TTTEJ - SUNDAY OREGOTfTATT, PORTLAND.' "MAT S3, 1915. C
Habit Defined
Disease
As
m
1RST INTERVIEW WITH DR. ERNEST S BISHOP BY SPECIAL PERMISSION OF
DR, KATHERINE DAVIS, COMMISSIONER OF CORRECTIONS
BY A. R. PARKHURST, Jit.
NEW YOKK, May 22. "Unless we
are to become a nation of drug?
addicts give us Federal legislation
that will put a stop to the illicit sale
of narcotics."
That was the concluding sentence of
an Impassioned address made on the
floor of the House of Representatives
by one of its members in the bitter
fight -waged there for the passage of
the Harrison bill, an act to curb the
f rowinff menace from drugs tha.t is
threatening the country. The Harrison
bill finally was enacted, and as a re
sult there were bared even more amaz
ing revelations of the drug evil than
were dreamed of by the police of the
larsest cities.
eiince then crusades have been start
ed all over the country and when police
officials of New York City emphat
ically stated that 74 per cent of the
criminals arrested here are drug ad
dicts the police of other cities awoke
to a realization that their comrades in
New York were on the right track in
their effort to check crime.
Lieutenant Scherb, chief of the nar
cotic squad.
Department,
ment of such cases In the infirmary
at the workhouse, and as much credit
is due the intelligent corps of nurses
who are co-operating with me and the
resident physicians as to the medicine
that is prescribed.
"Just what those results are, how
ever, you will have to discover for
yourself, for I cannot discuss them
with you. Neither can I discuss what
others are doing in their efforts to
cure the habit. I -have my own meth
ods. So far I am thoroughly convinced
I am on the right track. Results have
proved that. But I want It clearly
stated that I don't profess to have' 'a
cure." Find out for yourself and in
your own way what has been done and
let it go at that."
it did not take me long to realir.e
that I was confronted by a forceful
and unusual man of medicine. Dr.
Bishop is a strapping, broad shouldered
six footer, who, as tackle, had battered
his. way through many an opposing line
when he played on Brown's varsity
football eleven. After overcoming
Mingle with the various groups of
prisoners, and you will come in con
tact with a great many who have been
treated and are cured. Talk to them.
nd maybe their experience will furnish
want to bay this: In morphinism wa
have what will before many years b
and curable diseases ' in
Treatment which is based upon
almost insurmountable obstacles, he
of the New York Folice has not .only a splendid private prac
and his men have been tice, but also occupies the chair of
making scores of arrests daily of drug professor of medicine
le Poly-
addicts and those venders who pander
to them.
The Boy lan law. and more recently
the Block act, both enacted in New
York State, have made it extremely
hazardous for any venders to peddle
their poison about the streets. Hun
dreds of arrests have been made and
few have escaped conviction. The good
Work done by this squad and the valiant
aid the police generally are lending
are doins more toward stamping out
violence here than any step taken by
the uniformed force in years. Com
missioner Woods awoke to the peril of
the situation and the creation of the
narcotic squad speedily followed.
A day rarely passes now but that
teome unfortunate appears in one of the
police courts and asks the Magistrate
to commit him to an institution where
treatment may bo obtained for the
"habit." Oftener the victim requests
that he be sent to the workhouse, on
Randalls Island, where many remark
Able cures have been effected.
Determined to visit the Workhouse
wards and at the same time have a
talk with Dr. Bishop, I went to the
office of Miss .Katherine Bemont Davis,
the new Commissioner of Charities,
under whoso rule the Workhouse
comes. 1 found Dr. Davis just as deep
ly interested in the drug evil as any
official to whom I had talked, and
while she preferred, that I obtain from
Dr. Bishop the information desired on
the perplexing problem, she consented
to discuss conditions as they were and
do exist.
"There is in the Workhouse no class
of prisoners which is receiving more
attention from us just now than the
drug addict," said Dr. Davis. "The ac
tivity of the police in checking the
sale of drugs has increased tenfold the
number of these poor unfortunates who
come under our care. We are meeting
the need, however, and I think we are
not without a measure of success. We
are trying to apply sane and common
sense methods rather than theory and
the result Is very gratifying to me. Our
physicians and nurses are untiring in
their efforts to alleviate the suffering'
of the poor unfortunates they have
under their care, and I am confident
( Dr. Bishop, who supervises the work,
is as well if not better qualified for it
than any other man I know. A visit
to the wards where these patients are
undergoing treatment would soon cou
vince you of this, I am sure."
