Temperance Physicians: Developing

Home , Sylvester Graham

THE TEMPERANCE PHYSICIANS: DEVELOPING

CONCEPTS OF ADDICTION

Katherine H. Nelson

Submitted to the

Faculty of the College of Arts and Sciences

of American University

in Partial Fulfillment of

the Requirements for the Degree

of Doctor of Philosophy

History

Chair: jvara

:w:

Robert L. DuPontit A

Dean or the College of Arts and Sciences

" 3 J -t& P C-______Date

2006

American University

Washington, D.C. 20016 AMERICAN UNIVERSITY LIBRARY

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Katherine H. Nelson

2006

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE TEMPERANCE PHYSICIANS: DEVELOPING

CONCEPTS OF ADDICTION

Katherine H. Nelson

ABSTRACT

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 thorough their writings, lectures, and

public activities. They expressed new ideas about the effects of alcohol use, aspects of

which are consistent with what modem 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),

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 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.

iii

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGMENTS

I would like to take this opportunity to express my appreciation to the members

of my committee, Drs. Karin Wulf, Robert DuPont, Andrew Lewis, and Philip Stem. I

could not have written the dissertation without the help and encouragement of all my

committee members and am extremely grateful to them. My committee chair, Dr. Wulf,

has been a tremendous help and resource, giving generously of her time and outstanding

expertise in early American history. I am deeply grateful that she continued to chair my

committee even after she had accepted a new position at the History Department of

William and Mary. Due to her faithfulness and continued support I was able to complete

this dissertation. She improved my work immeasurably by helping me to develop both

the substance and style of the dissertation. Dr. DuPont, a recognized leader in the field of

drug and alcohol policy, helped through his continuous support and encouragement. I

felt honored to have him serve on my committee. Dr. Lewis helped in many ways and

improved the dissertation greatly by encouraging me to write the medical background

chapter (“Andrew’s chapter”). Dr. Stem generously joined the committee by special

request and insured that a full complement of AU professors had participated in the

process.

I am grateful to the many reference librarians who helped me throughout the

research phase of the dissertation. At the head of the list are the American University

librarians - the ILL staff, the reference librarians, and the archives staff. They were a joy

to work with and tireless in their efforts. In addition, I would like to thank Bill Pittman of

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Hazelden-Pittman Archives in Center City, Minnesota, for his research help and

enthusiastic support. Many others too numerous to mention also gave invaluable

assistance, especially the librarians of the Allen Medical Library of Case Western

Reserve Medical School, the Gelman Special Collections of George Washington

University, the Dartmouth College Library, the National Library of Medicine, and the

Mutter Museum Archives of the College of Physicians of Philadelphia.

I am very grateful for the support of American University. Thanks to the

assistance of the AU dissertation fellowship, I was able to devote an entire year to the

dissertation with reduced job demands. I appreciate the grant from the AU Graduate

Leadership Council that assisted me in attending the International Alcohol and Drug

History conference in Ontario, Canada. I have been fortunate to study under the

outstanding professors of American University. I am especially grateful to AU

professors Roger Brown, Valerie French, Robert Griffith, and Bob Beisner. A special

thanks to my early committee members, especially British historian Terence Murphy, and

Michael Kazin, my mentor in social reform movements, now at Georgetown.

I would also like to thank my friends and colleagues at the Alcohol and Drug

History Society. It has been a pleasure and inspiration to be in an academic community

with such illustrious members as Jack Blocker, William Rorabaugh, Ian Tyrrell, and the

many new scholars that I meet at conferences and on line.

Finally, I am deeply grateful to my family and friends who supported me

throughout the dissertation endeavor. I would like to thank especially those who read

parts of the manuscript and gave me valuable support in so many other ways: my

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. husband, Dr. John Nelson; my sons, James and Dr. George Nelson; and my friends,

Kathleen Montague, Heather McGiffin, and Natasha Kapetanovic. I could not have

accomplished half so much without their help and encouragement.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS

ABSTRACT...... ii

ACKNOWLEDGMENTS...... iv

Chapter

I. INTRODUCTION ...... 1

II. BACKGROUND OF THE FIRST AMERICAN TEMPERANCE MOVEMENT: THE SOCIAL AND CULTURAL INFLUENCES CONTRIBUTING TO THE RISE OF THE TEMPERANCE PHYSICIANS...... 18

III. THROUGH A GLASS DARKLY: TEMPERANCE IN THE CONTEXT OF EMERGING SCIENTIFIC METHOD, THE OLD GUARD IN MEDICINE, AND POPULAR DISCONTENTS . . 62

IV. THOMAS SEWALL, TEMPERANCE PHYSICIAN...... 93

V. REUBEN MUSSEY, PIONEERING SURGEON AND ARDENT TEMPERANCE. ADVOCATE...... 130

VI. CHARLES JEWETT, COUNTRY DOCTOR AND TEMPERANCE CRUSADER...... 173

VII. CONCLUSIONS...... 223

BIBLIOGRAPHY...... 240

vii

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INTRODUCTION

On a rainy evening in the spring of 1808, Billy J. Clark, a young physician in

Moreau, New York, sat in his home by the fireplace reading. He was perusing one of the

editions of Dr. Benjamin Rush's essay on intemperance, An Enquiry into the Effects o f

Spirituous Liquors upon the Human PerhapsBody} the treatise caused him to

contemplate the harmful effects of alcohol that he had encountered in his patients.

Perhaps he even pondered some specific incident that he had recently witnessed in that

upstate region of New York where lumberjacks gathered regularly to drink rum and other

spirits. We do not know his specific thoughts that night, but we know that he suddenly

left the comfort of his fireside and rushed out into the cold night, riding three miles to the

home of his friend, the local Congregational pastor, Lebbeus Armstrong. The first words

that he spoke to his friend were that they must give up drinking all intoxicating beverages

and urge others to do so as well, before they all became drunkards. Soon thereafter, on

April 30, 1808, Billy Clark and the pastor called a meeting at the local schoolhouse to

form a temperance society. Forty-three townsmen joined the new organization and

pledged to use “no rum, gin, whiskey, wine or any distilled spirits, or compositions of the

'Benjamin Rush, An Enquiry into the Effects of Spirituous Liquors upon the Human Body and their Influence upon the Happiness of Society (Philadelphia: John McCulloch in 3rd St., 1791). Published as early as 1784 and republished for many years afterwards. Before his death in 1813 Rush published and distributed thousands of copies of the Enquiry at his own expense.

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same, except by advice of a physician, or in the case of actual disease.” Thus was the

2 first American temperance society launched.

This account, given by Armstrong and found in several other reports,

highlights some of the social, economic, intellectual, and other forces that brought forth

the first American temperance movement. These forces provide significant contextual

material for the role that physicians would play in temperance reform. For example, it is

significant that Clark enlisted the help of a clergyman, for religious revivalism permeated

the temperance movement. And it is significant that the first temperance society was

founded in Saratoga County in upstate New York, within the area that social historians

recognize as the Burned-Over District. The town of Moreau produced a sizable number

of townspeople who willingly joined an organization that adopted an extreme temperance

position—the first members pledged what amounted to almost complete abstinence. And

more specifically, it is significant that Clark, an isolated country doctor, read Benjamin

Rush’s treatise and found it so persuasive as to inspire founding the first temperance

society. In taking such an extreme action Clark had joined a select group of physicians,

the temperance physicians.

This dissertation identifies as the temperance physicians those physicians,

beginning with Benjamin Rush and following him in first decades of the nineteenth

century, who publicly and prominently promoted the temperance cause. They were not a

self-defined group and would not have referred to themselves in such a manner, yet they

2Lebbeus Armstrong. The Temperance Reformation: Its History from the Organization of the First Temperance Society to the Adoption of the Liquor Law ofMaine, (NY: 1851 Fowlers and Wells, 1851), 222-23.

3John A. Krout, The Origins o f Prohibition (NY: Knopf, 1976), 77-78; John Kobler,Ardent Spirits {NY: Putnam’s, 1973), 48-51.

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shared a common intellectual outlook. Although a number of physicians joined

temperance societies as general members, the temperance physicians stand out as an

anomaly for their active and prominent participation in temperance reform. These few

physicians went beyond simple membership to gain national prominence through their

lectures, publications, and active support of temperance. They enthusiastically supported

the cause through their publications and public activities. Although they approached the

subject of drinking and intoxication with a different emphasis than the general

movement, they provided intellectual and ideological support to the cause. Moreover,

they expressed new ideas about the effects of prolonged, excessive drinking. They

helped to define new concepts about intemperance, pointing out that excessive drinking

of alcohol4 could lead to serious health problems for the drinker and his family. They

developed and expressed ideas associated with the modem conception of addiction.5 The

temperance physicians regarded alcohol intake in the light of medicine not morality.

They were interested in the relationship between alcohol and the physiological response.

Drawing upon their expertise and influence as physicians, they issued warnings about the

prevalent abuse of alcohol by the general public and their profession in particular.

At the outset it will be helpful to define some terms such as temperance and

addiction. The common definition of temperance conveys moderation and the opposite

4 The early temperance leaders warned against the dangers of “ardent spirits,” the term for distilled liquors. The term alcohol was not in common use, nor did the general public understand that fermented drinks (wine, cider, and beer) contained the same chemical substance as ardent spirits. Further discussions of the definition of alcohol and discovery of its composition will be addressed in Chapters. 2 and 3.

5A discussion of the evolving definition and concept of addiction follows in the text. For a discussion of the modem concept of addiction that is scientific, yet understandable to the layman, see Robert L. DuPont, M.D., The Selfish Brain, Learning from Addiction (Washington, D.C: American Psychiatric Press, 1997).

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of extremism. In using the terms temperance, temperance reform, and temperance

movement historians refer to something more specific and specialized than the common

definition would suggest. The term derives from the common definition, drawing upon

the idea of limiting intemperance in drinking, eating, and other activities. Certainly the

avoidance of drunkenness and gluttony represents a temperate, moderate, and reasonable

approach, but the use of the term took on specific meaning during the early temperance

era. In the early nineteenth century, temperance assumed additional definitions as it

related to the limitation of drinking intoxicating beverages. The temperance movement

gradually tended to move beyond a moderate, tolerant approach. However, the

movement retained the term temperance, perhaps as a means of maintaining wide appeal.

By the 1830s temperance organizations had extended their reform target beyond distilled

spirits to include all fermented drinks (wines, beer, and hard cider) in the temperance

pledge. Temperance reform also gradually moved from the position of limiting drinking

alcohol to endorsing complete abstinence from all alcoholic drinks. The changing

definition and goals of temperance will be further considered in Chapter Two and

elsewhere in the text.

In the late eighteenth century and early nineteenth century, the word addiction

was rarely used, and when the word was employed, its meaning differed from current

usage. Addiction was used in the sense of devotion or dedication. One might sign a

letter, “your addicted servant.”6 According to most scholars and experts, the modem

6 The word addict or addiction evolved over time to its current meaning of compulsive drug use. The word derived from Roman law, ad (to, toward) and dicere (to say, pronounce) and meant assignment of goods to someone by legal ruling. By the seventeenth century the meaning had evolved to express being attached or inclined to a pursuit or interest, as in “you are still addicted to the Royal Interest” (1685), or

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terminology and concept of addiction (the compulsion to use a drug or substance)

developed in the late nineteenth century, or even in the early twentieth century.7 This

dissertation will show that ideas associated with the modem concept of addiction

emerged much earlier, and that a few individuals, particularly with the temperance

physicians, expressed the new concept. They did not necessarily use the newer

terminology of the words “addiction” or “alcohol” in expressing their views, but they did,

nevertheless, express ideas consistent with language and concepts that would be used by

the end of the nineteenth century.

In a general sense the temperance physicians might be defined to include any

physician who joined the temperance cause, but such a definition obscures the

significance of the more specifically defined temperance physicians. As will be

thoroughly explicated in successive chapters, particularly the chapter on the medical

profession, doctors in the early nineteenth century took varied positions on the

temperance issue, ranging from opposition, to noncommittal, to moderate and even active

support. Although scholars have undertaken no complete account of the actual numbers,

the general assessment is that the majority of American physicians neither supported nor

opposed temperance. Some physicians, most likely in numbers commensurate with that

of other occupations in society, joined as rank and file members. They joined temperance

societies but without much further participation. The social, economic, and intellectual

“being addicted to his Art” (1850). The Oxford English Dictionary, 2nd ed. (Oxford: Clarendon Press, 1989) v I, 142-43.

7 The founding of the American Association for the Cure of Inebriety in 1870 marks the beginning of addiction treatment. For more information on late nineteenth-century addiction history, see William L. White, “The Role of Recovering Physicians in 19th Century Medicine,”Journal of Addictive Diseases (2000) v2, 1-10 and Bill Pittman, The Roots of Alcoholics Anonymous (Center City, Minn: Hazelden Foundation, 1988), 10-81.

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reasons for their participation, or lack thereof, are complex and will be considered in

successive chapters.

The temperance physicians, thus narrowly and specifically defined, enunciated

new ideas that demonstrate significant implications for understanding the temperance

movement. In order to understand their contribution and activities, it is essential to

describe the first temperance movement and its context within nineteenth century social

reform. The first American temperance movement, dating from around 1808 to the mid

1840s, resembled the other social reform movements of the era. Historians refer to the

temperance movement as a product of the reform impulse of nineteenth-century America.

Social reform movements of the period included the abolition of slavery, the

advancement of women’s rights, humane treatment of the insane, educational reform, and

many other social causes. Temperance reform, the movement to control excessive

drinking of distilled spirits and other alcoholic drinks, formed one of the many social

reform movements that developed in the United States, as well as in Europe. The

temperance movement flourished in Jacksonian America, proceeding from the religious

revivalism of the period as well as Enlightenment ideas of progress and social

improvement. By the mid-1830s, the temperance movement was organized in twenty-

three states, with a membership of approximately one million men and women in more

than five thousand societies. An astounding number, twelve per cent of the U.S.

population, had joined.8

8 Membership figures are from John Allen Krout, The Origins o f Prohibition (New York: Russell and Russell, 1925), 139; Blocker gives similar figures. Blocker is also to be credited with identifying the early nineteenth century movement as the first temperance movement, discrete from successive movements. Jack S. Blocker,American Temperance Movements: Cycles of Reform (Boston: G.K. Hall, 1989), 13-15.

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Nineteenth-century reform movements, especially the abolition of slavery and

the women's rights movement, are widely known and have been the subject of much

scholarship. Until recently the temperance movement has not received as much scholarly

attention as other reform movements, despite the fact that temperance far surpassed the

other movements in membership numbers. The temperance movement equaled the

abolition movement and women’s movement in its eventual success, or perhaps one

might say, influence in American society. The ultimate end of temperance reform,

however, resulted in Prohibition in the twentieth century, not widely regarded by

historians or the general public as a success. The general perception that Prohibition was

ill advised and ineffective has perhaps influenced scholars, even as they regard the early

nineteenth century temperance experience, to downplay the temperance movement in

favor of more attractive social reforms. As will be discussed in the next chapter, several

leading temperance historians have gradually changed the scholarly orientation to

promote the study of temperance. These leading temperance historians include Jack

Blocker, Ian Tyrell, and W J. Rorabaugh.9 Since their original scholarship in the 1970s

and 1980s, they have led the way to establish temperance as a significant, productive

field for historians. This dissertation joins other recent scholarly work by focusing upon

a particular aspect of temperance history. Given the extraordinary dimensions and

influence of the American temperance movement, and the growing interest of current

scholarship, the first American temperance movement presents a compelling topic for

historical study and analysis.

9Blocker, American Temp.Movements', Ian Tyrrell, Sobering Up, From Temperance to Prohibition in Antebellum America, 1800-1860 (Westport, Ct: Greenwood Press, 1979); W.J. Rorabaugh, The Alcoholic Republic: An American Tradition (New York: Oxford U. Press, 1979).

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This dissertation looks at the role of a handful of physicians in early

temperance, both as participants in the movement and contributors to emerging ideas

about alcohol’s physiological impact. It takes into account the general motivating forces

behind social reform and the specific conditions affecting the temperance physicians. As

the account of the young doctor in Moreau, New York, suggests, given a confluence of

circumstances, physicians had the potential to influence their patients to join in

temperance societies. The incident of the founding of the first American temperance

society foreshadows the prominent role that some physicians played in the temperance

movement. It also demonstrates the potential of newly developing ideas about alcohol

consumption that physicians expressed in the generation after Benjamin Rush. Heirs to

Benjamin Rush and his successors, Clark and the other temperance physicians helped to

develop and disseminate new ideas about the age-old problem of drunkenness. They

expressed new ideas about the effects of intoxicating beverages, proceeding from the

standpoint of health and medical science, more than a position of morality. They

developed an incipient understanding of what medicine and social workers later

identified as the process of addiction. The language they used and the attitudes they

adopted differed subtly, but significantly from the more general ideas in the temperance

movement. Yet, temperance leaders welcomed them because they recognized how

physicians could benefit the movement. This dissertation examines the ideas of these

physicians and their participation in the first American temperance movement. At the

very least the study will add useful data concerning the most widely joined social reform

movement in America in the first half of the nineteenth century. A more ambitious goal

is to use the writings, speeches, and biographical information of the temperance

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physicians to understand the development of new ideas about alcohol, and the complex

forces that motivated social reform.

Benjamin Rush (1746-1813), the first and most famous temperance physician,

strongly influenced the next generation of temperance physicians. The impact of his life

and ideas pervades the dissertation and helps to set the criteria for selecting the

temperance physicians who followed him. He was a signer of the Declaration of

Independence and Surgeon General during the Revolutionary War. He was among the

first in colonial America to oppose the use of ardent spirits on the basis of health. He

published his first treatise opposing alcohol in 1771, Sermons to Gentlemen upon

Temperance and Exercise, the first of his many temperance writings.10 His Inquiry into

the Effects o f Ardent Spirits upon the Human Body and his Mind, most widely published

treatise, published first in 1784 and widely circulated thereafter, influenced the next

generation of temperance reformers. Rush has provided a fairly easy target for historians

to criticize because many of his practices and tenets have now been disproved, especially

his over-reliance upon heroic measures during the yellow fever epidemic of 1793.

Nevertheless, when evaluated fairly, with an appropriate placement within historical

context, he must be regarded as one of the most influential figures in American social

reform and temperance in particular.

Using Benjamin Rush as the prototype, I developed the selection criteria. The

selection criteria for the dissertation research are those physicians who were highly vocal

and visible in the movement as they articulated new ideas about the effects of prolonged,

10Sermons to Gentlemen upon Temperance and Exercise was first published anonymously in a Philadelphia newspaper in 1771. Benjamin Rush, Sermons to Gentlemen upon Temperance and Exercise (Philadelphia: John Dunlop in Market Street, 1772).

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excessive drinking. This dissertation examines the ideas of these physicians and their

participation in the first American temperance movement. These few physicians, the

temperance physicians, provide the subject material of this dissertation. They are: Dr.

William James Clark (1785-1867), who helped found the first temperance society in

1808; Dr. Thomas Sewall (1786-1845), one of the founders of Columbia Medical College

in the District of Columbia; Dr. Reuben D. Mussey (1780-1866), one of the most

distinguished physicians of his age and a brilliant surgeon; and Dr. Charles Jewett (1807-

1879), a country doctor from Connecticut who became a prominent temperance physician

and lecturer.

The temperance physicians, thus defined, compose a very small, select group,

only a handful, five to be exact, counting Benjamin Rush. Of the other four, Dr. Billy

Clark, the first of the temperance physicians to succeed Rush, played a limited role. His

fame proceeded almost entirely from his position as the founder of the first temperance

society. Despite his prominence, the biographical and other details available about him

are quite limited. As a result the other three physicians have much more space devoted to

them in the dissertation. The selected temperance physicians were famous in their day,

but almost unknown to historians today. Given their relative obscurity, it is entirely

possible and even likely that I have overlooked other significant candidates for inclusion

in the category of temperance physicians. I regard this dissertation as a first attempt to

recognize and define the temperance physicians. I expect therefore that there will be

ample opportunity for further research, for either myself and for other scholars, to expand

the ranks of the temperance physicians.

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These physicians demonstrated both differences and similarities in their

backgrounds. Rush, Sewall, and Mussey came from academic medicine, from the most

elevated tiers of the profession, while Clark and Jewett were ordinary practitioners. Their

professional status in medicine may have influenced their attitudes and participation in

temperance, a factor that will be explored. Nevertheless, they all played significant roles

in the temperance movement. All except Rush originated from the Northeastern region

of the country, but two relocated during their careers, Sewall to the Mid-Atlantic and

Mussey, later in life, to Ohio. No doubt they also had much in common, as this

dissertation will delineate and analyze. At the most fundamental level they had a

common interest in human health and behavior, and a commitment to rational, evidence-

based medical practice.

The temperance physicians helped to develop and promote new ideas about the

effects of alcohol and the age-old problem of drunkenness. Although within the context

of emerging social and intellectual trends of the early nineteenth century, their ideas

proceeded from the standpoint of health and medical science, more than a position of

morality. They developed an incipient understanding of what medicine later identified as

the process of addiction. The language they used and the attitudes they adopted differed

subtly, but significantly from the more general ideas in the temperance movement. Yet

they were welcomed by the temperance cause because temperance leaders thought they

could benefit the movement.

Various complex forces combined to bring these few physicians to play such a

prominent role in temperance. Although these men’s lives and work provide the focal

material for the dissertation, in a broader sense they themselves are not the primary

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subject of the dissertation. Their biographical information serves as the vehicle for

understanding emerging trends and developments in the history of American temperance.

By highlighting their individual stories this dissertation undertakes to delineate the

changing forces in the complex social reform movement known as the first American

temperance movement.

Recognizing that the temperance physicians proceeded from the wider social

and intellectual trends of the period, the first two chapters after this introductory chapter,

Chapters Two and Three, place the temperance physicians within that context. Chapter

Two highlights the relevant events of the first American temperance movement, and also

draws upon the major historiographical work that has been accomplished in the field.

The temperance physicians displayed both similarities and differences from the

temperance movement and wider social reforms. Chapter Two discusses the origins of

the temperance physicians as they proceeded from the general temperance movement; in

what ways they coincided with the movement and also the ways in which they differed.

The dramatic social changes of the period provide the background and context for the

rapid growth of American social reform. Yet, as we shall see, socio-economic factors are

inadequate to explain either the role of the temperance physicians or the rise of American

temperance reform in general. Intellectual trends, or ideological influences must also be

taken into account. The ideological influences, known as Enlightenment thinking and the

Second Great Awakening, also played significant roles in promoting the temperance

movement. Historians continue to differ over the relative influence of socio-economic

and ideological factors in temperance reform. This chapter takes note of that ongoing

debate and locates the dissertation within the current historiography.

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Chapter Three outlines the major trends in the medical profession that affected

the temperance physicians. From a scholarly standpoint, it is essential to understand

what developments occurred in the medical and scientific fields during the period. Only

with that background is it possible to analyze and comprehend the significance of the

temperance physicians. The role of the medical profession and their attitude toward

alcohol use provides essential contextual information in this chapter. In the early

nineteenth century, the medical community was in a period of transition. Medicine, like

other professions, was entering a period of increasing professionalization. The medical

profession was attempting to establish itself on a more respected footing, with increasing

emphasis on the necessity of formal education and licensure. The old informal methods

of physicians learning a trade, much as an apprentice would learn any other trade, were

gradually being replaced by university education and licensing. Physicians increasingly

perceived themselves as rational men of science and wanted to project that image to the

public. In this chapter we shall consider the effects of their struggle to distance

themselves from the old-fashioned traditionalists with their home remedies.

In such a transition period, many physicians were open to new ideas about

improving health. They began to adopt more effective, preventive methods.

Temperance, in much the same way as other social reform thinking of the era, promoted

the concept of preventive health measures and good hygiene. In the changing ideology of

the period, many physicians responded to the popular health movement by promoting

health through more supportive, preventive measures. Perhaps they responded to the

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growing popular skepticism toward excessive bleeding and purgings.11 Medical science

was skeptical of the old treatments and looked for methods that, if not effective, at least

caused less damage to the patient. Thus preventive health formed the locus for many

social reforms. The reform movements covered a wide range of causes, all concerned

with physical health, for example, the reform movement for humane treatment of the

insane, the movement for prison and penal reform, dietary reform (especially the

Grahamites), and the temperance movement. 19

Chapters Four, Five, and Six form the center of the dissertation, the specific

chapters on the three central figures of the dissertation: Sewall, Mussey, and Jewett. A

chapter devoted to each temperance physician summarizes their biographical information,

describes their writings and speeches, and analyzes their temperance positions. All three

men joined the temperance movement in the 1820s. The dissertation treats them in

roughly chronological order, not by their ages but by their first public participation in

temperance. Chapter Four is devoted to Sewall (1786-1845), who made his first public

statement on temperance in 1827. Mussey (1780-1866) is the subject of Chapter Five.

He sponsored a college temperance society at Dartmouth in 1828. Chapter Six treats

Jewett (1807-1879), who publicly joined the temperance cause around 1829, although he

11 Paul Starr, The Social Transformation of American Medicine (Basic Books, Harper Collins, 1982), 34-56. Heroic treatments of the era included bloodletting, purges, and other extreme practices. By 1850 these heroic practices were declining and largely abandoned by the late nineteenth century.

l2Historians of medicine such as Paul Starr and John Duffy emphasize the defensive nature of physicians’ openness to new ideas. For a description of the rise of professional medicine and the opposition of the anti-professionals, or irregulars, such as the Thomsonians and the homeopaths, see John Duffy,From Humors to Medical Science: A History of American Medicine (Chicago: Illinois U. Press, 1993), 81-83 and Starr,Social Transformation of American Medicine, 44-60 & 51-59. For information on Sylvester Graham’s reform movement based upon diet and hygiene, 1830-1870, see Richard H. Shryock, Medicine in America (Baltimore: Johns Hopkins Press, 1966), 111-125.

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published his first temperance statement anonymously in 1826. Chapter Seven, the

conclusion, presents observations, additional commentary, and conclusions about the

temperance physicians’ contributions to the emerging new concepts in the temperance

movement.

Coming during the generation after Benjamin Rush, the temperance physicians

may be considered his successors both directly and indirectly. They were influenced

indirectly by the continuing social, economic, and cultural forces that had been set in

motion in the late eighteenth century, the same forces that had influenced Rush. These

complex forces provide important contextual information and will be further defined and

examined. The temperance physicians were direct successors to Rush to the extent that

they were influenced by his writings and subsequently further developed his concepts.

They continued ideas expressed by Rush about the harmful effects of drinking

intoxicating liquors. They furthered the ideas of the late eighteenth century about

drunkenness and excessive drinking. They participated in developing new ideas about

the nature of alcohol and its use. As they continued to explore ideas and approaches

surrounding excessive drinking, the new generation of temperance physicians pushed

Rush’s ideas even further.

The temperance physicians’ ideas coincided with the general movement in that

they expanded their warnings beyond distilled spirits to include all alcoholic drinks,

including fermented drinks. All of them, either sooner or later, advocated the position of

total abstinence as the safest and most healthful course. They themselves modeled the

teetotal position in their personal habits. In many ways their message resembled that of

the general movement. But they also had a different approach, more nuanced and more

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appreciative of the effects of the alcoholic content of beverages, as well as the medicines

widely prescribed. They challenged their profession’s increasingly prevalent use of

alcohol in medicines. They expressed views that alcohol use had progressive and

potentially harmful effects for all drinkers, some more than others. Because they could

not predict who might be at risk for the worst effects of alcohol use, they gradually

adopted the position of total abstinence for everyone.

In portraying the temperance physicians’ developing theories of the addictive

qualities of alcohol this dissertation will consider several key questions. How were these

ideas about habitual drinking and drunkenness different from the traditional eighteenth-

century views and the prevailing views of the early nineteenth century? Did the ideas

that the temperance physicians expressed about alcohol being addictive proceed from

ideas already commonly expressed by other temperance leaders? If it appears that

temperance physicians had a different approach, which is a hypothesis of the dissertation,

can the origins of these new views be identified? Perhaps their training, education, and

clinical exposure gave them a different perspective. Although these physicians were

products of the era of early nineteenth-century social reform, they perhaps perceived

information differently than other social reformers. Did they have access to different

information, particularly scientific and medical information?

In addition to the motivational issues, this study will define the attitudes that the

temperance physicians espoused concerning alcohol and addiction. Did they think that

all were equally at risk, or did they regard some as more vulnerable than others? Did

they include all people as potential victims, regardless of class, education, ethnicity, or

gender? Did they include themselves in the at-risk population? Did they express an

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opinion about the possibility of recovery from addiction? As they developed their ideas

and attitudes about beverage alcohol and medicinal alcohol, it will be important to

observe how they applied those ideas to themselves and others.

This dissertation intends to analyze the emergence of developing concepts of

addiction. It looks at innovative attitudes and emerging concepts expressed by a select

group of physicians. The central focus proceeds from the specific details of the lives and

writings of the individual temperance physicians. In this regard, the study provides

additional information and analysis not available in the current historiography. Despite

their fame during their period of history, with the exception of Benjamin Rush, they are

mostly unheard of today, even in the academic literature. The temperance physicians

deserve to be specifically identified and their contributions to be adequately considered.

This dissertation seeks to expand knowledge about this significant aspect of intellectual

and social history.

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BACKGROUND OF THE FIRST AMERICAN TEMPERANCE MOVEMENT:

THE SOCIAL AND CULTURAL INFLUENCES CONTRIBUTING

TO THE RISE OF THE TEMPERANCE PHYSICIANS

In portraying the emergence of the temperance physicians it is essential to

understand the principal features of the first American temperance movement— its

origin, background, and major historiographical approaches. Drawing upon main

historiographical trends in temperance literature, this chapter reviews the origins of

the movement, the drinking customs and attitudes of the era, the nature of early

temperance views and rhetoric, and the characteristics of the early movement. It also

identifies the origins of the temperance movement and examines the role of Benjamin

Rush, the earliest American temperance physician and a key figure in early

temperance history. Although alcohol and temperance historians will already be

conversant with most of the information, the familiar material lends itself to a more

specific purpose, understanding the temperance physicians.

The temperance physicians reflected the social, cultural, economic and

intellectual forces that swept late eighteenth-century and early nineteenth-century

America. As much as they were affected by the social and cultural trends of their

time they also made contributions through their ideas and activities. Their attitudes

about health, disease, and human behavior proceeded from their experiences. As the

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details of their lives and work demonstrate, they responded to the currents of the era

in ways similar to others in the temperance movement, but with significant specific

differences. As will be described more fully in successive chapters, they differed in

their conception of alcohol and drunkenness, and ultimately expressed new ideas

about alcohol’s inherent risks to the drinker. Since they responded to many of the

same forces as did the general movement, it is instructive to consider contextual

information about the temperance movement.

As one considers the first American temperance movement, questions of

terminology naturally arise. Some of the terminology issues have already been

considered in the first chapter, terms such as ardent spirits, alcohol, and addiction.

Another significant terminology issue revolves around the reference to the first

temperance movement. Terminology that distinguishes the period as the first

temperance movement is significant for several reasons. It gives insight into the

motivation and origin of temperance ideas and activity. The choice of terminology

aids in understanding the phenomenon of the temperance physicians and their

formative culture. Also, the choice of terminology reveals important debates in the

historiography.

Most temperance historians accept, or are at least familiar with, the

convention of referring to the temperance movement in early nineteenth-century

America by the nomenclature the first American temperance movement. One of the

path-breakers in temperance history, Jack Blocker developed this terminology and

concept. It has proved to be a helpful tool for temperance historians. In identifying

the first American temperance movement as separate and distinct, Blocker advanced

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the concept of the evolving nature of American temperance. He regarded the

American temperance movement as a series of movements rather than a single long

movement that moved inexorably toward nationwide Prohibition in the 1920s.1 By

identifying the first American temperance movement as a discrete entity in U.S.

history, Blocker perceived the unique, yet interrelated nature of the first temperance

movement. Employing the metaphor of cycles of reform, he demonstrated how the

attitudes of the participants in each temperance period differed from those of other

periods, and but with certain features alternately appearing and receding in

prominence.

Removing the temperance physicians from the association with the strong

prohibitionist sentiment of later periods allows a more accurate view of their

formative culture. The early temperance movement approached alcohol issues from a

non-coercive stance, with the objective of persuading people to adopt the temperance

position and lifestyle. In this regard Blocker’s approach of helps the whole endeavor

of temperance study. Specifically, Blocker points out that the coercive nature of the

Prohibition period was not a prominent feature of the first temperance movement, nor

is it a prominent factor in the current, or fifth temperance period. Prohibitionist

sentiment began to develop only gradually in the late 1830s on a limited scale, for

example, with stricter enforcement of tavern licensing and other such regulatory

measures. Prohibition agitation came much later, in the second half of the nineteenth

century and culminating in the Prohibition movement of the twentieth century. As

'Blocker identified as many as five distinct temperance movements in U.S. history. Jack S. Blocker, American Temperance Movements: Cycles of Reform (Boston: G.K. Hall, 1989), xv-xvi.

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will be explored in later chapters, the first American temperance reformers did not

usually attempt to abolish liquor sales, only to persuade people to reduce

consumption.2

Other advantages proceed from identifying the separate character of the first

American temperance movement. By labeling the early movement as distinct from

successive movements, Blocker has set chronological boundaries around the period

so that it would not suffer the taint of the perceived failure of later movements,

particularly Prohibition. Other temperance historians since Blocker have also noted

that the entire field of temperance history has frequently been affected adversely by

misconceptions about temperance, thus suffering what one historian has called a

“faint aura of ridicule” commonly associated with Prohibitionist sentiment. By

adopting the concept of separate periods of reform Blocker has allo wed historians to

take a fresh look at the first American experiment with temperance, unhampered by

preconceived ideas about the era.4

The historiographical debate over the character of the early temperance

movement has had far reaching effects upon the field. In a recent article in the Social

2 Blocker, 15-17, 157-161.

3 A.E. Dingle, The Campaign fo r Prohibition in Victorian England (Great Britain: Croom, Helm Ltd, 1980), 8.

4 Some contemporary historians in alcohol and drug studies persist in misconceptions about American temperance history by portraying all temperance reformers as killjoys or prohibitionist fanatics. For example Hasso Spode, a historian of German alcohol history, ponders questions about American “Puritanism” and organized state interference in American society. He does not make a distinction between the period of Prohibition and other periods of American temperance history. Without a perception of distinct differences in American historical periods (for example, the distinction between the first temperance period in the early nineteenth century and later periods), Spode sees all through the prism o f Prohibition. Hasso Spode, “What Does Alcohol History Mean and to What End Do We Study It?”The Social History o f Alcohol and Drugs, vl 8 (2003) 16-31.

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History o f Alcohol and Drugs Ian Tyrrell addresses the issue of the difficulties in

studying anti-alcohol movements, an endeavor that other historians might view as

peripheral, or as he diplomatically characterizes it, “not mainstream.” Tyrrell

recounts his experiences in academia with those who suspected that those who made

such studies (himself obviously included) might be “secret admirers of the killjoy

philosophy” and “pro-censorship.”5 Tyrrell still regards the position of alcohol

studies in the historical profession to be somewhat marginalized, but nevertheless

sees that the importance of alcohol and temperance studies as extremely valuable and

enduring.6

Temperance and alcohol history seems to be currently evolving to a more

respected position in academia, as a result of the to the work of Blocker, Tyrrell,

Rorabaugh, Dingle, and other temperance historians. With a more nuanced and

insightful view of temperance history, particularly an understanding of the typically

non-coercive nature of the early temperance movement, we can get a clearer picture

of the role of the temperance physician. Because the temperance physicians’

attitudes, activities and behaviors were situated within the specific time and place of

the first temperance movement, their participation tended to be more persuasive and

restrained rather than strident or militant.

5 Ian Tyrrell, “Thirty-Three Years of Temperance, 1971-2004,”The Social History of Alcohol and Drugs, vl9 (2004), 17.

6 Ibid., Tyrrell sees a growing significance in alcohol and temperance studies. He recounts a number of advantages and strengths in the field of temperance, for example the interdisciplinary aspects of temperance study, an approach that is gaining in prominence in academia.

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The clear and distinct differentiation of the first American temperance

movement from successive periods has allowed scholars to perceive the movement

more accurately in its appropriate socio-cultural context. Influenced by the work of

Blocker and other leading temperance historians, many temperance scholars have

located the first temperance movement within a framework contemporaneous with the

other social reform movements of the early nineteenth century. Identifying the early

temperance movement in this fashion allows a clearer understanding of its close

relationship to other social reform movements. The first temperance movement

developed within the context of the numerous social reform movements produced

simultaneously during the early nineteenth century. Situating temperance within the

host of other reform movements such as the abolition of slavery, the women's

movement, prison and penal reform, education of the deaf, humane treatment of the

insane, dietary reform, and many other social reforms, provides an objective context

n for understanding the temperance movement. Historians can appreciate similar facets

of the reform movements, their similarities in origin, motivation, ideology, and many

other significant aspects. We gain insight into the common reform impulses of

religious faith and evangelical Protestantism, millennial optimism, the activist spirit

of social improvement, and many other influences that the reform movements held in

common. Ronald Walters sums up the Zeitgeist of the early nineteenth century as

“the missionary impulse.”8

7 Ronald G. Walters, American Reformers, 1815-1860 (New York: Hill and Wang, 1978), see especially his chapters on antislavery, pacifism, and temperance.

8 Walters, 21-37.

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By placing temperance within an appropriate chronological context one also

gains awareness of the relative strength and significance of the early temperance

movement compared to other social reform movements. The temperance movement

far surpassed the membership of the other reform movements of the period. The size

of American temperance participation was extraordinary. It numbered approximately

one and a half million members in thousands of local societies in all the states,

compared to the numbers in the next most popular movement— abolition of slavery

with a membership of only about one-quarter million members.9 Historians of social

reform have not yet accounted for the phenomenon of the preeminence of temperance

reform, and most American historians are not yet even aware of the discrepancy.

Given the extraordinary size of the temperance movement compared to other social

reform issues of the period, it is surprising that temperance study has in the past

lagged behind the study of abolition, women’s rights and other reform movements.

Perhaps, with the growing interest in temperance among academics, which Tyrrell

has identified in his recent article, new study will be devoted to the many intriguing

questions surrounding temperance.

Temperance reform, like the other social reform causes of the period, arose

during a period of great social, economic, and political change. During the period

1815 to 1860, the U.S. population more than tripled from eight and a half million to

over thirty-one million. Rapid changes occurred in the United States as the nation

9 Estimates of membership vary from one to one and a half million at the height of membership in the mid-1830s. Krout gives the conservative estimate of one million. Krout, 152; see also Blocker, 13-14: “By 1835 the ATS [American Temperance Society] had reached the peak of its organizing success, claiming over 1.5 million members in more than eight thousand auxiliaries.”

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expanded west, the population grew both by natural increase and by immigration, and

the economy changed as a result of industrialization and agricultural expansion. The

number of states increased from eighteen to thirty-three. New cities developed

throughout the nation and the older ones grew rapidly in size. Urbanization

skyrocketed with cities and towns over 2,500 in size increasing from a few dozen in

1810 to almost 400 by I860.10 Urbanization and economic changes helped to set

conditions conducive to social reform. The slow tempo of agricultural life and rural

life had reduced social ills or at least made them less noticeable in a rural setting.

Farm workers could and did drink to excess without incurring the disapproval of their

supervisors. In early American agrarian society alcohol intake was regarded as

necessary to farm work and manual labor. Farmers generally presumed that alcohol

was necessary to bringing in the harvest. The rapid rise of the factory and

industrialism changed social and economic relationships. Factory based employment

and the market economy shifted relations between workers and employers. With the

rise of the factory setting supervisors began to take notice of their workers’ behavior,

their lateness and absenteeism.

In the nineteenth century urbanization and industrialization revealed and

emphasized the problems of excessive alcohol intake. In the crowded cities the social

ills accompanied by drunkenness attracted the attention of reformers. Urban poverty

and drunkenness in eighteenth century London had produced the world as portrayed

10 These basic statistics are available in American history survey texts. One o f the best survey texts for college coursework is George Brown Tindall’s American, A Narrative History (New York: Norton & Co, 1988). For facts on American demographics and economics see Tindall’s vol 1, chapter 12, “The Dynamics of Growth.”

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by William Hogarth in his famous “Gin Lane” engraving of 1751. Hogarth limited

his condemnation for distilled spirits in the form of “Dutch” gin as compared to his

approval of beer in the idyllic life portrayed in his “Beer Street” depiction.11 Poverty

and drunkenness were much more apparent in the growing cities than in the

countryside. And even in the countryside the social climate was changing. The

drunkenness in country taverns was no longer overlooked as reformers disapproved

of idleness and alcohol abuse. By 1814 Hogarth had his American counterpart in the

painting by John Lewis Krimmel, Village Tavern. In an early work of the American

temperance movement, Krimmel’s painting depicts the scene of the drunken artisan

and his friends in the local tavern. They ignore the pleas of the wife and child to stop

drinking and come home.12 In a climate of changing social and economic conditions

attitudes toward long held drinking customs were gradually changing.

Changes in transportation affected the environment that produced the

emergence of the temperance physicians. Transportation had been slow and tedious

at the turn of the century, but by the 1820s, expanded canal and road construction

substantially changed trade and transportation, as did the development of steamboat

transportation. Towns that had previously been isolated on the backroads and back

waters were more accessible to markets, trade, newspapers, and extensive social 11 influences. Improved transportation made possible the promulgation of social

11 Norman H. Clark, Deliver Us from Evil, An Interpretation of American Prohibition (New York: W.W. Norton, 1976), 8.

12 M. Therese Southgate, “John Lewis Krimmel, Village Tavern, ” on the cover of The Journal of the American Medical Association v 276 (Dec 18, 1996): 1855.

13 Tindall, America, vl, 447-65.

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reform literature and ideas, and even temperance reform agents. Improved

transportation promoted the rise of nationally based organizations, with better

communication from volunteer organizations. By the mid 1820s social reformers

could communicate and develop their membership with the aid of improved

transportation and communication.

Many historians have emphasized the economic and social changes as the

primary impetus of the temperance movement. Some of the temperance scholars

from the generation of the sixties, especially Joseph Gusfield,14 have stressed that

social and economic change engendered class conflict. Gusfield perceived the effects

of urbanization and industrialization according to class theory and social control

theory. In his 1963 work, Symbolic Crusade, Gusfield promoted the view that the

temperance movement was a product of the socio-economic upheaval in urbanizing

America, but in a limited and specific fashion. Gusfield takes an essentially class-

based, social control model of the rise of temperance. According to his portrayal,

temperance reformers were businessmen and other elites motivated by a desire to

control the urban factory workers and lower classes. Gusfield concluded that the

changes from a pre-industrial to a factory economy resulted in a need for the elite to

control the social habits, particularly the drinking habits, of their workers.15

Gusfield’s social control interpretation influenced many scholars whose

work followed in the next few years. Historians such as Paul Johnson, Robert

14 Joseph R. Gusfield, Symbolic Crusade: Status Politics and the American Temperance Movement (Chicago: U. of 111. Press, 1986,1st pub., 1963).

15 Gusfield, 10-19, 36-39.

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Hampel, and others published works in the late seventies and early eighties that also

pointed out the social control and class aspects of the temperance reformers. They

identified temperance reformers as men of property who were concerned not so much

about their own drinking, but about the excessive drinking of the lower classes. The

often-cited work of Paul Johnson, A Shopkeeper’s Millennium, looks at the social and

economic impetus to the rise of temperance activity in the heart of the Burned-Over

District in western New York, especially in Rochester. Johnson’s view of temperance

is constrained by a top-down interpretation of temperance that overlooks the breadth

and complexity of temperance and other social reform.

Taking a hierarchical view of temperance reform, Johnson focuses primarily

on the change in the workplace and the end of direct paternalistic control of workers

by the masters. In his view the shift in the economic and social system encouraged

the old order elite to attempt to regain some measure of control through the newly

emerging temperance message. They sought out temperance and the other moral

reform societies in order to improve the behavior and productivity of their workers.

They encouraged and even pressured workers to join the reform societies. Johnson

conveys the impression that the bosses were guilty of hypocrisy because they did not

intend to curtail their drinking or other bad habits; they merely wanted their inferiors

to behave. Johnson quotes one of the workers as saying “I’ll leave off [drinking]

when the boss does.”16 No doubt instances of hypocrisy existed and will be

addressed in the next chapters, but such analysis leaves much in the temperance

16 Paul E. Johnson, A Shopkeeper’s Millennium: Society and Revivals in Rochester, New York, 1815-1837 (New York: Hill & Wang, 1978), 80.

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movement unaccounted for— its diversity in class, geographic region, gender, race,

and other aspects.

