In the latter part of the 19th century, there was a rapid growth of treatment centers for alcoholics. In 1870, there were six such facilities in the United States, which grew to more than 100 facilities by the turn of the century. The first state-funded institution for alcoholics in the country was the Massachusetts State Hospital for Dipsomaniacs and Inebriates, in Foxboro, which opened its doors in 1893.

Treatment for alcoholics in past years ranged from the compassionate to the barbaric, such as forced sterilization of institutionalized alcoholic women in the early 20th century, because it was believed they would have defective children and that they were promiscuous. Some alcoholics received electric shock therapy while others received frontal lobotomies, which Doctors Walter Freeman and James Watts first performed in 1936, believing the procedure would cure alcoholism by eliminating the craving for alcohol.

It did not; one account in William L. White's Slaying the Dragon: The History of Addiction Treatment and Recovery in America discusses the case of a patient who was treated for his alcoholism with a lobotomy: "Following the procedure, the patient dressed and, pulling a hat down over his bandaged head, slipped out of the hospital in search of a drink. Freeman and Watts spent Christmas Eve, 1936, searching the bars for this patient, whom they eventually found and returned to the hospital in a state of extreme intoxication."

In the 19th century, aversion therapy was a common method of treatment. According to White, the Swedish Treatment comprised using whiskey to induce aversion: Said White, "In fact, that is all they could drink--whiskey, whiskey-saturated coffee, whiskey-saturated tea, and whiskey-saturated milk. All meals and all snacks, regardless of fare, were saturated with whiskey. Patients wore whiskey-sprayed clothes and slept in whiskey-saturated sheets. The goal was to satiate and sicken the appetite for alcohol and leave one begging for pure water." It is not known whether this treatment was effective.

Counseling was rarely used, unless it was the use of psychoanalysis, which was ineffective at treating alcoholism.

Most treatment institutions that opened in the 19th century were closed by about 1925, with the exception of private facilities and state psychiatric hospitals. By that time, wealthy alcoholics paid for private treatment and those without wealth were institutionalized with the mentally ill under extremely poor circumstances.

Most alcoholics treated in the 19th century were males, and most treatment was ineffectual or even harmful; for example, at the Franklin Reformatory Home for Inebriates, which opened its gates in Philadelphia in 1872, treatment was composed of bed rest as well as the administration of arsenic, strychnine, and electrical shock. In the few treatment centers for female alcoholics, treatment often consisted of abstinence and kindness--which alone were not effective albeit better than poisoning or shocking patients.

The treatments used in the 19th century varied from healthy diets to hydrotherapy, electric shock therapy, and drugs. According to White, some of the drugs used to treat alcoholics between 1860 and 1930 were whiskey, beer, cannabis, belladonna, cocaine, and many others that not only were not effective in treating alcoholism but were also harmful.

Many "miraculous cures," which were inefficacious, were sold to desperate yet hopeful consumers in the 19th century. In some cases, wives and family members were encouraged to treat the alcoholic without his knowledge. The directions were to sprinkle 15-20 drops of Formula A in the alcoholic's first drink, and if that failed to cause vomiting, sprinkle another 15-20 drops in the next drink that was consumed. Formula A contained ipecac, a drug that induces vomiting. Clearly, this was an unethical and dangerous treatment.

Special diets for alcoholics were popular in the 19th century and into the 20th century, especially diets that promoted vegetables or vegetarianism. Some believed that eating red meat could induce a craving for alcohol and thus should be avoided altogether. Many water cures were also popular, such as cold showers or Turkish baths.

References:

White, William L. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, Ill.: Chestnut Health Systems/Lighthouse Institute, 1998.

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