Demons: Our changing attitudes to alcohol, tobacco, and drugs

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She looks at how tobacco was promoted as a medicinal benefit. She considers the medical use of cannabis, LSD, and other drugs. And through all this, she traces the changes in scientific and medical knowledge. This is a complex story of whether, and how, the state should intervene. How do we balance the interests of personal freedom, public well-being, healthcare, and the economy? Is substance abuse a social issue, or a medical one? As governments, health services, and the World Health Organisation grapple with these issues, the wisdom and experience of history can help map the way forward.

Past and Present 2. Drugs for all 3. Convergence across the substances? She has published widely on the history of illicit drugs, smoking, and alcohol and has worked in both historical and non-historical settings. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Academic Skip to main content. Choose your country or region Close. Ebook This title is available as an ebook. To purchase, visit your preferred ebook provider. Demons Our changing attitudes to alcohol, tobacco, and drugs Virginia Berridge Considers varying attitudes to the use of drugs, tobacco, and alcohol from the 19th century to the present day Looks at how and why various substances have been regulated differently over time in different places Considers recent debates in public health in the light of historical changing attitudes.

Demons Our changing attitudes to alcohol, tobacco, and drugs Virginia Berridge. Marketing Health Virginia Berridge. Fanny died after taking a teaspoonful of powdered opium; Mr Story had to stand trial for manslaughter. Such cases could be multiplied time and again. Dealing with an opium overdose was commonplace and appeared as a standard section in most books of domestic medicine, self-help medical advice. He could always be roused, although with difficulty, but as soon as the stimulation was removed, this lethargy would return and death often followed. Christison was also involved in investigating the quality of drugs sold; for a major concern in the first half of the nineteenth century was the adulteration of all sorts of food and drugs.

He bought laudanum from seventeen different shops, fourteen in Edinburgh and three in a Scottish country town. These gave wildly varying percentages of morphia, one of the active principles of the drug. Further evidence of the lack of quality control was publicized in the Lancet, then a radical campaigning journal under the editorship of Thomas Wakley. Nineteen out of the twenty-three samples of gum opium purchased were found to be impure, with the most common additives being poppy capsules and wheat flour.

But not until later in the century, in the s, did the sale of adulterated drugs become punishable. Habitual use, what we would now call addiction, caused less concern. One can speculate as to why this was so. But this reliance was not always obvious. Supplies were available and it was only if they were suddenly interrupted that the situation became plain.

The surveys and the anthropological accounts of the late twentieth century were far in the future. Patterns of use appear haphazardly, and the survey which Christison and a surgeon, G. Mart, carried out in the s, was very unusual for the time. This recorded twenty opium eaters, thirteen women, of whom seven could be called working class, and seven males, two of whom were workers.

Their habit was known and acknowledged, so that fact alone made them out of the ordinary. Most addiction went unremarked. Robert Harvey was at that time an assistant to the house surgeon at Stockport Infirmary. At the end of his career he had become the Inspector General of civil hospitals in Bengal and reflected on his earlier experience while giving evidence to the Royal Commission on Opium in the s. Dr Frances Anstie, the editor of The Practitioner, wrote about the prevalence of opium taking among poor people in London.

It has frequently happened to me to find out, from the chance of a patient being brought under my notice in the wards of a hospital that such a patient was a regular consumer, perhaps, of a drachm of laudanum, from that to two or three drachms per diem, the same doses have been used for years without any variation. His comments on this discovery were realistic. In such a situation, where the drug was freely available with, in the first half of the century, and even after that, minimal controls, the type of distinction between what was medical and what was non-medical use was more blurred than it became later on.

In some areas such as the Fens, where usage was investigated in some detail, there was a recognition that consumers were taking the drug for part medical, part what we would now call recreational use. The writer Thomas Hood on a visit to Norfolk, was surprised to find out about opium eating in the Fens. Dr Rayleigh Vicars, who had grown accustomed to the unusual habits of his patients, also recognized this to be the case. The lives of middle-class consumers, it should be remembered, were less subject to investigation.