It was here that I interrupted Dr.
Davis with the request for permission
to visit these wards.
"No, I won't give you such a per
mit," Dr. Davis replied. "Dr. Bishop is
In charge of the work and under no
circumstances will I override his au
thority. I would suggest that you go to
see him and anything he might do, or
say. will be all right. He is in charge
and it is for him to decide."
When I left Dr. Davis' office bearing
a, card to Dr. Bishop, I lost no time in
calling upon Dr. Bishop at his home,
No. 151 West Eighty-fifth street. Be
fore taking up his story I wish to say
I was little prepared for what I later
learned from him. Practically all phy
sicians and specialists to whom I have
talked about drug cases referred to
the victims as "fiends" or "dopes." To
them the drug habit was a vice, a can
cer that was gnawing at and fast de
stroying the vers- vitals ot society. All
drug victims were essentially identical
and all were treated in exactly the
tame way.- There was a prescribed
course through which the sufferer must
go, and his physical condition at the
time of starting in on the cure mat
tered little. The addict, who had been
. user of drugs for 25 years, was
treated in precisely the same manner
as an addict of as many months. They
were poor unfortunates, who had sank
eo low that they were social pariahs.
Incompetents, and in most cases out-
clinic and Medical School and Hospital.
yet finding the opportunity to devote a
great deal of time to the human
derelicts who find their way to the city
workhouse, ills late post as resident
physician in charge of the narcotic
and alcoholic wards at Bellevue Hos
pital gave him the opportunity he
needed to study the drug addict at
close range, and there he accumulated
ideas,- conceived thr.ough practical ob
servation, which made it possible for
him to accomplish what is now being
done at the island.
"When some years ago I was resi
dent physician of the alcoholic and
prison wards of Bellevue," Dr. Bishop
continued, "my definition of narcotic
drug addiction would have voiced the
popular and generally accepted con
ception. I should have called it a con
dition based on some inherent weak
ness of will power and mental stamina;
a condition arising from the habitual
conditions as they appear in the indi
vidual case will give surprising results.
Most of the past treatments have aimed
at the withdrawal of morphine and at
the bolstering up by whatever means
were at command the supposedly de
fective mentality and will power.
"I want to state emphatically that
the use of morphine does not consti
tute morphinism nor does the with
drawal of the drug constitute the cure
for morphinism. The desire for mor
phine is in the majority of cases
simply the expression of body need as
the desire for water is an expression
of body need. The fundamental con
dition is the changed physiology which
makes morphine a necessity for or
ganic function. If this were not so
we would have long ago reached the
solution of our problem.
"Withdrawal of morphine has been
accomplished in many ways, and the
average patient will live through al
nost any method of so doing. Expe
dience shows, however, that following
treatment which depends upon and
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ff ktat tmSK?11 IN THS CARE OP THE rT?TMTv " 7
ADDICTS .'ygTBp
treating what he so flatly character- der supply it so long as it exists, nor to
izes "disease." eliminate, without artificial support, the
"When you visit the workhouse in- conditions which create this need and
firmary," he answered, "you will see to leave the patient well enough to
many patients under course of prepara- react the strain and readjusted to nor-
tlon for treatment for narcotic addic- inal functioning.
tlon. You also will see a great many "All this can be done, and if I were
in the actual course of treatment. If at liberty to do ho without harm to
you look far enough you will see a them 1 could summon the testimony of
score or more men and women who "able physicians, past patients. For its
have undergone the treatment now be- accomplishment 1 liuve no mugi'.' cure,
ing built up to follow a normal life, no routine treatment or universal
method to advance. I know of no drug
or combination of drups which prop
erly can be called a specific.
"Morphinism, fundamentally. Is a dis
ease. It shows stages ami variations
better and more graphic reading than Just as do other diseases. It is compll
anythtng I can tell you. cated by or complicates other dlseai-s
"But while we are on the subiect I exactly as do other morbid processes.
and every case is absolutely individual.
It ia just as reasonable to treat nil
recognized as one of the most definite "lies ot Pneumonia or typhoid or car-
medicine UIac "'"eases accoruing to otic routine
tHg. as 11 is so 10 treat morphinism. I i on-
recognition and removal of fundamental """? J. experience j.i as im-
iuiLMe io nnnesiiy promise a snort
duration euro for all cases of morphin
ism as it would be to do so in any
other disease. Rational treatment and
prognosis must depend in it. as in
other diseases, upon its history, H.i
stase and development, upon Its com
plicated complicating factors, upon th
condition of tho patient, mental ami
physical, in the individual case.
