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The Medical History of Alcoholism in Nineteenth-Century France

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The Medical History of Alcoholism in Nineteenth-Century France City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 5-2015 Before Addiction: The Medical History of Alcoholism in Nineteenth-Century France Lauren Saxton Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/1122 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] i Before Addiction: The Medical History of Alcoholism in Nineteenth-Century France By Lauren Elizabeth Saxton A Dissertation submitted to the Graduate Faculty in History in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The Graduate Center, City University of New York 2015 ii © 2015 Lauren Saxton All Rights Reserved iii This manuscript has been read and accepted by the Graduate Faculty in History in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy. Dr. Clifford Rosenberg Chair of Examining Committee Dr. Helena Rosenblatt Executive Officer Dr. Megan Vaughan Dr. Dagmar Herzog Dr. Mary Gibson Dr. Elizabeth Heath Supervisor Committee The City University of New York iv Abstract Before Addiction: The Medical History of Alcoholism in Nineteenth-Century France By Lauren Elizabeth Saxton Adviser: Professor Clifford Rosenberg In 1849 a Swedish physician coined the term “alcoholism,” but it was not until the advent of the Third Republic that French physicians began to give shape to this new disease. This work explores the medical facts physicians presented concerning alcohol consumption from the disease’s inception up until the outbreak of World War I, when regulation of alcohol consumption changed dramatically. It works to uncover the links between social anxieties and medical thought, and argues that physicians created a complex relationship between alcoholism and personal responsibility over these years. This relationship privileged bourgeois styles of consumption, undermined the cultural preferences of the working class, and perpetuated pre- existing medical and social beliefs concerning women. Critically, these physicians did not formulate a theory of addiction, which significantly changed the ways in which they understood the motives of drinkers, and the ways in which they evaluated a drinker’s personal responsibility in a variety of spheres, both criminal and civil. v Acknowledgements I would not have been able to complete this project without the generous support and guidance of my adviser, Clifford Rosenberg, who pushed me to think larger and harder. I’m also indebted to Megan Vaughan, particularly for her comments on the fifth chapter of this work, and Dagmar Herzog, who helped me to see the larger story that I was telling. Elizabeth Heath and Mary Gibson have also provided invaluable insights, even when it was impossible to be physically present. Evelyn Ackerman oversaw the initial stages of this project, for which I am deeply grateful. Any flaws that remain in this work are of course a reflection of my imperfections, not those of these thoughtful scholars. The support that I have received from The Graduate Center of the City University of New York’s Dissertation Research Grant program made my archival trip possible, as did the understanding and generosity of Marie Marionetti, the chair of the Lehman College History Department, and Helena Rosenblatt, the Executive Officer of The Graduate Center’s History Department. Dagmar Herzog’s thoughtfulness to me as her research assistant has also been crucial, in addition to her academic advising. Additionally, I have been lucky to be surrounded by historians and friends of the highest quality, who always took the time to read and comment thoughtfully, especially when the material was not cooperating. Kyle Francis, Megan Brown, T. Scott Johnson, Kat Mahaney, Secil Yilmaz, and Erin Wuebker have all read at least one of draft of over half this work, for which I owe them at the very least several bottles of good French wine. Finally, family and friends of all kinds have contributed substantially to the general cause of sanity throughout the writing of this of work. There are too many to name entirely, but I would be remiss to not particularly thank my parents, Jane and Greg Saxton, Suzanne Macey, Kate Parker, David Slifer, and Daniel Castillo. Their understanding and support has been the world to me over these past years. This list is a wildly incomplete accounting, and for the countless smaller intimacies and conversations that have all shaped this research and my thinking, I am endlessly grateful. vi Contents 1. Introduction 1 2. Only in France: Drinking Practices and Medical Rivalries 20 3. Alcoholism in Men 55 4. Can They Be Cured? 