This dissertation agrees with the concept that changes in the economy and

society contributed to the rise of the temperance movement, but in a much broader

sense than the social control model. The social control theory is inadequate in

explaining the rise of the first American temperance movement. It minimizes the

force of self-determination and the growing democratic sentiment of the Jacksonian

era. It assumes that workers acted as victims rather than asserting their rights with

their superiors. 1 7 Nonetheless one finds much of social theory to be useful, not so

much in the phenomenon of social control, but in highlighting the forces of social and

economic change. As a result of the early work of Gusfield (who is a sociologist

more than an historian), historians have had to grapple with the role of social change

in the rise of temperance. These changes resulted in social awareness that displayed

great diversity, cut across class lines, and promoted the rise of the movement. Ian

Tyrrell, in his study of the temperance movement, insightfully observes that work in

colonial, pre-industrial society was task-oriented rather than time-oriented. Shop

workers, agricultural workers, and family members could take time from work to

drink without the objection of having missed time from their work, since no one kept

track of work by the clock. But in the industrializing society of the late eighteenth

17 Current trends in historiography find more validity in agency of individuals rather than their victimhood as class members. In his recent dissertation “Advocating the Man: Masculinity, Organized Labor, and the Market Revolution in New York, 1800-]840,” Joshua Greenberg argues that working men opposed alcohol abuse and decided to live sober lives not because their bosses required it, but in order “to properly maintain household obligation and provide for one’s family.” Greenberg finds that New York workers were “domestic actors.” Joshua R. Greenberg, “Advocating the Man: Masculinity, Organized Labor, and the Market Revolution in New York, 1800-1840,” Ph.D. dissertation (Washington, DC: American U., 2003), 57-58.

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century work began to shift away from home to factories and shops, and so became

more time-oriented. The time lost from work due to alcoholic consumption became

more apparent in an industrializing society.18 In considering Tyrrell’s elegant

explanation one perceives that his analysis differs from Gusfield’s social control

theory. Tyrrell asserts that the social control motive of the employers is only part of

the causal dynamic. All aspects of society, bosses and workers, urban and rural, men

and women gained awareness of the prevalence of excessive drinking. To support his

theory Tyrrell points to the social, class, and cultural diversity of the early temperance

movement. He uses social history in a more complex way to study temperance. He

demonstrates that multiple social, economic, and cultural changes promoted the rise

of the temperance movement. In contrast, the social control theory does not

adequately explain social, economic, gender, or the myriad other aspects of diversity

evident in early nineteenth century temperance. Drawing also upon his international

perspective Tyrrell perceives that the motivating forces for social reform are multi

faceted and complex. While Gusfield’s has some validity and deserves credit for

valuable originating work in the temperance field, Tyrrell’s work gives a clearer

insight into the dynamics of the first American temperance movement, a diverse and

18 Ian R. Tyrrell,Sobering Up: From Temperance to Prohibition in Antebellum America, 1800-1860 (Westport, CT: Greenwood Press, 1979), 18-19. Paul Johnson inA Shopkeeper’s Millennium: Society and Revivals in Rochester, New York 1815-1837, published in 1978, makes an even stronger statement about the economic and social class motivation for temperance reformers. Johnson emphasizes the “social control” message that prosperous employers wanted to reestablish their control over their employees by limiting their (the employees’) drinking. Johnson’s social control or status anxiety theory agrees with the earlier work of Gusfield. Although both Johnson and Gusfield made valuable contributions to temperance historiography, their views have been superceeded by more complex analysis that takes into account a multiplicity of factors. Tyrell takes a broader view of the origins of temperance, both as an ideology and social movement.

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widespread movement. Recent historiographic trends have continued to emphasize

the diversity of the American temperance movement in many aspects.19

The dichotomy between the analysis of Tyrrell and Gusfield demonstrates

the issues one must address in understanding the rise of the temperance movement

and the influences that were brought to bear upon the temperance physicians. Were

the physicians merely falling into the vein of wanting to exercise social control over

their patients and their society, a view more consistent with Gusfield’s analysis, or

did they have other motives? While valuable in identifying one aspect, the social

control theory is limited in that it does not consider other significant motivating

factors for social reform, factors that significantly influenced the temperance

physicians. In this regard Tyrrell’s assessment of the rise of temperance provides

more perceptive context than that of Gusfield. The dramatic social and economic

changes in American culture provide background and context for the rise of social

reformers, but they do not in themselves completely and adequately explain the rapid

growth of temperance and the other American reform movements. If that were the

case, England and other European countries would have produced wide-scale reform

movements as a result of the rapid industrialization and urbanization that they also

experienced. Other forces were at work in American culture and society that

contributed to the rise of social reform. The social and economic changes of the

19 Ian Tyrrell, “Thirty-three Years of Temperance, 1971-2004,”The Social History of Alcohol and Drugs, v l9 (2004),14-17. Other historians also perceive the diversity of temperance, for example Donald Yacovone cites the diversity of temperance by describing the evidence of black temperance societies. Yacovone argues that the black temperance effort was part of their larger struggle for autonomy and self-respect. They did not espouse temperance under white dominating pressure. Donald Yacovone, “The Transformation of the Black temperance Movement, 1827-1854: An Interpretation” Journal of the Early Republic v8, 3 (Fall 1988) 281-297.

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period were necessary but not sufficient to produce social reform movements. De

Tocqueville, traveling in the United States in the 1830s, was surprised that hundreds

of thousands of Americans had pledged to abstain from alcohol, a phenomenon

incomprehensible to most Europeans. ‘70

The European experience with temperance societies differed greatly from

the American situation. Temperance reform societies developed later and on a much

more limited scale in Europe. European temperance societies, including the Irish

temperance movement, were modeled upon and even inspired by American example.

According to the work of scholars of European history such as Brian Harrison, James

Roberts, and Elizabeth Malcolm, temperance movements in England, Scotland,

Germany and Ireland were inspired directly by American example.0 1 Harrison

contends that the temperance movement in England and Scotland, dating from about

1830, was encouraged by the influence of American temperance activity and

literature. Similarly, Roberts and Malcolm find that the German and Irish temperance

societies were modeled on American societies. Roberts also describes the advent of

the American Temperance Societies in Paris in 1835 and their subsequent success in

establishing a temperance society. With the exception of the Irish temperance

movement before the famine of the 1840s, temperance reform societies in Europe in

20 Alexis De Tocqueville,Democracy in America, ed. Richard Heffner (New York: New American Lib., 1956; first pub., 1835) 201.

21 Brian H. Harrison, Drink and the Victorians, the Temperance Question in England, 1815- 1872 (Pittsburgh: U. of Pittsburgh Press, 1971), 100-104 ; and James S. Roberts, Drink, Temperance, and the Working Class in Nineteenth-Century Germany (Boston: George Allen & Unwin, 1984), 19- 24; Elizabeth Malcolm, Ireland Sober Ireland Free: Drink and Temperance in Nineteenth-Century Ireland (Dublin: Gill & Macmillan, 1987), 36-56.

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the first half of the nineteenth century remained a limited phenomenon without much

membership. 99

Comparing the American and European origins of the development of the

temperance movement aids the historian in sorting out the motivation and causal

factors for the movement. Recent trends in the study of alcohol and drug history

indicate that international approaches and comparisons will guide future study. In his

recent article in which he summarizes the direction of the field, Tyrrell indicates that

the international approach will yield much valuable information for historians.23

Certainly the historian needs all the help available because the social, economic, and

intellectual forces are extremely complex and intertwined.

In addition to the sweeping economic and social changes in American

society, other factors combined to produce the social reform movements. In

particular, two forces in American cultural and social life promoted social reform:

religion and Enlightenment philosophy. Religious revivalism and the Enlightenment

ideology of progress both promoted temperance attitudes. It is ironic that American

temperance flourished while European temperance languished because the cultural

and social ideas that promoted American temperance thinking were European

22 In addition to scholars of European history Brian Harrison, James S. Roberts, and Elizabeth Malcolm, see the accounts of Father Mathew and the rise of temperance in Ireland in the 1830s and 1840s. Irish temperance societies grew dramatically in 1840s as a result of Father Mathew’s crusade but began to decline around 1842 due to political unrest. The onset of the famine years in 1845 contributed to the further decline o f temperance in Ireland. Colm Kerrigan, Father Mathew and the Irish Temperance Movement, 1838-1849 (Cork, Ireland: Cork U. Press, 1992) and John F. Quinn, Father Mathew’s Crusade: Temperance in Nineteenth-Century Ireland and Irish America (Amherst: U. of Mass Press, 2002).

23 Tyrrell, “Thirty-Three Years of Temperance, 1971-2004,”The Social History o f Alcohol and Drugs, vl9 (2004).

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products. Although these forces were European in origin, they developed in America

in a dynamic, unique way.

The ideas of religious revival originated in Europe, especially with

dissenters, reformers, and evangelicals. The seventeenth-century Quakers and other

religious dissenters stressed that people could affect their own destiny, that they could

not rely upon traditional liturgical religion that required little moral commitment.

Quite the contrary, according to Quaker thinking, religiously committed people had

an obligation to follow the right moral path, according to their own “inner light.”

Quakers and other evangelical Protestants debated the predestination theories of the

Calvinists, gravitating toward the concept of free will. But the concept of free will

did not release them from strict morality and religious observance, but instead

required strict accountability to moral ideals. The personal responsibility imposed by

the concept of free will caused them to draw upon their strict Calvinist heritage in a

different way. Their theology of personal responsibility supported both personal

morality and social conscience. Quakers and other reformist sects in Europe were

persecuted, yet their ideas of personal religion and Christian morality flourished,

gaining new converts in Europe and especially in America.24

By the mid-eighteenth century the dissenters had immigrated to colonial

America as Presbyterians, Baptists, Methodists, Quakers and others. They brought

with them a zeal and commitment which would endure and flourish in their new

24For relevant information on the rise of Quakerism, Puritanism and the doctrine of the Inner Light, see E. Digby Balzell, Puritan Boston and Quaker Philadelphia (New Brunswick, NJ: Transaction Pub., 1996), 79-91 and Edmund S. Morgan,Visible Saints: The History o f a Puritan Idea (Ithaca, NY: Cornell U. Press, 1963), 88-94.

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setting. The phenomenon of the first Great Awakening in mid-eighteenth century

America engendered a revivalist spark that would periodically re-ignite throughout 9^ American history. During this period of American history Protestant denomination

churches grew rapidly, much more so than in their European countries of origin.

Because they could no longer depend upon state financial support as could the older

European churches, American churches became much more interested in attracting

converts. They found that promoting a message of personal salvation and redemption

helped to attract new members and keep older members loyal. The strong revivalist

message of the various denominations attracted members by emphasizing the vital

significance of religious faith and practice. 9 f \ Denominations competed with each

other for members and taught that the way to salvation required living a moral life

and helping others to do the same. Protestant churches attracted new members by

preaching that members could affect their own destinies by their choices in their daily

25 There are a number of outstanding historians of the social and cultural impact of American religious experience, e.g., Jon Butler, Awash in a Sea of Faith: Christianizing the American People (Cambridge: Harvard U. Press, 1990), 3-36. See also his chapter on “The Plural Origins of American Revivalism,” 164-189; Richard J. Carwardine,Evangelicals and Politics in Antebellum America (New Haven: Yale U. Press, 1993), and Nathan O. Hatch, The Democratization of American Christianity (New Haven: Yale U. Press, 1989). In referring to the first Great Awakening and the second Great Awakening many historians such as Butler see rather than a separation a long continuous period of revivalism in American history. All emphasize the significance o f evangelical religion in American life.

26Churches competed for members by showing that they were serious about their message and so required members to profess personal and social practices of morality. The idea that strictness has historically encouraged church membership is a prominent theory of Dean M. Kelley, “Why Conservative Churches Are Still Growing,”Religion: North American Style, ed. Patrick McNamara, 1978.

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lives. American churches competed with each other in their dynamic messages of the

merits of members living virtuous, sober lives. 97

Religious revivalism promoted social reform. Religious revivalism in early

nineteenth-century America, often referred to as the Second Great Awakening, a

period from about 1795 to the 1830s, promoted a great number of social reform

issues, including the temperance cause. Because of its combination of personal and

social concern, temperance made the ideal social reform cause. The heirs to the old

Puritan religion in New England, the Congregationalists and Universalists, although

abandoning some of the rigid tenants of their ancestors, still held firm convictions

about their personal moral responsibilities. And the myriad Protestant sects that

flourished throughout the country enthusiastically supported social causes. With their

commitment to morality and social justice they became ardent supporters of social

reform, advocating numerous reform issues—abolitionism, women’s rights,

temperance, and other many other causes. 9R

In understanding the rise of the temperance physicians and other temperance

reformers it is essential to place them within the context of the pervasive American

experience with religious revivalism. As we examine their lives and work, their

religious education and affiliations will be scrutinized for clues as to their potential

influence. The rapid growth of Protestant inspired evangelicalism supported the

widespread growth of social reform movements throughout nineteenth-century

27 Richard J.Carwardine, Evangelical and Politics in Antebellum America (New Haven: Yale U. Press, 1993), eh 1 and ch 7.

28 James Brewer Stewart,Holy Warriors: The Abolitionists and American Slavery (New York: Hill & Wang, 1976), 13-17.

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America. A number of historians portray the explosive growth and influence of

American revivalism during the period.29 They describe the camp meetings held

throughout frontier towns and the rural backcountry, as well as the revivals held in

cities in New England, the coastal south, and the interior new west. Religious

revivalism was a mass movement, affecting great numbers of people from all social

classes, women as well as men, New England clergy as well as western farmers and

townspeople, the poor as well as the rich.

Throughout the nation the extensive and rapid growth of Protestant

denominations promoted social concern with moral issues, especially those issues that

were regarded as matters of personal responsibility. In New England many

Congregationalist clergy preached the message of religious revivalism and

temperance. Religious revivalism flourished among the old-line Congregationalists

and Quakers, as well as the growing evangelical denominations such as the

Methodists. The growth of religious denominations promoted social reform and

moral piety. Evangelical denominations, especially the Methodists, Baptists, and

Presbyterians, grew rapidly in the newly settled frontier towns of the midwest and

southeastern states. As the churches competed to increase in membership, they

stressed the evangelical message of personal morality.

29 Jon Butler,Awash in a Sea of Faith: Christianizing the American People (Cambridge: Harvard U. Press, 1990), Richard J. Carwardine,Evangelicals and Politics in Antebellum America ( New Haven: Yale U. Press, 1993), and Nathan O. Hatch, The Democratization of American Christianity (New Haven: Yale U. Press, 1989).

30 The connections between revivalism and the social reform movement are widely accepted by social historians. See Walters, 21-37.

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The temperance message, endorsing self-control and personal piety,

proceeded naturally from the evangelical and revivalist fervor of the era. The

Protestant evangelical message regarded the traditional message of long established

churches to be lacking. The newly developing Protestant denominations stressed

personal piety and behavior over what they regarded as mere formalism and ritual of

the long established church fathers. Evangelical clergy and laymen throughout the

country became the strongest proponents of temperance, from the oldest parts of New

England to the western frontiers. The message of social reform also flourished in the

“burned-over district” of New York, in the trans-Appalachian regions of the Ohio

Western Reserve territory, and the mid-Atlantic region.31 Encouraged by the aged

Benjamin Rush, Presbyterians supported temperance at their annual meeting in 1811

•3 7 in Philadelphia. Methodists supported temperance as early as 1753 with the passage

of the Wesleyan rule that denounced drunkenness and opposed the use of distilled

spirits. James B. Finley, like other pioneer Methodist clergymen in the early

nineteenth century, made the temperance message part of his mission in the Ohio

valley.33

Although not the official policy of the Congregational Church, many of its

clergy and laymen supported temperance. In 1808, a Congregational minister had

joined with Dr. Billy Clark in founding the first temperance society. In 1813 the

31 Walters, 21-37.

32 Lender and Martin, 67.

33 Krout, 66-75, 102-118. The Wesleyan rule opposed drunkenness and sale or use of “spirituous liquors.”

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temperance organization in Massachusetts, the Massachusetts Society for the

Suppression of Intemperance, had many Congregational clergymen as members.34

The evangelicals often employed the rhetoric and tone of moral judgment.

They denounced drunkenness as a sin and a personal moral failing. Employing the

concept of sinfulness put the focus on the drinker and not the substance alcohol. It

implied a willfulness and personal choice by the drinker to engage in drunkenness. In

1811 Lyman Beecher, formerly a Congregationalist minister but joining the

Presbyterians, exhorted the parishioners of his Presbyterian church in Litchfield,

Connecticut to abandon Sabbath-breaking, profanity, and intemperance. He

continued his assault on the evils of drunkenness. In his Six Sermons on

Intemperance from the pulpit in Litchfield, Connecticut in 1825 Beecher opposed

intemperance. Using the language of moral condemnation, he pronounced,

“intemperance is the sin of our land” and “drunkenness is a sin which excludes from

heaven.”35 Comparing drunkenness to slavery, he declared that it was “like slavery, it

must be regarded as sinful.” Another celebrated Congregational minister, Justin

Edwards, began sermons against the evils of drink in 1816 and published a

temperance tract, The Well-Conducted Farm in Boston in 1825.37

The temperance physicians were exposed to this condemnatory approach in

evangelical teaching against drinking. The manner in which they responded to the

34Hampel, 13.

35 Krout, 107.

36 Lyman Beecher, Autobiography, Correspondence, etc. of Lyman Beecher, D.D., 2 vols., ed., Charles Beecher (New York: Harper & Bros, 1864), v2, 37.

37 Lender, Dictionary, 149-150.

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pervasive evangelical message is crucial to understanding their thinking and actions.

Did they adopt the condemnatory tone, or a more enlightened view? The religious,

evangelical message was only one part of their cultural context. For a full

understanding, we are required to consider the other significant cultural influence that

affected them, Enlightenment ideology.

The ideology of progress, an Enlightenment-bred idea imported from

Europe, was essentially a view that society was perfectible through knowledge,

education, and progress. Americans adopted European optimistic thinking with

exuberance and a spirit of innovation. The newly emerging culture of the early

American republic encouraged belief in the efficacy of social reform. Temperance

reform fit easily into that ideology of social improvement. Temperance reformers,

like other American reformers, approached the problems of intemperance as a social

ill that could be remedied through education and knowledge. The temperance

physicians would naturally have been much influenced by their medical education to

subscribe to Enlightenment ideas. Given the rapid changes in medial knowledge in

the early nineteenth century, the effects of new knowledge gained through experiment

and study greatly affected them. The next chapter will be devoted to examining the

transitional state of American medicine and delineate the potential effects upon

physicians.

Thus in a complex confluence of specific factors, the American temperance

movement grew out of the twin forces of religious fervor and Enlightenment thinking,

within the context of a rapidly growing and expanding economy and society. In

addition, the temperance movement responded to specific customs and attitudes

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toward alcohol usage in late eighteenth century and early nineteenth century America.

In considering the historical and social context of the first temperance movement, it is

essential to understand the customs and practices surrounding alcohol usage in this

specific period of American history.

Many historians of alcohol and temperance have concluded that the

temperance movement addressed an issue of real importance in American life. In his

pioneering work The Alcoholic Republic, W.J. Rorabaugh goes even further to assign

a central causal role to excessive alcohol consumption, a condition that he argues was

common in the period. Rorabaugh contends that unprecedented high alcohol

consumption in the period 1790 to 1830 precipitated the temperance movement.38

Many other historians, as well as writers in other disciplines who are interested in

alcohol and temperance, cite Rorabaugh’s argument that the period witnessed the

heaviest drinking in the nation’s history, before or since.39 As Rorabaugh concedes,

accurate consumption figures are, however, problematical for several reasons.

Because the figures are based upon revenue records, not actual consumption figures,

there is some doubt regarding their reliability. Especially after the imposition of the

federal whiskey tax in 1791 backwoodsmen throughout the states became more adept

at concealing their production in order to escape censure and to evade taxes.40 In

38 W.J. Rorabaugh, The Alcoholic Republic, An American Tradition (New York: Oxford University Press, 1979), 6-21.

39 One example among many is that of Nan Robertson, Pulitzer Prize-winning reporter for The New York Times. Citing Rorabaugh, she wrote that the early nineteenth century was “the heaviest drinking era in American history.” Nan Robertson, Getting Better: Inside Alcoholics Anonymous (New York: Wm Morrow & Co., 1988), 188. See also Lender and Martin, 46-47.

40 The resistance in the Whiskey Rebellion of 1794 in Pennsylvania is well known but resistance also arose throughout the western and southern states where production from local stills was

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addition, Rorabaugh concludes that colonial Americans probably consumed more

alcohol from hard cider than from the higher alcoholic distilled spirits. As he

suggests, accurate figures for colonial consumption are difficult to ascertain.41

Without reliable figures for the colonial period or the early nineteenth

century, one cannot definitively conclude that the period of the early republic had

levels of alcohol consumption that surpassed all other periods. In particular, there is

the problem of comparing consumption with the preceding colonial period. There is

strong evidence to suggest that high levels of alcohol consumption also marked the

colonial period. There are numerous citations and sources that indicate that a high

level of alcohol consumption was common throughout the colonies. In the southern

colonies hospitality invariably included alcoholic beverages, the sole exception being

the anti-alcohol experiment in the colony of Georgia, an experiment that was short

lived. In the middle colonies wealthy Quakers served rum for breakfast and

throughout the day. The Puritan settlers in Massachusetts were famous for

consumption of rum and fermented drinks. The New England hearty barley brewed

beers contained as much as six percent alcohol, and the hard ciders had an even

higher alcoholic content. The colonial shipping trade produced large quantities of

rum, available for consumption through import of either finished rum or molasses for

prodigious. Because of the protests Congress changed the 1791 law to exempt “personal stills” from taxation. Southerners and westerners continued to oppose the tax as discriminatory. They regarded the tax as discriminatory because they could not produce ciders and beers as easily as New England. Also rum, favored in New England, was exempt because it was considered an import on the basis that molasses, or the rum itself, had been imported. The entire incident supports the conclusion of substantial levels of alcohol consumption, in a variety of forms, in all regions of the nation. Rorabaugh, 50-55.

41 Rorabaugh, 9.

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American distillation.42 In addition to the prodigious rum production, the colonies

produced large quantities of whiskey from the native com and grains. Especially

after the Revolutionary period whiskey gradually surpassed mm as the favorite

American alcoholic beverage because of restrictions on mm trade from the West

Indies.43

I would argue that it is most probable that the motivating force for the first

American temperance movement was not a sudden increase in consumption but other

forces in American society and culture. Assuming that consumption did not

dramatically increase in the early nineteenth century, that alcohol abuse was a long

standing problem predating the early nineteenth century, produces a different view of

the origins of the temperance movement. In such a case temperance reformers were

responding not so much to an intensely escalating social problem but to an ongoing

problem, and perhaps conditions inherent in human behavior and society. The

question of the relative levels of consumption has not been settled, and is currently

beyond the scope of this dissertation. Nevertheless the question is significant because

it relates to the conditions to which the temperance physicians and other reformers

42 The triangle trade brought sugar cane and molasses from the West Indies to New England, carried rum to west Africa, and slaves to the West Indies. The trade also had a bilateral version, which omitted the African slave trade, and shipped New England lumber and fish to the West Indies fin exchange for cane and molasses. The result of the trading was large quantities of rum available for American consumption. Lender and Martin, 30-31.

43 Irish and Scottish immigrants were extremely knowledgeable in the production of distilled spirits, based on years of European experience in distilling malt grains. As the settlers moved west across the Appalachians, they found it profitable to condense twenty-four bushels of grain into a gallon o f whiskey, to be transported over the mountains. The grain crops were plentiful and provided plenty of whiskey for the eastern markets as well as for the frontier. The frontier farmers demonstrated the extent to which they profited from the whiskey trade in their rebellion against the Federalists’ whiskey tax in the Whiskey Rebellion of 1794. Lender and Martin, 32-33.

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responded. Was their motivation an unprecedented high level of consumption, or did

their motivation arise more from a growing awareness of an ongoing problem?

If the temperance physicians developed their ideas from insights about a

health issue regarding alcohol intake, then the argument about unprecedented high

levels of alcohol consumption becomes tangential. If such is the case then their

writings, lectures and activities will demonstrate different approaches from

mainstream temperance rhetoric. We will see that the temperance physicians were

not so much addressing an issue of social reform but were supplying a new diagnostic

framework for alcohol abuse. It is this concept that this dissertation addresses. As

Rorabaugh and others have persuasively demonstrated, there was indeed an actual

problem with alcohol abuse and drunkenness in society during the early nineteenth

century. The temperance reformers responded to a real, not an imagined problem;

however, the issue of unprecedented high consumption as a motivation for reformist

activity, intriguing as it is, is for the purposes of this study, peripheral.

What were the attitudes and customs surrounding alcohol use during the

period? Alcoholic beverages formed an ever-present part of American life in the

early nineteenth century. Many historians and social commentators have vividly

described the prevailing attitudes toward alcoholic beverages and the drinking

customs of the era. During the period of the rise of the temperance societies most

temperance historians agree that Americans were consuming alcoholic beverages of

all kinds in great quantities. Alcohol usage was a prevalent, accepted practice in all

regions of the country, in all social and work situations, and in all social classes.

Consumption of alcohol in many forms, distilled and fermented, was a widespread

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national habit. Distilled spirits, mostly in the form of rum and whiskeys, had an

alcoholic content of forty percent or higher, while fermented drinks ranged from one

per cent (small beer and light ale) to twelve percent for the hearty brews, hard ciders

and wines. New England produced and consumed more rum than other parts of the

nation, while whiskey was more prevalent in the trans Appalachian region and the

southern states. Rum became less popular with settlement spreading west. Since

molasses and already distilled rum were too bulky to transport, grain whiskeys

became the drink of choice for southerners and westerners. Grain was plentiful for

distilling in the west and south. In addition to providing for local consumption,

whiskey was shipped east as a commodity more economically transported than bulk

grain.44 Other distilled drinks such as applejack and brandies were also popular

throughout the nation.

Fermented drinks consisted of hard cider, beers, and wines, with an alcoholic

content ranging from one to twelve percent. Hard cider typically contained seven

percent alcohol. Hard cider was made from apples, and so was popular in New

England and the middle states. A common practice that originated in New Jersey was

to allow barrels of hard cider to freeze and then to drain off the unfrozen liquid. The

drink produced, “Jersey lightning,” was of high alcoholic content. Apples did not

grow well in the southern states and so fermented drinks made from other fruits,

peaches and pears, etc. became popular there. Their alcoholic content was similar to

44 Rorabaugh, 50-59.

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hard cider. Beers typically had alcoholic content averaging ten percent.45 Due to the

undeveloped state of American viniculture domestic wine production was limited.

Most wines were imported and sweeter than modem wines. Wines such as sherries,

Madeira and port were usually fortified to facilitate shipping and storage. Therefore

wines were not as commonly consumed.46 Mostly, wines were imported and

expensive, often four times as expensive as whiskey. Wine consumption became a

class issue. Many wealthy preferred wine, convincing themselves that wines were not

intoxicating.47 The leaders of the Massachusetts communities who formed the

Massachusetts Society for the Suppression of Intemperance (MSSI) in 1813

conspicuously excluded wine from their temperance cmsading efforts. Their

opponents criticized them for their lack of sincerity and hypocrisy. The failure of

MSSI members to consider the their own drinking behavior contributed to the demise

of the MSSI.48

Regardless of the particular form in which alcoholic beverages were

consumed, drinking was a widespread practice in the late eighteenth century and early

nineteenth century. Drinking alcoholic beverages was an entrenched cultural and

45 Lender and Martin, 30-54. Ten per cent is higher than that of modem commercial beers with an alcoholic content of three to five per cent.

46 For alcoholic content of beers, wines, and distilled spirits sees Avram Goldstein, M.D. Addiction, From Biology to Drug Policy (New York: Oxford U. Press, 2001), 136-7, and Robert L. DuPont, Jr., M.D. Getting Tough on Gateway Drugs: A Guide fo r the Family (Washington, D.C: American Psychiatric Press, 1984), 102-103. Fermented drinks (beer and wines) are naturally limited in alcoholic content—wines at twelve percent maximum, unless alcohol is added to the finished wine to make fortified wines. Fortified wines such as port and sherries have higher alcoholic content, about twenty percent.

47 Rorabaugh, 100-101.

48 Hampel, 17-22.

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social practice, found in every geographic region, in every social class, and including

men and women of all ages and conditions. The prevailing belief was that alcoholic

consumption was beneficial. Alcohol was considered to be necessary to all social

occasions, an essential part of any wedding, funeral, celebration, or social gathering.

Alcohol was though to increase the strength of laborers in the fields. The colonial

practice, which persisted into the nineteenth century, was to make alcohol readily

available to workers throughout the day. Distilled spirits were thought to be

necessary to working in the fields. Harvest workers in the field would regularly be

provided with a keg of rum or whiskey. Artisans and shop workers customarily drank

alcoholic beverages while on the job. Shops and offices would close at eleven

o’clock for “eleven o’clock bitters” and again at four o’clock for another alcoholic

break. Since the Revolutionary War and even before, alcohol had been provided to

soldiers and sailors on duty. Although consumption figures are not entirely reliable

due to-tax evasion and widespread home production, the figures that are available

indicate very high consumption, certainly when compared to modem standards.

Thus, the attitudes and practices of the era indicate that high alcohol consumption was

a prevalent, widespread social practice.49

As will be more thoroughly explored in the next chapter, alcohol had the

endorsement of the medical profession. In the absence of many effective medicines

alcohol was found in every doctor’s dispensary or medicine bag. Rum with milk was

49Historians have documented drinking practices and customs in a number of highly readable studies. For an extended discussion o f alcohol consumption and attitudes toward drinking, see Rorabaugh, Alcoholic Republic, 5-21; Mark E. Lender and James K. Martin, Drinking in America, A History (New York: Macmillan, 1982), preface, ch 1 & ch 2; John Kobler, Ardent Spirits, the Rise and Fall of Prohibition (New York: G.P. Putnam’s Sons, 1973), 26-33, and many others.

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prescribed for pregnant women, as well as nursing mothers. Rum-soaked cherries

purportedly helped cure colds and were prescribed to pregnant and nursing mothers as

well as to children. Most tonics and elixirs were mainly alcohol and colored water,

and this attitude and practice only increased in the period after the first temperance

movement.50

The most compelling and influential figure in the early American

temperance movement was Benjamin Rush. He was a transitional figure in

temperance and medicine, in many ways a bellwether of advances yet to come and at

the same time, a follower of established tradition. One of the most famous physicians

in colonial America, he achieved fame as surgeon general of the Continental Army, a

friend of the early leaders of the republic, and one of the first professors at the first

American medical school, the University of Pennsylvania. He taught at the

Philadelphia medical school during the period that two of the temperance physicians

(Sewall and Mussey) attended. Known as the “father of psychiatry” and insisting

upon humane treatment of the insane, Rush championed a number of social reform

causes. He was a leader in the anti-slavery movement, a spokesman for women’s

rights, and one of the earliest leaders in opposing intemperance. Yet despite his

leading role in social reform issues, he also followed the typical medical practices of

his time. He helped to perpetuate some of the most spectacular medical

misconceptions of the era, in particular the copious use of bloodletting and purging

50 Charles Jewett commented that giving a nursing mother alcohol to strengthen her was “a prescription of which any physician ought to be ashamed.” Charles Jewett, A Forty Years ’ Fight with the Drink Demon, A History of the Temperance Reform as I Have Seen (New It York: National Temperance Society and Publishing House, 1872), 397-398; Kobler, 26; J.C. Furnas,The Life and Times o f the Late Demon Rum (New York: Putnam’s Sons, 1965), 26-27.

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for numerous ailments.51 He also recommended some less harmful but also useless

remedies, such as a cure for drunkenness (apply “blisters to the ankles”) and a

treatment for exposure to cold (pour half a pint of rum in each of the patient’s

c'y boots). All these remedies he prescribed with confidence. His confidence and

optimism may have been the best medicine of all in an era that could provide so little

effective treatment.

In a confluence of eighteenth-century enlightenment optimism and the force

of religiously inspired social reform, Benjamin Rush developed his views on

temperance. His European medical education awakened his sense of skepticism and

interest in scientific inquiry. He was exposed to enlightenment philosophy through

his medical education at the University of Edinburgh, a leading medical center alive

with the excitement of new scientific discoveries. He also trained in London and

Paris, attending the lectures of William Hunter, and other prominent leaders in

medicine. These educational experiences helped to orient his thinking away from

traditional thinking and move him in the direction of experimental medical science.53

The University of Edinburgh provided a dual influence upon its students, with its

51 MarkE. Lender, Dictionary of American Temperance Biography, from Temperance to Alcohol Research, the 1600s to the 1980s (Westport, CT: Greenwood Press, 1984), 421-23.

52 Rush, An Enquiry into the Effects of Spirituous Liquors upon the Human Body and their Influence upon the Happiness o f Society (Philadelphia: John McCulloch in 3rd St., 1791), 12.

53 Rush benefited from exposure to medical education in Edinburgh, for example, learning about mental illness from Cullen. Hawke, 47; Benjamin Rush, The Autobiography o f Benjamin Rush, His Travels through Life, together with his Commonplace Book for 1789-1813, ed. by George W. Comer (Princeton: U. Press of Princeton, 1948), 52. Eighteenth century medical training in Edinburgh and other European medical centers had begun to break away from traditional ideas, inspired by the astounding discoveries of the circulation of the blood (William Harvey), the discovery of oxygen, the surgical advances of William Hunter, and advances of Newtonian physics. The state of medical thinking will be further examined in Chapter Three.

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combination of Scottish enlightenment philosophy and pious Protestant morality.

Both influences may be seen in Rush, as well as other Edinburgh medical students.

Thomas Trotter, an Edinburgh protege and Scottish physician, demonstrated

similarities to Rush. Fifteen years younger than Rush, and probably also influenced

by him, he published in 1804 a treatise similar to Rush’s earlier 1784 treatise against

strong drink.54

Rush’s educational and family experiences oriented him toward Christian

revivalist thinking. His family life exposed him to the force of religious revivalism,

as did his experiences in the pious, moral culture of Edinburgh, as well as his contacts

in the Philadelphia community. His “New Light” Presbyterian family background

promoted social causes and benevolence.55 In addition, he was almost certainly

influenced by the humanitarian reform advocacy of Quakers in Philadelphia.

Anthony Benezet, one of the leading Philadelphian Quakers, supported anti-slavery

and many other social reforms. Although some sources hold that Benezet influenced

Rush in his anti-drink view, it would seem that they mutually influenced each other

and that they both were affected by the Quaker cultural attitudes supporting social

54 Thomas Trotter, M.D. (1760-1832) published his treatise, An Essay Medical, Philosophical, and Chemical on Drunkenness and Its Effects on the Human Body (London, 1804). His treatise was an expansion of his 1788 M.D. thesis at the University of Edinburgh on the effects of drunkenness. Rush’s work predates both documents. Isaac Land, “Thomas Trotter,” Alcohol and Temperance in Modern History, ed., Blocker, et al., v2, 624-625.

55 Much o f Rush’s early experience supported his religious orientation. He was brought up in his mother’s church, Presbyterian and educated in his uncle’s Presbyterian school. He regarded the Anglican Church in a kindly light, as it had been the church o f his natural father, deceased at age thirty-nine, when Rush was five years old. Another evangelical influence upon Rush was the pious and staid environment of Edinburgh. Rush reported that “drunkenness in rarely seen among the common people,” the churches were filled on Sundays, and that “moral order” ruled the streets of Edinburgh after ten p.m. Rush, Autobiography, 50-52.

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reform. Benezet bolstered his support of temperance with medical arguments from

the young Benjamin Rush. Rush’s first temperance essays predate Benezet’s essay

by three years. Benezet’s 1774 essay against distilled spirits, The Mighty Destroyer

Displayed, opposed the use of strong liquor, using many of the same arguments

advanced by Rush. Benezet wrote that strong drink was physically harmful and

should be used only as a medicine when necessary.56

Rush began his temperance advocacy with essays published in 1771. As a

young man just beginning his medical practice, he wrote and published anonymously

three essays, “Sermons to Gentlemen upon Temperance and Exercise.” His essays on

temperance were published anonymously in the Gazette, a Philadelphia newspaper, in

1771 and the next year published as a pamphlet, also anonymously.57 Two of the

essays advocated moderation (“temperance”) in eating and exercise. In between the

essays on eating and exercise he positioned his second essay, “On the Use and Abuse

of Wine and Strong Drink.” In that essay Rush took a position regarding alcohol that,

for its time, was daring because he opposed the common idea that alcohol was

generally beneficial. He also professed a new assessment of alcohol by referring to

wine and distilled liquor almost interchangeably. His position on alcohol was not so

extreme that he opposed all alcohol use. He allowed wine and “strong drink” to be

given to the elderly (“old people.. .in the decline of life”), but only in moderation.

56 Lender’s Temperance Biography holds that Benezet influenced Rush (“[t]he immediate impact of Benezet’s temperance writings was slight, although there is little doubt that they had some influence on the later work of Benjamin Rush”), but he does not cite the earlier 1771 temperance publication of Rush. Lender, Dictionary of Am.Temp., 42.

57Benjamin Rush, Sermons to Gentlemen upon Temperance and Exercise (Philadelphia: John Dunlap in Market St., 1772).

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Agreeing with the common medical view of the day, he pronounced that “wine is a

sovereign remedy” for some chronic diseases, especially for fevers, and for those

stricken by grief. But his admonitions against “wine and strong drink” were lengthy.

He was adamant in prohibiting wine and strong drink for people under the age of

thirty-five or forty, unless they suffered from a medical condition that required it. He

was also adamant that parents should not give wine or strong drink to children. He

recommended against its use by “studious people” because their mental work already

put stress upon their constitution. It is noteworthy that he employed gender neutral

co language in his reference to “people.”

Rush continued to express temperance views as a result of his experience as

Physician General of the Continental Army in 1776 and 1777. He observed

drunkenness in the troops, his military patients, in the make-shift military hospitals.

He witnessed the soldiers in the hospital selling their blankets and clothes for whiskey

and rum. In October, 1777 he wrote his friend John Adams “[ujpwards of 100 of

them were drunk last night. We have no guards to prevent this evil.”59 In his

Directions Rush opposed the “custom of drinking spirituous liquors which prevails so

generally in our army.” He challenged the common belief that liquor warded off the

effects of both hot and cold weather: “on the contrary, I believe it [drinking spirits]

always increases them.. .leaving the body languid and more liable to be affected with

58 “Wine or strong drink may be given to the sick,” and “using wine and other spirituous liquors in moderation,” and also “to whom wine or strong drink should not be given.” Benjamin Rush, Sermon II, On the Use and Abuse o f Wine and Strong Drink (Philadelphia: Jn Dunlap in Market St., 1772), 18-22, 24.

59 Benjamin Rush to John Adams, Letters o f Benjamin Rush, ed., L.H. Butterfield, (Princeton: Princeton U. Press, 1951), v l, 156.

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heat and cold afterwards.” He recommended that soldiers not be given their

customary ration of rum, but instead carry water in their canteens. He disagreed that

rum fended off the effects of heat, cold and fatigue and argued that distilled spirit had

the opposite effect, wearing down the system and that it “lays the foundation of

fevers, fluxes, jaundices.”60 Rush also opposed the common practice of the rum keg

and whiskey barrel in the harvest field. In his 1778 essay he used the common sense

analogy of the workhorse that needs only “cool water” to do his work.61 In opposing

the use of alcohol for field workers and for soldiers he opposed the generally held

idea that liquor was necessary for manual labor and hazardous duty. In his writings

he consistently opposed the use of distilled liquor, but approved the moderate use of

fermented drinks.

Several years later in 1784 Rush published his most strenuous attack upon

distilled spirits, “An Inquiry into the Effects of Spirituous Liquors upon the Human

Body and Mind.” Published in Philadelphia papers and journals and frequently

reprinted year after year, it was to become his most famous publication.62 No longer

seeking anonymity, and more sure of himself and his reputation, he attacked the use

of spirituous liquors with conviction. He used graphic description to enumerate “the

chronic effects of ardent spirits upon the body and mind.” Passages such as the

60 Benjamin Rush, Directions for Preserving the Health of Soldiers, published by Order of the Board o f War (Lancaster, Pa: John Dunlop in Queen St., 1778), 4-5.

61 Ibid.

62 Binger, 198.

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following suggest that he was a clinical observer of the effects of excess alcohol

intake:

After a while the paroxysm of drunkenness is completely formed. The face now becomes flushed, the eyes project, and are somewhat watery, winking is less frequent than is natural; the upper lip is protruded—the head inclines a little to one shoulder—the jaw falls—belchings and hiccup take place—the limbs totter—the whole body staggers.

Rush listed “the usual consequences of the habitual use of ardent spirits”: decreased

appetite and stomach disorder, “obstructions of the liver,” “dropsy” (swelling) of the

feet and legs, and insanity.63

In addition to the catalogue of physical ills, he enumerated effects upon the

mental and moral faculties: “Not less destructive are the effects of ardent spirits upon

the human mind. They impair the memory, debilitate understanding...” However, to

Rush the most affecting symptom of alcohol abuse was the diminishment of “the

moral faculties.” The demoralizing effects of alcohol produced a number of moral

lapses, such as theft, fraud, murder, and suicide. Rush quoted one of the doctors at

the Pennsylvania Hospital who observed that one third of the patients confined for

madness had first suffered from the effects of ardent spirits.64

According to his view, intemperance could affect people in all stations of

society and women as well as men. In one reference to women he described the

result of women’s intemperance — when they imbibed ardent spirits they exhibited

63 Benjamin Rush, The Selected Writings o f Benjamin Rush, Dagobert D. Runes, ed. (New York: Philosophical Library, 1947), 335-338.

64 Benjamin Rush, An Inquiry into the Effects of Ardent spirits upon the Human body and Mind with an Account of the Means ofPreventing and of the remedies for Curing Them, 8th ed., (Brookfield: Merriam & Co., 1814), reprinted in Yandell Henderson, A New Deal in Liquor (New York: Doubleday, 1934), 194-5.

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“certain immodest actions.” From the context one can assume that he was not

referring to the “hallooing” and belching that he ascribed to drunken men, but that he

alluded to a lack of sexual restraint in intoxicated women.65 Wives as well as

husbands could harm the family through their intemperance. Husbands would feel

“shame and aversion” toward an affected wife. Wives would experience “deep

anguish” over a drinking husband. Intemperance could debilitate people regardless of

social standing. He indicated that government officials as well as laboring men could

suffer the ill effects, and even “minister[s] of the gospel.. .Here language fails me - -

If angels weep - - it is at such a sight.”66

Rush regarded intemperance as a progressive condition that affected one’s

health and well-being. He referred to intemperance as a disease (“this odious

disease”), but one must guard against presentism in interpreting his use of the word.

As will be discussed in Chapter Three the state of early nineteenth-century medicine

viewed disease as non-specific, a condition of “dis-ease,” or being unwell. In the

absence of knowledge of bacteria and other causal agents, medical science viewed

such matters only dimly and incompletely. In later editions of theInquiry Rush

included “A Moral and Physical Thermometer, or A Scale of the Progress of

Temperance and Intemperance.” His thermometer presented a schematic depiction of

the effects of various alcoholic and nonalcoholic drinks. It was in effect a

65 Rush, Inquiry, Henderson, 190-91.

66Rush, Inquiry, 195-196.

67 Rush,Inquiry, 189.

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progression chart of the harmful effects of increased alcohol intake. Water and milk

occupied the top position of the chart, at a comfortable seventy degrees, and

correlated with “health, wealth, serenity of mind, reputation, long life, happiness.”

Wine, cider, and beer came next, beginning at fifty degrees and descending to a chilly

ten degrees. Still on the temperate scale they were correlated with “cheerfulness,

strength, and nourishment” when taken “in moderate quantities” and “at meals.”

After that came a steep drop off into the intemperate zone, ten degrees and below.

“Intemperance” included drinking “punch, toddy and crank,” “grog, flip, and shrub,”

“gin, aniseed, brandy,” and “whiskey in the morning.” Drinking these concoctions

correlated with vices, diseases, and punishments, in increasing severity. Vices ranged

from “peavishness” to “lying” and ended with murder and suicide. Diseases

associated with intemperance began with “puking,” “tremors,” and “jaundice,”

progressed to “dropsy,”68 and ended in madness and death. Punishments ranged from

“debt” to “the gallows.”69

In a later edition of the Enquiry (the spelling of “inquiry” varied) published

in 1791, Rush continued his warning of the risk of the drinker’s falling into an

irreversible pattern of intemperance. His tone was serious but reasonable as he

considered the ramifications and possible outcomes of continued alcohol intake:

I acknowledge that I have known some men, who by limiting its strength constantly, by measuring the spirit and water, have drunk toddy for many years without suffering in any degree from it, but I have known many more who have

68 “Dropsy” was the eighteenth-century term for swelling.

69 Reprints of Rush’sMoral and Physical Thermometer found in Rorabaugh, 44, and.in Lender and Martin, 39.

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been insensibly led.. .and have afterwards paid their lives as the price of their folly.70

In this statement Rush indicated what he regarded as the unpredictability of drinking

“spirit.” Some could drink in moderation without risk, while others who began in

moderation succumbed to being “insensibly led.” Clearly by this later date his

thinking about the risks of alcohol use had evolved. He thought the risk of

irreversible harm too great to accept and therefore counseled abstinence. He

proceeded to recount “one case from among many” of his patients who suffered

progressive decline and death from prolonged alcohol intake. 71 His advice to any of

his readers regarding spirits was to “leave them off suddenly and entirely.” 79

Rush had personal experience with the damaging effects of alcohol abuse.

