An Instrument of Social Control: The Scientization of Drunkenness

Around 1800, the fields of medicine and psychology began to frame excessive alcohol consumption as a problem. By the end of the century, experts from these disciplines had pathologized the drinker and elevated bourgeois norms of moderate alcohol consumption to the status of scientific knowledge.¹ In this blogpost, I will outline this development for Germany. However, discourses on alcohol consumption in Germany were influenced by studies from the United States and other European countries.

I will contrast three interpretations of drunkenness within the academic discourse: drunkenness as a disease, as an addiction, and as a form of degeneration. I will show that these interpretations impacted the public perception and often also the social realities of excessive drinkers in distinct ways. Theories of alcoholism came to be used as instruments of social control. Medical discourses influenced anti-alcohol movements and later supported the tendency to make “drunkards” invisible by committing them to drinkers’ asylums. As I will sketch at the conclusion, the desire to keep heavy drinkers from public view and the stigmatization of drinkers that emerged in nineteenth-century science remain palpable in contemporary debates about excessive alcohol consumption.

Drunkenness as a Disease

In 1784, Benjamin Rush, one of the signers of the Declaration of Independence, was the first to define drunkenness as a disease.². In Germany, it was the physician Christoph Wilhelm von Hufeland who, in 1802, intensively studied the consequences of excessive drinking. He similarly understood this type of consumption to be a disease.³ Rush and Hufeland called for state interventions to prevent immoderate drunkenness, particularly from drinking hard liquor, or spirits, as opposed to wine and beer. From a medical perspective, they believed beer could counteract the poisoning and also the temptation of spirits and eventually lead heavy spirit drinkers to sobriety. 

Before these medical interventions, excessive drinkers were not considered diseased but prone to vice. The German term was “lasterhaft.” But once they began to be regarded as diseased, they were no longer perceived as acting immorally, choosing freely to drink, but as victims of the substance of alcohol. Accordingly, in the late nineteenth century, the substance itself came to represent a social problem as the medical view was increasingly accepted. The German doctor Hugo Hoppe summarized this widely acknowledged position in 1907: “Today, however, it is generally recognized as a scientific fact that drunkenness is not a vice, but a disease.”⁴

Drunkenness as an Addiction

The already mentioned Benjamin Rush was not only the first to define drunkenness as a disease but also introduced the term “addiction” to alcohol research. The first German physician to agree with Rush’s interpretation was C. von Brühl-Cramer, who lived in Russia.⁵ In 1819, Brühl-Cramer coined the term Trunksucht (drinking addiction). Nevertheless, as there was as yet no accepted concept of addiction, Trunksucht remained ill-defined. In 1890, the psychiatrist Carl Pelmann delineated Trunksucht as an increasing tendency to overindulge in alcoholic beverages. Pelmann observed an ongoing shift in the relationship between alcohol consumption and socioeconomic status that he attributed to the alcohol industry. Previously, drinking spirits was perceived as an upper-class habit as it displayed a certain level of wealth. However, when affordable high-proof alcohol became widely available, it had enabled the lower classes to engage in this practice in greater numbers. This development prompted the alcohol issue to be reframed as a class issue. Pelmann, for instance, expressed concerns about the effects of alcohol abuse on drinkers’ ability to perform manual labor and viewed this as a potential threat to the national economy.⁶Overall, medical and psychological experts at that time focused on drinkers’ productivity rather than on their individual health.