"Modern medicine lias been for omo
time getting away from the blind fol
lowing of routine and the search foi
the specifics, and aiming at the dis
covery and consideration of, and treat
ment of fundamental cause and under
lying conditions. When this method ot
research is applied widely to morphin
ism and other narcotic conditions, aird
the facilities of our great charity hos
pitals properly directed to Its furtlier-am-e
we shall rearrange our conception
of morphinism. Restraint and custod
ial care and psychiatric classification
will be a;. plied more sparingly ami
more intelligently. Many worthy ill
persons, instead of betnst refused ad
mission and turned back into tho
has for its sole aim withdrawal of the streets after inadequute Ireatment.
more hopeless and less efficient, ad'ling
to the municipal burden of the care of
Its unfit, will be rationally treated aiel
returned to health and telf-Mippoi ting
competency.
"The primarily normal sulTeier. inno
cent victim of circumstances or of mis
guided or unavoidable med icn t ion. will
bo treated us any other pHtlenl. in hi:i
home, in the general hospital or in
reputable sanitania, accoirlm to i,Im
wishes and purse ni the desire of his
physician. With unbiased study siiiri
education, medical and lay. will come
a rearrangement of our attitude toward
morphinism and toward tho treatment
of its victims, and In its pla., will
stand as a part of the ethical rational
practice of medicine the treatment of a
new disease."
drug comes1 months of suffering and
endurance of physical Inadequacy so
great and so constant that there are
few who do not relapse.
"Withdrawal should be simply one
step in the patient's treatment, under
taken and executed with due knowl
edge and understanding of the disease
and not by routine procedure. The
important factor is to sufficiently un
derstand the disease and its symptom
atology, so as accurately to estimate
the patient's actual body need for mor
phine, to neither oversupply nor un-
use of a narcotic drug which caused
deterioration, or degeneration of the
physical, mental and moral being; an
abandonment of the individual to the
pleasure derived from sensuous indulg
ence; a habit, a vice, a morbid appetite
to pander to which the debauche would
go to any lengths, and, lost to self
respect, did not wish to escape from
his degrading thralldom.
"A few months of bedside observa
tion and effort showed me how far this
conception fell short of clinical fact.
Literature and questioning of existing
authority failed in explanation of
obvious manifestations. In the end I
put preconceived bias and previous con
ception out of my mind and approached
the plentiful clinical material for my
solution. What I have learned is from
the study of the narcotic drug addict
as a clinical problem, viewing him as
a sick man, listening to his history
and his statements of narcotic drug
action, watching his clinical mani
festations and interpreting them in the
light of physical action and reaction.
"Since leaving Bellevue I have re
tained my interest in narcotic drug ad
diction and in the cases
"r TrophlrM in llrrnnnfl.
Indianapoli News.
Curio dealers from 10ntcl.iii4 and from
the Continent are reported to be In the
vicinity of battlefields in Northern
France endeavoring to buy trophies of
the war which they hope In time may
be valuable. They find, it Is suid, some
difficulty In" driving bargains. Am
ateurs who have come into possession
of trophies hold them for lilitli prices or
will not sell tin any consideration. It
is recalled that after t!i. American
Ci11 War c-atne to an end a bookseller
in tile Bermudas when the carries of
the blockade runners in th,. harbor nl
Hamilton were sold at uu. tlon bought
a number of package cases without the
least knowledge. of their conlenls.
Among these were several boxes oC
brass buttons consigned to tlte Confed
erate army for use. on soldiers' uni
forms. ,ome 2i) years later totirlHM
discovered these old Confederate but
tons. A New York dealer made a hluli
bid for the entire supply. This bl. wh
refused and theau'buuuns, for which in
the succeeding years a. small fraction
of a. cent was paid, have been telling at
75 cents and tl each.
WOMEN IN FIELD OF LABOR
from them despite my earnest desire
to do so.
"We will deal with the morphtne.ad
dict, for example," said Dr. Bishop in
resuming. "The facts I have gained
IRLS who are in business differ
from business men principally in
thejr physical resources. In all other
directions they can challenge compari
son with the masculine side of the
working world with perfect impunity.
