To dissertation's title page...
- Swedish translation, by Catherine Desroches, here.
THE AMERICAN DISCOVERY OF ALCOHOLISM, 1933-1939Preface
In the following pages I have sketched a brief and provisional account of the beginnings of the U.S.'s historical transition from a "temperance paradigm" to an "alcoholism paradigm" in our society's alcohol-problems domain or arena. My particular focus is on how the genesis of the alcoholism movement might be said to have emerged from the continuing Dry-Wet debate that characterized a half-dozen-year period following Repeal. In other words, I am interested in the prospects for sociological or historical explanation of the transition between these two great popular paradigms. My account begins and ends with specific historical events--Repeal at the outset, and a late-1939 event I've called "Bowman's Compromise" at the close (about which more in Section II, below).
I What chiefly differentiates the "temperance paradigm" from the "alcoholism paradigm" in the alcohol-related problems domain or arena? Indeed, what is meant by the notion of an "alcohol-problems domain or arena" in the first place?
The notion of an "alcohol-problems domain or arena" refers to the idea that alcohol-related concerns form a more or less freestanding department of life and society. This belief, in turn, reflects a persistent and Platonic inclination in American thought for grouping a variety of alcohol-related events and conditions together under a single topic heading and, in turn, regarding that heading as manifesting a meaningful, underlying reality. This penchant is evidenced in a great variety of ways -- for example, in governmental agencies defined in terms of alcohol-related problems (from the federal National Institute on Alcohol Abuse and Alcoholism down to agencies at state and local levels); in scholarly and popular journals and articles about alcohol-related problems; in the existence of lay and professional groups specifically addressing or specializing in alcohol-related problems, and so on. Common synonyms for "domain" and "arena" (Wiener, 1981) in this connection make reference to an alcohol-problems "world," "field," "area," or "territory." Scholarly or research work in connection with this territory is sometimes referred to as "alcohol studies" or even "alcohology."
The temperance and alcoholism paradigms offer quite different and competing conceptualizations for the interpretation and societal response to this "world" of alcohol-related problems. Following Levine (1978) and Beauchamp (1980), it will be convenient to outline the main features of the temperance paradigm by likening it to the implicit paradigm that many Americans currently hold with respect to an illicit drug such as heroin. Heroin is viewed as an addictive and destructive drug that is partly responsible for a wide variety of social problems--for example, crime, violence, prostitution, poverty, illness, mortality, family disintegration, and so on. The drug itself -- i.e., the substance, heroin, itself -- is viewed as the essence of this "drug problem" and provides the primary focus for societal efforts to control heroin-related problems. Thus, societal control is aimed in large measure at the production, importation, distribution, and suppliers of the drug. The enforcement of a legislative prohibition on the drug is the chief societal response to this drug problem.
Relatedly, any use of the drug is ordinarily regarded as problematic and deviant--we have no readily available normative framework in which "moderate" or "social" use of heroin is positively sanctioned. Use, per se, is seen as a social problem, not merely misuse. Popular thought, moreover, does not mark a strong distinction between "heroin users" and "heroin addicts." Heroin addiction or addicts are seen as one -- but only one -- of the manifestations of the "heroin problem." Addicts and addiction may be viewed with a mixture of sympathy and opprobrium. Treatment may be regarded as the best societal response to heroin addiction, but treatment of addicted persons is not seen as the chief means for addressing the country's "heroin problem." Indeed, treatment forms a relatively small part of the overall official societal response system--even though heroin addiction is widely regarded as an illness or disease-like phenomenon. Now--if one substitutes the term "alcohol" for "heroin" in the above, one will have in hand a reasonably good working model of the "temperance paradigm's" conceptualization of the alcohol-related problems domain. In short, classical temperance theory (Bacon, 1967) views alcohol in a heroin-like imagery (Levine, 1978; Beauchamp, 1980).
The alcoholism paradigm offers a strikingly different perspective. Alcohol is viewed as an addictive and destructive substance in only a minority of persons, known as alcoholics. Therefore it is the person of the alcoholic and not the substance alcohol that provides the focus of conceptualization and societal response. (Ordinary or "nonalcoholic" users of alcohol may "get in trouble" be cause of their drinking, too, but such troubles are attributed not to the alcohol but to the person's misjudgment, nonalcoholic psychological infirmity, or situational variables.) Thus, the societal control of alcohol-related problems is not aimed at the production, importation, distribution, and suppliers of alcohol but instead at consumers who drink excessively. The alcoholism paradigm is compatible with the more or less free public marketing and sale of alcohol--though misusers of the substance will be encouraged not to buy and use at all.