A close reading of his Autobiography indicates that one of his stepfathers, and

perhaps both, abused alcohol. Since Rush was devoted to his mother, he no doubt

developed a heightened sensitivity to the potential harm of alcohol use.73 In later life,

he seemed greatly affected by the loss of associates and colleagues who succumbed to

drink. His attitude was not condemnatory of his friends, but of the harm caused by

their alcohol intake. He wrote of the death of one of his publishers, John Dunlop:

“[t]owards the close of his life he became intemperate, so as to fall in the streets. He

70 Benjamin Rush, An Enquiry into the Effects of Spirituous Liquors upon the Human Body and their Influence upon the Happiness of Society (Philadelphia: John McCulloch in 3rd St., 1791), 12.

71 Ibid.

72 Ibid.,, 10-11.

73 Rush noted in his Autobiography that his mother had problems with all three of her husbands. The first displayed “extravagance and intemperance.” The second, Rush’s father, died at age thirty-nine o f unspecified causes, leaving the young mother and six children. The third husband was a distiller and according to Rush’s account, abusive to her. Autobiography, 27, 167.

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was early and uniformly my friend.”74 Rush grieved the loss of his favorite pupil and

close colleague, Dr. James Hall, who died of the effects of prolonged drinking. He

first noted the problem with Hall in 1791 and mourned his death in 1801.75

Evidence from his letters and commonplace book indicates that Rush

followed his own temperance advice. In his writings he consistently opposed the use

of distilled liquors, but approved the moderate use of fermented drinks. Although he

made no public pronouncements on his personal habits, the information that is

available suggests that he himself drank alcohol only in moderation. A few

references in his letters indicate that Rush occasionally drank wine in moderation, but

preferred coffee or tea. nf\ In his final years Rush turned to making temperance one of

his chief concerns. He had thousands of copies of his Inquiry published at his

expense and distributed by through the Presbyterian assembly in Philadelphia. In

May, 1811, two years before his death the Presbyterians began to distribute his

pamphlets.77

Rush’s publications influenced the next generation of temperance reformers

and promoted the formation of the early temperance societies. Temperance advocates

continued to distribute reprints of the Inquiry throughout the nineteenth century,

encouraging temperance ideas and the establishment of temperance societies.78

74 Rush, Autobiography, 320-321.

75Binger, 157.

76 Binger, 284.

77 Rush,Autobiography, 296; Lender and Martin, 66-67.

78 The American Tract Society, as well as others, disseminated tracts to local temperance societies in the 1820s and 1830s. Krout, 226-27.

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Where was the first American temperance society formed? Historians cite various

instances of the earliest American temperance societies, the Massachusetts Society of

1813, for example. Because historians are so often proven wrong in citing “the first”

it is preferable to cite the earliest society, as yet known, because research continues to

reveal even earlier instances. Based upon a through reading of the literature at this

point in time, the earliest temperance society was formed in Litchfield, Connecticut in

1789. According to temperance historian Daniels, in 1789 two hundred farmers from

Litchfield formed a temperance society “to discourage the use of spirituous liquors.”

They wanted to prevent drunkenness during the harvest season. 70 Presumably they

did not include beers and hard cider in their proscription. And presumably they were

not entirely successful long-term in their efforts because in the next generation

Lyman Beecher delivered his thunderous anti-liquor sermons from a Litchfield pulpit.

We do not know what early factors contributed to the creation of this temperance

society, but at that point some of Rush’s earliest treatises were in circulation. These

early versions of the Inquiry included the section on the danger of the rum-keg in the

harvest field. Daniels assumed that the Litchfield farmers heard of Rush’s treatise,

certainly a likely scenario.

The next known temperance society is the Union Temperance Society of

Moreau and Northumberland in Saratoga County, New York. This is the organization

described in the opening paragraphs of Chapter One. Dr. Billy James Clark, the

young physician in upstate New York and the Congregational minister Lebbeus

79 William Haven Daniels,The Temperance Reform and Its Great Reformers: An Illustrated History (New York: Nelson & Philips, 1878), 51-52.

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Armstrong began the society in 1808. In this case the influence of Rush’s treatise is

more apparent, at least as the proximate cause. Armstrong states that Clark had just

read the Inquiry when he was driven out into the rainy night to remedy the local drink

situation.

Undoubtedly other factors were also at work in the founding of the 1808

society, the myriad factors presented in this chapter—the strong cultural influence of

the religious revivalism of the region, the enlightenment orientation of the young

physician inspired to read the medical journals, and then the precipitating incident, as

described in the account. Clark had observed drunkenness in his patients in that

region of upstate New York where rum drinking in the local taverns was common

with lumberjacks, canal workers and other laborers. Clark and Armstrong, his

minister, had been present in the tavern where heavy drinking was a common event.

They themselves, by their own admission, feared they ran the risk of becoming

ensnared with the dangers of drinking. Armstrong related that both of them had

observed serious consequences of prolonged drinking in the local tavern across the

street from Clark’s home and office. As a result of the first meeting in April 1808,

forty-three townsmen joined the new organization. They pledged to use “no rum, gin,

whiskey, wine or any distilled spirits, or compositions of the same, except by advice

of a physician, or in the case of actual disease.”80 It is significant that the total

abstinence position appeared so early in one of the temperance societies. Apparently

80Lebbeus Armstrong. The Temperance Reformation: Its History from the Organization of the First Temperance Society to the Adoption of the Liquor Law ofMaine, (NY: 1851 Fowlers and Wells, 1851), 222-23; see also John A. Krout, The Origins of Prohibition (NY: Knopf, 1976), 77-78; Kobler, Spirits, 48-51.

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the seeds of the most extreme commitment to the temperance position were available

from the early beginnings, at least in that rural setting.

This chapter has summarized the background and early beginnings of the

first temperance movement. It has also begun to explore the cultural and social

influences that surrounded the temperance physicians. The next chapter will more

specifically address the influences of the medical professional world that they

inhabited.

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THROUGH A GLASS DARKLY: TEMPERANCE IN THE CONTEXT

OF EMERGING SCIENTIFIC METHOD, THE OLD GUARD

IN MEDICINE, AND POPULAR DISCONTENTS

The temperance physicians formed their views within the context of the

changing tides affecting American medicine. In the first half of the nineteenth

century, medical knowledge and practice experienced great changes, in a period

conventionally associated with the nomenclature of the scientific revolution. But

most historians now discern a more gradual nature of change than the term

“revolution” conveys. They recognize the conflicting tides and forces that coexisted,

sometimes promoting new, rigorous methods of scientific inquiry, while at other

times reinforcing old prejudices and long-accepted treatments for diseases, no matter

how injurious or useless. American physicians developed their ideas within specific

cultural, social, and intellectual contexts, sometimes drawn to the new methods of

medical science, while at other times relying upon the familiar and easily accessed

old paradigm.

These changing trends in the medical context affected the temperance

physicians in various ways. In general, they responded favorably to the new

directions in American medicine, as did many of their peers, but with one specific,

significant variation— their public promotion of the temperance cause. This chapter

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highlights four significant developments in medicine that influenced American

physicians in the first half of the nineteenth century: changes in the state of medical

knowledge and practice, developments in medical education and professional

association, changing popular attitudes toward medicine and its practitioners, and

finally, new views of the medical profession specifically regarding alcohol and

temperance. Fortunately for this research, a number of eminent historians of

medicine have written definitively on American medicine during the period. Among

them are John Duffy, Sherwin Nuland, Paul Starr, Ronald Numbers, J.H. Powell, and

many others.1 I rely upon these historians in this chapter, both for content and

interpretation, in addition to primary source material found in medical journals of the

period and other primary resources.

Circumstances in the medical culture served as an impetus to the views of

the temperance physicians in several ways. First, new methods of identifying cause

and effect in disease and human physiology influenced the temperance physicians to

consider the physical effects of the consumption of “ardent spirits” (alcohol) on the

body. Aided by new scientific discoveries in the chemistry laboratory and the

anatomy lab, scientists found new ways to think about the physical nature of the

'John Duffy,From Humors to Medical Science: A History of American Medicine (Chicago: U. of II. Press, 1993); Sherwin B. Nuland, Doctors (NY: Alfred Knopf, 1988); Paul Starr,The Social Transformation o f American Medicine (Harper Collins, 1982); J.H. Powell,Bring Out Your Dead, The Great Plague of Yellow Fever in Philadelphia in 1793 (Philadelphia: U. of Pa. Press, 1965).

2 For example, The Medical Repository of Original Essays and Intelligence, Relative to Physic, Surgery, Chemistry, and Natural History, published in New York, 1800 to 1824; The Philadelphia Journal of the Medical and Physical Sciences, published in Philadelphia, 1800 to 1827.

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-3 newly discovered chemical, alcohol. The emerging emphasis upon clinical

observation of the patient, although present in eighteenth century, developed further

and on a more empirical basis in the nineteenth century. Temperance-minded

physicians used their heightened clinical orientation to evaluate the effects of alcohol

upon their patients.

The new developments in medical education and professional medical

associations affected doctors who advocated temperance. Some were encouraged by

the trends that promoted academic medicine and competition. Physicians who held

medical degrees and had trained under top doctors benefited from developments that

raised professional standards. At the same time, other physicians, particularly those

from rural areas and those with less education and with less prestigious preparation,

probably found the new competition challenging or even intimidating.

Finally, the growing disconnect between empirical knowledge and

conventional medical treatments increased popular discontent with useless medical

procedures and “heroic” treatments such as bloodletting and purges.4 Some

physicians, aware of their limitations and responding to popular concerns, found the

3 In the early nineteenth century, “ardent spirits” was the term for distilled liquors. The term alcohol was not in common use, nor was it understood that fermented drinks (wine, cider, and beer) contained the same chemical substance as ardent spirits. In 1821, the first American edition of William Thomas Brande’s Manual of Chemistry was published in New York, based on the London edition. Before Brande’s experiments, it was not known that the substance alcohol was the common ingredient in all fermented drinks. Brande’s experiments demonstrated that fermented drinks had much more intoxicating ability than previously thought. C.C.Pearson and J. Edwin Hendricks, Liquor and Anti-Liquor in Virginia, 1619-1919 (Durham, NC: Duke U. Press, 1967), 86-87.

4 Heroic treatments popular included bloodletting and purges, carried to extremes. Physicians used the lancet to open a patient’s vein, often carried out repeatedly. Later in the century more moderate methods of bloodletting were used, through “cupping” and/or the use of leeches. Gastro-intestinal purges were accomplished through strong emetics and cathartics such as mercury, taken by mouth. “Patients could be bled until unconscious and given heavy doses of the cathartic calomel (mercurous chloride) until they salivated. Heroic therapy of this kind dominated American medical practice in the first decades of the nineteenth century.” Starr, 42, also 34-35, 56.

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holistic approach of the temperance message a means of improving the health of their

patients without exposing them to the dangers of heroic measures. They emphasized

the physical effects of alcohol on the body, as well as addressing the mental health

aspects of excessive alcohol intake. These observations are presented only in a

summary fashion at this point, but will be further explored in this and subsequent

chapters.

Emergence of Scientific Method in Medicine

The transitional period of late eighteenth and early nineteenth centuries is

often regarded as the beginning of modem medicine, in that medical knowledge

increasingly made use of scientific method and objective experiments. The

significant changes underway in medical knowledge and practice affected American

physicians generally and the temperance physicians specifically. American medicine

relied for the most part upon the European medical centers, especially Paris and

London, for new discoveries and advances in medicine. American medicine lagged

behind European advances, but gradually moved in the new directions forged by the

Europeans.

French medicine led the way in searching out the physical and biochemical

bases for disease. The French school of medicine in Paris increasingly influenced

American medicine through Americans training abroad, French immigration to the

United States, and general cultural exchange of medical information. A growing

number of American physicians studied in Paris in the early decades of the nineteenth

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century.5 France made rapid advances in medical research and treatment in the

aftermath of the Revolution and the Napoleonic wars, which supplied the surgery

cases and cadavers that advanced learning. In the laboratory, French medical

scientists and students took advantage of a plentiful supply of cadavers for

anatomical study.6 French medicine, with leading medical scientists such as Francois

Magendie, Rene Laennec, and ultimately, Louis Pasteur, made major contributions to

medical knowledge. They employed rigorous standards in both laboratory and

clinical medicine. Their methods required evidence-based experiments to support

scientific findings in the laboratory. For patient care, the French method emphasized

clinical diagnosis and practical observation of patients. They studied medicine from

an approach that diseases, and ultimately their cures, could be understood only by

correlating anatomical findings with practical clinical and diagnostic methods.7

Closely following the French physicians and scientists were the British

medical centers of research, with William Harvey’s discovery of the circulation of

blood, the advances of the two Hunter brothers in London in surgery and obstetrics,

5 During the 1820s, over one hundred American physicians studied in Paris. Another two hundred studied there in the 1830s. Duffy, 72-73.

6 Science and medicine flourished in the great hospitals of Paris as a result of the philosophies o f the Revolution. Nuland, 210-211.

7 Nuland, 168-215; Duffy, 72-73. Francis Magendie (1783-1855) was known for his experimental proofs that linked cause and effect in physiology, for example in sensory nerve experiments. He conducted analyses of drugs and pharmacology. His pupils, such as Claude Bernard, continued his work, identifying the cause of diabetes mellitus and defining the role of the liver. In addition to the invention of the stethoscope, Rene Laennec also did work on cirrhosis.

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and, later in the nineteenth century, the germ theory of Joseph Lister.8 German,

Austrian, and other European centers of medicine also influenced American

medicine. For the most part, American medicine continued to depend upon European

medicine for scientific advances until the late nineteenth century.9 However,

American medicine did make some significant discoveries, mostly in surgical

technique and the discovery of anesthesia.10

In the first half of the nineteenth century, medical knowledge profited from a

number of significant technical advances that enhanced diagnosis, such as the

development of the stethoscope and the diagnostic lens or microscope. These

scientific advances facilitated new methods of gathering clinical information, more

informative than relying upon impressions and physical signs gathered externally. In

using both the microscope and the stethoscope American medicine lagged behind

European discoveries. The more advanced American doctors, those with European

medical education and those in urban areas, adopted the more advanced technologies

earlier than others. The stethoscope provides a prime example of the technological

advances of the period and the relationship between American and European

8 The two Hunter brothers, John and William, were famous in London surgery and obstetrics. Joseph Lister was the English surgeon who deduced from Pasteur’s work the antiseptic procedure for surgery and wounds. Duffy, 28; 188-89.

9 Ronald Numbers and John H. Warner, “The Maturation of American Medical Science,” Sickness and Health in America: Readings in the History of Medicine and Public Health, ed., Judith Leavitt and Ronald Numbers (Madison, Wise: U. of Wise. Press, 1997), 130-142.

10 American medicine made the discovery of chemical anesthesia in the early 1840s. Dentists used ether or nitrous oxide (known as “laughing gas”). The Georgia physician Crawford Long was the first to use surgical anesthesia in 1842 in the removal o f a neck tumor. Duffy, 110-114. See also Meyer Friedman, Medicine’s Ten Greatest Discoveries (New Haven: Yale U. Press, 1998), 94-114.

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medicine. Although the stethoscope was invented in Paris in 1816," only a few

American doctors made use of it by the 1830s. Those doctors who used the

stethoscope tended to come from urban areas and the most prestigious eastern

medical schools such as Harvard. 12

Nineteenth-century European medicine recognized the importance and

necessity of dissection and autopsy in promoting scientific knowledge. French

physicians like Rene Laennec, the inventor of the stethoscope, made extensive use of

autopsy to identify the source of disease and to correlate it with the individual

patient’s clinical exam. Studying the organ or anatomical areas involved in a specific

disease was crucial to understanding the cause of disease. Dissection and autopsy

allowed doctors to pose new questions about the body and disease. They sought

answers to questions about how the body worked and what caused disease.

Physicians turned to dissection and autopsy to discover the inner workings of the

body. They needed to conduct autopsies on cases of known symptoms at death, to

correlate with internal sites. The bodies of executed criminals that had been the

meager supply in previous centuries were limited in their utility to disclose the

pathology of disease. The cause of death for most criminals was obvious- death by

hanging, guillotine, or other means of execution. Physicians, surgeons, and scientists

of nineteenth-century Europe recognized that they needed cases of known pathology.

11 Invented by the French physician Rene Laennec in 1816, the stethoscope allowed physicians to gather internal information about the patient. Laennec cared for patients with tuberculosis and other lung ailments. He learned to correlate specific pulmonary sounds to specific disease and then confirm his findings in subsequent autopsy. Nuland, 168; 210-23.

12Edwin P. Hoyt, The Improper Bostonian, Dr. Oliver Wendell Holmes (New York: William Morrow, 1979), 81.

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In Paris they were able to meet their dissection needs. England, Scotland, and 1 ^ America had more difficulty making cadavers available for study.

It is essential to note the difference between dissection and autopsy, terms

often used interchangeably, and therefore inaccurately. In his recent work A Traffic

o f Dead Bodies, Michael Sappol sets out the distinction between dissection and

autopsy.14 Dissection is a general term referring to the opening and cutting of the

body. Autopsy is a more specialized form of dissection. It seeks to find the cause of

death. Sappol points out the general uses of anatomical dissection, often used in

nineteenth-century America as a professional rite of passage that established medical

authority. Autopsy, according to SappoPs analysis, was considered as more

meritorious and less self-aggrandizing, because it sought helpful information. Elite

families often availed themselves of autopsy in order to establish the cause of death.

Autopsy was therefore not a shame, but a privilege. They employed a medical

coroner rather than mere medical students.15

By contrast, Sappol shows that dissection carried a derogatory connotation

for the subjects of dissection. Cadavers that were legally available for dissection

were those of executed criminals or suicides, but the supply was limited. For

example, the state of Massachusetts allowed only one body for the medical students

every four years. There were never enough cadavers to meet the growing needs of

13 Edinburgh in particular suffered from the Scots prejudice against dissection. There were only occasional opportunities for students to dissect a suicide or an executed criminal. The situation was not much better in either London or America in the late eighteenth century. Bell, Morgan, 58-59.

14 Michael Sappol, A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America (Princeton: Princeton U. Press, 2002), 100-119.

15 Ibid, 103.

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the medical schools’ anatomy labs. The scarcity of bodies caused medical schools to

resort to illegal means of securing cadavers. Sappol’s research indicates that Harvard

Medical School had difficulty in securing enough bodies for dissection. In the 1820s

the professor of anatomy at Harvard, John C. Warren, could not secure enough

cadavers for his anatomy course. Perhaps he had succumbed to the lure of hiring

body-snatchers and grave robbers. Yale’s medical department had similar difficulties

in obtaining bodies. The predicament of the medical schools in procuring bodies

would weigh heavily upon one of the temperance physicians in particular, Thomas

Sewall.16

Although Sappol emphasizes the predatory and self-promoting nature of the

medical schools in conducting dissections, he also recognizes the legitimate ends of

scientific research in dissection and autopsy. The long-held cultural opposition to

dissection in both Europe, and even more so in the United States, retarded scientific

development and knowledge. Yet, ultimately the physicians and surgeons prevailed

in their need to obtain precise information about the interior of the body, available

only through dissection and autopsy.

While medicine in Paris and London wrangled with the issues of dissection

and autopsy, American medical culture, especially in rural areas, remained suspicious

of the same. American urban centers and medical schools tended to accept the value

of dissection and autopsy, but even in those venues, controversy arose. An article in a

well-respected medical journal contended in 1828 that physicians should do all that

they could to obtain permission to conduct autopsies. According to the cases of

16 Ibid., 106, 114.

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“morbid anatomy” of the stomach, pancreas, and liver, there was no more valuable

resource for understanding disease than to attempt to locate the cause of death by the

internal organ affected.17 By contrast, another respected journal had given the

opposite opinion just five years earlier in 1823. The Medical Reformer pronounced

“the absurdity” of the medical practice of autopsy because the bodies of the dead are

too delicate once opened and exposed to the air, and furthermore (and one suspects,

more importantly) such an undertaking was “loathsome to the sight” and “sacrilege”

to the dead.18

Those physicians who clung to the old humoral theory opposed the need for

dissection and autopsy. One of the accepted theories in established eighteenth-

century medicine, which continued in American medicine in the nineteenth century,

and gradually receded in influence by the late nineteenth century, was the humoral

theory of the body. According to humoral theory, the body contained humors or

fluids, such as blood, bile, and phlegm. The health of the body depended upon

keeping these humors in balance. An excess or lack of one or more of the humors

caused illness. Only by correcting the imbalance could health be restored. From the

humoral view of the body as an integral system that required adjustments came

treatments such as bleeding and purging so prevalent during the period.19

17 Henry Schenk, M.D., “Disease of the Stomach, Pancreas, and Liver,”The New York Medical and Physical Journal (Jan-March, 1828), 78; Anonymous,The Medical Reformer (New York, Feb. 1, 1823) v 1,2, p. 35.

18Anonymous, The Medical Reformer (New York, Feb.l, 1823) v 1, 2, p. 35.

19 Nuland, 13-20; 155.

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The old medical standard of knowledge identified illness by the presence or

lack of the humoral substances. Bleeding and purging were depletory treatments,

thought to remove the excess humoral material from the body. Using the lancet to

bleed a patient, and emetics and cathartics to induce gastrointestinal purging, doctors

sought to treat illness based upon humoral theory.20 The effectiveness of the

treatments relied not on evidence-based research, but rather upon tradition and

accepted theory. Although medical treatments based upon humoral theory were

eventually disproved as erroneous, they were not irrational. Medical practitioners

based their diagnoses and treatments on the evidence of substances of bodily input

and output. The available evidence was superficial and often misleading or irrelevant

to the real underlying pathology.

Within the framework of available evidence, humoral treatments did attempt

rationality. They were mistaken, but rational. The established doctors were relying

on superficial information of output and input, not empirically based experiment, and

evaluation of internal pathology or symptoms. Doctors who used humoral treatments

made the case that they were relying on facts, backed by theory that had been arrived

at rationally. The flaw in their thinking is that they did not do what they purported to

do. They did not rely on facts, but instead took superficial information, collected

from bodily products and then leapt to conclusions based upon inadequate data.

Nevertheless, they were well intentioned and even dedicated to helping their patients.

Unfortunately, their good intentions often did more harm than good.

20 See footnote 4.

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When treatment^ did not work, doctors would often re-double their efforts.

For example, if bleeding a patient did not cure him, the treatment would often be

repeated. Patients themselves would often request additional, extreme bleedings and

purgings. A notorious example is found in the case of George Washington’s

deathbed illness in December 1799. George Washington, suffering with an infection

that closed off his windpipe, insisted upon excessive bleedings from his doctors. The

bleedings did not help him and probably hastened his death later in the evening.

Controversy surrounds the cause of his death, even to this day.21

New scientific methods challenged the practice of medicine based upon

humoral theory. The French school in particular opposed the use of bleeding and

purging as early as 1793 during the yellow fever epidemic in Philadelphia. American

medicine would cling to the practice for the next fifty years, until its gradual demise

in the post-bellum era. With increased knowledge of human internal anatomy based

upon dissection and autopsy, medical science could begin to trace symptoms and

signs to their organs of development. Physicians began to question old therapeutic

remedies based upon superficial input-output information and insist upon medical

21Washington requested additional bloodletting. Dr. Elisha Dick, a student of Benjamin Rush objected, but was overruled. Washington was also purged with calomel. After these treatments, he was able to swallow, but his condition worsened. He died of suffocation, probably from viral croup or acute bacterial epiglottis. Dick argued for tracheotomy, probably the only treatment that could have worked at the time, in the absence of antibiotics. Dick publicly criticized the other two doctors for listening to Washington instead of him. Public opinion seems not to have condemned Washington’s treatment. It was the standard of the day. David M. Morens, M.D., “Death of a President,” New England Journal of Medicine, v34, no. 24 (Dec. 9,1999) 1845-1848.

22 J.H. Powell, Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793 (U. of Pa Press, 1949; NY: Time Life Books, 1965); Dick Levinson, College of Physicians of Philadelphia, “Mysterious disease overwhelms medical system in 1793 (AMANews, 10/12/88).

23 Duffy, From Humors to Medical Science, 69-94.

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knowledge and treatments based upon more internal evidence and more rigorous

standards of clinical and laboratory observation. The more insightful of their

profession began to understand the real limits of their knowledge, much of which was

just emerging from the traditional confines of humoral theory and nosology.24

Nosology25 attempted to organize diseases by symptoms through an

elaborate system of classification. In the days of Benjamin Rush, nosology seemed to

provide a rational approach to medicine. In the eighteenth century, nosology grouped

diseases into categories, sub-categories, and classes, much as Linnaeus had

undertaken for botanic specimens. The nosological system that Rush learned at the

medical school in Edinburgh under the famous Sydenham established hundreds of

different diseases into an elaborate pattern. For example, all fevers were grouped

together in the same classification, a confusing and not very helpful assignation.

Under nosology, fevers of various kinds and origins were classed together as “putrid,”

intermittent,” “continuing,” etc, even though they were not, in reality, even remotely

related in cause.27 As nosology grew more complicated, it gained opponents.

Benjamin Rush, although professing nosology as a loyal product of the Edinburgh

school early in his career, eventually did much to subvert nosology and replace it with

24 For an example of the changing trends in medical observation and diagnosis, see “Review of A Treatise of the Materia Medica and Therapeutics” in The Medical Repository of Original Essays and Intelligence, Relative to Physic, Surgery, Chemistry, and Natural Science (New York, 1824) v 23, i , 48-80.

25 Nosology was an elaborate system of classification of diseases according to a theoretical framework.

26 David F. Hawke,Benjamin Rush, Revolutionary Gadfly (NY: Bobbs-Merrill, 1971), 50.

27 Richard H. Shryock, Medicine in America (Baltimore: Johns Hopkins Press, 1966), 240-41.

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more practical clinical orientation. 98 As one of the leading American physicians,

Rush persistently sought to understand diseases and their causes. He struggled with

the old theoretical system, praising it even as he helped to dismantle it. He looked for

cause and effect in medicine and despite his pronouncements to the contrary, was

ready to abandon the old framework of theoretical medicine in favor of empiricism.29

In the generation after Rush scientists looking for the specific causes of

diseases increasingly found the traditional classification of diseases in nosology to be

lacking. By the 1820s, leading physicians generally opposed orthodox nosology.

According to an article in a leading Philadelphia medical journal, the main problem

with existing nosology was that it grouped diseases by symptoms, misleading criteria

•j/\ at best. Instead, the journal editors proposed a “practical nosology:”

It occurred to us, that they [diseases] might be arranged as they presented themselves in the several parts or systems of the body. That this plan has its defects, we shall not deny—though, on the whole, it seems to be the most •5 i natural, simple, and practically useful.

Despite the tentative tone, the author proceeded to set forth a drastic change to the old

system of classification. The article proposed a simple system of ten categories,

based upon body systems: “circulatory,” “digestive,” “absorbents” (lymphatics),

“respiratory,” “secretory” (glands), “sensitive” (brain and nerves), “muscular,”

28 Ibid, 241; Hawke, 50.

29 Rush helped weaken the old theoretical framework by attempting treatments that seemed to work regardless of theory. In treating yellow fever by bleeding, he was an empiricist, developing the theory after he found a treatment that he thought effective. Paul E. Kopperman, “Rush’s Yellow Fever Therapy,”Bulletin of the History ofMedicine 78 (Fall 2004), 550-51.

30 David Hosack, “A System o f Practical Nosology,” The Philadelphia Journal o f the Medical and Physical Sciences, v2, no 4 (Philadelphia: 1821) 402-408.

31 Ibid., 405.

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“cutaneous” (skin), “osseous” (bones), and “generative.” The categories bear a strong

resemblance to modem medical specialties such as cardiology, gastroenterology,

endocrinology, neurology, orthopedics, dermatology, and reproductive medicine.

Old style nosology confused and obscured efforts to locate disease at its

internal, structural source. Those in the old guard who adhered to nosology and its

companion, humoral theory, perceived little need to trace the source of disease to a

specific location in body. The very question of what caused a specific illness or

disease challenged the general humoral theory and nosology. Traditional medicine

attempted to fit specific diseases into big theoretical classifications of nosology. New

empirical methods searched for specificity and challenged the old theoretical

limitations.

How these changes in medicine influenced the temperance physicians is a

complicated matter. Adhering to the new scientific approaches did not necessarily

result in a physician adopting a temperance stance. Although it is true that

temperance-minded physicians supported new scientific methods and opposed the old

heroic treatments, not all such physicians supported temperance. There are examples

of physicians who were in the vanguard of scientific medicine but who did not

support temperance. A prime example can be found in Dr. Oliver Wendell Holmes.

Holmes had a brilliant mind in analyzing medical problems. Long before anyone

else, he identified the cause of puerperal or child-bed fever. Using his unusual

powers of analysis and deduction, he discovered the infectious nature of the fatal

illness. Yet he did not support temperance. He enjoyed collegial dinner parties

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where “the wine flowed freely.” He concluded that temperance supporters were

overly zealous and refused to join their cause.

Although the new scientific method did not automatically result in the

temperance position, the adoption of rigorous standards in patient observation and

diagnosis provided fertile soil for the development of temperance views. The

temperance physicians responded positively to the transition in medicine that fostered

the use of scientific methods in medical diagnosis and treatment. Physicians who

were frustrated by the limited state of medical knowledge were likely to turn to

holistic, preventive treatments, especially when no other remedies seemed effective.

Those who favored temperance were generally more likely to oppose what they

regarded as quackery. They were receptive to new ideas and questioned the efficacy

of folklore or traditional medicine. They tended to insist upon treatment methods

based upon evidence-based science.

The temperance physicians, especially Reuben Mussey and Thomas Sewall,

were famous for their scientific experiments and pioneering surgical techniques.

Sewall emphatically denounced the pseudo-science phrenology in lectures to his

medical students. The temperance physicians developed their views on the effects

of alcohol within the context of newly emerging standards that promoted evidence-

based medicine and empirical knowledge.

32Hoyt, 144.

33Thomas Sewall, An Examination of Phrenology (Washington, D.C: B. Homans, 1837).

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Medical Education and Professionalism

American medicine, like other professions in the nineteenth century, was in

a transitional state. The practice of medicine continued to follow trends that had

begun in the late colonial period to increase professional standards and to define the

profession through a number of means. Leading American doctors sought to raise the

standards of medicine through the establishment of medical schools, professional

societies, and licensure. It was mostly an uphill battle. About half of American

doctors did not have formal education. Only a few American medical schools had

been established.34 The professional societies were limited in their abilities to raise

the standards of learning and practice. Licensure proceeded in a halting and limited

manner. The temperance physicians trained, studied, and practiced medicine in a

shifting and evolving organizational climate.

American doctors attempted to elevate the standards of medical practice

through the establishment of American medical schools, state medical societies, and

state licensing laws. The medical profession endeavored to establish itself on a more

respected footing, with increasing emphasis on the necessity of formal education and

licensure. In the eighteenth and nineteenth centuries American medical practitioners

turned to Europe for the most prestigious training. Those who could afford it,

34 The first American medical school was founded in 1765 in Philadelphia, the College of Philadelphia, followed by King’s College in New York in 1767 and Harvard Medical School in the 1780s. Philadelphia became the University o f Pennsylvania and King’s College became Columbia Medical School. Shryock, 9-11. After these medical schools had been founded, the states of Massachusetts, Vermont, Maryland, Pennsylvania, and South Carolina all founded medical schools before 1825. Columbian Medical College in Washington, DC was the seventeenth American medical school, founded in 1825, Craig, 15.

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traveled abroad to London, Edinburgh, and Paris to supplement their education.

Others managed to study at one of the American medical schools, connected with

established colleges. But many American doctors-in-training had no formal

education at all and had to settle for the old informal method of learning a trade, as an

apprentice under an established doctor.

No doubt the changes in medicine affected the temperance physicians, but

the issues are complex. In period of increasing competition, how did the temperance

physicians fare? The temperance cause might have helped their chances for

advancement if the cause were popular in their city or region. On the other hand, if

their peers or their patients did not support temperance, they would have risked losing

professional support as well as patients. Another consideration is the amount of

formal medical education that the temperance physicians held. For those with the

benefit of a prestigious medical degree and membership in medical societies (Rush,

Mussey, and Sewall), they could use their privileged position as insulation against

criticism of their views on a controversial subject such as temperance. The less elite

doctors in rural areas, Clark and Jewett, might have risked their professional status,

unless they could win their patients to adopt temperance views.

Another significant issue to consider is what advantageous effect did the

temperance position offer them against the looming competition of women who

practiced home remedies and even aspired to enter medical school?35 Women posed

a strong underlying support and membership for the general temperance movement.

35 The first woman to enter medical school was Elizabeth Blackwell in the 1840s. Rachel Baker, The First Woman Doctor; the Story o f Elizabeth Blackwell (NY: Messner, 1944).

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By co-opting their temperance message, men could strengthen their position in

opposing the entry of women into medicine. Although difficult to prove, these

significant issues will be further addressed in the individual accounts of the

temperance physicians. Taking into account the social and cultural pressures

encountered by the temperance physicians provides essential contextual information

and affords insight into their motivation and experience.

The medical historian Paul Starr emphasizes that physicians were mainly

interested in advancing their careers and would use credentialing to limit competition.

However, Starr notes that elevating the standards of practice and self-promotion were

not necessarily at odds. Nevertheless, Starr regards the nineteenth-century doctors to

have been primarily concerned with maintaining their position in a highly competitive

profession. They encountered considerable opposition from the non-elite, ordinary

doctors, as well as the general populace, in an era of rising democratic expectations.36

Regarding medical school education in America, the majority of early

nineteenth-century American doctors did not have formal education in medicine.

Their training consisted of studying under the apprentice system within the practice of

an established doctor. Those who could attend medical school, either one of the few

American schools, or one of the great universities in Europe, were the most interested

in raising the standards of licensing. Medical degrees required only two years of

formal study. A third year of medical school became common in the U.S. around

1870. Those medical students who could afford it, studied for a year or more in

Europe.

36 Starr, 44-50.

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Trends were underway in nineteenth-century America that required more

rigorous training, especially in urban centers. The old apprentice method was

gradually supplemented by university education in medicine and licensing.

Physicians wanted to develop and present an image of themselves as rational men of

science. They struggled to distance themselves from the old-fashioned traditionalists

and especially the women practitioners who relied upon home remedies.

Regular physicians encountered increasing competition from women who

practiced medicine without the credentialing of the formal medical degree. Midwives

competently did much of the work of childbirth and were held in respect by their

communities throughout the nation. With the increasing pressures for credentialing,

women realized that they needed formal medical education in order to compete and

maintain their position. The delayed rise of women to professional status in medicine

was not to be remedied until the late 1840s. The first woman to be admitted to

medical school was Elizabeth Blackwell. She graduated in 1849 from Geneva

Medical College in Geneva, New York.38

The credentialing process for physicians developed in a gradual and uneven

way. In 1760 colonial New York City passed the first licensure law, requiring that

doctors have a license to practice medicine.39 The supporters of the New York

legislation hoped to define and enhance the medical profession, yet the licensure did

37 Shryock, 180-82; Laurel Ulrich, “Martha Ballard and the Medical Challenge to Midwifery,”Sickness and Health in America, ed., Judith Leavitt and Ronald Numbers (Madison, Wise: U. of Wise. Press, 1997), 72-83.

38 See footnote 33.

39 Starr, 40; Shryock, 10.

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not require a medical degree or even membership in a medical society. Still the

medical profession had made the first attempt to limit competition and elevate their

position. Starr emphasizes the doctors’ intent to control competition and create a

profession that could limit practitioners at the entry level. This is a recurring theme in

Starr’s analysis of the medical profession’s attempt at control and the eventual

formation of a powerful profession.40

American medical licensing gained strength in the post-Revolutionary War

period. The colonial licensing laws had not been exclusionary, but had served to

indicate a level of fitness for practice. Colonial legislatures granted licenses to

practice medicine as an added confirmation of a doctor’s competence. The lack of a

license did not, in most places, exclude a physician from practice. Places like New

York City that did require licenses were few, and even there, the requirement was not

onerous to fulfill41

The Revolutionary War had interrupted licensure legislation, but in the post

war period there were new attempts to strengthen licensing. In a rush of visionary

and idealistic fervor, a number of states began to pass legislation that required

licensing. Between 1780 and 1810, a number of states passed legislation requiring

that a doctor have a license in order to collect fees. Thus, licensing aspired to become

more than an added commendation, as it had mostly been in colonial times; it would

become exclusionary. Starr emphasizes that the motivation of the medical profession

40 See Starr’s chapter “Medicine in a Democratic Culture,” 30-59.

41 Joseph F. Kett, The Transformation of the American Medical Profession (New Haven: Yale U. Press, 1968), 9-13.

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in promoting licensure was to increase power and authority. He also points out how

their efforts were ineffective.42

Although the supporters of licensure intended licensing to be exclusionary,

as a practical matter licensure was ineffective. The states granted licenses in a

haphazard manner, some requiring either study with an established doctor or

membership in a medical society. Also the licensure boards were lax in issuing

licenses, for fear of losing their licensing fees.43

By the 1830s licensing requirements were rejected in a flurry of Jacksonian

democratic anti-licensing activity. Licenses were not required or not enforced in

most states. Early nineteenth-century attempts to require licenses for physicians to

charge fees were rejected in state after state in the 1830s. Only decades later, in the

late nineteenth century, would the medical profession gain a privileged position of

strict licensure and required medical degrees.44

The medical societies did not succeed in controlling the credentialing

process any more than did the licensure authorities. Medical societies attempted to

establish a professional image and control against the less qualified, or those without

formal education. Mostly their efforts failed. Medical societies often had little real

power beyond assuring their own members of their superiority. Non-members and

the general public felt free to ignore their pronouncements on permissible fees and

accepted therapeutic methods. Popular opinion often looked askance at the many

42 Starr, 44-47.

43 Shyrock, 10-11.

44 Kett, 12-30.

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heroic medical practices that were often harmful and at best useless. The people still

had the power to consult whom they wished for medical care, a doctor without formal

education, a midwife, or a folk healer.45

Popular Attitudes toward Medicine and Its Practitioners

The temperance message of health through avoidance of alcohol was

consistent with new approaches of prevention and more gentle health measures.

Many who adopted the temperance message also adopted alternative health reform

measures. Growing public skepticism about heroic, drastic, and ineffective methods

of medical treatment encouraged the growth of a number of health irregulars in the

first half of the nineteenth century. Health irregulars, particularly homeopaths and

Thomsonians, opposed the accepted therapeutics of regular physicians. Popular

dissatisfaction with the status quo produced a multitude of alternative healers and

health providers. The failure of drastic bloodletting and purging to cure disease led

people to turn to less dramatic methods. The healing power of natural methods

gained in popularity. The popular culture supported dietary and health reform

measures.

In addition to popular reliance on preventive medicine, folklore, and home

health remedies, a number of new health sects arose. The most successful of them,

the Thomsonians and the homeopaths, adopted natural treatments and

recommendations. Other new medical theories, such as the phrenologists, gained less

support popularly. Some physicians, notably Oliver Wendell Homes, dismissed the

45 Starr, 45; Kett, 168-177.

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phrenologists as quacks. Others, for example the blustering Dr. Charles Caldwell,

adopted phrenology as a means of bolstering their own reputation.46 The temperance

physicians, especially Sewall and Mussey, rejected phrenology as quackery, but did

not attack the less extreme methods of the naturalists.

Thomsonians grew from the efforts of a New Hampshire farmer, Samuel

Thomson, to oppose current medical practice because of the death of his mother.

When he was a child, his mother died from the harsh mercury purges and bleeding.

Years later when his wife became sick, he dismissed the doctors and used mild,

herbal remedies. From his experiences he left his New Hampshire farm in 1805 to

become an itinerant herb practitioner. He gained a large following as he traveled

about, criticizing the harsh treatments of doctors, and extolling the benefits of natural

herbal remedies. By 1812, he published his first pamphlet on herbal medicine. Ten

years later he expanded his publication with the title New Guide to Health; or Botanic

Family Physician. Thomson hired agents to sell of his book at twenty dollars each

and promote his therapy.47

By the 1830s and for the next twenty years, the Thomsonians developed as

an alternative health reform movement. Thomsonian agents and societies gained

popularity in states throughout the country. Thomsonian agents organized “friendly

botanic societies” in the northeast, the southeast, and as far west as Ohio. Armed

46 Holmes also rejected temperance views (see footnote 29), while Caldwell was ambivalent on temperance. Charles Caldwell, M.D., Autobiography (Philadelphia: Lippincott, 1855), 201-202.

47 Duffy, 80-82.

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with popular support, they successfully withstood the efforts of regular physicians

and medical societies to prevent them from practicing medicine.

Homeopathy posed another major opposition to established medicine. As a

medical system, homeopathy garnered some respect from established physicians

because its founder, the German physician Samuel Hahnemann (1755-1843) had

studied medicine in Leipzig and Vienna. As Duffy cogently remarks, Hahnemann

had a brilliant mind, but occasionally “wandered out in the wild blue yonder.” 49 One

of Hahnemann’s theories was that infinitesimal amounts of drugs could effect cures.

The tiny amount of drugs prescribed, in dilutions as small as one-millionth of a grain,

had the advantage of not poisoning the patient, as did many of the extreme treatments

of the period such as mercurial purges. Homeopathy also took advantage of the fact

that many diseases are self-limiting and resolve on their own without any treatment.

Homeopathy reached America in 1825 through a disciple of Hahnemann, Hans Gram,

who settled in New York and gradually won converts. Homeopathic remedies gained

some support in the medical community and helped gradually to bring about less

drastic therapeutic measures.50

In an ironic twist of language, the old-line humorists referred to the

irregulars as “empiricists.” Medical journals of the era referred to those who

employed botanical and folklore methods as “empiricists,” using the terminology as

48 Kett, 20-23.

49 Duffy, 82.

50 See references to homeopathy and therapeutic change, Leavitt and Numbers, 91 et seq.; Duffy, 82-87.

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derogatory. Old guard doctors also referred to the new laboratory scientists as

empiricists in a pejorative fashion: they relied on experiments rather than theoretical

knowledge. Traditionally trained doctors prided themselves on their theoretical

education and therefore condemned those who relied on experience alone. In

describing the Paris Clinical School, one journal article was highly critical of the new

standards:

The practice of medicine according to this view, is entirely empirical, it is shorn of all rational induction, and takes a position among the lower grades of experimental observation, and fragmentary facts.51

Despite the resistance of traditional medicine, many physicians were open to

new ideas about improving health. Ideas of reform in medicine gave support to

temperance reform as a medical position. Reform movements covered a wide range

of causes in addition to temperance. All the reform movements related to physical or

mental health, for example, the reform movement for humane treatment of the insane,

the movement for prison and penal reform, and dietary reform. Dietary reform

included vegetarianism as well as the Grahamites, who endorsed the use of whole

wheat flour.52

Some historians, particularly Paul Starr and John Duffy, emphasize the

defensive nature of physicians’ openness to new ideas. They stress that although

American physicians resisted the challenge of the irregulars, especially the

51 L.M. Lawson, Western Lancet 9 (1849): 196. Only later in the century did the term empiricism evolve to a more positive connotation.

52For a description of the rise of professional medicine and the opposition of the anti professionals, or irregulars, such as the Thomsonians, see Duffy, 81-83 and Starr, 51-59. For information on Sylvester Graham’s reform movement based upon diet and hygiene, 1830-1870, see Shryock, 111-125.

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homeopaths and the Thomsonians, and they nevertheless responded gradually to both

their message and their financial pressures. In a defensive mode, to keep from losing

patients, many physicians began to adopt more effective, preventive methods.

Gradually, physicians responded to the growing popular skepticism regarding

excessive bleeding and purgings. By 1850 doctors used these heroic practices less

often and largely abandoned them by the late nineteenth century. Influenced by the

changing ideology of the period, many physicians responded to the popular health

movement by promoting more supportive, preventive measures. Thus, preventive

health formed the locus for many social reforms, including temperance.

Temperance, in much the same way as other social reform thinking of the

era, promoted the concept of preventive health measures and good hygiene. Popular

opinion grew skeptical of the old treatments and supported methods that, if not

effective, at least caused less damage to the patient. The temperance message of

controlling alcohol consumption and abuse fit easily into the preventive health

paradigm.

Medical Attitudes toward Alcohol and Temperance

The temperance physicians were atypical in their attitudes toward alcohol.

Alcohol use was a controversial and evolving subject for early nineteenth century

physicians. Although a number of physicians endorsed temperance ideology

privately, the medical profession did not, as a whole, adopt the temperance message.

Medical journals and medical textbooks of the period are silent on the issue of

temperance and alcohol use. Surprisingly, a search of the leading American medical

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journals of the period shows that alcohol and temperance are rarely mentioned.

Given the popular interest in the temperance movement and the alcohol question, the

omission is striking.

American doctors differed greatly on their temperance affiliation. Some

joined the temperance cause; others did not. No conclusive study has been conducted

that can give definitive data on the percentage of American doctors who joined or

those who did not join.53 Based upon existing sources and commentary, the best

estimate is that the majority of American doctors did not join temperance societies.

Perhaps most physicians were reluctant to endorse a nontraditional position. Still

others were perhaps themselves intemperate in their use of distilled spirits, wines, and

other alcoholic drinks. Even those who joined generally did so without much fanfare.

Perhaps they wanted to avoid controversy in their practice and did not want to risk

alienating patients.

