The Invention of Alcoholism

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

'Slavery

from

within':
and the

the question

invention

of free

alcoholism

of

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, immature, 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 moralfaculty: 'the will'. * Many thanksto all the people who helped me to navigatein new areasof researchand gave me ideas and suggestions,especiallyAlan Collins, Pat O'Malley and Nikolas Rose. t T. Clouston,'Some of the psychologicaland clinical aspectsof alcohol', British Journal of Inebriety, XI, 3 (1914), 114. 2 Robert Castel, The Regulation of Madness

(Berkeley, CA, I988), Introduction. 3 For a theoretical elaboration,from a Foucauldianperspective, of liberalgovernanceand its see A. Barry,T. Osborne and N. Rose paradoxes, (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 HistoryVol. 22 No. 3 October 1997 0307-1022

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Alcoholismcame to be regarded, in the late nineteenthcentury, as one of several 'diseases of the will'.4 At the level of high theory (that is, in the writings of philosophersand scientists), there was little agreementabout the ontologicaland for that matterthe physiological statusof the'will',5 but at the level of clinicalpracticeeveryoneacknowledgedthat whateverthe ontological status of the will, alcoholism treatmentwould only succeed if the patient was filly involved in the process.Alcoholism recoverywas (and still is) fundamentally paradoxical: the alcoholic'sown willpoweris the key elementin recovery, even though the very essenceof alcoholism is thought to be a defect in the will. This paradoxis not, I will argue,a curiosity of medicaldiscourse. It is a profoundly political paradox thatpervades liberalgovernance in general. As Barry Hindess has pointed out,6 the centralcontradictionof liberalism is that people are, on the one hand,regarded as'born free'(asLocke said)but, on the other hand,they haveto be made free throughtrainingfor autonomy. This trainingoften relieson despoticmeansthatstand in an uneasytension with the ostensibleends of self-governance and freedom. Within the context of the late nineteenth century'sstronglypaternalistic if not despotic model of medical treatment,alcoholism was unique in that the will of the individualwas regarded as the centralingredientin treatment. Recovering alcoholicswere also grantedthe for the time - unusualprivilege of writing about their own strugglesagainsta diseasein the pages of medicaljournals.7 Nevertheless, the temptationto treatalcoholismin the same manneras other illnesses- that is, as curablelargelythroughthe physicians' autonomousexertions- was always present.In the MedicalAssociation treatment notes US, theJournal of theAmerican publishedordinary physicians' on alcoholismin virtuallyevery issue between I895 and I905. Gold cures,strychnine, opium, cold water baths and hypnosiswere discussedand evaluated.But even physicianswho used drugs often pointed out that alcoholismcould not be treated,much less cured,if the patient did not activelyco-operate.One physicianwriting to reportpartialsuccessin treating'dipsomania' (alcoholism)through hypnosis cautioned that the hypnosis would only work 'if the is not only to cure the craze,but patientis willing to be cured.... The object of the treatment BritishJournal of Inebriety to strengthenthe will.'8A typicalarticlein the physician-dominated of alcoholismby statingthatalthoughalcoholism formulatedthe paradoxof medicaltreatment is indeed a disease,'the medical treatmentcan assistmen in carryingout their intention to become sober,but it cannotcreatethatintention.At the outset,whatmusttakeplaceis a change in the alcoholic'scharacter.'9 Many of the people diagnosedas inebriates/alcoholics belonged to socialgroupsbelievedto have quite small amountsof self-controland willpower to begin with: the 'vicious'poor, of Ladieswere thoughtto be especiallysuscourse,but alsoladiesof the middleand upperclasses. will to of the other diseases the ceptible (e.g. kleptomania).Gentlemen,by contrast,were and so the treatments used for as havingmuch greaterinnatecapacityfor self-control, regarded
4See the treatise by the influentialFrenchscientist Theodule Ribot, 7he Diseases of the Will (Chicago, 1915; 4th enlarged edn). 5 See Roger Smith,Inhibition: History andMeaning 7See, for instance,'Anex-patient','Thepsychoa recordof experiencesand of an inebriate: analysis xii, I (I914), Journal of Inebriety, reflections',British
22-7.

