As an outgrowth of the poison laws, of laws dealing with the regulation of the practice of pharmacy, or otherwise, most of the states have been operating for a longer or shorter period under some law seeking to control and bring within certain prescribed channels the sale and distribution of a group of drugs commonly known as narcotics. Etymologically such a classification includes any drugs producing sleep and in some states the list of proscribed drugs includes not only the true opiates but many of the milder soporifics.
The state anti-narcotic laws as distinct from the poison laws were the result of accumulating knowledge of the misuse chiefly of opium and cocain.
As we have seen in previous chapters the development of the problem under consideration was gradual, largely the outgrowth of professional treatment and self-medication as well as of dissipation or actual criminal intent. The awakening of the public—lay, professional, and legislative—was likewise gradual and here and there both municipalities and states sought to prevent or control the condition by legislative enactment.
The custom of smoking opium, which first reached this country through the importation of coolie labor, first caused alarm and resulted in the many laws directed at this practice and at the maintaining of opium "dens." That this was but a portion of the problem, however, became apparent and other uses of opium and of coca and certain other drugs were included in these local laws.
The first anti-opium law passed in this country as far as we have been able to determine was, according to Kane, a city ordinance enacted in San Francisco in 1875 as a result of the conditions arising out of the smoking of opium, which practice was rapidly increasing among the whites. This ordinance dealt exclusively with smoking opium, its possession, the possession of opium pipes and the conducting of smoking houses or "dens."

The next anti-narcotic law, according to Kane, was passed in Virginia City, Nevada, about. 1876. As this ordinance failed to effect control of the situation, the State Legislature of Nevada passed a stringent law a year or two later.
In 1882 the New York Assembly passed a bill introduced by Senator Koch, which prohibited the maintaining of places where opium was smoked under a penalty of three months' imprisonment or a fine of $500.00 or both. This act also included within its prohibition persons visiting such places for the purpose of smoking opium.
As so frequently happens in social reform, it required this more spectacular method of opium use, the character of the places in which it was smoked, chiefly in Chinatown, and the attendant social evils, to awaken public and official interest. As a matter of fact at the time of the passage of these laws, opium smoking among the whites had not reached large proportions. In 1880 Kane estimates that the number of whites involved was 6,000 and the number of Chinese was 20,000. The total number, therefore, was insignificant as compared with the number of individuals using opium in other forms, especially morphin hypodermically, as will be seen by referring to the survey conducted by O. Marshall in Michigan in 1878, page 11.
As during the past twenty-five or thirty years, first one state and then another passed anti-narcotic laws, especially as these laws became more rigid, sporadic illicit traffic in the drugs began to develop and the efforts of one state to eliminate the problem were nullified, it was claimed, by smuggling from nearby states where anti-narcotic laws as yet had not been enacted. Thus a demand arose for federal legislation that might control the interstate traffic in these drugs and bring about greater uniformity in the methods of their handling. Partly as a result of this demand and partly to fulfill our treaty obligations the Harrison Narcotic Act was passed in 1914.
We shall not discuss the older laws of the individual states. That in general they failed of their purpose is manifest from the present status of the problem. The present laws—digested in what f ollowsrepresent the most recent legislative control measures.' How far they have succeeded toward the solution of the problem is more a matter of conjecture than accurate opinion as the painstaking studies needed to determine this have never been made and—as we have pointed out in the previous chapter—are becoming more difficult of accomplishment.

I. DRUGS INCLUDED
In Table I 2 will be found listed the drugs included by the various states as described in most recent anti-narcotic laws.
It will be seen on consulting this table that, while a considerable variety of drugs is dealt with, two of the number stand out as those most commonly considered dangerous to the public health or welfare, namely, coca and opium. A critical study of the wording of a number of the state laws reveals a considerable amount of laxity in their construction and phraseology, and while the intent is usually clear, the wording of important paragraphs is such as to permit, apparently, of considerable evasion. Thus, in some instances, certain alkaloids or salts of erythroxylon coca are specified while others are omitted, as is also the crude drug itself. In some instances, as will be seen by a study of the table, even the better known of the synthetic preparations of cocain are mentioned in detail while the word "coca" appears nowhere in the law. The same may be said of the phraseology dealing with opium. With a few exceptions, there is no apparent attempt at uniformity, a circumstance which is daily becoming more apparent and which, in many instances, handicaps the administration of these laws and limits their usefulness as desirable supplements to the federal laws dealing with these matters.
Erythroxylon coca or one or more of its preparations is included in the anti-narcotic laws of every state. In this particular, it occupies a unique place among the drugs under discussion. On the contrary, opium and its derivatives are omitted from the anti-narcotic law of South Carolina.
The next most commonly included drug is chloral, which finds a place in the laws of sixteen states.
More recently, another group of drugs has found its way into the anti-narcotic laws of a number of the states. This group is included under the genus of cannabis sativa which includes the two species cannabis indica and cannabis americana. Their therapeutic properties and physiologic action differ only in degree, the Indian variety being more active than the domestic. One or another of these drugs is named in the laws of the following states—Arkansas, California, Idaho, Indiana, Iowa, Maine, Massachusetts, Nevada, New Mexico, New York, Oregon, Texas, Utah, Vermont, and Washington. These drugs are spoken of in the laws of several of the states as "loco weed," on account of the inebriation which they give rise to in both human beings and cattle. This drug is also known under the Spanish name of Man'ahuana.
Another drug possessing similar physiologic properties in so far as it causes inebriation, is anhalonium lewinii, "mescal button," "peyote," agara americana or lophophora williamsii, a species of cactus, the dried tubercles of which are consumed for the effects produced. It is included in the anti-narcotic laws of California, Colorado, Kansas, Nevada, North Dakota, and Utah.
In addition to the foregoing drugs which are usually termed "narcotic" or "habit-forming," the law of Arkansas, in addition to naming the drugs included, also includes "other potent narcotic drugs."
Although therapeutically and physiologically far removed from the narcotics, two states, Iowa and New Mexico, have employed the anti-narcotic law as a means to control the use of certain of the emmenagogues, as cotton root, ergot, oil of tansy, oil of savin and oil of pennyroyal.
New Jersey includes also stovain, alypin, tropocain and dionin.
North Dakota includes the phrase "any habit-forming drug, whatever its nature or character, or any substance or residue left after the smoking of opium."
Ohio also includes alypin, and Washington includes dionin.

II. EXCEPTIONS
In their exceptions of certain drugs, the state laws vary quite as widely as in the drugs included, and few, if any, are more strict in their provisions than is the federal law. The most common types of exception are those of a minimal dose of the proscribed drugs and of certain so-called household remedies, whether or not proprietary in nature.
Sixteen states specifically except decocainized coca leaves.
Exceptions in the case of cocain, its derivatives and synthetic substitutes, are less common and less liberal than is the case with opium preparations. Thus only three states except cocain in any quantity whatsoever from the provisions of the law. Of these three states, Texas excepts 1/16 gr., Oregon 1/6 gr., and District of Columbia 1/4 gr. to each ounce. Other states, while not excepting any amounts of cocain, do make exceptions in favor of eucain. Thus, five states except eucain, as follows: three Y8 gr., and two 1/6 gr. to each ounce. As regards the external use of cocain in liniments, ointments, etc., twenty-three states permit its use unrestricted under such circumstances, while twenty-six do not except its use even in preparations not designed for internal use. Further, one state specifically excepts 1/6 gr. to the ounce of novocain.
In the case of opium, three states make no exceptions, while forty-six except opium in certain doses as follows: one state excepts preparations containing not more than 0.4 gr., forty-two not over 2 gr., one 4 gr., one 10 gr., while one state uses the phrase "lawful quantity" and defines this as meaning that the amount of the drug excepted shall be "left to the discretion of a reputable, qualified, registered physician."
Morphin has no exceptions in the laws of four states. The remaining forty-five make the following exceptions: two states except 1/8 gr., thirty-eight except Yi gr., one 1/3 gr., one 2/5 gr., one 1/2 gr., and one excepts 1 gr., to the ounce, while again one state leaves this open to the judgment of the physician with the phrase "lawful quantity."
Heroin is not excepted in any quantity by seven states, while the balance make exceptions as follows: thirty-two 1/8 gr., one 1/6 gr., seven 1/4 gr., one 2/3 gr. to the ounce, while the remaining state again employs the phrase "lawful quantity."
Codein is not excepted by ten states. The others make exception for this drug as follows: two except 1/4 gr., two 1, gr., thirty-three 1 gr., one 2 gr., to the ounce, and one in "lawful quantity."
In addition to the foregoing exceptions, seven states make exceptions of cholera and diarrhoea mixtures when sold and used in good faith as such, eight except Dover's powder, while one state, California, requires that paregoric be sold only on prescription, and the remainder include it under the exempt preparations.
Other exceptions of preparations containing opium or its derivatives are made in the case of liniments and ointments in twenty-seven states, and in the case of preparations designed for external use only in thirty-four states, one of which further qualifies the exceptions by stating that such preparations "must contain other active drugs in sufficient proportions to confer upon them other and additional medicinal properties than those possessed by the unmixed drugs." It should be noted, however, that twenty-five states do not except. the use of cocain in liniments and ointments.
Chloral is not, excepted in any quantity whatsoever in thirty-eight states, while in eleven states it is excepted as follows: two except 2 gr., six 10 gr., one 20 gr., one 120 gr., and one 240 gr. to the ounce.
Of the ten states which proscribe the use of cannabis sativa, eight states permit its use in the following quantities: four in 1/2 gr., one in 1 gr. and three in 4 gr. to the ounce; one of these excepts its employment in corn cures in any quantity. The ninth state excepts the use of this drug for medicinal purposes only, and the tenth excepts it in any quantity when used for medicinal purposes.
In addition to the foregoing exceptions, the following should be noted:
Kentucky excepts antispasmodics of the National Formulary official at the time of sale.
Maine excepts preparations containing opium sold in good faith as remedies for neuralgia.
Maryland excepts laudanum and bona fide proprietaries containing codein.
Pennsylvania provides that no preparation containing any opium or coca leaves or any compounds or derivatives thereof in any quantity whatsoever may be sold, dispensed, distributed or given away to or for the use of any known habitual user of drugs or any child of 12 years of age or under except upon prescription.
'Tennessee excepts Godfrey's Cordial, Bateman's Drops and Castoria.
Vermont excepts compound medicinal tablets, pills and powders containing not over 1/20 of a grain of morphin, or 1/4 of a grain of codein or any of their salts except heroin to each pill, powder or tablet.
.Wyoming excepts preparations recognized by the U.S.P. or N.F. or pharmaceutical preparations to be used in the filling of prescriptions written by a regular practicing physician.

