the invention of alcoholism

'Slavery from within': The Invention of Alcoholism and the Question of Free WillAuthor(s): Mariana ValverdeSource: Social History, Vol. 22, No. 3 (Oct., 1997), pp. 251-268Published by: Taylor & Francis, Ltd.Stable URL: http://www.jstor.org/stable/4286440Accessed: 09/10/2009 19:01

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Mariana Valverde

'Slavery from within': the invention of

alcoholism and the question of free

wil*

The will is at the root of human conduct. It is the basis of moral action. It is the foundation of wisdom. It is the controller of impulse. Without it duty cannot be done.... It is the regulator of passion and desire. Without it in some strength no civilized, moral and permanent form of human society could exist. If it be true that this most authoritative faculty of man is in any way lessened by alcohol, that substance would seem to need no other condemnation.

(Sir Thomas Clouston, MD, igi4)1

INTRODUCTION

In his influential work on insane asylums in nineteenth-century France, Robert Castel argued that pOst-1789 psychiatry managed to recuperate the old and highly illiberal institution of the general hospital by claiming that only institutionalization could provide the treatment lunatics needed in order eventually to exercise some semblance of liberal freedom.2 Liberal regimes of governance,3 as many scholars have pointed out, make the exercise of liberal autonomy contingent on the possession of 'rationality'. Hence, those whose rationality is non-existent, imma- ture, or defective have only one right: the right to be despotically treated in such a way as to build up the capacity to reason that is the precondition of self-governance. Social and politcal exclusions based on ascriptions of rationality have received much attention from historians of colonialism, of slavery, and of gender relations, as well as historians of medicine and madness. This article turns the discussion in a different direction by exploring a historically specific problematic of liberal freedom that revolved not around supposed defects of intellect but rather on defects in a key moral faculty: 'the will'.

* Many thanks to all the people who helped me to navigate in new areas of research and gave me ideas and suggestions, especially Alan Collins, Pat O'Malley and Nikolas Rose.

t T. Clouston,'Some of the psychological and clinical aspects of alcohol', British Journal of Inebri- ety, XI, 3 (1914), 114.

2 Robert Castel, The Regulation of Madness

(Berkeley, CA, I988), Introduction. 3 For a theoretical elaboration, from a Fou-

cauldian perspective, of liberal governance and its paradoxes, see A. Barry, T. Osborne and N. Rose (eds), Foucault and Political Reason (London, I996), and the special issue of the journal Economy and Society on'Confficts and contradictions in governance', xxv, 3 (I996).

Social History Vol. 22 No. 3 October 1997

0307-1022 C Routledge 1997

252 Social History VOL. 22: NO. 3

Alcoholism came to be regarded, in the late nineteenth century, as one of several 'diseases of the will'.4 At the level of high theory (that is, in the writings of philosophers and scientists), there was little agreement about the ontological and for that matter the physiological status of the'will',5 but at the level of clinical practice everyone acknowledged that whatever the ontological status of the will, alcoholism treatment would only succeed if the patient was filly involved in the process. Alcoholism recovery was (and still is) fundamentally paradoxical: the alcoholic's own willpower is the key element in recovery, even though the very essence of alcoholism is thought to be a defect in the will. This paradox is not, I will argue, a curiosity of medical discourse. It is a profoundly political paradox that pervades liberal governance in general. As Barry Hindess has pointed out,6 the central contradiction of liberalism is that people are, on the one hand, regarded as 'born free' (as Locke said) but, on the other hand, they have to be made free through training for autonomy. This training often relies on despotic means that stand in an uneasy tension with the ostensible ends of self-governance and freedom.

Within the context of the late nineteenth century's strongly paternalistic if not despotic model of medical treatment, alcoholism was unique in that the will of the individual was regarded as the central ingredient in treatment. Recovering alcoholics were also granted the - for the time - unusual privilege of writing about their own struggles against a disease in the pages of medical journals.7

Nevertheless, the temptation to treat alcoholism in the same manner as other illnesses - that is, as curable largely through the physicians' autonomous exertions - was always present. In the US, theJournal of theAmerican MedicalAssociation published ordinary physicians' treatment notes on alcoholism in virtually every issue between I895 and I905. Gold cures, strychnine, opium, cold water baths and hypnosis were discussed and evaluated. But even physicians who used drugs often pointed out that alcoholism could not be treated, much less cured, if the patient did not actively co-operate. One physician writing to report partial success in treating'dipsomania' (alcoholism) through hypnosis cautioned that the hypnosis would only work 'if the patient is willing to be cured.... The object of the treatment is not only to cure the craze, but to strengthen the will.'8 A typical article in the physician-dominated British Journal of Inebriety formulated the paradox of medical treatment of alcoholism by stating that although alcoholism is indeed a disease, 'the medical treatment can assist men in carrying out their intention to become sober, but it cannot create that intention. At the outset, what must take place is a change in the alcoholic's character.'9

Many of the people diagnosed as inebriates/alcoholics belonged to social groups believed to have quite small amounts of self-control and willpower to begin with: the 'vicious' poor, of course, but also ladies of the middle and upper classes. Ladies were thought to be especially sus- ceptible to the other diseases of the will (e.g. kleptomania). Gentlemen, by contrast, were regarded as having much greater innate capacity for self-control, and so the treatments used for

4See the treatise by the influential French scientist Theodule Ribot, 7he Diseases of the Will (Chicago, 1915; 4th enlarged edn).

5 See Roger Smith, Inhibition: History and Meaning in the Sciences of Mind and Brain (London, I992).

6 Barry Hindess, 'Liberalism, socialism and democracy: variations on a governmental theme', Economy and Society, XXII, 3 (I993); reprinted in Barry, Osborne and Rose (eds), op. cit., 65-8o.

7See, for instance,'An ex-patient','The psychoanalysis of an inebriate: a record of experiences and reflections', British Journal of Inebriety, xii, I (I914),

22-7.

8 Anonymous,'Dipsomania and its treatment by suggestion',Journal of the American MedicalAssociation (henceforthJAA), xxxv (1900), 456.

9 A. T. Shearman, 'The effect of alcohol on feeling', British Journal of Inebriety, InI, 4 (i9o6), 34.

October 1997 Alcoholism and free will 253

them tended to be individualized and pastoral10 in nature. As we shall see in the last section of this paper, alcoholism treatment strategies both effected and reflected a social stratification of diseases of the will, and indeed of the will itself.

If alcoholism did not quite materialize as a coherent diagnosis, neither did 'the alcoholic identity' achieve the solidity that one might expect. As we shall see, working-class alcoholics were for a time absorbed into the 'feeble-minded' category, while ladies and gentlemen with 'drinking problems' were in turn subsumed under existing categories ranging from the alienist's 'mania' to the everyday, common sense category of 'bad habits'.