(London,I992). of MindandBrain in theSciences 6 Barry Hindess, 'Liberalism, socialism and democracy:variationson a governmentaltheme', XXII, 3 (I993); reprinted in and Society, Economy Osborne and Rose (eds),op.cit.,65-8o. Barry,

by and its treatment 8 Anonymous,'Dipsomania MedicalAssociation ofthe American suggestion',Journal (henceforthJAA), xxxv (1900), 456. 9 A. T. Shearman,'The effect of alcohol on
InI,4 (i9o6), 34. Journal of Inebriety, feeling', British

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them tended to be individualized and pastoral10in 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.11The 'real' history of alcohol, the evidence of qualitative change over time, lies not in the theory but in the technologies of treatment and cure. The illiberal technique of hypnotism; the psycho-medical talking cures; the evangelical methods of Salvation Army'Homes for Drunkards'; the totalitarian 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 evaluation 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-

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

13 Anonymous note, Medical LVII (i900), Record, man (ed.),Michel Foucault: Politics, Philosophy, Culture 410-I1. See also Joseph Collins,'The law and the (New York,I988). inebriate',New York Medical Journal, LXXIII, (4 May It Jessica Warner,' "Resolv'd to drink no more": 1901), 765-8. Collins falselybelieved that Canada addiction as a pre-industrial construct', Journal of had the legislativemachineryto coerce alcoholics Studies on Alcohol (November 1994), 685-9i. into stateasylums, incidentally. This misinformation Warner'sarticle is a refutation of the classic study by is typical:in general,the medical literatureoften Harry Levine,'The discovery of addiction',Journal laudsactualor supposedsuccesses in medicalization of Studies onAlcohol, XXXIX, I (1978), 143-74. of alcoholismtreatment, but has little information 12 A good account of many of these success on the failuresand reversals.

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or to other inmatesof such institutionsand their friends.'4Whether due to patientresistance other fledglingstateasylumsfor inebriatesin the US all failed to prosper.15 reasons, Partof the problemwas thatthe US temperancemovementhad set up its own non-medical basedon moralexhortation repair for treatment 'Homes',to which alcoholicscould voluntarily Given the great influence of evangelicaltemperanceactivityand the and self-help support.16 that,althoughthe people and medicalscience,it is not surprising hostilitybetween temperance by the firstdecadeof the twentiethcenturythere hostilitydiminishedat the end of the century, were still very few medicallyrun treatmentfacilitiesfor alcoholicsin the US. In Britain,where the HabitualDrunkards(laterHabitual Inebriates)Acts had set up an which were unibut significantnetwork of treatnent homes and reformatories underfunded versallysubjectto medicalinspection,even if run by temperancesocieties,the medicalization of alcoholismseemed more successfulfor a few brief years(fiom I900 to I908, roughly).But these inebriateinstitutionswere dealt a severeblow by the withdrawalof local government funding that began in I908, and by the repeal of the legislativeprovisionsfor state medical
inspection that took place in I9I4. 7

and If the institutional network of medicalizedalcoholismtreatmentwas small,fragmented in constantcrisis,the discursivenetwork was equallyunstable.From the invention of the unsuccessfulterm 'oinomania'in the i85 os8 throughto the FirstWorldWar,no one term was alconarcomania, ever adoptedeven within specialistmedicalcircles.Oinomania,dipsomania, the as As late I914, ... terms kept proliferating. holism, inebriety,habitualdrunkenness the British Inspectorof Inebriatesfelt compelled to state that the term 'inebriate'was for him chronicalcoholic,or dipsodrunkard, (thoughnot for otherexperts)synonymouswith 'habitual
maniac'.19

as a project.No however,simplyto conclude that alcoholism'failed' It would be insufficient, clearlydefined populationwith a widely accepted diagnosisever emerged;but that does not mean that nothing was being accomplished.The invention of alcoholism is perhapsbest either by 'success'or by 'failure',but characterized regardednot as a self-containednarrative ratheras a facet of a wider,quite complex processthroughwhich certainsocialgroupsthat did came to be subjectedto more or less despotic not fallwithin the medicaldefinitionof insanity20
14 T. D. Crothers,'The Norman Kerr memorial III, 3 (I906), 123. of Inebriety, lecture',BritishJournal 15See,for instance, a reporton an inebriateinstitution in Boston,JAAA, xxxiv (I900), I572-3; and xxxv (I900), i655. an anonymousreportinJA4MA, In i862, the legislatureof the United Provinceof Canada (which included most of present-day with a lengthy Ontarioand Quebec) was presented which as far and erudite report/recommendation, as I have been able to determine fell on deaf ears Asylums . . . games Bovell, A Pleafor Inebriate (Toronto,I862). The andDoctors: Dashaways 16 James A. Baumohl, in San Francisco Drunkards of Habitual Treatment from UnitheGoldRushtoProhibition (DSW dissertation, versityof Californiaat Berkeley,I986). 17 Gerry Johnstone,'From vice to disease? The concepts of dipsomaniaand inebriety,I860o-908', Socialand LegalStudies,v,I (I996), 37-56; Patrick

