alcohol is dispelled; the nervous suffering and dangers that usually wait upon sudden abstinence are minimized; and a career of wholesome activities and satisfactory success is imaged as the legitimate result of the abandonment of the compromising habit. The patient is left asleep an hour or more in the atmosphere of these convictions.

The author has treated in this way persons who came to him unwillingly, and who entered the sleep reluctantly with pronounced mental reservation; he has even dealt with 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; and he has won them by proving the earnestness and sincerity of his purpose in the effort at reclamation. Such a patient generally emerges from the first sleep, and 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 physiopsychic. 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 modern 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 pathology of alcoholic inebriety may not be discussed here. Be it understood, however, that the use of alcohol, at first stimulating, tends soon to diminish physical force as well as to enfeeble mental faculties. Every debauch means a lowered sense tone, a partial functional paralysis of blood - vessel sheaths somewhere or everywhere in the body, a deranged circulation with diminished absorption of nutrient substances, and concomitant atrophic changes in cell protoplasm. Alcoholic patients also suffer from indicanuria. Putrefaction products, absorbed from the intestine, poison the brain and so render resistance to temptation all but impossible. The alcohol, moreover, inhibits the elimination of these toxins, and so is established a vicious circle of causes that promote organic changes, notably in the heart muscle. Constant alcoholic anæsthesia shortly leads to mental reduction and finally to dementia. Nothing can be more pathetic than the sight of a man, once brilliant and successful, prematurely losing his value in the business world and rendered utterly irresponsible by drink.

These physical conditions are not overlooked by the conscientious practitioner, and response to the treatment accorded them is always suggested by the psychotherapist.

The psychological cause for alcoholic excess is not unfrequently 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 seventy-five 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 one thousand 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 fatal errand to the several organs of the body.

These poisons include (besides the chief active constitutent, nicotin): ammoniacal vapors that dry the throat and liquefy the blood, carbon monoxid or illuminating gas that induces a drowsy, dizzy condition and disturbed heart action, carbon dioxid or carbonic-acid gas, prussic acid in combination, sulphuretted hydrogen, and irritant aldehydes-all virulent nerve poisons capable in a concentrated conjoint action of paralyzing the muscles of respiration and so causing death. Of the aldehydes, the one known as furfuraldehyde, found in inferior alcoholic drinks and said to be fifty times as poisonous as alcohol, occurs in the smoke of cheap cigarettes. According to experiments recently made in London, the smoke of a single Virginia cigarette is likely to contain as much furfuraldehyde as two ounces of whisky.

Inhalers of tobacco smoke are listless, forgetful, undependable, 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 the age of thirty-five could not "pin himself down to any business." As the habit

is pushed the habitué becomes excessively nervous, and suffers from shortness of breath, muscular cramps and tremblings, rapid and irregular heart,1 nausea, giddiness, insomnia, irritable throat ("cigarette cough"), impaired digestion, and often dimness of vision which has been known to culminate in blindness (tobacco amaurosis). All these disturbances disappear with discontinuance of the habit."

Gravest of all the resulting evils is the lessening or complete loss of moral sensibility, with a conspicuous tendency to falsehood and theft. The moral propensities are eventually destroyed because of the destruction of those elements of the brain through which moral force is expressed. The victim degenerates into a sallow, unmanly, irresponsible incompetent, directly headed for the penitentiary or the asylum. Such is the influence on character of the cigarette habit, which has developed into a form of

1 A test made by Bush on each of fifteen men, in several different psychic fields, showed that tobacco-smoking produces a 10.5-percent. decrease in mental efficiency.

"The phrase "tobacco heart" has become commonplace not only with the profession, but also with the laity. This is not surprising, for there is indisputable evidence that the use of tobacco causes changes in the caliber of the coronary blood-vessels, and these changes react on the heart, explaining the angina-like attacks (angio-spasm) frequently seen in excessive smokers. Disturbances

of rate and rhythm, due to irregularities in the activities of the nerves supplying the heart, are traced directly to the toxic effects of nicotin.-Editor Journal of the American Medical Association.