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THE AMERICAN DISCOVERY OF ALCOHOLISM, 1933-1939
The great American metamorphosis: From demon rum to alcoholism
Nineteen thirty-three, the year national prohibition was repealed, marked a watershed in United States history. Before 1933, and stretching back more than a hundred years previously, the nation had been embroiled in a great controversy over beverage alcohol. In its long heyday, the alcohol debate--like the country's great debates about slavery and women's suffrage--provided one of the chief social issues and popular preoccupations of American life. On one side, the "Drys" argued that alcohol was an addictive and brutalizing poison unfit for human consumption; on the other, the "Wets" demurred at alcohol's vilification, argued for one's personal liberty to drink if one wished, and (late in the debate) argued that Dry-sponsored national prohibition had in any case created social problems worse than the problems Drys had hoped prohibition would solve.
In hindsight, we know that Repeal marked the effective end of that great debate. It also marked the beginning of a profound metamorphosis in American perceptions and concerns regarding alcohol and alcohol-related problems. Though Repeal did not end America's anxiety over alcohol, it ushered in a new era in which the cultural locus of such problems would become radically redefined. The country's attentions would no longer be fixed on beverage alcohol per se, nor on the industry that produced alcohol, nor on the place where drinking had ordinarily occurred (i.e., the infamous "saloon")--these were the three longstanding loci of temperance-movement attentions. Instead, the new era would focus attention primarily on the problematic drinker--that is to say, the modern alcoholic. Thus, the year 1933 marked a great divide in the country's alcohol consciousness, separating the old era of the "temperance movement" (1825-1933) from the new era of the "alcoholism movement" that would follow (1933-the present). How was this great metamorphosis in American society's popular paradigm of alcohol problems effected? How did we, as a society, get from the temperance paradigm and its rich and varied complements of conceptual focuses and social-action corollaries to the alcoholism paradigm and its equally rich but very different complements?
What can be said to be the conventional scholarly wisdom on the great transition? Unfortunately, there is astonishingly little of such to examine. The dearth of attention has a few notable sources. For one, the great transition falls across (rather than within) the conventional boundaries defining good sociological or historical research topics--so, for example, we have many more treatises on "the rise and fall of prohibition" or "the rise of the modern alcoholism movement" than on the transition from one to the other. In a like vein, Lender (1984) has suggested that historians have tended--like many Americans--to view Repeal as "an end to a chapter of the past, and to the 'liquor question' in particular, and not as the beginning of something new" (p. 177). Repeal, then, marked a great disjunction with the past, one to which the idea of "transition" (with its tacit and mild implication of historical continuity) could not be readily applied.
Equally important, if perhaps less well recognized, is that this paucity of interest and its associated imagery of disjunction are byproducts of the social mechanics of the transition itself. As Robin Room (1978, pp. 125-127) pointed out, the founders and early advocates of the modern alcoholism movement tended to see themselves as thoroughly new, different, and detached from the preceding temperance-movement era. This view stemmed both from their initial conceptual commitments and their political sensibilities. In Repeal's immediate aftermath it was widely felt that any new initiative concerning alcohol had to distance itself explicitly from both Dry and Wet camps. The public, it was thought, was too weary of the old debate and its old adversaries (Bacon, 1969). The new movement's differentness from and rejection of the old movement, then, provided the chief relationships spanning the two. Not surprisingly, these were themes that did not foster great interest in and sense of historical connectedness with the older temperance paradigm.
Yet, even differentness and rejection carried implications for the new movement's sense of its history and future direction. Obviously, rejection implied that the main relation between the two paradigms was negative. The old paradigm, then, could begin to take on the character of an anti-paradigm, providing a negative example of thought or action lines that should not be pursued by the new one's advocates. Rejection can occasion a dismissive attitude toward the earlier paradigm, one seeing its historical significance merely as that of an impediment to the adoption of the new. Rejection can also favor novelty in our image of the new paradigm's origins. The new paradigm, in other words, must be traced to some new insight, discovery, or innovation--or, put otherwise, the new paradigm is not based on something derived from the body of the old. Perhaps most important of all, the rejection model's implicit commitment to the new paradigm's novelty tends to imply that the new paradigm's origin and growth must be accounted for in its own terms. That is to say, the story of the new paradigm's ascendancy will take the form of an account of a chrysalis or new seed that in time grows, overcomes barriers, and finally flourishes, at last becoming diffused to and dominant in the wider culture.