98 5. Alcoholism in Women 139 6. Responsibility, Belonging, and Alcoholism 179 7. Conclusion 229 8. Bibliography 241 1 Introduction How did physicians decide what alcoholism meant when the term was first invented? Over- consumption of alcohol remains one of the most common and one of the least well-understood life-threatening social problems that troubles nearly every civilization. If all diseases and medical maladies are evaluated against cultural norms, surely some, such as a broken bone or Huntington’s disorder, are diagnosed as a result of clear evidence. Others, like autism or alcoholism, exist at the opposite end of that spectrum and their diagnoses rely in large part on the judgment of a medical practitioner.1 The only way to determine if someone suffers from alcoholism is to evaluate whether his or her relationship to alcohol is disordered compared to those around them.2 This work is intended to historicize the medical understanding of alcoholism, a phenomenon that has been largely viewed as unchanging over time, and common across spatial and cultural contexts.3 In the second half of the nineteenth century, physicians throughout the industrialized world grabbed hold of a new term, “alcoholism,” which they used as an axis around which to group observations concerning a variety of behaviors, physical changes, social concerns, and cultural transformations. Although the physical effects of alcohol consumption were the foundation of these discussions, individual contexts incorporated unique sets of anxieties and preferences with contemporary developments, all of which came to influence both the medical and popular 1 For a discussion of how the judgment and views of the treating physician, as well as social and cultural beliefs, are so important to the diagnosis of diseases on this end of the spectrum, see Steven Novella on February 23rd, “ADHD is Real,”NeuroLogica Blog, http://theness.com/neurologicablog/index.php/adhd-is-real/. 2 There are, of course, a number of scientific studies that try to make sense out of why some people develop alcoholism. These have pointed to, among other factors, heredity, gender, religion, upbringing, and certain electrical activity tendencies in the brain in order to explain why some people become alcoholics and others don’t. None of this, however, has identified as litmus test or causal agent for alcoholism. For more on diagnosis of disease through social behaviors, and social components of medical evaluation, see Rayna Rapp, Testing Women, Testing the Fetus: The Social Impact of Amniocentesis (NY: Routledge, 2000). 3 Gina Hames, Alcohol in World History (London: Routledge, 2012), Jean-Charles Sournia, A History of Alcoholism (NY: Blackwell, 1990). 2 understandings of what it meant to suffer from alcoholism.4 A close study of the information that physicians in France constructed in these years can help us to uncover the prejudices and assumptions that helped to shape the production of knowledge concerning alcoholism. A prodigious number of medical school theses, journal articles, and monographs were written on the medical definition of alcoholism between 1871 and 1915. Although the term alcoholism was invented in 1849, few physicians showed interest in it until after the loss of the Franco-Prussian war and the violent end of the Commune. Many then began to argue that alcoholism could induce irrational and violent behavior, and that it posed a significant threat to the survival of the young Third Republic. In these same years, social commentators throughout Europe instigated a number of influential discourses on social organization, which Christian Topalov has labeled a “reformist nebula.” 5 Medical concern over alcohol consumption fits into these conversations well, particularly as it was directed specifically at the working-class, where most of the reformist impulses found vent in these years. Concern over housing and nutrition, abortion and pre-natal health grew rapidly at the end of the nineteenth century. The future of the French nation was very much tied up in both anxiety over potential disasters and hope that these interventions could produce a bright, healthy future. In the case of alcoholism, reformist discourses and medical interest in alcoholism dropped precipitously following the 1915 military order outlawing the 4 For more on alcohol consumption in non-French nineteenth-century contexts, see An Vleugels, Narratives of Drunkenness (NY: Pickering and Chatto, 2013), Patricia Herlihy, Alcoholic Empire: Vodka and Politics in Late Imperial Russia (Oxford: Oxford University Press, 2002), Charles Ludington, The Politics of Wine in Britain: A New Cultural History (NY: Palgrave MacMillan, 2013), Gerry Johnstone, “From Vice to Disease? The Concepts of Dipsomania and Inebriety, 1860-1908” Social and Legal Studies, 5, no. 1, (1996): 37-56, Leo A. Loubère, The Red and the White: The History of Wine in France and Italy in the Nineteenth Century (NY: State University of New York Press, 1978), Marian Valverde, Diseases of the Will (Cambridge: Cambridge University Press, 1998), B. Lucas, “Reducing Discursive Complexity: The Case of Alcohol Policies in Europe (1850-2000),” in From Science to Action, eds. Richard Müller, Harald Klingemann (NY: Springer, 2004): 71-100.
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