Drunkenness as a a Form of Degeneration

Another approach also focused less on individual health than on collective health. In his 1857 theory of degeneration, the French psychiatrist Benedict Augustin Morel determined alcohol consumption to be a cause of degeneration. Morel’s ideas strongly influenced the German psychiatrist Emil Kraepelin, who was himself a prominent voice in the German alcohol debates. Kraepelin saw excessive alcohol consumption as a central cause of progressive social “degeneration.”⁷

Animal experiments were used to prove that alcoholism was a hereditary disease. In the late nineteenth century, US biologist Clifton F. Hodge conducted an experiment with two pairs of cocker spaniels: one that was regularly given alcohol and the other that was not. Both pairs had offspring three times. The pair of dogs that were given alcohol had puppies that were “malformed” or less viable.⁸ As late as 1922, a German abstinence advocate used this study to argue that women should not drink alcohol because, in his view, it affected their cells and would lead to the deterioration of the “race.”⁹ In another experiment with dogs and alcohol, the Czech doctor Gustav Kabrhel gave a female dog beer instead of water to drink. When the dog gave birth to puppies, he gave them beer, too, after weaning, and they quickly preferred it to water. From this, Kabrhel concluded that the tendency to drink alcoholic beverages can be passed on from parents to children.¹⁰ At the turn of the century, many scientists argued that alcoholism was hereditary. However, it is important not to misinterpret such medical debates on alcoholism as mere armchair disputes. These theories quickly shaped how excessive drinkers were perceived and how they were treated.

Drunkenness and Anti-alcohol Movements

In various Western countries, medical and psychiatric discourses on alcohol consumption spurred anti-alcohol movements. In the early nineteenth century, evangelical temperance reformers in the USA took up Benjamin Rush’s theories of drunkenness as a disease and spread them across the country. However, as some of these groups were grounded in religion, their views on drinking often oscillated between seeing it as a sin and as a disease.¹¹ The movements were divided into those that advocated complete abstinence and those that advocated temperance.In Europe, similar anti-alcohol movements emerged in the 1830s. They made alcohol a scapegoat for social problems. The upper classes were particularly active in these groups as abstinence and moderation reflected upper class norms of self-control.¹² In the wake of their activism, criticizing alcohol consumption now meant criticizing the drinking habits of the lower classes.

In Europe, similar anti-alcohol movements emerged in the 1830s. They made alcohol a scapegoat for social problems. The upper classes were particularly active in these groups as abstinence and moderation reflected upper class norms of self-control.¹³ In the wake of their activism, criticizing alcohol consumption now meant criticizing the drinking habits of the lower classes.

In Germany, anti-alcohol movements faded in mid-century, but the “alcohol question” re-emerged as a huge social issue by 1900. Medical and psychiatric experts got involved in anti-alcohol movements, with the cooperation between the movements and science proving to be mutually beneficial: while anti-alcohol activists called for further scientific research on the detrimental effects of alcohol, doctors and other scientists highlighted the need for reforming alcohol consumption. The medical doctor Ludwig Claren, who conducted research on drunkards’ asylums, appealed to other physicians to join anti-alcohol movements as they could provide the necessary knowledge and scientific understanding of alcohol abuse.¹⁴

It is worth noting that the lobbying of German experts in anti-alcohol movements did not lead to tighter legal restrictions on alcohol consumption, particularly when seen in an international perspective. The US even enacted the nationwide ban on alcohol manufacture, sales, and transport known as Prohibition, which lasted from 1919 to 1933. In Germany, the idea of banning alcohol met with little general approval, even though some anti-alcohol currents leaned in that direction. Even the Reichsausschuss Deutscher Katholiken gegen den Alkoholmißbrauch (Reich Committee of German Catholics against Alcohol Abuse) rejected a ban based on the US model in 1921 as its members believed that it would be ineffective for the police to enforce sobriety if the prevailing public sentiment were against it. The Reichsausschuss also wondered how anyone could seriously believe that one could promote German Gemütlichkeit (coziness, an easy-going, comfortable atmosphere highly touted in German restaurant culture) without beer and wine.¹⁵ Despite the similar views of German and American experts and presence of anti-alcohol movements in both countries, the two states’ approaches to regulation differed fundamentally. Even so, medical theories shaped more than just public debates and the efforts of anti-alcohol movements. They also gave rise to the tendency to seclude heavy drinkers.