in Scotland: reformatories McLaughline,'Inebriate and R. Room history'in S. Barrows an institutional in Modern History andBelief Behaviour (eds),Drinking: CA, I99I); and G. Hunt,J. Mellor and J. (Berkeley, Turner, 'Wretched, hatless and miserably clad: women and the inebriate reformatories from of Sociology,XL, 2 (I989), BritishJournal 1900-19I3', Anonymous, 'Oinomania; or the mental pathology of intemperance',TheJournalof Pathoviii (i April and MentalPathology, Medicine logical
I855), 175-207.
244-70. 18

19 BPP, Report of the Inspector. . for 1912,
XXXVi, 255 .

I914,

20The firstclauseof the BritishHabitualInebriare,firstof all,'not ates Acts declaresthatinebriates to jurisdictionin lunacy'(6I and62 Vict., amenable
1898).

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regimes, ranging from custodial and punitive institutions to therapeutic programmes emphasizing training for and in freedom. The logic of governing through alcoholism can perhaps be best discerned through a comparison 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 products, 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 hereditary or acquired tendencies. At a time when medicine often emphasized the relentless determinism 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 BritishJournalof Inebrietyadded 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 language 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

22 Norman Kerr, 21 See, among others,Daniel Pick,Faces ItsEtiolorNarcomania: Inebriety of DegenandJurisprudence Treatment (London, eration (Cambridge, I989); Nikolas Rose, The ogy,Pathology, PsychologicalComplex (London, I985); Angus I894; 3rd edn), I7. 23 ibid.,I97. Crusade Rce:TheEugenic OurOwnMaster McLaren, 24 'An ex-patient', 'The psychoanalysisof an (Toronto,I99I); and Nancy LeysStepan, in Canada and Nation in inebriate:a recordof experiencesand reflections', Race,Gender 'The Hourof Eugenics': BritishJournal of Inebriety, XII, I (1914), 23. America (Ithacaand London, i99i). Latin

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in the late i860S.25 elected to parliament Donald Dalrymple, home for inebriates in the country, licensing;in Dahrymple wanted to regulatethe privateinebriatehome businessby establishing addition, he wanted the state compulsorilyto commit certain individualsto these homes. original vision was not carriedout, since his proposedbill was watereddown to Dahrymple's the point of ineffectiveness. was importantdisBut the I879 act,howeverimpotentin practice, complicatedlegal and established It set out a legal definition of 'habitualdrunkards' cursively. machineryfor reconcilingstatecoercionwith the view thatthe patientneeded to choose freely to stop drinking.A habitualdrunkard was by a person who, not being amenableto any jurisdictionin lunacy,is notwithstanding, reason of habitualintemperatedrinking of intoxicatingliquors,at times dangerousto of managinghimselfor herselfand his or her himself or herselfor to others,or incapable
affairs.26

to 'inebriate',the definition Although the terminology was later changed from 'drunkard' stayedthe same throughoutthe life of the InebriateActs. Much could be said aboutthis definition;but for our purposesit is sufficientto note that the criterionof abilityto manageone's medicalone. No provisionwas ever madefor expertmedicaltestiaffairs was not a specifically mony to certifyinebriates. The legal machinery adopted by parliamentagainstthe wishes of the inebriety experts in frontof not one but two Justo makea declaration allowedbut did not compel individuals tices of the Peace,declaringthemselvesto be inebriatesand agreeingvoluntarilyto a certain period of confinement. As the inebriety expert Dr Peddie exclaimed,'No wonder that few of libertyon suchterms.'27 This ineffechavebeen found willing to makea voluntarysurrender act to the render useless,was in tive legal machinery, althoughundoubtedlydesignedprecisely keeping with the peculiar logic of alcoholism.Rather than having medical experts certify the liberalprivilegeof certiinebriates were awarded inebriatesin the samemanneras lunatics, even as they were subjectedto the JPs' Their free will was thus safeguarded fying themselves.28 authority. That the focus on the free will threatenedthe whole medicalizationproject was clear to typicallyarguedin manypeople outsideinebrietycircles.An AmericanLunacyCommissioner because the only sure a true not was disease,precisely (unlike insanity) I874 that alcoholism cure lay in the exerciseof the patient'sown will: is entirelywithin his control,provided or self-redemption The problemof self-abasement The key to the riddle he exercisea continuous determinationof his will not to partake. this own and without man's will of this alleged diseaselies in effort,no physiciancan will, cure or even relievehim.29
27 Peddie, op.cit., 7. For the I879 act,see 28 The self-certificationprocess later achieved to the BritishSociety address Dr Kerr's presidential for the Scientific Study of Inebriety,Proceedings tremendoussuccess with the founding of Alco(i886), 2-8, and A. Peddie,'The HabitualDrunk- holics Anonymous in the 1930s, an extremely on the practice basedprecisely popularorganization of the society ards Act, I879', also in the Proceedings of namingonesefasan alcoholic. (I886), 4-9. 29 John Ordronaux, 'Is habitualdrunkennessa 26 Definition quoted in BPP,Report of theDepartAmericanJournal of Insanity (April I874), on the Law Relatingto Inebriates, disease?', mentalCommittee I908, Xi, 3. 439.

