On the Trail of Fetal Alcohol Syndrome

  1800s   There is a 26 page article, "The Effects of  Drinking on Offspring:  An Historical Survey of American and British Literature" by Rebecca Warner and Henry L. Rosett (1975) in The Journal of Alcohol Studies which cites 19 articles written in this time period that warn against the use of alcohol when pregnant.  The complete articles are not presently included in this study but I have included the citations in the year they were written.

 1804.  An Essay, Medical, Philosophical and Chemical on Drunkeness and Its Effects on the Human Body. by Dr. Thomas Trotter.   London:  T.N. Longman and O. Rees, Paternoster-Row.  Trotter was one of the first physicians to describe alcoholism as a disease.  Dr. Trotter states. "...and when they marry, they get wenches:  they are generally fools and cowards;".  
     "...the habit of temulency (drunkeness) has been said to debilitate the offspring, and produce a puny race.  It is a known law in animal oeconomy, that all secreted fluids partake of the vices of the secerning organ.  A healthy action is required in every gland, that it might secrete healthy juices.  We have seen that the mental functions become deranged, when the brain is injured in its structure.  And if this happens, can it be too gross to suppose, that the organs of generation must equally suffer in both sexes, from frequent intoxication; and if offspring should unfortunately be derived from such a parentage, can we doubt that it must be diseased and puny in its corporeal parts; and beneath the standard of a rational being in its intellectual faculties?"   
    "Infants.  ...It is well known that nurses...are in the practice of giving spirits in the form of punch to young children to make them sleep.  The effect cannot fail to be hurtful:  such children are known to be dull, drowsy and stupid; bloated in the countenance, eyes inflamed, subject to sickness at stomach, costive constipated), and pot-bellied." 
    "...the food of women who suckle their own children is often very improperly selected.  The quanity of the milk, not the quality of it, is studied.  It is well-known fact, that this secretion partakes very much of the the nature of the diet that is used; that is to say, certain articles passthough the breast unassimilated:  vegetables give a more asccsent(?)  milk than animal food; but all drinks, containg ardent spirits, such as wine, punch, caudle (a warm drink of wine or ale mixed with sugar, eggs, bread and spices), ale and porter (a dark beer brewed with dark malts), must impregnate the milk; and thus, the digestive organs of the baby must be quickly injured.  These must suffer in proportion to the delicacy of their texture; and the disease which flow from this souce are cerainly not uncommon.  Physicians who have prescribed a diet and regimen for nursing mothers, have not sufficiently attended to the hurtful effects of wine and malt liquors.  Porter is generally permitted in large quantities  on these occasions; a beverage, if there is any truth in our remarks, highly improper and dangerous."

    1812.  Formation of the Massachusetts' Society for the Suppression of Intemperance.

        Rush, B.  An Inquiry into the Effects of Ardent Spiritis upon the Human Body and Mind:  with an Account of the Means of Preventing, and the Remedies for Curing Them.  Boston:  Manning and Loring.

    1819.  From an article by Friedrich-Wilhelm Keilhorn  in Addiction in reference to C. von Bruhl-Cramer book on alcoholism in which he writes, "A plain observation demonstartes that children of dipsomaniacs (alcoholics) always are feeble, meagre, suffering friom various diseases, really atrophic, often very stupid, sometimes, however, agile; scarecly have they grown out of their napkins, are they incredibly wicked and obstinate.  Furthernmore, we had observed something in their physiognomy which one can more easily perceived than describe, and of which one more often cannot observe a trace in their elder brothers and sisters.  Their growth is usually incomplete and inadequate with regard to their age.  If there are several brothers and sisiters, one sometimes is able to determine when their father or mother became dipsomaniac (alcoholic)." 

    1826.  Formation of the American Temperance Society

    1827.  Beecher, L.  Six Sermons on the Nature, Occasions, Signs, Evils and Remedy of Intemperance.  Boston:  Crocker and Brewster.
   
    1831.  Gooch, R.  (Skinner,G., ed) A Pratical Compedium of Midwifery. London:  Longman, Rees, Orme, Brown and Green.
 
    1837.  Ryan, M.  The Philosphy of Marriage in Its Social, Moral and Physical Relationships.  London:  John Churchill.

    1841-1842.  Beaumont, T.  "Remarks Made in Opposition to the Views of Dr. Clutterbuck."  Lancet. 

    1847.  Edwards, J.  The Temperance Manual.  New York:  American Tract Society.

    1848.  Forbes, J.  The Physiological Effects of Alcoholic Drinks.  Boston:  Massachuetts Temperance Society.
 
    Howe, Samuel G.,  Report Made to the Legislature of Massachuetts on Idiocy.  Boston:  Coolidge and Wiley.  Although couched in the language of the times, Howe does indicate the concern that alcohol consumption by parents, with particular mention of the mother, affects the minds and physical outcomes of the children.

   
    1857.  Morel, Benedict-Augustin.  Traite des Degenerescences Physiques, Intellectuelles et Morales de l'espece Humaine et des causes qui produisent ces varietes maladives.  Paris: Masson. 