The liberal politician and prime minister, William Gladstone, took opium in a cup of coffee before big speeches in the House of Commons, as did William Wilberforce, the reformer of the slave trade. Opium was simply a part of life for many consumers, neither exclusively medical nor entirely social. This, then, was the overall picture of British drug consumers in the nineteenth century. Drug use was common at all levels of society and was largely unconnected with medical practice before the arrival of the alkaloids of opium such as morphine of which more later.

This may not have been a universal model, even in European and North American countries. Non- medical use there was mainly in the form of opium smoking. What happened in the States, so it appears, was a move away from iatrogenic medical addiction and a descent down the social scale, with a greater role for underworld consumers by the end of the nineteenth century. Such a picture does not correspond at all with the British case and even the type of medically induced addiction seems to have been different, as we will see in Chapter 8.

But it is difficult to make comparisons. In the British pattern of use outlined above, the prescription had little importance until the twentieth century, until after the advent of National Health Insurance. The terminology of addiction comes later in the British context; the extent of opium use in the general population via pharmacists seems to have been greater, with access from different sources of supply.

While out in India he first encountered the use of cannabis. But it was used infrequently in medical practice because of its uncertainty of action. This was a useful debating point for cannabis reformers in the s but it appears to have little foundation in fact. Nevertheless the myth has continued to be circulated. In one area only—the treatment of insanity and of opium eating—did cannabis gain temporary popularity, ironically given its later denigration as a cause rather than a cure for mental illness.

But of popular use on the model of opium there was none in the nineteenth century. Coca, the leaves of the coca plant, had a similar limited role. Cocaine, the alkaloid, was in the process of being isolated. But it was the properties of the coca leaf which initially attracted most attention, with a number of doctors investigating them.

In , the American pedestrian, Weston, used the coca leaf in walking trials in London. His conclusion was that the drug did not help maintain physical endurance. But others, including medical men, were enthusiastic about its potential use. Foremost among them was Sir Robert Christison, the Edinburgh pharmacologist who had been the investigator of opium in the s. Now he became an advocate of the benefits of coca chewing.

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He was able to walk fifteen miles without fatigue and two ascents of Ben Vorlich in the Highlands were exceptional for a man of his age. At the bottom, I was neither weary, nor hungry, nor thirsty, and felt as if I could easily walk home four miles. Other medics were keen to promote its use for what might now be considered non- medical purposes. It was a cure for bashfulness, and helped in steadying the aim while out shooting. Later it was used in patent medicines and coca wines; in , there were at least seven firms producing coca wines for the domestic market.

However, here too, certain misconceptions have crept into general discourse, as we will see. There is no doubt that heavy drinking and the consumption of large amounts of alcohol, especially by men, was seen as normal and even beneficial well into the nineteenth century. Hard drinking was notable at all levels of society. Drink was embedded in all aspects of life and the rites of passage, christening, weddings, and funerals, were normally occasions for heavy communal drinking.

During times of public celebration, ale and wine would be distributed to the common people. In the eighteenth century, drink was built into the fabric of social life—it played a part in nearly every public and private ceremony, commercial bargain, and craft ritual. On the following day a young fellow who had become so intoxicated as to be incapable, would be selected as mock mayor for the next year.

From to the late nineteenth century there was a large increase in consumption; the consumption of beer, wine, and spirits all peaked around The consumption of tea also grew. These were trends which were associated with rising living standards. Within the overall trends, different groups in Great Britain had very different drinking patterns.

People in the countryside drank less than those in the towns and cities. Some groups were teetotal. Across the UK, urban dwellers tended to consume more alcohol than their rural counterparts, and areas dominated by trades like mining and dock work also recorded higher levels. Pubs became social centres for the lower classes but their activities were often regarded as problematic. Trade and political groups were prohibited from licensed premises by Parliament in because of fears generated by the French Revolution.

