habitues by the physician, as he would have frequent occasion to see the terrible effect of such drugs.

Geo. C. Bartells of Camp Point, Ill, said:

The most prolific source of the drug habit is the prescription of a physician, the physician often saying to the patient in giving him a prescription, "Get it filled any time you need it.'

Leo Eliel of South Bend said:

In most of the created drug habits the physician is to blame and he should be restrained by law.

(Mr. Eliel was President of the American Pharmaceutical Association, 1906-7), Albert E. Ebert of Chicago said:

It is ridiculous to place the supervision of the sale of such drugs in the hands of that profession whose members are most responsible for the creation of drug habits and whose membership numbers many who are themselves confirmed users of narcotic drugs. I refer to the medical profession.

One in Six a Victim.

W. F. Jackson of Orono, Maine, said:

In the writer's past experience as a druggist those cases of drug habits coming under his notice were, it is believed, largely the result of indiscriminate and frequent "refills" of prescriptions. An estimate some time since in the "Journal of Medicine and Science" (Portland, Maine) makes one-sixth of the physicians of the country victims in some form of the opium habit. We may well hope this estimate is exaggerated; but the fearful danger to the patient from this source, considering the well-known cunning and fiendish efforts of habitues to make others also victims, cannot be overdrawn.

F. B. Lillie, Secretary of the Oklahoma Board of Pharmacy, referring to the administration of cocaine by physicians, said:

The average physician desiring to retain the good will of his patient and his money as well will repeat the treatment..

Again the physician is called to a very common case, an overwrought nervous wreck who feels that he must have immediate rest and sleep. What a temptation to resort to the drug that will do the work at once. The deed is done. The patient is relieved for the time being and sings the praises of the physician. It requires a high order of character in a physician who can take cases of this character and tell them that their case must have rest and time to recuperate the wornout energies. Why? Simply because in nine cases out of ten he would lose his patient and some other physician, who had less care for the welfare of the patient, would do for him or her what this physician refused to do.

Then bear in mind that it is not always the physician who writes the prescription, who treats the patient. Practically all statute laws in force dealing with the distribution of drugs, countenance the dispensing physician and more than fifty per cent of the physicians in our country, at least, do more or less of their own dispensing.

The physician is then in a position that no one but himself may know what he gives his patients. Methinks the order sheets of some of our pharmaceutical and physicians' supply houses would tell some grave tales could they but be scanned.

In my own experience one physician has been known to order ten thousand onefourth grain morphine tablets at one time.

(This is an illustration of the immense quantity and the heavy doses of morphine dispensed by some physicians.)

These statements from thoughtful pharmacists go a long way toward putting the blame for a deplorable condition where it belongs, directly on the shoulders of careless, reckless or criminal members of the medical profession, and many similar statements could be quoted.

"Morphinism Among Physicians."

Dr. T. D. Crothers of Hartford, Conn., in October, 1899, read a most significant paper before the New York State Medical Association. This is quoted from because it antedates any considerable public discussion and is less likely to be clouded by extraneous matter than an article written in the heat of public agitation. The title of the paper was "Morphinism Among Physicians," and the following four paragraphs are quoted verbatim:

In 1890 I was appointed chairman of a committee to collect and study statistics of the prevalence of alcohol and opium inebriety. During this interval of nine years a large number of statistical observations and data have been gathered. From these facts I present a preliminary report confined exclusively to the study of morphinism among physicians. I shall give conclusions rather than tables, and general facts rather than exhaustive studies. These data came almost exclusively from physicians who were

requested to ascertain the number of medical men of their acquaintance and vicinity who used alcohol and opium, also to give a percentage of the whole number.

In this way a history of 3244 physicians residing in the Eastern, Middle and some of the cities of the Western States was obtained, ci whom twenty-one per cent were found using spirits or opium persistently. Ten per cent were using opium or other drugs secretly outside of this number. Over twenty per cent, including this number, used spirits in so-called moderation. In another study of 170 physicians, seven per cent. used opium or morphine, and six per cent. were secret drug takers. From the personal observation of a number of city physicians who have a large acquaintance with medical men, from eight to ten per cent. were found to be either secret or open drug and morphine habitues.

These figures appear to be approximately correct, and show that from six to ten per cent in this country are opium inebriates. This is considered a conservative statement, considering the fact that drug takers, and physicians in particular, are secretive and conceal their use of drugs, especially when it implies weakness and reflects on their social standing. *

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I cannot stop without calling attention to the fact that morphinism is increasing among physicians. The reports from private asylums and public hospitals show that within five years medical men form a considerable part of their inmates. Specialists of nervous diseases sustain the same fact. The young and middle aged men are the most common victims. Often they are from that class of delusional thereapeutists who want to prove everything by personal experience, or who have exalted conceptions of the power of drugs, and believe that reseaches in that direction will open the road to a physical millennium.