25 See Johnstone,op.Cit., 41.

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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 the most imporproblematic substances. Dr Norman Kerr's huge tome Inebrietyor Narcomania, its that the British work makes it clear alcohol is tant relevant of time, although primary site of inebriety, it is not the only one. While endorsing the existing term 'inebriety', whose penumbra 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',33but even the medicalizing project was not internally consistent, for the multiplicity 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'suggestthat the current-daymeaning of 'addiction'datesback only to the I920S. Although a full study of the history of addictionhas not yet been produced,my research provisionally confirms the OED'sdating,since althoughthe terms'addiction'and'addict' were used,especially in the context of opium and other drugs, at the turn of the century, the meaningthen was much wider. Addiction was then not much if at all different fiom 'habit'. 31 See V. Berridgeand G. Edwards, andthe Opium 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.

Dreams Valverde, of theWill:Alcoholism,Alcohol Regulationand the Dilemmas of Freedom, (forthcoming,
New York, Cambridge Uriiversity Press).
34

35

Johnstone,op.cit.,37-57. Michel Foucault, Disciplineand Punish:The

Birth of the Prison (New York, 1979).

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a defect alcoholismwas in the I88os defined as a defect in liberalsubjectivity, As statedearlier, affectednot so much the rationalbut the moralfaculties,specificallythe that,unlike insanity, whereasothersstressed thatdrinkingcausedan erosionof willpower, will. Some people stressed defectsled to excess drinking.But whateverthe cause-effect that previouslyexistingcharacter there was generalagreementthat inebriety could be defined as 'the loss of will relationship, gainedcurand'dipsomania' A very earlywork,writtenbeforethe terms'inebriety' function'.36 anonymanias. The to the disease allied was a much alcohol drinking too that argued rency, mous medicalauthorbaptizedthis diseaseas 'oinomania',describingit as follows: The most generalexcitantof the appetiteis that condition of the mind in which there is excitement and littlepowerof theuill to resistthe temptasimply a desirefor pleasurable tion to gratifythe desire.37 the 'ordinary' drunk,who drankbecausehe or she wantedto, Willpoweris what distinguished or alcoholic,who drankbecausehe or she felt compelledto do so. The from the dipsomaniac for the drinkingand its conformerfell within the domainof law,since he/she was responsible explained only the latterfell within the domainof medicine.An inebrietyspecialist sequences; wisdom as follows: this commnon The man who deliberatelydrinks to excess is without apology a vicious and criminal choice and it is fromdeliberate drunkard. He has complete power of will over his actions; himselfbrutishanddangerous.... Between such a man andthe hopethathe thusrenders each possessingless willpowerthan less dipsomaniac there are many gradesof drunkard, the former.38 Acts inquiryinto the workingsof the Inebriates Some yearslater,the Britishparliamentary mathematical twist,describinginebrietynot expressedthe sameidea but addeda sophisticated ratio betweendesireandwill. People asan absolutelack of willpowerbut ratherasan inadequate but those born with a with snall desiresdid not need a strongwill in order to be temperate; large amount of willpower.The only great love of life'spleasuresneeded a correspondingly the committee concluded,was to 'alterthe ratiobetween self-controland solution to inebriety, it to normal,either by diminishingdesire,or by increasingself-control,or desire,and restore both'.39 The close connection between drinkingand the will was importantnot only for moralists but also for scientists.In the time period understudy,the will playeda centralrole in scientific as exemplifiedin the passageby Sir Thomas Clouston quoted theories about human progress, at the beginning of this article.The greatEnglishscientistHenry Maudsleyhad arguedin an was I884 work entitled BodyandWillthat'the function of the will in the highestmoralsphere' becauseit is evolution's the lastand thereforethe highestproductof humanevolution.Precisely
36 Dr JamesStewart,'Thetreatment of inebriety of the Proceedings in the higherand educatedclasses', Study of Inebriety for the Scientific British Society ix (I889), 3. (henceforthProceedings), 37 Anonymous,'Oinomania. . .', Op. cit., I78. 38 J. Muir Howe, 'The treatmentof inebriety',