Stevens, J.P.  "Some of the Effects of Alcohol upon the Physical Constitution of Man."  Sth. Medical Surgical Journal.  As of this date, I have been unable to locate a copy of this citation.

    1872.  Bessey, W.E.  "On the Use of Alcoholic Stimulants by Nursing Mothers."  Canadian Medical Record.  As of this time, I have been unable to locate a copy of this citation.

    1873.  Beginning of the Women's Crusade which later became the Women's Christian Temperance Union.

    1876.  Dr. John Haddon in "On Temperance in Women with Special Reference to Its Effects on the Reproductive System."  British Medical Journal, wrote, "On her family the effects of intemperance are strongly marked. Children born at the full time (of her intemperance) are generally weak and puny, and likely to fall at an early age victims to disease.  ...it is possible that a large proportion of our excessive infant mortality may be due to the malnutrition ofthe embryo, caused by the use of alcohol."  Dr. Haddon goes on to say, "...however much it may please the palate and raise our spirits, (wine) is hurtful in health andin disease, requires the utmost discrimination in its use."

    1876-1897.  Criminal Man by Cesare Lombroso, published in five editions from 1876 to 1897.  This book was one of the first to ever attempt to classify criminals by inherited physical features rather than condemning the criminal for purposeful acts against society.  Lombroso felt that criminals, in general, had certain physical characteristics that indicated that criminality is an inherent trait rather than assumed from the environment.   (From Born to Crime:  Cesare Lombroso and the Origins of Biological Criminology by Mary Gibson. 2002.)
    Some of the physical features were:  small heads, protruding cheekbones*, flat noses, large ears, deformed skulls, greater height and weight*, protruding jaws, lack of muscular strength, and little sensitivity to pain.  In particular, Lombroso was interested in the size of the head.  (*Note:  characteristics not normally found in people with full FAS.)
    Lombroso also refers to behavioral characteristics such as the lack of remorse, inability to control their passions, laziness and ineptness at crime because of the repetitiveness of their behavior.  (Note:  Repetitiveness might be interpreted as the inability to learn from one's mistake.)
    Lombroso also had a theory of degeneration which "explain physical and psychological malformations that had resulted from fetal disease rather than inherited weakness....Their development blocked in the womb, babies could thus be 'born' with predisposition to crime..."
Others from his school of thought also noted that these people had evidently been unable to transition from childhood to adulthood, had hands like apes (simian crease?) and noted that many were descended from alcoholics.  Lombroso also had a category which he called The Morally Insane.  The Morally Insane, he stated, were "people who looked normal but were unable to distinguish between good and evil behavior."  They were identical to other criminals because of "...their compulsion to harm others and their lack of remorse." These people also exhibited a lack of physical sensitivity.  [Note:  Lombroso's work fellinto disrepute as his observations were used to justify racial profiling and may have been included as a part of the propaganda that produced the German Aryan race "theory".  However, many people in the modern justice system and in social work still call some children "FLK" or "funny looking kid"; a remnant of the Lombroso studies on physical characteristics.]

    1877.  Fournier., E.H.  Annual Oration.  Transcript of  Medical Association Alabama.  As of this date, I have been unable to obtain a copy of this citation.

    1879.  Long, J.F.  "Use and Abuse of Alcohol."  Transcript of Medical Society of  North Carolina.  As of this date, I have been unable to locate a copy of this citation.

    1880.  Prohibition Party was started.
 
    1883.  McDaniel, W.H.  "The Effect of Alcohol Upon the Foetus Through the Blood of the Mother."  Maryland Medical Journal.  

    1890.  Dr. T. D. Crothers' article in the Journal of the American Medical Association, "Alcoholic Heredity in Diseases of Children".   Crothers notes of two children whose parents were alcoholics, "...both invalids, and had been under constant medical care from infancy, the general diagnosis being scrofula (a skin disease), and general anaemia; both were of pale and delicate appearance, extremely excitable and nervous.  They had continuous irritation of the stomach...were very passionated at the slightest opposition to their wishes, and after a period of rage would be greatly exhausted and have a distinct fever for a day or more." 
    Their family physician found that "...both had suffered from rubeola and scarlatina (scarlet fever), and were supposed to never have fully recovered. Bronchitis, enteritis, gastritis, neuritis, and various heart diseases were constantly threatening."  A new physician recognized the alcoholic heredity of these cases and ordered "...(their) diet restricted and enforced exercise...and frequent bathing."
    Crothers goes on to state, "No fact is more firmly established than that alcoholic ancestors will transmit to their children a defective brain and nerve power.  The form and shape of this defect and its manifestations will vary greatly.
    "In many cases, it might not be prominent until after the higher peripheral brain has reached a certain development, especially in the growth of the emotional and inhibitory centers.  In others thisdefect is seen in infancy, in anabnormal hyperaesthesia of the senses, and nutrient disturbances.  Some children manifest irritation at all sounds, and all changes of light and surroundings by continuous crying; the skin of the alimentary canal is also very sensitive, and various skin disorders and nutrient troubles follow.  Low powers of vitality and slow irregular growth are common.  This condition may continue for years, then gradually disappear, and only re-appear at puberty..."
    Crothers notes of some other children of alcoholics, "...noted...by their precocious development of brain and nerve force.  They exhibit powers of brain receptivity and instability that is called genius, which gives way early to some disease or form of nerve degeneration from various causes."  He goes to note, "...their extreme sensitiveness or obtuseness to sensory impressions, and low powers of vitality and recuperation..."
    Other symptoms that are noted are, "...extremes of activity, particularly where there is a tendency to the sudden liberation of nerve energies, as in violent passion (grief or joy) or work, play or study, which is followed by extreme prostration.  The child is said to be sullen, morose, or melancholy, then suddenly manifests the other extremes, indicating a great instability of brain cells and functional control.  (The child's) life seems to be threatened with fevers, prostrations, and inanitions (state of being empty), accompanied by mental irritations and wandering neuralgias...they always point to a degree of nerve and brain degeneration or retarded development, and defective co-ordination..."
    Crothers states, "From these facts it will be obvious that the diseases of children of alcoholic parentage are far more complex, and require greater care."  Interestingly, he recommends the following care:  "1.  No form of alcohols are safe...  2.  The diet should not include meats of any kind...the diet should always be non-stimulating and farinaceous (rich in starch), and should be carried out with military regularity.  3.  ...avoid brain and nerve stimulation...  4.  ...(guard) against every possible extreme, both in the surroundings and physical conditions." 