The superintendents of six sanitariums, all of them doctors, were consulted regarding the cause of drug addictions. In each instance the superintendent said that in the majority of cases coming under his observation the habit was formed by first administration by physicians, and all likewise agreed that the medical profession furnished more habitues than any other.

The Keeley Institute numbers its "graduates" by the thousands. Nearly every community of any considerable size has from one to a dozen of them. Most of these "graduates" are leading active and useful lives, while others have relapsed into drunkards or "fiends" because they prefer to be such rather than to be sober and upright. Thirteen years ago the parent Keeley Institute at Dwight, Ill., issued in printed form a most significant report of 1,000 cases treated at the Keeley Institute, reported upon in the order of their arrival for treatment. The Chicago "Tribune" (February 13, 1894) commented editorially upon this report in the following language: The Experience at Dwight.

One of the most remarkable features of this report is the statement that 74 per cent of all the patients claimed the drug was first given by physicians and in many cases continued without their knowledge until they had formed the habit. So it would seem the medical fraternity is responsible to a large extent for the terrible indulgence in narcotics * * The doctors may be entitled to the doubt that in some cases they are unfairly charged with being the prime causes of the habit being formed, yet the report ought to make them more careful about the use of narcotic medicines in their future practice.

Of the 1,000 patients reported upon 480 were women and 520 were men. The women were self-classified as follow: Actresses 12, housewives 306, widows 118, miliners 61, nurses 8, spinsters 30, teachers 8. Of the men 146 were physicians, 28 were attorneys, 26 farmers, 24 were merchants, 25 were druggists, 22 were bankers, 22 were clerks, 18 were dentists, 18 were bookkeepers, 12 were editors and 8 were ministers. Other professions had a scattering representation. The forms of slavery from which these patients sought relief were as follows: Alcohol, including perfumeries, Florida water, cologne, spirits of camphor, etc., 197; atropia, 45; bromidia, 65; chloroform, 6; chloral, 61; cocaine, 86; cannabis indica, 3; ether, 5; gum opium, 37; smoke opium, 18; laudanum, 46; morphine, mouth, 105; morphine, hypodermic, 285; morphine, rectum, 4; paregoric, 4; strychnia, 3; salol, I; sulphonal, 3; tincture of ginger, 7; tincture cinchona, 15; and tincture valerian, 14. The report says: "Seventy-four per cent of all these patients claimed that the drug was first given by physicians, and in many cases continued without their knowledge until they had formed the habit."

Four years later a similar report covering 1,000 cases of drug addiction was published by the same company. Of the cases recorded 616 were men and 384 women. Of the men 150 were physicians; of the women 236 registered as housewives. Twenty were dentists and 17 were druggists. In all 24 professions or occupations were recorded

and 74 of the patients registered as having no occupation. Next to physicians came attorneys, represented by 30 habitues.

According to the report 53 per cent received first administration from physicians, 24 per cent acquired the habit through the use of medicines, and 13 per cent were "self-acquired."

A superintendent of a Texas Sanitarium says: "The hypodermic syringe in the hands of careless doctors is accountable directly for over 50 per cent of all cases. Humanity has been the loser by this means of administering drugs."

It is only semi-occasionally that news items or discussions regarding the causes of drug addiction reach the public through the newspapers, and unfortunately the medical publications have few if any readers among what the doctors learnedly refer to as "the laity." However, there are some exceptions, and a few are here quoted.

In Kansas City, on March 7, 1907, a Dr. W. M. Banks, graduate of the University of Missouri, 1891, and a licensed physician told, to a police magistrate before whom he was arraigned, the story of his degradation. The newspapers reported the incident and it was telegraphed to papers in other cities. The following account is reproduced from the St. Louis "Republic."

Physician Tells Story of His Degradation.

Kansas City, Mo., March 7.-Doctor. W. M. Banks, a graduate of the University of Missouri, class of '91, and a licensed physician, stood before Judge Kyle in Police Court today and begged not to be sent to the workhouse.

"It is my life I am pleading for, Judge," he said. "If I am locked up out there where I cannot get morphine I will die before a week has passed."

Doctor Banks acknowledged that he is a slave to the drug habit. A man of education and pleasing address, he wept as he told the story of his degradation.

"I was in the university from 1887 to 1891, inclusive," said Dr. Banks. "I was graduated in the academic course, afterwards taking two years in medicine. I went to Texas, and there I contracted the morphine habit.'

"You are a physician. How long do you think you will live ?"