The choice of treatment/cure methods as a central object of our enquiry is important. One of the curious facts about the history of alcoholism is that a substantial number of physicians have insisted, for many generations now, that alcoholism is a disease, but this insistence has seldom managed to produce a full network of well-funded specific institutions. In the field of alcohol and alcoholism, intellectual history is thus quite limited, since one can find physicians arguing that alcohol is 'addictive' as far back as the seventeenth century.11 The 'real' history of alcohol, the evidence of qualitative change over time, lies not in the theory but in the tech- nologies of treatment and cure. The illiberal technique of hypnotism; the psycho-medical talking cures; the evangelical methods of Salvation Army'Homes for Drunkards'; the totali- tarian technique of complete Prohibition; the risk-management strategies deployed in liquor control and pub-hour laws - these and other equally complex regulatory strategies demonstrate that alcohol consumption and its regulation offer the historian of social, moral and legal regulation a very fruitful and largely unstudied field of research.

THE FAILURE OF MEDICALIZATION

Why did the project to create a new medicalized identity not succeed? Or, more accurately, why did it simultaneously succeed and fail, given that the turn of the century was a time when medico-legal and medico-moral specialists were scoring so many other successes?12

The first medical establishment for 'the treatment and cure of alcoholism' was, it seems, set up in New York state, after a petition signed by over I000 physicians was presented to the state legislature.13 But the patients' families apparently rebelled against the physicians' treatment of alcoholics as if they were insane, and lobbied the legislators until they deemed the experiment to have failed. The institution was then turned into a regular insane asylum. In a I906 evalu- ation of medical treatment facilities, the leading US inebriety expert, Dr T. D. Crothers, stated: 'In America the bitterest critics and most unrelenting opponents of asylums have been the

10 I am using the term 'pastoral' in Foucault's sense: see the lecture'Omnes et singulatim: towards a criticism of political reason', reprinted in L. Kritz- man (ed.), Michel Foucault: Politics, Philosophy, Culture (New York, I988).

It Jessica Warner,' "Resolv'd to drink no more": addiction as a pre-industrial construct', Journal of Studies on Alcohol (November 1994), 685-9i. Warner's article is a refutation of the classic study by Harry Levine,'The discovery of addiction',Journal of Studies on Alcohol, XXXIX, I (1978), 143-74.

12 A good account of many of these success

stories is found in David Garland, Punishment and We!fare (London, 1985).

13 Anonymous note, Medical Record, LVII (i900),

410-I1. See also Joseph Collins,'The law and the inebriate', New York Medical Journal, LXXIII, (4 May 1901), 765-8. Collins falsely believed that Canada had the legislative machinery to coerce alcoholics into state asylums, incidentally. This misinformation is typical: in general, the medical literature often lauds actual or supposed successes in medicalization of alcoholism treatment, but has little information on the failures and reversals.


inmates of such institutions and their friends.'4 Whether due to patient resistance or to other reasons, other fledgling state asylums for inebriates in the US all failed to prosper.15

Part of the problem was that the US temperance movement had set up its own non-medical 'Homes', to which alcoholics could voluntarily repair for treatment based on moral exhortation and self-help support.16 Given the great influence of evangelical temperance activity and the hostility between temperance people and medical science, it is not surprising that, although the hostility diminished at the end of the century, by the first decade of the twentieth century there were still very few medically run treatment facilities for alcoholics in the US.

In Britain, where the Habitual Drunkards (later Habitual Inebriates) Acts had set up an underfunded but significant network of treatnent homes and reformatories which were universally subject to medical inspection, even if run by temperance societies, the medicalization of alcoholism seemed more successful for a few brief years (fiom I900 to I908, roughly). But these inebriate institutions were dealt a severe blow by the withdrawal of local government funding that began in I908, and by the repeal of the legislative provisions for state medical inspection that took place in I9I4. 7

If the institutional network of medicalized alcoholism treatment was small, fragmented and in constant crisis, the discursive network was equally unstable. From the invention of the un- successful term 'oinomania' in the i85 os8 through to the First World War, no one term was ever adopted even within specialist medical circles. Oinomania, dipsomania, narcomania, alcoholism, inebriety, habitual drunkenness ... the terms kept proliferating. As late as I914, the British Inspector of Inebriates felt compelled to state that the term 'inebriate' was for him (though not for other experts) synonymous with 'habitual drunkard, chronic alcoholic, or dipsomaniac'.19

It would be insufficient, however, simply to conclude that alcoholism 'failed' as a project. No clearly defined population with a widely accepted diagnosis ever emerged; but that does not mean that nothing was being accomplished. The invention of alcoholism is perhaps best regarded not as a self-contained narrative characterized either by 'success' or by 'failure', but rather as a facet of a wider, quite complex process through which certain social groups that did not fall within the medical definition of insanity20 came to be subjected to more or less despotic

14 T. D. Crothers,'The Norman Kerr memorial lecture', BritishJournal of Inebriety, III, 3 (I906), 123.

15 See, for instance, a report on an inebriate institution in Boston,JAAA, xxxiv (I900), I572-3; and an anonymous report inJA4MA, xxxv (I900), i655.

In i862, the legislature of the United Province of Canada (which included most of present-day Ontario and Quebec) was presented with a lengthy and erudite report/recommendation, which as far as I have been able to determine fell on deaf ears games Bovell, A Plea for Inebriate Asylums . . . (Toronto, I862).

16 James A. Baumohl, Dashaways and Doctors: The Treatment of Habitual Drunkards in San Francisco from the Gold Rush to Prohibition (DSW dissertation, Uni- versity of California at Berkeley, I986).

17 Gerry Johnstone, 'From vice to disease? The concepts of dipsomania and inebriety, I860o-908',

Social and Legal Studies,v, I (I996), 37-56; Patrick

McLaughline,'Inebriate reformatories in Scotland: an institutional history' in S. Barrows and R. Room (eds), Drinking: Behaviour and Belief in Modern History (Berkeley, CA, I99I); and G. Hunt, J. Mellor and J. Turner, 'Wretched, hatless and miserably clad: women and the inebriate reformatories from 1900-19I3', BritishJournal of Sociology, XL, 2 (I989),

244-70. 18 Anonymous, 'Oinomania; or the mental

pathology of intemperance', The Journal of Patho- logical Medicine and Mental Pathology, viii (i April I855), 175-207.