v (i885), 5. Proceedings, 39 BPP,Report as to theOperation of theCommittee to Inebriates, I908, xii, 6. For an of the LawRelating of the scientificcontext of the excellent discussion on free will, see Smith, committee'sdeliberations op.cit. Inhibition,

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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 influenced 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 melancholia.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 Inebrietyor 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 43

the will, see the perceptivecommentaryby Anson Rabinach, The Human Motor (New York, I990),
I63-6.
4 45

ibid.,26-31.
ibid., II-.2o. On Ribot's analysis of diseases of

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

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'badhabits'such as excess coffee drinkthereforedeterminedthe boundarybetween ordinary ing and the specificallymoraldiseaseof 'inebriety'.46 were hardpressedto Defining inebriety in moral terms as a diseaseof the will, physicians give specificallymedical advice on how to rebuildthe Will.47In a very earlymeeting of the formulatedwhat one could a participant British Society for the Scientific Study of Inebriety, call 'the paradoxof liberalfreedom'as follows: How can all power of will to abstain. And supposethe inebrietyhas absolutelydestroyed not exist? ... It would on the foundationof a will that does you build up a new character by means of a will which is to all intents be an endeavourto build up a new character dead.48 The evangelicaltemperancereformershad a clear and consistentanswerto this question, answer. neverreallydevelopeda satisfactory however, namely'the graceof God'.The physicians, by makinga distincOne medicalauthority, SirWilliam Collins,tried to dissolvethe paradox tion between two kinds of will, the (bad)'self-will',involved in deciding to drink, and the and control especiallyif British,operatedto suppress (good)'free-will'thatin rationalcreatures, of the will', Collinsoutlined subtitled'Slavery 'self-will'.In a speechsignificantly the passionate this theory of the dual will as follows:'It [sobriety]is the limitationof self-will in the interests of free-will and self-control.... The suppressionof slavery from within as well as from the paradox of alcoand does not in any way resolve, This formulationonly repeats, without'.49 could ever succeed for it is not at all clearhow a personwho is self-enslaved holism recovery, in overcomingthe stateof inner slavery.50 of the 'free'subject,alcohol As well asplayinga centralrole in definingthe politicalcapacities deteriorand generational asa centralfeatureof the processof racialdegeneration was regarded ation. A typicalstatement,found in a largeplacardpastedin public placesby the Borough of in I905, put it succinctly: Hampstead

46 In the 1996 Americandebatesabout the role smoking,Robert Dole, of governmentin curtailing campaignwas rumouredto be whose presidential 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 in in this article,but it will be addressed addressed research. fiurther 47 Andrew Scull has documented the ways in on insanityco-opted and which medicalspecialists eventually monopolized the administrativeand therapeuticpracticesknown as 'moral treatment', practicesoriginallypioneeredby lay persons,most notably at the York Retreat, as an alternativeto (AndrewScull,Museum treatment 'medical' physical

suggests (New York,I979)). His research ofMadness treatment of 'moral' thatthe medicalmen'stakeover was complete by the late nineteenthcenturyin the but asseen here,in the alcoholfield field of insanity, appropriated moral treatmentwas not successfillly Todaymoralis most commonlypracby physicians. tised in lay AA groups. 48 Muir Howie, op.cit.,6. 49 Sir William Collins, Sixth Annual Norman of Inebriety, Journal KerrMemorial Lecture,British today'sAA groups, which veer uneasily between stressingpersonal to a'higher subservience autonomyanddemanding power'locatedoutsidethe self. See KlausMikela et as a MutualSef-helpMoveAnonymous al., Alcoholics (Madison,1996). ment:AStudyin EightSocieties,
XIII, 3 (anuary I9I6), 146. 50 The paradoxpersistsin