    1893.  "The Effect of Alcoholic Intoxication Upon the Human Brain and Its Relation to the Theories of Heredity and Evolution."  Quarterly Journal of Inebriety.  By A.H. Forel.   I have not be able to find a copy of this article  but in an anonymous editorial in a 1910 Journal ofthe American Medical Association, Volume 54.  617., the writer states. "...Forel in particular, having contended that alcoholism injures the germinative cells; he supported this view with statistics from asylums for the insane and epileptic, and gave to the alteration in the germinative cells the title of 'blastophtorie'."

    1895.  Anti-Saloon League was formed.

    1895.  Dr. Lloyd Andriezen at the Neurological Society of London as reported in Journal of the American Medical Association,  "Alcoholism and Its Relation to Heredity."  Dr. Andriezen states,   "...that the more frequent results of alcoholic parentage showing its expression in the offspring, viz; (1) imbecility and weak-mindedness; (2)  infantile convulsions and meningitis; (3)  a large proportion of still births; and (4) brutal degradation and incapacity in the children, with tics and impulses, including hereditary drink-craving.   ...The inebriate as a result of his habits transmitted to the offspringa damaged or diseased germ (ovum and spermatozoon), and even the most healthy married couple could from temporary intoxication do the same and beget a child which might exhibit one or another of the abnormalities above mentioned."

    1898.  Ballantyne, J.W.  "The Pathology of Ante-Natal Life."  Glasgow  Medical Journal. 

    1899.  From the notes of a discussion in the Journal of the American Medical Association,  "Alcoholism and Its Relation to Heredity."  Dr. Seymour Turke "...insisted on the fact that inebriety in the parents resulted in damage to all the tissues of the body--some more than others--and must affect the ovum or the foetus according to the period when the drinking began."
      Dr. Fletcher Beach "...emphasized the fact that imbecility and even idiocy resulted in the children from parental intemperance...The effect ofalcohol reaching theovum and germ elements by the circulation could not for a moment be doubted..." 
    The (unnamed) President of the section "...summed up the discussion, referring to the special fact of some form of nervous or mental instability being transmitted to the children of alcoholic subjects and stated that the evidence of facts in this direction in the field of mental disease was overwhelming."

    "A Note on the Influence of Maternal Inebriety on the Offspring."  Journal of Mental Science. (1899) by W.C. Sullivan and Stewart Scholar.  Both Sullivan and Scholar were medical officers in British prisons.  This study was conducted in the women's prison in Liverpool.
    The main point of this study was to determine the number of fetal and early childhood deaths of children born to women who drink.  As can be expected, the death rate climbs in a direct relation to the birth order of the child.  First born children seem to be less affected, but as the birth order increases, so does the probability of death or epilepsy (an older term  for convulsions which may or may not be caused by epilepsy).
     The website of Davidson College, N.C.  <http://www.bio.davidson.edu/kabemd/ seminar/studfold/ Fall/Embryo/ethanol/ EthanolontheBrain.html> has this quote from Sullivan and Scholar,  "Maternal inebriety is a condition peculiarly unfavourable to the vitality and to the normal development of offspring.  Its gravity in this respect is considerably greater than that of paternal alcoholism.  There is a tendency to still births and abortions, and a high rate of epilepsy in the surviving children. This influence of alcohol is in part due to a direct toxic action on the embryo."
    The University of Duisburg Essen's German site, <http://www.uni-essen.de/~ibp010/ alkemb/FASinfo/depubrig. htm> quotes Sullivan and Scholar as having written, "...that pregnancies of these women resulted in stillbirths and infant death, 2 1/2 times more often than those of their sober female relatives."  Also, "...that infants born to alcoholic mothers had a starved, shriveled and imperfect look."

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