After relaxation of the laws however, trade union activities resumed in pubs. Branches often associated themselves with particular houses in the city. Alcohol, like opium, also had its medical uses and these became the subject of agitations by medical temperance supporters later in the nineteenth century. Smoking too had spread in Europe since its introduction in the sixteenth century.

In England, tobacco had become a mass consumption commodity by the late seventeenth century at least. Enough tobacco was available for at least 25 per cent of the population to have a pipeful once a day. Until the invention of the cigarette for mass production in the second half of the nineteenth century, the clay pipe was a major means whereby tobacco was consumed.


Demons: Our changing attitudes to alcohol, tobacco, and drugs

Cigars also spread among middle- class consumers and more widely in Southern European countries. British consumers turned to snuff from the late eighteenth century but not to chewing tobacco. Like opium, tobacco also had its medical uses and Goodman has noted that, like that drug, the boundaries between medical and non-medical recreational usage, are difficult to draw at this time. The pipe returned to the British tobacco scene and by the middle of the century, 60 per cent of British consumption was pipe tobacco.

Pipes too changed during the century as more became manufactured of briar rather than clay. But clay pipe smoking remained common among working-class consumers. The habit was seen as essential for them to perform their everyday work. Publicans gave away pipes free and the association between drinking and smoking was close. By the middle of the century cheaper cigars were more widely available and began to appear more widely in the novels of Dickens, Thackeray, and Trollope.

Devotees collected the props of smoking culture, including clay pipes, briar pipes, pipe cleaners, matches, cigar holders, cigar cases, snuff boxes, and pipe racks. Tobacco, alcohol, and opiates were in common use, although in different ways and for different purposes. But they began to follow very different regulatory and cultural routes by the early twentieth century.

Those paths were set at two stages: The next chapters will examine the factors which impacted on changing culture and regulation: All these operated to differentiate the substances from each other. We will begin by looking at the role of social movements and what would now be called activism: Temperance Joseph Livesey, a Preston weaver, had founded a temperance group within the Sunday school he ran for adults; many young men who attended signed the pledge of moderation in drinking.

He felt that the alcohol in wine and beer was the same as that in spirits and equally harmful. So in he took the step which marked the birth of the British temperance movement.

On the social focus on women's drinking -- Part 2

On Thursday, August 23rd , John King was passing my shop in Church Street and I invited him in, and after discussing this question, upon which we both agreed, I asked him if he would sign a pledge of total abstinence, to which he consented. The pledge provided the founding charter of the temperance movement. That stance was to have significant consequences for society in the nineteenth and early twentieth centuries and also for the position of drinking and its regulation.

This chapter begins the consideration, in turn, of factors which have impacted differentially on alcohol, drugs, and tobacco. Each will be illustrated by means of a case study. Social movements, or the more restrictive term, pressure groups, can be major catalysts for policy and also for cultural change. In present-day society, we are used to the activities of campaigning groups across a range of issues. In the nineteenth century, such activity was a new development in the UK, which is where the case study is located.

Movements like the one for the abolition of slavery, or for the abolition of the Corn Laws, represented something different in society. They brought together the organized efforts of men usually so at this stage to try to achieve changes in social attitudes but also in legislation. It affected culture, but also developed a political dimension, which began to draw upon the extended role of the state in the last decades of the nineteenth century.

The roots of temperance lay in wider changes in Victorian society. The historian Roy Porter drew attention to the emergence of philanthropic lobbies, fired by Evangelicism, and given over to rescuing drunkards. There were both moral and economic arguments against drink, in terms of its impact on social mores and the way in which it could aid the exploitation of workers, as in the custom of paying wages in pubs.

Temperance in Britain went through four major phases in its heyday of the nineteenth century. In the s, it was a movement with clergymen and upper-class reformers leading a mainly middle-class membership. The focus was on the consumption of spirits, not wine or beer. The movement also had support from Quaker and nonconformist business interests, and, later in the century, from the churches. American influence on the movement was important, in particular the passing of the Maine Law in , which inspired British temperance supporters who wanted to bring prohibition into being.