III. SALE TO CONSUMER
In the ultimate distribution of the proscribed narcotic drugs, every state attempts to limit the channels through which these drugs shall reach the consumer by confining their retail distribution to the dispensing, administering or prescribing by one of three professional groups—physicians, dentists or practitioners of veterinary medicine. In some states only one or two of these three groups are included among those authorized to order retail sales. Twenty-five states specifically provide that physicians, etc., may dispense or administer, while twenty-four do not include such a provision. Most of the states specifically provide that prescribing and dispensing may be carried on in the course of professional practice only and some further limit the dispensing to personal attendance of the physician, etc. Thus, while forty-four states require that prescriptions be required from one or another of the three groups mentioned, five states limit the distribution of these drugs to the consumer through the prescription of physicians alone. Among those permitting physicians, dentists and veterinarians to authorize the dispensing of these drugs, there are certain slight variations in the qualifications required. Thirty-two states require simply that the individuals in question be licensed; two require that in addition to being licensed, the physician must also be registered under the Harrison Narcotic Act; four states specify that the licensing may be in the state in which the individual resides; four states further restrict those qualified to dispense narcotics by specifically requiring that they be registered under the Harrison Narcotic Act and two that the individual be of good habits, not intemperate or a user of drugs.
Eighteen states further restrict the sale to consumer by providing that the proscribed drugs may not be distributed to addicts except under certain conditions. In the majority of cases this restriction does not apply if the drug is prescribed, etc., for treatment.

IV. SALE TO DEALER
The state anti-narcotic laws for the most part have not made any attempt to regulate the wholesale distribution of narcotic drugs as has the federal law. Thus, thirty-one states specifically exempt sales by wholesalers from all provisions of their laws. Of the remainder three states require that wholesale orders be written on official order forms similar to those required by the federal law; six states require an order from an authorized person and that such order shall be kept on file for two years; three require that such sales be made only when official order forms, of local design, are used; two require both an order from an authorized person and an entry of the sale in a book kept for the purpose; one requires that the wholesale disposition of these drugs be carried on under restrictions similar to the federal law. The three remaining states omit all mention of wholesale transactions.

V-VI. RECORD TO BE KEPT BY PHARMACISTS AND PHYSICIANS
As a further means of checking illegal sales, the anti-narcotic laws have sought to provide for. the keeping of a record of sales by retail druggists. Nine states require that prescriptions or orders from physicians, dentists or veterinarians be kept permanently on file for inspection by authorized agents. Three states require that such prescriptions be kept on file for five years; two for three years; twenty-one for two years; one for one year and four require simply that they be kept on file, without specifying a period. Nine states make no requirements relating to the keeping of records by pharmacists.
As a further check upon the distribution of the proscribed drugs, certain anti-narcotic laws have included in their provisions that physicians, dentists or practitioners of veterinary medicine who are permitted to prescribe narcotics shall keep a record of their prescriptions. As in the case of the pharmacists, the period during which these records shall be kept and the method and form of recording vary. Five states require that records of prescriptions be kept on file without specifying the period for their preservation; three require that they be kept on file for two years and one that they be kept on file five years; six require that such records be kept except of drugs dispensed when the physician is in personal attendance on patient; one requires that the records be kept on forms supplied by the State Board of Health for two years; and two that they be kept in the same manner as required by the federal anti-narcotic law. In addition to specifying that a record must be kept on file, one state provides that in the case of addicts these records need be kept only two years; one state provides that record of exempts be kept on file only two years and one state specifies that record of dispensing only need be kept. Twenty-eight states require no form of record keeping whatsoever.

VII. POSSESSION
The possession of narcotic drugs by unauthorized persons is obviously a matter of importance from the administrative point of view and is made unlawful in thirty-four states, fifteen omitting reference to the subject.

VIII. SMOKING OPIUM
Among the older state laws drafted at a period when the smoking of opium and the existence of opium dens were more of a problem than to-day, special provisions against the use, sale or other distribution of smoking opium were introduced, and we find that in thirteen states the possession or use of smoking opium or the conducting of opium dens or places where opium is held or used for smoking is prohibited; thir:y-six states omit specific mention of smoking opium.

IX. RESTRICTIONS SURROUNDING PHYSICIANS
Aside from the keeping of records, further restrictions have been thrown around the prescribing, dispensing and administration of these drugs by physicians and others licensed to handle them. These restrictions vary considerably in different states, but occur in one form or another in the laws of thirty-six states while thirteen states make no attempt to regulate physicians in their practice.
The most commonly employed provision is that of prohibiting the prescribing of these drugs for habitual users except Tor the purpose of treatment "in good faith." This provision occurs in the laws of seventeen states. In addition, two states require that a record of cases be kept, one state permits the administration to users only in order to save life, and one only when decreasing doses are employed.
The restrictive provisions found in the laws of other states differ too widely to be grouped and therefore require individual handling.
Arizona limits the period during which a physician may prescribe for an individual suffering from drug addiction to three weeks, after which a consultation must be held with a medical representative of the Board of Health.
California provides that a physician or other person licensed to handle narcotic drugs may not administer these drugs to himself as an habitual user nor to habitual users except for their treatment, limiting the amount of the prescribed drugs to certain daily quantities—opium 8 gr., morphin 4 gr., cocain 2 gr., heroin 2 gr., and further providing, after 15 days' treatment, for a 50% reduction of these doses and after 30 days requiring the entire discontinuance of the drugs. The law further requires that cases of this nature be reported to the board of pharmacy when their treatment is undertaken, and that their progress be further reported in 15 days and at the end of 30 days.
Colorado permits physicians to prescribe, dispense or give away these drugs to habitual users "in the course of their professional practice" and that records of such drugs sold, prescribed or dispensed shall be kept for a period of two years. Further, physicians who are shown to be addicted to the use of these drugs "in a manner contrary to the public welfare" may have their licenses revoked.
Delaware requires that the prescribing of these drugs be in good faith and in the course of the physician's professional practice for medicinal purposes only. It also requires that physicians keep a record of all drugs so dispensed, distributed or given away for a period of two years.
Florida provides that physicians may prescribe, dispense or administer for the treatment or cure of disease in the course of their professional practice, but not to persons addicted to their use, except that for the treatment of "habit or addiction" they may prescribe or administer these drugs in reducing doses to an habitual user, while personally controlling and supervising such user. In the event that such user shall prove "refractory" or "difficult of treatment," the physician is required to report him to the state board of health, the local board of health or the county judge. The law also requires that such report shall be made in case the patient "does not pursue his treatment in good faith until final cure." Should the case prove to be incurable and so declared after investigation by the county judge and an agent of the state board of health, opium or its preparations may be prescribed.
Idaho provides that physicians may furnish or administer these drugs to a patient under his immediate care or treatment.
Indiana prohibits physicians from writing prescriptions for any habitual user of these drugs but they may "legitimately administer said drugs."
Massachusetts and Rhode Island in their anti-narcotic laws provide certain restrictions surrounding the practice of medicine which are not found in the laws of any other states in that they require that physicians shall only prescribe, dispense, administer or give any narcotic drug to any person when the drug is obviously needed for the treatment and cure of a disease or ailment and not needed for any condition or disease directly due to any drug habit or resulting solely from the failure of an habitual user of narcotic drugs to procure the particular narcotic drug to the use of which he is addicted. These two laws provide, however, that a physician may "personally administer" any narcotic drug at such time and under such circumstances as he in good faith and in the legitimate practice of medicine believes to be necessary for the alleviation of pain and suffering or for the treatment or alleviation of disease.
A further unique provision of these laws is that physicians, dentists or others licensed to handle narcotic drugs shall not solicit by public advertisement or otherwise applications for prescriptions for, or sale of, narcotic drugs nor shall they advertise any treatment the principal element of which consists in the administering, dispensing, fur nishing, giving away or delivering of a narcotic drug.
Montana, in a law passed in 1921, has introduced certain provisions hitherto not included in laws of .this nature. While permitting physicians to dispense, administer or distribute these drugs in good faith in the course of their professional practice, the law requires that a physician who prescribes, dispenses or administers these drugs to a person known or believed by him to be an habitual user or a drug addict shall report within 48 hours to the county attorney in the county in which he prescribed, the "name, address, physical and mental condition and any necessary substantial information regarding such cases."
The law further requires that if a physician shall prescribe, administer or give to a patient any of these drugs daily for more than 30 days, such physician shall register with the county attorney the name of such person together with a statement of his physical and mental condition and a prognosis as to the probable future necessity of prescribing, administering or giving of such drugs to such patient, and such prognosis shall include an estimate as to the length of time which, according to the judgment of the physician, will be required to remove the necessity of administering the drugs in question to such patient. It shall then become the duty of the county attorney, upon receipt of such notice, to file immediately complaint against such habitual user in the district court of his county.
The Montana law also requires that physicians shown to be addicted to these drugs "in a manner contrary to the public welfare," after a fair hearing, may have their licenses revoked and that these later may be re-issued.
In spite of the specific course above outlined to be followed by physicians in the treatment of drug addicts, the law states in another section that the prescribing for, dispensing, administering or giving away of such drugs to an addict for self-administration by such patient shall not be deemed to constitute in itself legitimate medical treatment. This is apparently a contradiction of the privileges of the physicians in relation to the handling of these cases as set forth in the preceding paragraph which permits, under certain conditions, the prescribing, dispensing or -administering of these drugs to an addict for a period of thirty days.
Nebraska provides that physicians may administer these drugs only in the course of their professional practice when necessary for medical purposes, except it shall be unlawful for physicians to prescribe or administer them to addicted persons, except a "reputable and duly licensed practicing physician" may "personally administer" to an addicted person when it in good faith has been determined by two reputable and duly licensed physicians, in consultation, to be absolutely necessary in the medical treatment of said cases, in which case the physician administering said drugs or any of them, shall make and keep a record in writing of the name and address of the person to whom said drugs were administered, date administered, form _and quantity administered, name and address of consulting physician, date and place of consultation, which record shall be preserved for a period of at least two years.
New Jersey provides that physicians may administer, dispense or prescribe these drugs only for a legitimate and necessary purpose in the practice of their profession.
Ohio provides that physicians may administer, dispense or prescribe these drugs only for a legitimate and necessary purpose in the practice of their profession.
Pennsylvania prohibits physicians from prescribing, dispensing or administering these drugs to an habitual user except for the cure or treatment of some malady other than the drug habit, provided, that a physician may in good faith prescribe or dispense opium in any form for the cure of the habit of taking such drugs and not for the purpose of satisfying a craving for the drug. In such cases physicians shall make a physical examination of the patient and report to the state board of health the name and address of the patient and the amount of drug prescribed in the first treatment. When the patient leaves his care, the physician shall report to the state board of health the result of his treatment.
South Dakota prohibits a physician from prescribing, furnishing, selling, administering or giving away any of these drugs except when, in the opinion of such physician, the taking of such drug by the person for whom prescribed will be beneficial to such person.
Washington provides that licensed physicians treating any addict, upon beginning said treatment, immediately shall report the same to the health officer, and such report shall give the name of the person receiving such treatment and such other information as shall be deemed necessary by the State Board of Health.