Nowadays when we have women work
ing in almost all the fields which for
merly belonged exclusively to men we
may well ask if there is anything done
by man which cannot be equally well
done by woman. The answer is no,
with a reservation, however, pertaining
to physical ability. The work can be
just as well done by woman If she is
physically able.
Now, there is no use discussing the
fact that men are far better able physi
cally to combat the difficulties and
in mv service
casts, who would stoop to any crime as visiting physician at the Workhouse
in order to replenish their supply of HosDital. and audi us T v, i
"dope." private practice or in consulation have from lons study r tneae addicts "er
But what Dr. Bishop had to tell me clarified and classified mv iri, a beacon light of "hope, and convince
came as a revelation. Straight off he increased my ability to relieve the ad
said: "The drug habit, you know, is diet of his affliction.
a disease." "My present definition of narcotic
"A disease!" I echoed. "You mean a drug addiction is this: A definite
Tree, don't you?" physical disease condition, presenting
"Nothing of the sort." came the constant and definite physical symp-
vigorous denial. "A disease. 1 repeat, toms and signs, progressing througn
ami. a most pronounced and well-de- clean cut clinical stages of develop-
fined one 'at that." ment, explainable by a mechanism of
"Now, before we go any further," Dr. body protection against the action of
Bishop continued, "I wsh you to narcotic toxins, accompanied by inhibl-
understand that I am not what might tlon of function and autotoxemla, often
be termed a drug specialist. I have no displaying deterioration and psychoses
desire to be so classified in my pro- which are not intrinsic to the disease.
but the result of toxemia, malnutrition,
anxiety, fear and suffering.''
This definition was so entirely at
variance witb those I had heard epe-
suffering upon withdrawal of the drug and dependence, loses its power to giv hardships of a business career than
. auuauj uuua.auie lWrme accom- pleasurable sensation and hc. women are. Men nave lar greater
simply a part of their daily sustenance,
exacting physical' agony from its non-
Sering. I further learned that the de- administration.' When this occurs they wlu power What they lack in actual
panied by physicl and organic disturb
ances and manifestations sufficient to
account for and prove the actual suf-
physical resources to draw upon than
the weaker sex, although very often
women make up in determination and
fession. I am a medical man, a prac
titioner, a diagnostician, . if you will,
and In no circumstances will I discuss
the drug habit from the viewpoint of
medicine. Neither will I tell you what cialists outline that for a time I was
my treatment is. When I tell you I inclined to regard Dr. Bishop as a
regard the drug habit as a disease you theorist, a dreamer, but hardly one who
was getting actual "cures" from his
efforts. Before I left him I was con
vinced of my error, all of (which was
strengthened a thousandfold before I
concluded my visit to the Workhouse
drug wards. And, added to this, I had
opportunity to read several papers that
Dr. Bishop had offered before medical
bodies. These papers treated of drug
addiction and the. many so-called
can draw your own inferences.
"You know as well as I do that no
two persons afflicted with the same
malady can be treated in precisely the
fame way. Circumstances alter cases.
The treatment given drug addicts de
pends entirely upon the drug by which
they are enslaved, as well as upon their
physical condition when they come
"Niinder medical care for treatment. We
me that ultimate rescue Is possible for
the majority of the so-called Incurable
dope fiends.' I am firmly convinced
that the majority of users of morphine
have been terribly wronged in a firmly
rooted and widespread opinion preva
lent among both medical men and the
laity. This opinion is that chronic
morphinism is a. morbid habit a per
verted appetite, a vice; that only he
who is morally or mentally defective
would allow it 'to get a hold upon him,"
and that its main character manifesta
tions are those ofTnental, physical and
moral degeneration. Morphine users
are often painted as liars, full of der
ceit, absolutely untrustworthy, using a
dream and delight-producing drug for
the sensuous enjoyment it gives them
addicts who do not want 'to discon
tinue its use. They are thought of as
mental and moral cowards who, aAer
realizing their deplorable condition, re
fuse to exert will power in the endur
ance of discomfort as the price of free
dom. This was my opinion when I first
went to the alcoholic ward in Bellevue,
and for a time I worked on that theory.
"From my patients themselves and
from watching and studying them. I
later learned truths that have since
been mightily strengthened that the
lightful sensations to which we attrib
uted their continuance of drug use, and
make no effort to control its amount'or
method of use, and It. with other condi-
which have formed the background for tions attendant upon their mode of life.
strength. Even will power will give
out eventually, however, under the
save themselves! By saving themselves
la not meant saving on their work, but
saving on their physical strength.