The British organization, the United Kingdom Alliance, was founded in to emulate the American example. From the s onward, political tactics came to the fore and the movement aimed to infiltrate the Liberal Party as the likely vehicle of licensing reform. The aim was the so-called Permissive Bill, which would have allowed local preferences to decide what the drink situation should be in a particular neighbourhood. The nineteenth-century history of temperance showed how the focus of a social movement could change from the initial stress on individual responsibility to reliance on the role of the state.

The sale of beer, but not wines and spirits, was removed from control by licensing justices. Anyone could sell beer on payment of a two guinea fee. It was a free market solution which had an immediate impact. Over 24, licences were taken out in the first six months after the Act was passed and 21, over the following eight years.

The Act coincided with a period of rural unrest and rioting, and an enquiry into this blamed it for a great increase in intemperance among the lower orders. Thomas Whittaker, one of the Preston pioneers, gave a description of his activities during a visit to London in which gives a sense of the drive and enthusiasm. In London we are going on gloriously … During the last week I have held nine meetings and distributed 2, tracts; and large as London is I hope before long there will not be a soul in it who has not heard of teetotalism … On Saturday morning, I distributed tracts on the Margate steamer; and in the afternoon, accompanied by several friends, went to Greenwich.

We held the first teetotal meeting ever held in Greenwich Park, and a good one it was. Returning home, I distributed tracts and gave admonitions at the dram shops. The doyen of temperance historians, Brian Harrison, attempted an estimate of how many actual temperance supporters there were. Here he drew a distinction between people who were actively involved and the wider circle who were influenced by temperance ideas.

The efforts of this minority affected the personal habits of at least a million adult teetotallers, and probably influenced the conduct of many others who did not join teetotal organizations. There was a huge range of temperance literature. Temperance in the Hay and Harvest Field in the s urged the end to free beer in the harvest field. The story showed how drink could ravage a family. The misfortunes of the Danesbury family, owners of an engineering business, began when the baby William Danesbury was nearly poisoned by his drunken nurse.

His mother, called home to nurse him, was killed in a carriage accident caused by a drunken turnpike keeper. Soon a new wife arrived, who pressed wine upon her stepchildren and children. The results were predictable. Quakers became significant supporters of temperance and the Friends Temperance Union was established in This, like other societies, undertook widespread educational work often aimed at young children. The public meeting was central to reform campaigns and mass movements of the time. It was a way of demonstrating to government the power of the movement and also of attracting support.

The good temperance speaker would have the rapport with his audience and the showmanship of a professional working-class entertainer. The United Kingdom Alliance, a prohibition organization founded in the s, used public meetings more than any other technique. As early as , more than Alliance meetings were held throughout the year in England, Wales, Scotland, and Ireland. By , there were over 2, and by , 4, with an attendance of over a million. Why did people drink? To disprove ideas about nutrition Livesey entered into public demonstrations of the composition of alcohol, which greatly impressed his audience.

This, too, was a theatrical experience and the temperance meetings paraded reformed drunkards to public gaze. All had a story of personal degradation and then redemption. In addition to the adult culture of temperance, there were several hundred thousand child teetotallers in the Band of Hope.

In , 6, children crowded into Exeter Hall in the Strand in London for a meeting. Thousands of children could not gain entry and the press of numbers stopped traffic in the Strand, while those inside the Hall adopted a formal presentation to the ten year old Prince of Wales. The first temperance song was written in the s and its first verse went as follows: Come, all ye children, sing a song, join with us heart and hand Come make our little party strong, a happy temperance band.

We cannot sing of many things, for we are young we know, But we have signed the temperance pledge a short time ago. It was attractive to a particular type of Victorian working man and later woman , a craft unionist, attracted by thrift, self-respecting and interested in religious matters. The reformer Josephine Butler, who campaigned in the s and s against the Contagious Diseases Acts, which penalized prostitutes but not the men who infected them, characterized them vividly. They are the leaders in good social movements, men who have had to do with political reforms in times past, and who have taken up our cause.