"I give myself two years."

"How do you account for so many persons addicted to the drug habit ?" "Principally because of its indiscriminate use by physicians. Another reason is the laxity of the law governing the sale of drugs by pharmacists."

On April 29, 1907, Dr. George Gifford of Toledo, Ohio, was arraigned before Judge Morris of the Common Pleas Court, on a charge of breaking into a house and stealing $2.50. He had been in jail four weeks, and during that time had been given no "dope." He thought if he could be given a month more he would be "cured" of the habit. "Taking the 'dope' is like a disease, Judge," he said, “and when a man is cured that's all there is to it."

And yet doctors who specialize in the cure of "dope fiends" are held up to scorn by the American Medical Association, if they merely advertise the fact, so that the friends of habitues can find out where to send them to be cured!

The Chicago "Tribune" not long ago told of a physician who became a victim of cocaine, and who administered it and other drugs to his family until they were all slaves. The doctor, Wilibald Doser, a graduate of a German University and at one time a respected practicing physician, finally committed suicide by drinking carbolic acid. The whole sad story is too long to reprint here. The property the doctor had accumulated was dissipated, and for a time the family lived in a tent, near Gross Point, a suburb of Chicago, dependent upon the charity of those who, in the days before cocaine enslaved him, felt honored by the friendship of the prosperous Dr. Doser. The wife and children were put in charitable and correctional institutions-the innocent victims of a doctor's lust for cocaine.

In November, 1905, there was printed in Denver papers, and sent out to papers in other cities, the story of Dr. Jessie Patton, who became a slave to chloral and who was confined in an insane ward in a hospital. In the same month and year, Dr. George E. Brown, formerly of Denver, was before an insanity commission in Judge Conrey's Court in Los Angeles, (Los Angeles "Times," November 29, 1905), his condition due to the use of cocaine. In December, 1905, at Marion, Ind., Dr. C. C. Cronkhite and his son, Dr. Burton Cronkhite, were removed to Hartford City for treatment, having been declared of unsound mind as a result of the drug habit (Indianapolis "News," December 1, 1905). Both father and son are said to have first taken drugs to relieve pain caused by rheumatism.

Doctor and Wife Victims.

On September 8, 1905, the New York "World" printed, as news, a statement that Dr. Abraham Lewis, 233 E. Twenty-eighth street, a graduate of the New York Medical College, was a prisoner in the Yorkville Court, charged with being a drug victim. The "World" said that Dr. Lewis was a physical wreck and that his wife was, on that date, in the prison ward at Bellevue Hospital in a critical condition, it is alleged, from the use of drugs.

The Bay City (Mich.) "Tribune" printed a news item to the effect that Dr. J. Newton Babcock has been given an indeterminate sentance in the Ionia House of Correction for forging a check for $3.65. A year before he had been sentenced, but the sentence was suspended to give him a chance to undergo treatment for drug addiction. He relapsed, however, became addicted to drugs again, and was sent to Ionia, after his mother, with whom he lived, had turned him over to the officers.

Dr. Oliver Cook Haugh, a multi-murderer, convicted at Dayton, Ohio, was a "cocaine fiend" and had probably administered cocaine to the numerous women he married and afterwards killed.

Even more terrible was the case of Dr. Asa F. Partridge, of Detroit, an inveterate user of morphine and cocaine, who was committed to an insane asylum. It was shown that Dr. Partridge because of his own addiction administered cocaine and morphine to his patients, and was responsible for the downfall of perhaps scores of victims.

These are comparatively few of the instances of drug addiction among physicians which have found their way into public print, despite the efforts physicians always make -frequently successfully-to suppress news of this sort.

The introduction of cocaine into the country and its extended use are of comparatively recent date. In the hands of the skilled physician the drug has been a vast boon to humanity. But its use has been so perverted that it is questionable whether it is today not more of a curse than a blessing. Fortunately, the agitation against cocaine, together with the restrictive laws in many states in connection with the National Food and Drug Law, have practically put a stop to the sale of cocaine snuffs.

Danger Is from Prescriptions

The danger of cocaine addiction arising from the use of cocaine snuffs masquerading as "patent" medicines has always been small as compared with the danger of addiction from the prescriptions of physicians, or from cocaine dispensed by physicians. Recently enacted laws in many states have practically destroyed the sale of cocaine snuffs masquerading as "patent" medicine and have greatly reduced the danger of addiction from that source. But in no way have these laws lessened the danger arising from the use of the drug when prescribed or dispensed by physicians. This danger is as great as it ever was, and is no nearer solution than it was years ago.