Alcoholism treatment is the chief societal response to the alcohol problem, and a sharp divide is drawn between alcohol's "moderate" or "social" use, on the one hand, and "problem drinking" or "alcoholism," on the other. Misuse, but not use per se, is seen as problematic. Alcoholics are regarded as virtually (though not absolutely) co-extensive with the world of alcohol-related problems--for example, alcohol-related family disruption, job problems, and even drunken-driving arrests may be regarded as "signs of alcoholism" more than as evidence of alcohol's inherent problem-causing potentials. A considerable treatment system has grown up in the country since Repeal and forms the primary official societal response system to alcohol-related problems (though many such problems are still handled in other institutions as well). Even the word "alcoholism" -- which defines this problem territory -- is a designation applied to a person, whereas "the drug problem" (a temperance idea) designates a substance.
II In the autumn of 1939 the Research Council on Problems of Alcohol quietly voted to devote all of its new research energies in the foreseeable future to alcoholism and cease the promotion of all other research projects devoted to other alcohol-related problems (the latter included, for example, investigations of the form of alcohol's relationships to crime, poverty, insanity, etc.). It appears that Karl M. Bowman, the recently-elected chair of the group's Executive Committee, promoted this policy decision to the rest of the group -- and hence my name, "Bowman's Compromise," for the event.
At first, this move was described to RCPA membership as an interim scientific policy choice, designed to fill a time gap until a comprehensive review of the alcohol literature then in progress would be completed and provide new inputs for planning the future of alcohol-related research (see Jellinek, 1942). In fact, however, the decision was neither interim nor a time-filler. The RCPA's leadership was urgently trying to reason through how they might ethically justify accepting "Wet" or alcoholic-beverage industry funds for the support of their alcohol-related research. Ever since its origins in mid-1937, the RCPA had been involved in a seemingly futile search for funding for its program of alcohol-related research and by October 1939 the only prospect for keeping the group alive seemed to lie in the acceptance of the beverage industry's offers of support.
But the beverage industry had emerged from the nation's temperance-movement era highly stigmatized in the public mind. Moreover, RCPA scientists knew that many of the studies they wanted to conduct might generate results bearing on alcohol's reputation in popular thought. It was, they recognized, a no-win situation. If their beverage industry-funded research showed that alcohol was less responsible for some sort of harm or untoward consequence than previously thought, then the RCPA would be laid open to charges of bias stemming from the industry funding source; on the other hand, if the results showed that alcohol was as responsible or more responsible than previously thought, then researchers could scarcely expect their industry patrons to continue supporting their research.
Bowman resolved this dilemma by proposing in effect to drop from the RCPA's list all proposed studies with empirical results that would bear directly on alcohol's reputation. The move, as it happened, left behind on the RCPA's list only studies of alcoholism or aspects of alcoholism. Thus did Bowman and most of his RCPA colleagues make the decision to concentrate entirely on alcoholism. That done, they could and did quietly begin to use beverage industry funds to support the group's new research. Because this event (a) marked an embracing of the alcoholism focus and a rejection of a variety of other foci for alcohol-related research, (b) was the action of an important (indeed, the most important) group then in the alcohol research arena, and (c) was a decision that deflected the course and emphasis of subsequent RCPA research and orientations -- thus playing in the emergence of the modern alcoholism movement thereafter -- I have regarded Bowman's Compromise as a significant genesis moment in the story of the modern alcoholism movement.
As I have discussed in Chapter IV, most accounts of the history of the modern alcoholism movement have tended to focus on either the origins of the fellowship of Alcoholics Anonymous (in 1935) or follow Mark Keller's account of the RCPA's origins, tracing it back to Norman Jolliffe's failed efforts to interest the Rockefeller establishment in supporting a comprehensive study of alcoholism at Bellevue Hospital in New York City (in 1936). Typical accounts also highlight the new movement's beginnings in the Yale Center of Alcohol Studies, the Yale Summer School of Alcohol Studies, and Marty Mann's National Committee on Alcohol Education, in a period from 1939 to the mid-1940s (see, for example, Kurtz, 1988; Blocker, 1990; Keller, 1975; Page, 1988; Schneider, 1980; Johnson, 1973).
In part, my choice to focus on a different and unconventional aspect of the movement's origins reflects the documentary materials I have been able to find and the path that they have led me on. It should also be borne in mind that my study's focus is not cast forward in time toward questions of how Bowman's Compromise (or any other origin experience) in turn flowered into the modern movement's ascendancy, but, on the contrary, is cast backward in time toward questions of how this event can be understood as the end-result of a previous six-year struggle to define a new societal focus for the country's continuing alcohol-related anxieties in the immediate post-Repeal era--running from 1933 to 1939.