Drunkenness Becoming Invisible

In the decades after Benjamin Rush described drunkenness as disease and as an addiction, experts began calling to treat heavy drinkers in residential institutions.¹⁶ In 1851, the first asylum for people with alcohol problems in Germany was founded in Lintorf (now Ratingen near Düsseldorf). But, even if there was medical knowledge about disease, addiction, and degeneration at the time, there was none about how to deal with drinkers in a sensible way. Pastor Hirsch, who headed the Lintorf institution after 1869, even questioned if excessive alcoholism was a remediable medical condition. He felt that if drunkenness was just a disease, then a “medicine” would already have been found to cure it.¹⁷

Nevertheless, the asylum infrastructure quickly expanded. Next to the Lintorf asylum, a “Kurhaus Siloa” (spa house) was opened in 1879 for “drunkards from the educated classes”. In the following years, more and more drinking asylums and “spa houses” in Germany opened their gates – all of them with religious orientation. The first sanatorium for women was opened by Berta Lungstras, the daughter of a local pastor, in Bonn in 1889. Although the expressed purpose of these institutions was “healing,” actual therapy did not take place at these houses. Most merely isolated excessive drinkers from society while forcing them to perform manual labor.

In 1903, another approach emerged in the German debates that harked back to ideas of degeneration. The racial hygienist Ernst Rüdin argued that alcoholics should not be “rescued” but rather deemed “inferior” and “unworthy of marriage.”¹⁸ Over the next decades, eugenic theories on alcoholism became more and more popular. In Nazi Germany, drinkers were eventually criminalized. The Gesetz zur Verhütung erbkranken Nachwuchses (Law for the Prevention of Hereditarily Diseased Offspring), passed on July 14, 1933, legalized the persecution of drinkers. Nazi regulations made it possible to send them to concentration camps by labeling them “asocial.”¹⁹ With this approach, the Nazis implemented the most extreme form of ostracizing drinkers from society.

Today’s medical science defines alcoholism as a treatable disease and has developed a variety of therapies. However, heavy drinkers are still stigmatized by attributions rooted in the medical discourse of the nineteenth century. From Benjamin Rush’s first description of excessive alcohol consumption as a disease through the Nazis’ murderous criminalization of alcoholism, there has always been a common misconception that drunkenness can be eliminated by making the drinker invisible. This approach is still tangible in numerous discourses on drunkenness today, for instance, when public alcohol drinking in German cities is discussed. By simultaneously restricting the public consumption of alcohol and begging in inner cities, local authorities continue to associate the consumption of alcohol with the threat of poverty. As in the 1800s, the solution is to shield the supposedly productive society from the allegedly non-working drunkard. 

Mareen Heying is a historian at the Institute for Social Movements, a central research unit of the Ruhr-University Bochum. As a postdoctoral researcher, she is currently working on “good aging” in deindustrialized regions. Her other research interests include drinking studies, gender history, labor history, history of pub culture, sex work, and women’s resistance to fascism.

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I would like to thank Raphael Rössel and Casey Sutcliffe for their excellent support in finalizing this article.