The temperance physicians were an anomaly in their profession. They

comprised a small, vocal minority of the medical profession as they promoted the

temperance cause. A number of factors must be evaluated and understood in order to

understand their unusual approach in promoting temperance. Their interest in new

scientific discoveries concerning alcohol greatly influenced their thinking. Their

opposition to the use of alcohol coincided with chemical discoveries and experiments

on the substance alcohol, a discovery they were almost certainly aware of. English

53 Gerald W. Olsen’s 1994 study of the British medical community and temperance concluded that only a radical minority of British physicians supported teetotalism or temperance during the period 1830 to 1855. The majority of British doctors promoted the moderate use of alcohol as both food and medicine, even more so than they had previously. Gerald Wayne Olsen, “ 'Physician Heal Thyself': drink, temperance and the medical question in the Victorian and Edwardian Church of England, 1830-1914,”Addiction 89 (1994): 1167-1176.

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chemist William Brande’s discovery of the chemical component alcohol was

published in the United States in 1821. Prior to Brande’s experiments, it was not

known that alcohol, commonly referred to as ardent spirit, was present as a discrete

chemical in fermented drinks.54 The temperance physicians cited additional

experiments on alcohol by the French physicians and chemist Francis Magendie.

Magendie conducted chemical experiments on alcohol and its effects on the body.

Thomas Sewall, one of the temperance physicians, specifically cited Magendie’s

work.55

Nineteenth-century medicine regarded alcohol as a necessary medicine in

the materia medica or pharmaceutical treatments. Since at least the eighteenth

century, doctors had included alcohol in their medical treatments. Physicians

prescribed alcohol to patients in the form of whiskey, brandy, rum, wines and beer for

a wide variety of ailments. They considered alcohol as therapeutically effective in

stimulating the body to regain its natural humoral balance. Although his writings

give no such indication, even Benjamin Rush must have used alcohol as a medicine in

the late eighteenth century. His hardwood medicine chest contained whiskey and

54 In 1821, the first American edition of William T. Brande’s Manual of Chymistry was published in New York, based on the London edition. Before Brande’s experiments, no one knew that the substance alcohol was the common ingredient in all fermented drinks, the same as distilled spirits, only less concentrated. William Thomas Brande, A Manual of Chemistry (New York: no publisher listed, 1821). William Brande (1788-1866) was a member of the Royal Institution in London. His analysis o f alcohol, found in chapter eight of his manual, gives exact proportions of alcohol present in a variety of wines and malt beers. His work was published in London five or six years prior to the American publication. The volume that I studied came from the private library of A.L. Metz, M.D., from the archives of Tulane University.

55 Frangois Magendie (1783-1855) was a pioneer in physiology and pharmacology. He did experimental work on the spinal nerves and also on alcohol and other drugs. See ch. 4 on Thomas Sewall for more information on Sewall’s understanding of Magendie’s experiments.

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brandy in addition to the cathartics such as mercury and calomel, and opiates such as

paregoric.56

Beginning in the 1820s, doctors increasingly used alcohol as a routine

medicine. In the wake of popular opposition to heroic methods many physicians

turned to the use of alcohol as a medicine, as an alternative to the heroic methods of

bleeding and purging. By comparison, they regarded alcohol as benign and less

drastic. Physicians regarded alcohol as a stimulant, instead of the modem

classification of alcohol a depressant. They regarded the diseased body as “asthenic,”

or enfeebled, and requiring stimulation. Physicians increasingly prescribed alcohol to

patients, in both distilled and fermented form, for a wide variety of ailments. Alcohol

was prescribed for colds, infectious diseases, dysentery, and pneumonia, and a wide

variety of other diseases.57 The use of alcohol as a medicine persisted throughout the

nineteenth century and well into the twentieth century.

As the temperance movement gained membership and more influence, a few

physicians began to question the use of alcohol even as a medicine. Although the

early temperance physicians, Benjamin Rush and Billy Clark, apparently allowed the

medicinal use of alcohol, later temperance physicians doubted its validity. By the

1830s the later temperance physicians (Sewall, Mussey, and Jewett) consistently

opposed the too frequent use of alcohol as a medicine. They categorically opposed

alcohol use as medicine, citing the danger of producing dependency in patients.

56 Gretchen Worden, “A Look inside Dr. Benjamin Rush’s Medicine Chest,” American Medical Association News, June 25, 2001, 17.

57 Cheryl Krasnick Warsh, “Alcohol as Medicine,” inAlcohol and Temperance in Modern History, An International Encyclopedia, ed. Jack Blocker, David Fahey, & Ian Tyrrell, (Santa Barbara, Cal: ABC-CLIO, 2003), II, 407-409.

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This overview of the changes in medicine in the nineteenth century provides

essential context for considering the world of the temperance physicians. The myriad

changes of nineteenth-century medicine provide the cultural and scientific milieu in

which the temperance physicians conceived their temperance ideas. The changes in

medical knowledge, practice, and popular attitudes helped to shape the ways that

temperance physicians perceived alcohol use. The medical and scientific discoveries

in technology and chemistry contributed to their understanding of alcohol and its

effects upon health, but so much was yet unknown about the body and alcohol. Their

perceptions were imperfect and unclear. Although the cultural and scientific context

of medicine provides necessary information, it is not sufficient to describe the

phenomenon of the temperance physicians. In order to understand the temperance

physicians, we must search the details of their individual experiences.

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THOMAS SEWALL, TEMPERANCE PHYSICIAN

In January 1818, rumors reached a local family that their daughter’s body had

been exhumed from her grave in the nearby Essex Church graveyard. A hair ornament

that had been buried with her body had been found lying on the cemetery grounds.

Suspicious, the family had the grave re-opened and discovered that her body had been

stolen. With this appalling discovery, other graves in the cemetery were searched. By

April of that year seven other bodies were discovered missing. Charges were brought

against Dr. Thomas Sewall, the physician in the small Massachusetts town of Essex.1

Sewall had been caught procuring cadavers for dissection and autopsy. With a newly

established practice and his wife expecting their first child, he might have felt some

reluctance to engage in such an objectionable and illegal activity. Yet, something

compelled him to take the risk.

This early incident in the life of Thomas Sewall (1786 -1845) provides clues in

understanding his later role as a prominent temperance leader and advocate. His views

on temperance and his grave-robbing participation proceeded from the same impulse,

emerging changes in scientific methods. Sewall, like the few other physicians who

played a prominent role in the first American temperance movement, regarded the

1 The bodies exhumed were those of Mrs. Mary Millet, aged 35; Miss Sally Andrew, 26; Mr. William Burnham, 79; Mr. Elisha Story, 65; Mr. Samuel Burnham, 26; Isaac Allen, 10; Philip Harlow, 10. The eighth body was reported as not known, but supposed to be that of “Caesar, a coloured man, buried several years since.” History of Ipswich, Essex and Hamilton, www.rootsweb.com/lpswichllistorv. accessed 9/9/2003, 1-12. 93

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temperance cause primarily as a health issue rather than a moral issue. Sewall

approached problems as a scientist first and foremost. He regarded intemperance and

habitual drunkenness as a physiological process, with potentially harmful effects on the

body, mind, and spirit of the drinker. The practical outcome of his views on both

medicine and temperance often clashed with established social norms. In order to

understand Sewall’s mindset and actions, one must understand the medical, scientific,

and social context of Sewall’s world.

Sewall was on the leading edge of new approaches in medicine, influenced by

changing currents of scientific inquiry underway in the early nineteenth century. The

search for medical knowledge during this period increasingly encouraged autopsies and

dissection. Medical training and research had begun to require more rigorous methods of

scientific inquiry than had been customary during the eighteenth century. Medical

schools preferred that students and researchers learn human anatomy by witnessing and

participating in autopsies. The old eighteenth-century medical knowledge, based upon

humors, systems, and theory, was gradually being replaced by more rigorous methods of

scientific observation and experiment. Although medical schools increasingly regarded

dissection as an essential tool in education and research, procuring bodies remained

difficult. Because bodies were so hard to obtain, doctors and students resorted to getting

them wherever and however they could. Often they engaged in grave-robbing or “body-

snatching,” a practice that the public resented. The bodies of the poor, the working class,

or unattended deaths were especially vulnerable. The bodies of criminals that had been

executed were in some cases available, but not as instructive as those who had died of

disease. In order to study pathology, medical scientists needed to conduct postmortems

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upon the bodies of those who had died from known symptoms or diseases. Grave

robbing, although illegal, was a common method of procuring bodies for dissection.2

The grave-robbing incident indicates the extent to which Sewall would go in

pursuing his scientific interests. For s physician like Sewall, the product of first-tier

medical schools, Harvard and Pennsylvania, and inclined to use scientific methods to

learn the causes and cures for diseases, the opportunity to conduct postmortems for

known symptoms must have outweighed the risk of apprehension. Most likely Sewall

knew the deceased and the circumstances of their deaths. He may even have attended

them in their final illnesses. Unfortunately, or so it must have seemed to him and his

family, he was caught. In the town of Essex, numbering only a little over one thousand,

the exhumation and removal of bodies from the graveyard was appalling to the entire

community. Many had relatives buried in the community church graveyard, including

the Sewalls, Choates, and other prominent families. Samuel Sewall, Sewall’s younger

brother, had been buried there only a few years before.3 Under such circumstances,

Sewall would probably have found it difficult to continue his practice in the area.

2 The first decades of the nineteenth century mark a transition in medicine between the old classical methods of vague systems and conjecture to the formation of modem clinical methods. The French physicians, as well as some English physicians such as William Harvey, led the clinical methods of scientific observation by combining clinical observation with subsequent dissection. New standards of medicine emerged that employed scientific method. Autopsies became essential to the new scientific approach and the development of surgical method. Still, old prejudices against human dissection often impeded scientific inquiry. For more information, see Paul Starr, The Social Transformation o f American Medicine (NY: Harper Collins, 1982) 54-55 and 177; also John Duffy,From Humors to Medical Science: A History of American Medicine (Chicago: U. o f 111. Press, 1993) 131-33; also Michael Sappol, A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America (Princeton: Princeton U. Press, 2002), 100-119. For the need to conduct autopsies on cases of known pathology, see Sherwin B. Nuland, Doctors, the Biography of Medicine (New York: Knopf, 1988) 153-154.

3 The inscription read “In Memory o f Mr. Samuel Sewall who died April 10, 1812; AEt 21 [at age 21] Mine is the house appointed for all the living.” Inscriptions from the Old Burying Ground, Essex, Mass, ed. Kurt Wilhelm, accessed 9/19/03, p. 13-16.

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Further demonstrating the significance of Sewall’s situation, the Rev. Crowell,

the minister of the Ipswich Congregational Church, preached a sermon in July 1818 on

the serious matter of the recent grave-robbing incident. He expressed the shock and

sorrow of the community over the exhumations from the community burial ground. Even

though the minister attempted to make allowances for the importance of dissection for

legitimate scientific inquiry, he could not condone such a serious offense as grave

robbing. He condemned those guilty of “the inhumanity and impiety of forcibly taking

the dead from their graves.”4

Despite the help of excellent legal defense from then Massachusetts

congressman Daniel Webster, Sewall was convicted on three counts of grave robbing and

fined eight hundred dollars.5 According to his one surviving sister, Rebecca, Sewall

decided to leave Massachusetts, due to unspecified “circumstances.” We may assume

that the circumstances related to his conviction of grave robbing. In 1820, encouraged by

his lawyer and friend Daniel Webster, he moved to the federal city, Washington.6

In Washington, Sewall gained prominence as a founder of the Columbian

College Medical Department and as a temperance advocate. In 1827 he addressed the

medical students graduating from Columbian College. For perhaps the first time in

public, he warned against the dangers of alcohol consumption, “a rock on which many of

4 Ibid.

5 Elmer Louis Kayser, A Medical Center: The Institutional Development of Medical Education in George Washington University (Washington: GW University Press, 1973), 20. Sewall’s case was tried under the 1815 Massachusetts law that punished unauthorized possession of a dead body with a maximum fine of $ 1000 and imprisonment for up to one year. Sappol, 102.

6 Rebecca Webster, letter to her nephew, the Rev. Thomas Sewall, son of Dr. Thomas Sewall, n.d., (1845-1870); Kayser, 20-21, Library of Congress Manuscript Division.

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our profession have foundered.”7 By 1827 Sewall was an eminent physician, respected in

the medical school and in medical science. During the next eighteen years of his life,

until his death in 1845, Sewall advanced the cause of temperance through his lectures and

publications. Although he became as famous in the temperance movement as he had

been in medicine, he is mostly unknown today, even to historians of temperance and

social reform. It is therefore worthwhile to bring to light the ideas and activities of such a

man. By examining Sewall’s life and work, we can infer some of the influences on his

thinking. We can also identify how his temperance ideas relate to those of the larger

temperance movement, particularly his contribution to the emerging concept of the

process of addiction.

Thomas Sewall was bom in the township of Hallowell, Maine on April 16,

1786, to Thomas Sewall (1750-1833) and Priscilla Cony Sewall (1749- 1836). The

Sewalls were a large family, with deep Puritan roots in New England.8 A prominent

family in and around Boston, they tended to be well educated and connected with

Harvard both as students and professors. Their choice of profession included the Puritan

(Congregational) clergy, the law, and similar scholarly pursuits.9 Thomas Sewall’s

7 Thomas Sewall, A Charge Delivered to the Graduation Class of the Columbian College, D.C. at the Medical Commencement, March 22, 1827 (Washington, D.C: Duff Green, 1828) 6.

8 The Sewalls were first established in the colony of Massachusetts by Henry Sewall, a Puritan minister. One o f the early-recorded Sewall ancestors, Henry Sewall, had emigrated from Bishopstoke, Hampshire to Ipswich, Massachusetts in 1635. Henry’s father, also named Henry, had advised him to emigrate, most likely aware that Puritan ministers would find uncertain job opportunities with religious and political strife in England. Henry Sewall Webster, Thomas Sewall; some of his Ancestors and all ofhis Descendants: A Genealogy (Gardiner, Maine, 1904) 4.

9 The first Henry Sewall had three sons, Samuel, John, and Stephen. All the Sewalls in Maine are descended from John and his two sons Samuel and Nicholas. The two sons came to York soon after their sister married and moved there about 1701. Other Sewall relatives are Stephen Sewall (1734-1804), professor of Hebrew and other languages at Harvard, Judge David Sewall from York, Maine, and

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famous relatives included Judge Samuel Sewall, one of the judges who presided over the

Salem witch trials in 1692.10 Judge Sewall is famous in temperance history for

attempting in 1714 to monitor the raucous behavior of drinkers in local taverns,

demanding that they behave themselves. His efforts met with mixed results, as did most

of the attempts of social elites to control drinking behavior.11

Thomas Sewall’s immediate family lived in Hallowell, a rural township that in

the 1700s included all the surrounding territory, as well as the later incorporated town of

Augusta. Hallowell was probably much like other small Maine towns of that period that

provided the seedbed for future temperance support. According to historian Alan Taylor,

that part of Maine, the Eastern Country, was a frontier area, where heavy drinking was a

prevalent and pervasive custom. Maine settlers wanted a beverage that was easily

transported into the woods and to their workplace outdoors in the cold. Rum was the

drink of choice, rather than cider, the lower alcohol-content drink more common in

southern New England. In rural Maine, as in most of America during the period,

drinking alcohol was a daily custom in almost every social setting, and drunkenness

missionary Jotham Sewall. Sewall/Sewell Family Records, www3.simpatico.ca/Robert.sewell/letter.html, 33 pgs, accessed 9/5/02, 2-10.

10 Judge Samuel Sewall (1652-1730) in The Encyclopedia of New England (NY: Green Spring, 1985) 420.

11 In the eighteenth century elites such as ministers, clergymen, and public officials attempted to control drunken behavior of those they regarded as their social inferiors through legal and also informal mechanisms. Their job became increasingly difficult with the rising tide of democratic expectations and the increase in Boston rum production in the eighteenth century. W. J. Rorabaugh, The Alcoholic Republic (New York: Oxford U. Press, 1979) 28-29.

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abounded. The area was to provide an active ground for temperance activity later in the

nineteenth century, including the famous Maine prohibition laws passed in 1846. 12

Thomas SewalPs father, also named Thomas, and the son of a shoemaker,

practiced the lowly trade of tanner in Hallowell. Having set up the first tannery in the

Kennebec Valley, he located the tannery in a ravine near his house. He had participated

in the Revolutionary War in a local militia and was credited with three months service.

He used to relate, probably with some exaggeration, his experience as a prisoner on a

British ship. Thomas married Priscilla Cony, daughter of Deacon Samuel and Rebecca

Cony, in November 1779.13

Some of the other Sewalls in town enjoyed more social prominence than did the

senior Thomas Sewall. The Captain Henry Sewall in Laurel Ulrich’s A Mid-wife's Tale,

based on Martha Ballard’s diary during the period 1785 to 1815, was probably Thomas

SewalPs cousin. Henry Sewall and his wife “Lady Tabitha” held high social position in

Hallowell. Having served under General Washington, Henry Sewall then held the

important position of town clerk of Hallowell and Augusta for over thirty years. By

contrast, Thomas Sewall, the father of our subject of interest, got himself entangled in the

town scandal concerning the clergyman Isaac Foster. Apparently he had rented out a

house to Foster for three shillings and in 1788 sued him for back rent. It seems a routine

affair from a monetary standpoint, but a number of town leaders, including Henry Sewall,

had determined to dismiss Foster from his position as the established minister. At the

12 Alan Taylor, Liberty Men and Great Proprietors, The Revolutionary Settlement on the Maine Frontier, 1760-1820 (Chapel Hill: U. o f NC Press, 1990), 84-85, 36-37; Rorabaugh, 141-42; Mark E. Lender and James Martin, Drinking in America, A History (New York: Macmillan, 1982), 42-46.

13Henry Webster offered in his genealogy the opinion that Thomas Sewall senior probably inflated his military adventures. Webster, 6.

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time of Foster’s dismissal several months later, he had a number of debts that he could

not pay. Given that Foster had made a number of enemies in town and also that Thomas

Sewall, Sr. had friends in high places, it is not surprising that Sewall won his case, plus

court costs.14

The family life of Priscilla and Thomas Sewall must have been simple, probably

even humble. They had six children to support from the tannery business. The extra

income from renting to Foster, even though modest, was needed. At the time of the

Foster incident, Thomas and Pricilla’s son was two years old. As a matter of interest to

those interested in the potential influence of order of birth on the formation of

personality, Thomas was their fourth child and first son. His three older sisters were

Rebecca Guild, six years older; Mary Seward, four years older; and Harriet, two years

older. There followed two more children in the family after Thomas: Daniel, two years

younger and the sixth and last child, Samuel.15

The religious practice of Sewall’s family provides relevant information for

identifying social and cultural influences that affected him. Thomas Sewall’s family

followed the established religious practice of New England, Congregationalism, beyond

mere convention. Thomas’s older sister Rebecca recalls that a Methodist circuit preacher

called at their house when her brother was about five years old. The family prayed with

the preacher, the Rev. Jesse Lee, not in the Congregational style of standing that they

14Henry Sewall took an interest in the larger matter o f having Isaac Foster dismissed from his post as the established Congregational minister in Hallowell. Henry may have worked behind the scenes to reduce the town salary owed to Foster and to force him to pay his outstanding debts. Laurel Ulrich, A Mid wife’s Tale, The Life of Martha Ballard, Based on Her Diary 1785-1812 (NY: Knopf, 1992)30-32, 107- 114.

15 Webster, 6.

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were accustomed to, but kneeling, as the Methodists preferred. Rebecca, writing and

recalling the incident years later, reported that her brother, even though a young child,

knelt of his own accord and indicated a strong affinity for prayer.16

As has been thoroughly documented by a number of historians, the growth of

evangelicalism strongly promoted the infant temperance movement. This incident from

Sewall’s childhood illustrates the growth of evangelical Christian churches on the Maine

frontier. Sewall grew up in an environment, both in his family and in his community,

where evangelicalism promoted social reform. At this period in the late eighteenth

century the Baptists and the Methodists challenged the old line Congregationalists with

missionary preachers. They had already or were in the process of, surpassing the

Congregational Church in membership. This development was a triumph for the

evangelicals and a defeat for the established New England church, a common occurrence

throughout the American frontier. Evangelical churches such as the Baptists and

Methodists promoted temperance and other matters of personal piety. The growing

evangelical churches used their revivalist teachings of individual piety on matters such as

drinking to attract new members. Their stance on temperance promoted the cause not

only in the new churches, but also caused the established Congregational churches to

i >7 address the issue of temperance as well.

16 Rebecca Sewall Webster, letter to the Rev. Thomas Sewall about his father, after 1845 (Washington, D.C: Library of Congress, Manuscript Division).

17 Alan Taylor describes the evangelical influence specifically in the region of Hallowell and the Kennebec Valley. Taylor, 139-140; For a more general discussion of the role of evangelical Protestantism in the American temperance movement, see Joseph Gusfield on evangelical challenges to traditional churches, Symbolic Crusade, Status "Politics and the American Temperance Movement (Chicago: U. of Illinois Press, 1986), especially 46-50. Gusfield’s view differs somewhat from Taylor’s approach in that he emphasizes the social conflicts and self-serving interests o f the old and new religious denominations.

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When Sewall was a boy of about ten or twelve years old he was sent to live in

Augusta, near Hallowell, in the family of his mother’s brother, Judge Cony, so that he

could attend school. The school had a noon recess during which all the children went

home for lunch. Thomas came back after recess, heated from running, and sat by an open

window. A storm blew in, drenching him as he sat by an open window. He was said to

have caught not only a bad cold, but after that always seemed to be prone to respiratory

infections. A relative who lived with him in later years reported hearing him say, “I have

i o had consumption for more than forty years.”

The Sewall family was highly conscious of gender roles as reflected in an

incident that occurred when Thomas Sewall was a young man. When he was about

fourteen years old and in high school, Sewall had decided to study medicine. After

finishing high school, he lived and studied with an uncle, who had been a practicing

physician. At this time he contracted a severe virus or illness that affected his lungs, so

severe that his life was threatened. While he was in danger, his sister Mary prayed with

and for him to recover. According to private family papers, Mary, who was also ill with

a lung ailment, prayed that if it was the will of God that one of them should die, that her

brother Thomas might be spared, for she felt that he would accomplish something

extremely important for the world. Mary’s attitude of deference indicated that she, at the

very least, accepted the reality of men’s superior prospects in their society. For example,

no women were allowed to train as physicians, nor would they be admitted into medical

18 M.A. Cruickshank, Reminiscences of My Childhood, Sewall family papers, Manuscript Division, Library o f Congress, 2.

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schools until decades later.19 It is even likely that she doubted her own abilities and

worth (a conclusion consistent with her pronouncement), but without knowing more

about Mary personally, it is difficult to determine her exact state of mind. But we do

know that Mary and Thomas were very close and affectionate. Next to his mother,

Thomas confided in and trusted Mary more than anyone else. After a while Thomas did

recover, except for a slight cough that followed him the rest of his life.

Mary also recovered, but only for a few years. She married Dr. Reuben Mussey,

the same man who later became famous as a physician and temperance leader. Mussey

and Sewall became life-long friends, related first as in-laws and later as professional

colleagues. Mary died at age twenty-four, in 1807, apparently of tuberculosis. One can

speculate upon the sense of duty, responsibility, and perhaps even guilt, that young

Thomas, then twenty-one and in the early stages of studying medicine, would have felt.20

He returned to his studies, which had been interrupted by his sister’s long illness. He

remained with Dr. Mitchel of North Yarmouth until he went to Boston to continue his

medical education at Harvard Medical School

Like most doctors in the early nineteenth century America, Sewall studied under

an established physician. After a few years he was able to pursue his medical education

more formally. Sewall secured medical degrees from both Harvard Medical School and

the University of Pennsylvania, two of the leading medical schools in America. The

formal course of study for a medical degree was a great deal simpler in those times than it

19 The first woman to receive a medical degree was Elizabeth Blackwell, graduating in 1849 from Geneva Medical College in Geneva, New York. For her biography see Rachel Baker, The First Woman Doctor; the Story o f Elizabeth Blackwell (NY: Messner, 1944).

20 Webster, Thomas Sewall; some of his Ancestors, etc., 6; R. Webster, letter to the Rev. Th. Sewall.

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is now. Generally, earning a medical degree required attending only two years of study,

consisting of lectures of only five months during the year. Instead of tuition, students

purchased tickets to attend lectures. One of Sewall’s lecture tickets still survives in the

Harvard Medical School archives. He took classes at Harvard at least as early as 1807, at 91 age twenty-one. He also studied at the University of Pennsylvania Medical School in

Philadelphia, beginning in 1811. He continued his studies there for two years, taking

classes with Dr. Barton and also with the famous Dr. Benjamin Rush. He was listed as

Dr. Barton’s student, but took at least one class under Rush. He took Dr. Rush’s class

“Upon the Institutes and Practice of Medicine and Upon Clinical Cases.” It was one of

the last classes that Rush taught before his death in 1813.22

Sickness and deaths in his family slowed Sewall’s progress in medical school,

but even so, he excelled in his classes. When he graduated from Harvard Medical School

in 1812, at the age of twenty-six, Harvard awarded to him the Boylston gold prize for the

best essay on diseases of the heart. After he lost his sister Mary in 1807, in February

1811, he lost another sister, Harriet, the cause of death unknown. She was two years

older than he, and was reputed to have been tall and very beautiful. She left a husband

and two children. Sewall now had only one remaining sister, Rebecca. The following

year, 1812, his youngest sibling died, Samuel, at age twenty-one. Of the six Sewall

21 Thomas Sewall, Harvard University Lecture Ticket, 1807 (Cambridge, Mass: Harvard U, 1807); Prior to the 1870s, the course of study for the M.D. was two years. After 1870 the third year was added to the curriculum, and in the 1890s the fourth year was added. Henry K. Craig, “Historical Sketch of the George Washington University Medical School,” The Caduceus (May 1915) 15-18.

22 Kayser, 18-20.

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children, only three now survived: Thomas, his sister Rebecca, and his younger brother

Daniel. 'J'X Despite all this, Sewall had continued and even excelled in his medical classes.

After graduating from Harvard, he returned for a few months to Maine. There

he received a request from Mussey, his brother-in-law, requesting him to handle his

practice in Ipswich, Massachusetts,24 while he attended lectures in Philadelphia during

the winter. Aged twenty-six and equipped with medical degrees from two respected

institutions, Sewall took over the Ipswich practice from Mussey. He also took over his

boarding spot and tutoring job with one of the local families, the Choates. When Mussey

returned from Philadelphia, he relocated his practice to nearby Salem, allowing Sewall to

continue the Ipswich practice. O f t

In the following year, 1813, Sewall married Mary Choate, the twenty-one year

old daughter of Captain David and Miriam Choate. Sewall had tutored her younger

brother, Rufus, a friendship that was to continue for the rest of his life.27 The newly

married couple continued to live in Ipswich in their own residence, according to census

23 Henry Webster, 6, 13.

24 Ipswich, Massachusetts was the parent town of Essex, north of Boston and Salem, near the coast. Ipswich was the first location o f the Sewall immigrants, and near the burial site in Newbury, Massachusetts of Henry Sewall and other Sewall ancestors beginning in the late seventeenth century. Sewall Family Records, www.svmpatico.ca/robert.sewall. accessed, 9/5/2002.

25 Rebecca Webster, 3.

26 Mussey had lived in Ipswich, the parent town o f Essex, at least since 1806, according to the records of the Congregational Church. Essex, Mass. Congregational Church Members, 1681-1937 (www. Rootsweb.com. Massachusetts US GenWeb Project, accessed, May 1,2003).

27 Mary Choate (b. October 3, 1792, Ipswich, Mass; d. March 29, 1855, Rockville, Maryland), Webster, 15. Rufus Choate (1799-1859) grew up to serve as U.S. Representative from Massachusetts, 1831-1834, and U.S. Senator, 1841-1845.

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records.28 Later, in April 1818, they had a son, named Thomas. What should have been

a joyous time for the young married couple was, however, marred by the grave-robbing

incident that had begun to unfold only a few months before the birth of their son. In 1820

the Sewalls moved to Washington.

Professionally, Sewall fared much better in Washington. Despite his conviction

for grave-robbery, he moved there with a job already waiting for him, a professorship in

medicine. In 1821, the newly established Columbian College,29 created by Congress that

year, appointed Sewall as Professor of Anatomy and Physiology. The conjunction of the

grave-robbery incident and his subsequent medical appointment indicates the state of

science and medicine. Despite social norms that found the grave-robbery shocking on a

community level, the emerging trends in the scientific community made it possible to

overlook the scandal. It was important for the new medical school to employ a scientist

who performed autopsies and conducted rigorous scientific experiments. The opening

ceremonies in January 1822 featured an address by the first president of Columbian

College, the Reverend William Staughton, D.D., a Baptist minister. At first, the course

of instruction was general liberal arts, referred to as the Classical Department. The

curriculum for the Classical Department included science and medical courses, with plans

for a medical school (and a law school) to be added soon. With this end in sight, Sewall

28 According to the 1814 Census, there were three members in the Sewall household in Ipswich. The identity of the third member is not clear.

29 Columbian College was the forerunner of George Washington University in Washington, D.C.

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was appointed along with Dr. Janies Staughton, the president’s son, as Professor of

Chemistry and Surgery.30

Only three years later, in the summer of 1824, the medical school was founded

according to plan. It was the seventeenth in the nation and the first in the District of

-j i Columbia. Sewall was appointed president of the Medical Faculty and continued in his

position as professor of Anatomy and Physiology. Staughton continued as professor of

Surgery. To the two existing medical professors were added four more: Thomas

Henderson, professor of the Theory and Practice of Medicine; N.W. Worthington,

professor of Materia Medica;32 Edward Cutbush, professor of Chemistry; and Frederick

May, professor of Obstetrics. Thus, the new medical school boasted six medical

professors, more than most medical schools of the time. A few medical schools had

seven professors, but most had only three.34

On March 30, 1825, Sewall gave the inaugural address at the Medical

Department’s official opening. He highlighted the historic significance of the school’s

30Kayser, Title Page of President Staughton's Inaugural, with Kayser’s notation, facsimile illustrations, no page numbers; & Kayser, 23-24.

31 The first medical school had been established in Philadelphia in 1765, subsequently named the Medical Department o f the University of Pennsylvania. Next was established Columbia College in New York City, then Kings’ College in 1767. The states of Massachusetts, Vermont, Maryland, Pennsylvania, and South Carolina all founded medical schools before the opening of Columbian Medical College. Craig, 15.

32 Materia Medica was the term employed for remedies and treatments. The early nineteenth century still relied upon many of the old remedies o f emetics, cathartics, narcotics, and bleeding, although there were indications o f more effective (and less harmful) treatments on the medical horizon. For additional information, see the review of Dr. John Eberle’s Treatise of the Materia Medica and Therapeutics, published in Philadelphia in 1822, found in The Medical Repository of Original Essays and Intelligence, New York, 1824, vol. 23, no.l.

33 Kayser, Circular of the Medical Department, facsimile reproduction, d.

34 Craig, 16.

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founding and predicted that future graduates would contribute to the progress of medical

science. He expressed the hope that the institution might produce a doctor of the caliber

of a Benjamin Rush or a John Warren (of Boston).

The medical school was located in downtown Washington, midway between

Congress and the “President’s House,” on the northeast comer of Tenth and E Streets

N.W. The four-story building housed all the classrooms as well as the rooms for the

students. According to the medical school bulletin, arrangements had been made to

educate the students in all areas of medical knowledge. As was typical for the era, the

Columbian Medical Department required a two-year course of academic study for a

medical degree. Students attended a prescribed course of daily lectures for a period of

several months during the two-year period. Lectures were scheduled daily from Monday

to Saturday, beginning on the first Monday in November and continuing to the last day of

Febmary.

As professor of anatomy, Sewall would lecture on Saturdays during the term.

According to the bulletin, the anatomy class had been furnished with “ample opportunity

for the cultivation of Practical Anatomy.”38 By all indication, bodies were available for

dissection and autopsy. It would appear that Sewall’s past difficulties with procuring

35 Thomas Sewall, M.D., Lecture Delivered at the Opening of the Medical Department of the Columbian College in the District o f Columbia, March 30, 1825 (Washington: Columbian Office, 1825).

36 Nancy B. Pauli, Capital Medicine, An Illustrated History of the Medical Society of the District of Columbia (Encino, Ca: Jostens Pub, 1994), 14 &15.

37 The course of study was kept at two years until 1879, when a third year was added for a medical degree. In 1893, the four-year course was instituted at the medical school. This was the typical progression for medical school education during the nineteenth century. Craig, 18; Starr, 42-43.

38 From the first printed Circular of the Medical Department, Washington, March 30, 1825, GW Archives.

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subjects for dissection were behind him. The dissecting room was located on the top

floor of the medical building, with a mansard roof-line that allowed numerous windows

to provide natural lighting to supplement oil lamps. As the master of his own laboratory,

Sewall was at last free to conduct his scientific inquiries.39

Sewall inhabited a scientific world in the midst of change. Early nineteenth

century medicine was changing from systems based on balancing bodily “humors”

(blood, phlegm, and other body products) to new standards of scientific inquiry. The

newly emerging medical science required more rigorous standards of scientific

experiment, with results that could be replicated, showing cause and result. Eminent

medical historians such as John Duffy, Sherwin Nuland, and Paul Starr describe the

changing world of medicine from the old limitations of humoral systems and nosology to

the new reliance on scientific experiment.40 Medical researchers made use of new

technology, such as the stethoscope41 and the microscope, to study the interior of the

body. No longer would physicians be limited to futile attempts to regulate body fluids by

external means, according to vague theories of humors. The new science began to

challenge Benjamin Rush and his generation’s practice of bloodletting, emetics, and

purging. In this transitional state of medicine, the old ways would persist for decades

more, but the first assaults had been launched against the old paradigm.

39 Pauli, 15.

40 John Duffy, From Humors to Medical Science: A History of American Medicine (Chicago: U. of 111. Press 1993); Sherwin B. Nuland, Doctors, The Biography of Medicine (NY: Knopf, 1988); Paul Starr, The Social Transformation o f American Medicine (NY: Harper Collins, 1982).

41 Discovered by Dr. Rene Laennec in 1816. Nuland, 168-9.

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Sewall sided with the small but growing ranks of those who insisted upon

scientific method and evidence. He wanted to search for the cause of diseases and to

look beyond the externally visible surface of the body. For Sewall, the need for proof led

him to the dissecting table. For any theory he developed, he insisted on scientific

evidence. His insistence had made him an exile from his New England home, but he

subsequently gained the compensation of his own laboratory and the power of his

position as president of the medical school to protect him.

The new medical school gave professors the means “for exhibiting to the class

the Clinical Practice and Operative Surgery,” making use of the Infirmary of the

Washington Asylum.42 Sewall and the other staff physicians would care for the poor who

used the infirmary or hospital of the school. As described by Paul Starr and others, the

hospitals of the era housed charity patients, not those who could afford to receive care at

home. Hospitals and asylums treated those with no other options 43 More will be said of

Sewall’s private practice to the elites of Washington. As is well known regarding this

period in medicine, all surgery, conducted without anesthesia and before the knowledge

of bacterial infection, was swift and dangerous.

The chemistry professor of the medical school had a laboratory equipped with

every facility to demonstrate “the experimental parts of that science.”44 The chemistry

lab must have held interest for Sewall, although there is no direct information regarding

his use of it. He showed an interest in the chemical composition of alcohol and other

42 Circular of the Medical Dept., 1825, GW Archives.

43 Starr, 72-73.

44 Ibid.

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substances, citing chemical studies. Scientists in England had just recently found new

methods for analyzing the chemical composition of alcohol. These discoveries, based on

sound scientific method, must have held interest for the newly emerging scientific

temperance movement and Sewall in particular.

The new school set forth academic requirements for the medical students that

seem not too demanding by today’s standards. However, the strict rules for student

conduct demanded a monk-like morality, if they were enforced— which is unlikely. The

stated rules for behavior applied to all aspects of their personal lives. Students found that

“all immorality in word or deed” was “forbidden, and that anything approaching

ungentlemanly conduct” would result in dismissal. “Lady-like” conduct was not an issue

because there were no female students at Columbia, or any other medical school in the

nation.45 Students were forbidden to visit the theater “or any such place.” Students must

have felt some temptation, since the med school building at Tenth and E Streets N.W.

was located dangerously close to hotels and taverns only a few blocks away near

Pennsylvania Avenue. The rules further specified that they could not visit a hotel except

under special circumstances, presumably related to their medical education. One

wonders if any students ever tried to invent extenuating circumstances to permit such a

pastime. Cards and gambling were forbidden, and last, but certainly not least, all

“intoxicating liquor” was completely off limits. It would seem that students of Columbia

45 The first female student attended Columbia Medical School, renamed the National Medical College, in 1884. Sandy Holland, ed., From Strength to Strength, A. Pictorial History of the George Washington University, 1821-1996 (Washington, D.C: George Washington U. Press, 1995), 11. See also note 19.

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College would have been exposed to ample temptations. Whether the stringent

institutional rules effectively counteracted the lure of those temptations is debatable.46

As head of the medical school, Sewall held a position of authority and respect in

the medical community for the next twenty years. He chaired the regular meetings of the

medical faculty and the board of trustees, which were routinely held in his own office.

He was strongly involved in all major decisions of the medical school, including

curriculum decisions, the tuition and fees, the appointment of professors, and the physical

plant. The decision at an August 1839 meeting, concerning the requirements for students

to earn the medical degree, provides a typical example. Sewall insisted that the standard

be maintained that students first study for at least three years under a practicing physician

before being admitted to the medical school.47

Sewall played a vital role in the debates surrounding professional medical

standards. As was common in major cities of the period, leading physicians set up

medical societies to attempt to bring some order to the chaotic conditions in medical

practice. Sewall served as a prominent member of the Medical Society of the District of

Columbia, the MSDC, founded in 1817. The MSDC gathered as a scientific community

to share information and discuss medical issues. A group of leading physicians

established the MSDC because they were concerned about the growing number of

“quacks, imposters, and charlatans everywhere.”48 Congress chartered the Society in

1819, with authority to issue licenses. At first the MSCD considered mostly academic

46 Craig, The Caduceus, 16.

47 Minutes of the Board of Trustees and Minute Book of the Faculty, August, 1839 (George Washington U. Archives) Box 9, 11-16.

48 Pauli, 10.

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and scientific topics. But after a few years, other issues began to develop. Members

wanted to address disagreements in the community over fees, licensing, and ethical

violations, matters that were beyond the charter of the MSDC. In 1833, in order to

address these issues, doctors in the MSDC founded the Medical Association with

essentially the same membership. Sewall held prominent membership in both

organizations. The new association named as its president Dr. Joseph Lovell, Surgeon

General of the United States, who was known for his high standards of medical treatment

and education. The MSDC remained an academic body, while the Medical Association

attended to economic matters and ethical issues.49

Coming from a similar background, having the mutual benefit of a medical

degree from Harvard Medical School, and agreeing on significant medical and health

issues, Sewall and Lovell must have had collegial relations. In all likelihood, Sewall

enjoyed friendly relations with Lovell and the newly formed Medical Association.

Although there is no surviving correspondence or other commentary to confirm the

relationship, the circumstantial evidence is very strong. Lovell, a native of Boston and a

fellow New Englander, had graduated from Harvard Medical School in 1811, the class

ahead of Sewall. Lovell shared similar opinions with Sewall on a number of important

health and medical issues. Serving as the Surgeon General of the United States from

1818 until his death in 1836, Lovell supported Dr. William Beaumont’s famous study of

the digestive processes. Lovell encouraged Beaumont’s study in 1822 of a military

patient with an unhealed wound to the stomach. The study allowed Beaumont to observe

the digestive process. It was a controversial study, but given its subject and premise of

49 Ibid., 1 4 -1 5 .

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scientific methodology, Sewall almost certainly followed it with interest. The experiment

prefigured the studies that Sewall would undertake in the following years on the effects

of alcohol on the stomach and other organs. Sewall and Lovell also supported each other

on health issues for U.S. soldiers. In pronouncements reminiscent of Benjamin Rush’s

treatise on “Preserving the Health of the Soldiers,” Lovell encouraged changes in the

soldiers’ diet to include more vegetables and bread, and to eliminate hard liquor from the

rations. Under his leadership the military substituted other drinks such as molasses and

beer for hard liquor.50

In addition to his professional duties, Sewall practiced medicine in Washington

for the next twenty years, seeing both public charity patients and private patients. As was

common in medicine at this time, the hospital was a place of last resort, entered by those

who had no means of being cared for at home. The poor went there out of desperation.51

Charity patients appeared daily at the entrance of the Washington Infirmary near the

medical school. If they could afford it, they paid the steward a very small fee for room

and board, and then were treated by the attending doctors, led by Sewall, for free.52

Sewall frequently quoted Rush, one of the founders of the Pennsylvania Hospital, about

the moral obligation to treat the poor. He said, “I esteem the poor my most profitable

patients, for God is their pay-master.”53 There is no reason to doubt the sincerity of his

remark, but it is also true that patients who died poor and alone provided an uncontested

50 Mary C. Gillett, “Joseph Lovell,”American National Biography (New York: Oxford U. Press, 1999), v 14, 13-14.

51 Starr, 72-73.

52 Kayser, 54.

53 Ibid., 21.

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supply of postmortem material. Hospital records give no mention of autopsies, but

SewalPs commitment to explore anatomy in all ways possible, including the use of

autopsies, indicates that he must have made use of available cadavers.

In addition to the poor patients at the Asylum, Sewall saw private patients. His

leadership position in the medical school increased his prestige and enhanced his

reputation, making it easier to build a private practice. He treated the elite, among them

his friend and sponsor, Senator Daniel Webster. Apparently, he was well regarded by his

patients. Webster wrote favorably of his care under Sewall in a letter to his (Webster’s)

new wife.54 A letter from another of his patients illustrates the high regard his patients

felt for him. Stephen Olin’s wrote a letter to SewalPs son in 1845 that testified glowingly

to the care he received from Sewall over many years. He commended Sewall for his

wisdom in selecting treatments from 1833 onwards, although he gives no specific

information about the treatments that he received. In addition, he praised SewalPs

dedication and Christian character. In a cryptic reference, Olin also referred to the many

trials and challenges that Sewall faced, including “mental struggles and spiritual

warfare.” Olin wrote that Sewall “won the victory through faith in the blood of Christ.

Thank God for the testimony of such a man.” 55 Again, we are given no specifics, but we

do know that SewalPs temperance stance was not universally accepted in his profession,

nor was it completely accepted by the general public.

54 Charles M.Wiltse, ed., The Papers o f Daniel Webster, Correspondence (Hanover, NH: Darmouth College, 1976) v 4, 94.

55 Stephen Olin, letter to Thomas Sewall, Baltimore, Md, May 15, 1845. Condolences to the Rev. Thomas Sewall, Methodist minister, upon the death of his father, Dr. Thomas Sewall. Manuscript Collection, George Washington Library Special Collections.

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Sewall made his first public statement on temperance in his commencement

address to the medical students on March 22, 1827. In the absence of the president of the

college, Sewall spoke on his behalf as well as the medical school. He used the

opportunity to speak persuasively and unequivocally to advocate the temperance

message:

“[t]here is no subject, gentlemen, on which I would entreat you with more earnestness than upon this. It is a rock on which many of our profession have foundered, a whirlpool into which many of them have been drawn.”56

Sewall appealed to the students as equals. He observed that their profession in general

was at risk. Their elite status offered them no special protection from the danger of

intemperance. His use of the metaphor of the whirlpool indicates that he understood that

the force of drinking could take down someone against his will. Sewall had identified

progressive intemperance as a destructive force over which the victim, once he had

succumbed, had no control.

He emphasized the responsibilities that the students would be assuming, because

the profession “will place you in a commanding attitude, and give you an influence in

society far beyond the scene of your personal labors.” It would appear that Sewall

viewed his work as a physician with idealism and serious dedication. He next spoke of

the professional ethics of medicine, stating that even if he had to risk his career, he must

never resort to falsehood. At this point, one is reminded of his grave-robbing charge and

how he did not attempt to evade it, but accepted the consequences of his deeds. He

continued by saying that “the intelligent, honorable, and high-minded physician.. .needs

56 Thomas Sewall, A Charge Delivered to the Graduating Class of the Columbian College, D.C. at the Medical Commencement, March 22, 1827 (Washington, D.C: Duff Green, 1828), 9.

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not resort to falsehood to shelter him from the charge of error or the want of skill. He

desires not to augment the difficulty of his cases, or to enhance the importance of his

cures.” Furthermore, he observed that while it is “proper for the physician to encourage

the hopes of his patient and dissipate his fears” that it is never right to lie to a sick man.57

At the center of his remarks, he devoted the most time and energy in warning the

students of the dangers of alcohol, specifically naming ardent spirits. Sewall advised the

students to “observe strict temperance in the use of ardent spirit,” indicating that he was

advocating not moderation but complete avoidance. Further reading of the address

confirms his stance — he advocated complete abstinence, because of the danger

involved. He advised them to refuse the perennially offered glass as they made their calls

and engaged in social events.' After a while their patients and acquaintances would cease

to make offers and would accept their temperance stance. The tone of his remarks was

serious, pleading, and persuasive, as if he thought their very life depended upon it. He

spoke of the particular risk that physicians fall under—“the habits and the occupation of

ro the physician expose him peculiarly to the vice of intemperance.”