They may not be the majority, but they are men of the most weight and zeal in their towns, and who have a considerable acquaintance with life, and large provincial experience, and they gather round them all the decent men in the place; when they start a movement they get all the rest to follow; and properly so, because they are men of character. Small female temperance groups came later than the male ones—in the s.

By , led by the redoubtable Lady Henry Somerset, it had nearly branches and 45, members. Temperance was one of the first organized activities in which women found a role in public life. All this tells about the cultural change to which a social movement can contribute. Certainly temperance supporters were always in a minority, numerically speaking, but their influence was writ large. They helped to rewrite the terms of the debate and indeed to initiate a debate in a way which would not have been considered before.

The combination of association and abstinence was a powerful one. Change in drinking habits was much to the fore by the s, in part through temperance promoted initiatives such as water drinking, the consumption of cordials, and the establishment of eating houses outside the pub. Other developments, for example, the rise in working- class living standards, which brought a move away from drink, had less to do with temperance. Culture was one level where temperance had a profound influence.

But increasingly the movement also looked to the state to provide solutions. From the s, when the role of government was expanding in other areas, public health for example, temperance supporters looked to obtain solutions from government. They argued that, as advocates of prohibition, they were also agents of liberation. They aimed to free consumers from the tyranny of drink, and also of the drink trade. An obvious counter to this was that prohibition itself would be a dictatorial solution.

The answer was in the tactic of the local veto. Ratepayers in a particular area would be given the right to vote to go dry; a two-thirds majority would be needed. A bill for the local veto, the Permissive Prohibition Bill, was introduced into the Commons in and thereafter annually, with the MP Sir Wilfred Lawson as its champion. For much of the next few years, the debate was dominated by what to do about licensing and the public house, and the connection with local government.

Out of these electoral battles came the polarization of parties and electorates. Temperance reform became associated with the Liberal Party while the drink trade became associated with the Conservatives. So the tactic of prohibition gained power through its association with these wider political objectives. The high point came in when the Liberal leader Harcourt was willing to introduce a bill which all the UKA wanted and which also denied publicans the right to financial compensation when they lost their businesses.

But the Local Veto Bill never reached a second reading in and the Liberals fell from power, a fall which was widely interpreted as signifying public opposition to the policy of local veto. With hindsight, the defeat was more significant than it appeared to be at the time. It marked the end of the UKA as a significant force in Liberalism at the national level. Drink still continued to be a high-level policy issue in the first decade of the twentieth century.

The defeat by the Lords of the Licensing Bill, which would have accelerated and expanded reduction of licences, restricted compensation, and allowed for local referenda on the local veto, meant that the issue became part of constitutional struggles over democracy.

John Greenaway in his study of licensing in this period explains the dominance of drink as a political issue between and by changes in the composition of the parties themselves, in particular the dominance of nonconformist Liberals in the Liberal Party. Lloyd George used drink cleverly as a means of arousing working-class support, with the brewers and the landed classes as easy targets.

In fact, temperance as a social movement was in decline before the First World War. Back in the s, Joseph Chamberlain, as Mayor of Birmingham, had promoted a different form of temperance solution called the Gothenburg System. This Swedish port, much of interest to drink reformers, had set up a trust company in run by unpaid directors. This ran the local pubs—not to make a profit, but in order to invest the returns into the town treasury and the local agricultural society. The aim was to discourage drinking through higher prices, and shorter hours, with pubs closing at 7 or 8 p.

Managers could keep profits from food but not from drink or from serving more than one drink per person. But he had been defeated in part by the determination of prohibitionists to keep to their objective as the only possible aim. In the early s, aims within temperance became more fragmented. In part this was because of the spread of different political ideologies and discussion of the role which poverty played in drink consumption.