X. PROVISION FOR ADDICTS
The state anti-narcotic laws, in some instances, include provisions for indigent or criminal addicts, but for the most part provisions for the treatment of these cases are contained in other laws than those dealing with narcotics.
In seven states, according to the anti-narcotic laws, these cases may be committed to city, county or state hospitals. One state provides that such cases may be committed to a city, county or state hospital or a licensed private hospital. Another state designates simply "a" hospital, while two others provide also for voluntary commitment. Four states provide for commitment to an "insane hospital," two states provide that these cases may be treated by physicians under restriction, while one state simply designates that the state board of health is empowered to make regulations as to the treatment of addicts. Therefore, thirty-one states make no provisions whatever in their anti-narcotic laws for these cases.

XI. REGISTRATION OF ADDICTS
None of the states requires at the present time that narcotic addicts be registered as such directly, though such a requirement was incorporated in a former law of New York state. Three states, however, Arizona, Montana and Pennsylvania, require that physicians treating such cases report them to the state board of health.

XII. DEFINITION OF ADDICTS
Although the laws of the various states frequently employ the term "addict," "habitual user," "habit," "habitué," etc., none of these terms is defined except in the laws of two states. Montana describes as a narcotic addict "any person who has needed or demanded the prescribing for, dispensing or administering or in any manner the giving of opium or coca leaves or any of their derivatives, salts, preparations or compounds at more or less regular intervals for thirty consecutive days prior to the day such person applies to a physician or to a physician of any institution for the prescribing for, dispensing, administering or the giving in any way of any such drug or their derivatives." Washington defines an addict as follows: "A narcotic addict is one who habitually uses a narcotic drug."

XIII. PROVISIONS FOR ENFORCEMENT
There is a considerable amount of diversity as to the powers selected in the different states to enforce anti-narcotic laws. In eleven states, the law does not particularize on this point, leaving the matter in the hands of the duly constituted general law enforcement officials. In eleven states, the boards of pharmacy have charge of prosecutions brought under the drug laws: in eleven, the matter is left in the hands of the state boards of health ; in two, the bureau of foods, and drugs or the food commissioner is charged with the enforcement; in two, the laws designate the county attorneys as enforcement officers; in one it is left to the department of registration and education; in one, to the justice of the peace; in one, to the secretary of agriculture; in one, the superintendent of police is the enforcing officer; one, the board of pharmacy and attorney; one, the state board of health and food commissioner; one, the peace officer and county attorney ; one, the board of pharmacy and state board of health; one, the state board of health and internal revenue agents; one, the "board of pharmacy and district attorney and officials in charge of drug and food work in state"; one, the department of foods, fertilizers and dairies, and one, the board of pharmacy, police and sheriffs.

XIV. PENALTIES FOR VIOLATION
The most common penalty is misdemeanor carrying with it a fine varying from not less than $25 to not more than $2000, and/or not more than ten years. In ten states, the penalty is felony with an accordingly higher fine or longer term of imprisonment.

XV. MISCELLANEOUS PROVISIONS
In addition to the restrictions relating to the drugs themselves, six states include in their anti-narcotic laws restrictions surrounding the purchase or possession of hypodermic syringes and needles.
In Alabama, the possession of a federal license without the fulfilling of the state qualifications is a violation of the state law in the case of dealers.
The California state law provides that the state board of health shall furnish upon request in writing from the state board of pharmacy, a list of incurable diseases or ailments which in its judgment, might require excessive amounts of narcotic drugs to be prescribed for or furnished by a physician for relief or benefit. In a communication under date of August 27, 1927, the secretary of the California State Board of Pharmacy states that the State Board of Health has been unable to come to an agreement on such a list and has therefore not supplied one.
The California law requires that prescriptions containing more than ten grains of chloral hydrate or four grains of Indian hemp or loco weed to the fluid ounce may not be refilled except upon the written order of the prescriber, and no copy of such prescription shall be given.
The possession of pipes or attachments or contrivances for smoking opium or extracts or tinctures of hemp or other narcotic preparations of hemp or "loco weed" is made a misdemeanor by the California law.
In 1917, Colorado passed a separate act, making it a crime to sell, give way or dispose of anhalonium or peyote.
In Connecticut and Delaware, physicians, veterinarians and dentists shown to be addicted so as to render them incapable of performing their duties may have their licenses revoked.
In 1920, a law was passed in Kansas, prohibiting the sale, furnishing or giving away or possession of peyote.
In 1921, Minnesota passed a law relating to habitual offenders, making the penalty imprisonment, not to exceed three years.
The Montana law undertakes to interpret the words "good faith" as used in the law to mean that when a physician prescribes, dispenses, etc., these drugs, it shall be for the actual relief or treatment of disease or surgical operation, but if such prescribing or dispensing is not being done for relief in the treatment of disease or surgical operation and if such drugs are being used for the purpose of providing the drug addict with the aforesaid drugs sufficient to keep him comfortable it shall be considered as a perversion of the meaning of the words "good faith."
In 1923, the board of pharmacy of North Carolina notified all general merchants and general retail dealers that they might not sell exempt preparations, such as paregoric, Godfrey's Cordial, Bateman's Drops, etc., after the expiration of their current federal licenses—June 30, 1924.
In 1923, Texas passed a law making it a felony to carry a pistol or other weapon or arm while. possessing for unlawful sale, furnishing or giving away, any of the proscribed drugs, and making a special penalty of imprisonment for not less than one year or more than three years.
The Washington law provides that state, county and municipal health officers, or their authorized deputies, who are licensed physicians, within their respective jurisdictions, are directed and empowered, when in their judgment it is necessary to protect the public safety, health and morals, to make examinations of persons reasonably suspected of being habitual users of any narcotic drug, and to require persons whom they have reasons to suspect to be habitual users of any narcotic drug to report for treatment to an approved physician, and continue treatment at his own expense until cured, or to submit to treatment provided at public expenses, until cured, and also to isolate or quarantine habitual users of such narcotic drugs or their derivatives. Such officer, deputy or physician shall make a written finding that such person is an habitual user of a narcotic drug, which finding shall be filed in his office; provided, that such habitual users shall not be isolated or quarantined until the state board of health, by general regulation, first shall determine that the quarantine or isolation of all habitual users is necessary: provided, further, that any person suspected as herein set forth may have present at the time of his examination, a physician of his or her own choosing: and provided further, that the suspected person shall be informed by the health officer of his or her rights under this act.
Any person convicted under the provision of section 4 of this act or any person who shall be confined or imprisoned in any state, county or city prison in the state and who reasonably may be suspected by the health officer of being a narcotic addict shall be examined for and if found to be an habitual user of said drugs, or any of them, shall be treated therefor at public expense by the health officers or their deputies who are licensed physicians. The prison authorities of any state, county, or city prison are directed to make available to the health authorities, such portion of any state, county or city prison as may be necessary for a clinic or hospital wherein all persons who may be confined or imprisoned in any such prison, and who are habitual users of said drugs or their derivatives, may be isolated and treated at public expense until cured, or, in lieu of such -isolation any such person, in the discretion of the board of health, may be required to report for treatment to a licensed physician, or submit to treatment provided at public expense, as provided in section 6 of this act. Nothing herein contained shall be construed ,to interfere with the service of any sentence imposed by a court as a punishment for the commission of crime.
Any person committed to quarantine under the provisions of section 6 or 7 of this act, feeling aggrieved at the finding of the health officer that he or she is an habitual user of such drugs, or at the finding that he or she be committed to quarantine, shall have the right of appeal from such finding to the superior court of the State of Washington for the county in which said person is quarantined.
Any person held in quarantine deeming himself cured may make application for discharge to the health officer ordering commitment, or his successor, upon which application findings in writing shall be made within five days therefrom. In the event that the application is denied, the applicant may appeal to the superior court in the manner herein provided from the findings of the quarantine officer in charge that he or she is not cured of such habit: provided, however, that said appeal shall not lie until after said person shall have been in quarantine for a period of at least six months.
Wisconsin provides that no person shall take or use narcotic drugs habitually, excessively or except in pursuance of a prescription for such permitted use as is prescribed in subsections 5 and 6 of this section. The possession of narcotic drugs by persons not authorized by law to have such possessions, or their possession of a hypodermic syringe and hypodermic needle used in the administration of drugs shall be prima facie evidence of the unlawful use of such drugs. Any person violating the provisions of this section shall be guilty of a misdemeanor and upon conviction shall be punished by a fine of not more than one hundred dollars, or by commitment to an institution for the treatment of drug addicts, for a period not less than six months, or until such person shall be cured of his addiction to the use of narcotic drugs, but not exceeding one year; provided, however, that upon the certificate of the superintendent of the institution to which such person has been committed, that such person has been cured of his addiction to the use of narcotic drugs, such person shall be released, and such commitment terminated. Any person so committed who has been confined in such institution for at least six months, and who has been refused a certificate of cure and release by the superintendent of such institution may obtain a trial of the question of the cure of his addiction to the use of drugs in the same manner and with the same effect as is provided for the retrial of insane persons by section 51.11.