III What form does this story actually take? In one respect it is mostly a story of failures. Bowman's Compromise comes at the end of five quite different--but all failed--alcohol-related initiatives in the post-Repeal period. My assumption has been that a careful study of these failures provides a window into both (a) what was probably necessary for a new alcohol-related paradigm to succeed and (b) how, in fact, the new paradigm underwent its "gestation" period in the old paradigm's immediate aftermath and expiration. I believe that a careful, close examination of the historical experience of this transition offers the best available means for understanding the new paradigm's relationship to the contemporaneous sociocultural environment.
At Repeal, Wets and Drys faced different problems and addressed themselves to different action agendas. Wets sought to consolidate their victory by advocating a new moderation in drinking--if you will, a new "Damp" ethos or code. The promotion of moderate, responsible, or cultured drinking norms and practices seemed to offer the best route toward a future society in which alcohol would pose less of a social problem, thus excite Dry passions less, and, therefore, delay or eliminate the widely-feared prospect of another great prohibition drive in the country's future.
Drys, on the other hand, regarded "moderation" as anathema. If drinking was an evil, after all, why then advocate the "moderate" practice of it? Drys, therefore, either ignored or fought against Damp initiatives where and when they arose in the post-Repeal period. For its part, Dry thought bided its time until a new tide of post-Repeal alcohol-related problems made its appearance in the society. Many Drys also advocated both greatly enhanced educational efforts aimed at illuminating alcohol's evils and a new spirit of scientific objectivity and research in relation to evaluating both Dry and Wet claims about alcohol.
Both kinds of efforts -- Damp (Wet) and Dry -- would meet with apparent disappointment and failure. Two Damp post-Repeal initiatives I examine -- Everett Colby's Council for Moderation (Chapter III) and Waddell and Haag's report in Virginia (Chapter VI) -- fell victim to some sort of latent cultural veto that Drys, though defeated by Repeal, could still effectively exercise. One Dry-leaning initiative -- Harry Moore's Sponsoring Committee for the National Conference on Alcohol (Chapter V) -- fell victim to its inability to attract funding from either the Rockefeller Foundation and other wealthy individuals and foundations. Two "new scientific" initiatives -- Norman Jolliffe's efforts to promote expanded alcoholism research at Bellevue Hospital (Chapter IV) and the early Research Council on Problems of Alcohol (Chapter VII)--also fell victim to lack of funding interest. In contrast, Bowman's Compromise not only allowed an alcoholism-focused RCPA to survive and conduct research but surmounted a number of other barriers that had also thwarted previous initiatives. For one, it managed to construct a loose and temporary consensus between Dry and Wet interests just long enough for the "new scientific approach" to assume cultural "ownership" (Gusfield, 1975) of the alcohol problem.
But the story that emerges is considerably broader, and must include social and historical circumstances rather far afield of the alcohol arena. Perhaps the most important non-alcohol body of influences playing in the post-Repeal transition to the alcoholism paradigm derived from the Great Depression. The depression had partly occasioned Repeal in the first place, it being widely argued at the time that a re-legalized alcohol trade would give a boost to the nation's crippled economy as well as generate much-needed tax revenues. After Repeal, the depression spurred alcohol-related endeavors by sparking the entrepreneurial instincts, survival needs, and social consciences of men like Everett Colby and Harry Moore. The depression's massive unemployment--and the widely held view that science and scientific technology were more than a little responsible for it (because of science's responsibility for the expansion of labor-saving technologies)--also tarred American science's popular image, thus partly motivating (I argue in Chapter VII) the American Association of the Advancement of Science's interest in the RCPA in 1937 and 1938. Bowman's Compromise itself would no doubt have had much less urgency if the country were not still in the long shadow of the Great Depression and people were not still accustomed or obliged to scrape for funds wherever they might legitimately be found.
The story is broader still. Indeed, there are a number of other domains that I unfortunately have not given proper accounts of in the following pages. A fuller treatment of my topic, for example, might have reserved chapter sections or even full chapters for such subjects as (a) the public health craze of the 1930s--with particular emphasis on public preoccupation with syphilis and that preoccupation's parallels with the alcohol territory; (b) the rising tide of science and scientism in the country, and the broader metaphysical debate within which the scientific establishment's takeover of the alcohol territory was occasionally presented and justified; and (c) the literature and practices associated with alcoholism treatment in the 1930s--i.e., before the ascendancy of Alcoholics Anonymous and the alcoholism research movement.