1. Jan Dietrich Reinhardt, Alkohol und soziale Kontrolle: Gedanken zu einer Soziologie des Alkoholismus (Würzburg, 2005), 16–17; 47.[↩]
2.  Benjamin Rush, An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind, with an Account of the Means of Preventing, and of the Remedies for Curing them (Philadelphia, 1784.[↩]
3.  Christoph Wilhelm Hufeland, Über die Vergiftung durch Branntwein (Berlin, 1802), 4.[↩]
4.  Hugo Hoppe, Der Alkohol im gegenwärtigen und künftigen Strafrecht (Halle/Saale, 1907) 29.[↩]
5.  C. von Brühl-Cramer, Über die Trunksucht und eine rationelle Heilmethode derselben (Berlin, 1819).[↩]
6.  Carl Pelmann, “Trinker und Trinkerasyle,” in Real-Encyklopädie der gesammten Heilkunde: Medizinisch-Chirurgisches Handwörterbuch für praktische Ärzte, Vol. 20, Towyw – Veratrin, 125–33 (1890), 125–27.[↩]
7. On Morel’s essence of degeneration in relation to alcohol, see Claus Finzen, Alkohol, Alkoholismus und Medizin: Ein Beitrag zur Sozialgeschichte der Psychiatrie (Rehburg-Loccum, 1980), 12–16.[↩]
8.  Clifton F. Hodge, “Action of Alcohol on Dogs as regards Non-viability and Malformation of the Young, and Severity of Attack in an Epidemic of Distemper,” Journal of the Boston Society of Medical Sciences 4, no. 2 (1897): 35–38, 35.[↩]
9.  Ewald Appelt, Die Alkoholfrage. Ein Mahnwort an das deutsche Volk (Leipzig, 1922) 11.[↩]
10.  Gustav Kabrhel, 1909, quoted in Finzen, Alkohol, 28.[↩]
11. Katherine A. Chavigny, “Reforming Drunkards in Nineteenth-Century America: Religion, Medicine, Therapy,” in Altering American Consciousness: The History of Alcohol and Drug Use in the United States, 1800–2000, ed. Caroline J. Acker and Sarah W. Tracy, 108–23 (Amherst, 2004), 109.[↩]
12.  Cordula Hölzer, Die Antialkoholbewegung in den deutschsprachigen Ländern (1860–1930) (Frankfurt/Main, 1988), 7; Martin Lengwiler, “Im Zeichen der Degeneration: Psychiatrie und internationale Abstinenzbewegung im ausgehenden 19. Jahrhundert,” in Biopolitik und Sittlichkeitsreform. Kampagnen gegen Alkohol, Drogen und Prostitution 1880–1950, ed. Judith Große, Francesco Spöring, and Jana Tschurenev, 85–110 (Frankfurt/Main, 2014), 104.[↩]
13.  Cordula Hölzer, Die Antialkoholbewegung in den deutschsprachigen Ländern (1860–1930) (Frankfurt/Main, 1988), 7; Martin Lengwiler, “Im Zeichen der Degeneration: Psychiatrie und internationale Abstinenzbewegung im ausgehenden 19. Jahrhundert,” in Biopolitik und Sittlichkeitsreform. Kampagnen gegen Alkohol, Drogen und Prostitution 1880–1950, ed. Judith Große, Francesco Spöring, and Jana Tschurenev, 85–110 (Frankfurt/Main, 2014), 104.[↩]
14. Ludwig Claren, Die deutschen Trinkerasyle und ihre Leistungen (Düsseldorf, 1895), 3–4.[↩]
15.  Keine Reden! Praktische Arbeit!, supplement to the leaflet by F. Schlegel, Hilfe für Alkoholkranke!, Heidhausen, Ruhr, press material for the education week on the alcohol issue from March 4 to 11 (Breslau March 11 to 17): Landesarchiv NRW, Abteilung Rheinland, signature: BR 0007 No. 38990.[↩]
16.  Chavigny, “Drunkards,” 110; 120; Claren, Trinkerasyle, 6.[↩]
17. Eduard Hirsch, Direktion der Rheinisch-Westfälischen Pastoralgehülfen-Anstalt zu Duisburg, Sechster Bericht des evangelischen Asyls zu Lintorf: Nebst Nachricht von dem neuerbauten Asyle für Trunkfällige aus gebildeten Ständen (Oberhausen, 1879), 14–15: Landesarchiv NRW, Abteilung Rheinland, signature: BR 0007, No. 54584.[↩]
18. Elke Hauschildt, “Auf den richtigen Weg zwingen”: Trinkerfürsorge 1922 bis 1945 (Freiburg im Breisgau, 1995), 41.[↩]
19. Julia Hörath, “Asoziale” und “Berufsverbrecher” in den Konzentrationslagern 1933 bis 1938 (Göttingen, 2017), 22.[↩]

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