Anti-Narcotic Legislation in New York State:
While we have had neither the time nor the facilities at our disposal to undertake a study of the results of the operation of the narcotic laws in the various states as evidence of their success or failure in the solution of the problem, we have been able in the course of other work, more through the accident of proximity and contact than otherwise, to collect data relating to the results obtained through the enforcement of the various anti-narcotic laws of New York State. Although presumably not typical of other states, the history of this state's legislative activities is of distinct interest and therefore is given below.
The first so-called anti-narcotic law was passed by New York state in 1913. The only drug dealt with was cocain and its derivatives and not until 1914 was the sale of opium, its salts, alkaloids, derivatives, compounds, or preparations and chloral dealt with by a New York state law. This was known as the Boylan Law and became operative April 14, 1914. It prohibited the sale of the drugs named by a pharmacist, druggist, or other person except upon the prescription of a duly licensed physician, veterinarian, or dentist. This law exempted proprietary remedies within certain amounts of narcotic content. The law further provided that prescriptions should contain certain information relating to the condition of the patient and prohibited physicians, veterinarians, and dentists from prescribing any of the drugs referred to in the act except "after a physical examination of any person for the treatment of disease, injury, or deformity." It also required that the prescription be kept on file by the druggist and made the possession of these drugs, except by dealers, physicians, veterinarians, and dentists, a misdemeanor unless such possession was authorized by the possession of a certificate described in the law. The law further provided that the state commissioner of health should supply to board of health officers official order blanks, serially numbered in duplicate for distribution to pharmacists, druggists, physicians, dentists, and veterinarians upon which all orders for the purchase of any of the drugs enumerated should be written. Physicians, druggists, pharmacists, veterinarians, and dentists were required to keep a record for five years of the name and address of persons to whom the proscribed drugs were adMinistered, disposed of, or given away. The sale of hypodermic syringes and needles was prohibited except upon the written order of a physician or veterinarian. Another section provided for the commitment of habitual drug users who were defined as persons constantly using any habit-forming drug except under the direction and consent of a duly licensed physician.
In 1915 a law was passed amending the foregoing law in certain details but not changing it in general tenor or subject matter.
The next effort at narcotic control by New York state was expressed in the passage in April, 1916, of a resolution concurrently by the assembly and senate authorizing the formation of a Joint Legislative Committee to investigate and examine the laws in relation to the distribution and sale of so-called habit-forming narcotic drugs. A preliminary report of this committee, published on February 19, 1917,3 states:
"The Joint Legislative Committee appointed to investigate and examine the laws in relation to the distribution and sale of so-called habit-forming narcotic drugs, the manner in which such laws are enforced and the measures to be taken for the better enforcement of said laws submits the following preliminary report:
The Committee was authorized, by concurrent resolution of Senate and Assembly in April, 1916, with instructions to report by February 1, 1917. The Committee was appointed in September, 1916, and met for organization in November, 1916. Under concurrent resolution of January 30th and 31st the time of the Committee for submission of its report was extended to March 1, 1917.
"The Committee has held public hearings in New York, Brooklyn, Buffalo, Syracuse and Albany. These hearings have been well attended and a large amount of testimony has been taken and many valuable suggestions have been received both from those charged with the distribution of narcotic drugs and those responsible for the enforcement of the laws in respect to the sale and use of such drugs, your Committee therefore here wishes to express its appreciation for such co-operation and its indebtedness to members of the Judges and Justices Association of the State of New York, to members of the medical profession asso-
'

ciated in drug addiction work in the great penal, charitable and correctional institutions of the State and to laymen and members of the pharmaceutical profession who aided in its investigations.
"The statements prepared for the Committee of Judges and Justices by Dr. Ernest S. Bishop of New York, and submitted to your committee through the courtesy of Judge Cornelius Collins of the Court of Special Session, New York City, together with reprints of Dr. Bishop's writings on the subject of narcotic drug addiction, were especially useful in giving your Committee insight into existing narcotic conditions.
"Corroborating testimony regarding the problem of narcotic drug addiction also was offered by Drs. Alexander Lambert of New York City, Charles Rosenwasser, Newark, N. J., and James F. Rooney of Albany, N. Y., Franklin C. Graham, Buffalo, N. Y., and George E. Pettey, Memphis, Tenn. Other most valuable testimony was put in evidence by Chief Magistrate McAdoo, New York city, Judge Cornelius Collins, New York city, Judge John F. Brady, Albany, Commissioner of Correction Burdette Lewis, New York city and other officials and prosecuting officers of the State and city of New York.
"The evidence adduced by the hearings of your Committee shows that •the problem of narcotic drug addiction has passed all bounds of reasonable comprehension in the State of New York and in the United States. In a recent report promulgated by the Massachusetts Commission, entrusted by the State Legislature with investigation of drug addiction in that State, it was estimated that 60,000 addicted lived within its confines.
`While there is no definite data at hand upon which to base an estimate as to the exact number of drug users in the State of New York, your committee believes that at least 100,000 people are now suffering from this disease.
"The vital importance of making a systematic study and classification of this affliction from a sociological and medical standpoint can not therefore be overestimated to the commonwealth.
"Lack of understanding and appreciation of the disease of narcotic drug addiction and its treatment by a large majority of the medical profession has fostered conditions which make it impossible to determine a rational procedure for treating and curing the addicted by the State at this time.
"Such absence of uniformity of opinion has worked great hardship upon the public and has laid the narcotic drug addict open to misconception, misunderstanding and medical treatment which, in many instances, has resulted in harm rather than good.
"Evidence offered by physicians shows that many addicts have died under the method of treatment existing today and that a large percentage of those discharged from institutions as 'cured' are driven back to use of narcotic through unbearable physical torture induced by improi)er withdrawal of their drug.
"Evidence from physicians was adduced wEch denied that any cure for narcotic drug addictions existed in any of the private or public institutions of this State. Evidence from other eminent physicians was adduced which bore testimony to the fact that the disease of narcotic drug addiction was curable.
"The difference of medical opinion existing in medical circles regarding this vitally important question should be made the subject of a thorough and searching investigation as a matter of the greatest importance to the welfare of a large number of people in the State of New York.
"Your Committee has found that narcotic drug addiction bears no relation in point of character and seriousness to any other known habit induced by the use of stimulants. Narcotic drug addicts, according to evidence adduced, should not be classed with the alcoholic or the tobacco addict or the cocaine habitué.
"The constant use of narcotics produces a condition in the human body that many physicians of medical authority now recognize as a definite disease, which diseased condition absolutely requires a continued administration of narcotics to keep the body in normal function unless proper treatment and cure is provided.
`Withdrawal of the drug of addiction induces such fundamental physical disorganization and unbearable pain that addicts are driven to any extreme to obtain narcotic drugs and allay their suffering by self-administration.
"Testimony of physicians coming in contact with the addicts and statements of addicts themselves show that those afflicted with this disease express every desire to secure humane and competent treatment and cure and that most narcotic drug users are willing to undergo physical torture, and often do voluntarily undergo such torture, in an effort to be rid of their so-called habit.
"In the present chaotic medical opinion on this subject, it is impossible for the addict today to either secure authentic information on the subject of his disease and its treatment, or to procure at the hands of the average physician competent treatment for his malady.
"It has further been stated by competent authorities before your Committee that drug addiction is not confined to the criminal or defective class of humanity.
"This disease, however contracted, is prevalent among members of every social class. Some physicians estimate that addicts of the so-called underworld are far outnumbered by unfortunate drug users drafted from social circles of refinement and intelligence in the State of New York, who have become addicted to the constant use of narcotic drugs, but who are able to hide their affliction from the public.
"The attitude of the public toward the narcotic drug addict, fostered by the increasing prevalence of the disease in the criminal classes and by the apparent lack of medical help, has forced such drug users to keep their affliction a secret.
"This necessity in turn, your Committee finds has apparently contributed to the existence of many unsound nostrums for the cure of narcotic drug addiction and many private institutions where this disease is purported to be cured which exist solely for the purpose of preying upon the addict.
"State investigation and regulation of such cures and institutions is recommended by your Committee.
"Your Committee is inclined to criticize the medical profession for its lack of study of the increasingly important subject of narcotic drug addiction. The only excuse which can be offered for this unfortunate condition lies in the fact that there has not been medical appreciation of the conditions and that legislation, both State and Federal, has forced upon the physician a situation for which he was wholly unprepared.
"Your Committee believes it to be one of the first duties of the State, in dealing with this grave situation, to establish a supply of narcotic drugs to which
the confirmed addict shall have access, under proper State regulation, pending
the establishment of rational and recognized scientific treatment for his disease.
"The Committee believes that of even greater importance is a thorough and searching investigation of all phases of the great problem of narcotic drug addiction existing in the State of New York, with the definite view of requesting or employing services of medical experts familiar with this disease and evolving from the mass of contradictory evidence at hand some order and classification which shall point to competent care and ultimate cure.
"Searching and thorough investigation is needed in order to determine and establish fundamental and recognized elements and principles which are in accord with existing facts, and which shall be available as an authoritative foundation for the guidance, decision and direction of those dealing with the addict, and for the determination of honesty, good faith and intelligent procedure in those undertaking his treatment and care.
"It has been impossible in the brief time afforded your Committee adequately to study the various treatments given in municipal, State and private institutions, with a view to recommendations on this subject, or to get the addicts' full story or detailed testimony on the subject of narcotic drug use.
"Your Committee recommends that more time be given to study conditions, and that the power of the Committee be enlarged to provide for an investigation and examination of all institutions, private and public, attempting or claiming to treat or cure narcotic drug addictions.
"Your Committee is convinced that this subject is of such vital importance to the people of the State of New York as to justify this procedure.
`Proper and humane treatment and cure should be provided for the addict by the State and necessary legislation enacted to prevent the spread of narcotic addiction.
"The testimony taken by your Committee shows that those charged with the sale and distribution of narcotic drugs are in the main observing the law, and that the legal distribution of these drugs is less than before the enactment of existing narcotic laws, both Federal and State.
"On the other hand it is apparent from this testimony that public consumption of narcotic drugs has increased to an alarming extent. The inevitable conclusion is that the unfortunate addict has been forced to and does obtain his supply illegally.
"This condition arises very largely from the fact that many physicians and pharmacists, either through misunderstanding of the law or the true nature of the addict's disease, have refused to prescribe or dispense narcotic drugs to the sufferer.
"Your Committee contends that any member of the medical or pharmaceutical professions who refuses either to prescribe or dispense narcotic drugs to the honest addict to alleviate the suffering and pain occasioned by lack of narcotics is not living up to the high standards of humanity and intelligence established by these great professions.
"In the opinion of your Committee, supplemental remedial legislation should be enacted at the present session of the Legislature with a view to further safe-guarding the public from the ravages of narcotic drug addiction and providing means for a better check upon the narcotics dispensed in New York State.
"Such legislation should provide for a more complete record of narcotics distributed through legal mediums to the public in the form of a triplicate order blank upon which physicians, pharmacists, veterinarians and dentists shall obtain their supply of narcotics from manufacturers and jobbers.
"A definite form for these blanks should be established by the State Department of Health and the distribution of the said blanks should be under the authority of the said Department.
"Every physician, pharmacist, veterinarian or dentist ordering narcotics in quantity should be required to keep a copy on a form supplied, stating the amounts of the said drugs so ordered and the date when the order is entered. "A copy of this official order blank should be forwarded to the manufacturer or jobber filling such order and another copy of the said order should be forwarded to the State Department of Health, at Albany, N. Y., for record in that Department.
"Regulations regarding the inventory and accounting of narcotic drugs should be as far as possible in accord with the provisions of the present so-called Harrison Law now on the statute books of the Federal Government, so that excessive clerical labor shall not fall upon the medical and pharmaceutical professions.
"Physicians and pharmacists, testifying before your Committee, have endorsed this recommendation as one that will help the administrative authorities of the municipal, county and State governments, to run down and prosecute malpractitioners who violate the ethics of their profession, the laws of the State, and the mandates of humanity by wilfully propagating and perpetuating narcotic drug addiction.
"Your Committee also recommends that means be provided for the gathering of statistics upon narcotic drug addiction in the State of New York and the registration of addicts with some central department of the State government for the purpose of not only recording these unfortunate persons, but of offering such advice as to rational treatment and cure as may be authentically brought to the attention of the State in the future.
"Serious objection has been raised to this procedure by members of the medical profession on the ground that such registration is in violation of the ethical standards of that profession and on the further ground that proprietors of unsound 'cures' for narcotic drug addiction and of so-called 'fake' sanitariums for the treatment of narcotic drug addiction would have access to the record recommended, and promote trade thereby at the expense of the addict.
"Your Committee recommends that the department of the State government instructed to file and keep such addiction records be also instructed to divulge its contents only to the proper authorities charged with enforcement of the law in the municipal county and State governments.
"It further submits that a record of narcotic drug addiction so kept would be of great value to the State in dispensing knowledge as to the true nature of addiction disease and in bringing to the attention of the addict any authentic and scientific formula, procedure or method of treatment for this disease that may be evolved in the future.
"Such record of addicts also would be of great value in properly administering the proposed drug supply recommended to be established by the State for the use of confirmed narcotic dmg addicts in another part of this report.
"Having in mind the enlightened classification of narcotic drug addiction as a definite disease and not a vicious 'habit' that can be broken at will, brought to the attention of your Committee by eminent physicians, it is further recommended that the present laws providing for commitment of narcotic drug addicts to penal, correctional or charitable institutions be amended to also permit the commitment of said addicts to the care of a reputable physician who shall be found to be conducting his affairs in accordance with the laws of the State of New York and the established ethics of the medical profession, provided that the person so committed shall have at hand sufficient funds to defray the expense of such treatment.
"Your Committee submits that the illicit traffic in narcotic drugs, fostered by the absolute need of the addict for narcotics, is the greatest evil with which the commonwealth has to contend at the present time and that much illicit traffic presents a real and increasing danger of spread of the narcotic drug addiction disease to normal persons through the unlicensed and unregulated distribution of such drugs by irresponsible persons.
"Your Committee submits this illegal traffic in narcotic drugs is promoted by lack of uniformity in the public health laws of adjacent states and the Federal Government in relation to the regulation of sale, manufacture and distribution of narcotic drugs and that this lack of legislative uniformity is now a matter calling for the gravest consideration of the governing bodies of the various states of the union and of the Federal Government.
"Officials charged with the administration of the law in the State of New York and municipalities thereof have testified before your Committee that the absence of uniform federal and state statutes dealing with the great question of narcotic drug addiction and the manufacture, distribution and sale of narcotic drugs largely invalidates the statutes of this State and renders increasingly difficult the apprehension of illegal distributors who spread narcotic drug addiction by unlicensed distribution.
"It is recommended by your Committee, as a means of ameliorating this condition as far as possible by immediate legislation, that the present law be amended to include within its scope all persons, not duly licensed, physicians, veterinarians, dentists, or officials of private or public institutions charged with the treatment of disease, who shall aid or abet or assist in any way in procuring narcotic drugs other than through the regular channels for distribution established by the state, and that such person shall be guilty of a misdemeanor.
"It is further recommended by your Committee that the present law be amended to bring within its scope any person or persons who shall procure or attempt to procure narcotic drugs through false representation as a duly licensed physician, pharmacist, veterinarian, or dentist, or who shall forge a prescription or order for these drugs and that such a person shall be adjudged guilty of a felony.

