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in my mind several cases of inebriety which were traceable to the habit of taking something to relieve pain at these periods. A woman whose husband held a high official position, thus acquired a craving for alcohol and became a confirmed drinker. He was finally compelled to place her in an institution for treatment.

“Alcohol affords relief, not by lessening the internal congestion which causes the pain, but by paralyzing or benumbing the nervous system. In fact, alcohol, instead of relieving, aggravates the internal congestion. It is a deceiver, for it makes the patient believe she is benefited when in fact the condition is made worse. The uterus has become more congested by its use, and when the paralyzing effect of the alcohol has worn off the pain will be found more severe, and the demand for alcohol increased correspondingly. The only safe and wise plan when suffering from pain due to internal congestion is to remove the cause. If uterine misplacement exists suitable treatment must be taken to correct this. Almost immediate relief from pain due to congestion of the pelvic organs may be obtained by taking a hot full bath. A hot foot or leg bath is also a good treatment since the warming of the extremities quickens the circulation in the limbs and relieves congestion in the pelvic region.

“There are various forms of dysmenorrhea or painful menstruation and each form has a treatment by itself. The congestive type which is due to taking cold is better relieved by a hot sitz bath before the date expected, the temperature of the water should be 101°-103° with the feet in water a degree or two hotter. If at the time of the period the pain still continues, an enema or vaginal douche will usually give the necessary relief unless the patient should be exposed to cold by allowing the hands, arms, feet or legs to become chilled.

“Many women do not dress their limbs warmly enough at any time. Just before the menstrual period the tendency is for the pelvic organs to become congested; there is a greater tendency to cold feet then, than at any other time. I would therefore advise warmer clothing on the limbs at such times. The drinking of hot pepper tea, ginger tea, etc., is a pernicious practice, for these irritants inflame the mucous membrane of the stomach and intestines. Hot lemonade or hot water will afford the same relief without leaving an inflamed surface behind to be irritated by the next meal.

“There are some cases of great constriction of the uterine canal which have reflex irritability in the stomach. Those having the stomach affected cannot take food, the least thing is rejected. It is best for such to remain quiet in bed, applying heat to the stomach and abdomen and to the feet until relief is experienced. Those suffering from headache should also remain quiet in bed. Some resort to anodynes and form the habit of using codeine, morphine. All these are bad and should be avoided. I have never found it necessary to give one dose of either to relieve pain at such times. Hot applications with the enema, vaginal douche, or foot bath, has usually been all that was required.

“I recall many cases of severe pain where the extremities were cold and clammy and the entire body was in a hysterical contraction that were immediately relieved by a hot vaginal douche. The muscles relaxed, the patient warmed up and recovered nicely.

“For securing sleep in insomnia, a hot toddy is often used, but a quicker and better effect can be gained by a hot, or neutral bath. The latter given at 99° or 100° for twenty minutes will produce sleep and refreshment, as it equalizes the circulation by bringing the blood to the surface.

“It is safer under all circumstances to do without alcohol or other dangerous drugs in treatment of these diseases.”—Dr. Lauretta E. Kress, Washington, D. C.

Note—An experienced nurse says that prompt relief in painful menstruation may often be found by sitting upon a toilet water-jar half full or more of hot water. The steam rises and the heat relieves.

TOTAL ABSTINENCE AND LIFE INSURANCE.

Nothing shows more clearly and convincingly that alcoholic liquors have a tendency to shorten life than the figures published by life insurance companies. A most interesting and valuable paper upon this theme was read before the Actuarial Society of America, in 1904, by Mr. Joel G. Van Cise, actuary of the Equitable Life Assurance Society of the United States. In it he gives the experience of different life insurance companies which have separate sections for total abstainers and non-abstainers. The Mutual Life Insurance Company of New York, one of the large companies, showed after a few years’ experience with the two sections a death-rate 23 per cent. higher among the drinkers than among the abstainers. The Sceptre Life for the years from 1884 to 1903, inclusive, gave the following: Expected deaths of abstainers, 1,440; actual deaths, 792, being 55 per cent. of the expected. Expected deaths of non-abstainers, 2,730; actual deaths, 1,880, or 79 per cent. of the expected. The Scottish Temperance Life from 1883 to 1902 gave the following: Abstainers, expected deaths, 936; actual deaths, 420, or 45 per cent. of the expected. Non-abstainers, expected deaths, 319; actual deaths, 225, or 71 per cent. of the expected.