19 BPP, Report of the Inspector . . for 1912, I914,

XXXVi, 255 . 20 The first clause of the British Habitual Inebri-

ates Acts declares that inebriates are, first of all,'not amenable to jurisdiction in lunacy' (6I and 62 Vict., 1898).


regimes, ranging from custodial and punitive institutions to therapeutic programmes empha-

sizing training for and in freedom. The logic of governing through alcoholism can perhaps be best discerned through a com-

parison with other, better documented, disciplinary projects of the same time period. The

'feeble-minded', for instance, those dreaded spectres of social Darwinism, were by and large

presumed to be incapable of being trained for freedom. Regarded as evolutionary waste prod-

ucts, they were confined to institutions, experimented on, sterilized and subjected to other

despotic forms of governance.21 Alcoholics, by contrast, were often praised for their valiant battles against their own heredi-

tary or acquired tendencies. At a time when medicine often emphasized the relentless deter-

minism of degeneration, it is indeed striking to hear Britain's most famous inebriety expert, Dr

Norman Kerr, sing the praises of the individual will of the deviant:

The continuous and victorious struggle of such heroic souls with their hereditary enemy - an enemy the more powerfil because ever leading its treacherous life within their breasts,

presents to my mind such a glorious conflict, such an august spectacle, as should evoke the

highest efforts of the painter and the sculptor. Before so protracted and so lofty a combat,

the immortal group of Laocoon contending with the serpents, grand though that great

work of art is, must pale its ineffectual fires.22

Kerr later pays homage to the recovering alcoholic by deploying the considerable power of the

'freeborn Briton' discourse against the prevailing discourses on degeneration:

The depths of misery and despair into which the relentless tyranny of alcohol has, by

inheritance, plunged its victims, seem to have permeated their whole being with hatred

of their enslaver, and to have inspired them with the determination to strike a blow for

freedom, and casting off forever the yoke of the oppressor: 'To burst the chains which

drink for ever flings/ On the entangled soul's aspiring wings.'23

An ex-patient writing in the BritishJournal of Inebriety added his voice to Kerr's, stating that

recovering alcoholics are 'no fit objects for cowardly repression or endless, petty slights', but

should instead be considered as representatives of 'the moral courage of inebriety'.24 This lan-

guage is noteworthy because one cannot imagine a person labelled'insane' or'feeble-minded'

writing (in this time period) about the moral courage of their deviant group, much less being

given space in a medical journal to sing its praises. The contradictions involved in inventing a disease that could only be cured by the patient's

own will are particularly apparent in the first of the British Inebriate Acts, passed in I879. This

act owed its existence in large part to the efforts of the physician operating a famous private

21 See, among others, Daniel Pick, Faces of Degen- eration (Cambridge, I989); Nikolas Rose, The Psychological Complex (London, I985); Angus McLaren, Our Own Master Rce:The Eugenic Crusade in Canada (Toronto, I99I); and Nancy Leys Stepan, 'The Hour of Eugenics': Race, Gender and Nation in Latin America (Ithaca and London, i99i).

22 Norman Kerr, Inebriety or Narcomania: Its Etiol- ogy, Pathology, Treatment and Jurisprudence (London, I894; 3rd edn), I7.

23 ibid., I97. 24 'An ex-patient', 'The psychoanalysis of an

inebriate: a record of experiences and reflections', BritishJournal of Inebriety, XII, I (1914), 23.


home for inebriates in the country, Donald Dalrymple, elected to parliament in the late i860S.25 Dahrymple wanted to regulate the private inebriate home business by establishing licensing; in addition, he wanted the state compulsorily to commit certain individuals to these homes. Dahrymple's original vision was not carried out, since his proposed bill was watered down to the point of ineffectiveness. But the I879 act, however impotent in practice, was important dis- cursively. It set out a legal definition of 'habitual drunkards' and established complicated legal machinery for reconciling state coercion with the view that the patient needed to choose freely to stop drinking. A habitual drunkard was

a person who, not being amenable to any jurisdiction in lunacy, is notwithstanding, by reason of habitual intemperate drinking of intoxicating liquors, at times dangerous to himself or herself or to others, or incapable of managing himself or herself and his or her affairs.26

Although the terminology was later changed from 'drunkard' to 'inebriate', the definition stayed the same throughout the life of the Inebriate Acts. Much could be said about this definition; but for our purposes it is sufficient to note that the criterion of ability to manage one's affairs was not a specifically medical one. No provision was ever made for expert medical testi- mony to certify inebriates.

The legal machinery adopted by parliament against the wishes of the inebriety experts allowed but did not compel individuals to make a declaration in front of not one but two Jus- tices of the Peace, declaring themselves to be inebriates and agreeing voluntarily to a certain period of confinement. As the inebriety expert Dr Peddie exclaimed,'No wonder that few have been found willing to make a voluntary surrender of liberty on such terms.'27 This ineffec- tive legal machinery, although undoubtedly designed precisely to render the act useless, was in keeping with the peculiar logic of alcoholism. Rather than having medical experts certify inebriates in the same manner as lunatics, inebriates were awarded the liberal privilege of certi- fying themselves.28 Their free will was thus safeguarded even as they were subjected to the JPs' authority.

That the focus on the free will threatened the whole medicalization project was clear to many people outside inebriety circles. An American Lunacy Commissioner typically argued in I874 that alcoholism was (unlike insanity) not a true disease, precisely because the only sure cure lay in the exercise of the patient's own will:

The problem of self-abasement or self-redemption is entirely within his control, provided he exercise a continuous determination of his will not to partake. The key to the riddle of this alleged disease lies in man's own will, and without this will effort, no physician can cure or even relieve him.29

25 See Johnstone, op. Cit., 41. For the I879 act, see Dr Kerr's presidential address to the British Society for the Scientific Study of Inebriety, Proceedings (i886), 2-8, and A. Peddie,'The Habitual Drunk- ards Act, I879', also in the Proceedings of the society

(I886), 4-9. 26 Definition quoted in BPP, Report of the Depart-

mental Committee on the Law Relating to Inebriates, I908, Xi, 3.

27 Peddie, op. cit., 7. 28 The self-certification process later achieved

tremendous success with the founding of Alco- holics Anonymous in the 1930s, an extremely popular organization based precisely on the practice of naming onesefas an alcoholic.

29 John Ordronaux, 'Is habitual drunkenness a disease?', American Journal of Insanity (April I874),

439.


But the medicalization project was endangered in other ways as well. One of the main debates at the turn of the century in regard to the practices later called'addiction'30 concerned the extent to which drinking alcoholic beverages was qualitatively different from the consumption of other problematic substances. Dr Norman Kerr's huge tome Inebriety or Narcomania, the most important relevant British work of its time, makes it clear that although alcohol is the primary site of inebriety, it is not the only one. While endorsing the existing term 'inebriety', whose penum- bra of meaning included opium and morphine use, Kerr also attempted to market a term of his own invention,'narcomania', encompassing much of what would now be called'addiction'.

Although Dr Kerr was the president of the Society for the Scientific Study of Inebriety, his effort to focus medical attention on the broader category of inebriety/narcomania (as opposed to alcoholism) was by no means universally accepted even in inebriety circles. Other physicians stressed the dangers of alcohol itself, perhaps out of a political interest in the vexed debates about the role of the state in liquor regulation. In the UK, as in the US, the long-standing byzantine regulations of pub hours, pub licences, off-licence wine sales, liquor taxes and so forth developed quite separately from the more strictly medical debates about regulating the sale of drugs such as opiates and morphine.31

This combination of factors meant that no consensus ever emerged, in the years before the First World War, on the question of whether to focus medical and legal enquiries on a single substance ('the demon rum'), on a group of substances (Dr Kerr's'narcomania' strategy), a moral process (the evangelical interest in sin), the physical effects of evolutionary degeneration,32 or - as in the post-Second World War definition - a personality type, the alcoholic or addict. The absence of one generally agreed-upon term is quite significant, for without a single term it is difficult if not impossible to create a new identity, medicalized or otherwise. The discourse of the medical specialists was constantly undermining itself by falling into the older language of 'vice' and 'habit',33 but even the medicalizing project was not internally consistent, for the mul- tiplicity of strictly medical terms remained unresolved.