One of the subtle but important corollaries of the above view of the modern alcoholism movement is that the new paradigm won out over the old--or came to occupy its territory--primarily because of its technical superiority. Much as a new airplane displaces an old one because it can fly farther, faster, more safely, or with larger payloads, the modern alcoholism movement displaced the older temperance movement because it provided a truer conceptualization and, thus, more effective means for dealing with the country's alcohol-related difficulties. This is an imagery, I would argue, that would explain the great transition primarily in terms of features inherent in the new paradigm and its pragmatic implications. The story of change, to re-use the airplane metaphor, becomes--most importantly-- the story of how engineers and technicians managed to craft the innovations that made the plane go farther, faster, etc. Such a story's social dimension provides merely the context and color associated with innovation and the obstacles encountered and great victories won by advocates who struggled to achieve public acceptance for the new technology. In other words, the particularly social aspect of social change is confined to the role of a passive and somewhat resistant audience to the technologic change. This technological motif--to the degree that movement advocates can successfully invoke it--both tends to provide good copy in advancing the movement's on-going ascendancy and provides a happy story or myth of its own birth and progress toward wide acceptance. At least in broad terms, the conventional picture of the modern alcoholism movement's birth and ascendency can be said to follow many of the themes and directions described above.
A small collection of social scientists (Levine, 1978; Blocker, 1989; Beauchamp, 1980; Gusfield, 1967; and Room, 1978) have offered a number of alternative visions of the ascendancy of the modern alcoholism movement. Interestingly, these have often been tendered in the framework of critical appraisals of the modern paradigm--a fact that no doubt emphasizes (in a rather different aspect) the close linkage between historical reinterpretation and paradigm shift. Each of these analysts has made a material contribution to the building of a wider and richer sociological interpretation of the great change.
Running against the grain of the conventional wisdom's emphasis on discontinuity is historical sociologist Harry Gene Levine's (1978) image of continuity across the two movements. Levine, in a widely-cited and seminal 1978 essay, "The Discovery of Addiction: Changing Conceptions of Habitual Drunkenness in America," argues that the era of the modern alcoholism movement and the era of the temperance movement are more alike than different. Their similarity, he contends, derives from both paradigms' conceptual roots in the idea of alcohol addiction. "The idea that alcoholism is a progressive disease--the chief symptom of which is loss of control over drinking behavior," argues Levine, "and whose only remedy is abstinence from all alcoholic beverages--is now about 175 or 200 years old, but no older" (Levine, 1978, p. 143). Hence, in Levine's perspective, the big change in American conceptions of alcohol happened at the turn of the 19th century, and not in the 1930s. He concedes that an important shift occurred after Repeal, too, but reduces its relative magnitude to "inhouse and intraparadigmatic" proportions (Levine, 1978, p. 145). "Contrary to the prevailing wisdom in the current literature on alcohol," Levine writes,I am suggesting that post-Prohibition thought...is of a piece with a major strand of 19th century thought--the ideology of the Temperance Movement. The most important difference between temperance thought and the 'new disease conception' is the location of the source of addiction. The Temperance Movement found the source of addiction in the drug itself--alcohol was viewed as an inherently addicting substance, much as heroin is today. Post-Prohibition thought locates the source of addiction in the individual body--only some people, it is argued, for reasons yet unknown, become addicted to alcohol. Although that change represents a major development in thought about addiction, the post-Prohibition ideas are still well within the paradigm first established by the Temperance Movement (Levine, 1978, p. 144).Levine focuses his explanatory attentions on the great pre- and post-1800 change he has identified. Much of this analysis turns on an examination of change in the images of alcohol and drunkenness across that temporal marker, particularly in relation to contemporary conceptions of Desire and Will. Following Foucault's analysis in Madness and Civilization (1975), Levine lays great stress on the American middle class's rising premium on individual liberty and (its normative corollary) individual responsibility over the course of the 18th century (p. 163 et seq.). By the beginning of the 19th century, Levine argues,the value of inner discipline had become increasingly divorced from its religious scaffolding. In the colonial period it was thought even among Puritans that social control had to be maintained by a complex and hierarchical web of community relations. In the 19th century, however, the ideological and structural features of life shifted the locus of social control to the individual (Levine, 1978, p. 164)."The invention of the concept of addiction, or the discovery of the phenomenon of addiction, at the end of the 18th and the beginning of the 19th century," Levine concludes,can be best understood not as an independent medical or scientific discovery, but as part of a transformation in social thought grounded in funda mental changes in social life--in the structure of society...[T]he medical model [of alcoholism] has much deeper roots than has previously been thought (Levine, 1978, pp. 165-166).For Levine, continuity across the two paradigms implies continuity in those aspects of American society that gave rise to and have sustained the addiction idea since 1800. In Levine's view, then, "the structural and ideological conditions which made addiction a 'reasonable' way to interpret behavior in the 19th century have not disappeared in the 20th" (Levine, 1978, p. 166). Ironically, Levine's emphasis on continuity in pre- and post-Prohibition eras provides little more reason for careful study of the great change than did the conventional wisdom's emphasis on discontinuity.
Even in Levine's very long historical perspective, however, there is room for an important point regarding the social requirements of the addiction idea as it passed from the temperance to the alcoholism era. Levine suggests that any disease conception of alcoholism suitable for the post- Repeal era must abandon the temperance paradigm's idea that alcohol, like heroin, was an "inherently addicting sub stance" (Levine, 1978, p. 162). Repeal's implicit relegitimation of alcohol lay at the requirement's root. Alcohol could not be both "demon rum" and authorized for public sale and consumption within the same official wisdom. In the post-Repeal paradigm, Levine argues,alcohol could be understood as a socially accept able, 'domesticated' drug which was addicting only to some people for unknown reasons. Thus alcoholism became the only popularly and scientifically accepted person-specific drug addiction. For the first time, the source of addiction lay in the individual body, and not in the drug per se (Levine, 1987, p. 162).Historian Jack S. Blocker, Jr.'s recent monograph, American Temperance: Cycles of Reform (1989) offers another kind of apparent continuity in his nominally cyclical model of transition. In Blocker's perspective, the U.S.'s experience with the social control of alcohol reflects five distinct and repeating cycles of temperance activity. Each cycle contains an internal dynamic that takes temperance activity from initially suasive efforts finally to coercive action over that cycle's full course.
Following Norman Clark's (1976) lead, Blocker (1989, p. ix) seeks to revitalize serious consideration of temperance agendas and history as well as gain a better picture of change in the nation's actual drinking patterns over time (see Burnham, 1968 and Dannenbaum, 1984). Blocker's perspective on temperance also reflects the seasoned historian's appreciation of the complexity and subtlety of his topic. It is in the light of this appreciation that Blocker finds it "more useful to conceive of temperance as a series of movements [rather] than as a single movement" (Blocker, 1989, p. xv)--this providing the organizing theme of his monograph.Although the various movements are united by the goal of control over drinking, they are distinguished by the specific constellations of historical forces that impelled men and women at different times to choose temperance as a solution to what they pereceived as problems in their own lives or in the lives of others. Each movement was different as well because of the lessons temperance reformers drew from the remembered experience of their predecessors (Blocker, 1989, p. xv).At first glance, and contrasted with the conventional perspective, Blocker's characterization of the modern alcoholism movement as a "temperance cycle"--the fifth and most recent temperance cycle--seems mildly shocking, and, perhaps, a second expression of Levine's (1978) continuity theory. But first glances can deceive. First, Blocker uses a very broad definition of "temperance movements" that demands little more than that there is a shared desire to control someone's drinking behavior. Second, Blocker's description and analysis of the post-Repeal alcoholism cycle or era is more or less the conventional historical account. The two points are logically connected to each other, for if the definition of "temperance" is wide enough, the