EDITORIAL

© 2003 Society for the Study of Addiction to Alcohol and Other Drugs

Addiction,

98

, 139–140

Blackwell Science, Ltd

Oxford, UK

ADDAddiction

0965-2140© 2003 Society for the Study of Addiction to Alcohol and Other Drugs

98Editorial

EditorialEditorial

‘Ask the physician’: the modern relevance of an 18th century public health crisis

Both law and science construct a world of universal, abstract rules and values. It is an orderly and predict-able world, intelligible and legitimate, a world of authority. In creating meaning the dramas of public action shore up a fence against the awesome scepti-cism of unending alternatives, ambiguous facts and the confusion of the concrete and the particular

(Joseph Gusfield, 1981 [1])

In January 1726 John Freind, a physician and member ofthe British parliament, was asked to present a petitionbefore the House of Commons. The request came from theRoyal College of Physicians, whose members had at longlast decided to weigh in on the gin craze then sweeping thecapital. The physicians, perhaps realizing that long peti-tions are almost never read, limited themselves to just foursentences, only one of which contained any substance.The frequent use of gin, it read, had rendered ‘great num-bers of both sexes...diseased’ and ‘not fit for business’; ginwas, moreover, ‘too often the cause of weak, feeble, anddistempered children, who must be, instead of an advan-tage and strength, a charge to their country’ [2].

The physicians’ petition was destined to languish incommittee, in large part because Freind, a staunch Tory,was on the outside with the Government headed by SirRobert Walpole [3,4]; but over the next several years theCollege and its members were to play an increasinglyprominent role in the campaign against gin. CorbynMorris, writing about London and its population, urgedhis readers to do as he had done and ‘ask the physician’,confident that any doctor ‘will instantly declare, that thecertain consequence to adults of drinking these burningpotions is to be enervated, and rendered less fit for bodilylabour, and procreation of children’. Thomas Wilson,Bishop of Sodor and Man, claimed to have consulted twoor three ‘eminent physicians’ while writing

Distilled Spir-ituous Liquors the Bane of the Nation

[5]. Isaac Maddox,Bishop of Worcester, preached an entire sermon againstgin citing, among others, a report (since lost) by the Col-lege of Physicians [6]. That same year, as the Gin Act of1751 was making its way through parliament, severalphysicians were asked to testify [7], each to the effect that‘spirituous liquors are to the last degree detrimental tothe human constitution, being the causes of dropsies,jaundice, consumption, fluxes, dejection, frenzy, & c’ [8].

RELEVANCE FOR MODERN TIMES

It all sounds so very modern; and that is precisely thepoint. Gin happened to come of age in the early decades ofthe Enlightenment, and it was the Enlightenment thatprovided politicians and reformers alike with a new set oftools with which to control gin and the shabby peoplewho drank it. Those tools, under the apt rubric of ‘politi-cal arithmetic’ [9], derived their authority from the beliefthat science and its practitioners are inherently objective,and that both can and should be enlisted in formulatingpublic policies. But is it so simple? Can physicians andother practitioners of science be even remotely objectivewhen asked to weigh social problems that they them-selves find both distasteful and threatening?

The example of the gin craze suggests otherwise. Ginbecame popular among London’s slum-dwellers just astheir social superiors were starting to dabble in a newform of advocacy in public life, one that, in the true spiritof the Enlightenment, deferred to science and its practi-tioners. There was, however, just one small problem.While the methodologies had become far more sophisti-cated, the underlying social vision had not. That is, whilethe crusaders against gin were now able to back up theirarguments with hard numbers and scientific reasoning,they themselves remained committed to a highly reac-tionary social vision. That vision was animated by twovery old-fashioned ideas: states flourish when they candraw on infinite reserves of sailors and soldiers, and econ-omies flourish when wages are kept low [10], as theyinevitably are when the supply of labour exceeds demand.Both scenarios required that the poor reproduce at prodi-gious rates, which while doing little for their own health,was presumed to do a great deal for the health of thenation as a whole. Hence the claim that ‘the strength andriches of a national community consist in the health andnumerousness of its labourers; for if these be not pre-serv’d, where will your produce be? Where will you findsoldiers?’ [11]. Hence, too, the physicians’ fascinationwith the poor and any threats to their ‘prolific faculties’.

The theory has its problems. For a start, I think thatwe can all agree that poor people who reproduce beyondtheir means are doing little for their own health or forthat of their children. To that extent, then, the physiciansof Georgian England had the interest of neither at heart.