Gerry Johnstone's recent article on the inebriety diagnosis has noted that the expected'medicalization' process did not in fact take place in the UK at this time, but he simply notes the absence of medicalization, and does not go on to note what there was instead.34 The history of alcohol control is indeed full of notorious failures, from the unsuccessfuil medicalization documented in this article to the crashing failure of North American Prohibition. But as Foucault said about the prison,35 perpetually failing regulatory projects ought not to be simply dismissed as 'failures': they can be analysed in order to illuminate the structural dilemmas involved in disciplining 'deviants' in a liberal society of 'free' individuals.

30 The OED's entries on 'addiction' and 'addicted' suggest that the current-day meaning of 'addiction' dates back only to the I920S. Although a full study of the history of addiction has not yet been produced, my research provisionally confirms the OED's dating, since although the terms 'addiction' and 'addict' were used, especially in the context of opium and other drugs, at the turn of the century, the meaning then was much wider. Addic- tion was then not much if at all different fiom 'habit'.

31 See V. Berridge and G. Edwards, Opium and the

People (London and New York, I98I). 32 The most important British advocate of the

theory that alcoholism was not a cause but a result of evolutionary degeneration was Henry Maudsley. See H. Maudsley, Body and Will (New York, I884).

33 For a development of this argument, see M. Valverde, Dreams of the Will:Alcoholism,Alcohol Regu- lation and the Dilemmas of Freedom, (forthcoming, New York, Cambridge Uriiversity Press).

34 Johnstone, op. cit., 37-57. 35 Michel Foucault, Discipline and Punish: The

Birth of the Prison (New York, 1979).


DISEASES OF THE WILL

As stated earlier, alcoholism was in the I88os defined as a defect in liberal subjectivity, a defect that, unlike insanity, affected not so much the rational but the moral faculties, specifically the will. Some people stressed that drinking caused an erosion of willpower, whereas others stressed that previously existing character defects led to excess drinking. But whatever the cause-effect relationship, there was general agreement that inebriety could be defined as 'the loss of will function'.36 A very early work, written before the terms 'inebriety' and 'dipsomania' gained cur- rency, argued that drinking too much alcohol was a disease allied to the manias. The anonymous medical author baptized this disease as 'oinomania', describing it as follows:

The most general excitant of the appetite is that condition of the mind in which there is simply a desire for pleasurable excitement and little power of the uill to resist the temptation to gratify the desire.37

Willpower is what distinguished the 'ordinary' drunk, who drank because he or she wanted to, from the dipsomaniac or alcoholic, who drank because he or she felt compelled to do so. The former fell within the domain of law, since he/she was responsible for the drinking and its con- sequences; only the latter fell within the domain of medicine. An inebriety specialist explained this commnon wisdom as follows:

The man who deliberately drinks to excess is without apology a vicious and criminal drunkard. He has complete power of will over his actions; and it is from deliberate choice that he thus renders himself brutish and dangerous.... Between such a man and the hope- less dipsomaniac there are many grades of drunkard, each possessing less willpower than the former.38

Some years later, the British parliamentary inquiry into the workings of the Inebriates Acts expressed the same idea but added a sophisticated mathematical twist, describing inebriety not as an absolute lack of willpower but rather as an inadequate ratio between desire and will. People with snall desires did not need a strong will in order to be temperate; but those born with a great love of life's pleasures needed a correspondingly large amount of willpower. The only solution to inebriety, the committee concluded, was to 'alter the ratio between self-control and desire, and restore it to normal, either by diminishing desire, or by increasing self-control, or both'.39

The close connection between drinking and the will was important not only for moralists but also for scientists. In the time period under study, the will played a central role in scientific theories about human progress, as exemplified in the passage by Sir Thomas Clouston quoted at the beginning of this article. The great English scientist Henry Maudsley had argued in an I884 work entitled Body and Will that 'the function of the will in the highest moral sphere' was the last and therefore the highest product of human evolution. Precisely because it is evolution's

36 Dr James Stewart,'The treatment of inebriety in the higher and educated classes', Proceedings of the British Society for the Scientific Study of Inebriety (henceforth Proceedings), ix (I889), 3.

37 Anonymous, 'Oinomania . . .', Op. cit., I78. 38 J. Muir Howe, 'The treatment of inebriety',

Proceedings, v (i885), 5. 39 BPP, Report of the Committee as to the Operation

of the Law Relating to Inebriates, I908, xii, 6. For an excellent discussion of the scientific context of the committee's deliberations on free will, see Smith, Inhibition, op. cit.


latest innovation, it is also 'the least stable', and is therefore 'the first to undergo dissolution'.40 Excessive and/or uncontrolled drinking was thus for Maudsley, and for most scientists, both a symptom and a cause of degeneration, and a particularly important one since it attacked the 'highest' faculties.

Maudsley's strictly Darwinian, strongly anti-spiritualist discussion of the will very much influ- enced the work of the French scientist Theodule Ribot. In Ribot's work, alcoholism and other forms of 'inebriety', such as the 'opium habit', were to be understood as key members of the family of 'diseases of the Will'.41 Attempting to provide a fully somatic theory of the will as an ability that grows organically out of simple cellular reactions (thus trying to subordinate the will to the body), Ribot provided a classification of 'diseases of the will' whose moral and social content is clearly apparent despite his efforts at using strictly somatic scientific language. Some diseases of the will, he argues, consist of 'defect of impulse' or 'irresolution'. Artists, writers and upper-class women seem peculiarly prone to this type of disease of the will, including melan- cholia.42 But while some people do not have enough will, others have too much: Ribot lists a whole array of diseases marked by an excess of activity, with 'dipsomania' as the first of these. (The others are kleptomania, pyromania, erotomania, homicidal and suicidal mania, epilepsy and hysteria.) While most of these manias are effects of an excess of will, of a surplus of desire, alcoholism is distinct in that it acts as cause as well as effect, since alcohol (as Maudsley and Clouston both stated) directly weakens the will. Thus alcohol has a special role in speeding up the process of racial degeneration. Ribot outdoes Maudsley, incidentally, in arguing that alcohol not only affects the higher (moral) faculties first, but even affects the physically higher parts of the body before the lower - thus the arms become unco-ordinated before the legs.43

The use of moral criteria to single out the disease of inebriety also characterized Dr Kerr's Inebriety or Narcomania. After a long enquiry into the nature and effects of over a dozen problematic substances, from opium and morphine to coffee and tea, Dr Kerr comes to the conclusion that true 'narcomania' is characterized not by the intensity of the compulsion to consume a substance as much as by the degree of impairment of 'the will', specifically of the ability to make moral decisions. Tobacco, for instance, does create a habit, but

No husbands are charged with killing their wives or assaulting their children through its excessive use.... Nor does it seem to give rise to mental and moral perversion as does alcohol.... There is therefore no true tobacco Inebriety or Mania.44

While coffee consumption could cause a number of serious physical deteriorations, such as sleeplessness and 'shattered nerves', Dr Kerr argued that coffee drinkers were not true maniacs because'I have not yet seen an uncontrollable crave or impulse [for coffee] to which all natural affections and duties are subordinated'.4 Moral abilities rather than physiological states

40 Maudsley, op. cit., 243. See also the chapter on 'Volition' in H. Maudsley, The Physiology of Mind (London, I876), chap. 7.