"It has also been suggested to your Committee by various authorities in the State of New York charged with the enforcement of the law that the present law relating to the use, sale and distribution of the hypodermic syringe should be amended to require the issuance of a certificate to any person using such an implement and not a duly licensed physician, pharmacist, veterinarian, or registered nurse, which certificate shall entitle its holder to possession of the said hypodermic syringe for a period of time required for its legitimate use and the non-possession of which certificate shall make the possessor of the said hypodermic syringe amenable to prosecution under the law as it now is written upon the statute books of the State.
"Your Committee is prepared to draft legislation, and recommends the passage of such legislation by the State Legislature, embodying the points set forth in this report toward the end that laws may be enacted by the legislative body of the State of New York which shall, so far as possible, restrict the manufacture, sale and distribution of narcotic drugs in a manner that will prove beneficial to the moral and physical welfare of the people of the State of New York and also take into grave consideration the needs of the victim of narcotic drug addiction.
"Your Committee closes the report formulated upon its hearings held in the State of New York and cities thereof with reiteration of its opinion that constant use of narcotic drugs by an increasing minority of the people of this State is a matter so gravely important to the welfare of the commonwealth that it merits the most serious consideration of State legislators and officials whose duties include the promotion of moral and physical good health.
"A copy of the hearing held by your Committee is appended.

GEO. H. WHITNEY, Chairman, GEO. R. BRENNAN,
R. M. PRANGEN,
JOHN J. BOYLAN,
MAURICE BLOCH,
Members of Assembly."

Following these investigations the first so-called Whitney Law was passed in 1917.
In general it resembled the Boylan Law but in the following provision differed therefrom:
It omitted chloral from the drugs included and covered only opium, its salts, alkaloids, derivatives, compounds, and preparations.
It also provided that if a prescription was for a person addicted to
the use of these drugs, such prescription should contain a statement that it was issued in case of addiction.
It permitted a physician, after making a physical examination, to administer or prescribe for any person whom such examination showed to be addicted to the use of these drugs reasonable quantities dependent upon the condition of such person and his progress toward recovery, providing the physician acted in good faith solely for the purpose of relieving physical stress or of effecting a cure of such "habituate." Further it provided that the physician was obligated to assure himself that the person was thus seeking a means of relieving physical pain and not procuring or attempting to procure the drugs for illegal sale or distribution.
The law required the filing of one copy of an order for drugs with the state board of health at Albany, except in cities of the first class, in which case they were to be sent to the local board of health,—one by the person placing the order and one by the person making the sale.
It authorized dealers to file on July 10 of each year, with the state board of health, an inventory of their stock of drugs on hand as of July 1.
In cases where the person for whom the drug was dispensed or prescribed was an habitual user, the law required that a separate record of the prescription be made and that on the first day of each month physicians, hospitals, institutions, and sanitariums make reports to the state board of health of the name, age and residence of each such addict prescribed for, a copy of which was to be kept open for inspection by the proper authorities.
It prohibited veterinarians and dentists from prescribing, dispensing, or furnishing the drugs for treatment or consumption by human beings.
The law also provided that local boards of health could furnish without charge to a person found after physical examination to be addicted a prescription for such quantity of the drug as was deemed necessary in the opinion of the physician of the board of health to provide for the need of such person pending treatment.
On March 1, 1918, the Joint Legislative Committee above referred to transmitted its Final Report from which we quote as follows:'
"In its report of last year the committee expressed certain opinions and conclusions as to the extent and effect of the drug evil.
"Our investigation of this year has confirmed in the main the opinions and conclusions then expressed and it is therefore unnecessary to repeat them.
"The time has come when the Legislature must determine whether the causes and existing conditions are such as the State, in the exercise of its legitimate functions, can and should control and remedy by statute effectively enforced and if so, what means should be adopted to accomplish such purpose.
"It has been conclusively established to our satisfaction that drug addiction, however acquired, is not of itself a vice but is rather a disease and one which affects not alone the low and criminal but afflicts honest, intelligent people in all walks of life. Its effect is to sap the strength and vitality of the body, disarrange the functioning of its organs, and create a deplorable, diseased condition. When the drug is not furnished, its victim suffers the most horrible and excruciating pain from which he can obtain no relief except from a supply of the drug in accustomed quantity or a substituted medical treatment most intelligently and scientifically administered.
"It may not be the function of the State to cure disease, but it is the function of the State, so far as it can be reasonably done, to prevent the contraction and spread of disease and to furnish to the afflicted, within reasonable limits, such general public facilities as will aid in enabling them to obtain permanent relief.
"Estimates were given the committee by persons in position to be able to gauge conditions with a fair degree of accuracy that from two to five per cent of the entire population of the city of New York were victims of drug addiction. Reliable statistics obtained from police and other authorities and the evidence gathered by federal authorities and produced upon recent trials in the federal courts indicate that the disease is more prevalent and widespread in the smaller cities and rural communities than has been believed to be possible.
"When it is taken into account what this means in loss of money, loss of producing power, increase of crime and drains upon public and private charity to say nothing of its direct effect upon youth and society, from a business and economic point of view alone it would seem to be the part of sound common sense on the part of the State to endeavor systematically and effectively to prevent the spread of the disease and afford as far as practical all possible facilities for stamping it out.
"The drugs which are the sources of the difficulty are cocaine and eucaine with their salts and derivatives and opium and its derivatives, codeine, morphine and heroin. All have such unquestioned therapeutic value in the treatment of disease that their continued use is necessary. Both the state and national governments have endeavored to confine their use to proper channels by regulative and restrictive measures, but in this have been only partly successful. In some measures such failure seems to have resulted from well-intended but ineffective legislation, the history and effect of which it may be well to call briefly to your attention.
"Article eleven-a of the Public Health Law relating to opium and its derivatives by reason of continued amendment has become so complicated and verbose in language and covers such a mass of detail which should properly be left to departmental regulation that an intelligent construction of its provisions is almost impossible for an attorney and is impossible for a layman.
"Under it there is grave doubt whether a physician can dispense any of these drugs, and even their administration must be accompanied with so much record keeping and detail that few physicians will have anything to do with them. The federal statute permits them to be dispensed by a physician while absent from his office in personal attendance upon a patient without individual record and the failure of the state statute to permit this has proved to be a serious hardship particularly in the country districts where frequent calls daily are impossible.
"The multifarious record keeping and inability to understand the various statutory requirements have produced a like effect upon the apothecary. Like the physicians very few apothecaries will dispense any of these drugs where a separate record or certificate or label is required and then only at extortionate prices, the excuse being given that with the various statutory requirements some of which are conflicting and many of which they do not understand they cannot afford for any reasonable compensation to take a chance of getting into trouble.
"No fixed policy exists for the enforcement of the State statutes except in the larger cities of the State but their enforcement has been left to the desultory or spasmodic efforts of local police officials who have come to look upon every person addicted to the use of narcotic drugs, not as a person afflicted with disease, but as one who is a degenerate or a criminal. The most intelligent enforcing agency has been the federal internal revenue department which has now become so engrossed with handling conditions growing out of the war that it will for some time be unable to give the matter the attention which it otherwise would. As a result, the use of these narcotic drugs is on the increase and the traffic in them has been driven into the hands of the peddlers and unscrupulous apothecaries and physicians who have commercially exploited their victims to the last extremity.
"The testimony adduced before the committee indicates that the treatment employed in many private sanitaria advertising to cure drug addiction has been ineffectual. If only a small part of the evidence on this subject be true, the need of some supervision of these institutions is apparent.
"Certainly these conditions cannot be permitted to continue. If the conditions are as serious as the facts presented to us seem to clearly indicate it is the duty of the Legislature to enact one statute covering the whole subject clear and concise in terms, easily understood, in harmony with the federal statute, elastic in application, to be enforced by a central state authority adequately supported and equipped to effectively cooperate with the federal authorities and with a fixed policy along definite lines. It should make every possible effort to stop the growth of drug addiction as well as to reduce it to such an extent as medical science stimulated and encouraged and intelligently applied will render possible.
"To accomplish this purpose we recommend the creation within the State Department of Health of a department of drug control at the head of which shall be a commissioner with such administrative force only as will enable him to effect an organization which can conveniently cooperate with the federal internal revenue department in the several internal revenue districts within the State and utilize so far as possible information obtained by the federal inspectors and agents without expense to the State; that the commissioner have discretionary power to make such needful rules, regulations, rulings and decisions from time to time, not inconsistent with the statute, as may be necessary to meet changing conditions and the rulings and decisions of the internal revenue department, thus giving to the statute elasticity in detail administration which seems to be absolutely essential for its intelligent and practical enforcement; that the commissioner should have power to obtain data and information relative to drug addiction and the means by which it can be controlled, reduced or eliminated for the information and assistance of the medical profession as well as the public generally. "That comformably with the federal system all persons who manufacture, distribute or dispense cocaine or opium or its derivatives should be required to register annually with the department upon the payment of a nominal fee so that the commissioner may have a record of those who purpose to handle the drugs.
"That all of such drugs purchased should be ordered upon official order blanks one of which should be filed with the department and all of such drugs prescribed for or dispensed to those suffering from drug addiction should be upon official blanks, one of which should be filed with the department.
"That pharmacists, druggists, physicians, dentists, veterinarians and hospitals and institutions for the treatment of disease should be required to keep only such records as are required to be kept under the Harrison Law and make such reports as the commissioner may require to enable him to determine whether or not the purpose and intent of the statute is being fully complied with; that private hospitals, sanitoriums and institutions maintained or conducted in whole or in part for the treatment of inebriety or drug addiction be required to procure a certificate of authority from the department; that the provisions of the present statute restricting the possession of the hypodermic syringe and relating to commitment of persons suffering from drug addiction to public hospitals and institutions for the treatment of disease be retained; and that the penalty imposed for a violation of any of the provisions of the statute be made a misdemeanor.
"We have formulated and will shortly present a proposed bill covering these recommendations and will respectfully submit it for your consideration.
"The committee further recommends that as soon as the financial condition of the State will permit it provide at State expense an institution or institutions for the treatment of drug addiction where a scientific study can be made and information obtained as to the most effective remedies and methods to be employed and utilized in such treatment.
"We again urge upon the medical profession the necessity of a more thorough study of drug addiction as a disease and of the scientific methods to be employed in its treatment, which is essentially a problem to be solved, by the physicians and not by the Legislature.
"We fully appreciate the importance and gravity of the subject of our investigation and sincerely hope that as a result of our efforts lasting good may be effected.
"All of which is respectfully submitted.

