legitimate practice of medicine. If you will give them the money necessary to get those figures out in your appropriations, you will get some figures which everyone the world over interested in the narcotic problem is asking for, and it can be done. The figures are there.

Mr. FAIRCHILD. The figures are in the Treasury Department?

Doctor LAMBERT. The Harrison law forces every hospital in this country to keep a record of all narcotics used and a record of the number of patients that it treats. Those figures are open to inspectors of the prohibition unit or narcotic unit. The inspectors can gather those figures. You can take the census of the number of patients in the hospitals and the amount used, and you can gather accurate information of the amount used in legitimate practice of medicine.

Mr. FISH. What is the objection on the part of the Treasury to announcing those figures?

Doctor LAMBERT. They have no money to use for it; the appropriation does not allow it.

Mr. FISH. It certainly would not cost very much.

Doctor LAMBERT. No.

Mr. FISH. How much would it cost, in your opinion?

Doctor LAMBERT. I think $25.000 would do it.

Mr. FISH. That is what I wanted to bring out.

Mr. LINTHICUM. What effect do you think prohibition has had upon the inincrease in the use of these drugs?

Doctor LAMBERT. I think those subjects necessarily run parallel but do not necessarily interlock.

Mr. COCKRAN. What do you mean by that?

Doctor LAMBERT. I mean that since prohibition drug taking has not increased.

Mr. LINTHICUM. It has not affected it?

Doctor LAMBERT. No; it is a parallel situation.

Mr. LINTHICUM. Are you connected with any institution by which these matters have come under your notice?

Doctor LAMBERT. Certain statistics published of the insane hospitals in New York State seem to show it.

Mr. LINTHICUM. What institution are you connected with so that you could give your experience in a number of these cases?

Doctor LAMBERT. I have seen the thing in Bellevue Hospital and in my own private practice, a great deal of it.

Mr. COCKRAN. Have you any connection with the addict establishment on Wards Island ?

Doctor LAMBERT. NO.

Mr. COOPER. How large a hospital is Bellevue?

Doctor LAMBERT. Twenty-two hundred beds now.

Mr. CONNALLY. When you say prohibit the manufacture of heroin you mean absolutely prevent it for medicinal purposes?

Doctor LAMBERT. Absolutely prevent it, obliterate it.

Mr. CONNALLY. It is not necessary for medical purposes?

Doctor LAMBERT. No; it is not, in my opinion.

Mr. CONNALLY. Does not the Harrison law limit the manufacture as well as the sale of these narcotics? Does the Government check up on the manufacturers and the laboratories and limit their output?

Doctor LAMBERT. That law gives authority to control it, which they do by their regulations.

Mr. CONNALLY. Does the Treasury keep a record of the output of these laboratories, the narcotic products. It they do not, would that be a good provision to put into law?

Doctor LAMBERT. They have that check now.

Mr. CONNALLY. If they have that check and also have the statistics of the amount used legitimately it would be somewhat easy matter to trace where the legitimate opium comes from.

Doctor LAMBERT. Yes.

Mr. CONNALLY. Except that smuggled in.

Doctor LAMBERT. But Congress will not appropriate enough money to enforce the Harrison law.

Mr. CONNALLY. We could request the President to submit that in the Budget. The CHAIRMAN. The difficulty is this: Under the Harrison law they are able to keep a check on pharmaceutical manufacturers and a check on the wholesale druggists who buys them, but they have not sufficient force to keep a check on all of the upward of 50,000 retail druggists in the country-the dispensing druggists.

Mr. CONNALLY. Why can not we give them that power?

The CHAIRMAN. I do not see how you could accomplish it even if they had the power, because the drugs are so easily handled.

Mr. CONNALLY. If we can not regulate it at home, how are we to regulate Persia and Turkey?

The CHAIRMAN. The purpose is to strike at the root of the evil by regulating the production and restricting the use to scientific and other legitimate purposes..

Mr. CONNALLY. If they produce it illegitimately, against the law, what is the use of passing some more laws as to Turkey and Persia.

The CHAIRMAN. My own personal view is that since The Hague convention many nations have passed laws to control narcotic traffic, and those laws have failed.

Mr. CONNALLY. Have you had this matter up with the Department of State or the President? Are they in sympathy with this movement?

The CHAIRMAN. I have had it up casually.