41 Ribot, op. cit. 42 ibid., 26-31. 43 ibid., II-.2o. On Ribot's analysis of diseases of

the will, see the perceptive commentary by Anson Rabinach, The Human Motor (New York, I990), I63-6.

4 Kerr, Inebriety, op. cit., 147-8. 45 ibid., iso.


therefore determined the boundary between ordinary 'bad habits' such as excess coffee drinking and the specifically moral disease of 'inebriety'.46

Defining inebriety in moral terms as a disease of the will, physicians were hard pressed to give specifically medical advice on how to rebuild the Will.47 In a very early meeting of the British Society for the Scientific Study of Inebriety, a participant formulated what one could call 'the paradox of liberal freedom' as follows:

And suppose the inebriety has absolutely destroyed all power of will to abstain. How can you build up a new character on the foundation of a will that does not exist? ... It would be an endeavour to build up a new character by means of a will which is to all intents dead.48

The evangelical temperance reformers had a clear and consistent answer to this question, namely 'the grace of God'. The physicians, however, never really developed a satisfactory answer. One medical authority, Sir William Collins, tried to dissolve the paradox by making a distinc- tion between two kinds of will, the (bad) 'self-will', involved in deciding to drink, and the (good) 'free-will' that in rational creatures, especially if British, operated to suppress and control the passionate 'self-will'. In a speech significantly subtitled'Slavery of the will', Collins outlined this theory of the dual will as follows:'It [sobriety] is the limitation of self-will in the interests of free-will and self-control.... The suppression of slavery from within as well as from without'.49 This formulation only repeats, and does not in any way resolve, the paradox of alcoholism recovery, for it is not at all clear how a person who is self-enslaved could ever succeed in overcoming the state of inner slavery.50

As well as playing a central role in defining the political capacities of the 'free' subject, alcohol was regarded as a central feature of the process of racial degeneration and generational deterioration. A typical statement, found in a large placard pasted in public places by the Borough of Hampstead in I905, put it succinctly:

46 In the 1996 American debates about the role of government in curtailing smoking, Robert Dole, whose presidential campaign was rumoured to be heavily funded by tobacco interests, has declared that for him smoking is not 'an addiction' but merely'a habit'. How the line between 'habit' and 'addiction' has been drawn at various points in history is a question which cannot be directly addressed in this article, but it will be addressed in fiurther research.

47 Andrew Scull has documented the ways in which medical specialists on insanity co-opted and eventually monopolized the administrative and therapeutic practices known as 'moral treatment', practices originally pioneered by lay persons, most notably at the York Retreat, as an alternative to 'medical' physical treatment (Andrew Scull, Museum

of Madness (New York, I979)). His research suggests that the medical men's takeover of 'moral' treatment was complete by the late nineteenth century in the field of insanity, but as seen here, in the alcohol field moral treatment was not successfillly appropriated by physicians. Today moral is most commonly prac- tised in lay AA groups.

48 Muir Howie, op. cit., 6. 49 Sir William Collins, Sixth Annual Norman

Kerr Memorial Lecture, British Journal of Inebriety, XIII, 3 (anuary I9I6), 146.

50 The paradox persists in today's AA groups, which veer uneasily between stressing personal autonomy and demanding subservience to a'higher power' located outside the self. See Klaus Mikela et al., Alcoholics Anonymous as a Mutual Sef-help Move- ment:A Study in Eight Societies, (Madison, 1996).

October 1997 Alcoholism and free will 26I

BOROUGH OF XA

Physical Deterioration and

Alcobol. The report of the Committee, presented to

Parliament by command of His lVajesty, emphasises the following facts:-

The abuse of alcoholic stimulants is a imost potent and deadly agent of physical deterioration.

If the mother as well as the father is given to drink the future of the race is imperilled.

Abstinence from alcohol is conducive to full physical strength and activity.

Alcoholic persons are specially liable to consumption and all inflammatory diseases.

Alcohol is really a narcotic, and often its first effect is to weaken a man's self-control while his passions are excited; hence the number of crimes which occur under its influence, as well as the spreading of vice and disease.

Lunacy figures show a large and increasing number of men and women admitted to asylums through drink.

Alcoholism perverts the moral nature, affects the judg- ment, and weakens the memory; it creates an enormous loss to the community through destroying the productiveness of-the worker.

This placard is issued by order of the Borough Council.

GEORGE BARHAM, Mayor. ARTHUR P. JOHNSON, Town Clerk. G. F. MOCLEARY, M.D., Medical Officer of Health.

TOWN HALL, HAMPSTEAD. Novmber, 1905.

Figure 1. Placard from Borough of Hampstead

262 Social History VOL. 22 : NO. 3

The abuse of alcoholic stimulants is a most potent and deadly agent of physical deterioration. If the mother as well as thefather is given to drink the future of the race is imperilled.51

But alcoholism was unusual among the symptoms/causes of 'degeneration' in that it was not thought to be confined to criminals, to the racially other, to the poor, or to neurasthenic upper- class women. The upper classes were thought to be born with more willpower (the good kind of will, 'free' will, of course) than the poor, and men were similarly thought to have more willpower than women of the same class and race; but alcoholism and other addictions certainly affected the highest strata, as many physicians noted from their own clinical experience.

Innate willpower, just like inherited capital, could not be taken for granted: it could and indeed often was squandered and lost. Turn of the century physicians were as concerned with restoring the willpower of the gentleman inebriate (and, to a lesser extent, of the lady with addictions) as they were with the better known process by which working-class inebriates,

especially women, were confined to state reformatories. The differential treatment programmes provided for different classes and genders in the UK both reflected and reproduced certain highly political assumptions about the unequal distribution of the preconditions of liberal subjectivity among the population.