GEORGE H. WHITNEY, Chairman
JOHN J. BOYLAN
RICHARD M. PRANOEN MAURICE BLOCH
GEO. R. BRENNAN.
Dated, at the Capitol. Albany. N. Y. February 28, 1918 "

Following the completion of the second Joint Legislative Investigation, the so-called second Whitney Act was passed and became a law May 13, 1918. The points of difference between this and the former
Whitney law were the following:
This law provided for a department of narcotic control, the head
to be the Commissioner of Narcotic Drug Control, appointed by the governor with the consent of the senate for a term of six years. The following covers the duties and powers of the commissioner as set forth in the law:
"The commissioner is hereby empowered to make all needful or helpful rules, regulations, rulings and decisions which in his judgment may be necessary or proper to supplement or effectuate the purposes and intent of this article or to interpret or clarify its provisions or to provide the procedure or detail requisite in his judgment to effectually secure the proper enforcement of its provisions, which rules, regulations, rulings and decisions, when made and promulgated by the commissioner, shall become rules, regulations, rulings and decisions of the department, and until modified or rescinded shall have all of the force and effect of statute. The commissioner may divide the state into not to exceed four districts and maintain a branch administrative office in each, except that in which the capitol is located. It shall be the duty of the commissioner to enforce the provisions of this article and all the rules, regulations, rulings and decisions of the department. The commissioner may for cause deemed by him to be sufficient, after having given reasonable notice and opportunity to be heard, revoke any certificate of authority issued by the department and revoke, cancel or withhold official blanks issued or applied for. The commissioner shall obtain data and information relative to the extent of drug addiction and the means by which it can be controlled, reduced or eliminated and the means and methods used in its treatment. He shall have the power to inspect and examine any hospital, sanatorium, institution or place in which persons are treated for drug addiction. He shall report annually to the legislature with such recommendations as he may deem warranted. The commissioner and each of his deputies shall have the power to administer oaths, compel the attendance of witnesses, the production of books and papers and to take proof and testimony concerning all matters within the jurisdiction of the department and in such connection no communication made to a physician shall be deemed confidential. The commissioner shall fix the prices to be paid for blanks procured from the department and the fees, not specifically fixed herein, to be paid upon the issuance of any certificate of authority to be issued by the department."
The law further provided for the appointment of three deputy commissioners by the commissioner, each of whom was vested with the same powers as the commissioner within the territorial district to which he might be assigned, except the power of appointment to position, the power to grant and revoke certificates of authority, and the power of making and promulgating rules, regulations, rulings and decisions.
The drugs included in the law were cocain, opium, morphin, codein, heroin and any compound, manufacture, salt, derivative, or preparation thereof including alpha or beta eucain, or any of their salts or any synthetic compound of any of them, excepting decocainized coca leaves or preparations made therefrom which did not contain cocain. The possession, sale, distribution, administration, or "dispensation" of the foregoing drugs, except as expressly and specifically authorized by the provisions of the law, was declared to be dangerous to the public health and a menace to the public welfare.
The law further required that manufacturers, wholesalers, apothecaries, physicians, dentists, veterinarians, or private hospitals, sanatoria, or institutions maintained or conducted in whole or in part for the treatment of disability, disease, inebriety, or drug addiction should register with the department their place of residence and place of business and receive from the department a certificate authorizing them to carry on such business.
Those authorized to possess or otherwise handle the proscribed drugs were required to order them on serially numbered, triplicate blanks which were procurable from the Department of Narcotic Drug Control, one copy to be retained by the person ordering, one by the person filling the order, and the third to be sent to the department.
Apothecaries were authorized to fill prescriptions written upon unofficial prescription blanks when properly made out, providing such prescriptions did not contain more than 5 grains of cocain, 30 grains of opium, 6 grains of codein, 4 grains of morphin or 2 grains of heroin and also upon a like prescription, i.e., unofficial, if it contained any of such drugs in excess of said respective quantities, if it stated upon the prescription that it was to be used in the treatment of a surgical case or disease other than drug addiction. Apothecaries could also dispense these drugs in excess of the quantities above mentioned if the prescription was written upon a serially numbered official prescription delivered to him in duplicate provided he kept one of said duplicates for a period of 2 years and mailed the other within twenty-four hours to the department.
Physicians were authorized "in the course of the legitimate practice in good faith" of their profession and to relieve or prevent pain or suffering, or to effect a cure, to administer, prescribe, or dispense cocain or opium in such amounts and upon such prescription forms as indicated above could be filled by apothecaries. Further, physicians were authorized to administer or dispense to patients under treatment not to exceed 2 grains of cocain, 15 grains of opium, 3 grains of codein, 2 grains of morphin or 1/4 grain heroin.
Also while absent from their offices in personal attendance upon patients physicians were authorized to dispense, to be taken in their absence, the amounts of the proscribed drugs listed in the preceding paragraph.
For any other administration or dispensing of these drugs physicians were required to record in writing upon a serially numbered official dispensing blank in duplicate to be procured from the department, the name and quantity of the drug and the form in which administered or dispensed, the original of such dispensing blank to be kept on file for two years and one copy to be mailed to the department within twenty-four hours.
The law provided that the provisions of the foregoing section relating to the conditions under which unofficial and official prescription and dispensing blanks could be used were, to the department, directory only and could by rule or regulation of the department be changed to meet existing conditions.
The law provided that hospitals, sanatoria, or other institutions, federal state or private, in which persons were treated for disease or disability other than drug addiction or for inebriety or drug addiction and which had unrevoked certificates of authority issued by the department, under the supervision of a physician, could administer cocain or opium to inmates who were under treatment as patients.
No manufacturer, wholesaler, apothecary, physician, dentist, or veterinarian could possess or obtain the proscribed drugs except for the conduct of a lawful business or in the legitimate conduct or practice in good faith of his business or profession.
The law required that only physicians, dealers, apothecaries, dentists, veterinarians, or nurses or internes of a hospital or sanatorium or institution in which persons were treated for disability or disease could at any time possess a hypodermic syringe or needle unless such possession was authorized by a physician's certificate issued within one year.
The law provided for an even more comprehensive system of recording by those concerned with the handling of the drugs in question than did any of the former laws.
Seized, confiscated, or surrendered drugs were to be disposed of by the commissioner.
All records, papers, information, statements, and data acquired by the department were to be regarded as confidential and not open to inspection by the public or any one other than the official custodian or such persons as might be authorized by law or by the commissioner.
The law declared "the habitual use of cocain, opium, or its derivatives, except as administered, prescribed or dispensed by a physician," to be dangerous to the public health and safety and provided that upon a complaint made to any magistrate that a person was so addicted or upon the voluntary application to him of an addict, the magistrate, if satisfied of the truth thereof, might commit such person to a state, county, or city hospital or institution licensed under the Lunacy Commission or any correctional or charitable institution maintained by the state or any political subdivision thereof or private hospital, sanatorium, or institution having an unrevoked certificate of authority from the department for the treatment of disease or inebriety. Such committed cases were to be released when the chief medical officer of the institution should certify to the magistrate that they had been sufficiently treated or when, for any other reason, it was deemed adequate or sufficient by the magistrate.
It was provided further that any public hospital, sanatorium, or institution might accept as a charity patient any person voluntarily applying for treatment for drug addiction if the applicant signed a statement that he desired treatment in the same manner and subject to the same rules and restrictions as if committed by a magistrate, and without formal commitment, with like effect as if formally committed subject to discharge when sufficiently treated or for other reason. Such commitment might also be had upon the application of the commissioner or any local health board or officer. These provisions of the law were not intended to restrict the right of any hospital, sanatorium, or institution to treat cases of drug addiction at other than public expense.
As to fraud or deceit the law stated:
"Any fraud, deceit, misrepresentation, subterfuge, concealment of a material fact or the use of a false name or the giving of a false address in obtaining treatment in the course of which cocaine or opium or its derivatives in excess of lawful quantity shall be prescribed or dispensed or in obtaining any supply of such drugs shall constitute a violation of the provisions of this article. For the enforcement of the provisions of this article statements, representations or acts herein referred to shall not be privileged as confidential communications."
Licenses could be revoked as provided in the following:
"Any license heretofore issued to any physician, dentist, veterinarian, pharmacist, druggist or registered nurse may be revoked or suspended by the proper officers or boards having power to issue licenses to any of the foregoing upon proof that the licensee is addicted to the use of any habit-forming drug or drugs after giving such licensee reasonable notice and opportunity to be heard. Whenever it shall appear that such licensee has fully recovered and is no longer an addict to any of such drugs, such board may grant a rehearing and in its discretion reissue or reinstate the license of such licensee. Whenever any pharmacist, druggist, physician, dentist, veterinarian or registered nurse shall have been convicted of the violation of any of the provisions of this article, any officer or board having power to issue licenses to any such physician, dentist, veterinarian, pharmacist, druggist or registered nurse may, after giving such licensee reasonable notice and opportunity to be heard, suspend or revoke the same."
In any complaint, writ, or indictment laid or brought under or for the enforcement of any of the provisions of the law it was declared not to be necessary to negative an exception or exemption and the burden of proof was placed upon the defendant or person proceeded against to establish affirmatively any exception for exemption claimed.