Mr. CONNALLY. They are not averse to helping to suppress this traffic.
The CHAIRMAN. Absolutely not.

Mr. CONNALLY. Why do they not go on and do what this resolution asks them to do if they are in sympathy with it, if they have the power. Why should we spend our time in asking them to do it?

The CHAIRMAN. It would be a good thing to strengthen the hands of the President, because we would then have both branches of the Government-legislative and executive-pushing it. That is the purpose of this resolution.

Mr. CONNALLY. Under the situation he has absolute power, and I believe in keeping these branches of the Government separate myself. It seems to me if the President or the Secretary of State want to do this, and the chairman has told them about it and made them acquainted with this situation, it would save time for them to go on and do it.

Mr. MOORE of Virginia. The report made by the committee appointed by the Treasury Department, on which Mr. Henry T. Rainey served, recommended to the Secretary of State that he should take the matter up with other nations and strengthen the treaty now in effect.

Mr. COOPER. It seems to me there might be some legislation in the matter of interstate traffic in these things to make it more stringent than now. I remember to have read that Wallace Reid went to get treatment, and it was in the institution where he went for cure that he was made the victim, largely made

the victim of the drug habit in that institution to which he went to get cured, so the paper stated. That is quite an important point in view of what the doctor said. The doctor said there are statistics required under the Harrison law from various institutions, which statistics show the amount of these drugs legitimately used for medicinal purposes. What kind of a certificate would the head of an institution like that make, to which Wallace Reid went, and what sort of certificate would he make as to the legitimate purposes or uses made in that hospital of such habit-forming drugs, if he told the truth? There ought to be something in the United States law governing the importation of these habit-forming drugs so that the users will be right under the public gaze all the time, so far as accurate statistics are concerned, and punish the offenders. I know the Harrison law to-day is very defective in many particulars.

The CHAIRMAN. We can discuss that in executive session.

Mr. LINTHICUM. I would like to ask leave to introduce into the hearings resolutions passed by the Loyal Order of Moose, in which they request the President to set aside national antinarcotic week, and to call an international conference of leaders of this and other organizations to formulate plans to control the traffic in narcotic drugs.

The CHAIRMAN. Yes.

(The letter referred to is as follows:)

RESOLUTION OF BALTIMORE LODGE, NO. 70, LOYAL ORDER OF MOOSE.

Whereas incontrovertible evidence, based upon facts gathered by the United States Government proves that despite existing laws traffic in narcotic drugs, including morphine, cocaine, and other opiates, is spreading to an alarming extent, not only in the United States but throughout the world; and

Whereas it is disclosed that the use of these habit-forming drugs is increasing so rapidly as to become a grave peril to the Nation: Therefore, be it

66

Resolved by Baltimore Lodge, No. 70, Loyal Order of Moose, Baltimore, Md., in meeting assembled, That the President of the United States be respectfully requested to set aside a week to be known as National antinarcotic week," so that the public may be awakened to the dangers involved; and that he be requested to call an international conference of leaders of this and other nations for the purpose of formulating plans for the control of the traffic in narcotic drugs between the various countries of the world; and be it further

Resolved, That this resolution be sent to the President of the United States and copies thereof to the governor of this State and the United States Senators and Congressmen from this State, and the same be published in the newspapers of this city.

Hon. STEPHEN G. PORTER,

Chairman Foreign Relations Committee,

WM. B. McCADDIN, Dictator.
F. FRIEDEMANN, Secretary.

NEW YORK, January 24, 1923.

House of Representatives, Washington, D. C.

DEAR MR. PORTER: When you proposed certain questions to me concerning opium I thought that I had the data on them all collected. But I had my material put together over a year ago and had not had it brought up to date. I have, since returning home, had this done for me.

As I recall it, the questions you asked were as follows:

1. How many addicts are there in the United States?

2. What is the gross amount of opium produced in and exported from India and Persia and Turkey?

3. About what is its value?

4. About what is the acreage in India?

5. What ratio to the total revenue of India is the opium revenue?

6. What per cent of profit is made out of the production of opium in India?

Inclosed is a pamphlet of mine giving you the amount of opium used in the legitimate practice of medicine.

