Alcoholism in America: From Reconstruction to Prohibition (review)

Abstract

Reviewed by: Alcoholism in America: From Reconstruction to Prohibition Ron Roizen Sarah W. Tracy . Alcoholism in America: From Reconstruction to Prohibition. Baltimore: Johns Hopkins University Press, 2005. xxiii + 357 pp. $48.00 (0-8018-8119-6). What sociologists call "the modern alcoholism movement" emerged in the United States soon after the repeal of national prohibition in 1933. One of the new movement's goals was to convince the American public that it was not alcohol but instead a disease called alcoholism that should be the primary focus of alcohol-related [End Page 472] health policy. The new movement's advocates sought to distinguish their enterprise wholly from the temperance movement and its longstanding hegemony in the United States' alcohol-problems social arena. The new group argued that their ideas offered a completely new and modern approach. The book under review recalls an alcoholism treatment movement that spanned the years from soon after the Civil War to the onset of national prohibition in 1920. In this period, according to Sarah W. Tracy's account, reformers created over two hundred public and private institutions for inebriates in a diversity of forms that included private sanitariums, proprietary clinics (e.g., the franchised establishments offering Lesley E. Keeley's famous bi-chloride of gold cure), and state-run inebriate hospitals, farm colonies, and asylums. Tracy's particular interest lies in illuminating the stresses that arose in these early institutions as a result of alcoholism's dual cultural definition as both an illness and a vice. Although pennywise state legislators might try to economize by treating inebriates in already existing asylums for the insane, experience showed that the two patient populations did not get along well together and caused headaches for asylum administrators. Alcoholics were too frequently troublemakers and posed heightened escape risks. "In a surprisingly short time," wrote the superintendent of the Boston Lunatic Hospital in 1879 about dipsomaniac patients, "he is on his feet, under perfect control, looking around for a lawyer" (p. 159). On the other hand, mental patients resented inebriate co-residents and believed that the mentally ill enjoyed a sounder claim to the institution's care. Inebriate asylums were creations of the state, both for the treatment of the inebriate and the maintenance of public order and well-being. The administrators of these institutions had to take care that the public did not get the impression that inmate drunkards were enjoying a vacation spa at the public's expense. Confinement ordered by a magistrate for a specified term of weeks or months was one way to communicate the quasi-penal quality of the inebriate asylum. The State Hospital for Inebriates at Knoxville, Iowa, resolved the tension between therapeutics and penal discipline by employing the so-called "wheelbarrow cure." Farm labor for inebriates, it was argued, got them out into the fresh air, strengthened their backs, contributed to the institution's food stores, and even allowed the institution to extend a helping hand to nearby farmers at harvest time. "I tell you when the men get through with that cure," wrote Judge John Crownie, "they will hesitate a long time before they touch whiskey again and have to go back to the wheelbarrow" (p. 217). Yet the administrators of inebriate asylums also felt a genuine duty to protect the therapeutic and benevolent ideal of their enterprise. They saw their asylums as cutting-edge expressions of a modern medicoscientific sensibility. Moreover, they argued that the state had a moral responsibility to provide real treatment to inebriates because the state both sanctioned the sale of alcoholic beverages and derived tax revenues from those sales. Asylum administrators also sought to attract voluntary and paying patients, both to generate income for the institution and to vouchsafe their therapeutic character. [End Page 473] However genuine their therapeutic ideal, inebriate asylum administrators were plagued by what they perceived as the poor quality of the alcoholic patients being received. Judges used inebriate asylum commitments as dumping grounds for recidivist cases, and disgruntled wives used commitment to sequester drunken and sometimes dangerous husbands. Asylum staff responded by creating typologies of inebriates for differentiating various categories of "worthy" and "unworthy" patients, which were then triaged to different confinement circumstances. Alcoholism...