description and analysis of individual temperance cycles can be particularistic and free to follow what ever story the "actual" history seems to suggest. If any explanatory gloss is offered at all in his account, it is that the modern movement's reliance on the disease conception of alcoholism, on research, and on effective alcoholism treatment offered new hope that new noncoercive measures might successfully mitigate the country's alcohol-related problems, thus re-starting Blocker's cyclical suasion-to-coercion process. "These new temperance reformers," writes Blocker,presented themselves as citizens who sought to control drinking without bringing on the excesses of past reform. Indeed, they rejected the label of 'temperance reformers' and sought to distinguish themselves from all those who had previously tried to control drinking (Blocker, 1989, p. 133).The nuance, here, is ironic, for Blocker seeks to illuminate in their experience the same forces pushing such an endeavor toward coercive measures. It is, in his words, an "uneasy triumph" (Blocker, 1989, p. 133). For our purposes, however, the cyclical model offers little more than a convenient device for organizing Blocker's narrative history--and not a model or mechanism of social change in the alcohol arena (though such a model might emerge from Blocker's thesis in the future). His model, it seems, was primarily intended to serve the book's objective, "to provide for the general reader a synthesis of the historical research on drinking and temperance in the United States published during the past century and especially during the last quarter century" (Blocker, 1989, p. ix).
Sociologist Joseph R. Gusfield provides an interesting and useful model of transformation in the social handling of deviant behavior in a 1967 paper titled, "Moral Passage: The Symbolic Process in Public Designations of Deviance" (Gusfield, 1967). Gusfield argues that the social handling of deviant behaviors is determined by the moral definition attached to a particular form of deviant conduct. He suggests three broad categories of moral standing--the repentant, the sick, and the enemy deviant. Such moral judgments, in turn, are structurally linked to variations in the normative status of deviant acts and deviant actors. The circumstance of low consensus surrounding such norms, for example, calls forth the "enemy-deviant" moral standing. Deviance in this category involves a high discrepancy in the social influence or power between the dominant, rule-defining group and the deviant group on whom the deviance-defining rule is enforced. Societal reaction to "enemy" deviance is the most energetic, in that the "enemy deviant" is seen as challenging the legitimacy of the norm being transgressed, thus lending a sense of urgency and new purpose to the social-control response. As the power of deviant subgroups grows or as the legitimacy of the norm is perceived to increase, the moral status of the same deviant act may change toward the "repentant" or "sick" status, thereby modifying and mollifying the societal response.
Gusfield employs the arena of deviant drinking to illustrate his model of change. In his view, the early temperance movement drew upon a good deal of normative con sensus, thus occasioning "repentant" deviance among drinkers. The failure of suasion and the persistence of drunk enness as a social problem gave rise to "enemy" deviance and calls for prohibition. These policy efforts were also aimed at deviant cultural groups--e.g., the Germans and Irish--who were perceived to be outside the growing Dry consensus in middle-class America. In the wake of Repeal, however, public support of the abstinence norm was displac ed by a growing consensus around a norm of moderation in drinking. Thus, deviant drinking's moral status shifted once again, this time to the "sick" drinker. Gusfield notes that the symbolic threat to a norm posed by the "sick" deviant is nil. For this reason, in Gusfield's analysis (unlike Levine's ), temperance advocates (who sought to develop a strong consensus around an abstinence norm) were in little sympathy with the illness view of alcoholism, which morally defined deviant drinking independently of the normative constraints on drinking.
Gusfield's model of change is driven by shifts in popular moral sentiment and power relations. As such it begs the question of how these factors change over time. Gusfield's analysis does not enlighten us on this point, beyond noting that the public designation of devianceis open to reversals of political power, twists of public opinion, and the development of social movements and moral crusades. What is attacked as criminal today may be seen as sick next year and fought over as possibly legitimate by the next gen eration (Gusfield, 1967, p. 187).Such change Gusfield calls "moral passage," the "transition of the behavior from one moral status to another" (Gusfield, 1967, p. 187).
