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By Jay Doblin

This publication is for designers, scholars, draftsmen, and all who use point of view.

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Two specialties in particular guided the physicians who organized the AACI: public health, which became 14 Alcoholism in America a discipline in its own right in the early decades of the twentieth century; and psychiatry, whose practitioners were still called “alienists” in 1870. Inebriety was a key problem within each of these fields. Urban sanitarians working to make the city a cleaner, healthier, safer environment viewed drunkenness as a proverbial thorn in their sides. Not only did the habitual drunkard’s health suffer, but so did his family’s.

57 Rothman’s assessment of the turn-of-the-century asylum and penitentiary was remarkably apt, and it set the stage for decades of scholarship. The histories of specific institutions such as the state hospitals for inebriates in Massachusetts and Iowa allow us to extend this analysis and to see that conscience and convenience were at times more complicated than Rothman suggested. The Massachusetts and Iowa stories suggest that “conscience” varied between institutions and even between institutional regimes, influenced by a host of local, medical, and nonmedical factors.

I argue that there was a general terminological movement from intemperance to dipsomania and inebriety, and finally, to alcoholism. Each of these terms represented a particular constellation of cultural assumptions about gender, class, ethnicity, heredity, and personal responsibility. Of course, each diagnostic label was also a reflection of the state of medical thinking on habitual drunkenness. The two are intimately related: terms such as dipsomania, which stressed the connection between drinking and insanity, also comprised a rhetorical strategy for the promotion of the disease concept and the authority of the medical profession.

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