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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 judgment, 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. Figure1. Placardfrom Borough of Hampstead

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is a most potent and deadlyagent of physicaldeterioration. stimulants of alcoholic Theabuse is given to drink the futureof the race is imperilled.51 as wellas thefather If themother in that it was not of 'degeneration' But alcoholismwas unusualamong the symptoms/causes upperother,to the poor,or to neurasthenic to the racially thought to be confinedto criminals, classwomen. The upperclasseswere thought to be born with more willpower(the good kind of will, 'free'will, of course) than the poor, and men were similarlythought to have more willpower than women of the same classand race;but alcoholismand other addictionscernoted from their own clinicalexperience. as many physicians tainlyaffectedthe higheststrata, Innate willpower,just like inherited capital,could not be taken for granted:it could and were as concernedwith and lost. Turn of the centuryphysicians indeed often was squandered restoringthe willpower of the gentlemaninebriate (and,to a lesser extent, of the lady with
addictions) as they were with the better known process by which working-class inebriates,

programmes The differential treatment especiallywomen, were confinedto statereformatories. certain in both reflected and reproduced UK and the genders providedfor differentclasses of liberalsubof the preconditions about the unequaldistribution highly politicalassumptions jectivity among the population.
CLASS AND GENDER IN THE ETIOLOGY AND TREATMENT OF

ALCOHOLISM After the I898 act, officiallyrecognizedinebriateswere divided into two groups:those conor else throughthe legal machineryof fined to privateretreats (eithervoluntarilyand privately, namingoneself as an inebriatein front of a JP) and,on the other hand,those confined to state The two kindsof institutionswere so differentthatit could be arguedthat there reformatories. annualreportsbegin by was no such thing as an inebriatein general.Most of the Inspector's
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, immorality, 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 continualexpense and chargeupon the state.53 ontology'. Needing to justify move here could be describedas'administrative Branthwaite's
the facilities and the relative freedom offered in retreats,the Inspector constructs an ontology

happensto fit with the regime of governance of human differencethat, not coincidentally,
'PhysicalDeteriorSl Borough of Hampstead, reprintedon backpage, ation and Alcohol',placard of Inebriety BritishJournal [19041.The 1904 InterdepartmentalCommittee on PhysicalDeterioration did much to emphasizethe link between alcohol and 'the race';in I904, and for a couple of years had a afterwards,the BritishJournalof Inebriety largenumberof articlesdevotedto the remarkably alcohol intake. questionof maternal 52 See Ian Hacking, 'The looping effects of D. Premackand A. J. human kinds'in D. Sperber, Premack (eds), Causal Cognition(Oxford, I994), chap.I2. 53 BPP,Report oftheInspectorfor 1901,I902, xii, 47.

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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 completely 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 gentlemanly 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 BritishJournal of Inebrietysang the praises of a private
(I900), ii. (Most issues carried the same advertisement.) 57 BPP, Report of the Inspectorfori0og, I9II, xxix, pole Home in ibid., 38. 56 Advertisement in British Journal of Inebriety part i, I8-I9. 54 ibid. 55Extractfromthe annualreportof the Dalrym-

264

Social History AD VERTISE.VENTS

VOL. 22:

NO.

3

BRITIES JOURNAL Of' LMEB3IBTT

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Or ABUSE OF DRUGS.

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

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Acts.) i Licensedunder the Intebriates O~L:. ME: G:TI: FOR E hotise is situated in a dry. bracing lim ite. 45o fect above sea-lcvcl, conmmsanding extensive sea. views,and coutainsisix Pulblic kounis, Billiard Ruoon (with two :ull-suscd tablcs) Loncert Hall, and 45 liedroanns. r (tw. acres). Tennis The grouinda are ticarly 2oo Urcs i extetilt, in which there are walld-itn Gardvn z miles rouild), LALc and Strc;An. Rabbit-:hooting. Lawnt. Croqtket Lawin. anid Goli Course Ni holtc, I barrieri not enclosed by physical These grounds arc apply to For trealttient ;sod parliCulars DONALD, L.R.C.P., LR.C.S. (Edin.). JOHN Proprietor and Re:sident Physician. 71te,ra,#hic Aldress.: " Salubrious. Upper targo." Nearest Railsay Station-Kilconqubar. 7'WqA,'h,: No. 8, Uppcr L-.rgo (l'.O. Sycteut)

Q.