Like Levine, Dan E. Beauchamp (1980) is interested in the deeper ideological and sociocultural springs of the alcoholism paradigm. Also like Levine, Beauchamp is critical of that paradigm, and his analysis seeks to provide an understanding that will facilitate passing "into a new phase" (Beauchamp, 1980, p. 4) of alcohol-related thought. Yet Beauchamp's analysis falls somewhere between the radical image of schism of the conventional wisdom and Levine's radical image of continuity. In Beauchamp's view the post-Repeal alcoholism paradigm was not entirely new but "spec ifically modern and different from previous usage" (p. 5). He notes that the construction or development of the alcoholism paradigm "was not simply, or even mainly, a process of scientific investigation, but rather a process of collective definition" (p. 5) relying upon the construction of a new public consensus, rooted in "modernism." "The alcoholism movement's central ideas cannot be understood," Beauchamp argues,apart from the transformations occurring in American society during the first fifty years of this century. Paradoxically, even as the drive for national Prohibition succeeded and seemed to thrive, the very forces of rising prosperity--urbanization, mass media, advertising, and the automobile--were undermining the cultural fundamentalism that sustained Prohibition. These forces for change set the stage for the 'discovery' of a new theory of alcohol problems, one that would conform to the central tenet of modernism, the freedom of the individual from community controls of personal conduct. Thus, the idea that the vast majority of drinkers possessed a personal ability to control their drinking was a theory that perfectly matched the triumph of modernity (Beauchamp, 1980, p. 6).Beauchamp acknowledges Levine's case for continuity, but argues that the essence of the modern alcoholism paradigm lies not so much in the few people who fell prey to alcoholism as in the many who would not (see Beauchamp, 1980, pp. 8-9). Like Levine, Beauchamp argues that the alcoholism movement's case for the localization of alcohol's perniciousness in only a few drinkers sprang from the cultural imperatives of Prohibition's failure and national rejection. That failure, Beauchamp argues,directly transformed our collective definition of alcohol problems from being a threat to the entire community to being a threat only to a minority of drinkers. The need was to construct a definition or explanation of alcohol problems that relegated alcohol as a substance to a relatively minor role (Beauchamp, 1980, p. 9).Beauchamp stresses the alcoholism movement's effort to defend the moderate drinker. For him, the alcoholism move ment provided an escape from the cultural control of personal behavior. In short, its central sociocultural utility was to create a small and distant subgroup on whom alcohol worries and controlling energies would be localized, thus freeing everyone else to the dictates of indivdidual conscience. In an "Age of Less" this shift may, however, be itself in line for change. "A shift seems to be occurring that challenges the dream of a limitless vista for the unbounded self and the unlimited promise of leisure, consumption, and personal gratification" (Beauchamp, 1980, p. 21).
Robin Room (1978) offers a rich and elaborated conception of alcohol-related paradigms. In his view, the world of alcohol-related thought and action is crowded with several paradigmatic idioms or "governing images" vying for attention and use--he describes, for examples of these, the epidemic model, the disease model, the temperance model, the ambivalence model, and so on. Thus, in Room's view, the climate of opinion at any given historical moment can be said to be multi- paradigmatic and multi-layered. If Levine has wheeled the historical telescope so far back that only a single paradigm dominates from 1800 to the present, Room can be said to have wheeled it closer and equipped it with a series of theory-sensitive lenses for discerning the scope and interplay of existing models. Partly, Room's picture of multiple alcohol-explaining models is a reflection of that world's multi-disciplinary character; and partly it reflects the diverse theorizing that can be sustained when the problem being addressed is intractable over a long time.