Regulations
Pursuant to the authority conferred by the second Whitney law, the commissioner of narcotic drug control issued, from time to time, rules and regulations for the administration of the department. The following is a digest of the regulations revised as of December 27, 1920, insofar as they related to the practice of medicine and the handling of cases of chronic opium intoxication:
One regulation required the pharmacist filling a prescription issued on the triplicate prescription blanks to endorse on the face of the original and the duplicate the date of filling, file number, his name and business address, and the name of the person to whom the prescription was delivered, if other than the person for whom it was issued.
A "drug addict" was defined in the regulations as follows:
"Any person who has needed or demanded the administering, prescribing for, dispensing of cocaine, opium or their derivatives at more or less regular intervals for thirty consecutive days prior to the time such person applies to a physician or a physician of any institution for the administering, prescribing for or dispensing of any such drugs or their derivatives; provided, however, that upon the filing of the report of the case by the attending physician or the physician of any institution in charge of the patient, with this Department, it may rule that such person shall or shall not be recorded."
Examination prior to undertaking the treatment of cases of chronic opium intoxication was required in the following language:
"A physician or a physician of any institution before beginning the treatment of a person for drug addiction must make a thorough physical examination of such person, and such other examination as is necessary to satisfy him that the patient is addicted to the use of cocaine, opium or their derivatives. The physician or the physician of the institution must keep on file a statement of his examination with the name of the patient, his address and the date of the examination."
The reporting of cases of chronic opium intoxication was required as follows:
"A physician or physician of any institution prescribing for, administering or dispensing cocaine, opium or their derivatives daily for more than thirty days to a patient shall register with this Department or its authorized agent, the name of such persons, together with a statement of the physical or mental condition of such person and a prognosis as to the probable future necessity for continuing the prescribing, administering or dispensing of cocaine, opium, or their derivatives to such patient; such prognosis shall include an estimate as to the length of time which, according to the judgment of the registered physician or the physician of any institution will be required to remove the necessity of administering the aforesaid narcotic drugs to such patient."
The reporting of "probable addicts" was also required as follows:
"A physician or physician of any institution is expected to cooperate with the Department of Narcotic Drug Control and is required to register within forty-eight (48) hours, with said Department, the name, address, physical and mental condition, and any necessary circumstantial information regarding any person who applies for professional treatment, and whom the physician or the physician of the institution thinks is an addict."
One regulation altered the provisions of the law as follows:
"A physician or physician of any institution issuing a prescription for, administering or dispensing cocaine, opium or their derivatives in any quantity whatsoever, whether for a drug addict or any other patient, shall only do so upon the official triplicate prescription blank or the official duplicate dispensing blank.
"An apothecary must not dispense cocaine, opium or their derivatives on any prescription, unless it is written on the official triplicate prescription blank.
"All provisions of law and all regulations applying to the filing of official prescription blanks and official dispensing blanks shall apply to such blanks used pursuant to this regulation."
The law as relating to the prescribing of the named drugs was interpreted as follows in the regulations:

"The first paragraph of subdivision 5 of Section 427 of Article XXII, Chapter 639 of the Public Health Law reading: 'A physician may, in the course of the legitimate practice in good faith of his profession and for the purpose of relieving or preventing pain or suffering on the part of the patient, or to effect a cure, adminster, prescribe or dispense" cocaine or opium or their derivatives as follows:' shall be interpreted to mean that where a physician or a physician of any institution prescribes for, administers or dispenses opium, cocaine or any of their derivatives to an habitual user thereof, such prescribing for, dispensing or administering, not being issued in the course of professional treatment in the attempted cure of the addiction, or for relief in the treatment of any other disease or surgical operation, but being used for the purpose of providing that addict with the aforesaid drug or drugs sufficient to keep him comfortable, will be considered by the Department as a perversion of the meaning of the words 'good faith' contained in said subdivision."
The regulations further stated:
"While opium, cocaine or their derivatives may legitimately be used in connection with or as part of the treatment for the cure of addiction, the prescribing for, administering or dispensing of such drugs to an addict for self-administration by such patient shall not be deemed to constitute in itself legitimate medical treatment for the cure of such addiction, unless the physician purposes either by a gradual reduction in the dose or by some other method of treatment to effect within a reasonable limit of time a cure of the addict."
Also referring to the handling of cases of chronic opium intoxication the regulations provided:
"A physician or a physician of an institution issuing a prescription for, administering or dispensing cocaine, opium or their derivatives to a drug addict in any quantity whatsoever, shall ascertain, if possible, the date of the last dosage given to the addict, the amount of the dosage, the name of the physician who prescribed, administered or dispensed it, and insert such information on the official blank used."
In addition to the Whitney law and its regulations, we find in the Second Annual Report of the Narcotic Drug Control Commission,5 the following account of a control measure:
"In an attempt to prevent the addict from receiving drug through more than one doctor, the New York City Health Department, in cooperation with the State Department of Narcotic Drug Control, experimented with an administrative procedure designed to make it impossible for the addict to secure drug more than once a day. Every addict was required to be registered. When he presented himself at the clinic, he was physically examined by a physician. after which he received a dosage card which contained his name, his address, his age, the usual amount of drug he had been accustomed to taking, and his picture. Every time the doctor prescribed for an addict, he was required to sign a designated blank space on the dosage sheet for that day, and the apothecary, likewise, when filling the prescription. It was hoped that the addict would not receive more than one prescription for that day because the next doctor or apothecary would see that the spaces on the calendar dosage card for that day had already been signed, and therefore would not violate the law. Over 7,500 addicts were thus registered."
No comment as to the success or failure of this method of registration is made in the report.
In 1921 the New York State legislature repealed the second Whitney law and New York had no state anti-narcotic law in operation,
although a number were presented for passage, until 1927 when the
legislature passed a law which in general followed the provisions of
the Harrison Narcotic Act. In addition, it contains the following features:
A physical examination is required to be made by physicians, dentists, and veterinary surgeons before the administration, dispensing, or prescribing of "any habit-forming drugs." Instruments for the injection of habit-forming drugs may not be possessed except by professional groups or upon the order of a physician. Notice of conviction of professional men "for wilful violation" of the law is required to be sent by the clerk of the court or by the magistrate to the depart-
ment, board or officer having power to suspend or revoke the license of
the person convicted. Provision is made for the commitment by a
magistrate upon the voluntary application to him of any habitual user of any habit-forming drug to any hospital or charitable institution maintained in whole or in part by the state or any political subdivision thereof which is willing to receive such addict.
Sufficient time has not yet passed to permit of an evaluation of the merits of this law.
New Orleans Clinic:
Another state, Louisiana, undertook by a supplementary activity to provide for certain emergencies arising out of the operation of its anti-narcotic law and in 1919 there was opened in New Orleans by Dr. M. W. Swords with the authority of the state board of health a clinic or dispensary where an effort was made to handle cases of chronic opium intoxication in a practical manner. The following quotation describes the operation of the clinic: 6
"Narcotic laws in vogue being apparently defective in controlling the drug traffic and narcotic addiction, the State of Louisiana recently enacted a new State Narcotic Law, directed towards the better control and regulation of said drug traffic, particularly thru its principal offenders, the `trafficker,' vendor,"morphine doctor' and 'dope apothecary.' This legislation created a drug 'panic' in addict circles, causing drug 'vendors' to cease their activities temporarily, by cutting off the main source of drug supplies. In desperation, addicts applied to the Louisiana State Board of Health for relief, the only place where they could have reasonable assurance of assistance.
"It was apparent, after reflection, that in the passage of this anti-narcotic law, the addict, the principal one affected, had been overlooked. His unfortunate plight had not been sufficiently considered, and the possible results of the law not intelligently comprehended. The Louisiana State Board of Health came to the conclusion that addicted humans were deserving of consideration and care, as well as those unfortunates afflicted with other diseases, and a remedy was sought to meet the occasion.
"Neither the State nor Board was financially able to care, even temporarily, for these sick people. It was expedient that immediate means must be had by which a grave condition could be met. It was decided, therefore, to supply addicts with their drug at cost price, plus a sufficient margin to meet expenses incidental to the operation of the dispensaiy.
"It was found that opium (and its derivatives) was the one drug of physiologic necessity insofar as addiction is concerned. Consequently, it was decided that morphine, the principal opium derivative, should be the only drug dispensed.
"The Narcotic Dispensary having been established, other questions presented themselves, the most important of which was 'Why so many addicts?' and 'Whence the enormous supply of drugs?' It was found that the main supply was thru 'drug traffickers,' made up of irresponsible `vendors,' unscrupulous apothecaries' and 'morphine doctors.' Knowing the supply, the natural question was 'How to combat it?' Laws being ineffective, it was determined that some rational means be established to strike at the heart of this nefarious evil.
"Legitimate supply seemed to be the most logical plan that presented itself. To meet the illegitimate vendor and prescriber of drugs on a common ground the narcotic Dispensary supplied addicts in a legitimate way at a price so low that the vendor would not take chances of falling into the hands of the law for the small profits brought about by this new form of competition. The effect of this modus operandi was apparent. The vendors of drugs utilized their wits unsuccessfully in attempting to combat a practical demonstration of legitimate supply, with the result that their activities became noticeably less, many of them being forced to seek more profitable sources of revenue.
"Cause and effect, profit and supply are the basic principles that must be met in the solution of the drug problem.