1. Number of addicts in the United States: The State Department of Narotic Drug Control in New York a few years ago actually registered in New York City 7,464 addicts, and the records of the department show in round numbers 13,000 addicts, who were recorded as obtaining the drug from physician's directly or on prescription. The department says that a safe and conservative approximation of the number of addicts in the State would be 39,000. This was in the second annual report of the department, April 7, 1920. Some months later during the last few weeks of the existence of the department there were actually recorded in the files for the State, 38,000 addicts. These figures do not take into consideration the addicts supplied by peddlers, nor, of course, is it a complete list of other addicts in the State. The department considered that an estimate of 50,000 would be moderate. This makes a percentage of one-half of 1 per cent for the total population of the State, approximately.

The special commission appointed by the Treasury Department made the statement in June, 1919, that there were about 1,000,000 addicts in the United States, based on the best available information. Every physician registered under the Harrison Act was asked how many addicts he was treating. Replies were received from 30 per cent, showing 73,150 addicts. If the same average had been maintained and they had received 100 per cent replies, it would have amounted to 237,655 addicts. A questionnaire sent to health officers was answered by 26 per cent, who reported 105,837 addicts. This on a 100 per cent basis would amount to 420,000 addicts. These are the only figures obtainable with any basis of fact behind them. All other figures are estimates, biased by the personal judgment of those making them.

2. The amount of opium produced in and exported from India, Persia, and Turkey: The best information I can obtain of the amount of opium produced in Turkey shows an average of 7,000 chests annually, each chest containing 150 pounds, while in good years the amount rises to 12,000 chests; that is, the amount varies from 1,050,000 to 1,800,000 pounds. The Turkish opium contains 12 per cent of morphine, while the Indian opium contains only 8.5 per cent.

The Statesman's Year Book, 1922, page 1193, shows exports of opium from Persia in thousands of krans, 25 krans in a pound, since 1919, and gives the following:

1918-19

1919-20-.

This opium also contains 12.5 per cent of morphine.

Krans. 28,595 24, 166

It is claimed by G. Graham Dixon in "The Truth About Indian Opium," printed officially by the British Government, that Persia exports 30 per cent more opium than India, and Turkey in normal times exports about the same amount as India. India exported in 1918-1919, 1,534,500 pounds; in 1919-1920, 916,600 pounds.

3. Value of opium exported from India: The value of the exports in 1918-1919 was £2,086,050; in 1919-1920, £1,960,262.

4. Acreage in India under cultivation for opium: The acreage in 1918-1919 was 206,733; in 1919-1920, 181,787.

5. Ration of revenue from opium in India to total revenue: The relation of opium revenue in India to the gross revenue of India, according to Dixon, was as follows:

6. Per cent of profit: The relative cost and the net revenue in India was as follows:

There is a statement published by the British Government, 1922, called "Statement of Action Taken by British Government," which is printed by Harrison & Sons (Ltd.), 44 St. Martins Lane, W. C. 2. This is their official statement about the International Opium Convention in 1912, and I think would interest you. It is dated from the home office November, 1922. It is a small pamphlet that would probably be in the possession of the State Department.

If I can help you further, let me know.
Sincerely yours,

ALEXANDER LAMBERT.

THE AMOUNT OF OPIATES USED IN THE LEGITIMATE PRACTICE OF MEDICINE.

By Alexander Lambert, M. D., New York.

In all discussions of the narcotic question in the United States, no figures have ever been obtainable of the amount of opium and its alkaloids used in the ordinary practice of medicine. In the report of the special committee of investigation appointed by the Secretary of the Treasury in 1918, on the traffic in narcotic drugs, it is said that the yearly consumption of opium in the United States for the period 1910-1915 averaged 491,043 pounds. It further says: "It has been stated that about 90 per cent of the amount of these drugs entered for consumption is used for other than medical purposes. While this statement is probably extreme, a comparison of the per capita consumption in this country with that of other countries indicates that this counry consumes from 13 to 72 times as much opium per capita as is consumed by other countries, the records of which were available. The following table brings this out more clearly:

TABLE 1.-Per capita consumption of opium by United States and certain foreign countries.1

"As the average dose of opium is 1 grain, the amount consumed in the United States per annum is sufficient to furnish 36 doses for every man, woman, and child. When it is considered that the greater portion of our citizens do not take a single dose of opium year after year, it is manifest that this enormous per capita consumption is the result of its use for the satisfaction of addiction." Since the Harrison law requires a record to be kept in each hospital of the amount of opium and its alkaloids purchased and the amount consumed, it would seem possible, by calculating from the number of patients treated in the