health.

Among the sub-committees is one appointed to investigate the question as to the effects of alcohol on the body lesions. I have the honor to serve as a member of this committee.

The question is much more difficult of solution than might at first appear to be the case, and calls for much first hand original study and observation.

At the outset one is confronted with the difficulty that one rarely or never sees cases of fatal alcoholic poisoning. What we are called upon to study is a disease condition,-Alcoholism-the etiological factor of which is alcohol; but the complications and digressions of which comprise many other factors. Thus, in alcoholism, especially as we see it in the great cities, are such important factors as exposure, under and malnutrition, and all the other numerous effects of dissipation-these contribute to the lesions of alcoholism which then becomes a complicated disease picture. It is not the toxic effects of alcohol alone, but the conglomerate result of many pathological factors which combine to make up this disease picture.

It would seem that one should be able easily to induce experimentally in animals the lesions of alcoholism-but results in this direction have for the greater part led to either entirely negative findings or to changes quite different in character or degree from those which we know to develop with a high percentage of occurrence in cases of clinical alcoholism; we have alcoholic poisoning, and these changes may be easily induced in animals, but not alcoholism.

Hence it is that we must fall back chiefly on the study of the body tissues after death in cases which have clinically pursued the course of the alcoholic.

There exist many instances in which alcohol may be used to excess

throughout an active life without producing any disease changes in the body which may be correctly attributed to the drug. These cases are, of course, rare and they are commonly such as have during life shown few of the toxic symptoms which usually result from the abuse of alcohol.

Alcohol affects the female to a much more serious degree than the male. Not only is woman more susceptible to the dosage of alcohol per body weight than man, but the course of the alcoholic woman is much shorter than that of man and the evil effects on her tissues are more 'rapid as well as more fatal in their early effects.

My studies are from cases of the New York variety,—they have been collected mostly from Bellevue Hospital, City Hospital, Harlem Hospital and from a large Hebrew Hospital,-thus it may be seen that my statistics are probably quite fairly founded on all nationalities; Americans, English, Irish, Scotch, Italian, Bohemian and Hebrew, all maintaining to a more or less degree, their national drink characteristics though in a new habitat.

I shall attempt to adhere strictly to the results of the abuse of alcohol for I believe that in this agent we have a therapeutic power as valuable and nearly as dangerous as strychnine or morphine and a food substance of irreplaceable value which, however, at times becomes as poisonous as sugar to the diabetic or as purin bases to the sufferer from renal disease. There is no absolute guide as to the physiological or pathological dose except experiment and personal experimental medicine is a very perilous branch of vivisection research for the layman.

Changes in the circulatory system in alcoholism do not play an important role .except when primary disease of the kidneys or liver have developed in which instances secondary circulatory changes appear. Certain exceptions must, however, be made. When great quantities of the milder alcoholics, as beer, are taken, a condition of fatty and dilated heart results closely allied to the Munich beer drinkers' heart which is found so constantly in the dead houses of that beautiful city. Arteriosclerosis or hardening of the arteries does not appear to be a frequent result of alcoholism except when complicated by kidney disease or when the disease is associated with dissipation, with great mental strain or the like-all conditions it is true aggravated or induced by alcohol.

Among the most serious and frequent lesions induced by alcohol are those of the gastro-intestinal tract. Dilation of the stomach, chronic and acute inflammatory disease of the stomach and intestine are among the most certain of the effects which the alcoholic is to expect. To a certain extent in this country the decreased consumption of the stronger alcoholics has resulted in a lessening of these changes and the crafty alcoholic has found that the "high ball" or the "wine and seltzers'' give equal drug or force effect and cause less gastro-intestinal disturbance than the whiskey straight or the undiluted wine-his experience is based on a thoroughly well confirmed pathological basis.