Figure 2. Advertisements

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Alcoholism and free will

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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 influences.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 threeyear term (and denied access to their children while imprisoned), in contrast to a handful of male inebriates convicted of theft, assaultor 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
Advertisement, British Journal of Inebriety ii (various issues). Other medical journals, including the very widely distributedJournal of the American MedicalAssociation,also ran such ads; this suggests that physicians often referred their patients to these homes. 59BPP, Reportof 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. Generally, at that stage, they think they are quite equal to resist temptation, which is quite a mistake, as NO RESTORATION OF THE WILLPOWER CAN
(I900), 58

HAVE TAKEN PLACE .. .'. BPP, Report of the Inspectorfor1904, 1905, xi, 122.
61 Lucia Zedner, Women, Crimeand Custodyin Victorian England (Oxford, I99I), chap.6. The evidence for the prevalenceof prostitutesamong the reformatorypopulationis found in an interviewbased survey carried out by the Inspector of Reformatoriesin i9i0. This surveyrevealedamong other things that 52 per cent of the women committed under section 2 (that is, as police court recidivists) hadbeen previously convictedof prosti-

tution-related offences. BPP, Reportof the Inspector of InebriateReformatories, I9II, xxix, part I, 32.

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reformatories in Britain were involved in the policing of women's sexual and reproductive conduct as much as or more than in the regulationof alcohol. Classwas (in the UK, though not in the US)62as importantas genderin the differentiation of treatmentregimes:the separwhile originallyintendedto reflectthe fact thatsome ation between retreats and reformatories, inebriatescould indeed cure themselvesthrough their own will, aided only by pastoralcare, whereasother inebriateswere beyond reform,ended up being administered simply on a class basis.Thus in 1903 the Inspectoradmittedthat gentlemen and ladies,even if they broke the law,were never sent to reformatories: Some day,when the numbersare sufficientlylarge to warrantthe expenditure, it will be necessaryto add accommodationfor good classpersons who happen to be committed under this act. Three personswere sent to reformatories during the year under review, who were well educated,and obviously not suited for detention under arrangements which at presentare chiefly adaptedfor dealingwith the lower classes.63 were quietlytransferred to those havensof freewill, the privateretreats. These threeindividuals (The Inspectordoes not specifywhether they,like other patientsat retreats, paid for their own treatment.) The reformatory populationwas viewed in a new,even more sinisterlight,duringthe moral and'mentaldefect'.Fromabout I904 on, panic of the early I9OOSabout physicaldeterioration of the Society for the Studyof both the reportsof the InebriateInspectorand the proceedings of the poorerurbanclassestendingto disappear underthe now Inebrietyshow the alcohoLsm of Inebriates more capacious label.Dr MaryGordon,namedAssistant 'feeble-minded' Inspector andput in chargeof the women in reformatories, wasfirmlyconvincedthatmanyof the women even those who subjectto her inspectionwere 'imbecile'or'insane',and that,more importantly, showed no 'outwardsigns of degenerationor imbecility'are nevertheless 'feeble-minded'.64 were used by other expertsas'evidence'for takenof the women in reformatories Photographs Branthwaite the claimthatmost inebriates were'feeble-minded'.65 carriedout his own Inspector in I905 and concludedthat upwards of 62 per cent of the persons extensiveprimaryresearch Acts were eitherinsaneor'defective'.66 underthe Inebriates committedto reformatories
JamesBaumohl'swork suggeststhat although there were some class differences between the and the more middleworking-class'dashaways' class members of the American Temperance Union, neverthelesstemperancewas a cross-class movement,and its techniqueswere not sharplydifby class(Baumohl,op.cit.). At the turn ferentiated of the century,the American temperancemovement, which had a much strongerfeminist influence than either religious or medical sobriety movementsin the UK, had succeededin identifrman,especiallythe workinging the working-class class immigrant man, as the paradigm of 'the alcoholic',but it is notable that in the UK system the typical working-classalcoholic was female,as (Zedner,op.cit.). Zedner has demonstrated 1903,I905, Xi, 136. of theInspectorfor 63BPP, Report 64 Dr Mary Gordon,speech in British of Journal XII, 2 (1914), Inebriety, 99. Probablybecause she
62

the end of the life of the InebriateActs, anticipated Dr Gordon was hopeful that she could use an alternative legal strategy to institutionalize the problemwomen:'The new MentalDeficiency Act, new powersfor dealingwith thisclass I913, provides
of inebriates' (Ioo). It would be interesting to see

how many former 'inebriates'were put away in institutionsfor the feeble-mindedafterthe Inebriate Acts ceasedto haveeffect. 65 F. W Mott, 'Alcohol and insanity', British the phoIx, I, I9. Interestingly, Journal of Inebriety, tographyof inebrietywas an exclusivelyfeminized in the were represented Male inebriates endeavour. not with line drawings, annualReports oftheInspector with photographs. 66 BPP,Report for 1905, I906, xvi, of the Inspector 593ff.This reportincludesseveralpagesof photographsof women inebriates.