CLASS AND GENDER IN THE ETIOLOGY AND TREATMENT OF

ALCOHOLISM

After the I898 act, officially recognized inebriates were divided into two groups: those confined to private retreats (either voluntarily and privately, or else through the legal machinery of naming oneself as an inebriate in front of a JP) and, on the other hand, those confined to state reformatories. The two kinds of institutions were so different that it could be argued that there was no such thing as an inebriate in general. Most of the Inspector's annual reports begin by clarifyirig the sharp differences between the two kinds of institutions and referring these back

to the alleged essential differences between naturalized populations.52 The average patient in a

retreat, Inspector Branthwaite states, is

apart from his drink mania, intellectual, gifted, and the best of companions. The average

reformatory case, on the other hand, as we have learned to know him (or more often her) is an entirely different being. Long neglect, years of unrestrained drunkenness, immoral-

ity, and filth, have between them, created a class of person who is often on the borderland

of insanity, generally degraded morally and physically, filll of criminal tendencies, a curse

to law and order, and a continual expense and charge upon the state.53

Branthwaite's move here could be described as 'administrative ontology'. Needing to justify the facilities and the relative freedom offered in retreats, the Inspector constructs an ontology of human difference that, not coincidentally, happens to fit with the regime of governance

Sl Borough of Hampstead, 'Physical Deterior- ation and Alcohol', placard reprinted on back page, BritishJournal of Inebriety [19041. The 1904 Interde- partmental Committee on Physical Deterioration did much to emphasize the link between alcohol and 'the race'; in I904, and for a couple of years afterwards, the British Journal of Inebriety had a

remarkably large number of articles devoted to the question of maternal alcohol intake.

52 See Ian Hacking, 'The looping effects of human kinds' in D. Sperber, D. Premack and A. J. Premack (eds), Causal Cognition (Oxford, I994), chap. I2.

53 BPP, Report of the Inspectorfor 1901, I902, xii, 47.


applied in those institutions. Although gender is specifically mentioned in the quote above, it was a class-specific gender, since ladies were never sent to reformatories, however weak their self-control. Branthwaite makes the transition in one of his reports between the section on retreats and the section on reformatories as follows:'On leaving the former (retreats) we com- pletely turn our backs on the principle of voluntary admission, and with it what may justly be called the 'drawing room' aspect of all efforts toward inebriate reform'.54

The gentlemen's retreats, full of jovial gentlemen whose 'drink mania' could be regarded as a mere blemish, often offered ample facilities for billiards, hunting, fishing and other gentle- manly pastimes. The most important of these homes, Dr Dalrymple's 32-bed home, reported in 1902 that during its lifetime it had been inhabited by 37 army or navy officers, 44 doctors, 32 solicitors, ii stockbrokers, 3I manufacturers, 22 brewers and distillers, I52 gentlemen of 'no occupation' and 59 clerks.55 Another gentlemen's home, Plasy-Yn-Dinas in Wales, advertised itself in the following terms:

The Home is devoted to the care of Gentlemen of the Upper Classes only, suffering from Inebriety, Neuritis, Nervous Debility, Neurasthenia, and the Abuse of Drugs. The Plas is a handsomely furnished modern residence, replete with every convenience, containing fine reception-rooms, hail and billiard rooms, twenty four large and airy bedrooms, and seven bathrooms.... Well-preserved Shooting over 22,000 acres, containing large grouse moors, pheasant coverts, and enclosed rabbit warren.... Private golf links, lawn tennis, croquet.... Terms from six Guineas a week.56

The treatment applied to these gentlemen consisted partly in the harm-reduction measure of removing them from their usual sources of alcohol, but it also inivolved an important element of individualized pastoral care. Dr Branthwaite, who had directly treated alcoholics before becoming Inspector, stated that the propaganda of temperance societies was not useful because it was too general, and that something 'more capable of individual application is wanted':

Every inebriate possesses more self-control than he appears to possess, or believes that he possesses.... It is the possibility of awakening dormant self-control, or stimulating, by exercise, weakened self-control, that gives the man who is treating drunkards his best chance of success.... Self-control needs as much care and nursing as a delicate plant.... The secret lies in personal influence, that power of support exercisable by a stronger over a weaker will ... in the search for additional measures the individuality of the inebriate must be taken into account.57

Branthwaite clearly had in mind the gentleman inebriate of the Dalrymple home when he wrote these lines, not the working-class reformatory women earlier labelled as 'morally and physically degraded'.

Less information is available on the operation of the retreats for ladies, since the operators of these homes did not send elaborate reports to the Inspector. Their advertisements, too, seemed less eloquent, perhaps because ladies did not expect 22,000 acres of good shooting. A typical advertisement published in the British Journal of Inebriety sang the praises of a private

54 ibid. 55 Extract from the annual report of the Dalrym-

pole Home in ibid., 38. 56 Advertisement in British Journal of Inebriety

(I900), ii. (Most issues carried the same advertisement.)

57 BPP, Report of the Inspectorfor i0og, I9II, xxix, part i, I8-I9.


AD VERTISE.VENTS BRITIES JOURNAL

Of' LMEB3IBTT

QS EA I SLAN D FOR THE CURE OF

Or ABUSE OF DRUGS. Island Estate nearly four miles round. No public bouses. Full liberty. Bracing air. Boating. Billiards. Badminton. Fishing. Golf. Gardening. Sea Bathing, etc. Resident Physician: DR. REED. Ladies and Gentlemen taken as Irivate Patients, or under the Act. Terms, 3 to 5 guineas inclusive. Apply: Illustrated Guide F. N. CHARRINGTON, Esq., Osea Island, Heybridge, Essex sent to Inquirers

JNE: BR3XE:rTY, D RUGSS, RE:S-T CURE.

TOWER HOUSE, Avenue Road, Leicester.

PRIVATE HIGH-CLASS HOME FOR LADIES. (ESTABLISHED iS64.)

Excellent Medical References. Medical Attendant - A. V. CLARKE, M.A., M.D. Cantab.

For terms and particulars apply to Mrs. MIILLS. Telegrams: "'THEOBALv. LEICESTER."

CE LONDON: 43, NEW CAVENDISH ST., W.

T N.m L n jJ il , MANCHESTER: 176, OXFORD ROAD. GLASGOW: 28, WINDSOR TERRACE.

TELEPHONES:mTELEGRAMS: London: 1472 Paddilngo. D Q ' ata.Lno Manchester: 5213 Central. 1 L U IIULU 'Tactear, Maondo.'

,f949 Charing X (Mat.).* R* Tactear, M?anchester.' Glasgow :{47Ceta (PO. 'Surgical, Glasgow.'

Superior trained NMale Nurses for 'Medical, Surgical I NMental Dipsomania, Travelling and all cases. -NpursesJ reside on the premises and are always ready for C PER ATION. urgent calls, day or night. Skilled Masseurs and good Valet Attendants supplied. The Nurses are fully Insured

Terms from ?L 16s. 6d. M. D. GOLD, Secretary against accident.

The Alcohol and Drug Habits, Neurasthenia and Neuritis. TINV" E lNTITlEIE L DDG-E, Colinsburgh, -Fife, Scotland.

i Licensed under the Intebriates Acts.) FOR G:TI: ME: O~L:.