Despite his reference to the “vice of intemperance,” his tone was non

moralizing. Sewall appealed to reason. He outlined a list of reasons why they should

shun alcohol. Besides the danger to themselves, there was the danger to their patients.

So many people suffer from intemperance. If they, as physicians, take a temperance

position, they will be in a position to influence others. Sewall also noted that as

physicians they must always “preserve your minds in that unclouded state, which may

57 Ibid., 3-5.

58 Ibid., 9-10.

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render you equally able at all times to pronounce on the cases you may be called to

investigate.”59 This observation, like his entire temperance message, has the mark of

someone who speaks from experience. We do not know if his experience is personal or

professional, but the specificity and practical tone effectively conveys his message.

His remarks lack the tone of moral indignation and denunciation that is often

found in temperance literature. He was intent upon outlining to the students the course

that produces a drunkard, an insidious process that occurs slowly and imperceptibly.

Although Sewall did not use the term addiction,60 he described a condition consistent

with the modem terminology. There is no mention of moral failing, or a willful neglect

of propriety. SewalPs description had the same quality of clinical detachment, describing

the course of a disease, similar to what one finds in Benjamin Rush’s work61:

Recollect that no person ever became a drunkard at once. In almost every case the progress is slow and imperceptible, and probably no one ever felt the least apprehension of danger when he began to fall. But he advances by degrees, and at every step his path become more steep, and every day adds a new and a stronger link to the chain that binds him beyond the hope of deliverance.62

SewalPs message conveyed the concept of compulsive use. He described a process that

occurred over time, was unintended, and ultimately would become a trap. He

59 Ibid., 10.

60 The word addiction was a term infrequently used during this period. When used it usually meant “devoted to” in the sense of a pastime or hobby. The current definition of addiction, meaning an uncontrollable, compulsive process that takes over one’s life, was in the early stages of development during the nineteenth century. The Oxford English Dictionary, 2nd ed. (Oxford: Clarendon Press, 1989) v 1, 142- 143.

61For a citation of Rush’s Moral Thermometer, a sort of primitive progression chart of addiction, see W.J. Rorabaugh, The Alcoholic Republic (NY: Oxford U. Press, 1979), 44.

62 Sewall, 1827 Address, 9.

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emphasized the hopelessness of the process once it took hold. In Sewall’s view there was

no reversing the process or initiating a cure. For him, the drunkard who was in the vortex

of the “whirlpool,” there was no reversal, no ability to return to his former control. Yet

he did not condemn the drunkard. He disassociated the man from the resulting behavior.

His non-condemnatory tone is consistent with his view of chronic intemperance as a

health problem, not a moral failing. Even though he had not used the term addiction, he

described conditions associated with addiction, a destructive state, with a known cause

and course of development.

Sewall expressed his views forcefully and without qualification. We do not

know how his remarks were received, or if he in any way put himself at risk by

expressing his views. Presumably his position as the president of the medical school

gave him the ability to express his views fully. Yet we know that not all doctors agreed

with him. Temperance was still a minority view in the medical profession. As a

physician who occupied a prestigious and respected place in the medical community and

the community at large, he was insulated from any negative repercussions from his strong

temperance stance. Apparently, he also felt that he could point out the problems that

many of his profession had with their drinking habits.

At this point one wonders about Sewall’s personal conduct and practice. Did he

practice in his private life what he recommended publicly? Information about his

personal life is scant, but we do have some surviving letters that describe Sewall’s

Washington household and lifestyle. According to letters written by a close observer of

the family, in the 1840s intellectuals, scientists, and political leaders frequently gathered

at Sewall’s house. Among the visitors were the writer Sir Charles Lyell, the naturalist

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Audubon, the inventor of the telegraph Samuel Morse, senators, congressmen, and

judges. Dolley Madison attended at nearly age eighty, elegant in her turban. The letters

describe a brilliant, yet sedate, and decidedly sober company:

It was usual to receive company, especially gentlemen, in the afternoon and evening. Very frequently a dozen or more would assemble in our parlor. It was desirable not to interrupt the conversations going on amid the various groups. Therefore the servants would quietly pass their trays around with a cup of tea or coffee, and some light refreshment could be taken in the hand without hindrance to the flow of talk.. .Ah me! The delight of listening to such minds has left me hungry ever since.63

During this period Sewall needed someone to head his house, not as a

housekeeper or servant, but as a hostess and social equal. A distant relative, an elegant

elderly woman, came to fill that role. Sewall referred to her as “Aunt.” With Aunt

Sewall serving as hostess, SewalTs household participated in the Washington culture of

the salon, most likely not with the typical gaiety of the Washington society, but with

quiet dignity. Aunt Sewall was the grandmother of Margaret Cruickshank, the writer of

the letters. Cruikshank’s letters do not mention Sewall’s wife, Mary, only his son. This

raises questions about what happened to his wife. There is no evidence of a separation or

divorce. Perhaps she was ill, or perhaps she had to care for a sick family member. I

continue to search for information on Sewall’s wife, Mary Choate Sewall. She outlived

him and died in Rockville, Maryland, in 1855. It is not clear if his son, Thomas, lived

with him, as he would have been twenty-two in 1840. His son became a Methodist

minister in later years.64

63The letter is undated, but from the information given about Dolley Madison we can determine the period to be in the mid 1840s. Margaret E. Cruickshank, Two reminiscences relating to Dr. Sewall’s household in Washington, D.C., undated, Manuscript Material Collection, Library of Congress.

64 R. Webster, letter.

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Sewall’s relationship with his brother-in-law, Rufus Choate, seems to have been

cordial. Sewall had tutored Choate when he had boarded with the family in Ipswich.

Choate lived at Sewall’s house at some point during his congressional career, although

the period of his residence is not clear from his letters. Several surviving letters to Sewall

from Choate show an amicable relationship with Sewall, but a strained relation with his

sister in 1825, only a few years after her marriage to Sewall. There were persistent

rumors of Rufus’ drug addiction, but no proof.65

During this period Sewall remained interested in the alcohol question. In 1830,

two years after his temperance address to the medical school, Sewall gave a speech that

gives invaluable insight into the progression of his thinking about alcohol, a term he used

for the first time in a public setting. He addressed the Washington City Temperance

Society on the occasion of their first anniversary on November 15, 1830. In the text of

this speech, Sewall cited the harmful effects of intemperance on the morals, intellect, and

physical health of the drinker. In this respect, giving the three-fold analysis of the effects

of intemperance, Sewall echoed the treatises and teaching of Benjamin Rush more than

two decades earlier. Although Sewall did not attribute Rush’s influence, it is

unmistakable. But in this address Sewall added a new dimension to the indictment

against intemperance. He used new language and new concepts for the physical effects.66

For the first time, at least publicly, in this speech Sewall used the term alcohol

as he described the physiological effects of drinking. He was able to identify the

65 Letters from Rufus Choate (1799-1859) to Thomas Sewall, Darmouth Manuscript Collection. Choate’s biographer Samuel Brown denied the rumors of his addiction to opium. Samuel Brown, The Works o f Rufus Choate, with a Memoir o f His Life (Boston: Little, Brown & Co., 1862), v 1, 314.

66 Tho. Sewall, An Address, etc.

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“alcoholic principle,” in referring to the composition of not only “ardent spirit” but also

fermented drinks, specifically citing wines. Sewall now comprehended that the chemical

component, alcohol, was the same in intoxicating drinks, both distilled and fermented.

He quoted the experiments of the “celebrated French Physiologist, Magendie” in

demonstrating the physical presence of alcohol in the body: “He [Franqois Magendie]

ascertained that diluted alcohol, a solution of camphor, and some other odorous

substances, when subjected to the absorbing power of the veins, are taken up by them,

and after mingling with the blood, pass off by the pulmonary exhalants.”67 Sewall also

referred to a study by Dr. Nish, an obscure reference, at least to current historians of

medicine and temperance, that demonstrates that “[t]he perspirable matter which passes

off from the skin becomes charged with the odour of alcohol in the drunkard, and is so far

changed in some cases as to furnish evidence of the kind of spirit drank.. .1 have met with

two instances, says Dr. Nish, the one in a claret, and the other in a port drinker, in which

the moisture that exhaled from their bodies, had a ruddy complexion, similar to the wine

on which they had committed their debauch.”68 Nish’s experiments lacked scientific

rigor and his results, if Sewall had attempted to replicate them, would have failed

scrutiny, yet the idea of the physical component of alcohol and its effects represented a

significant change. This new view represented the first rumblings of a Kuhnian paradigm

shift in scientific thinking regarding alcohol. Sewall, along with other scientists, had

identified alcohol as an identifiable substance with specific chemical effects.

67 Ibid., 8.

68 Ibid., 8.

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Sewall continued his remarks to the assembled members of the temperance

society, launching into a full-scale, detailed account of the effects of alcohol upon every

part and organ of the body. Again, his descriptions are reminiscent of Dr. Rush, but

much more detailed and based upon autopsy reports. He observed, “The whole system

soon bears marks of debility and decay,” and proceeded to describe his observations of

the muscles, joints, complexion, eyes, nose, etc. and the general “bloating” of the body.

As if he were lecturing to medical students, Sewall gave extensive detail of autopsy

findings of “inebriates” on the stomach, liver, pancreas, spleen, brain, heart, and lungs.

For example, he noted “morbid changes in the liver.. .schrivelled, indurated” and cited

the “chronic inflammation of the brain.” He cited a case from the streets of London

where a man died after drinking a quantity of gin. When his body was dissected at the

Westminster Hospital, the ventricles of his brain reportedly contained alcohol.69

In his presentation to the Temperance Society, Sewall described the effects of

alcohol upon the stomach. He cited the cases of drunkards, giving detailed physical

findings. He held forth at length, describing in explicit detail the color, condition, and

physical appearance of the stomach and other affected organs. The graphic nature of his

descriptions was consistent with actual dissection. At the end of his lengthy description,

Sewall removed all doubt about his activities. He said, “I have never dissected the

stomach of a drunkard, in which the organ did not manifest some remarkable deviation

from its healthy condition.”70 It is now obvious what he had been doing in his dissecting

69 Ibid., 11-12.

70 Ibid., 10.

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lab on the top floor of the medical school. He had been conducting autopsies on expired

drunkards. He had been studying the physical effects of alcohol on the human body.

Sewall was not an elitist in his temperance stance. In his 1830 address Sewall

declared that intemperance affected “every class of society” equally— the rich and the

poor, the educated and the uneducated, those from “the cottage and the palace.”

Intemperance “stalked within the very walls of our Capitol,” and has “dragged down” its

victims from the clergy. We know from his previous address that he regarded physicians

to be particularly at risk. No profession, either high or low was spared. Yet he obviously

missed one crucial component of society, women. Apparently Sewall did not perceive

that women could develop the condition of intemperance. All of his vocabulary refers to

“men” and uses the masculine pronouns. One explanation might be offered that he used

the generic masculine case to refer to all people, meaning both men and women.

However, Sewall negates this explanation by his next statement. He calls upon “the

female sex of our country” to join the fight against alcohol: “mothers, wives, and

daughters.. .1 invoke your aid.”71 It is also possible that Sewall did indeed know of cases

of women inebriates, but his nineteenth-century sense of chivalry and propriety prevented

his identifying them.

Also in this address Sewall opposed the medical profession’s prevailing view

that alcohol served as a beneficial medicine. He decried the medicinal use of what he

regarded as poison and as worse than useless in treating illness. According to Sewall, it

was bad enough that quacks and charlatans used alcohol as treatment, but it was even

71 Ibid., 23.

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more offensive that regular doctors should prescribe it. He lamented, “[t]his opinion has

slain its thousands and its tens of thousands, and multitudes of dram-drinkers daily shelter

themselves under its delusive mask.” 79

SewalPs address to the City Temperance Society received wide distribution.

The American Temperance Society printed the entire address and circulated it through

the American Tract Society. The Journal o f Humanity, a popular temperance journal,

also made the address available to its readership for free and to others for a modest cost.

According to the March 1831 issue of the Journal o f Humanity, “[w]e are glad to learn

that this valuable Address [Thomas Sewall’s address to the City Temperance Society] has

been stereotyped by the American Tract Society. It may now be procured, in any

quantity, at about two cents a copy.” An edition of 10,000 copies was made immediately

available without charge to Journal subscribers.73

Sewall moved to a new level of public visibility in 1833 when he addressed the

first official meeting of the Congressional Temperance Society. The U.S. Congress had

held a preliminary meeting in the spring of 1832 to consider forming such a society.

Several members of Congress enthusiastically supported forming the Congressional

Temperance Society. At the preliminary meeting the Democratic-controlled Congress

had heard an address by the Reverend Justin Edwards on the evils of ardent spirits. Even

though Edwards was an old-style Federalist, his temperance message received bi-partisan

support Lewis Cass, Secretary of War under the Democratic presidential administration,

72 Ibid., 20.

73 Journal of Humanity and Herald of the American Temperance Society, March 3, 1831 (Andover, Mass: Flagg & Gould, printers, 1831) vol. 2, no. 93, 161 -163.

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supported forming a society. Cass himself was a total abstainer from alcohol. Later that

year, in November, he ordered eliminating the army’s liquor ration and replaced it with

coffee and sugar. A number of congressmen were eager to join the temperance effort,

including Senators Frelinghuysen of New Jersey, Senator Felix Grundy of Tennessee,

and even Sewall’s friend Senator Daniel Webster, not known for his opposition to liquor.

In fact, Senator Webster even offered a resolution endorsing the new society, but his

support for temperance would later diminish.74

Thus, in February 1833 the Congressional Temperance Society was officially

established, with its stated purpose “[b]y example and kind moral influence to

discountenance the use of ardent spirits and traffic in it.” Perhaps many joined not from

personal conviction, but for political reasons. The members came from both parties,

slightly more Whig than Democrat, and from all sections of the country, but with a

disproportionate number from New England and the Middle Atlantic states. This was the

powerful and influential group who heard Sewall’s lecture.75

Sewall presented his findings from his autopsies to the Congressional

Temperance Society, as he had three years earlier at the City Temperance meeting. He

also gave the same anti-alcohol message that he had previously presented. He warned of

the progressive nature of the physical and mental effects of alcohol on the habitual

drinker. But at the Congressional meeting he had additional, more compelling evidence.

In addition to his description of his findings and his medical views on the subject of

alcohol, he had visual aids. He presented a series of illustrations of his stomach

74 Webster’s letters show him not friendly to temperance in 1843 , Correspondence, v5, 310.

75 Krout, 138 -37; Furnas, 57; Lender and Martin, 73 - 74; Pegram, 22 -23; 32.

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dissections. The colored plates were drawn to show the appearance of the stomach in

autopsies that he had conducted. Drawn from specimens from the dissecting lab, the

illustrations were accurate and realistic. They showed the anatomical detail of the

subjects and included the dissecting instruments. Intended to demonstrate the

progression of the effects of alcohol, the dissected stomachs came from abstainers,

moderate drinkers, and drunkards.76

Sewall presented lectures and evidence as compellingly as possible, hoping that

they would serve as sobering evidence of the seriousness of his message. His temperance

message was substantively different from that of other temperance advocates. His

message was based not upon the evils of the vice of drinking or the sinful nature of the

drinker. Sewall confronted a health problem, one based upon a specific substance that

had specific consequences for physical and mental health. He viewed intemperance from

a new perspective and he presented new information indicating the addictive,

progressively harmful effects of the substance alcohol.77

Whether or not his message was effective in changing attitudes about alcohol is

debatable, but his lectures and drawings received wide circulation. Sewall’s stomach

drawings were later published by Edward Delavan of Albany, New York, a retired

businessman and temperance promoter. He published about 150,000 of the diagrams, in

76 The illustrations consisted of a set of six dissected stomachs: 1) “Healthful,” 2)”Moderate Drinking,” 3) “Drunkards,” 4) “Ulcerous,” 5) “After a long debauch,” and 6) “Death by Delerium [sic] Tremens.” The drawings showed the progressive deterioration of the stomach from pale and smooth to heavily veined, mottled, and finally dark and tumorous. Sewall regarded the progressive stomach pathology to be only one indication of the increasing damage done by alcohol. Kobler, 103.

77 In addition to the Krout, Furnas, Lender and Martin, etc. reference, see Kobler, Ardent Spirits, 103. For an example of the condemnatory, evangelical temperance argument, see the six sermons from 1826 of Lyman Beecher, “Drunkenness is a sin which excludes from Heaven.” Kobler, 54.

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color. He planned to place the diagrams as educational aids in New York schools.

Sewall’s works were published in Europe in 1840s, and translated into German. 191

Sewall disliked the pseudo-science of phrenology. He publicly opposed Dr.

Charles Caldwell and the phrenology theory in lectures and a published essay in 1837.

Sewall was outspoken against phrenology, saying the theory was inaccurate and not

based on scientific observation. He said that trying to understand the human mind by

looking at the skull was like trying to judge a jewel by its case.79 One gets the distinct

impression that had Sewall not been so busy dissecting stomachs, he would have liked to

dissect brains Perhaps he did so, but did not publish the results.

Sewall died in 1845 at age fifty-nine after attending the funeral and burial of his

friend Senator Bates of Massachusetts. It was a cold, raw day in March at the

Congressional Cemetery where Bates was buried. Sewall died three weeks later of a lung

infection.80 The faculty of the Columbia Medical Department wore black arm bands for

the next thirty days to show their grief for the loss of their leader.81

Sewall was a scientist first and foremost. His temperance views, although

strongly held, seemed always to be subjugated to his scientific method. His fascination

with the chemical effects of alcohol upon the mind and body led him to conduct

experiments to further explore the process. He became convinced that alcohol posed a

serious health risk to the drinker. He considered the physiological effects caused by

78 Kobler, 103; Lender and Martin, 110.

79 Thomas Sewall, An examination of phrenology; in two lectures, delivered to the students of the Columbian College, District of Columbia, February, 1837 (Washington, D.C: B. Homans, printer, 1837).

80 Margaret Cruickshank, undated letter, Library of Congress Manuscript Division.

81 Minutes of the Columbia Medical Department Board, 1845, George Washington Archives.

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alcohol as well as the behavioral effects upon the individual drinker. He found that once

the intemperate process took hold of the drinker, the force, “ a whirlpool,” would become

irresistible. The process advanced “by degrees” and destroyed health, careers, and lives.

Although he did not use the term addiction, he described certain phenomena consistent

with addiction. We do not know which cases he had in mind — they may have been

patients, colleagues, relatives, or friends— but we can be sure that he referred to specific

and compelling evidence. Dr. Sewall made a habit of drawing his conclusions from

evidence.

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REUBEN MUSSEY, PIONEERING SURGEON

AND ARDENT TEMPERANCE ADVOCATE

On a day late in the spring term of 1809, a young student of medicine sat

submerged in a bath of madder, a strong chemical dye. Three pounds of madder,

rubia tinctorum, dissolved in water covered most of his body, including his arms and

legs. Although the experiment posed a potential danger to his health, he was

undeterred in his objective. The student was Reuben Mussey, conducting research for

his medical degree from the University of Pennsylvania Medical School. He would

later become one of the foremost physicians of his time, famous for his experimental

surgical techniques. He would also turn his scientific interest to the effect of alcohol

upon the body and gain a reputation in the temperance cause as one of its foremost

advocates, as had his medical professor Benjamin Rush. But unlike Rush, Mussey

would move the investigation of the temperance issue to a more exacting level of

scientific inquiry and away from earlier attitudes about the nature of the intemperate

drinker.

Mussey remained immersed in the madder solution for almost three hours.

He was willing to risk damage to his health, or at the very least, his appearance, in

order to prove the absorptive nature of the skin. He thought that madder seemed a

good choice because it would certainly stain his skin and if his experiment succeeded,

130

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it would also change the color of his urine.1 It was almost incidental that his

experiment would fulfill the graduation requirement for a medical thesis from the

Pennsylvania Medical College. Others had graduated with a thesis far less rigorous,

and without conducting laboratory experiments. Moreover, he already had a medical

degree from Dartmouth College. Obviously he had greater aspirations than the

ordinary medical student.

The young doctor, Reuben Dimond Mussey (1780-1866), already exhibited

traits that would lead him to contribute to advances in surgery and medicine, as well

as in his other interest, the temperance cause. During his career he pioneered

numerous surgical advances, among them, advances in cancer surgery, orthopedics,

and urological procedures. He promoted the early use of anesthesia, using ether and

chloroform as soon as they became available in the 1840s.2 While still developing his

medical career, he became a champion of the temperance cause, advancing theories of

the addictive powers of alcohol, and applying methods of experimental science to the

substance alcohol. Like his colleague Thomas Sewall, he would bring his spirit of

disciplined medical inquiry to advance the temperance cause. He became, as did

Sewall, a persuasive advocate for temperance, drawing upon his scientific orientation

and clinical skills. By the midpoint of his life and career he had helped to define a

new concept regarding alcohol abuse and its effects, using the new language and

'Reuben D. Mussey, “Experiments and Observations on Cutaneous Absorption,”The Philadelphia Medical and Physical Journal v 3 (Aug 1808): 288-302; “Biographical Sketch of R.D. Mussey, M.D.,”Western Lancet 17 (1856): 309-310.

2 His professional peers considered him to be a “great surgeon.” John B. Hamilton, M.D., “Life and Times o f Doctor Reuben D. Mussey,” The Journal of the American Medical Association 26, no. 14 (April 4, 1896): 649-652.

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conceptual approach of the temperance physicians. Both endeavors, surgery and

temperance, would require determination and a willingness to take risk, traits that

Mussey exhibited in abundance.

Mussey’s experiment with the chemical bath demonstrated determination,

courage, and a willingness to challenge authority. He emerged from the chemical

bath and was pleased to note that the madder had indeed stained his skin.

Furthermore, for the next two days his urine was turned bright red. As soon as he

saw the color of his urine, he knew his experiment had worked. He had intended to

prove his hypothesis of cutaneous absorption, contrary to the commonly held theory

of non-absorption through the skin. All his professors at the medical school in

Philadelphia, even the highly exalted Benjamin Rush, taught the accepted theory of

non-absorption.3 By disproving the conventional theory, Mussey had added to

scientific knowledge, and also helped to make a name for himself as an original

thinker. In the course of his life and work he would often prove the old guard wrong,

rejecting ideas based upon tradition rather than rigorous scientific research. He

sought out new ideas and looked for cause and effect in medical science. Even in this

experiment from his early career, he predicated his findings on evidence-based

research, writing that “our opinions should be fixed by experiment alone.”4

Despite the dramatic results of young Mussey’s experiment on absorption,

not all the medical community in Philadelphia accepted his new theory. Mussey

3 Western Lancet, 309-310; Reuben D. Mussey, Experiments and Observations on Cutaneous Absorption (T&G Palmer: Philadelphia, 1809).

4 Mussey, Cutaneous Absorption, 289.

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repeated his experiment with a solution of rhubarb, showing that rhubarb, like

madder, was undeniably detected in the urine. He repeated his experiment with

additional substances: indigo, amotto, redwood, and other potentially toxic

substances, including nutgall, a component of ink. Nutgall had a highly astringent

effect that proved to be especially dangerous. Mussey soaked for three hours in a

nutgall solution, followed by three hours in a solution of sulphate of iron. On

emerging from the six hours’ immersion, no ink was found in the urine. Intent on

showing internal effect, Mussey opened a vein, but found that his blood would not

easily flow. His blood had almost coagulated. He fainted, probably as a result of

lowered blood circulation and decreased blood pressure. It took days for him to

recover from the harmful effects of the nutgall experiment.5

At the Pennsylvania medical school, proponents of the conventional theory

of non-absorption opposed Mussey’s experimental findings. These students, whose

identities have long since been obscured, defended the theories they had learned from

their professors, among them Benjamin Rush and Chapman. They pronounced that

Mussey’s experiments were flawed, that the substances had entered the body through

“other bodily outlets” and not through the skin. They then attempted to disprove

Mussey’s findings by plastering up the “bodily outlets,” an indignity for the

participants, who cooperated for the sake of medical science. After the plastering

preparations, the participants soaked first in the madder solution and then in the

rhubarb solution. Despite their precautions, madder and rhubarb were still detectable

in the urine. Discounting the evidence, the traditionalists concluded that madder and

5 Western Lancet, 310-311.

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rhubarb were unusually “penetrating” and continued to reject Mussey’s theory of skin

absorption. It was left to Mussey’s friend and brother-in-law, Thomas Sewall, to

definitively prove the absorptive nature of human skin.6 Sewall conducted an

experiment from his home and office in Ipswich, Massachusetts. He immersed his

hand and wrist for periods of eight hours in a madder bath. No orifice of his body

was exposed to the dye, yet plenty of madder was found in the urine.7

This account from the early career of Reuben Mussey gives an insight into

the changing world of medical science and education of the period. The tenacity of

the proponents of traditional theory illustrates the -transitional state of medicine, the

tug-of-war between the old accepted ways and the new laboratory science. The

traditionalists adhered to outdated theory in the face of compelling laboratory

evidence to the contrary. But increasingly and relentlessly, many long-held theories

of medicine conflicted with experiments conducted in laboratories using more

rigorous scientific method. Eventually, evidence-based science would become the

norm, but in the early nineteenth century scientists like Mussey regularly made new

discoveries and just as often encountered resistance.

The account also gives insight into Mussey’s personality and motivation.

Although a young man at the start of his career, the incident foreshadows the

determined surgeon he would become, respected for his daring and skill. Mussey

appreciated the value of tradition and education, as demonstrated in his pursuit of

6 Mussey married Mary Sewall, Thomas Sewall’s sister, in 1805 when he was twenty-five. They lived in Ipswich, Massachusetts. Mary died, possibly from tuberculosis, several years later in May 1807. She was twenty-four years old. They had no children. Henry Thomas Sewall,Thomas Sewall; some of his Ancestors and all of his Descendants: A Genealogy (Gardiner, Maine, 1904), 4.

7 Western Lancet, 311.

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formal medical credentials. Yet he was willing to subject accepted beliefs to

experimental methods and seemed even eager to counter accepted theories in the

medical profession. Consistent with his visionary and risk-taking persona, Mussey

recognized the value of the discovery of anesthesia soon after its discovery and

helped to spread its use. He successfully performed surgeries never before attempted,

among them the removal of an osteo-sarcoma (cancerous tumor) of the shoulder blade

o and collarbone.

Mussey made similar, path-breaking contributions in the field of alcohol and

other substance abuse. His scientific approach in studying alcohol was two-fold: first,

he considered the physical effects of the substance alcohol and secondly, he studied

its potentially addictive effects upon the drinker. As he developed in his medical

career, he promoted new ideas about the nature of alcohol, both as a substance and

also in its effects upon the human body. As he became convinced of the harmful

effects of alcohol upon the drinker, both the physical and mental effects, he became a

vocal advocate for the temperance cause. He employed his scientific research

abilities to examine the progressively damaging effects of alcohol use. Ultimately he

advocated total abstinence from all forms of alcohol, even opposing the medicinal use

of alcohol prevalent during his era. Although many physicians joined temperance

societies, in the nineteenth century the medical profession as a whole did not endorse

temperance. On the contrary, the medical profession approved of moderate use of

* American Journal o f Medical Science 21 (Philadelphia, 1837): 390-94.

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alcohol and employed alcohol as a medicine.9 How did Mussey come to adopt these

new ideas about alcohol and intemperance, opposing conventional attitudes?

For insight into the development of Mussey’s ideas on alcohol and

temperance, we turn to some relevant features of his life and writings. One could not

predict from his early life as the child of a poor country physician in rural Pelham,

New Hampshire, that Reuben Mussey would grow up to make major contributions in

medicine. But an alternate way of considering his background is that his early

formation in a hard-working, simple family contributed to his work ethic and his

practical orientation toward solving problems. Despite their limited financial

resources, John and Beulah Mussey supported their son by moving to Amherst so he

could attend the district school during winters. Although John Mussey had not

attended medical school and practiced medicine without formal medical education, he

knew Latin well enough to teach his son Latin at home. At age fifteen, equipped with

his home education, Mussey entered the academy in Amherst. He continued to work

to help pay his educational expenses throughout college and medical school, working

as a hired hand on a farm in summers and also teaching school from age sixteen in

Peterborough, New Hampshire.10

9 For a general discussion of the medical profession’s view of temperance and alcohol, see Chapter Three, “The Transitional State of American Medicine.”

10 General biographical data on Reuben D. Mussey (1780-1866) derived from the following sources: “Reuben Dimond Mussey,”National Cyclopedia of American Biography 9 (New York 1899): 91-92; Olive Hoogenboom, “Reuben Dimond Mussey,”American National Biography 16 (New York: Oxford Press 1999): 190-191; “Reuben Dimond Mussey,”Dictionary of American Biography 13 (New York 1934): 372-73.

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At the age of twenty-one Mussey entered the junior class at Dartmouth.

Two years later he graduated in the upper academic level of his class. He continued

his study and practice of medicine as an apprentice with Nathan Smith, a highly

respected doctor and founder of the Dartmouth Medical School. Mussey studied

under Dr. Smith except for summers when teaching at Petersborough. While there he

studied under Dr. Howe of Jaffrey, New Hampshire. After fours years of intermittent

study under Smith at Dartmouth, in August 1805 he received the degree of Bachelor

of Medicine from Dartmouth Medical School. As part of his graduation requirement

he defended a thesis on dysentery. Immediately after graduation from Dartmouth

Medical School, Mussey began his practice in Ipswich (or Essex), Massachusetts.

Also in that year he married Mary Sewall, sister of his colleague Thomas Sewall, who

also was practicing in Ipswich.11 Mary died three years later, probably as a result of

tuberculosis, a disease she had contracted earlier in life.12 After her death, Mussey

enrolled in classes at the medical college of the University of Pennsylvania in

Philadelphia. He left his Ipswich practice in the capable hands of his friend and

brother-in-law, Sewall. While studying medicine at the University of Pennsylvania,

Mussey conducted his bold experiments proving the absorptive nature of skin. After

studying in Philadelphia for nine months, Mussey earned his second medical degree

11 Mussey and his wife were members of the Congregational Church in Ipswich, according to the church records for 1806. The US GenWeb Project, www.rootsweb.com. Congregational Church Members, 1681-1937, p. 2-4, accessed May 1, 2003.

12 In 1813, six years after the death of Mary, Mussey married Mehitable “Hetty” Osgood, the daughter of Dr. Joseph Osgood, an army surgeon in Salem, Mass. National Cyclopedia, 92.

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in 1809. Despite initial resistance to Mussey’s work, the medical school accepted his 1 ^ thesis on skin absorption as fulfilling one of the requirements for the M.D.

While still a young man, Mussey adopted personally temperate habits. He

decided to go against the common practice of drinking ardent spirits. Apparently he

tried drinking and decided to give it up for a sober life-style. According to Crosby, he

gave up ardent spirits while still a college student:

Even in his college days he abandoned, after a brief trial, the practice, then so universal as to have required all a young man’s courage in its breach, of keeping ardent spirit to counteract the bad effect of water upon himself and friends. Ever since he had a wonderful power of conforming his life to his convictions, however strenuous, and, as it seems now in looking back, a more liberal growth of conviction late in life.. .He was ready.. .to receive new truths, and if they called for action, to act upon them, even to the alteration of fixed habits.14

Mussey’s study at the medical college in Philadelphia exposed him to the

teaching of Benjamin Rush, who was in his final years there before his death.

Although there are no extant lectures notes or personal notes of Mussey to confirm

specifically his medical educational experiences in Philadelphia, we do know that in

1809 Rush’s influence was at its zenith. No doubt Mussey encountered Rush’s

teaching and thinking on “ardent spirits” and his temperance views. We can surmise

that at an early stage in his career he would have at least been impressed with the

significance of the burgeoning alcohol issue. Rush expressed his views on

intemperance in both moral and physical terms, closely relating the two. Rush had by

1809 published numerous statements and treatises on intemperance, campaigning

13 Western Lancet, 310; Hoogenboom, 190.

14 A. B. Crosby, “Eulogy on Reuben Dimond Mussey, M.D.” inThe Transaction o f the New- Hampshire Medical Society, Concord, New Hampshire, 1869, 75.

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against “ardent spirits” and the moral failings that intemperance caused. Rush’s

moral and physical thermometer promoted the idea of the progressive nature of the

downward decline of the drinker. Because it was a crude and not especially scientific

approach, Rush’s theory of intemperance may not have resonated with Mussey’s

more rational approach. Since Mussey had already challenged the traditional

teachings of Pennsylvania medical professors in his experiments upon cutaneous

absorption, there is reason to assume that he would have subjected Rush’s teachings

on intemperance to the same scrutiny. Nevertheless, the notion of the danger of

intemperance had been introduced to Mussey at an impressionable age in his medical

career.

At his first clinical position after his graduation from Pennsylvania, Mussey

again encountered the alcohol issue. His early medical practice led him to the turf of

one of the first organized temperance societies, the Massachusetts Society for the

Suppression of Intemperance, or the MSSI. Immediately upon graduation, Mussey

had joined the practice of Daniel Oliver in Salem, Massachusetts. For next five years

the practice grew as Mussey rapidly gained a reputation as an expert surgeon.15

During his time in Salem, Mussey was associated with the Massachusetts Society for

the Suppression of Intemperance. Organized in Boston in 1813, the MSSI was one of

the earliest temperance societies, and the first statewide temperance society in the

nation. According to Robert Hampel, the leading authority on the MSSI, the

members of the organization came from the Boston elite. They were men of

15 Additionally, Mussey gave courses of lectures on chemistry in Salem, the specific content of which is not extant. Hoogenboom, 190.

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established position, mostly ministers, merchants, and lawyers. Almost all were

Federalists, and from a traditional religious background, predominantly

Congregational and Unitarians. By 1815 a number of Massachusetts towns had

organized auxiliary societies of the MSSI. The membership requirement for local

MSSI societies was not as exclusive as for the central organization in Boston.16

Mussey had joined the MSSI at least by 1818, and perhaps even several

i ' i years earlier. A reputable secondary source reports that he joined the MSSI as a

founding member in 1813. If such is the case, he joined the MSSI during his years in

Salem, most likely not as a charter member of the central Boston committee, but as a

1 ft member of an auxiliary committee. As a relatively new doctor in practice, Mussey

could have enrolled in the local MSSI society, where the members came from less

exalted social positions than the Boston elite. Although Mussey came from a simple

farm family background, his status as an educated physician would have made him a

welcome member of the MSSI.

Regardless of when he joined the MSSI, the organization most likely

received Mussey as they did other physician members, because of the medical

legitimacy that doctors could bring to the temperance cause. The MSSI employed the

16 Robert L. Hampel, Temperance and Prohibition in Massachusetts, 1813-1852. (Ann Arbor, Michigan: UMI Research Press, 1982), 12-24.

17 The MSSI annual report for 1818 listed Reuben Mussey as a member. Massachusetts Society for the Suppression of Intemperance, Constitution of the Massachusetts Society for the Suppression of Intemperance, as revised and altered together with their annual report for the year 1818, and a list of the officers and members of said Society (Boston: Sewell Phelps, 1818), 28.

18 According to John Krout, Mussey helped to organize the MSSI, but as his name is not listed among the Boston founders, he most likely helped to organize an auxiliary society. John Allen Krout, The Origins o f Prohibition (New York: Russell & Russell, 1967), 146, note 56.

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rhetoric of morality and religion, entreating drunkards to repent of their drunkenness.

Despite their moral rhetoric, the organization welcomed the scientific endorsement

that the medical community conferred on the society. The MSSI never did set up a

means of distributing its message on a mass scale through publishing sermons,

addresses, or by other means, as did later temperance agencies. They relied mostly

on exerting their authority upon local workers and others over whom they could

exercise control. They turned to town officials to enforce liquor licensing laws and

laws against drunkenness.19 In the absence of mass distribution of the MSSI

message, it is unlikely that the rational message of physicians reached many through

the agency of the MSSI. Their message of rationality would reach only a limited

audience at that time.

Mussey’s membership in the MSSI did not necessarily mean that at that

time he adopted strict anti-alcohol ideas, but most likely he had a more committed

opposition to alcohol usage than the average member. The MSSI took an indefinite

stance on what constituted temperance. The MSSI mission statement opposed

excessive drinking, but did not address the issue of wines and fermented drinks.

Members were not required to practice abstinence. Taking a moralistic view of the

temperance question, the MSSI combined it with other moral issues of Sabbath-

breaking, smoking, and profanity. The MSSI described intemperance and

drunkenness in terms of “vice” and “evil.” They pronounced that if their views were

19 Hampel, 17-21.

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followed “much individual evil would be prevented.” They congratulated themselves

that their society “has contributed in some degree to diminish these evils.” 90

The MSSI gave the message that the habits of the working class needed

oversight by a presumably sober elite. The whiff of self-righteousness and

condescension was all too apparent and almost certainly contributed to the limited

success and eventual dissolution of the MSSI. 91 Although the MSSI decried

excessive drinking by the working class and the poor, the organization did not look

too closely at the drinking habits of their own members. They often served wine at

their meetings, unconcerned with the apparent inconsistency. Their own members

were assumed to be exempt from any intemperance and were free to continue their

drinking habits, protected by their status in society. With an appalling lack of critical

self-insight, the MSSI opposed the “ardent spirits,” of the poor but perceived no

difficulty with its members drinking Madeira and other expensive wines. 99

Mussey’s views, as he expressed them later in his life, went far beyond the

MSSI’s ambivalent attitude toward drinking. Regarding his personal drinking habits,

it is difficult to pinpoint the exact time at which Mussey decided to become an

abstainer. He eventually endorsed total abstinence from all alcohol, including all

fermented drinks. As previously indicated, there is strong evidence that even as a

20 MSSI, Annual Report, 1818,16.

21 Robert L. Hampel, “Massachusetts Society for the Suppression of Intemperance (MSSI),” Alcohol and Temperance in Modern History, An International Encyclopedia, v. 2 (Santa Barbara, Cal 2003): 401-402.

22 Robert L. Hampel, Temperance and Prohibition in Massachusetts, 1813-1852 (Ann Arbor: UMI Press, 1982), 12-22.

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young man he had decided to reject “ardent spirit.” 99 At least by the late 1820s, when

he reached middle age, he had became a total abstainer and recommended that others

do the same. Although there is limited information regarding his membership or

activities at this stage of his life, it is at the very least possible to confirm an early

commitment to the temperance cause. Based upon his ensuing temperance activities

and reputation at Dartmouth, it is also reasonable to assume that he had a more

serious motivation than did the general MSSI membership.

Mussey differed from the MSSI membership in more than his eventual

temperance attitude and commitment. Coming from a humble social background, he

certainly differed in social status from the elite members of the organization. He was

not one of the “gold headed-cane” elite, as the MSSI membership is typically

characterized.24 At best he was rising in social status, and would eventually arrive at

his social position not by birth, but by talent and hard work. Although he had not yet

arrived at that exalted position, Mussey had certainly begun his ascent in social and

professional standing. In 1814, after five years of successful practice, he left Salem 9 ^ with his new wife, to take the position as professor of medicine at Dartmouth

Medical School. According to the Sixth Annual report of the MSSI in 1818, Mussey

joined the MSSI, listed in the Boston membership, and with Dartmouth given as his

residence. At Dartmouth, Mussey succeeded his old preceptor, Nathan Smith, under

whom he had studied at Dartmouth only ten years before. In time, he would surpass

23 Crosby, “Eulogy,” 75.

24 J.C. Furnas, The Life and Times of the Late Demon Rum (New York: Putnam’s Sons, 1965), 51. 25 See note 12.

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his teacher in ability and national reputation. At Dartmouth he taught Materia Medica

(drugs or pharmacology) and the Theory and Practice of Physics (the theory and

practice of medicine), holding these professorships until 1820. During his tenure at 9f\ Dartmouth he also served as a professor of chemistry.

Mussey’s medical career and his temperance views are closely intertwined.

As one examines Mussey’s views and participation in the temperance movement, it is

essential therefore to describe his developing medical career. The temperance

physicians made a unique contribution to the temperance movement, most likely

because their training and orientation as physicians gave them a different view of the

drink question than that of the general temperance movement. Mussey’s views of

alcohol and intemperance are closely related to his experimental approaches in

medicine. His scientific experiments sought the cause and effect link, based upon

careful and rigorous experimental methods. A consideration of his medical

accomplishments provides insight into his methodology in approaching the subject of

temperance and alcohol. With that goal in mind, we consider some highlights of

Mussey’s developing medical career.

While at Dartmouth, Mussey’s reputation and skill as a surgeon continued to

grow. In 1820 he was additionally appointed Professor of Anatomy and Surgery at

Dartmouth, giving two daily lectures to medical students during the term. In addition

to his other appointments, he served as professor of obstetrics from 1814 until 1838.

Throughout his life, he was in demand as a surgical innovator and authority at a

number of medical institutions. In addition to his teaching at Dartmouth, he gave

26 Hamilton, 650.

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lectures at a number of medical schools, for example lecturing at Middlebury College

in Vermont in 1817. From 1831 to 1835 he was called to lecture at Bowdoin, the

Medical School of Maine, on anatomy and surgery.

As Mussey continued to develop his skill and reputation in anatomy and

surgery, he made an extended visit to European hospitals in 1829 and 1830. For ten

months Mussey visited distinguished physicians in Paris and London. As discussed

in the previous chapter on medical background, London and Paris were centers of

experimental medicine and medical advances at this time. As such, they exerted

considerable influence upon American medicine. Mussey, however, did not go as a

suppliant. He had developed new surgical techniques that he was anxious to share

with the European experts. While in London he took a patient specimen to Sir Ashley

Cooper, the famous English surgeon. Mussey demonstrated that, contrary to what

was conventionally thought, bones could heal after intracapsular surgery for a fracture

of the neck of the thighbone. Mussey brought with him the healed specimen from a

deceased patient that he had operated upon (the patient had subsequently died of other

causes). Complaisant in his exalted position, Cooper refused to accept Mussey’s

compelling evidence. Cooper examined the specimen and declared that there had

never been a fracture, rejecting Mussey’s evidence. Yet future medical advances

would bear out that Mussey had indeed developed a new procedure that could heal a

condition previously believed hopeless.28

27 Western Lancet, 312.

28 Western Lancet, 313; These specimens are now housed in the Museum of the Cincinnati General Hospital. Dictionary of Am.Bio, 373.

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During his long career, Mussey developed a number of pioneering surgical

techniques in obstetrics, urinary tract surgery, cancer surgery, and orthopedics. He

was one of the first to use ether and chloroform as anesthesia. According to

Hamilton, Mussey “was a factor in the speedy popularization of the greatest

discovery in its relations to practical surgery, of any in all antecedent history, namely,

that of anesthesia.” He was known for his modesty and reluctance to operate,

except when otherwise unavoidable. Once a decision was made to operate, he was

fearless. He made great contributions to the surgical field, often experiencing

entrenched opposition, as in the case of his encounter with the famous London

surgeon.

As Mussey grew and developed in his career, he began to make equally

significant contributions in the field of temperance. While at Dartmouth, Mussey

helped to found a temperance society for Dartmouth students in 1828. Krout notes

that Mussey, with his national reputation for temperance advocacy, greatly

encouraged the temperance efforts of the young Dartmouth men.30 No further

specific information is available on the Dartmouth temperance society beyond the

fact of Mussey’s founding role. Mussey’s only recorded address to the students,

given in 1818, made no specific mention of temperance, but does give insight into his

opinion of the ideal medical student and doctor. He emphasized the need to pay

attention to new scientific discoveries:

29 Hamilton, “Mussey,” 649-50.

30 Krout notes that Mussey, as a nationally known temperance supporter, encouraged the “earnest efforts o f the young men” o f the Dartmouth campus. Krout, 146.

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.. .we should avail ourselves from year to year, of the progress the science is making among our neighbors and abroad.. .From the discoveries, improvements and suggestions contained in Journals, and the record they exhibit of the progress of medicine in different countries, we receive fresh impulses to exertion for the 1 promotion of its interests and the extension of its blessings.

He also revealed a strong moral sense regarding the profession, admonishing his

students repeatedly to remember that as physicians they carried a special burden of

being bound by religion and duty:

You, gentlemen, have chosen a profession which can place you in a commanding attitude in society, and give you an influence far more extensive than the sphere of your personal intercourse. When therefore, you commence the practice of medicine, it will be optional with you whether to give your influence in aid and support of those pillars which prop the fabrick of human society, or whether you will submit to become the reptiles who attempt to undermine or gnaw them down. Duty to yourselves, to your profession, to society, to your God, demands your exertions on the side of morals and religion.

In 1827, Mussey delivered his first temperance address to the public, a year

prior to his role in establishing the Dartmouth temperance society. Mussey’s address

to the New Hampshire Medical Society’s annual meeting on June 5,1827 is

significant to addiction history for several reasons. According to the temperance

historian Krout, the address established his national reputation as a temperance

advocate. The address was soon thereafter published at the request of the Medical

Society, and therefore gained further circulation.

31 Reuben Mussey, An Address Read to the Medical Class at Dartmouth College, December 1, 1818 (Hanover, N.H: Charles Spear, 1818), 9.