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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 genderspecific 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'69have 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,particularlyin the light of the Inspector'spractice of transferringgentlemen inebriates who did fall into the clutches of the law out of reformatories and into 'voluntary' retreats. The second classof inebriates distinguishedby the I908 committee is barely distinguishablefrom 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 The class subtext of this discourse on mental defect is obvious. signs of other mental disorders.71 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 DepartmentalCommitteeas to

69 I908 Committee Report, 820. 70 Michel Foucault, ne

vol. History of Sexuality:
822.

the Operationof the Law Relating to Inebriates,I908, xii, 8i7ff. (Cd. 4438). This will be referred to subsequently as the '1908 Committee Report'.

(New York,I982).
71 I908

Committee Report,

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NO.

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culture by artificial The committee noted that there existsin naturea peculiarclass,'inebriates interpelratherthan by nature'.These are the 'ladiesof the upper and higher middle classes' lated in the advertisements cited above;the committee notes that they often take alcohol for and without pain relief or during an illness,and slowly find that they depend on it. Gradually any realwickednesson their part,their 'self-controlis weakened'. replacedby three quite distinctsocial/medicaltypes. The alcoholicis thus effectivelyerased, The upper-class gendemanwith the strongdesiresis simplya little too virile,but he is fundaenterprising gentlemanfor whom mentallysound. He is the prototypeof the Empire-building On their part,the mentally drinkingtoo much is an incidentaland contingent characteristic. deficient and violence-proneinebriatesof the second classare characterized in termsof classfromview. Finally, the ladieswho unrelatedmentalqualities; drinkingagaintendsto disappear wittingly fall into inebriety because they follow a doctor's prescriptionfor alcohol-based medicines do not have a drinkingproblemas much as a gender problem.They gulliblybuy alcohol-remedies for femalemaladiesor follow a physician's bad advice:their problemis really havingexone of excessfemininity. The threecategories Thus they too arenot reallyalcoholics. it seemsclearthat there areno alcoholicsleft haustedthe content of the 'inebriate' designation, - just overlyvirile gentlemen,degenerateproletarians and weak-willedladies.And to put the final nail in the coffin of the medicalization concludedthat while strategy, the I908 comnmittee it did not attackinebriates 'as influenzamight';it wasn't inebrietywas in some ways a disease, or even more modestly,'a habit'.72 peculiarity', reallya disease, then, but rathera 'constitutive CONCLUSION We have seen that the projectto constructa new medicalizedidentity- the alcoholic- was underminedat every turn. Sometimesthose labelledalcoholicsrebelledagainstthe medicalizato have been the case in the firstinebriateasylumin the US; but, tion of drinking,as appears wasundermined fromwithin.Physicians, and legislators more often,the projectof medicalization it other writersagreedthateven if alcoholismwasa disease(a point not necessarily granted), was of a unique diseasewhose cure was more likelyto be effectedby the willpower the patientthan by either scientificknowledge or clinicalpractice.It was, one might say,the liberaldiseasepar or free exerciseof the veryliberalsubjectivity excellence: treatnenttherefore involveda strenuous will thoughtto be impairedthroughtoo much drinking.And even those people caughtwithin did not, at leastin the UK, constitutea singlepopulation. the medicaldefiition of 'inebriety' workedtogetherto fiagment'thealcoholic'into distinctgroups. Classand genderregulation FouThis study thereforesuggeststhat it may proveusefulto questionthe by now standard the increasing cauldianthesisregarding power of governancethroughidentity categoriesproduced by experts.Detailed historicalstudiesmay thus help us to overcomeand go beyond the currenttendencyof historicalsociology to overvaluethe effectivityand the internalcoherence Whateverthe fortunes of the alcoholic in later periods,in the period of expert discourses. immediatelyprecedingthe FirstWorldWar the alcoholic,although certainlyinvented,was a perpetuallyfailingidentityThis study thus seeks to highlightthe importanceof contradiction and failurein the historyof social,legal and moralregulation. University ofToronto
72 I908

Committee Report, 822-3.