Stories from psychiatry’s past: Drinking, drunkards and dogs
Throughout January, it seemed that alcohol – or rather, the lack of it – was on many people’s minds. Amongst my friends there were resolutions to cut back the hours spent in the pub, fundraising ‘Dryathlons’, and that immortal line, “I’m going to give up drinking this year”. Meanwhile, in the press, barely a week goes by without an article about what we’re drinking, how much, and how often. The fondness of the British newspapers for binge-drinking ‘shockers’ – with photographers despatched to town centres on Saturday nights – shows no sign of abating, whilst the middle-class, middle-aged domestic drinker is becoming an increasing cause for concern.
Whether you believe that we’re in the throes of a lager-sodden apocalypse, or that alcohol unit guidelines are little more than guesswork, the effect of alcohol consumption isn’t a question confined to the Sunday supplements. In laboratory research, what alcohol does to our bodies and brains has consistently informed experimentation. A few months ago, Neuroscience published the findings of a group of researchers who, in explaining the importance of their study, challenged popular concerns about alcohol consumption. The idea of ‘moderate’ and socially acceptable drinking was, they said, an elastic concept: such consumption may be more harmful than people realised.
To investigate the effect of persistent moderate drinking on the brain, they divided adult rats into two groups – one given an alcohol-free diet for 14 days, the other a diet that included alcohol. The rats’ resulting blood alcohol level approximated the legal driving limit (0.08%) in the US and UK. They were then given motor skill and learning tasks, and the number of new cells produced in the hippocampus (the area of the brain associated with memory) was measured. Whilst the rats’ performance in the tests was unaffected by their alcohol consumption, the researchers found a significant decline in the production of new brain cells. It seemed that moderate alcohol consumption – even if it had little intoxicating effect – could have a profound influence on the brain.
This concern for the mental and bodily consequences of drinking isn’t a new one. In the late 19th century, problem drinkers frequently attracted the attention of asylum doctors. The sufferer of ‘alcohol induced delirium’ or ‘mania a potu’ took up valuable space in the country’s asylums as he or she ‘dried out’, often being admitted to the asylum more than once. The coincidence of alcohol and insanity was too perfect to ignore, and the two were easily bound together by the rhetoric of degeneration theory – the idea that with progress came the regression of the ‘weakest’ members of society. When settling upon an ‘exciting cause’ for madness, Victorian alienists frequently appealed to ‘Alcoholic excess’, ‘Intemperance’, or ‘Drink’. In many cases this occurred in conjunction with the more deep-rooted ‘predisposing cause’ of ‘heredity’. This link between inherent and exciting factors was cited by (among others) Frederick Mott at Claybury Asylum, who warned that just a small amount of alcohol was enough to tip an already unstable individual over the edge into insanity.
The direct effect of alcohol upon the brain was investigated by a number of researchers, many couching their work in the language of temperance reform. John Percy’s thesis on the presence of alcohol in the ventricles of the brain, for example, made clear the dangers of ingesting excessive amounts. He related the case of a man brought dead to the Westminster Hospital having ‘drunk a quart of gin for a wager’ and whose brain yielded ‘a considerable quantity of a limpid fluid, distinctly impregnated with gin, both to the sense of smell and taste, and even to the test of inflammability’.
Like the researchers in Neuroscience, Percy and his contemporaries sometimes used animals to investigate alcohol’s effects. William Bevan Lewis wrote in his Text-book of Mental Diseases (1889) that:
‘At the West Riding Asylum a dog, to which alcohol had been administered for a lengthened period, not only succumbed to all the symptoms described in alcoholism in animals by [Valentin] Magnan (hallucination, terror, savage temper, motor trembling, and paralysis); but the nutrition of the skeleton also became affected … and attendant deformity ensued.’
Whilst today we are more cautious about extrapolating results from animals to humans, Bevan Lewis wasted no time in doing so. Based on his observations of the dog, he attributed the ‘dwarfed stature of [the local] mining community’ to drink, noting that ‘excessive indulgence … [was] only too frequent’ amongst them.
Although drinking was increasingly medicalized, the morality and self-control of the individual was still central. Asylum doctors expressed their exasperation with patients who returned to the asylum again and again as a result of such ‘excessive indulgence’. ‘So long as the “uncontrollable drunkard” is allowed to go free and unmolested,’ wrote L. Forbes Winslow, ‘so surely must lunacy continue to increase’.
It was in such a climate that legislation was passed at the end of the century – such as the Habitual Drunkards and Inebriates Acts – that provided for the detention of problem drinkers in reformatories or ‘inebriate asylums’. Thankfully, no one’s yet touted involuntary confinement in institutions as a solution to Britain’s apparent binge-drinking epidemic. Today alcoholism is less likely to be referred to as a ‘disease’ than it was in the late 1800s, though the tension between viewing excess drinking as a medical or moral problem remains. The responses may be very different – commitment to the asylum in the 19th century has been replaced by educational ad campaigns today – but it’s evident that the concern for the effect of alcohol on our physical and psychological health is an enduring one.