"What is the cause? The medical and allied professions, environment of the `tenderloin,' and association are the principal causes.
"What is the effect? The addiction of people to a drug, opium, or its derivatives, causing what heretofore has been known as a 'habit,' but what in reality is a physiologic changing of the proper functioning of every organ and tissue, creating the pathologic mechanism of a definite 'disease,' characteristic in its symptomatology and pathology and which cannot be combated except by scientifically adapted measures. Drug addiction, as applied to opium, and its derivatives, is a disease and not a human frailty, and must be recognized as such before any rational solution of the problem can be understood and any treatment successfully directed towards its cure and eradiction.
"What is the supply? Doctors, hospitals and the underworld, thru illegitimate vendors.
"What actuates this practice? Millions of dollars each year spent by men and women which go into the coffers of the 'man higher up,' who directs the business and is the real recipient of this enormous profit.
"How to combat it? By furnishing a legitimate supply. Addicts are not necessary, but are with us; their addiction-disease is a part of themselves, a condition eternally demanding relief. A legitimate source of supply should be provided at a price so low that the illegitimate vendors must meet it or go out of business. Legitimate supply is the basic principle on which this Narcotic Dispensary is combating the drug evil. It will take time and education to effect perfect results. Necessarily there are other scientific problems for solution. The first is to extricate the poorer addict from his unwholesome surroundings. This we have attempted to do by establishing a dispensary that in appearance and respectability inspires dignity and confidence."
"Our Medical Clinic is equipped for determining any physical disability or illness of its clientele. This clinic has in attendance two doctors and a trained nurse. Histories are taken and filed, covering past and present condition of patients, together with statements of physical irregularities. Each addict is examined to establish primarily whether he or she is an addict, the cause of addiction and every other detail pertinent to the physical and mental condition. In our Dispensary we endeavor to practice the highest type of medicine.
Objects of the Dispensary
"1. We realize that a permanent cure of those afflicted with drug addiction-disease is impossible, in the great majority of cases, unless the addict be placed in a position to secure scientific treatment. The sole object of this dispensary is to relieve suffering until such time as a scientific treatment may be had.
"2. The basis of operation is legitimate supply versus illegitimate trafficking.
"3. To prevent a victimized people from being more thoroly victimized by heartless, profiteering 'ghouls.' To prevent the making of new addicts.
"4. Diminishing petty thievery which constitutes a tax, or burden, on society, for the reason that many addicts, unable to pay the price of $1.00 or $3.00 per grain, are forced to criminal methods.
"In the operation of this Dispensary, we have refrained from 'registration' of addicts, compulsory hospitalization and police interference, all of which would intimidate the addict and drive him back to the underworld supply, and thus defeat our primary purpose. We have no 'registration' to compromise addicts or subject them to posSible blackmail. Their secret is guarded in strict confidence. We work in harmony with officials, but not to the extent of betraying confidences.
Treatments
"This Dispensary does not attempt to cure addicts, realizing that this is a problem that can only be solved when addiction-disease is better understood. We are establishing, however, in connection with our Dispensary, a 'research laboratory' with the hope that ultimately this may lead to some scientific means by which cures may be effected.
"Much has been written regarding addiction that has been actuated by mercenary interests. Facts regarding morphinism are known to but few. The literature is filled with various 'treatments,' a few only by scientific men who have a conception of drug addiction-disease and what it means.
"The 'reduction' treatment is much discussed. In our opinion, it is a fallacy, pure and simple. The 'hot shot' and other forms of treatment are empirical and not based on scientific knowledge. Some are effective, no doubt, in individual cases, but this obtains only in isolated cases and must not be confused with the entire problem of addiction-disease.
"The 'forcible reduction' treatment will do more harm than good and is worse than no treatment at all. . . ."
"The Dispensary has accomplished the following: Temporary relief of addicts at minimum cost. No new recruits thru this Dispensary. Petty thievery diminished among the lower class of addicts. We have made economic assets of many who formerly were human derelicts. We have made many happy mothers and children by enabling fathers and husbands to keep honestly employed. We have raised the morale of addicts to the extent that they no longer will to steal, since the actuating motive has been removed. We have concentrated and segregated the principal offenders in petty crime. We have surrounded the high-type addicts with security and protection. All addicts are known and if any are 'wrong-doers,' they are apprehended. This instils a fear of crime and results in good behavior. The addicts have come to know the Dispensary as their best friend where the hand of sympathy and understanding is held out to them. All of this has been accomplished at no cost to State or Board of Health. Our fight has been hard, due to the ignorance of laity and medical profession as well."
As stated in the article above quoted the clinic was opened as an emergency measure and its operation continued upon the advice of Judge A. V. Coco, Attorney General of the state of Louisiana, whose opinion is abstracted as follows from a report of Dr. Swords as an excerpt from the minutes of the Louisiana State Board of Health.

"Excerpt From Minutes of La. State Board of Health:
Meeting held on Feby. 20-21, 1919: . . . Attorney General Coco was asked what should be the procedure of the Board towards supplying narcotics to drug addicts. The Attorney General was informed that Dr. Swords, Secretary of the Board, had, (luring the absence of the Board's President, furnished addicts who had applied to the Board with narcotics, and his opinion was asked as to the wisdom of such a procedure, as well as the possible legal aspect of same. The Attorney General's answer was to the effect that Dr. Swords had acted perfectly well and within the law, that the intent of the law was plain and that it was not only humane and commendable for the Board of Health to attempt to care for the present addicts under existing circumstances, but from a legal point of view it was incumbent on the Board to make provision, temporary or permanent, to care for and relieve those suffering with habitual drug use, protecting society and property by so doing. The Attorney General was asked the direct question by Doctor Dowling, President, if the State Board of Health, on account of the gravity and seriousness of the situation, could charge addicts for habit-forming drugs, and could the Board dispense such a drug, or drugs, without violating the law, it being explained that the necessary funds were not otherwise available to procure drugs for these addicts, and that said drugs could not be furnished them by any other known means. The Attorney General stated that the Board had a perfect right to dispense drugs to addicts, and that there was nothing in the law preventing the Board from charging said addicts for drugs obtained. He said that addicts, in applying to the Board for relief, were applying to the only source where they had a right to expect aid and assistance to lessen their misery and suffering. That he, as Attorney General, heartily approved of what had been done, and further stated that it was absolutely up to the Board of Health and State to take care of the situation."
The written opinion of assistant Attorney General Robertson, according to Dr. Sword's report, was read into the Minutes of the Board as follows:
"Doctor Oscar Dowling, President, Louisiana State Board of Health,
New Orleans, Louisiana. Dear Doctor:
"The Attorney General has referred to me your letter of even date requesting an opinion as to the authority of your Board and the various health officials of the State to provide for the treatment of drug addicts. In reply, I beg to advise that Act 157, of 1894, provides for the treatment and cure of such persons where a petition is filed in the District Court having jurisdiction over the addict by any kinsman or friend. The person to be treated must consent to the petition and agree to take the treatment. Section 2, of this Act, limits the expense of said treatment to the sum of $100.00, payable out of the funds of the Parish in which the addict is domiciled. The constitutionality of this act was upheld by the Louisiana Supreme Court in Webster vs. Police Jury, 51 La. An. 1204. While the expense is limited to $100.00 for each commitment, if the party be not cured at the expiration of the term paid for by said sum, I know of no law which would prevent a second petition being filed with the court, and an additional course of treatment given thereunder. Section 19 of Act 252, of 1918, (the narcotic law) provides for like treatment of drug addicts at public expense, but does not limit the amount. This section also stipulates that said treatment must be given on voluntary application of the patient. Both laws provide that the treatment be in some hospital or institution in the State. I note that you say that drug addicts are regarded by the medical profession as 'sick persons.' Act 42, of 1880, requires Police Juries to make provision for the support of all indigent, sick, infirm or disabled paupers residing in their respective Parishes. In speaking of this Act, the Supreme Court in 'State vs. City of New Orleans,' 50 La. An. p. 890, said:
"'There can be no question as to the duties of cities to support their indigent sick, disabled and infirm persons within their borders; but the question is how and under what circumstances and conditions are they to do so. Had the city built or leased premises having this object in view, and placed employes over them, and made provision through its ordinances for the payment of expenses incurred in so doing, no one, we suppose, would question the validity of such ordinances, by reason of a want of authority in the city to pass them.'
"This office is, therefore, of the opinion that your Board and the local health authorities throughout the State, have the legal right to petition the Court to have drug addicts placed in the various hospitals and institutions in this State for cure and treatment. However, the laws quoted above refer to cases in which the addict willingly consents to said treatment, and a different question arises where the addict refuses to avail himself of their provisions. In such cases, and where the addict becomes deranged or partially deranged through excessive use of drugs, and is dangerous to be at large, your Board, and the local health authorities, may have the parties so addicted taken in custody by the Sheriff, and on petition by the District Attorney of his District, and a Commission composed of two reputable physicians and the Court may be appointed to inquire into his mental condition, and if adjudged insane by reason of excessive use of drugs, the court may order him to one of the Louisiana hospitals for the insane for treatment and care. The person so interdicted is transported at the expense of the Parish where he is living, and the cost of his treatment and cure is paid by the State, unless the patient, or the husband or wife, is able to pay for same. In that case, the District Attorney may bring suit to recover the amount so expended on his treatment at said hospital. See Act 68, of 1918. Trusting I have answered your query, I am, Very respectfully yours,

(Signed) Thos. W. Robertson, Assistant to Attorney General."

After this clinic had been in operation for about two years it was closed, according to Dr. Swords, because of the persistent requests of Government officials.

1 The digest covers laws passed prior to July. 1927, in the various states and the District of Columbia.

2 'For tables see Appendix VI.

3 Preliminary Report of Joint Legislative Committee appointed to Investigate and Examine the Laws in relation to the Distribution and Sale of so-called Habit-forming Narcotic Drugs. State of New York, No. 31. In Senate. February 19, 1917.

4 ' Final Report of the Joint Legislative Committee Appointed to Investigate the Laws in Relation to the Distribution and Sale of Narcotic Drugs—State of New York No. 35. In Senate. March 1, 1918.

5 .Second Annual Report of the Narcotic Drug Control Commission. April 15, 1920.

6 °Swords, M.    résumé of Facts and Deductions obtained by the Operation of a Narcotic Dispensary—American Medicine—January 1920. p. 23.