There s no reason why any cirl should
come borne from her office absolutely
exhaus:ted each night, just depending
on her night's rest to Hive her enouKli
strength to get through the following
day. If this condition exists something
is wrong.
It usually means that she is fritter
ing away her strength on unnecessary
things, for if she were living as she;
ought and knew how to conserve her
physical resources she would never feel
absolute exhaustion. She mleht know
fatigue, but the absolute, deadlassitud;
of complete exhaustion, never!
Learn how to aae yourselves, girls!
You must realize that this physical dif
ference in the biggest thing you have to
overcome in order that your work may
equal your brother man's. This can
never be done by constantly wearing
your strength to the limit, drawing on
your resources to the last gasp. Not at
all! The quickest way to overcome this
all pictures of them hitherto painted,
had n many if not in most of the cases
with which I had come in contact, never
been-experienced, or if they had ever
existed, they, had long ago been lost
and all that remained in morphine ef
fect was support to organic processes
necessary to the continuance of life
relieves society of the menace of their
membership. '
"As a class these are the true dope
.fiends, largely incurable and hopeless;
socially, economically and personally
unworthy of salvage. They are not,
however, hopeless and . worthless be
cause they- happened' to' have acquired
strain of working with an unfit body, difference ia to learn how to save your
and it is an excellent "Idea to learn selves.
how to conserve the physical forces and
how to btrlld up and save the strength
already possessed.
So few business girls know how to
No point is useless which may help
to conserve your strength. Once a
month take a whole Sunday In lied.
Just for complete physical relaxation.
and activity. . To be brutally plain, the morphinism, but because they are fund-
morphine addict has in the majority, of amentaiiy what tney are diseased, de-
cases never experienced any real enjoy
ment as a result of the drug and has
BROKEN HEARTS NOW MENDED
generate and defective. The morphine
element is an incidental to their funda-
other 'diseases from which they may
suffer. ....
"These are the types who have fallen
Into the hands' of charity hospital
alienists and the workhouse and peni-
endured indescribable agony because of mental condition as are many of the
a non-supply.
"I do not mean by this that morphine
will not produce pleasant sensations or
that it is never used to the end of ex
periencing these sensations. . There is a
class of the inherently, or otherwise
degenerate -who indulge in morphine
from a morbid . desire for sensuous
pleasure just as they . would and do
indulge in any other f orm . of perver
sion. The individuals of this class are
ROKEN hearts are being mended in
Russia now.
Not the hearts shattered by unfor-
influence of ether very soon after the
injury, part of the chest wall was re
moved, the heart lifted fron its bed.
tunate romances, , but 'the valvular or- and the utitches quickly Introduced In
gans pierced by knives. Time mends tween pnlsations. The bony chest wall
the first kind, but only the skillful sur- over the heart was not put tack into
geon, Zeldler, can be depended on to
operate successfully on the knife-torn
tentiary physicians. ' The observations heart.
of these physicians made In the past
upon this class of addicts, have had an
unwarranted Influence in the status of brought to the hospital with hearts
Dr. Zeldler operates
at Obuchow. Thirty-one
morprinism. and the stigmatizing of the
morphinist.' ' Because tho degenerate
mentally incapable of self-restraint, in- class uses morphine to secure sensuous
gratification is no reason for stigmatiz
ing the mass of those afflicted with
place, that organ being left protected
only by skin and muscle. This was
done to give the heart room to expand
little hospital and to prevent adhesions from em
barrassing the heart a at tion.
Rapid convalescence has been the
rule with Dr. Zeldler'a patients and ell
persons
dtijging jaded appetite with new stim
uli! They yield themselves to any and
all torms of self-indulgence and grati
fication of appetite.
"f5re comes a time when for them
Save been very successful in the treat- "cures," but I was forbidden to quote ao-called d'scomfort we think of them morphine,', from Increasing tolerance - Question - him - about - his methods of - The- patients -were all put under tho
morphinism as persons of perverted ap
petite." -Here I interrupted Dr. Bishop to
pierced and slashed by knife wounds
have successfully had their organs re- are now going about their dally tasks
paired and have recovered entirely, to as usual.
all appearances, from their remarkable
experiences. One patient has lived
seven years and shows no sign of
having been affected by the heart
wound and subsequent sewing up.
Warninc Bearoia,
Exchange.
Sometimes a man sees so many hor
rible examples he decides he won't Join
'em.-