The temperance physicians: Developing concepts of addiction

During the first temperance movement, which flourished in the early decades of nineteenth-century America, some new ideas emerged about intemperance and alcohol use. These ideas proceeded from a complex interplay of social, cultural, and intellectual forces. A small group of physicians, whom I refer to as "the temperance physicians," gained prominence in the temperance movement through their writings, lectures, and public activities. They expressed new ideas about the effects of alcohol use, aspects of which are consistent with what modern terminology recognizes as addiction. This dissertation explores the ideas of the temperance physicians and highlights significant biographical data. The first temperance physician is Benjamin Rush of Philadelphia (1746-1813). A signer of the Declaration of Independence and physician to the Continental Army, Rush is also one of the founders of the American temperance movement. His many treatises on the effects of "ardent spirits" and intoxicating beverages influenced the next generation of temperance physicians. They are: William Clark (1785-1867), who helped organize the first temperance society in New York in 1808; Thomas Sewall (1785-1845), a founder of Columbian Medical College in Washington, D.C. Reuben Mussey (1780-1866), one of the most brilliant surgeons of his time; and Charles Jewett (1807-1879), a country doctor from Connecticut who became an influential temperance leader. These men, famous as they were in their time, are largely unknown today, even to most historians. The temperance physicians viewed the subject of alcohol use differently than the other temperance reformers. They approached the topic from a health standpoint and promoted ideas about the dangers of alcohol use. The nineteenth-century concept of addiction differed from contemporary understanding; however, there are similarities both then and now in that the concept of addiction involves overwhelming, compulsive, and destructive use of a substance. Like their predecessor Rush, the temperance physicians regarded habitual drunkenness not so much as a vice or a moral failing, but as a physical process that attended the frequent use of intoxicants. The temperance physicians promoted ideas of the destructive power of intemperance, based in part upon the newly discovered chemical composition of alcohol.