I, more than anyone, am keenly aware that the history and analysis that follows represents only a first and provisional beginning and not "the final word" on the various questions and problems raised by the temperance-to-alcoholism transition in the American historical experience with alcohol. What follows, then, is offered merely as a pilot venture, a tentative and occasionally rather speculative charting of some new historical and sociological terrain--no more. I look forward to and will heartily welcome subsequent efforts that will improve on my sketch or, perhaps, offer different and better pictures built on alternative conceptual assumptions and historical resources entirely.
IV The work congealed in this dissertation could not have been done without the help, support, and advice of a great many people. Therefore, it is a pleasure for me to acknowledge and thank some of the colleagues, friends, and family who have so readily and so selflessly given me their time and their good will.
This work lies at the juncture of three of my favorite subjects: social change, the history and sociology of science, and alcohol studies. Kenneth Bock, my dissertation committee's chair, sparked my interest in social change a long time ago -- when, as an undergraduate, I had the good fortune to enroll his 1964 seminar on that subject. My indebtedness to him, however, must be said to stretch considerably beyond. As scholar, teacher, and mentor, Professor Bock, more than anyone, has provided over the years my clearest image of the ideal of scholarship and the scholarly life. He has also played an all-important part in this dissertation--indeed, without him it would never have seen the light of day. Troy Duster, my committee's second member, is also a long-time student of social change, though my indebtedness to him in this context derives from his interest in the sociology of science. His 1983 seminar on this subject -- one of three courses in which I enrolled in my mid-life return to the Sociology Department -- reawakened my old scholarly love affair with that territory. His scholarship, and his advice and support over the years, have been greatly appreciated. Robin Room, a reading member of my committee, has been my colleague and friend at the Alcohol Research Group (ARG) for twenty years, during which time it has been my honor and great good fortune to have him serve as my main guide and teacher in the mysterious world of alcohol studies. Robin has also provided an important scholarly model -- of indefatigable energy, scholarly generosity, and graceful prose. I thank Frederick Crews, my committee's "outside person," for his kind willingness to join my committee on short notice and despite the press of other duties.
Andrea Mitchell and Geoffrey Hunt have been stalwart encouragers, supporters, and helpers in this project. Andrea has successfully coordinated many of my literature requests to ARG's library and, more importantly, she and Geoff have offered the unending flow of their confidence in this enterprise. Don Cahalan, ARG's former director, has also made a special effort to push forward my work--for which I am very grateful. Genevieve Knupfer, Don's predecessor as ARG director, carefully read several parts of this work as it evolved and offered her always trenchant and perceptive comments. Walt Clark has selflessly and painstakingly read and edited much of this manuscript as it evolved, always with an eye to simplifying and clarifying my prose. Walt's clear and modest writing style has long provided an ideal model for me, and I only wish that I might have emulated it more successfully. John Rumbarger, who happened to be spending a year-long fellowship at ARG while this work was in progress, stimulated many an interesting exchange of ideas, both in connection with this work and his own.
Other colleagues and friends who have specially af forded me their generosity, encouragement, and help include Mary Philips, Brian Katcher, Karen Trocki, Gloria Bocian, Petra Liljestrand, Alex Millar, Beth Thomas, Maria Dinis, and Kaye Fillmore. I thank my friends Charles Wohl and David Rome for ongoing encouragement and good wishes. I thank Elsa Trantor for always gently guiding me through the bureaucratic mazes associated with my atypical career as a doctoral aspirant. I owe a general debt of gratitude to all my co-workers at the Alcohol Research Group--Raul Caetano, Cheryl Cherpitel, Gary Collins, L.C. Jordon, Reuben Kuszel, Judith Lubina, Marek Marciniak, Jane Martin, Marjorie Robertson, Laura Schmidt, Carol Seiden, David Smith, Libby Smith, Paul Smith, Mark Temple, and Connie Weisner-- for their support in this endeavor, no matter what form it took.
Many librarians and achivists have lent my project the bounty of their help and expertise -- assistance all the more gratefully acknowledged because my work on this dissertation did not involve extensive travel. I warmly thank Tom Rosenbaum (Rockefeller Foundation Archives), Michele Aldrich (American Association for the Advancement of Science), Betty Vadeboncoeur (Lane Medical Library, Stanford University Medical School), Susan Brady (Yale University Library), Christine Kehrwald (Gelman Library, The George Washington University), Patricia Haynes (Carnegie Corporation of New York), Conley Edwards (Virginia State Library and Archives), Jodi Koste (Tompkins-McCaw Library, Virginia Commonwealth University), Elizabeth Sage (University of Chicago Library), Alfred Epstein (Frances Willard Memorial Library for Alcohol Research, Woman's Christian Temperance Union), Lisa Dunkel (Department of Psychiatry and Langley Porter Psychiatric Institute Library, University of California, San Francisco), Jill Bogard (American Council on Education), Peter Hirtle (National Library of Medicine), Janice Goldblum and Wendy Ailor (Archives of the National Academy of Sciences), Alice Rwabazaire (Oral History Research Office, Columbia University), Karen McAdams (Green Library, Stanford University), Don Walker (National Education Association), Jim Rush and Aloha South (U.S. National Archives and Records Service), Joan Cullinane (and other librarians at the Graduate Theological Union Library, Berkeley), and, finally, the many skilled librarians of the University of California, Berkeley system--notably at Doe Library (particularly Doe's Reference Room, Newspaper Room, and Government Documents Section), at the School of Public Health Library, at the Business and Social Science Library, and at BAKER. University of California, Berkeley librarians have unfailingly made that system's superb resources available to me.
