Medical Rhetoric and the Sympathetic “Inebriet”: 1870–1930

Abstract

The modern view of addiction as a progressive brain disease originated in the sec­ond half of the 19th and early decades of the 20th centuries. Historians attribute the shift from a moral to a medical concept to the efforts of a small but well-organized band of physicians forming what is known as the Inebriety Movement in the United States and Great Britain. Members aimed to distribute the disease theory to a dis­interested and biased medical community, establish protocols for evidence-based treatments, and transfer the management of drinkers and drug users away from religious organizations and penal institutions to the care of trained practitioners. Members’ efforts to rhetorically achieve these goals on the pages of medical jour­nals has received scant attention in the scholarly community. Based on an analysis of 92 medical articles on addiction published between 1870 and 1930, I will reveal a complex, inclusive, and multimodal rhetoric employed to refigure “drunkards” and “underworld” drug “fiends” as patients and their confounding addictive behaviors as symptoms rather than signs of degeneracy. Before advanced under­standing of brain’s pleasure circuits and dopamine receptors, these early medical authors dramatically rendered the havoc that substances can play on those sys­tems. Recovering the narratives and patient tropes I find in these texts may be instructive as we try to find ways to erase persistent stigma surrounding addiction. My findings will hopefully encourage dialogue and new research pathways for scholars interested in the rhetorical history of addiction.