Room recognizes the relative hegemony of the disease conception of alcoholism in the post-Repeal era and offers his own conjectures regarding the temperance-to-alcoholism transition. His analysis begins, however, with an examination of the 19th-century history and cultural standing of the disease conception. If (as Levine  has suggested) the disease conception of alcoholism was present in the temperance movement, Room asks, then what accounts for its relatively low level of importance in the temperance context and what accounts for its rapid rise to dominance after Repeal? Room ties the 19th-century fate of the disease idea to the beleagured historical experience of the inebriates asylum movement. Room suggests that, unlike the mental asylum movement, the inebriates movement failed to leave a lasting legacy to the 20th-century because it fail ed to build an enduring economic base, supportive constituency, and secure place in governmental obligation (Room, 1978, p. 128; see also Baumohl and Room, 1987).
Regarding the alcoholism paradigm's flourishing in the post-Repeal period, Room's analysis focuses on how and why alcohol activists came to narrow their post-Repeal focus down to an almost exclusive interest in "alcoholism." In so doing, they abandoned jurisdiction over a much wider array of problems (e.g., drunk driving, alcohol and crime, alcohol-related physical disease, and so on) that Americans had grown accustomed to attributing to alcohol without necessarily mediating that attribution through alcoholism. In Room's view, then, the era of the temperance paradigm did not suddenly change into the era of the alcoholism paradigm, but the great shift occurred when the multifarious interests and preoccupations of the older paradigm were suddenly narrowed to a single all-important phenomenon, alcoholism. Room considers two potential explanations for this sudden shrinkage (see Room, 1978, pp. 135-143): first, Mark Keller's "AA-capitulation" hypothesis, and, second, that the new movement was co-opted by the alcoholic beverage industry. Room finds neither compelling. Keller's hypothesis (see Keller, 1972) grew out of his contemplation of the odd fact that although an impressive scientific as sault on alcoholism was launched in the late 1930s, nevertheless it would be the insights and treatment approach of a lay organization, Alcoholics Anonymous (AA), that would guide the emerging movement. Why so, asks Keller? Keller's brief answer is that the scientific assault on alcoholism had little to offer in "the practical business of successful treatment" and, therefore, AA's rapidly rising popular appeal and lay wisdom were "capitulated to" by key alcohol scientists.
Room is dubious of Keller's explanation. First, alcohol scientists in the movement's formative years,1 Room argues, offered a competing (rather than AA-mimicking) form of treatment. Moreover, the scientific movement sought to strengthen ties with the state and to develop publicly-supported treatment facilities and bureaucracies. These tendencies, Room argues, were antithetic to AA's assumptions and practices. Regarding the hypothesis of beverage-industry co-optation, Room suggests that although industry leaders were well aware that the alcoholism paradigm might prove greatly useful in legitimizing drinking for the great majority of Americans and in staving off renewed pressure for a new prohibition drive, nevertheless their stake in the alcohol-research world was too small to explain the subsequent embrace by alcohol researchers of the alcoholism model in the formative years of the modern movement. Alcohol researchers, Room concludes,do not appear to have adhered to the alcoholism movement and its disease concept because of either the pressure of the alcoholic beverage industry or the compelling power of the Alcoholics Anonymous model. There is no denying that both these factors were influential in pointing towards and promoting a concentration on alcoholism rather than on alcohol studies and problems in general (Room, 1978, p. 143).Harking back to his analysis of the failure of the 19th-century inebriates asylum movement, Room concludes that the key to the modern movement's post-Repeal success lay in its greater success in developing institutional sources of support and stability. "Work on wartime alcohol problems..." writes Room,and on public information with recovered alcoholics...pointed the way to practical usefulness in society, to securing a basis of data and support for research work, and to leadership positions in a social movement fueled with the energies of recov ered alcoholics as footsoldiers....If the researchers can be said to have sold out to anything, it was to their own institutional ambitions and altruistic aspirations" (Room, 1978, p. 143).