One of the keenest pleasures connected with this whole enterprise has been exchanging correspondence and telephone conversations with Mark Keller. His letters have offered a wealth of recollections and reflections, and even in disagreements between us, Mark has consistently travelled the high road of commitment to objectivity and generous collegiality. Robert Straus has also read and corresponded with me, and his many kindnesses, suggestions, and unfaltering support have been much appreciated. Selden Bacon has graciously contributed his observations of draft chapters.
A number of scholarly works and their authors deserve special thanks. Peter Kuznick's (1987) study of the American Association for the Advancement of Science greatly lightened my burdens and provided a key element in my reconstruction of the 1937-1938 contact point between alcohol activism and mainstream, American science. Charles Biebel's (1976) study of the Rockefeller Foundation's American Youth Commission also saved me much time by laying out a ready-made and authoritative historical account of that enterprise and its relationship to the Great Depression. Allen Brandt's (1987) social history of venereal disease, though I have not cited it frequently, provided valuable insights into both the country's enthusiasm for public health and the parallel experiences of syphilis and alcohol in the 1930s. Virginius Dabney (1938) was kind enough to chat with me by telephone about his recollections regarding the Virginia events that occupy my Chapter VI, adding color and life to both his own previous account and my other sources. Philip Pauly's (1990) work on Mary Hunt's conflict with the American physiologists (see my Chapter V) and his comments on my Chapter IV are also appreciated. Though I have had no personal contact with him, my reliance on David Kyvig's Repealing National Prohibition (1979) in my Chapter II also merits special notice. I also thank Elden Ernst of the American Baptist Seminary in Berkeley for helpful counsel. Finally, it might be noted that were it not for Ray Lyman Wilbur's well-ordered files on the Research Council on Problems of Alcohol it would not have been possible to write Chapters V, VII, and VIII.
In a rather different vein, I thank Ladell Crawford, Harry Bingham, Gary Krebs, J.B. Burkhard, Oren Dahl, Charles Wohl, and Buck Thurston for issuing me in effect an open-ended leave of absence from my bi-weekly poker game for the duration.
My mother, Doris Roizen, her friend, Doris Swales, my sister, Heidi Roizen, her husband, David Mohler, my brother, Peter Roizen, and his wife, Sonja Boler-Roizen, have all been loyal rooters on behalf of finishing this dissertation (or any dissertation). Also standing right behind me have been both my older children--Sebastian Rupley, Zoe Roizen, and Ezra Roizen--and my wife's older children--Demian Entrekin and Caleb Entrekin. I owe a special thanks to my brother, Peter, for T/Maker--the software package he in vented in 1980--which has been a pleasure to work in and has greatly assisted me in this project. I owe an unrepayable debt to my father, the late Joseph Roizen, who--with my mother--made it possible for me to enjoy opportunities in higher education that they never had.
Finally, I thank my wife, Maggie, whose contributions to this enterprise have been made in the hard currencies of the extra chores she has shouldered, the hiatus in her own work as an artist, and the sundry deprivations associated with my absent evenings, absent weekends, and my generally "away" state of mind over much of the project's course. No debt is greater than that owed for her loving and cheerfully-tendered support and help, which included a stint as the virtual single parent of our four-year-old daughter. And to Alexis, who has waited for daddy's "D" to be done for about a third of her young life, I dedicate this humble work.
I gratefully acknowledge the National Institute on Alcohol Abuse and Alcoholism (NIAAA) for their support of my work in alcohol studies over the years. The present work was partly supported by NIAAA's National Alcohol Research Center grant AA-05595 to the Alcohol Research Group, Institute of Epidemilogy and Behavioral Medicine, Medical Research Institute of San Francisco.
Responsibility for any errors or misjudgments in what follows is, of course, entirely mine and in no way that of those noted above.