The great and imperative need now is the enactment of laws regulating the acts of doctors who prescribe or dispense cocaine and other narcotic drugs, doctors being responsible for the great majority of cases of cocaine addiction among people of the so-called "better class." Many of those of the so-called "lower class" who are addicted to the use of cocaine "flake" have acquired the habit through association and environment.

Members of the medical profession are often the stumbling block in the way of adequate anti-narcotic legislation. In Illinois, for example, a bill was favorably reported in both houses of the legislature to regulate the sale of narcotics by druggists and which somewhat restricted the medical profession from indiscriminate prescription of these drugs while not interfering with the proper prescribing of them. This bill was defeated by members of the medical associations and their spokesman on the floor of the House. This bill surrounded with proper restrictions the sale of narcotics by druggists, and was strongly urged by the Board of Pharmacy, and supported by the drug trade generally.

In the vast majority of cases (estimated by some experts to be 98 per cent) the victims of the morphine and opium habit are started on the downward path by reckless prescribing and dispensing by physicians. In very few states are physicians restricted in the use of these drugs any more than they are in the use of quinine or

Epsom salts. In other words, there is no law to protect the public from those physicians who, by their own reckless acts, create the habit in 98 per cent of the cases of morphine and opium addiction!

Existing laws protect the public from the articles which in the past have caused two per cent of the evil, but permit those who are responsible for the other 98 per cent to escape! This may seem just to the medical profession, but it is hard for any one not of the profession to see where the public is adequately protected.

Good Laws Urged by Proprietary Association.

If the history of legislation against cocaine is ever written, the honest historian will at least give the Proprietary Association credit for using its influence consistently and effectively to aid in stamping out the evil arising from the misuse of this drug. To some extent this effort may be charged to self interest, for cocaine snuffs have furnished the text for many indiscriminate and unjust attacks on patent medicines, although no manufacturer of such an article could have secured membership in the Proprietary Association. Reckless writers have lied so industriously in regard to this subject that some of their readers have actually been led to believe that the Proprietary Association was responsible for these cocaine snuffs when, as a matter of fact, it has for years been consistently aiding to suppress them and those who are responsible for their manufacture and sale. The Proprietary Association has no more to do with cocaine snuffing than it has to do with opium smoking in China. The traffic in cocaine will exist as long as doctors abound who will prescribe it with "refill" prescriptions and as long as druggists will fill and refill such prescriptions. But the stuff thus prescribed and dispensed is cocaine and is in no manner or sense a patent medicine.

The position of the Proprietary Association is shown by the following resolutions unaminously adopted December 5th, 1905:

Resolved, That this Association thoroughly disapproves of any effort on the part of any persons or firms, members of this Association or not, to market as medicines any articles which are intended to be used as alcoholic beverages, or in which the medication is insufficient to bring the preparation properly within the category of legitimate medicines.

Resolved, That the Legislative Committee be and hereby is instructed to earnestly advocate legislation which shall prevent the use of alcohol in Proprietary Medicines for internal use in excess of the amount necessary as a solvent and preservative.

Resolved, That the Legislative Committee be also instructed to continue its efforts in behalf of legislation for the strictest regulation of the sale of cocaine and other narcotics and poisons, or medicinal preparations containing the same.

Resolved, That this Association urges upon its members the most careful scrutiny of the character of their advertising and of claims for the efficacy of their various prescriptions, avoiding all over statements, and thus putting themselves in a position where they cannot be criticized on these lines.

Reports of Legislative Committee.

Long before the passage of the resolution above quoted the Committee on Legislation (in its annual reports for 1903, 1904 and 1905) had outlined the position of the Association upon the subject of legislation to regulate the sale of drugs and poisons. In 1903 the committee said:

The field of legislation as a whole presents frequent complications and often unexpected difficulties arising from local conditions, political and otherwise. In all these matters it should be possible to find a common ground upon which intelligent and reasonable men can stand. It should be our policy to secure, if practicable, an agreement with the representatives of the National Wholesale Druggists' Association, the American Pharmaceutical Association and the National Association of Retail Druggists, upon the draft of a model statute regulating the sale of drugs in general and a model poison law. In this way misunderstanding and friction may be avoided and much good may result, for it is to the advantage of the public and of all legitimate interests to have a reasonable pharmacy and poison law in every state.

In 1904 the committee said:

Undoubted evils resulting from the indiscriminate sale of cocaine in many states have given rise to a legitimate demand for strict regulation of the sale of that drug. The Proprietary Association should favor such measures, and our individual members should not fail to make their position upon this question clearly understood. We have every reason, in common with all good citizens, to advocate laws for the protection of the public health; and to aid in maintaining the highest standard of morals and good citizenship in all branches of the drug trade.