It could be argued that there is much apparent disagreement across these five theorists regarding the great Repeal-era transition. Levine stresses continuity across the Repeal divide, Blocker sees the initiation of a new cycle, Gusfield's analysis traces the shifting moral status of deviant drinking to the equally shifting norms and norm ative consensus (in a model only loosely tied to Repeal per se), Beauchamp emphasizes disjunction and a new modernism, and Room offers a model of narrowing interests occasioned by a mix of self-serving and altruistic motivations. Beauchamp sees the post-Repeal paradigm as offering a cultural license to drink for most Americans--i.e., as an extension of modernism's hedonist inclination--whereas Levine and Blocker see the alcoholism paradigm as a cultural device for continuing control of drinking, if under new terms. Levine sees temperance ideology rooted in the addiction idea whereas Gusfield sees temperance interests threatened by it. Still more differences might be cited.
Yet there is good potential for complementarity across the five theorists, too. All of them emphasize the ties between the cultural conception of alcohol-related problems and sociocultural structure. Together, they identify a number of important sociological boundary conditions that may specify the lines of relationship between sociocultural factors, on the one hand, and the alcohol-related problems paradigm, on the other. Levine, for example, offers the thesis of the necessity of domestication or devilification as a requirement in any post-Repeal alcohol-problems paradigm. His argument asserts that the alcoholism paradigm harbored the singular virtue of narrowing beverage alcohol's addictive powers down to a hold over the vulnerable few who were susceptible to the illness, thus relieving beverage alcohol of its inherent evil. The removal of alcohol's inherent evil allowed it to be symbolically redefined in greater harmony with its post-Repeal legality. Such a conception, as Beauchamp argues, legitimized drinking for all who were not now and probably would never become alcoholics. But the alcoholism paradigm also set limits on acceptable drinking, as Blocker and others have suggested, thus providing a new social standard for drinking in the post-Repeal era. This feature of the paradigm allowed the new movement both to define and, equally important, enforce the development of moderationist drinking practices in the post-Repeal America. The alcoholism idea involved the articulation of a system of symptoms or signs--all ostensibly for the identification of the syndrome--but all equally capable of conceptualization as the normative fenceposts in a newly-explicated cultural perimeter around so-called "normal" or "social" drinking. Alcoholism's implicit evil as an illness--after all, we may define ill folk as not responsible for their condition but we nevertheless continue to see their illness as bad (Stewart, 1951)--could also provide a negative focus for anti-alcohol sentiment in the culture, thus offering Dry sentiment a new and viable focus for opprobrium against alcohol (as Blocker's cyclical model might suggest).
Taken together, then, the five theorists offer a broadly-defined sociocultural frame defining the paradigmatic features that would best fit the post-Repeal circumstance: devilification, the development of moderationist drinking norms and appropriate authority for their enforce ment, a suitable alternative negative focus for anti-alcohol sentiment, and, it might be added, a new and benevolent group to which to assign the management and treatment of alcohol-related problems in the society. In these terms, then, the modern alcoholism movement fit a demanding set of sociocultural desiderata, and its ascendancy in the post-Repeal era could be traced to the goodness of that fit.
Yet there are three outstanding limitations that these sociocultural perspectives and hypotheses harbor as well:1. To the extent that they focus on the compatibility or fit between the alcohol paradigm and the wider sociocultural environment, they may be better suited as explanations of the evolution or development of the new paradigm than as explanations of its genesis or birth. How, after all, can good sociocultural "fit" actually call into existence an appropriate alcohol- problems paradigm?In order to address these issues it will be necessary to examine some history.
2. Though they articulate a concordance between the alcohol paradigm and the wider sociocultural environment, they offer no readily apparent means for testing the explanatory significance of that fit. In other words, we do not know whether the match between paradigm and sociocultural context arose out of mere coincidence, was an unintended byproduct of other change processes, or, perhaps, merely reflects the facile abilities of social scientists to find at least one or two plausible lines of affinity between the modern alcoholism paradigm and the post-Repeal environment.
3. These hypotheses tell us nothing of the actual mechanisms or operations of sociocultural causation. How, after all, does such sociocultural causation impose its impress on the emerging course of vents? How does the "society" come to carry out socioculturally dictated requirements? What are the mechanisms by which such requirements communicate with the unfolding history?
1Room's analysis is focused on the alcohol research movement that grew up at Yale University in the early 1940s.