Citation

May C. Addiction Research 1997; 5(2): 169-187.

Copyright

(Copyright © 1997, Informa - Taylor and Francis Group)

DOI

10.3109/16066359709005258

PMID

unavailable

Abstract

Chronic alcohol misuse is an intractable problem for contemporary medicine. This paper explores some of the origins of this intractability, by examining the formulation of medical and moral models of habitual drunkenness during the nineteenth century. Its objective is to sketch out an historical perspective for contemporary problems in disentangling the relationship between culpability and susceptibility in alcohol dependence.Notes1. I deliberately do not deal with the impact of the temperance movement on medical models of alcoholism during this period. Porter (1984), Thompson (1988) and Berridge (1990) provide very helpful accounts. A classic survey of the growth of the Temperance cause in the United States may be found in Gusfield (1963). Heather and Robertson (1984) also note the close interlinkage of disease concepts of alcoholism and the emergence of medical models. Their discussion of the growth of the inebriate asylum is particularly useful in the context of this paper (see Heather and Robertson, 1984 pp 33-45).2. This perspective led, within fifty years, to the forced sterilisation of an unknown number of African Americans, as well as white psychiatric patients and criminals in Europe and America. Its appalling consequences in forming a rationale for genocide in Europe do not need to be elaborated upon here.3. Such views increasingly characterised discussion about social policy at the end of the century. So much so that it was possible for the key commentators and political thinkers on whom the present welfare state rests, (Sydney and Beatrice Webb, William Beveridge, Winston Churchill, HG Wells and so forth), to consider building into their recommendations for Poor Law reforms in the early 1900s the proposal that the unemployed and unemployable should be settled in camps in the least hospitable parts of East Anglia, and isolated from respectable society (Harris 1979)4. The medicalised discourses that surround alcohol misuse in 19th century Britain reflect a more general set of propositions about the gendered nature of behavioural conditions. The wilfully immoral female was largely the product of discourse about the labouring classes, while a range of behavioural problems related to libidinous appetites in the realm of sexuality and addiction were-for middle and upper class women, at least-organised in terms of somatic problems. 1 am grateful to an anonymous reviewer for drawing to my attention work by Smith-Rosenberg (1978) in this regard, but see also contributions to Martha Vicinus' germinal edited collection (1972), especially those by Cominos (1972) and Stearns (1972).

Language: en