The patient's point of view in regard to future drinking is a second essential for successful treatment. He must have as his goal, no matter how fantastic the idea may seem in the beginning, the complete renunciation of the use of alcohol as a beverage in any quantity however small for all time.

No man who has ever passed from normal or hard drinking to chronic alcoholism, or who has shown persistently a disposition to act in an antisocial manner when under the influence of intoxicating beverages, can ever expect to be shown how to drink in a controlled manner, or to learn how by himself even after long periods of abstention.

The very concept of eventual drinking, however remote, seems to be fatal to satisfactory results. The going-on-the-wagon point of view and the giving-it-up-forever point of view have little or no relationship.

The first is only a stop-gap. Sober conduct, to be sure, may temporarily result from it, but the alcoholic conflict continues in the mind and sooner or later results in action.

Dr. Elwood Worcester, a pioneer in the psychological treatment of inebriates, tried in the early days of his work to teach drunkards to drink "like gentlemen."

He told me that in spite of his best efforts was 100 per cent unsuccessful. Because of Dr. Worcester's skill and experience this would seem to be convincing testimony of the futility of trying to teach the art of drinking to one who has ever reached the point where it has become a pathological problem.

Mr. Courtenay Baylor, after seventeen years' successful work with alcoholics, is most emphatically of the same opinion.

Why it is that certain persons have a morbid reaction to alcohol after a period of fairly normal indulgence has been indicated in the first part of this book. Whether some day the microscope will disclose psychological deteriorations now unknown is a matter of mere conjecture.

Nevertheless, lack of specific knowledge on this interesting point, however helpful it might be, does not seem to stand in the way of successful treatment.

Once the mental conflicts, at least those within reach of the conscious mind, have been broken up, the outlook is forward rather than back.

Suffice it to say, once a drunkard always a drunkard, or a teetotaler! A fairly exhaustive inquiry has elicited no exceptions to this rule.

Of course a man who has had long periods of abstinence may on a few occasions be able to manage things pretty well when he resumes drinking, but sooner or later, depending somewhat on outside conditions, but still more on the stage of psychological deterioration that he has reached, he will crash harder thin ever.

One of the reasons that may make it difficult for an inebriate to reform permanently is an idealization of the past, which he futilely believes he can revive, a belief often unexpressed with which he fools himself over and over again. "This time it is going to be different," you may hear him say, but if you know him well you will smile.

There are plans made to drink slowly, to take small drinks, to stick to beer (the most futile of all), to prime first with olive oil, and not to drink before or after certain hours; all in the long run are of no avail.

Then there are the occasions; at first only the big ones will cause the vows to be broken, but before long the little ones are getting their full share of alcoholic attention, and eventually they are deliberately invented.

Just as the glow of the first cocktail cannot be repeated on any given party no matter how many may be imbibed, so the carefree days when the nerves were strong are gone forever for the man who has abused his nervous system through long periods of excessive indulgence.

He has exhausted all but the most fleeting pleasures that can be derived from drinking, and he must understand that he can never recall them.