Mr. Van Cise goes on to show that the statistics which have been published from time to time, giving the percentages of mortality in the various occupations of life, invariably show a higher death-rate among those engaged in the liquor business than among those engaged in other lines of work, except such as are specially hazardous. He says: ‘The higher death-rate among liquor dealers is so universally recognized by life assurance companies that a number of them will not issue policies, even on the lives of the richest brewers, upon any terms, and not one of the companies, to my knowledge, admits liquor dealers upon as advantageous terms as those engaged in other ordinary occupations.’ He then quotes from a circular sent to the agency force of a prominent United States company, in which attention is called to a rule which forbids the taking of any risks on bartenders: ‘Saloonkeepers, generally, not taken, but best of this class may be accepted on 10 or 15 year endowments only.’ Others connected more remotely with the liquor business might be taken with a charge of $5.00 per thousand extra. The circular of instructions adds that the limitations of liquor dealers are made necessary ‘by the very excessive rate of mortality found to exist among persons so employed.’

Mr. Van Cise closed his address before the Actuaries’ Society by saying: ‘I contend that the facts given in this paper show conclusively that the effect of total abstinence is to lower the death-rate, and increase the average duration of human life.’

The Equitable Company had a section for total abstainers for a few years which was discontinued on account of the new insurance laws which came into effect in 1907. The actuary writes in response to inquiry: ‘We are very careful in our selection of risks, and only those who drink in moderation will be accepted. I think it safe to say that, other things being equal, all American life insurance companies would consider a total abstainer a more desirable risk than a moderate drinker.’

The United Kingdom Temperance and General Provident Institution, of London, is a large and successful company which was organized in 1840, expressly for total abstainers, because at that time larger premiums were asked from abstainers than from drinkers, the common opinion then being that alcoholic liquors were necessary to health. In 1846, this company added a general section, in which carefully selected moderate drinkers were accepted, but each section was kept entirely separate from the other. This separation has continued to the present time, both classes paying the same premiums, but sharing in profits according to the earnings of the section to which the members belong. From 1866 to 1900, for every 100 deaths in the temperance section there were 137 deaths in the moderate drinking section, based on a corresponding number of lives at risk. The dividends for a recent five years average $20 to the temperance members, and $17 to the drinking members.

The actuary of this English company, Mr. Roderick Mackenzie Moore, read a paper before the Institute of Actuaries, in 1903, in which he reviewed the work of this company during its history of sixty years’ experience with abstainers and over fifty with non-abstainers. He showed that there has been no marked difference in the number of policies in force in the two sections, and the average amount of the policies in each section has been about the same, so that the comparison is as fair as could possibly be made. He gives these figures: ‘Non-abstainers, male, expected deaths, 8,911; actual deaths, 8,947; per cent. of actual to expected, 100.4. Abstainers, male, expected deaths, 6,899; actual deaths, 5,124; per cent. of actual to expected, 74.3.’ This shows a difference of 26.1 per cent. between the actual and expected deaths of abstainers and moderate drinkers, and the full figures show the death rate among the drinkers to be 35 per cent. higher than among the abstainers.

The American Temperance Life Insurance Association was organized in 1887. It gives a lower premium rate to members of the abstainers’ section than to those in the general section. The circulars sent out by this company state that the average life of moderate drinkers is thirty-five and a half years; tipplers, fifty-one years; total abstainers, sixty-four and one-fifth years.

Very interesting is the result of an inquiry made of various insurance companies not long ago as to whether they consider the habitual user of intoxicating beverages as good an insurance risk as the total abstainer; ‘if not, why not?’ All but two out of forty-one companies answered, ‘No.’ The two answered, ‘Depends on quantity used.’ In answer to the ‘Why not?’ the Etna said, ‘Drink diseases the system and shortens life’; Hartford Life, ‘Moderate use lays foundation for disease’; Knights of the Maccabees, ‘Drink tends to destroy life’; Knights Templar and Masons’ Life Indemnity, ‘Drink lessens ability to overcome disease’; Sun Life, ‘Drink injures constitution. Habit apt to grow’; Massachusetts Mutual Life, ‘Drink causes organic changes. Reduces expectation of life nearly two-thirds.’ The rest of the answers are much the same as these.—M. M. A.

INDEX

Abbott, Dr. A. C., 264, 278, 280, 281, 368

Abdominal bandage, 199

Abel, Prof. J. J., 128

Abernethy, Dr., 36

Acetanilid, 180, 301, 346

Acetic acid in pharmacy, 134, 136

Acid drinks kill bacilli, 150

Adelung, Dr. Edward Von, 326, 379

Adynamic disease, 272

Aiken, Dr. J. M., 376

Alabama law and alcoholic prescriptions, 27

Albumen, 30, 60, 62, 152, 173

Alcohol,
food claims, 112-114, 128
a mocker, 364, 377
a narcotic, 121, 123
a poison, 28, 29, 100, 105, 358, 371, 388
injurious to living cells, 275
advance in study of, 380
affinity for blood and tissues, 114
affinity for water, 148, 149
and foods, action contrasted, 406
and empty stomach, 100
mental work,

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