32 Ibid., 23.

33 Reuben Mussey, An Address on Ardent Spirit: Read before the New Hampshire Medical Society at Their Annual Meeting, June 5, 1827 (Boston: Perkins and Marvin, 1829); Krout, 146.

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The address is also important because, as his first recorded statement on

temperance, it gives an indication of the development of his thinking on alcohol and

alcohol abuse. Although the address is entitled “An Address on Ardent Spirit,”

Mussey used the new alcohol terminology from the very beginning of the address.

Interestingly, he began by explaining to his audience the derivation of the perhaps

unfamiliar word alcohol:

More than nine hundred years ago, an Arabian Chemist discovered by distillation, a pungent and warming liquor, to which was given the name of Alcohol, and which we call ardent spirit.34

In equating ardent spirit with the terminology alcohol, it would seem, at first glance,

that Mussey was not aware of the new chemical understanding of the composition of

liquor, the discovery that William Brande had published six years before in his

Manual o f Chymistry. In this address Mussey did not cite Brande’s work, but he did

observe that wines, specifically those available locally, also contained greater

amounts of the substance alcohol than commonly thought. Mussey noted that the

content of the substance was much higher in wines than had previously been known,

i f and therefore harmful. Mussey’s presentation of this new finding challenged the

tolerance of temperance organizations such as the MSSI for wines and fermented

beverages as benign and exempt from banishment. In an attempt to define the

chemical composition of alcohol, Mussey noted that “alcohol is strongly allied to

34 Mussey, 1827Address, 2.

35 Ibid., 12.

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ether in its chemical relations, and it is capable of passing from the stomach into other

- j z r organs without having its inflammability destroyed..

Mussey’s address was significant for more than the use of the new

terminology and its implications. In language and tone somewhat similar to

Benjamin Rush’s treatises and especially consistent with Sewall’s treatise, delivered

just a few months prior,37 Mussey described the multiple effects of excessive use on

the drinker—the physical, social, intellectual, and moral effects. He addressed the

effects of alcohol usage in a holistic, comprehensive fashion, cataloging the damage

that alcohol would cause to all aspects of the drinker, beginning with the physical

effects:

.. .it [alcohol] diffuses its influence over the whole body...the whole face is swollen, the forehead and temples patched with red and white, the cheeks of a deep crimson, the nose tipped with ruby, the comers of the mouth drawn down.. .it is carried by the blood, and circulates through the alimentary organs, through the lungs, muscles, and the brain, and doubtless through every organ of the body.. .When taken by the nursing mother, it enters into the delicate food prepared by nature [breast milk].38

It is significant that Mussey used language more clinical, detached and scientific than

the language Rush had used to describe the drunkard. Mussey employed scientific

terms and concepts to describe the appearance of the drunkard. He continued to

detail the physical damage caused by alcohol to all parts of the body, using language

that indicated that physical exams had been undertaken on drunkards, both living and

36 Ibid., 8.

37 Mussey’s address was presented in June, 1827, three months after Sewall’s address of March, 1827. Since they had been in contact regarding previous presentations and publications, it is reasonable to expect that they exchanged information on a topic that they both addressed.

38 Mussey, 1827Address, 5.

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after death. He included in the physical effects all the systems of the body and all the

organs.

Mussey also demonstrated a more rigorous physiological analysis of the

effects of alcohol than had his predecessors- for example, his finding of presence of

alcohol secreted in breast milk countered the prevailing view of the benefit of alcohol

to the nursing mother and child. Such a finding was congruent with his earlier

experiments on the absorptive property of the skin. It is not clear who had conducted

the analysis of the ability of alcohol to pass into the breast milk, but the similarity

between the absorptive ability of the skin was closely related to the permeability of

other tissue. Such an experiment was clearly within Mussey’s scientific interest and

abilities.

He continued his indictment against alcohol by describing the mental,

emotional, and social effects of alcohol:

What permanent influence does it exert upon the social affections and the moral feelings? Was it ever known to increase conjugal attachment and kindness, parental tenderness, or filial love and obedience?.. .Who was ever inspired by alcohol with lofty moral sentiments?.. .On the contrary, who has not seen its effects in poisoning the fountains of social and moral feeling, and in transforming the affectionate, kind, and hopefully devout man, into a savage or a brute?39

According to Mussey’s account, the intellect of the habitual drinker was also

diminished. He identified the brain as the source of the intellect, “the healthy

functions of which are essential to vigorous intellectual operation.”40 Citing physical

findings, he indicated that dissections of the brains of drunkards evidenced physical

39 Ibid. 4-5.

40 Ibid., 6.

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damage to the brain tissue, which appeared harder and less flexible, in contrast to the

appearance of softer, healthy brain tissue of abstainers. The physical findings

correlated with impaired intellectual function, according to Mussey. He cited cases of

those who had been destined for demanding and productive intellectual professions--

specifically physicians, lawyers, preachers, and public servants, those who carry on

“the abstract and retired operations of the mind.” But they did not attain their early

promise, because they had fallen victim to alcohol.41

The language of Mussey’s Address did not condemn those who succumbed,

but rather demonstrated a sympathetic approach. Mussey sympathized with families

of the inebriate, those who perhaps had high hopes for a son, but now “weep for him

in secret places.”42 Interestingly, but not surprisingly, he was not gender neutral—he

did not mention daughters. Although his language was serious and urgent, he did not

condemn the drinker. His language and tone conveyed his desire to impart what he

regarded as factual, scientific findings that would help his audience avoid the danger

of alcohol and help others to do the same. He reported upon the effects of alcohol,

not the character of the drinker. He did not assume that the drinker was sinful or

weak. Instead, he condemned the process of excessive alcohol intake that gradually

but relentlessly affected the drinker.

Mussey’s message was quite different from the prevailing teaching of

temperance literature. His use of physical findings and his description of the effects

of alcohol lack the moral condemnation of the drinker that is so prevalent in

41 Ibid., 6.

42 Ibid., 4.

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temperance literature. Instead of dwelling upon the moral weakness or sinfulness of

the drinker, he pointed to the physical effects of the substance alcohol, its insidious

nature, and its eventual consequences. He described the effects according to their

progressive nature, demonstrating the progression of the drunkard’s condition. He

described the effects of excessive alcohol use, beginning with the physical effects

evident to the close observer. He then described the ensuing emotional effects, the

intellectual effects, and the moral effects. Adopting a step-by-step delineation of the

effect on the whole person, his description is reminiscent of Rush’s description of the

progressive effects of alcohol.

In recounting the progressively negative effects of alcohol,43 Mussey left the

mainstream of temperance ideology that assumed the sinful nature of the drunkard.

He emphasized instead, the habit-forming qualities of alcohol— “such be the strength

of the habit, and so great the danger of forming it.”44 He stressed that habitual use

would inevitably lead to damage, both physical and mental. In Mussey’s view,

alcohol actually changed the character. Alcohol seemed harmless at first, but the

pleasant effects of alcohol “are transitory,” while the damage done to the entire

system is “permanent.”45 He employed emphatic language to warn of the power of

alcohol:

It possesses, more than any other invention of man, the power of transforming character; but what is worthy of particular notice, is that all its good transformations are transitory, and nearly all its bad ones, permanent. Does it give

43 For more information on the evolving terminology of alcohol, see chapter 3, footnote 3..

44 Ibid, 9.

45 Ibid., 3.

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momentary strength to the feeble? Its habitual use makes the strong man weak.. .it relaxes benevolent exertion, and renders the mind habitually less sensible to the sufferings of others.46

Although Mussey’s views of the power of alcohol were complex and nuanced, he did

not display a nuanced attitude that allowed for exemptions or exceptions. All were

subject to the devastating effects of habitual use, regardless of class, profession, or

talent. In this, his first public address, he did not specifically mention the effects of

alcohol upon women. It is unclear as to whether he exempted women from

intemperance or merely lacked the inclusive language to refer to them specifically.

Mussey gave examples of the powers of alcohol and although he did not use

the term “addictive,” his assessment of alcohol’s addictive power was clear. The first

example was a “tippler” who had been put into an almshouse and prevented from

drinking. He tried several ruses to procure rum, but failed. Finally he hit upon the

perfect plan. He went into the woodyard, found an axe, and with a single blow,

chopped off his hand. Holding up the stump, he cried out for rum as a remedy for the

wound. People came rushing to his aid and gave him what he wanted, even more

than his hand—rum. This example is so extreme that its authenticity seems doubtful,

unless the man had been suffering from mental illness or the effects of delirium

tremens.47 Regardless of the reality of the story of the crazed drunkard, the fact that

Mussey recounted it demonstrates his orientation toward the addictive power of

alcohol. Using this story, Mussey portrayed alcohol as a substance that had

46 Ibid., 3.

47 For accounts of nineteenth-century incidents of delirium tremens, see Ric Caric, “The Man with the Poker Enters the Room, Mania a Potu in Philadelphia, 1828-1850,” American Historical Association presentation, Washington, D.C., January 2004.

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irresistible attraction for the “tippler.” He emphasized not a moral failing in the

drunkard’s decision, but the insanity of the lure of alcohol and the extent to which an

addicted drunkard would go to procure it.

The other examples that Mussey used to demonstrate the strength of the

alcoholic habit are less extreme and therefore more believable. Especially interesting

is the case of the reformed drinker who made a vow to abstain from all intoxicating

drink for forty years, thinking that he would live only forty more years. He kept his

vow for that stipulated period. When the time expired, he attempted to drink

moderately and soon died of alcohol overdose, thus demonstrating the power of

addiction. Another similar case concerned a man who had renounced liquor because

of his habit of intemperate drinking. He remained sober until his physician prescribed

alcohol as a remedy for “mild dyspepsia.” He returned to drinking and “by degrees,”

fell victim to full-blown intemperate drinking.

Citing these examples, Mussey displayed his conception of the addictive

nature of alcohol. He believed that the progression of addiction continued even

during abstinent periods. His use of the example of the drinker who had taken a vow

of abstinence for forty years illustrated the relentless force of addiction. Even after

decades of sobriety, when the elderly man returned to drinking, he quickly

accelerated to his former addiction. Thus the process of addiction had continued even

48 Address, 8-9.

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during the extended period of sobriety. According to the account, the man soon died

from excessive drinking.49

Mussey regarded the process of addiction to be progressive and on-going.

He described instances of the ability of the drinker to delude himself that he could

drink moderately and without danger. Continuing in the same lecture, he gave an

example of the man who was a moderate, regular drinker. The man boasted that he

could control his drinking and continue to drink moderately without danger. Mussey

related the unexpected outcome of moderate, sustained drinking for this man. Despite

his certainty that he would not fall into intemperance, the man became a drunkard.

Mussey remarked that “[unconsciousness of danger is no proof of security. ”50 The

lack of awareness of the addictive power of alcohol was central to the problem,

according to Mussey.

Because he was so convinced of the harmful effects of alcohol, in all its

many aspects, Mussey also addressed the question of the medicinal use of alcohol. In

no uncertain terms he opposed the use of alcohol as a medicine, although he admitted

its seeming convenience. In the absence of any other effective treatment, a constant

problem for nineteenth century medicine, doctors frequently turned to the medicinal

use of alcohol. For fainting, he prescribed, instead of alcohol, “ammonia and the

volatile oils.” Likewise for the treatment of pain, he insisted that opium was superior

to alcohol. Interestingly enough, he did not consider the addictive power of opium.

He did, however, regard opium as dangerous and poisonous, referring to it in his

49 Ibid., 9.

50 Ibid., 15.

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address as comparable to arsenic and other harmful substances: “Does a healthy

labouring man need alcohol? No more than he needs arsenic, corrosive sublimate, or

opium.”51 Mussey opposed the use of alcohol as a medicine on the grounds that it

might create dependency:

I maintain then, that, taking into view the danger of making tipplers by giving ardent spirit to the sick, and considering that all its medicinal virtues are found in other articles, mankind would not on the whole be losers, if it should be banished from the houses of every class in the community, but also from the shops of the apothecary.52

Mussey used the term ardent spirit interchangeably with alcohol in this address.

Most of the influences upon Mussey’s temperance ideas proceed from

general circumstantial evidence— his background, his education, and his associates.

There is, however, a small but significance piece of evidence that proves that Mussey

and his relative Sewall maintained contact with each other and influenced each other.

Evidence of their communication is found in a letter from Rufus Choate, who was a

student at Dartmouth, to his brother-in-law Thomas Sewall in October of 1825. In

this letter Choate remarked favorably on one of Sewall’s manuscripts (it is unclear

which manuscript he referred to). Choate also remarked that Mussey had praised

Sewall’s manuscript highly, that he considered “it to be a most permanently valuable

contribution to our medical literature.”53

51 Ibid., 9.

52 Ibid., 12.

53 Letter from Rufus Choate to Dr. Thomas Sewall, Dartmouth Manuscript Collection, October 30, 1825. Transcription by K.N. “I think, so does Dr. Mussey, extremely favorably of the thing.. .hold it to be a most permanently valuable contribution to our medical literature.. .Dr. Mussey thought it worth a thousand of Henderson’s, and was feeling and loud in his praise of it.” Rufus Choate (1799-1859) was the younger brother o f Mary Choate, the wife of Thomas Sewall. Both Mussey and

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One can also find textual evidence that Mussey and Sewall communicated

and influenced each other’s views. Although neither Sewall nor Mussey use the term

“addiction,” both comment upon the gradual, irreversible ruin that awaits the drinker.

They depict the addictive nature of alcohol without using the term “addiction.” Both

men gave significant temperance addresses, three months apart in March and June of

1827. The addresses show a similar organization, approach, and message. SewalPs

address was the earlier of the two. Both documents describe the physical effects of

alcohol upon the drinker, as well as the mental and emotional effects. Both Sewall

and Mussey note the gradual process of dependence that often results in destruction

of the drinker.

During the next few years after his 1827 temperance address, Mussey

continued to develop his skill as a surgeon, not only at Dartmouth, but also at several

other medical institutions in the northeast. While maintaining his Dartmouth

appointment as a Professor of Surgery and Anatomy, he also served as a Professor of

Surgery at Bowdoin College and the College of Physicians and Surgeons in Herkimer

County, New York. During this period he continued to pioneer surgical techniques in

orthopedics and obstetrics. It was also during this period that he traveled for ten

months in Europe to meet with the famous continental physicians.54

We have no specific information about his temperance activities during the

years after the 1827 temperance address, but by 1835 Mussey had written another

then Sewall had lived with the Choate family in Ipswich, Massachusetts, serving as tutors to their children. For more information on the relationship, see the previous chapter on Sewall.

54 Hoogenboom, 190; National Cyclopedia, 91.

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major treatise on the alcohol question, the “Prize Essay on Ardent Spirits and Its

Substitutes As a Means of Invigorating Health.” Published in Washington, D.C., the

treatise was widely and extensively used by temperance advocates in the American

Temperance Society.55 Mussey wrote the sixty-five page, three-chapter treatise while

a medical professor at Dartmouth. Written eight years after his previous temperance

essay, the treatise provides a wealth of information about Mussey’s developing ideas

and attitudes towards alcohol and the process of addiction. He continued to expound

and develop his anti-alcohol views. He also continued to intensify and expand his

concept of the addictive qualities of the drug. He continued his long-time methods of

investigating the effects of alcohol, using laboratory technique. The treatise also

lends insight into his sources of information on the subject. In the absence of

surviving personal correspondence, the essay gives clear evidence of the colleagues,

such as Rush and Sewall, who influenced his thinking.

Mussey devoted the entire first chapter, eighteen pages, to describe the

history of the discovery of alcohol and the distillation process. At the beginning of

the essay, he dispelled some of the previous confusion about the terminology ardent

spirit and alcohol. His explanation left no doubt but that he was fully aware of the

substance alcohol, its chemical properties, and the extent to which alcohol was

present in fermented drinks. In his opening sentences, he settled the question of the

nomenclature, ardent spirit and alcohol, making them interchangeable:

Ardent Spirit or Alcohol is a thin colorless fluid, lighter than water, somewhat volatile, of a pungent smell and taste, readily inflaming by the application of a

55 Reissued in 1837 together with an essay by Dr. Harvey Lindsly Temperancein Prize Essays (Washington, D.C: Duff Green, 1837).

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lighted taper, and burning with a dim blue or purple flame. It is produced only by the decomposition of vegetable and animal substances, in a state of fermentation. It is the intoxicating principle of all fermented liquors, as wine, cider, beer, &c., and may be separated from them by distillation and other processes.56

After this introduction, he gave a review of the origin of alcohol, with the

first known instances of the uses of wine and other fermented drinks in antiquity. His

descriptions have the tone of objectivity, demonstrating his scientific interest in the

chemical discoveries and processes. Although he would deplore the effects of

alcohol later in the treatise, his scientific bent found the subject of the chemical

discoveries of great interest. Employing an objective tone, much as would an

anthropologist, he traced the early use of alcohol and the origin of distillation. His

first example from ancient times was Noah’s vineyard, with an account of Noah’s

indiscretion while drunk with wine, a reference that would have been familiar to his

audience and readers. He made no moral judgment or condemnation of Noah, though

perhaps that might not have been necessary, given the implicit or complicit attitude of

his audience. In a thoroughgoing fashion, he proceeded to catalogue the ancient

annals of alcohol use, citing the Greeks, the ancient Chinese (who sought “the elixir

of life”), and the Arabic chemists, who furthered their experiments. The Chinese and

Arabics he credited with the invention of distillation from fruit juices and “farinous

56 Reuben D. Mussey,Prize Essay on Ardent Spirits and Its Substitutes as a Means of Invigorating Health (Washington: Duff Green, 1837), 13.

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grains.” He subsequently traced the spread of the knowledge of distillation to

Europe, brought from the east, giving specific listings of countries and dates. 57

The second chapter of his 1835 treatise carries the title “Effects of Ardent

Spirit upon the Animal Economy.” It deals with the effects of ardent spirit or alcohol

(once again Mussey used the terms interchangeably) upon the body. In this more

scientific chapter, we see the continuing evolution of the terminology used to refer to

alcohol. Increasingly, Mussey substituted the term alcohol for ardent spirit.

Numerous times in this and the following chapter he referred to alcohol and alcoholic

intoxication. Increasingly he coupled the word alcohol with wine and fermented

drinks, thereby indicating that alcohol was the chemical ingredient of interest: “[t]he

free use of ardent spirits, wine, beer, or any intoxicating liquor, when continued for

some days, has invariably produced these morbid changes.

Mussey also repeatedly referred to alcohol as a “poison,” thereby

emphasizing the dangerous nature of the chemical. He pronounced that alcohol was a

stimulant, not a depressant. He described the effects of alcohol intake as “alcoholic

excitation”: “[t]he first effect.. .upon the living fibre is stimulating” and “[t]he brain

and the nerves of the senses partake in the exhilaration.” Drawing upon his habitual

practice of scientific experiments, he had conducted experiments with alcohol by

applying it to the web of a frog’s foot. He viewed the circulation of blood in the

small vessels of the affected area of the frog’s foot under a microscope. He detected

57 Ibid, 17-18. Mussey described how “Saracens” brought distilling to Spain in the eighth century, Hungary and France produced spirits in the fourteenth century, and Holland produced gin in the seventeenth century. Gin was distilled with juniper berries.

58 Ibid., 29.

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an increased velocity in the movement of the blood through the capillaries when

alcohol had been applied, thus hypothesizing that alcohol acted as a stimulant.

Shifting his experiment from the animal to the human model, he next applied alcohol

to human skin. He observed that applying alcohol upon human skin “augments the

sensibility and quickens the circulation upon the surfaces with which it is brought in

contact.” He also remarked that alcohol taken into the stomach in a concentrated

state “instantly occasions a burning pain.”59

One wonders if at this point in his life he himself was the subject of any part

of the experiment, a likely instance given his previous record, or if he had already

become a complete abstainer and would have refused to take any alcohol even under

experimental circumstances. At this point in the document there is no specific

evidence to definitively support either conclusion, but the next part of the account

supplies some insight as Mussey proceeded to detail the appearance of the drinker.

The ensuing description leaves no doubt that Mussey had not conducted the

experiment upon himself. He had either secured a volunteer or made an observation

of someone, or perhaps many subjects, who had drunk excessively.

Mussey’s physical description of the physical appearance of drinker, in its

clinical detail, was consistent with similar descriptions by other temperance

physicians. It was also reminiscent of the observations published over thirty years

earlier by Benjamin Rush, but devoid of Rush’s judgmental language:

The voluntary muscles at the same time indicating their enfeebled condition, by

59 Ibid., 19-20.

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the falling of the eye-lid, the open mouth, the driveling lip, and the hanging head... [t]he physiognomy tells what has been done.. .Even strong passion is but faintly portrayed by the half palsied muscles of the face, and sluggishness dwells in that mind which was once impelled by a spirit of activity and enterprise. The powers of digestion, and nutrition having been effectually invaded, the stomach admits less food than before, and the whole system is but imperfectly supplied with nourishment.60

Mussey’s account continued to give further details of the effects of excessive intake

upon the drinker, maintaining clinical, descriptive, and non-judgmental language:

In deep drunkenness there is lethargy and stupor, the face is often pale, sometimes flushed, very rarely livid and swollen, and still more rarely natural. The breathing is generally slow, sometimes stertorous or laborious, seldom rapid or calm. The respiratory movements are chiefly or wholly abdominal.. .The extremities are almost invariably cold; the pulse feeble and slow.. .the pupil generally dilated.61

Mussey’s description of the effects of alcohol is objective and conveys not even a hint

of condemnation for the affected subject. He does not, as had Rush, describe the

drinker’s behavior as something of derision or a shameful failing. Mussey’s detached

clinical description is oriented to the physical effects of the chemical substance upon

the drinker.

Moving from the physical description of the outward appearance of the

drinker, Mussey turned to the effects upon the internal organs. For this section of the

treatise, he used information taken from “the bodies of persons dead from a fit of

drunkenness.” There follows a systematical description of the effects observed upon

the brain, heart, lungs, stomach, intestines, liver, and kidneys. The precise, graphic,

and detailed nature of the anatomical descriptions indicates that they were obtained

60 Ibid., 20-21.

61 Ibid, 21.

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from actual dissections: “the ulcerations of this membrane [the intestinal wall], “its

blood vessels engorged; turbid serum beneath the arachnoid membrane [the brain]

and “its surface frequently uneven, pale, mottled,.. .exhibiting fatty degenerations [the

liver]” and “its wall sometimes three or four times their natural thickness and

indurated [the stomach].” Despite the passive voice of the language (“the following

appearances have been observed”),62 Mussey probably conducted the autopsies

himself. As professor of anatomy and an already celebrated surgeon, he had access to

his own dissection lab at the medical school. Only an inability to procure bodies

would have precluded his performing the dissections.

His descriptions and accounts indicate that Mussey kept informed of the

current medical thinking and developments in the study of alcohol. The language

indicates that autopsies were conducted for the subjects. His descriptions of the

appearance of the internal organs bear a strong resemblance to those of his friend

Thomas Sewall. It is obvious that he was aware of Sewall’s autopsy results. In the

next chapter he refers directly to the findings of “Dr. Sewall of Washington city”

regarding the effects of alcohol. He related the experience of Sewall while visiting

the cholera hospitals in New York City. In the New York hospitals Sewall found that

almost all of patients were intemperate, and that such was the case in the other

hospitals that he visited.63 Using the reports from Sewall, Mussey inferred that either

62 Ibid., 22.

63 Ibid., 36. According to Mussey, Sewall had written to a friend that of the 204 cases of cholera in the Park Hotel in New York, there were only six “temperate” patients, and that those had recovered, while 122 of the others subsequently died.

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alcohol contributed to the contraction of chronic diseases, or that patients with

chronic disease often turned to alcohol.

In the 1835 Essay, Mussey cited the alcohol experiments of other medical

researchers. He explicitly referenced the work of Dr. Brodie and Dr. Francis

Magendie, the European doctors who were famous for rigorous methodology in

medical experiments in alcohol research and other areas. Mussey noted that

Magendie had conducted alcohol experiments upon a dog to show that alcohol passes

from the stomach into the circulation of the blood.64 He cited other researchers in

medical science who were interested in the effects of alcohol. He cited the

experiments of William Beaumont, the doctor who had conducted experiments upon

the young man with an open wound to his stomach. Beaumont had hypothesized that

intemperance in eating and drinking produced a deteriorated lining of the stomach.

Mussey agreed with and quoted Beaumont’s assessment that “[t]he free use of ardent

spirits, wine, beer, or any intoxicating liquor, when continued for some days, has

invariably produced these morbid changes” in the lining of the stomach.65 It is also

significant to note that Mussey’s assessment included wine and beer in the same

category with ardent spirits as “intoxicating.” Significantly, he did not make a

distinction between the more socially acceptable wines favored by the elites and the

64 The famous French medical scientist Magendie did experiments upon a dog with alcohol to show that alcohol passed from the stomach into the circulation of the blood. Ibid., 24. For more information on Magendie and other European medical researchers, see Chapter Three on the medical background of the period.

65 Mussey’s 1835Essay, 28-29. For more information on William Beaumont’s experiments on the physiology of digestion during the period 1829 to 183 land his patient, Alexis St. Martin, see John Duffy,From Humors to Medical Science: A History of American Medicine (Chicago: U of 111 Press, 1993), 107-110.

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lower class whiskies and rum. To Mussey all kinds of alcohol posed a health risk.

He did not exempt the more socially acceptable wines of the elites. That sort of bias

and misinformation had hindered the MSSI in achieving their goals twenty years

earlier in the movement.

After having thoroughly demonstrated the deleterious effects of excessive

alcohol use, Mussey turned in the third and final chapter of the Essay to a discussion

of “substitutes” for the “poisonous” alcohol. In this section Mussey revealed his two

fold motivation in promoting temperance views. He had both religious and scientific

motivations, a blend of emotional intuition and practical rationality. He

recommended a substitute to fermented drinks and distilled spirits: water. He

endorsed water, “the natural and proper drink of man” as a healthful substitute for

alcohol. In lyric and flowery language, typical of the period, he described water as

the preferred beverage in the Garden of Eden, provided by “an omnipotent and all-

bountiful Creator.” In this approach we see rare glimpses of his religious, non-

rational side. Usually he used the rational language of medicine and science. In

language atypical for Mussey, he extolled “[a] river flowed from Paradise” that

provided a drink that “no human invention has equaled.” 66

Soon, however, he returned to his more accustomed rational approach, and

what he described next is clear evidence of his understanding of the addictive process.

After the flowery prose praising water Mussey gave a practical explication of its

health benefits. His principal observation was that water could not lead to unnatural

66Essay, 36-39.

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“relish.” Uppermost in his analysis was that water had no “hurtful” effects and that it

“offers no temptation.” Additionally, water would not be guilty of “perverting the

natural appetite of thirst” and it would present no danger that one would be “betrayed

into drinking too much.”67 Significantly, in these references, both in substance and in

rhetorical tone, Mussey conveyed an incipient understanding of the process of

addiction. His language did not condemn the drinker, but instead condemned the

effect of the substance upon the drinker. In his view, specific substances had either a

natural or an unnatural effect upon the appetite. His analysis did not consider the

morality of the substance, but rather its physical effect upon the drinker. Water was

safe and natural, while alcohol resulted in unnatural and deleterious appetite.

To fully illustrate his point about the addictive nature of alcohol as opposed

to water, Mussey used the example of a child’s unspoiled appetite for water.

“Children drink because they are dry,” he observed, while adults “drink anything but

water, because this fluid is intended to quench only a natural thirst, and natural thirst

is a thing which they seldom feel.”68 He believed that water was the pure drink

provided by nature, or “the Creator,” that did not subvert the natural appetite.

Alcohol stimulated unnatural appetite that would become uncontrollable.

Although Mussey did not specifically use the word addiction, yet he

described aspects of the addictive process. He used the words “betrayed,” “artificial,”

and “perverting the natural appetite” when citing the effects of fermented and distilled

67Essay, 36-39.

68Essay, 38.

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liquors.69 Using persuasive language he described the progressive loss of control and

dependence that resulted from the frequent use of alcohol. In an 1830 publication he

described the ill effects of “habitual use”: “the resistless desire for its [the sensation]

repetition.”70

Mussey cited the positive health benefits of water, taking the approach of

pro-active, healthy lifestyle choice. He recommended replacing a harmful substance,

alcohol, with a healthy alternative. For a final endorsement of water Mussey turned

to eminent physicians, past and present, who also commended water as the best, most

healthful beverage. Comfortable in the company of fellow scientists, he cited

Sydenham, Haller, Stahl, Boerhaave, and even Celsus, Galen, and Hippocrates. He

noted that “[t]he experiment has been made on a large scale, and many thousands of

witnesses” attest to the health benefits of drinking water instead of alcohol. He

recommended water both as a drink and for bathing. Taking a holistic approach,

Mussey endorsed water as a healthful substance and substitute for the alcoholic

prescriptions of the general medical community. Mussey was one of the early voices

to espouse the water remedy that would become more popular later in the nineteenth

century. In the absence of effective medicines, and with the limited arsenal of the

nineteenth century, water was not a bad choice. His recommendations and

endorsement of water fell in line with the Hippocratic proscription to “do no harm.”

69 Ibid.

70The Rev. John Marsh quoted Dr. Mussey in his address. John Marsh,Putnam and the Wolf, or the Monster Destroyed, An Address delivered at Pomfret, Connecticut, October 23, 1829 (Hartford: Robinson & Co., 1830), 14.

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Because of the chronological limits of this dissertation, I will refrain from

delving into much detail about Mussey’s later life. In summary, Mussey in later years

was productive, dynamic, and healthy, living to the age of eighty-six. He proceeded

along the path he had set earlier, both professionally and personally. Although he

kept his religious faith a private matter, he was, according to one commentator, very

religious and a devout Christian. He was known to pray before all his surgeries, often

kneeling before the bedside of the patient. His physical appearance was, according to

/ Samuel Gross, one of his contemporaries, unimpressive, but his surgical

accomplishments were “brilliant and fearless.” 71 As previously noted, Mussey’s

accomplishments in surgery were extraordinary. Other observers were more

complimentary of Mussey’s physical health and appearance, noting his vigor and

magnetic personality even at age seventy-six.72 Late in life, Mussey continued to

develop surgical techniques, becoming the first to successfully tie the carotid arteries

in an operation to remove aneurysmal tumors of the head. He successfully repeated

the operation in 1854. His eulogist wrote that Mussey was one of the most brilliant

and accomplished surgeons of his time, pioneering a number of surgical

breakthroughs.

71 “Mussey was of low stature, of an attenuated form, with high cheekbones, a prominent chin, a small gray eye, and an ungraceful gait. His head was of medium size, and he possessed none of that personal magnetism which gives a man a commanding influence over his fellow-men “ and “his surgical exploits were of a brilliant and fearless character.” Samuel D. Gross, M.D., Autobiography, with Sketches of Contemporaries (Philadelphia: George Barrie, 1887), 317and 313.

72 Western Lancet, 316.

73 Hamilton, 651.

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Mussey and his wife Hetty had two daughters and seven sons. He

eventually moved with his wife and children west to Ohio. Two of their sons,

William and Francis, became physicians.74 Another son, Richard, quoted his father in

ne temperance tracts that he wrote for Sylvester Graham’s Journal o f Health. From

1838 to 1852, Mussey was professor of surgery at the Medical College of Ohio in

Cincinnati. In 1850 he was elected head of the American Medical Association. In

1852 he founded the Miami Medical College in Ohio, where he lectured and wrote

until he moved back to Boston in 1860 to be with family members. In later years he

continued his healthy lifestyle of abstinence and temperance. In addition to his

abstinence from alcohol he became a vegetarian, and also opposed the use of tobacco.

nr At age seventy-six, he had the vigor of a man much younger.

Mussey continued in his dedication to evidence-based medicine even in his

late career. In one of his last publications, The Trials and Rewards o f the Medical

Profession, published in 1853, he encouraged new medical students at the opening

session of the Miami Medical College in Cincinnati to persevere in their studies,

relying upon their knowledge gained in the dissecting room and in clinical

observation. He counseled them always to resist giving in to popular opinion when

they knew it was in error. Above all, Mussey valued scientific integrity, even when

74 National Cyclopedia, 92; Dictionary o f Am. Bio, 373.

75 Richard Mussey, “Dr. Mussey’s Opinion on Cider,”The Graham Journal o f Health and Longevity Devoted to the Practical Illustration of Life, as Taught by Sylvester Graham and Others (New York, 1837), v 16, 125.

76 “[F]or more than twenty years [at age seventy-six] he has been a water-drinker,”Western Lancet, 316.

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patients might be impressed by “medical quackery.” Mussey urged them to resist

giving in to fads such as homeopathy, “one of the most prominent delusions of our

time.” Mussey had a low regard for Hahnemann’s homeopathy, the product of “a

medical imposter” and “the extravagant imaginings of a bewildered brain.” Instead,

Mussey urged his students to rely upon “the inductive method in learning the nature

of diseases and the effect of remedies” as opposed to the dreams and imaginings of

Hahnemann, the founder of homeopathy.77 Mussey remained until the end of his

career a disciple of scientific method, even in the face of attractive and popular new

fads.

Mussey contributed ideas to the temperance movement about the addictive

nature of alcohol and also the physical effects of alcohol. He approached his subject

in a scientific manner, with an orientation to scientific experiments and observations.

His approach was similar to that of his colleague Thomas Sewall. Both Mussey and

Sewall focused on the effects of excessive alcohol intake upon the drinker rather than

making judgments about the morality of the drinker. Both physicians conducted

scientific experiments to determine the physical and other effects of alcohol.

Increasingly both Mussey and Sewall explored the addictive and uncontrollable

nature of the substance alcohol upon the drinker. They stressed the danger to the

social drinker who gradually lost control of his drinking. Mussey and Sewall both

lectured and published their findings, mostly to their colleagues in medicine, but

always with the intent that their assessments might reach a larger audience.

77 Reuben D. Mussey,The Trials and Rewards of the Medical Profession: an Introductory Lecture Delivered at the Opening of the First Session of the Miami Medical College (Cincinnati: T. Wrightson, 12 W. Second Street, 1853), 14 and 16-17.

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Mussey also inherited temperance views of the original temperance

physician, Benjamin Rush. Both Rush and Mussey were concerned with the holistic

health issues of alcohol use. In the words of Rush, they studied the effects upon the

body and the mind. Although Mussey did not specifically cite Benjamin Rush’s

treatises on temperance, it is inconceivable that he would not have been very familiar

with his early temperance writings and teachings. He studied at the Pennsylvania

Medical College while Rush was still on the faculty. Mussey made it a habit to read

conscientiously in the medical literature. Even if Mussey had not read all of Rush’s

works, it is highly improbable that he was not thoroughly familiar with all his

teachings, including those concerning temperance.

Textual evidence also confirms the influence of Rush upon Mussey.

Mussey’s language and analysis was more advanced and specific in understanding of

the substance alcohol than was Rush’s. Mussey had more accurate information about

the specific chemical analysis and concentration of the substance. Nevertheless, he

conceived of the progressive nature of drinking in ways that drew upon Rush’s early

conceptions. The similarity is especially evident in the descriptions of the

progression of the effects of excessive use. Rush’s Moral Thermometer was in

essence, although crude, a progression chart of addiction. Rush’s chart showed the

relentless climb up the stairs of drinking stronger alcoholic content beverages and the

accompanying consequences. In Rush’s temperance tracts he identified the physical

effects and catalogued them, followed by the mental and emotional effects, and

finally the spiritual or moral alienation. Mussey followed a similar train of analysis,

showing the physical effects, and ensuing mental, emotional and spiritual effects

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upon the drunkard. In this regard, all the temperance physicians describe a

progression of events or consequences for the drinker. Those consequences may be

identified as the process of addiction.

Mussey surpassed the ideas of Benjamin Rush and even his colleague

Thomas Sewall regarding the effects of alcohol use. He warned against the

deleterious effects of alcohol, but went beyond citing the negative effects in order to

suggest the healthy alternatives. He framed the study of alcohol use in the context of

the healthy lifestyle, advocating drinking water, eating healthy foods, and avoiding

the use of tobacco. He advocated eliminating alcohol use and in its place, substituting

healthy daily habits. His clinical detachment and language conveyed the message

that, in his professional judgment, alcohol use caused damage and often irreparable

harm to the drinker. In his efforts to convince his patients, students, and colleagues to

avoid the trap of addiction and other harm, he promoted healthy alternatives to

alcohol, and followed his own advice in his personal life.

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CHARLES JEWETT, COUNTRY DOCTOR

AND TEMPERANCE CRUSADER

On a cold spring night in 1822 a fifteen-year-old boy struggled to ford a

swollen stream with his wagon and four horses. Fighting the swift current in the

pitch-black dark, the boy decided to loosen the reins and let the horses follow their

instinct to swim to safety. The boy was returning from a day at market. He had sold

a load of coal at what he hoped was a satisfactory price, high enough to save him

from a flogging from his brother-in-law, Henry Dexter.

The boy was Charles Jewett, who in later years would struggle to become a

physician as well as a leader in the temperance movement.1 During the high tide of

the first temperance movement in the 1830s and 1840s he would work as a leading

temperance agent in two states, Massachusetts and Rhode Island. He became famous

in his day, known throughout the temperance movement for his lectures and

publications. Temperance organizations published his numerous speeches, as well as

his many poems and essays. He brought his expertise as a physician to the

temperance cause, as had temperance physicians Thomas Sewall, Reuben Mussey,

and others before him. Yet, his story and experience were different from those

previously considered in this dissertation. Charles Jewett’s origins were much

‘For basic biographical facts of Charles Jewett (1807-1879) see Mark E. Lender, “Charles Jewett” entry inDictionary of American Temperance Biography, From Temperance Reform to Alcohol Research, the 1600s to the 1980s (Westport, Ct: Greenwood Press, 1984), 259-261. 173

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humbler. He became an ordinary country doctor without the benefit of much formal

education. Despite his limitations, or perhaps because of them, he developed a

different approach to the temperance cause than the other temperance physicians. His

contribution to temperance ideas was less scientific and less scholarly. His ideas

about the addictive nature of alcohol were similar to those expressed by Sewall and

Mussey, but his method of expression differed. Instead, his temperance message,

addressed to the general public, was more practical in rhetoric, language, and tone. In

order to appreciate these differences one must understand Jewett’s background and

environment.

Charles Jewett grew up on a farm near the town of Lisbon in rural eastern

Connecticut. Bom in 1807, he was the youngest child of nine children. Despite the

family’s thrift and industry, running a small nail-making shop in addition to

subsistence farming, they remained poor. His parents sent him at age twelve to live

with his sister and her husband on their farm in Herkimer County in upstate New

York. According to all accounts, his sister loved him dearly, as did his parents. They

had thought that the new situation would help both families financially and also

continue to provide a supportive home for young Charles.

Things had not worked out according to plan— the Jewetts remained poor on

their farm and Charles Jewett had endured harsh, abusive treatment from his brother-

in-law. He often worked all night in the local coal pits and then during harvest was

forced to work also on the farm the next day. The neighbors and local townspeople

2 William M. Thayer, Charles Jewett: Life and Recollections (Boston: James Earle, 1880), 18-27.

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of Herkimer County said it was “outrageous for a boy to be worked as Dexter worked

him.” After four years they finally interceded on his behalf, sending the authorities to

release Jewett from his servitude. The sixteen-year-old Jewett thus escaped his

brother-in-law’s abuse and returned to his parents’ farm in Connecticut. Dexter let

him go with one dollar in his pocket, not enough to cover even the cost of his journey

home. The boy occasionally caught a ride with a passing traveler and walked the rest

of the way, a journey of almost two hundred miles.3

According to one of Jewett’s biographers, the difficult experience had made

him courageous and determined, which well may have been the case, but a selection

that Jewett wrote years later for the temperance cause suggests an additional result.

Writing temperance literature for boys and girls in his widely published Youth’s

Temperance Lecturer, Jewett put his thoughts into verse:

He drives them off, to toil all day And a part of the weary night, And takes their hard-earned pennies away, And at the bar will he daily stay To drink, and curse, and fight.

Shoeless, over the frozen ground His wretched children go; And away he staggers to where the sound Of drunken revel is ringing around, To taste the cup of woe.4

3 Charles Jewett (1807-1879) in Lender’sDictionary, 259-261; the account o f the stream crossing and Herkimer County farm experience, from Thayer, Charles Jewett, 52-65.

4 Charles Jewett, Youth’s Temperance Lecturer (Boston, 1840; reprint, New York: Landmark Press, 1934), 27. In citing this passage John Krout indicates that it demonstrates that Jewett thought young people could restrain their parents excessive drinking, an assessment that a more thorough reading of Jewett’s writings does not support. John A. Krout, The Origins o f Prohibition (NY: Russell & Russell, 1967), 241-2.

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Jewett accompanied his verse with an explanation of the experience that children of

drunken fathers endured. They were forced to work to support the idle father and

were threatened with whippings if they refused. The tone and inference of the poetry

suggests that Jewett wrote from personal knowledge and perhaps personal experience.

The passage of poetry from The Youth’s Temperance Lecturer also lends

insight into Jewett’s conception of intemperance. Interestingly, he condemned the

rum-seller as “cruel,” while referring to the father as “a poor drunkard.”5 Jewett

viewed the rum-seller as much more culpable, because he chose his profession and

presumably knew the extent of the damage that his business caused to the drinker. In

contrast, Jewett viewed the drunkard with compassion, an attitude consistent with his

understanding of the addictive power of alcohol. We shall return to a full delineation

and consideration of Jewett’s emerging conception of addiction, but at this point will

continue to examine potential motivations for his career choices, actions, and ideas

about drinking alcohol.

Given the above cited passage from his temperance writing, one may conclude

that Jewett’s early experience of physical and mental mistreatment may have been the

result of his brother-in law’s alcohol abuse. Granted, it is also possible that his

brother-in-law was entirely sober and simply violent by nature, but circumstantial

evidence suggests an alternative explanation. The fact that he mistreated his nephew

without the normal inhibition of vulnerability to public opinion suggests that he was

incapable of restraining his behavior, as might be the case with a drunkard. Another

clue is that Jewett’s sister, although she loved him dearly, was not able to protect him

5 Jewett, Youth’s Temperance, 26-27.

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from her husband’s abusive behavior. This situation suggests that she was

intimidated by her husband’s anger and abuse, a common scenario in the alcoholic

family that Jewett highlighted and expounded upon in later years.

Such indications of the alcoholic family situation may be found in passages

from Jewett’s prodigious temperance literature produced throughout his life. He

would often take as his theme the hardships that the drinker would impose upon his

family. He expressed the drinker’s loss of control and his aggressive tendencies,

often resulting in violence. More specifically, Jewett often referred to domestic

violence occasioned by the drunkard. In one such example of physical abuse as a

result of intoxication, Jewett rhetorically quoted the drunkard in verse:

“What though our wives should scold and fret? Blows well applied will cool their spunk While rum our parching throats can wet, Rejoice, and be exceeding drunk.”6

Noticeably, in this selection, the drunkard is male and the victim is the wife, a

potential recreation of Jewett’s childhood situation in Herkimer County. If he were

exposed at an early age to abuse, an almost certain situation in fact, but then allowed

to return to the safety of his family home, such an experience would have inspired a

commitment in young Jewett to want to correct such abuse. In his later life as a

physician and temperance worker he expressed his compassion for those in physical

need and mental distress, and also a determination to remedy the problems of alcohol

abuse that he perceived in society.

6 From “The Grog-sellers’ Invitation,” composed by Jewett in Rhode Island when he was a young man early in medical practice; Charles Jewett,A Forty Years ’ Fight with the Drink Demon or A History of the Temperance Reform As I Have Seen It and of My Labor in Connection Therewith (New York: National Temperance Society & Publishing House, 1872), 47; stanza also found in Thayer, 131.

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Charles Jewett’s background and participation in the temperance movement

differs considerably from that of Thomas Sewall and Reuben Mussey. His family

condition was poorer and he had less formal education than did either Sewall or

Mussey.7 His parents’ decision to send him to live with his brother-in-law did not

provide him the hoped for education. His education there did not meet even the

customary minimal educational levels of the time. In contrast, Sewall and Mussey

both had benefited from access to formal medical education and subsequently had

joined the elite ranks of medical academia. Although Jewett had received very little

formal education, he seemed to have been exceptionally intelligent and had developed

his intellect by exposure to occasional stints of classroom education as a youth.

Mostly, however, he was self-taught, reading the Bible, Shakespeare, and the standard

classics. He did not earn a degree from a medical college, but attended medical

lectures for only a few months during the course of two winters. As was often the

practice for training doctors in the early nineteenth century, he studied as an

apprentice to a country doctor and learned by experience.8

Although Jewett did not have the benefit of much formal education or a

medical degree, he compensated by means of his habits and talents. He became a

7 Charles Jewett was the youngest child of Joseph Jewett and Betsey King. He was raised with devout Congregational religious observance, attending Sunday services at the only meeting-house in the area and following the rule of strict Sabbath observance. The family needed him to work on the farm, but when possible he attended the local country school. From a young age he wrote poetry. Lender, Dictionary of Am.Temp., 259-26; Thayer, 25-49.