Tl E hotise is situated in a dry. bracing lim ite. 45o fect above sea-lcvcl, conmmsanding extensive sea. T views, and coutainsisix Pulblic kounis, Billiard Ruoon (with two :ull-suscd tablcs) Loncert Hall,

and 45 liedroanns. The grouinda are ticarly 2oo Urcs i extetilt, in which there are walld-itn Gardvn r (tw. acres). Tennis

Lawnt. Croqtket Lawin. anid Goli Course Ni holtc, I z miles rouild), LALc and Strc;An. Rabbit-:hooting. These grounds arc not enclosed by physical barrieri

For trealttient ;sod parliCulars apply to JOHN Q. DONALD, L.R.C.P., LR.C.S. (Edin.).

71te,ra,#hic Aldress.: " Salubrious. Upper targo." Proprietor and Re:sident Physician. 7'WqA,'h,: No. 8, Uppcr L-.rgo (l'.O. Sycteut) Nearest Railsay Station-Kilconqubar.

Figure 2. Advertisements


home ('Established in I 864') for the 'treatment and cure of ladies of the upper and higher middle classes' suffering from 'inebriety, the morphia habit, and the abuse of drugs'.58

The little information available on ladies' retreats suggests that ladies who abused the botde or became overly fond of the opiate-based patent medicines common at this time were given less individualized care than were their male counterparts. One ladies' home had its treatment regime described by the Inspector in the following terms:

The treatment at The Grove may be summed up in a few words: rigid abstinence; no drugs; healthy exercise and cheerful employment; punctuality, cleanhness, religious influ- ences.59

The scant available evidence suggests that lady patients were likely to receive a treatment effected through the impersonal architectural and temporal controls favoured in lunatic asylums, rather than the heroic dark-night-of-the soul individual pastoral care sometimes provided by male physicians for their peers. Ladies would never end up with as much willpower as gentlemen, then; but despite the gender differences, the retreats all had the same purpose, namely the 'restoration' of weakened'willpower'.60

By contrast, the regime of the reformatories was neither pastoral nor liberal, and little 'moral treatment' was provided. The I898 act instituted compulsory commitment procedures for some habitual inebriates who had run foul of the law, and allowed for the building of special state semi-penal institutions known as inebriate reformatories. The mechanism of the 1898 act allowed the courts to sentence certain offenders to three-year terms in inebriate reformatories: these offenders were either the police court recidivists repeatedly convicted of drinking offences, or those convicted of major offences that were arguably attributed to inebriety. As Lucia Zedner has shown, the latter group ended up, in practice, being composed almost exclusively of working-class mothers who, in the opinion of the NSPCC, neglected their children. About 450 mothers convicted of child neglect were sent to inebriate reformatories for a three- year term (and denied access to their children while imprisoned), in contrast to a handful of male inebriates convicted of theft, assault or manslaughter. The former group, composed mostly of people arrested in the street for public order offences, was not quite as gender-biased, but women still predominated, and most of the women appear to have been prostitutes.61

The skewed reformatory figures, in particular the near-complete absence from the compulsorily committed population of the hard-drinking violence-prone working-class man that one might have expected to find in such institutions, certainly suggests that the inebriate

58 Advertisement, British Journal of Inebriety (I900), ii (various issues). Other medical journals, including the very widely distributedJournal of the American Medical Association, also ran such ads; this suggests that physicians often referred their patients to these homes.

59 BPP, Report of the Inspectorfor 1903, I904, x, 8o6. 60'There is often a difficulty in persuading men

to remain in the Home a sufficiently long time to derive the benefit they would by staying on after they begin to feel their nerves are restored. Gener- ally, at that stage, they think they are quite equal to resist temptation, which is quite a mistake, as NO RESTORATION OF THE WILLPOWER CAN

HAVE TAKEN PLACE .. .'. BPP, Report of the Inspectorfor 1904, 1905, xi, 122.

61 Lucia Zedner, Women, Crime and Custody in Victorian England (Oxford, I99I), chap. 6. The evidence for the prevalence of prostitutes among the reformatory population is found in an interview- based survey carried out by the Inspector of Reformatories in i9i0. This survey revealed among other things that 52 per cent of the women committed under section 2 (that is, as police court recidivists) had been previously convicted of prosti- tution-related offences. BPP, Report of the Inspector of Inebriate Reformatories, I9II, xxix, part I, 32.


reformatories in Britain were involved in the policing of women's sexual and reproductive conduct as much as or more than in the regulation of alcohol. Class was (in the UK, though not in the US)62 as important as gender in the differentiation of treatment regimes: the separ- ation between retreats and reformatories, while originally intended to reflect the fact that some inebriates could indeed cure themselves through their own will, aided only by pastoral care, whereas other inebriates were beyond reform, ended up being administered simply on a class basis. Thus in 1903 the Inspector admitted that gentlemen and ladies, even if they broke the law, were never sent to reformatories:

Some day, when the numbers are sufficiently large to warrant the expenditure, it will be necessary to add accommodation for good class persons who happen to be committed under this act. Three persons were sent to reformatories during the year under review, who were well educated, and obviously not suited for detention under arrangements which at present are chiefly adapted for dealing with the lower classes.63

These three individuals were quietly transferred to those havens of free will, the private retreats. (The Inspector does not specify whether they, like other patients at retreats, paid for their own treatment.)

The reformatory population was viewed in a new, even more sinister light, during the moral panic of the early I9OOS about physical deterioration and'mental defect'. From about I904 on, both the reports of the Inebriate Inspector and the proceedings of the Society for the Study of Inebriety show the alcohoLsm of the poorer urban classes tending to disappear under the now more capacious 'feeble-minded' label. Dr Mary Gordon, named Assistant Inspector of Inebriates and put in charge of the women in reformatories, was firmly convinced that many of the women subject to her inspection were 'imbecile' or'insane', and that, more importantly, even those who showed no 'outward signs of degeneration or imbecility' are nevertheless 'feeble-minded'.64 Photographs taken of the women in reformatories were used by other experts as 'evidence' for the claim that most inebriates were'feeble-minded'.65 Inspector Branthwaite carried out his own extensive primary research in I905 and concluded that upwards of 62 per cent of the persons committed to reformatories under the Inebriates Acts were either insane or'defective'.66

62 James Baumohl's work suggests that although there were some class differences between the working-class 'dashaways' and the more middle- class members of the American Temperance Union, nevertheless temperance was a cross-class movement, and its techniques were not sharply dif- ferentiated by class (Baumohl, op. cit.). At the turn of the century, the American temperance movement, which had a much stronger feminist influence than either religious or medical sobriety movements in the UK, had succeeded in identifr- ing the working-class man, especially the working- class immigrant man, as the paradigm of 'the alcoholic', but it is notable that in the UK system the typical working-class alcoholic was female, as Zedner has demonstrated (Zedner, op. cit.).