© 2003 Society for the Study of Addiction to Alcohol and Other Drugs

Addiction,

98

, 139–140

140

Editorial

While the physicians were right when they com-plained about gin’s deleterious effects on the health of itsdrinkers their programme, like that of other social con-servatives, did not go nearly far enough. That is, while ginwas doubtless bad for a good many people, its effects wereinevitably compounded by social conditions that neitherthe physicians nor their allies in parliament had anyintention of tackling, were they malnutrition, overcrowd-ing, poor sanitation, disease or simply poverty in general.The physicians, in other words, were half right: gin wasassuredly bad for the health of its drinkers, but povertywas just as bad—and probably several times worse.

Two other incidents also reflect rather poorly on thephysicians of that time. In 1740, at the beginning of theWar of Austrian Succession, the Admiralty approachedthe College, asking ‘whether malt spirits was as good andwholesome as French brandy for the sailors’; the physi-cians, eager to help the Admiralty in its attempts torecruit and retain sailors while also cutting costs, readilyagreed that ‘malt spirits might be drank by them withoutany detriment’ [12]. Three years later, in 1743, a distillerby the name of Davis took out an advertisement in

TheLondon Evening-Post

, claiming that his ‘sugar brandy’ was‘far more wholsome than any foreign brandies, as willshortly be demonstrated before the whole College of Phy-sicians’ [13]. It is unclear whether Davis ever succeededin his plan, but it is telling that he was prepared toannounce success in advance of the fact.

DEBATES OVER HOW PEOPLE CHOOSE TO LIVE THEIR LIVES

It is, of course, easy to scoff when physicians get it wrongand lend their names and authority to dubious causes. Itis, by that logic, easy to laugh at the claim that ‘more doc-tors smoke Camels than any other cigarette’*—or at thebad epidemiology behind the campaign to reform theslum-dwellers of Georgian London; but that is not thepoint. The real point, like that of all morality tales, is sim-ple: debates over drugs are necessarily debates over howpeople choose to live their lives. By the same token, whenwe react against a drug and the effects it might have onother people’s behaviour, we are also reacting against theculture in which the drug has taken root and from whichit derives much of its meaning. Sadly, physicians are noexception. When they write and testify on behalf of drugpolicies they inevitably become players in cultural skir-mishes, and to that extent their claims to scientific objec-tivity must suffer.

I hasten to add that I am not an enemy of science—medical or otherwise. I believe that the Enlightenment didus much more good than harm. However, reason can andwill fail when it is enlisted on behalf of unreasonablecauses, or simply on behalf of policies that offer simplesolutions to what are in fact complex, ambiguous andultimately very expensive social problems. This is not anew observation, nor is it especially profound; but it doesbear repeating, if only because the types of scientific advo-cacy that first emerged in the early 18th century havebecome a permanent part of our political and culturallandscape [14].

JESSICA WARNER

Centre for Addiction and Mental HealthRoom T519

33 Russell Street

Toronto

Ontario M5S 2S1

Canada

E-mail: Jessica_Warner@camh.net

REFERENCES

1. Gusfield, J. R. (1981)

The Culture of Public Problems: Drinking-Driving and the Symbolic Order.

Chicago: University of ChicagoPress.

2. Royal College of Physicians of London (1726)

Annals

, 19January, ff. 71 verso, 72 recto. London: Royal College ofPhysicians.

3. Munk, W. (1861)

The Roll of the Royal College of Physicians ofLondon

. London: Longman, Green, Longman and Roberts.4. Sedgwick, R. (1970)

The History of Parliament. The House ofCommons 1715–1745

,

Vol. 2.

New York: Oxford UniversityPress.

5. Wilson, T. (1736)

Distilled Spirituous Liquors: the Bane of theNation.

London: Printed for J. Roberts.6.

The Norwich Mercury

, 2–9 March 1751, p. 1.7.

Journals of the House of Commons (London)

(1803) Vol. 26, p.112.

8.

The London Magazine,

March 1751, p. 126.9. Gay, P. (1996)

The Enlightenment

,

Vol. 2.

New York: W. W.Norton Co.

10. Coats, A. W. (1958) Changing attitudes to labour in themid-eighteenth century.

Economic History Review

,

11

, 35–51.11. Jekyll, J. (1736)

The Trial of the Spirits: or, Some Considerationsupon the Pernicious Consequences of the Gin-trade to GreatBritain

. London: Printed for T. Cooper.12.

The London Evening Post,

2–5 February 1740, p. 2.13.

The London Evening Post,

30 December

−

1 January 1743,p. 2.

14. Warner, J. (2003)

Craze. Gin and Debauchery in an Age ofReason

. London: Profile Books.

*Examples can be found by going to http://roswell.tobaccodocuments.org/pollay/dirdet.cfm

and

searching on ‘doc-tor’. Reference courtesy of Dr Joanna Cohen of the OntarioTobacco Research Unit.