Ken Burns and Lynn Novick’s extensive, educational, and entertaining PBS documentary “Prohibition” has done a great service to today’s Americans: It has presented a specific story of how activism can prove politically successful in creating laws, yet can fail in the end if humans refuse to change. But it might have provided a more realistic introduction to the alcohol problem by paying deeper attention to both the alcohol-versus-water and medical issues.
The three-part series premiered nationwide Oct. 2-4. While the first episode eloquently covered the century-long movement culminating with the Eighteenth Amendment, it seemed to simplify the problem of alcohol excess by indicating that commerce made drink available mainly because people wanted it. The program basically skirted two vital points: (1) alcohol’s substitution for water as a cheap, disease-free mainstay in the society’s diet, and (2) the medical view of addiction.
Very early in the first episode, the alcohol/water connection is mentioned with only one sentence, a reference to doctors believing that alcohol was healthier than filthy river water. It didn’t go into the fact that most American towns growing into cities had been established next to rivers. And disease rising from contaminated drinking water had become a major fear. These illnesses could include bacterial infections such as botulism, cholera, dysentery, and typhoid fever. New York City and New Orleans had seen epidemics of cholera in 1832, with 3,000 deaths in the north and 4,340 in the south.
The scholar Paul Fisher points out alcohol’s impact in replacing drinking water in House of Wits (2008), his thorough biography of the James family (including the prodigious brothers, psychologist William and novelist Henry). In 1820 America, Fisher notes, “when water was often polluted and coffee and tea cost dearly, stiff drinking had become a daily ritual for most Americans.” That year in fact, he says, “saw the highest per capita consumption of alcohol in American history. Estimates range from between four and seven gallons of pure alcohol, per person, per year. In any case, it was more than twice the amount now consumed in the United States.” That included alcohol given to babies and children.
So alcohol in America had evolved as, not simply a wanton consumption, but a vital necessity. As a major player in a “healthy” diet, it could be seen to help a population survive, and therefore be able to thrive. But it could also provide a breeding ground for addiction.
Meanwhile, society in that era had no real concept of alcoholism as a medical disease. A man who couldn’t hold his liquor–and men were the breadwinners and primary political force at the time–was considered “unmanly,” as the “Prohibition” documentary points out. To become a drunk was considered a scourge on one’s family and society.
To combat this, the “Prohibition” documentary stresses, movements rose to challenge alcoholism, including the Washingtonians and other 19th century organizations. In the early 20th century, the Oxford Group became of international significance.
The understanding of alcoholism as a medically diagnosed physical allergy–leading a person to obsessive, uncontrollable drinking–gradually grew with the advancement of psychology and psychiatry in the 20th century. The combining of spiritual and medical approaches to alcoholism seems to have culminated with the founding of Alcoholics Anonymous by two recovering alcoholics, a stockbroker named William Griffith “Bill” Wilson and a physician, Dr. Robert Smith. The fellowship now claims more than 2 million members.
Wilson and Smith formed AA in 1935, just under two years after the repeal of Prohibition. Wilson gleaned principles and philosophy to include in the program from a wide range of sources, including the Washingtonians, the Oxford Group, and William James’ book The Varieties of Religious Experience. “Prohibition” indicated in its third installment that Wilson and Smith hadn’t been aware of the Washingtonians, but that’s inaccurate. Wilson refers to them in the 1953 book Twelve Steps and Twelve Traditions, saying in Tradition Ten, among other things, “In many respects, the Washingtonians were akin to A.A. of today.”
Dr. William Silkworth clarified the medical view of alcoholism as an allergy in “The Doctor’s Opinion,” a chapter within AA’s 1939 first edition of Alcoholics Anonymous. Silkworth was Director of the Charles B. Towns Hospital for Drug and Alcohol Addictions in New York City. A psychiatrist who had treated hundreds of alcoholics including AA founder Wilson, he wrote, “We [he and his fellow doctors] believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving [resulting from the allergy] is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all.”
Yet a couple of paragraphs later, Silkworth adds, “On the other hand–and strange as this may seem to those who do not understand–once a psychic change has occurred, the very same person who seemed doomed, who had so many problems he despaired of ever solving them, suddenly finds himself easily able to control his desire for alcohol, the only effort necessary being that required to follow a few simple rules.” Those “rules” are the Twelve Steps of AA, designed to lead to a spiritual awakening which includes the lifting of the obsession to drink.
A whole medical treatment industry has arisen in the U.S. since AA’s formation–rehabilitation centers which are not directly connected to AA, but incorporate the AA process in their programs. Despite this, and the abundance of healthy drinking-water systems nationwide which makes alcohol no longer a dietary necessity, alcohol consumption remains a major activity, and alcoholism still a vast, serious problem. Would prohibition solve the problem? History says no, as well as the current status of troubles with the proliferation of illegal drugs, including abuse of prescription medicines. Prohibition seems to have little effect there, while combined medical and spiritual treatments have made inroads.
The water-versus-alcohol issue and medical aspects of alcoholism have played important roles in American society before, during and after Prohibition. It would have been valuable for the producers to include them with some depth in their vibrant, quality documentary.