63BPP, Report of the Inspectorfor 1903, I905, Xi, 136. 64 Dr Mary Gordon, speech in British Journal of

Inebriety, XII, 2 (1914), 99. Probably because she

anticipated the end of the life of the Inebriate Acts, Dr Gordon was hopeful that she could use an alternative legal strategy to institutionalize the problem women:'The new Mental Deficiency Act, I913, provides new powers for dealing with this class of inebriates' (Ioo). It would be interesting to see how many former 'inebriates' were put away in institutions for the feeble-minded after the Inebri- ate Acts ceased to have effect.

65 F. W Mott, 'Alcohol and insanity', British Journal of Inebriety, Ix, I, I9. Interestingly, the pho- tography of inebriety was an exclusively feminized endeavour. Male inebriates were represented in the annual Reports of the Inspector with line drawings, not with photographs.

66 BPP, Report of the Inspector for 1905, I906, xvi,

593ff. This report includes several pages of photographs of women inebriates.


It can be concluded, therefore, that the reformatories failed to focus on alcohol itself. They worked largely to institutionalize working-class women who were failing to perform as mothers or who were guilty of sexual infractions. After the I904 panic about physical deterioration and the related moral panic about feeble-mindedness, both males and females convicted under the Habitual Inebriates Act were likely to be regarded as evolutionary waste products, not as valiant alcoholics possessing'the moral courage of inebriety'.

The story of the acts' peculiar obsession with femininity rather than with drinking has already been told by Lucia Zedner;67 but what neither she nor subsequent scholars have noticed is that this process by which a medical law relating to alcoholics was used for purposes of gender- specific and class-specific moral regulation is but an aspect of a more general failure of the acts to constitute a distinct kind of person - the alcoholic.

The internal contradictions of the Inebriates Acts, including the contradictions within the medical definitions of alcoholism, are apparent in the deliberations of the I908 Departmental Committee on the Operation of the Acts.68 Despite being composed largely of physicians and other social-legal experts, the I908 committee was reluctant to label all or even most excessive drinking as a medical condition. There are many people who can control their drinking, the committee concluded, but they simply choose not to. These 'occasional drunkards, weekend drunkards, bank-holiday drunkards'69 have no defects in their faculties: they simply choose to act in an immoral manner. They are therefore garden-variety drunkards. Inebriates, by contrast, have a quasi-diagnosis: they are characterized by a 'constitutional peculiarity' that makes them unable to exercise self-control.

Now the 'inebriate' defined in this manner seems to parallel Foucault's 'the homosexual', distinguished by an inner identity that persists whether or not the person is drinking/having sex.70 But the committee proceeded to undermine and fragment the very identity they were attempting to create. The inebriate does not really exist, they go on to conclude, for there are really three distinct classes of inebriates.

The first class of inebriates consists of people who are often 'superior and intelligent', and who do not really lack self-control. Their problem is not absence of control but rather an excess of desire: they are 'persons born with an excessive degree of the common capacity of deriving pleasure from the use of alcohol'. These are, of course, the 'gentlemen inebriates', social peers of the committee's members. The committee does not name class or gender, but the referent is clear, particularly in the light of the Inspector's practice of transferring gentlemen inebriates who did fall into the clutches of the law out of reformatories and into 'voluntary' retreats.

The second class of inebriates distinguished by the I908 committee is barely distinguishable from the feeble-minded. It consists of 'persons 'deficient in self-control', persons of 'low intelligence' or low self-respect, who are furthermore often prone to violence. For them, even small amounts of alcohol can result in 'outbreaks of temper, of violence', and many of their family members show signs of other mental disorders.71 The class subtext of this discourse on mental defect is obvious.

Finally, the third class of inebriates consists of 'persons' who are obviously the 'ladies of the upper and middle classes' who populated the retreats whose advertisements were cited above.

67 Zedner, op. cit., chap. 6. 68 BPP, Report of the Departmental Committee as to

the Operation of the Law Relating to Inebriates, I908, xii, 8i7ff. (Cd. 4438). This will be referred to subse- quently as the '1908 Committee Report'.

69 I908 Committee Report, 820. 70 Michel Foucault, ne History of Sexuality: vol.

(New York, I982). 71 I908 Committee Report, 822.


The committee noted that there exists in nature a peculiar class,'inebriates by artificial culture rather than by nature'. These are the 'ladies of the upper and higher middle classes' interpel- lated in the advertisements cited above; the committee notes that they often take alcohol for pain relief or during an illness, and slowly find that they depend on it. Gradually and without any real wickedness on their part, their 'self-control is weakened'.

The alcoholic is thus effectively erased, replaced by three quite distinct social/medical types. The upper-class gendeman with the strong desires is simply a little too virile, but he is fundamentally sound. He is the prototype of the Empire-building enterprising gentleman for whom drinking too much is an incidental and contingent characteristic. On their part, the mentally deficient and violence-prone inebriates of the second class are characterized in terms of class- related mental qualities; drinking again tends to disappear from view. Finally, the ladies who un- wittingly fall into inebriety because they follow a doctor's prescription for alcohol-based medicines do not have a drinking problem as much as a gender problem. They gullibly buy alcohol-remedies for female maladies or follow a physician's bad advice: their problem is really one of excess femininity. Thus they too are not really alcoholics. The three categories having ex- hausted the content of the 'inebriate' designation, it seems clear that there are no alcoholics left - just overly virile gentlemen, degenerate proletarians and weak-willed ladies. And to put the final nail in the coffin of the medicalization strategy, the I908 comnmittee concluded that while inebriety was in some ways a disease, it did not attack inebriates 'as influenza might'; it wasn't really a disease, then, but rather a 'constitutive peculiarity', or even more modestly,'a habit'.72

CONCLUSION

We have seen that the project to construct a new medicalized identity - the alcoholic - was undermined at every turn. Sometimes those labelled alcoholics rebelled against the medicalization of drinking, as appears to have been the case in the first inebriate asylum in the US; but, more often, the project of medicalization was undermined from within. Physicians, legislators and other writers agreed that even if alcoholism was a disease (a point not necessarily granted), it was a unique disease whose cure was more likely to be effected by the willpower of the patient than by either scientific knowledge or clinical practice. It was, one might say, the liberal disease par excellence: treatnent therefore involved a strenuous exercise of the very liberal subjectivity or free will thought to be impaired through too much drinking. And even those people caught within the medical defiition of 'inebriety' did not, at least in the UK, constitute a single population. Class and gender regulation worked together to fiagment'the alcoholic' into distinct groups.

This study therefore suggests that it may prove useful to question the by now standard Fou- cauldian thesis regarding the increasing power of governance through identity categories produced by experts. Detailed historical studies may thus help us to overcome and go beyond the current tendency of historical sociology to overvalue the effectivity and the internal coherence of expert discourses. Whatever the fortunes of the alcoholic in later periods, in the period immediately preceding the First World War the alcoholic, although certainly invented, was a perpetually failing identity This study thus seeks to highlight the importance of contradiction and failure in the history of social, legal and moral regulation.

University of Toronto

72 I908 Committee Report, 822-3.

the invention of alcoholism

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