8 At age nineteen, he began to study medicine as an apprentice to Dr. Elijah Baldwin, the local family doctor, four miles from the Jewett farm. Before he could study with Dr. Baldwin, he had to learn some Latin. He studied with the local Latin teacher and was reading advanced Latin (Virgil) within six weeks. The following winter he attended medical lectures at Pittsfield, Massachusetts. Thayer, 73-74, 94-96.

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voracious reader, with a predilection for reading medical literature and journals.

Based upon accounts of his display of memorized poetry, drama and other material, it

seems that he had a remarkably retentive memory. He also had a dramatic flair, a

comic talent and a good singing voice. From a young age he enjoyed being before an

audience. He was a natural mimic, a quick wit, and loved to joke.9 These abilities

served him well in his future career as a temperance lecturer and agent. Although a

good and competent doctor, he never reached the exalted realms of medical academia

as did Sewall and Mussey. Jewett’s tone and rhetoric was more practical and

homespun, unlike the professional style of Sewall and Mussey. He cited the medical

literature, but wrote none himself. Instead he wrote temperance tracts for the general

public. His unsophisticated lecture style, with many practical examples and stories,

suited the popular audience of the temperance hall.

In understanding other influences that affected Jewett’s orientation toward

joining the temperance cause, one must consider the socio-cultural forces that

affected him. In this regard, his formative experiences in his church and community

are significant. He was raised in the Congregational Church, the church of his family

in Lisbon, Connecticut and the only church in town. Although no longer the

established church of the state of Connecticut, the Congregational Church of that time

and place was often the only available church, especially in rural areas. As such was

the case in Lisbon, the local church exercised a strong and pervasive influence in the

community. Jewett’s family followed the strict morality and ethics that the church

9 As a boy Jewett began to write poetry, a talent that he would use extensively. As a young teen he entertained his fellows by giving dramatic rendition of various characters. Thayer, 59-62.

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taught. They attended regular services and insisted on strict adherence to “keeping the

Sabbath.”10 Although the Lisbon Congregational Church did not take a definitive

point of view on the liquor question, the church’s emphasis on strict religious

observance and morality predisposed its members to take their Christian duty

seriously and perhaps even soberly. Raised in such an atmosphere, Charles Jewett

gravitated toward the Christian teachings of duty and responsibility, concepts

consistent with the temperance message.

Jewett’s temperance attitudes were significantly influenced by his medical

career, but it is, nonetheless, also important to take into account the social and

cultural influences that evangelical revivalism exerted upon him. We shall see that

his overall approach more nearly coincides with that of the temperance physicians

than with the evangelicals, but both influences were brought to bear upon his

thinking. His medical orientation mitigated the condemnatory, judgmental aspects of

the evangelical approach, resulting in his more compassionate approach to the drink

question. Nevertheless, one may make the case that socio-cultural influences play a

significant role in delineating Jewett’s temperance orientation.

Temperance thinking found a hospitable venue in the evangelical reform

movements that swept Protestant churches in the first quarter of the nineteenth

century. Although the Congregational church did not universally take a temperance

stand as a matter of doctrine, many of its individual members supported the

temperance cause. The evangelical and reform branch of the Congregationalists

10 Thayer, 25-30.

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supported temperance, Sabbatarianism, and other reforms .11 An especially visible and

vocal supporter was the Rev. Lyman Beecher. Beecher, “one of the most prominent

characters in the early history of the total abstinence reform,” had located in

Litchfield, Connecticut in 1811.12 Previously a Presbyterian, Beecher had joined the

Congregational Church in Litchfield as pastor. Beecher is well known to historians

for his strong temperance message to the clergy and laity in New England. Shocked

by drunkenness, he at first recommended and later insisted that the churches quit 11 dispensing liquor at church functions such as ordinations and baptisms.

The temperance message of evangelical religious leaders such as Beecher

was couched in the language of moral indignation. Beecher’s opposition to

intemperance and drunkenness culminated with his famous series of sermons on

intemperance, Six Sermons on the Sin o f Intemperance, delivered in Litchfield in

1825 and published a year later.14 Beecher took the position, both in his rhetoric and

in the substance of his message, that intemperance was a moral offense. He preached

that drunkenness was a sin and condemned it as such. He castigated drunkards,

asserting that they were excluded from salvation. His rhetoric was emphatic and

condemnatory, pronouncing that “drunkards, no more than murderers, shall inherit

11 For more discussion of the role of evangelical reform in temperance, see ch. 1 and 2 of this dissertation and Richard J. Carwardine, Evangelicals and Politics in Antebellum America (New Haven: Yale U. Press, 1993), 100-103.

12 W.H. Daniels, The Temperance Reform and Its Great Reformers (New York, Boston, Buffalo, etc: Nelson & Phillips, 1878), 62.

13 Krout, 84-45.

14 Walters, 125-27; Kobler , Ardent Spirits, 52-54.

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the kingdom of God.”15 Beecher’s message had a pervasive influence throughout

revivalist New England, especially among evangelical Protestants. Reform-minded

Congregationalists fell within that category.16

Because the temperance message of Protestant evangelicals such as Beecher

impacted the popular conception of temperance ideology, it is appropriate to consider

the extent to which such ideology affected Jewett’s thinking and approach. The

evangelical influences upon Jewett and his family emanated from the revivalism that

swept the so-called Bumed-Over-District, the area in upstate and western New York

along the Erie Canal. Jewett was raised in geographical proximity to the Bumed-

Over-District. As described by Ronald Walters and other historians of the reform

movements of the Second Great Awakening, there was a strong connection between

revivalism and reform movements in the first half of the nineteenth century.

Preaching the gospel message throughout the Bumed-Over-District, as well as

throughout other districts in the northeast, the Midwest, and other regions of the

country, Protestant evangelicals from all denominations promoted reform measures

1 *7 such as temperance with great fervor. Herkimer County, New York, where Jewett

spent four years of his young teen years, fell within the boundaries of the Bumed-

Over-District. During this period of his life he experimented with “preaching” in an

evangelical style to entertain his friends and perhaps to ventilate his feelings of

frustration with the domineering authority of his brother-in-law. He preached at the

15 Daniels, 75.

16 Ibid., 62-71.

17 Walters, 23.

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coal-pit camp owned by his brother-in-law, literally a stump preacher, standing on a

stump in the camp. The assembly thought him so eloquent that he should pursue a

career as a minister. He rejected the idea of becoming a minister, but remembered

favorably the experience of speaking to an audience.18

Jewett would use his public speaking experience later as a temperance

lecturer, but his first venture into the temperance arena, at age nineteen, was much

more circumspect. In 1826, while living in his family home in Connecticut, Jewett

wrote his first temperance message and posted it anonymously on the village green in

Lisbon. According to Jewett’s own account he left the treatise posted to the old

whipping post, “that old relic of barbarism,” at the crossroads in the center of town.

As the crowd assembled to read the notice, Jewett also pushed his way through the

crowd and read with feigned interest and thus preserved his anonymity.19

What prompted Jewett’s first temperance venture? There are several

immediate influences to be considered. His older brother Joseph had recently taken a

temperance stand. He refused to drink alcohol, opposing the common opinion that

agricultural work could not be done without strong drink. Joseph had accepted a

challenge from other workers during harvest to see who fared the best, spirit drinkers

or himself, a water drinker. He went against the prevailing view and proved that he

could accomplish more work on cold water than laborers who drank alcohol during

18 Thayer, 60-62.

19 Jewett,Forty Years, 18.

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the summer harvest. Jewett comments that “[h]ere.. .was a practical refutation of on prevailing opinions; and some of us saw it and were instructed.”

Jewett was also influenced by his father’s recently adopted temperance

position. His father encouraged him to write something in verse to oppose the

widespread abuse of ardent spirits in the area. We do not know specifically what

motivated Jewett’s father, but his temperance support was dramatic and extremely

affective to young Jewett. Regarding his father, Jewett commented that “though he

was not at the time a personal abstainer, [he] had begun to get his eyes open to see 01 things as they were.” Jewett wrote that he still clearly remembered, after forty-five

years, his father encouraging him to write on the subject of temperance, an issue that

the family had “discussed around our hearth during a certain evening with a good deal

of earnestness.” Perhaps the family had discussed Charles’ experience living with his

brother-in-law and had gained insight about the harm that excessive drinking could

cause. Or perhaps the temperance decision of Charles’ older brother Joseph had

persuaded the family to adopt a temperance position as well. Regardless of the exact

cause of the family conversion, the outcome was dramatic. Jewett’s father asked him

to use his writing talents: “...try your hand for once on a subject of some

consequence.. .the folly and wickedness of granting men license to destroy the peace

and happiness of the neighborhood by selling liquors.” Jewett wrote the suggested

temperance appeal. Jewett’s father then arranged, at his own expense, for a hundred

copies of his son’s literary effort to be published privately and anonymously. While

20 Jewett, Forty Years, 15.

21 Ibid., 16.

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the villagers of Lisbon, Connecticut, slept, copies were left at homes and businesses

throughout the village.

Jewett had thus composed a lengthy address in rhyme on the subject of the

damage that liquor caused, and the need to restrict the sale and use of ardent spirits

and other intoxicating drinks in the village. In poetry sentimental but effective he

wrote:

Most other evils to this fount we trace, Which blast our pleasures and destroy our race. For this, the widow mourns—her husband dead; For this, the starving children cry for bread; For this, the wife sits waiting for her spouse, At midnight hour, and ponders o’er her woes, While he, poor wretch, all power of moving fled, Sleeps by the fence, or in• yon crazy shed... 99

In this passage Jewett demonstrated the mainstream temperance view of the “evils” of

liquors. He adopted the moral language and tone that typified much of the

temperance movement of the day. It is very likely that he had heard or been exposed

to the rhetoric of the evangelical Protestant temperance men such as Lyman Beecher.

Thus, we do not yet see in Jewett at age nineteen much of the objective message of

the temperance physician. He did not use the language of the scientist to consider the

addictive nature of the chemical alcohol. He did not consider the negative health

consequences of chronic alcohol intake. Instead he expounded upon the typical

temperance view of the damage done to the family, “the starving children” and the

“wife.. .waiting for her spouse.” In due time Jewett would expand his repertoire and

language, after he had developed the insight and practical experience of the physician.

22 Jewett, Forty Years, 19.

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In this regard we will be able to discern some of the influence of the temperance

physicians’ message and their unique approach to the drink issue.

The young man Jewett concluded his verse with a prohibitionist appeal, also

not typical of the more reasonable temperance message of the physicians. In the

conclusion of the lengthy poem, Jewett appealed to the town leaders to restrict the 9^ sale and use of alcohol, to “banish the grog shops” and to “check this ill.” Like

Luther’s theses posted on the door of the cathedral, the notice occasioned much

public discussion, controversy, and eventual changes in the village. Some villagers

supported the temperance appeal, while others vehemently opposed it. According to

Jewett’s account many expressed their “rum wrath” within the hearing and immediate

presence of the (unknown to them) author. But despite their opposition, the town of

Lisbon formed a temperance society in the following year, 1827. Jewett, his father,

and other family members signed the pledge to abstain from “spirituous liquors.”24

Thus Jewett adopted the temperance position early in life, just as he was about to

launch his medical apprenticeship with a local doctor in a town several miles away.

Notwithstanding his zealous, prohibitionist style, even at this early stage of his

medical career his tone demonstrated something of “moral suasion” (his own words)

and showed compassion for the drinker and his family. His verse referred to the

drinker as the “poor wretch,” not as a sinner or reprobate.

After the event of the posting of the temperance notice, Jewett spent the next

two years serving a medical apprenticeship with Dr. Baldwin near Lisbon,

23 Jewett, Forty Years, 20.

24 Ibid., 15-20.

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Connecticut. Working and living with the local doctor, Jewett quickly learned the

practical skills that a general practitioner had to know, such as how to set a bone, how

to deliver a baby, and how to treat a medical emergency caused by accidents upon the

farm. Mostly he learned through practical on-the job training, but he also attended

some medical lectures in nearby Pittsfield, Massachusetts during the winter. Jewett

got the opportunity to directly care for some challenging cases, for example a boy

with a severe injury to his skull. Using the metal working skills learned in his

father’s nail-making shop, he even crafted his own surgical instruments.

Apparently Jewett’s training was a success because a few years later, his training,

such as it was, was completed. Jewett set up his first solo medical practice in nearby

East Greenwich, Rhode Island in 1829 at age twenty-two.26

Early in his practice of medicine the young doctor began guardedly to teach

his temperance message. His Rhode Island patients were tradesmen and factory

workers, not the more rural population that he was familiar with from his childhood.

He remarked that they did not observe the Sabbath and many never even attended

church. Jewett was apparently not favorably impressed with their secular life, full

of drinking and rowdiness. His biographer describes the populace and Jewett’s

reaction:

There was little regard for the Sabbath.. .Only a small part of the population attended meeting. The moral status of such a community is well understood. A profane, vulgar, rowdyish, intemperate population, as a whole, was the inevitable

25 Thayer, 96-99.

26 Ibid., 101.

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result. Drunkenness abounded.. .Everybody used intoxicating liquors. It seemed to him [Jewett] that a majority of men used them excessively.27

Despite his disapproval of their habits, Jewett remained their genial, tolerant

doctor. During his first years of practice he noted that he had to be “careful not to

give needless offense.. .[w]ith a little medicine I mixed a little temperance, and

despite all my skill and caution in compounding the latter I found it more difficult to

render it agreeable to certain parties than even my pills and powders.” 9ft He realized

that he could not abruptly change his patients’ lifestyle. He had to be content to

devote most of his efforts to taking care of their medical needs, and thereby earn their

confidence and respect. He was also practical enough to recognize his limitation, as a

young, new doctor, to wield much influence. His livelihood depended upon his

patients’ good opinion of him.

Although he was hampered from changing his patients’ habits in using

alcohol, he nonetheless carefully observed their practices and lifestyle choices. As he

cared for his patients he took note of their habits, seeing widespread alcohol abuse

and its effects. Their experiences affected him greatly. Jewett recounted one such

incidence of addiction among his patient population. While in practice in Rhode

Island he had as his patient a family with a fourteen-year old girl afflicted with

tuberculosis. One frosty morning as he made his rounds earlier than usual, he came

to the home with the tuberculosis patient. He found the girl alone in a frigid house,

sitting in a chair with a blanket wrapped around her, trembling from the cold. The

fire was completely out and there was no wood in the house to restart it. Jewett asked

27 Thayer, 104.

28 Jewett,Forty Years, 23.

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where her parents were and she replied that they were in bed. She had been sitting up

all the night, sick and alone. Jewett, aware of the family condition, remarked that he

knew that both parents were drunk and therefore unable to care for their daughter.

Years later in public lectures Jewett referred to the incident:

Is there another influence under heaven, with which any one before has ever become acquainted, strong enough to drag a mother from the side of a dear, sick, suffering child.. .except the accursed influence of the intoxicating cup?.. .1 have lived more than forty years, and been a pretty careful observer of what is passing in the world around me, and I have never witnessed the operation of any other power than that of alcoholic drinks which was capable of conquering a mother’s love.29

This passage reveals several significant themes in Jewett’s conceptual

thinking and practical, clinical approach to alcohol abuse. First, it demonstrates his

dedication and compassion for his patients, qualities that contributed to his reputation

and his professional success. Even as a new doctor in practice he gained a solid

reputation for his responsibility and his compassion for his patients. In this account

of his early practice he started his day early in the morning in order to complete a full

schedule of daily calls. His services were much in demand and his patients gave

testimony to his skill on numerous occasions. He responded to the situation with

compassion and a commitment to promote change in his patients’ lives.

Secondly, it indicates, even in his early years, his developing awareness of the

power of addiction. Despite the fact that his commentary on the incident was not

contemporaneous with the incident, he still identified the problem of alcohol abuse

and the lack of control that accompanied the same. At the time he certainly

29 Charles Jewett,Speeches, Poems, and Miscellaneous Writings on Subjects Connected with Temperance and the Liquor Traffic (Boston: John P. Jewett, 1849), 75-77; incident also cited in Thayer, 105-106.

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understood that drunkenness was a serious problem for the family; however, his

commentary on the strength and force of addiction came later. His ideology and

conception of addiction developed with more conviction and precision over time. But

even at this early stage of his career he opposed alcohol abuse as a destructive force

to individual and family health.

The incident also reveals something about his attitude regarding the issue of

gender. It shows that, as much as Jewett portrayed the drunkard as male, he was

sufficiently objective in his observations of patients to see that women could also be

affected by alcohol abuse. He usually emphasized the prevalence of alcohol abuse as

a male-dominated realm, especially in the setting of the “grog-shop” or tavern. Yet,

he acknowledged the existence of female alcohol abuse, presumably less prevalent or

at least less noticeable within the confines of the home setting. The fact that women

abused alcohol at home did not, however, make their behavior less destructive, in his

opinion. Jewett assessed the mother’s behavior with a gravity especially revealing.

He was stronger in his indictment of the mother than the father. Both were

presumably just as incapacitated by drunkenness, but he employed his most

emotionally-charged lament for the mother’s behavior, rather than that of the father:

“I have never witnessed the operation of any other power than that of alcoholic drinks

which was capable of conquering a mother’s love”—no mention is made of a father’s

love. I will return again to the theme of Jewett’s conception of gender as it relates to

addiction, but now continue with Jewett’s chronological story.

Jewett continued to develop his temperance stance as he treated patients. In

Greenwich, Rhode Island, where he first opened his medical practice, there were

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numerous examples of “immorality and intemperance,” according to his biographer

Thayer. Surely old Puritan New England was not what it used to be. The

declension of the old morality was prominent and pervasive. Jewett further solidified

his temperance view as he encountered the accidents and damage occasioned by

widespread alcohol abuse among his patients. Jewett found instances of alcoholic

mishaps to be common among his patients. He counseled them to adopt the practice

of temperance and abstinence as he conducted his routine medical visits, but found

that abusive drinking practices were well entrenched in the populace. On one

occasion he stitched up a man who had been injured in a brawl. He told him to rest at

home and instructed him not to drink even a drop of liquor during the recuperation

period. When checking upon his patient the next day, Jewett was told that the man

•2 t was at the local tavern, drinking rum. Such experiences convinced Jewett that he

was dealing with a habit over which the drinker had lost all control. His daily

experiences persuaded Jewett of the seriousness of the alcohol issue.

Although Jewett’s early efforts to encourage his patients to abstain from

alcohol were not at first particularly effective, he gradually helped in promoting

temperance sentiment in Greenwich and surrounding towns. By the early 1830s he

had begun to see some changes in temperance attitudes. Several of the local towns in

Rhode Island had organized temperance societies, not a surprising development

during a period when membership in temperance societies was spreading throughout

the nation. With increased temperance activity and a confluence of several events,

30 Thayer, 108-109.

31 Ibid., 106-7.

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Jewett felt emboldened to give his first public temperance talk in 1832. The occasion

was a situation involving a Baptist preacher, Levi Meech, in the nearby town of

Exeter. Meech had recently opposed liquor in his sermons. Jewett heard from some

of his patients who were members of Meech’s church that their pastor was under

attack. Jewett decided to come to his aid by lecturing in Meech’s town, Exeter, on

the ill effects of alcohol use.

In his decision Jewett had the support of his wife, Lucy Adams Tracy, whom

he had married just a month earlier in 1832. Lucy Jewett very probably was one of

those women who would have eagerly assumed a leadership role in the temperance

movement if social attitudes had allowed it. She strongly supported the temperance

cause, joining a temperance society that had two pledges, a “short pledge” abstaining

from distilled spirits and a ’’comprehensive pledge” abstaining from all intoxicating

liquors. Lucy had taken the comprehensive pledge the year preceding her marriage.32

The young couple had made a serious commitment in publicly supporting

temperance. It was a risky business for a young doctor to take a temperance stance

that would not likely be popular with all the community. He commented that without

his wife’s support he would not have been able to undertake such a venture, “Reader,

if you have not learned that a married man rarely succeeds in any important

undertaking without the permission if not the aid of his wife, it is time you did.” In

addition to his wife’s commitment to the cause, the comment reveals the relegation of

women to a secondary role in the temperance movement during the period.

32 Jewett, FortyYears, 25.

33 Jewett, Forty Years, 24-25;Thayer, 109-112.

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Jewett’s 1832 lecture achieved varied success. His address was successful in

that temperance societies recruited his support. He had taken the first step in his

newfound temperance career. According to his biographer, “from this time Dr.

Jewett’s labors were sought in the temperance lecture-field.”34 His lectured, without

pay, throughout the area, night after night, in little school houses and lecture halls

throughout the local region. On the other hand his public lecture was not entirely

successful, as it posed a threat to his medical practice and even to his safety. His

temperance support put his medical practice in Rhode Island at risk. He received

threats from the local pro-liquor forces. Since he was out traveling alone at night,

both on temperance lecturing and taking care of patients, his friends advised him to

discontinue his night calls. With his wife’s support he refused to discontinue his

mission. He continued, carrying a pistol. He taught his wife, at home, how to use a

gun- she became a good markswoman.

Increasingly Jewett worked more for the temperance cause and less in his

medical practice. Eventually he worked completely for the temperance movement

and left, for a while, the practice of medicine. Around 1837 he and his family moved

to Providence, Rhode Island, where he accepted a job as temperance agent for the

Providence Temperance Society and the Rhode Island Temperance Society. He

plunged into temperance work, pledging hundreds of new members and spreading the

temperance message. The timing of his move to fulltime temperance work was

however, unfortunate from an economic standpoint. The economic crisis of 1837 hit

34 Thayer, 113. Copies of his first address were printed and distributed to local temperance societies. A copy o f his address has not been located at the time of this writing.

35 Ibid., 113-14.

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the manufacturing economy of Rhode Island hard. The local factory economy was

depressed and many workers were unemployed. People who had pledged to

contribute to the temperance society could not continue to do so. Because of

financial difficulty the temperance agency could not always pay him. Needing the

money, Jewett was forced to return fulltime to practicing medicine, seeing patients in

Providence. Just at the time when his finances were at their lowest ebb, another

problem surfaced: Lucy Jewett became seriously ill with “lung hemorrhages,” an

indication of tuberculosis. As their problems mounted Jewett lamented that after

ten years of hard work in the temperance field they were as poor as ever. The Jewetts

were reduced to selling some of their furniture and living with Lucy’s relatives in

Connecticut. In a low moment, alone and waiting for the train to take him to seek

work in Boston, Jewett admitted that he broke down and wept.37

There were more opportunities for temperance work in Boston than in Rhode

Island. In 1838 Massachusetts had passed the fifteen-gallon law, limiting sales to

fifteen-gallon containers only. The law prohibited the sale of liquor in quantities of

less than fifteen gallons and as a result, on site drinking in taverns. The law met with

fierce opposition from pro-liquor forces. One of the most compelling arguments that

they made against the law was that it discriminated against those who could not

afford to buy in large quantity. The elitist implications of the law harkened back to

the old elitism of the earlier Massachusetts Society for the Suppression of

Intemperance of 1813. The anti-prohibitionists used the argument, an effective one,

36 Thayer, 150-51.

37 Jewett, Forty Years, 77-80.

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that similar elitist forces were in play a generation later.38 The forces opposing

prohibition found ingenious ways to circumvent the law, the most famous being “the

striped pig” event, a means of providing liquor by the drink without direct sales. A

tent was set up, along with advertisements to view a pig with stripes like a zebra for

an entrance fee. Patrons paid their fee and once inside viewed an ordinary pig with

stripes crudely painted upon it. They were then offered “free” drinks, and so one

might pretend that the prohibition against the sale of alcohol was not violated. The

striped pig subterfuge occasioned great hilarity and helped to overturn the law. The

controversial law was repealed in 1840, having caused a great deal of political and

social tension in the state. The restrictive law proved to be too prohibitionist for

popular opinion and so Massachusetts reverted to the law that had been in effect in

1837. The prior law had allowed county-by-county licensure laws. Although

statewide prohibition had failed, temperance sentiment still flourished in

Massachusetts in individual counties.

Even though Jewett had curtailed his participation in the temperance cause at

that time in order to concentrate upon his medical practice, he continued to support

the cause. He attended the presentation of the fifteen-gallon petition to the

Massachusetts legislature in 1838 in order to offer support by his presence. After the

law was enacted he continued to support the law and opposed those who favored its

repeal. Although he maintained his medical practice, Jewett’s actions in the highly

visible Massachusetts fifteen-gallon law campaign demonstrated that he was

38 For a through discussion of the Fifteen Gallon Law see Robert Hampel, Temperance and Prohibition in Massachusetts, 1813-1852 (Ann Arbor, Mich: UMI Press, 1982), 79-101.

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sympathetic with the partial prohibitionist approach. He also declared in his

autobiography that he was determined that the merriment surrounding the Striped Pig

affair should not be used to promote the pro-liquor interests in repealing the law. He

wrote that he participated in publishing material that denounced the liquor interests in

the Striped Pig affair, by which he meant the sellers and wholesalers.39

It is not clear how public Jewett was in his activities to support the

Massachusetts law. Perhaps he feared detrimental effects upon his medical career.

The material that opposed the repeal, A History o f the Striped Pig, was published

anonymously in Boston in 1838, but evidences the hand of Jewett.40 The three-

chapter work shows Jewett’s style, humor, and philosophy. Especially revealing is

the way that it ridicules the sellers and wholesalers of alcohol, not the drunkard. Such

an approach is typical of Jewett’s thinking. The History ridicules the sellers for

representing themselves as friends of the poor—“we leave these pure, disinterested,

and patriotic philanthropists.. .to their further orgies.” They were the “masters of the

spell” and “a swinish confederacy.”41 The satire of the drinker is gentle by

comparison—the drinker “saw double and beheld two pigs.”42

Other clues to authorship are found in the third chapter, a satirical report of

the reputed post-mortem of the Striped Pig. The combination of satire and medical

knowledge strongly indicate it as Jewett’s work. The medical exam was reported to

39 Jewett,Forty Years, 94-118.

40 A History of the Striped Pig (Boston: Whipple and Damrell, 1838).

41 Ibid., 43,4.

42 Ibid., 6.

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have been made more difficult due to the “alcohol which saturates the pig.” The post

mortem reported on the condition of the pig’s brain (“emitted an alcoholic odor, and

burnt readily”), heart (“entirely ossified”), and intestines (“inflammation discovered

in the abdominal viscera”).43

The final indication that Jewett authored the History o f the Striped Pig is his

trademark, the overblown verse that he somehow could not resist writing:

Grasp the bowl, in nectar sinking Man of sorrow, drown thy thinking Within the goblet, rich and deep Cradle thy crying woes to sleep.44

In addition to the verse style, the compassion evidenced for the drunkard is consistent

with Jewett’s attitude toward the drinker.

In 1839 when Boston hosted the state temperance union meeting, Jewett had

attended as a delegate from Rhode Island. Yet he still worked full-time in medical

practice in order to support his family. Most likely because of his growing

temperance reputation, Jewett was approached in 1840 by the Massachusetts

Temperance Union to speak to their annual convention in Boston. Jewett decided he

could not afford to do so; he needed to continue to see patients and pay off a bill for

drugs that he had ordered, in the amount of seventy dollars. His wife urged him to

reconsider his decision. Loyal to the temperance cause and determined as ever, she

encouraged him to write another temperance verse for the upcoming convention,

Jewett was persuaded by his wife’s plea. He wrote a long poem on temperance for

the convention. He attended the meeting in Boston and recited the poem there.

43 Ibid., 71.

44 Ibid., 20.

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Immediately after his presentation one of the delegates asked if it could be printed up

and purchased by delegates to take home with them. It was printed overnight and

bought in great numbers by the delegates, raising the sum of seventy dollars, the exact

amount needed to pay his medical supply debt. The poem was also published in the

winter of 1840 in the Boston newspapers.45

In the next decade Jewett’s fame and reputation as a temperance leader grew

into national prominence. In 1840 Jewett accepted a position as a temperance agent

for the Massachusetts Temperance Society and once again left the practice of

medicine. Throughout the 1840s he worked full-time as a temperance agent for the

Massachusetts temperance cause. He traveled throughout the Eastern and

Midwestern states as antiliquor crusader, lecturing and teaching. He edited the

Temperance Journal during the 1840s and early 1850s. He was particularly

successful in getting great numbers of people to sign the pledge.46

Despite his national prominence Jewett continued to encounter personal

financial difficulties. The rise of the Washingtonians in the early 1840s and later the

Sons of Temperance had eroded the base of the statewide and national organization.

The Washingtonians came to Massachusetts in 1840. Jewett helped them although

they eventually eroded the local temperance societies that he had worked to establish.

The membership in the societies of the American Temperance Society, based in

Boston, declined after 1840.

45 Jewett, Forty Years, 72-75; Thayer, 133-139; 150-51.

46 Lender, 259-60.

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Once again Jewett found that his work as a temperance agent did not pay well.

By the 1850s the competing temperance organizations had made inroads upon the

ability of the state and national temperance societies to fund temperance agents such

as Jewett. Under these circumstances the Jewetts faced great difficulties. They

suffered from financial difficulties and they may have had health problems as well.

Their exact health condition is unclear, but Lucy Jewett had suffered from

tuberculosis and Jewett apparently had also experienced some respiratory symptoms.

Jewett decided he should abandon his demanding lecturing schedule in order to

rebuild his health and help care for his wife. According to the health

recommendations of the day, they sought the fresh air treatment and moved to the

Midwest with their children.47 In 1852 Jewett moved his family to a small farm in

Ohio, where he farmed as well as did some temperance lecturing.

They stayed in Ohio for two years, then moved further west in 1854 to

Illinois. With land prices lower in the west, they bought a farm, first in Batavia,

Illinois and then in Fairbault, Minnesota. In Minnesota Jewett’s health returned and

along with it his enthusiasm for the temperance cause. Late in life, with improved

health, Jewett returned to temperance lecturing and even local politics, and was

47 Charles and Lucy Jewett had thirteen children, including two sets of twins, ten boys and three girls. One o f the twin boys died at birth. One son, William, died after they moved to Ohio. Another son, John, was killed in 1863 as a soldier for the Union forces at the battle o f Chickamauga. A comrade said that he was “the best fellow in the whole company.. .We could never persuade him to join us in any of our scrapes, nor to drink a drop, nor even so much as to smoke or chew.” Another son, Frank Fanning Jewett, bom in 1844, was regarded as his legacy became active in the temperance cause. A graduate of Yale, he became a professor at Oberlin College and assisted Howard Hyde Russell in founding the Anti-Saloon League. Thayer, 15, 316-18, 328-329, 331-336.

48 Thayer, 241-47.

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elected to the Minnesota state legislature. In the last three years of his life he gave

temperance lectures in New York, New Jersey, Pennsylvania, and Maryland.49

We now leave the chronological summary of Jewett’s life and experiences in

order to address more extensively his ideas and his means of expressing them. How

did he view the effects of alcohol on the individual drinker and society in general?

How did he view the role of society in social reform? Did he accept the addiction

model that had been adopted by the temperance physicians, or was he more in the

mold of the evangelical temperance reformers? As we consider these questions we

examine Jewett’s temperance ideas and also the ways in which he expressed them,

that is to say, we examine both his ideology and rhetoric. To some extent his

ideology can be placed within the context of the temperance physicians. He

promoted the disease concept of the substance alcohol and advanced a practical

theory of addiction. Yet it is also evident that Jewett was a hybrid, not completely the

medical man in his approach to temperance. We shall be able to identify his approach

not only in his ideas, but also in his rhetoric, in his language and tone. The way in

which he expressed his message is just as revealing as the message itself.

Jewett’s temperance ideas and his rhetoric are marked by a duality. He was a

hybrid, in part influenced by his medical training and profession, and also in part

influenced by the more mainstream temperance thinking. First, we consider his ideas

about temperance and intemperance as a product of mainstream temperance. In this

regard he was less like the temperance physicians. In attacking alcohol, Jewett

49 Jewett died of a heart condition at age seventy-two. He was buried in Lisbon, Connecticut, his childhood home. Lender, 260; Thayer, 355-56.

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emphasized the conditions of poverty and crime that he regarded as a direct result of

drunkenness. As a product of a less advantaged socio-economic class, and with less

academic orientation, he differed from Sewall and Mussey. Perhaps because he and

his family often experienced economic difficulties, Jewett identified strongly with the

problems of the underclass. According to Jewett’s mindset, the principle cause of

poverty was alcohol. If there were any other contributing causes he did not focus

upon them. For him, alcohol was the main problem for social problems and

abstinence was the panacea.

Jewett was inclined to ascribe the many social ills of the people—poverty,

domestic violence, crime, illness, and social inequality—to alcohol and intemperance.

He conformed to the common thinking of the nineteenth century temperance

reformers who identified alcohol as the primary causal factor for many social ills.

His speeches, writings, and drawings are filled with references to the poverty and

other social ills caused by intemperance. The drunkard he depicted as dressed in

“ragged clothes, worn-out shoes, and old slouched hat. He has spent his money for

strong drink, so that he has none left to buy new clothes.”50 He cited the drunkard’s

children who did not have enough to eat, who were ill clad, going “shoeless, over the

frozen ground” and forced to work for “hard-earned pennies,”51 or “beggared children

roaming through the street.”52 In Jewett’s interpretation, their plight was the result of

a drunken parent, usually the father. Jewett believed that alcohol and other

50 Jewett, Youth’s Temp. L ed., 6.

51 Ibid., 27.

52 Jewett, Speeches, 143.

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“stimulants”53 such as opium caused social ills wherever they were used: “Visit any

portion of the civilized world, and inquire after the causes of poverty, degradation,

and crime, and you will find the employment of unnatural stimulants.”54 Jewett’s

economic and social philosophy proceeded from individualistic theory. Individuals

were responsible for their own welfare and that of their immediate family.

Intemperance interfered with the individual’s ability to provide for himself and his

family. Therefore, according to Jewett’s views, a man must maintain sobriety in

order to be capable of providing an economic livelihood for himself and his family.

Jewett’s philosophy did not consider the potential role of class oppression, political

oppression, ethnic prejudice or other means by which the stronger took advantage of

the weak. In this regard he was a product of the Protestant work ethic and capitalism.

His religious affiliation coincided with Protestant individualism, Protestant

membership being a common affiliation of temperance reformers. According to their

ideology, individuals could control their fate through their individual actions and

choices. Temperance, self control, and industry fit comfortably into that ideological

approach.

Jewett’s stories and speeches contain frequent references to the wife and

mother who suffered the poverty and disgrace of abandonment: “What though our

wives sit quite alone, and muse on hopes and pleasures gone?”55 If the drinker’s wife

had children, she was unable to protect or provide for them: “[tjhere stands his wife,

53 Jewett’s assessment of the chemical composition and effect of alcohol will be discussed later in this chapter.

54 Jewett, Speeches, 52. 55 Ibid., 147.

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with weeping children round,” victim of “that [intemperance] which will rob a mother

of her rest, and take from half-fed children needful bread.”56 Or worse still, women

and their children might be subjected to domestic violence because of drunkenness.

In his temperance book for instructing children Jewett depicted a scene from the

drunkard’s home and commented upon a drawing that illustrated his text:

Look at that intoxicated man. He is holding his little boy by the hair with one hand, while the other is raised to give him a blow. And see that afflicted mother, doing what she can to save her poor boy from the blow which is aimed at his head, while his little sister is running away in a fright. Are they not objects of pity? Thousands of children are beaten every day by intemperate parents. Strong drink makes them more cruel than wild beasts... 7

Despite Jewett’s emphasis upon the socio-economic aspects of the harm

that alcohol caused women within the patriarchal social system of the era, in contrary

fashion, he also conceived and expressed a broader view of the effects of alcohol

upon women directly. He also described the effects of intemperance upon those who

did not suffer from economic distress, men who were economically well established

in society. I will return to this significant aspect of Jewett’s thinking, significant

because it demonstrates the duality of his thinking. It is Jewett’s hybrid nature that

makes him such an intriguing figure. In some respects he voiced the typical

temperance line of thought, but at the same time he often adopted the more rational

and objective language and thinking of the medical scientist.

We return for now to a delineation of his mainstream temperance ideology.

Another way that demonstrates Jewett’s more mainstream, non-medical approach to

temperance is his support of prohibition. During his temperance career he

56 Ibid., 144.

57 Jewett,Youth’s Temp.Lect., 22.

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enthusiastically supported prohibition in a number of guises, from limited licensure of

selling and serving alcohol to outright prohibition of all sales and consumption. In

this regard he was much more fanatic, or one might say, dedicated to the cause than

were the other temperance physicians. The medical, scientific approach to

temperance stressed the health consequences of alcohol use or abuse. The rational

approach of medical advice assumed that rational people would heed the medical

warning. Their approach employed the supply-side method of the equation. If only

people had enough information, they would make the correct choices and abstain

from intemperance.

Apparently for Jewett the rational, medical approach was insufficient.

Because of his orientation toward the socio-economic harm of alcohol Jewett adopted

a more extreme, interventionist approach. He seemed not to trust that his stature as a

medical authority would carry sufficient weight to persuade his patients. He

expressed that he must be “careful not to give heedless offense” and that “with a little

CO medicine I mixed a little temperance.” Because his efforts often yielded so little

results he felt that people needed more than good health advice—they required legal

constraints. Thus we see that from his earliest ventures into the temperance cause,

Jewett promoted some form of prohibition. At various points in his career he

endorsed the limitation and even prohibition of the sale of alcohol. His first youthful

assaults on alcohol, posting the notice on the village green, attacked the sale of rum in

the local tavern. In that his first foray against liquor he called for the local tavern to

be closed.

58 Jewett,Forty Years, 23.

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Also from his first anonymous participation in the temperance cause he aimed

his sharpest barbs at the wholesalers and retailers of alcohol. Over time his

endorsement and commitment to prohibition became more public and outspoken. His

literature is replete with opposition to the sellers of alcohol. He treated the drunkard

with pity and compassion, but saved his scorn for the purveyors of the substance. For

he viewed the sellers as those who “fill up your coffers with the price of blood.”59

Jewett was convinced that if the sellers did not engage in “their vile traffic,”60 there

would be no drunkards. The pro-alcohol forces responded to Jewett’s condemnation

in kind. Jewett frequently encountered local opposition from the pro-liquor forces

and was even exposed to threats of violence. He experienced several narrow escapes

and, as previously related, learned to carry a pistol as he went on his rounds at night.

Jewett continued his drive for various prohibitory measures throughout his

life. Yet even in this undertaking one can detect the nuance of his dual nature. On

one hand his public prohibitionist stance contrasted with the more moderate stance of

the other temperance physicians. Jewett’s most famous prohibitionist campaign was,

as previously discussed, the Fifteen Gallon Law in Massachusetts in 1838.61 The law

prohibited the sale of liquor in quantities of less than fifteen gallons and so marked

the first salvo in the increasingly prohibitionist sentiment in the temperance

movement. Jewett enthusiastically promoted the prohibitionist cause. However, the

59 Jewett,Speeches, 143.

60 Ibid., 122.

61 Jewett attended the presentation of the petition for the law in the Massachusetts legislature in 1838. Jewett,Forty Years, 98.

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method he used to challenge the repeal efforts in the Striped Pig incident, for

example, demonstrates the other dimension in Jewett’s approach. He said he was

“determined to turn the popularity of the pig to account, and make it, if possible,

contribute to the advancement of the temperance system.” He gently satirized the

conditions of the drinker who would go to such lengths in order to procure his

alcoholic drink. If indeed, as is strongly indicated by the evidence, he authored A

History o f the Striped Pig, he employed humor in discussing the supposed post

mortem of the pig. Instead of moral indignation Jewett used humor to illustrate his

point. His use of humor, rather than the opprobrium and condemnatory tone typical

of temperance advocates, indicates his ability to adopt a more reasonable and rational

tone in the debate. Although the difference in Jewett’s approach may appear subtle, it

marks a significant difference that is typical of the temperance physicians. He never

directly attacked the drinker, whom he regarded as a victim of the “liquor system.”

Instead he displayed an attitude of acceptance of the drunkard, but a rejection of the

condition of addiction.

The other side of Jewett’s dual nature and approach to temperance proceeded

from his more rational approach and training as a physician. In this regard he

resembled the other temperance physicians. He developed ideas about the harm of

alcohol as a substance that had numerous deleterious effects upon his patients and

others with whom he had close contact. As has been previously recounted in this

chapter, Jewett was strongly influenced by the damage that alcohol caused physically,

mentally, and spiritually. Early in his medical practice he became sensitized to the

62 Jewett,Forty Years, 105, 116-118.

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damage that alcohol could cause. He grew concerned about what he regarded as the

addictive qualities of alcohol, although he did not employ the word addiction. As is

discussed in the opening chapters of this dissertation, the term meant something else

at this period and did not come into modem usage until the twentieth century.

The language that Jewett adopted to describe the phenomenon of addiction

was “the artificial appetite.” In his theory of the artificial appetite Jewett posited that

certain substances produced a craving, an unnatural appetite. All artificial appetites

were governed by the same influence or natural law. They produced a loss of control

in the victim. Jewett specified that certain substances produced an artificial appetite:

intoxicating beverages, narcotics, and other stimulants, specifically tobacco. As

Jewett described the artificial appetite, it overtook the natural appetite and subverted

it. Jewett taught that alcohol gradually replaced the natural appetite with an unnatural

appetite. In contrast with the natural appetite, the unnatural appetite invariably

demanded more, with harmful results:

“The law of artificial appetites is a law of increase. Their demand is for more, more, more; give, give, until we drop into our graves. It is this law which, when a man has heedlessly formed an appetite for intoxicating stimulants, drags him on and down, through a course of indescribable sufferings.. .Now there is no such tendency in natural appetites for food or drink.. ,63

According to Jewett’s conception of addiction the drunkard was not weak-

willed or immoral. Quite the contrary, all drunkards began their drinking career as

moderate drinkers and with all intentions of controlling their intake. They assumed

that they could drink alcohol safely and without ill consequences. Only gradually did

63 Jewett, Speeches, 10.

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the artificial appetite engendered by alcohol take over its victim. Before his fall into

intemperance the typical drunkard had proclaimed, with full confidence, that he could

safely drink. The incipient drunkard would say, according to Jewett’s rendition: “Do

not give yourself any uneasiness on my account. I know when I have taken enough. I

can drink, or, if I please, I can let it alone.”64 But such a man was, in Jewett’s view,

in danger of being trapped by the addictive power of alcohol. His lack of awareness

of his vulnerability to the artificial appetite made him all the more susceptible to the

danger of alcohol.

In his speeches and writing Jewett often referred to the force of the artificial

appetite, illustrating the theory with practical examples. He illustrated the principle

of artificial appetite with ordinary, homespun examples that his audience could

identify with. In order to demonstrate the difference between natural and artificial

appetite, he used many examples. One such example was that of a boy eating an

apple from a large basket of apples (or alternately Jewett used the example of a bowl

of strawberries or some other fruit). If one were to give a child an apple— beautiful,

ripe, and delicious— he would enjoy eating the apple. He would eat according to his

natural, healthy appetite. He would eat the apple with relish and “gusto.” But,

according to Jewett’s example, if one were to place a whole barrel of apples next to

the boy, day after day, he would not be in danger of eating two the next day, three the

next, and so on until he gorged himself into oblivion. The boy was satisfying a

natural appetite, and was not likely to overindulge by eating the whole basketful. By

64 Ibid., 15.

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contrast, Jewett described the “artificial appetite” that was developed for

“intoxicating stimulants,” whereby the drunkard could not stop the overindulgence.65

Jewett gave the same example with other healthy substances, for example,

cold water. When one felt thirsty he would drink a glass of water and thereby satisfy

a natural thirst. He would not place himself in danger of drinking more water on

successive exposures to water. Thus, Jewett made a distinction between the healthy,

natural appetite and the unnatural appetite that alcohol stimulated. A natural, healthy

substance would not engender an artificial, destructive appetite.

Jewett’s concept of addiction extended to addictive substances other than

alcohol and narcotics. He specifically mentioned tobacco as having addictive

properties, and occasionally opposed its use. He regarded tobacco as “a narcotic

substance” that also produced an artificial appetite, but did oppose its use with the

same intensity as he did alcohol. He did not regard its use as causing the same

emotional, mental, or moral damage as alcohol:

I would not proscribe the use of tobacco on the same ground upon which I would condemn the use of alcoholic stimulants. I have never known an individual led to the commission of crime by an extra Havana.. .Pig-tail or old Cavendish, though they induce a filthy habit, and impair the health of the consumer, especially of the nervous system, do not destroy the moral sense, alienate of annihilate the social affections, inflame the passions, and impel an individual, -as do intoxicating drinks, — to kick his wife and children out of doors, or imbrue his hands in their blood.66

What attitude did Jewett take regarding the potential of addiction to

overeating food? Jewett admitted the possible addictive characteristics of food and

65 Charles Jewett,Speeches, 10-12.

66 Jewett,Speeches, 12.

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specifically identified the reality of overeating. He cited the phenomenon of

excessive food intake as a problem: “natural appetites, when improperly indulged,

lead to excess, as well as those which are artificial” and he conceded that “we have

gluttons as well as drunkards.” ft 1 But he insisted that gluttony developed only when

people ate improper food, not plain and simple food that was necessary to nutrition.

He cited the examples of plain foods such as apples, strawberries, and dairy products

as counter examples to the inducement of the artificial appetite. He emphasized that

excessive food intake was exacerbated by drunkenness and thereby returned to his

preferred addictive agent, alcohol. Throughout his writings and lectures he made few

references to excessive food intake. When considering addiction, he focused his main

interest upon alcohol. Preoccupied with alcohol, he generally downplayed the health

consequences of other substances.

Another significant way in which Jewett did not follow the conventional

socio-economic thinking about the dangers of alcohol was in his appreciation of

individuality in the addictive process. Leaving behind the conventional socio

economic conception and prejudice that drunkenness Was the bane of the working

man, he viewed addiction as a condition that affected individuals equally. According

to his conception, all individuals were equally at risk of addiction. He thought that

the artificial appetite posed a danger to rich and poor, educated and uneducated, male

and female. His writings and speeches are replete with examples of upstanding and

respected men, as well as women, who found themselves caught and trapped “under

67 Ibid., 13.

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/ o the bewildering, maddening influence of liquor.” They were like the young father

who was “naturally kind hearted and well disposed,” but transformed by alcohol into

a “blind rage,” or the respected clergyman who experienced a blackout while

conducting funeral services. In the case of the clergyman, Jewett described the

effects of alcohol that produced temporary amnesia. Jewett did not use the term

amnesia or even the contemporary term blackout, yet such was the phenomenon he

described. The facts of the case were as follows: the minister had officiated at a

burial of a church member during the day. Alcohol had been freely offered

throughout the proceedings, beginning with the wake. Later that evening, sitting at

the table of the wife of the deceased, he asked how her husband was doing. The

company was horrified as they realized that the minister had no memory of having

conducted the man’s funeral earlier in the day. Jewett thus described the classic

blackout in which the victim appeared to be functioning, but the alcohol intake had

erased his memory. There are two observations to be gleaned from this example.

First, Jewett reported the event with the clinical eye, accurately and descriptively.

The second observation is that Jewett in no way condemned the minister, but instead

described him with compassion and pity.

Many other examples of inclusivity are found in Jewett’s speeches and

writings. His account of the addicted the mother who, in a state of intoxication,

abandoned her seriously ill child is one such example. As discussed earlier, he

recounted the anecdote of the child suffering from tuberculosis whose parents were

68 Jewett,Forty Years, 85.

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too drunk to take care of her.69 In this example, although he seems to assign more

fault to the mother than the father for neglecting the sick child, he nevertheless

demonstrated his concept of alcohol addiction affecting all regardless of gender. His

concept of the addictive nature of alcohol was that addiction was a scourge with equal

opportunity potential. His anecdotes invariably conveyed the strength of the

addictive power of the substance. Jewett commented that it was the only known

power that could defeat a parent’s love for the child.

Drunkards were drawn not only from the ranks of the working classes whose

habits forced them into poverty and crime; they could come from the highest echelons

of society—ministers, academics, and even physicians. Jewett cited with special

compassion the case of the old, burned out doctor who had fallen into addiction. His

compassion contrasted with the contempt that an inn-keeper had shown to the elderly,

bleary-eyed doctor who had come for his daily intake of alcohol. According to the

inn-keeper, the doctor had been “one of the most celebrated physicians in this part of

the country,” but now “his copper is pretty much burned out.”70 Jewett observed that

the person who deserved scorn was not the drunkard doctor, but the liquor interests

that had participated in his downfall. He was incensed that the old man, who had

served the public so faithfully for so many years was now regarded as worthless:

“just the remembrance of that heartless utterance concerning that feeble, wretched,

despairing old man, makes my blood boil.”71 The fact that Jewett placed the blame

69 Jewett,Speeches, 75-77; incident also cited in Thayer, 105-106.

70 Jewett,Speeches, 250.

71 Ibid., 252.

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upon the seller of the alcohol rather than the drinker is consistent with Jewett’s

concept of addiction.

Another aspect of Jewett’s more rational temperance stance may be found in

his personal decision to adopt total abstinence. Jewett’s concept of addiction did not

admit the possibility of moderate drinking of alcohol, but required abstaining entirely

from all alcohol in all forms. His reasons for taking the position of total abstinence

resonate more with his rational, reasoned approach rather than a moralistic

imperative. He believed that the artificial appetite could not safely tolerate exposure

to the “poison” present in alcohol. In order to appreciate the distinction of the two

motives, rationality versus religious stricture, it is important to examine the means by

which he reached his decision to adopt personal abstinence. Jewett reached the

teetotal position in successive stages. His personal journey of abstinence began first

as a young man, after the incident on the village green when he decided to take the

pledge to abstain from distilled spirits. No specific mention was made in his first

pledge, the “short pledge,” to restrict wines or other fermented drinks such as cider

and ales. But early in his career as a physician, he made the additional decision to

abstain from wines. His stated motive was that he wanted to set a good example for

his patients. Apparently his moderate drinking of wine had caused one of his patients

to refuse to abstain from his excessive consumption of gin. When Jewett had asked

his patient why he continued to drink gin, the man responded by asking Jewett why

he drank wine. When Jewett responded that he found an occasional glass of wine

refreshing, the man eagerly replied that he also found gin “refreshing.” According to

his own account Jewett realized that if his moderate drinking of wine caused a patient

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to continue to drink and as a result, develop a problem, he wanted to avert that

situation. After that encounter he gave up drinking all wines in addition to abstaining

from distilled liquors. 79

A similar situation subsequently developed with one of his patients that

persuaded him to abstain also from cider. Although the hard cider of the period had a

lower alcoholic content than most wines, it contained enough alcohol to produce

intoxication if taken in sufficient quantities. Jewett was called to treat a patient who

had indulged in such intake. The man was a reformed drunkard, but had managed to

get himself into a drunken stupor drinking only hard cider. Worse yet, he had bought

his supply, a barrel of cider, from Jewett’s own cellar. Jewett was extremely

chagrined to learn that the man he was treating for alcoholic relapse had gotten the

substance not from a local tavern but from his own cellar. The Jewetts had sold it to a

passerby who, unknown to them, was a recovering drunkard. Jewett attempted to buy

back the barrel from the man so that he could dispose of it. In an amusing aside, the

man, aroused from his stupor but in a combative mood, refused to give the barrel to

Jewett and threatened him with violence. Jewett’s wife, learning of the difficulty

from her husband, managed to persuade the man to give up the barrel. After that

experience Jewett wanted to remove any appearance of endorsing the substance and

therefore gave up drinking hard cider or even storing it. His motivation was the same

as it had been for giving up wines. He took this final step in adopting the total

abstinence position early in his medical career, in the early 1830s.73

72 Thayer, 114-15.

73 Thayer, 122-24.

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In considering Jewett’s abstinence decision it is important to place it within

the social context of the larger temperance movement. As described in the opening

chapters of this dissertation the early temperance movement did not invariably require

total abstinence of its members. By the mid-1830s, the total abstinence position of

temperance societies increasingly prevailed, but by no means would have been

required of Jewett as a temperance advocate. Although he would have felt some

influence from the gradual shift within the temperance movement toward adopting

the total abstinence position, it appears that his decision proceeded from more

practical, immediate considerations. There are two sources for accounts of his

abstinence decision, his autobiography and his biography. Given the fact that

motivation is invariably a difficult assessment for historical analysis, one certainly

must concede that ascribing motives to Jewett’s decisions are problematical.

Nevertheless, the best information available suggests that he adopted total abstinence

as a result of his experiences as stated. Jewett held practical reasons for wanting to

provide a good example for his patients. The evidence indicates that he reached the

total abstinence position for practical reasons, rather than as a result of following

restrictive moral imperatives.

Other practical, rational explanations also help explain Jewett’s personal

decision to adopt total abstinence. Increasingly he became aware of the new medical

discoveries relating to alcohol. In his speeches and writings he gradually replaced his

references to “distilled spirits” with the more general and inclusive terms “alcohol”

and “intoxicating poison.” He referred to the physical effects of alcohol in his

writings and speeches, particularly emphasizing the destructive effects of alcohol

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upon the body, causing “general debility” and damage to the internal organs.74

Although he himself conducted no chemical or physical experiments, he

demonstrated knowledge of medical literature. There is evidence that he was aware

of Mussey’s and SewalPs temperance work. He cited Mussey and acknowledged his

temperance work in his autobiography, Forty Years Fight with the Drink Demon.

He was impressed with the experiments and pronouncements that Mussey reported

concerning alcohol. He believed that although alcohol damaged all the organs, the

damage began in the stomach and spread to the rest of the body. Apparently

influenced by Sewall’s stomach autopsy diagrams, he emphasized the injury that

alcohol did to the stomach: “the stomach is the primary seat of the disease, or has

been early and severely affected by it.”76 It is also significant that he referred to

excessive alcohol intake as a disease. The disease concept of alcohol abuse is

consistent with the medical view, rather than the moralistic, evangelical view.

Jewett also cited “the truths of science, the ascertained relations of alcoholic

liquors to the physical organizations of men.” He pleaded that these new discoveries

“must now come to the front and fight our battle for us, or victory can not [sic] be

ours.”77 He emphasized unequivocally the significance of “the verdict of science”

74 Jewett, Speeches, 17; Jewett,Forty Years, 286, “...any theory of the action of alcoholic liquors on the bodies of men and their various organs and tissues” must take into account the physical damage inflicted.

75 Jewett,Forty Years, 399-400.

76 Jewett,Speeches, 17.

77 Jewett,Forty Years, 390.

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concerning the dangers of alcohol.78 He cited numerous medical researchers, among

them Silliman, the Yale professor of chemistry. He also cited the alcohol

experiments of French physicians, but did not cite them specifically by name in his

writings. He likened the chemical effects of alcohol to the effects of the anesthetics

chloroform and ether. He referred to the work of Professor Silliman, concerning the

composition of alcohol: “Alcohol was closely related in its chemical composition and

influence to chloroform and ether.”79 He commented upon the effects of alcohol

upon the organs of the body, pronouncing that alcohol did great internal damage.

As was common in the science of the period Jewett seemed somewhat

confused as to whether alcohol acted as a stimulant or a depressive in its effects on

the body. He did not, however, recognize his confusion any more than did other

medical scientists who also used the terms without noting the inherent contradictions.

Sometimes he referred to the stimulant effects of alcohol, but also contradictorily

reported its anesthetic effects. Frequently he opposed the idea that alcohol was a

stimulant and argued that alcohol could be used as an anesthetic because, like an

anesthetic, it kills pain and “paralyze[s] the nervous system.” Alcohol should not,

therefore, be given as a restorative because it has the opposite effect, “the arrest of

vitality.”80 Other terms that he employed support his theory of addiction, especially

his occasional use of the term narcotic. In later years, after the 1840s, he applied the

term to alcohol and tobacco interchangeably. His use of the term narcotic is

78 Ibid., 391.

79 Ibid., 396.

80 Jewett,Forty Years, 396-7.

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consistent with his use of the term anesthetic rather than having the properties of a

stimulant.

Jewett vehemently opposed the prevalent use of alcohol as a medicine. In his

opposition he joined the positions of Mussey and Sewall. He voiced his opposition in

a letter written to a colleague in 1846: “no one [obstacle to temperance] gives me

O 1 more anxiety than the undue importance attached to alcoholic liquors as medicines.”

He decried that physicians so commonly proscribed brandy to dying patients, thinking

that they are promoting vitality, but in fact, according to Jewett they accomplished the

opposite effect. The patient would die drunk and in a stupor. He criticized the

methods of doctors who inadvertently made drunkards of their patients.82

Jewett’s recommendation to nursing mothers is an example of an early

understanding of the physical effects of alcohol and its ability to be excreted in breast

milk. He opposed the use of alcohol for nursing mothers, citing the ill effects upon

both the mother and the child. He explained that the mother’s excessive drinking of

alcohol could cause the nursing infant to be doped to the point of constant sleeping.83

Jewett understood the mind and body to be interconnected. Taking a holistic

approach, in the same vein as all the temperance physicians, beginning with Benjamin

Rush, Jewett saw the interconnection of the body, mind, and moral faculty. In

pronouncing the interrelationship, he observed that the drinker “does not escape the

physical penalty, however. The body is injured and, through its mysterious

81 Letter to Kimball, April 6, 1846,Speeches, 190.

82 Jewett,Forty Years, “Temperance and the Doctors,” 395-399.

83 Jewett, Forty Years, 397-98.

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connection with the mind, the intellect suffers.”84 The physical health was related to

the health of the mind and moral sense. One’s mental health could closely affect

one’s moral actions. Jewett extended the idea of addiction to other substances,

tobacco and food. He made a distinction between the moral danger of alcohol

addiction and other addictions because he perceived an impairment of the moral

sensibilities, unlike the effects of tobacco or food addiction.

Based upon the plentiful information available relating to Jewett’s

temperance views and motivations, we can make a number of informed assessments

regarding his participation in the movement. We have access to much more detailed

information relating to Jewett’s biographical facts and activities than we have for the

other temperance physicians. Significant sources include his autobiography and

Thayer’s very complete and lengthy biography. Also his published speeches, essays,

poetry, and some of his letters provide invaluable information. He had a number of

powerfully influential motives for temperance reform. As already described, he was

very likely influenced by his difficult adolescent experience living with his sister’s

family. He also had the influence of his abstaining older brother, and the

encouragement of his father to write his first essay on temperance. Other personal

influences must include the strong influence of his wife, an ardent temperance

supporter who encouraged him to continue even when they endured financial

difficulties. He displayed throughout his life an interest in nature and practical things,

coming from his farm background. He liked to experiment in horticulture, and build

84 Ibid., 287.

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practical things, even making his own medical instruments. He had an artistic bent

or and drew his own illustrations for pamphlets.

In addition to his personal, formative experiences, he evidenced the influence

of the growing medical evidence about the newly discovered substance alcohol. In

this regard Jewett displayed similarities with Sewall and Mussey. His use of the

scientific, rational approach is evident in his thinking and approach. Like the other

temperance physicians he came from a Christian background, but did not use his

religion to condemn the drunkard. Instead, as did Sewall and Mussey, he

demonstrated compassion and concern, turning his moral sense to a positive

approach. He had compassion for sick people and a non-judgmental attitude toward

the drinker. In comparing Jewett’s temperance stance with the other temperance

physicians, one can also cite differences. As this dissertation has portrayed, his

principal differences are found in his fervent prohibitionist stance and his keenly

developed popular appeal. His conception of addiction allowed scant provision for

nuance or uncertainty. All were subject to the threats posed by alcohol.

Yet his similarities to the temperance physicians are more pronounced than

are his differences. To summarize, his commitment to opposing use of alcohol in all

forms, his personal decision to abstain, his concept of addictive nature of alcohol, and

his opposition to the use of alcohol as a medicine are the significant areas of

similarity with the temperance physicians. Jewett’s conception of the addictive

nature of alcohol is entirely consistent with the theories of the temperance physicians.

He explained the increasing loss of control for the drinker and the resulting damage in

85 Thayer, 99.

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absolute terms. He built upon the work of the other temperance doctors by framing

the concept of addiction in simple examples that his general audience could

understand. His popularly crafted message marks his most significant contribution to

the temperance cause.

In conclusion, Jewett’s participation in the temperance movement is

significant in showing the effects of popular culture and, at the same time, the more

reserved, restrained voice of the medical profession. Jewett is marked by an inherent

duality. He functioned as a hybrid, as one outside the norm. He was situated

between two formative cultures of the period, the medical world with its health

reform approach and simultaneously, the mainstream culture of evangelical New

England Protestant reform. Both cultures exerted influence upon Jewett. He drew

upon both in terms of ideology and rhetoric. He adopted the health message with its

orientation toward promoting health and avoiding disease. He took up the medical

rhetoric of the ill effects of the substance alcohol and its resulting addictive process.

Grafted upon his medical approach, his popular message had wide appeal. He

brought a homespun vigor to the medical view, making it more accessible to the

ordinary populace. He employed the sentimental language of the day to reach a

general audience. Because of his popular orientation, he could explain the addictive

force of alcohol in understandable terms.

Jewett appealed to various segments of society as he expounded upon the

temperance message. He appealed to the economic concerns of the family, struggling

in the changing market economy. He emphasized the damage alcohol would bring to

the family economy, and the potential injury to the perceived weaker family

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members, wives and children. He appealed to the farmer, the manual laborer, and the

clergymen, all of whom faced the challenges of social and economic change.

Leaving the constraints of the medical profession, he showed no reluctance to

advocate prohibition, a legal remedy that physicians and scientists eschewed.

Relating easily to the general public, he was able to explain the danger of addiction in

a practical and at the same time, in a forceful and effective manner.

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CONCLUSIONS

The temperance physicians developed a new way of defining and viewing

intemperance. Through their writings, lectures, and other public activities they

promoted a concept of alcohol abuse and its effects that differed from the mainstream

temperance view. Their new views contributed to an emerging theory of addiction.

The general view of most participants in the first American temperance movement

was that intemperance was a problem caused by a failure of character and lack of

morality. The weakness, bad habits, or moral failings of drunkards resulted in

intemperance and all its attendant social ills. According to the prevailing viewpoint,

the sin of intemperance, “the sin which excludes from heaven,”1 was a serious

problem that affected society, the workplace, and the family. Evangelical leaders

taught that drunkards were sinful and lost to salvation. Therefore, opposing

intemperance was a moral duty of right-thinking people. It was the responsibility of

society to condemn the drunkard’s bad behavior and to show the way to moderation

and self-control.

The temperance physicians enunciated a different view of intemperance.

In promoting temperance ideas they expressed a difference both in message and tone.

They regarded the problem as a health issue and a problem that could be reformed

1 Lyman Beecher, Autobiography, Correspondence, etc. of Lyman Beecher, D.D., 2 vols., ed. Charles Beecher, v2 (New York: Harper & Bros, 1864), 37.

223

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through knowledge. In their view chronic drunkenness was a condition that gradually

developed through loss of control, not a deliberate act or choice. Drinkers could

exercise choice about their drinking early in their drinking career, but at some point

lost their ability to choose. The temperance physicians viewed intemperance not as a

vice or moral transgression, but as a progressive condition. As Sewall graphically

described it, drinkers fell into “a whirlpool”—they involuntarily lost control. Another

metaphor of addiction alluded to the chains of slavery, also indicating the binding

ry power of alcohol. Drinkers became slaves to drink, losing the freedom to choose

their actions.

Because of his outspoken views on alcohol and intemperance this

dissertation identifies Benjamin Rush as the first temperance physician. His

pronouncements were made from the standpoint of medicine and health. In

describing alcohol consumption as a chronic condition, he perceived that

intemperance was not a willful act or choice but a process that developed. As

visually demonstrated by his Moral Thermometer chart, Rush regarded the concept of

the reprobate drunkard as too simplistic. True, the drunkard ended up in a situation

that evidenced physical, social, and moral damage, but falling into intemperance was

a process, not a deliberate choice of the drinker. Although Rush’s chart and treatises

appealed to popular sentiment with colorful, dire warnings, yet he did not condemn

the drunkard himself. Rush’s approach posited that the problem was not the drinker

2 “It [intemperance] is a rock upon which many of our profession have foundered, a whirlpool into which many of them have been drawn.” Also: “... every day adds a new and a stronger link to the chain that binds him...” Thomas Sewall, A Charge Delivered to the Graduating Class of the Columbian College, D.C. at the Medical Commencement, March 22, 1827 (Washington, D.C: Duff Green, 1828), 9.

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but the effect of the substance he ingested. Intemperance progressed by degrees,

from a beginning of moderate, benign drinking. Although lacking scientific

precision, Rush’s thermometer chart served as a rudimentary progression chart of

advancing alcohol use. His chart graphically demonstrated the process by which the

drinker moved from moderate to immoderate use and thereby lost control of drinking.

A chain of events set in motion by increased alcohol intake produced intemperance

and all its consequences. Beginning with health and well-being, gradually

descending to slight illness then to serious illness, the chart showed increasingly

worse physical, mental and social results. Starting with health and happy social life,

the drinker ended with broken health and a destroyed life. Ardent spirit, according to

Rush, was the principal culprit. His chart listed small beer and wine in moderation as

acceptable and even beneficial, but even fermented drinks in excess had a predictably

bad outcome.

Rush’s view of intemperance differed from the prevailing attitudes toward

drunkenness. His approach was based more upon medicine than morality. His

insistence upon the physical, mental, and emotional effects of alcohol intake cast a

different light on the subject of intemperance. His lengthy description of the

drunkard resembled a medical report of a patient’s physical and mental state. In his

treatises and other pronouncements Rush invoked the disease concept and applied it

to the drinker. Also by arranging the effects of alcohol consumption in a progression

chart he provided a framework for something resembling the addictive process. In

later years his thinking grew more oriented toward ideas associated with the modem

concept of addiction. He referred to the gradual process of the drinker being

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“insensibly led” to his downfall even while attempting moderation. Rush thought that

redemption was possible for the chronic drinker, through abstinence. Because

alcohol was dangerous and unpredictable, he counseled drinkers to quit drinking

“suddenly and entirely.”

Rush was a transitional figure in the paradigm shift of medicine,

intemperance, and newly developing concepts of addiction. Rush referred to

intemperance as an “odious disease,” but not in the modem sense of the disease

concept. The state of early nineteenth-century medicine viewed disease as non

specific, a condition of “dis-ease,” or being unwell. In the absence of knowledge of

bacteria and other causal agents, medical science viewed such matters only dimly and

incompletely. Yet as one of the leading American physicians, Rush persistently

sought to understand diseases and their causes from a practical viewpoint, based upon

inductive reasoning. He struggled with the old theoretical system, praising it even as

he helped to dismantle it. He looked for cause and effect in medicine and despite his

pronouncements to the contrary, frequently abandoned the old framework of

theoretical medicine in favor of empiricism.4

The new ideas enunciated by Rush influenced the next generation of

temperance physicians. Dr. William Clark, a young country doctor from upstate New

York, was the first to be convinced by the new views expressed by Rush. As he

3 Benjamin Rush, An Enquiry into the Effects o f Spirituous Liquors upon the Human Body and their Influence upon the Happiness of Society (Philadelphia: John McCulloch in 3rd St., 1791), 10-12.

4 See Chapter Three for discussion of early nineteenth century medicine and Rush’s contribution to weakening the old theoretical framework. He attempted treatments that seemed to work regardless of theory. In treating yellow fever by bleeding, he was an empiricist, developing the theory after he found a treatment that he thought effective.

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contemplated Rush’s treatise on intemperance he gained sudden insight into the

consequences of continued alcohol intake. Growing increasingly agitated and fearful,

he concluded that he must immediately discontinue drinking all intoxicants. For

Clark, moderate drinking was no longer an option. He concluded that the dangerous

qualities of alcohol perverted normal health and posed too great a risk. In his view,

even moderate intake could produce a steep and sure drop-off into a complete loss of

control. He pronounced that he and his friends must quit drinking completely or else

they were all in grave danger of becoming drunkards. Within a few days of his

conversion-like insight he and his friend had signed a pledge of total abstinence and

persuaded others to join them. One would not expect such a dramatic and precipitous

beginning to endure, but Clark’s temperance society survived. Although many of the

early members drifted away, the nucleus of the Moreau Temperance Society

continued to meet for fifty years. The original core members of the group survived

intact from their beginning in 1808 to celebrate fifty years of sobriety in 1858.5

The influence of Rush’s ideas extended further into the early nineteenth

century to influence the next generation of temperance physicians. In the 1820s,

temperance physicians Sewall and Mussey found the new ideas regarding the effects

of alcohol use to be compelling. More educated, urbane, and scientifically oriented

than the country doctors Clark or Jewett (whose participation came later), these

physicians ultimately came to similar conclusions about the harmful effects of

5 The original members still in the temperance society in 1858 were Lebbeus Armstrong, Billy James Clark, Gardiner Stow, and James Mott. Anniversary drawing of the four members, John Kobler, Ardent Spirits: The Rise and Fall of Prohibition (New York: G.P.Putnam’s Sons, 1973), following p. 130.

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alcohol. They approached their studies with an orientation to the chemical and

physical properties of the substance. As their frame of reference they used the

methodology of the scientific laboratory. Because of their more pronounced

orientation to medicine as evidence-based science, they were particularly disposed to

learn about the new scientific discoveries concerning the chemical nature of alcohol.

The discovery of the chemical composition of alcohol in fermented as well as

distilled liquors had shifted the debate for the temperance physicians Sewall and

Mussey.6

Armed with new information regarding alcohol and intemperance, Sewall

and Mussey explored the effects of alcohol through experiments, observations and

autopsies. They conducted chemical experiments on alcohol and other substances.

Mussey began his medical research career by conducing an experiment on cutaneous

absorption, submerging himself in a chemical solution of red dye. Later in life he

conducted experiments upon the permeability of alcohol upon internal and external

organs. Taking a cue from Francois Magendie in Paris who performed alcohol

experiments on dogs, Mussey conducted experiments on frogs—not to see if he could

get them intoxicated, but to study the chemical effect of alcohol upon frog skin and

organs. Mussey was interested in the chemical nature of alcohol, observing that it

was closely related to ether. At least by 1827 he taught his students that wines

contained more alcohol than previously known and were therefore potentially

harmful.

6 See Chapter Three for discussion of the discovery of the chemical composition of alcohol.

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Sewall and Mussey studied the substance alcohol for its physical effects

upon the body and the mind. They concluded that alcohol harmed every organ in the

body, with serious health consequences. Sewall, the professor of anatomy, studied

the physical effects of alcohol upon human organs through dissection and autopsy.

His quest for cadavers had resulted in his re-location to Washington. Given his

Harvard and Philadelphian background, it must have seemed more like exile than an

upward career move, yet he furthered his research in Washington, perhaps more

effectively than would have been possible in the established, entrenched medical

environment of New England. An apparently ready supply of cadavers, with varied

history of sobriety and inebriation, gave him the opportunity to conduct experiments

upon the physical effects of alcohol upon the internal organs. He gained particular

fame through his dissections of stomachs from drinkers and non-drinkers. Many of

Sewall’s comments upon the physical effects of alcohol indicate that he was

interested in the effects upon other organs in addition to the stomach and conducted

autopsies on these organs as well.

Mussey, like his colleague Sewall, demonstrated interest in the

physiological aspects of alcohol, citing the effects upon every major organ—the

brain, heart, lungs, intestines, liver and kidneys. Employing the language of clinical

detachment, he taught that alcohol was “capable of passing from the stomach into

other organs without having its inflammability destroyed.”7 He noted the secretion of

alcohol into human breast milk and therefore rejected the common endorsement of

7 Mussey,1827Address, 8.

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alcohol for nursing mothers. He cited the results of alcohol experiments conducted

by Magendie, Sewall, and others. Mussey also conducted experiments and

dissections to understand the effects of alcohol, although his publications! deal mostly

with his surgical innovations rather than alcohol studies.

Sewall and Mussey helped to further ideas about the harmful nature of

prolonged alcohol use by considering the interconnectedness of the physical and

mental effects of alcohol intake. Like Rush, they adopted a holistic approach to the

effects of alcohol. They considered the effects of alcohol intake upon the whole

person: mind, body and spirit. They conducted experiments to discover the chemical

effects of alcohol upon the body and then related their findings to the mind and spirit.

As they conducted their observations they developed theories to explain the impact

upon the mental and emotional state of the heavy drinker. They concluded that

chronic heavy drinking gradually produced an impaired mental state and loss of

control. In addition to employing the image of the whirlpool, Sewall observed that

“no person ever became a drunkard at once. In almost every case the progress is slow

and imperceptible...he advances by degrees, and at every step his path becomes more

steep...”8

Mussey chronicled the dangers of alcohol in theory and language similar to

that of Sewall. Although he did not employ the term addiction, he described certain

aspects of what modem terminology recognizes as the addictive process. He referred

to the impact of “the resistless desire” upon the chronic drinker. He called attention

8 Thomas Sewall, A Charge Delivered to the Graduating Class of the Columbian College, D.C. at the Medical Commencement, March 22, 1827 (Washington, D.C: Duff Green, 1828), 9.

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to the habit-forming nature of alcohol, “the strength of the habit, and so great the

danger of forming it,”9 and stressed the potential consequences of continued use. He

identified the harmful physical effects of alcohol upon the user, reciting the results of

chronic alcohol intake. Using the words “betrayed,” “artificial,” and “perverting the

natural appetite,” he warned against the loss of control that often accompanied

drinking both fermented and distilled liquors.10 Mussey never condemned the fallen

drinker but expressed sympathy for the victim and his family. He referred to the

parents of a promising young man who had become a drunkard, saying “they weep

for him in secret places.”11 Emphasizing the destructive power of alcohol, he

recounted the rapid fall of a long-term abstainer who returned to drinking after forty

years of abstinence. Mussey reported that his swift descent into intemperance

demonstrated the relentless power of alcohol use. 19

Charles Jewett, the final temperance physician presented in this

dissertation, also expressed ideas about the progressively harmful impact of alcohol

use. Jewett’s approach differed from the academic physicians Rush, Sewall, and

Mussey. More the simple country doctor, he did not undertake scientific

experiments, train in European medical centers, or even earn a formal medical degree.

Yet in his country practice he treated many patients who had problems with excessive

9 Reuben D. Mussey,An Address on Ardent Spirit: Read Before the New Hampshire Medical Society at Their Annual Meeting, June 5, 1827 (Boston: Perkins and Marvin, 1829), 9.

10 Reuben D, Mussey,Prize Essay on Ardent Spirits and Its Substitutes as a Means o f Invigorating Health (Washington: Duff Green, 1837), 36-39.

11 Mussey, Address, 1827,4.

12 Ibid., 9.

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alcohol consumption, and so he attempted to teach his patients (“with a little medicine

I mixed a little temperance.”)13 He joined the temperance cause and developed a

practical, effective method of describing aspects of the addictive process, or as he

termed it “the artificial appetite.” His homespun example of the artificial appetite

(the boy eating an apple from a large basket of apples) described addiction in

practical terms that the general public could appreciate. The boy’s natural appetite

would not be perverted so that he would be tempted to eat increasingly more apples

each day until he ate himself senseless. The reasoning against that scenario,

according to Jewett, was that apples were a healthy substance, unlike the unhealthy

addictive substance of alcohol.14 As Jewett continued his temperance work in later

years, he used the language of addiction more specifically. In his autobiography,

published in 1872, he cited “the power of alcoholic liquors or other stimulant-

narcotics over men who become addicted to their use.”15

The temperance physicians demonstrated tolerance and inclusivity regarding

social class and intemperance. In their view all classes and professions were equally

at risk, the social elite as well as common laborers. In the words of Thomas Sewall,

intemperance affected all classes equally, from “the cottage and the palace” alike.

Laborers in the harvest field were advised by all the temperance physicians that they

could perform their work better and more safely without alcohol. The physicians did

13 Charles Jewett, A Forty Years’ Fight with the Drink Demon or A History of the Temperance Reform as I Have Seen It, and of My Labor in Connection Therewith (New York: National Temperance Society and Publishing House, 1872), 23.

14 Charles Jewett, Speeches, Poems, and Miscellaneous Writings on Subjects Connected with Temperance and the Liquor Traffic (Boston: John P. Jewett, 1849), 10-12.

15 Jewett,Forty Years, 111.

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not exclude the professions of public service, the ministry, or even medicine. To the

contrary, all of them beginning with Rush indicated the high risk that their own

profession encountered with continued alcohol intake. Rush was particularly

distraught with the loss of his colleague to intemperance. Clark obviously believed

that doctors and clergymen could become severely affected by intemperance. He and

his minister formed the temperance society because they perceived that they

themselves were at risk. Early in his career as a medical professor Sewall warned his

students of the dangers that physicians met in their daily rounds where they were

invariably offered alcohol, “the rock on which many of our profession have

foundered.”16 Mussey warned his colleagues of the dangers of intemperance. Jewett

also made a special appeal to his professional colleagues and ministers to reform.

As the temperance physicians made their appeal for temperance their tone

was not judgmental or denunciatory, as had been the case of many early temperance

reformers. They differed from some early temperance members who had appeared

condescending to the general public, a perception not aided by those early members

who excluded their own drinking behavior. In contrast, the temperance physicians

adopted temperance and applied the same rules to themselves as they recommended

to the public. Rush personally gave up “ardent spirits” and drank wines only in

moderation. The biographical evidence regarding Sewall is not absolutely

16 Thomas Sewall, A Charge Delivered to the Graduation Class of the Columbian College, D.C. at the Medical Commencement, March 22, 1827 (Washington, D.C: Duff Green, 1828) 6.

17 See Chapter Four for more information concerning the position and conduct of members o f the Massachusetts Society for the Suppression of Intemperance in 1813.

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conclusive, but indicates that he abstained from all intoxicants. The evidence clearly

indicates that the other temperance physicians, Clark, Mussey, and Jewett eliminated

the use of all alcohol, including wines and other fermented drinks. Clark’s 1808

decision to abstain from fermented drinks predated the discovery and analysis of the

alcoholic content of fermented drinks in the 1820s.

The later generation temperance physicians made use of the newly

discovered chemical analysis. They concluded that fermented drinks, as well as

ardent spirits, contained enough alcohol to pose a health threat. Employing the

objective, non-moralizing language of scientific terminology, they expanded the

proscribed list of harmful alcoholic drinks to include fermented drinks. They

abandoned Rush’s reassuring but mistaken pronouncement that “[f]ermented liquors

contain so little spirit and that so intimately combined with other matters, that they

can seldom be drunken in sufficient quantities to produce intoxication.”18

Regarding gender issues, the temperance physicians evidenced conventional

contemporary attitudes. Adopting the prevailing nineteenth-century attitudes toward

women, they rarely addressed issues of women’s consumption of alcohol. As they

defined the population that suffered from the physiological impact of alcohol use,

they excluded women for the most part. Rush made occasional reference to women

in his writings, commenting that when they imbibed ardent spirits they exhibited a

loss of self-control. Although the physicians had very likely observed instances of

intemperance in women, they nevertheless yielded to conventional attitudes regarding

18 Rush, Inquiry, 10-12.

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women. Commonly accepted ideas of female morality (such as the cult of

womanhood and feminine virtue) prevented them from exposing the reality of

women’s intemperance. As has been pointed out, the temperance physicians

especially regarded physicians to be at risk because of the nature of their profession.

That perception reinforced their omission of female intemperance because women

were excluded from becoming medical doctors at the time. Sewall solicited women’s

aid in promoting the cause of temperance, but his public pronouncements contain no

specific reference to intemperate women.19 Mussey, demonstrating similar attitudes

as his colleague Sewall, also neglected to include women in the at-risk population.

Mussey demonstrated interest not in female intoxication per se, but in the physical

aspects of the transference of alcohol into breast milk.

Jewett’s view of women and intemperance differed from that of his medical

colleagues. His examples of drunkenness occasionally included women. For

example he gave the instance of the drunken parents who neglected their seriously ill

child. Focusing more upon the drunken mother than the equally drunken father, he

commented that only alcohol “was capable of conquering a mother’s love.”20 More

typically Jewett portrayed women not as drunkards but as victims of drunkards.

Drawing upon contemporary socio-economic stereotypes, he often depicted women in

19 Sewall, Address, 1827, 23.

20 Jewett, Speeches, 75-77.

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the role of the abused wife of the alcoholic husband. Jewett’s appreciation for

women in temperance was aided by the active participation of his wife in the cause.21

One of the most significant findings of this dissertation is the temperance

physicians’ innovative approach to understanding intemperance. Because of a unique

confluence of number of cultural, social, and other forces, they approached the social

reform issue of temperance in a different way. They formulated and expressed ideas

consistent with aspects of the modem conception of addiction. They expressed the

idea that alcohol was a dangerous substance that could gradually destroy the

individual drinker. They adopted the view that the process could affect anyone,

regardless of social station, profession, or education. They concluded that they

themselves could be at risk if they continued to use alcohol. They did not regard

intemperance as a moral failing but a trap that anyone, no matter how worthy, could

fall into. They studied, lectured, and taught the general public about the dangers of

continued use. Using the rhetoric of medicine and health they attempted to convince

others to follow the healthy path. They used the language of reason and persuasion,

attempting to appeal to people’s desire to improve themselves, their families, and

society. They sought to demonstrate to the public and their medical colleagues the

specific ill effects of continued alcohol intake. Finally, and perhaps most

convincingly, they followed their own advice and made the decision to abstain from

all intoxicating drinks.

21 See Chapter Six for a description of the role of Lucy Jewett in the temperance cause. In speeches and publications Jewett credited her for her temperance support.

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The attitudes of the temperance physicians toward alcohol and

intemperance were motivated by the interplay of social and cultural forces, and

strongly influenced by their specific medical environment and scientific training. The

social and cultural influences that affected them were the same as those of the general

movement. The temperance physicians experienced the influence of religious

revivalism in their family background and education. Enlightenment ideas, with the

particular American overlay of enthusiasm for reform, the missionary impulse, also

informed their thinking. In this regard their motivation resembled that of the general

movement. In addition to those general forces that oriented them toward temperance

issues, the physicians drew upon the specialized experiences of their medical

profession and training. New scientific approaches of empiricism in disease and

human physiology affected their thinking. The emerging emphasis upon clinical

observation of the patient gave them the impetus to observe the effects of drinking

behavior. New discoveries in chemistry allowed them to approach alcohol in a more

objective manner. Influenced by the changing medical environment, they perceived

intemperance through the lens of health and disease. Taught to approach medical

problems objectively and inquiring into possible causes of illness, they regarded

intemperance as a medical problem rather than a sin. They concluded that what the

inebriate required was not condemnation but a plan for good health. Looking for a

remedy for intemperance, more often than not a fruitless search for most maladies in

nineteenth century medicine, they counseled abstinence. Interestingly only Benjamin

Rush, the eighteenth century physician, attempted to prescribe additional remedies

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(for example, to cure drunkenness apply blisters to the drunkard’s ankles).22

Frustrated as they were with the inability to cure so many of the diseases they

encountered, the temperance physicians stumbled upon a condition that they could

actually help, but only through prevention. Struggling in a competitive profession for

recognition and patient population, they responded to the opportunity to give advice

that might actually prove effective.

The tone of their message differed from that of the general temperance

movement. Because they viewed intemperance from a medical and clinical vantage,

they used the language of the physician describing a health issue. Their language

lacked the tone of moral indignation displayed by leaders who denounced

intemperance as a sin. Often their rhetoric was that of the detached clinical observer,

cataloguing the physical deterioration of various internal organs. Their comments

upon the behavior of the drunkard, if they revealed any emotion, conveyed pity not

scom. Even the most clinically detached and scientifically oriented of the temperance

physicians, Sewall and Mussey, demonstrated compassion for the intemperate

drinker. Their attitude was consistent with, and even promoted, their emerging

conception of the addictive nature of alcohol.

Although the temperance physicians’ message about alcohol was effective

in many ways, it did not contain much hope for the confirmed drunkard. Their

message demonstrated compassion for the condition of the drunkard but no remedy

beyond simple abstinence and prevention. The temperance physicians diagnosed

intemperance as a medical problem without a cure. Their message centered on

22 Rush, Enquiry, 1791, 12.

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warnings about the physical and mental damage of alcohol. Rush’s treatises

presented the progressive dangers of alcohol consumption and served as a warning to

abstain from spirits. The temperance movement circulated Sewall’s stomach

drawings widely to discourage intemperance in the general population, especially the

young who were not yet addicted. Sewall warned medical students and his colleagues

not to descend into the whirlpool of addiction. Mussey stressed the benefit of a

healthy lifestyle, and warned the public that alcohol posed a serious health problem.

Jewett taught all who would listen to avoid alcohol, the cause of most suffering

according to his all encompassing view. By the 1840s, frustrated with the lack of a

solution to the problem, he, like the next phase of the temperance movement, moved

steadily toward the position of legal restriction. Without a cure available for

intemperance, prohibition seemed the only viable alternative. The temperance

physicians had identified and publicized the health threat of intemperance. Their

professional opinion held that continued alcohol use threatened the user with an

uncontrollable descent into addiction. Without a plan for a remedy or treatment, the

next phase of temperance reform entered a new phase. The next temperance cycle

would move increasingly away from continued warnings, and toward attempting to

prohibit use altogether of the newly identified substance alcohol.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. BIBLIOGRAPHY

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History of Medicine

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Baker, Rachel. The First Woman Doctor; the Story o f Elizabeth Blackwell. New York: Messner, 1944.

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Valverde, Mariana. Diseases o f the Will: Alcohol and the Dilemmas o f Freedom. Cambridge, Mass: Cambridge U. Press, 1998.

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General Social and Political History

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Articles

Aaron, P. and David Musto. “Temperance and Prohibition in America: A Historical Overview” in M. Moore and K. Gerstein, eds. Alcohol and Public Policy: Beyond the Shadow o f Prohibition. Washington, D.C: National Academy Press, 1981.

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Gillett, Mary C. “Joseph Lovell.” American National Biography 14 (1999): 13-14.

Hamilton, John B. “Life and Times of Doctor Reuben D. Mussey.” Journal o f the American Medical Association 26, no. 14 (April 1896): 649-52.

Hoogenboom, Olive. “Reuben Dimond Mussey.” American National Biography vl6, 190-91. New York: Oxford Press, 1999.

Katcher, Brian S. “Benjamin Rush’s Educational Campaign Against Hard Drinking.” American Journal o f Public Health 83, no. 2 (Feb 1993): 273-81.

Kopperman, Paul E. “ ‘Venerate the Lancet’: Benjamin Rush’s Yellow Fever Therapy in Context.” Bulletin o f the History o f Medicine 78, no. 3 (Fall 2004): 539-74.

Levine, Harry G. “The Discovery of Addiction: Changing Conception of Habitual Drunkenness in America.” Journal o f Studies on Alcohol 15 (1979): 493-506.

Meyer, Roger E. “The Disease Called Addiction: Emerging Evidence in a 200-Year Debate.” The Lancet 347 (Jan 20, 1996): 162-66.

Morens, David M. “Death of a President.” New England Journal o f Medicine 341, no. 24 (Dec 9, 1999): 1845-1849.

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Olsen, Gerald Wayne. “'Physician heal thyself: drink, temperance and the medical question in the Victorian and Edwardian Church of England, 1830-1914.” Addiction 89 (1994): 1167-1176.

Rohrer, James R. “The Origins of the Temperance Movement: a Reinterpretation.” Journal o f American Studies 24, no.2 (Aug 1990): 228-35.

Room, Robin. “Cultural Contingencies of Alcoholism: Variations Between and Within Nineteenth-Century Urban Ethnic Groups in Alcohol-Related Death Rates.” Journal of Health and Social Behavior 9 (June 1968): 108.

Shultz, Suzanne M. “The Medical Education of William Brooks Bigler (1863).” Annals o f Internal Medicine 129, no. 5 (Sept 1998): 426-30.

Snow, David A. and Robert D. Benford. “Master Frames and Cycles of Protest” in Aldon Morris and Carol Mueller, eds. Frontiers in Social Movement Theory. New Haven, Ct: Yale U. Press, 1992.

Spode, Hasso. “What Does Alcohol History Mean and to What End Do We Study It?” The Social History o f Alcohol and Drugs 18 (2003): 16-31.

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Tyrrell, Ian R. “Thiry-three Years of Temperance, 1971-2004.” The Social History o f Alcohol and Drugs 19 (2004) 12-27.

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Dissertations, Theses, and Unpublished Papers

Bell, Richard. “Drinking to Death in the Alcoholic Republic.” Paper presented, meeting of Organization of American Historians. Washington, D.C., April, 2006.

Bland, Sister Joan. “Hibernian Crusade: The Story of the Catholic Total Abstinence Union of America.” Ph.D. diss., Catholic University, 1951.

Caric, Ric N. “The Man with the Poker Enters the Room, Mania a Potu in Philadelphia, 1828-1850. Paper presented at the American Historical Association meeting, January, 2004.

Ferentzy, Peter L. “The Addiction Concept: How the Language of Sin Was Replaced by That of Disease.” Ph.D. diss., York U., Canada, 2001.

Greenberg, Joshua R. “Advocating the Man: Masculinity, Organized Labor, and the Market Revolution in New York, 1800-1840.” Ph.D. diss, American University, Washingon, D.C., 2003.

Levine, Harry Gene. “Demon of the Middle Class: Self-control, Liquor, and the Ideology of Temperance in 19th-Century America.” Ph.D. diss., University of Cal., Berkeley, 1978.

McKean, Matthew K. “'A world wherein there will be no Disorders': Temperance Reform in Early America, 1645-1813.” Paper presented at the International Conference of Drugs and Alcohol in History in London, Ontario, May, 2004.

Nelson, Katherine. “Thomas Sewall: Temperance Physician.” Paper presented at meeting of American Historical Association. Washington, D.C., January, 2004.

______. “The Legacy of Benjamin Rush, Successes and Limitations of Scientific Observations.” Paper presented at the American University Student Research Conference, 1992.

______. “Alcohol in Early Modem England,” paper presented at Conference on Patristic, Medieval, and Renaissance Studies, Villanova University, Sept. 1997.

Osbum, Matthew. “Delirium Tremens, Nineteenth-Century American Literary Context.” Paper presented at meeting of the American Historical Association in Washington, D.C., January, 2004.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Parsons, Elaine Frantz. “Manhood Lost: Drink, Gender, and Self in the Nineteenth-Century United States.” Ph.D. diss., Johns Hopkins University, 1999.

Sandage, Scott. “Deadbeats, Drunkards, and Dreamers: a Cultural History of Failure America, 1819-1893. Ph.D. diss., Rutgers University, 1995.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.