The temperance argument had been that poverty was caused by drink. In the s reformers such as Joseph Rowntree began to look at drink in a different way and to argue that licensing reform needed to be part of a more general programme of social reform. It argued that excessive drink consumption continued to be a problem but saw this in a different context to the prohibitionists. The dullness and monotony of working-class life was in part to blame, but also the capacity of the Trade, which could influence both national governments and local municipal life. The solution, so they argued, was to take the trade interest out of the sale of alcohol.

Sherwell had visited the USA and Scandinavian countries in the course of his researches, and was convinced by the contrast between the shortcomings of the local veto in the USA and, by contrast, the operation of regulated management in Sweden and Norway. The profits would be handed to a central state-run authority which would hand profits back to localities in proportion to population and not to profits earned.

The issue of how to deal with drink thus divided the temperance movement before the First World War and beyond. Many temperance reformers were more interested in a moderate form of reform and some found a home in the Church of England Temperance Society. The most successful trust set up was not part of temperance. In Earl Grey began a campaign to raise the tone and restore country pubs.

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Within twelve months its takings from non-alcoholic drinks were nearly 70 per cent of its turnover. In , this Trust expanded and became a public company, Trust Houses Ltd, controlling a hundred inns and hotels, the ancestor of the later commercial operation, the Trust House Forte chain. We can leave temperance as a social movement with a political programme in the decade before the First World War.

What it had actually achieved at the cultural level is difficult to disentangle from a host of other changes taking place at the same time. Drink consumption began to decline in the mid s. Even rising living standards in these years and greater disposable income did not lead to rising levels of drink consumption. Temperance reformers retreated within their own organizations rather than reaching out to a wider sympathetic audience.

Politically, the movement had achieved something and we will discuss the particular case of the impact on women and children in Chapter 5. But it had not achieved prohibition or the power of the local veto. Alcohol remained set within the magistrate-run licensing system and drink as a party policy issue was in decline before Although licences were reduced in some areas, no overall prohibition or disinterested system of municipal liquor control came into being.

This chapter has used British temperance as its main case study to demonstrate how a social movement can help position a substance in a particular way at a particular point in time. Temperance did not operate in the same way, or achieve the same outcomes, in all the nations which had strong movements.

The great exemplar of a temperance movement which did ultimately achieve its aim, of prohibition, was that of the United States. Some of the overall story in the USA is familiar from the British one. The movement began in the USA as in the UK as an anti-spirits one with support initially from economic entrepreneurs who wanted a more disciplined work force. By there were more than 6, societies and a million members pledged to total abstinence from the use of spirits. In the s it became more of a working-class organization, as the newly founded Washingtonian societies focused on working-class drunkards.

After the Maine Law the aim became prohibition through an alliance of evangelicals, wealthy entrepreneurs, and respectable middle and lower-middle-class people united against the threat of pauperism and crime. Prohibition was achieved in thirteen states, a success which had no parallel in the UK. Some of the arguments made about liberty, in terms of liberation from the tyranny of drink, were also similar. But there were clear differences in the sphere of religious enthusiasm. The evangelical equivalents of English dissent in the USA had no established church or hereditary aristocracy blocking their way.

Ian Tyrrell has pointed out it was therefore relatively easy, by comparison to English temperance, for these US reformers to channel their views into socially dominant positions. The British movement, despite its apparent importance in the pre-war Liberal government, was spent as a political force before the war.

The American, by contrast, was on the way up. The Anti-Saloon League, by comparison with, for example, the United Kingdom Alliance, had no fixed political affiliations, but offered its impressive electoral machine to any politician who would support its anti-drink agenda. Prohibition was achieved in a significant number of US states, albeit temporarily, whereas in Britain the local veto was achieved for Scotland in , the only country where it was still a living issue.

The social basis and class structure of support was also different. As US historian Harry Levine puts it, The prohibition crusade was justified in terms of the needs of a new, complex, heterogenous, class stratified, industrial efficiency-oriented society of the twentieth century. The new prohibition ideology stressed the need to eliminate two particularly nefarious institutions: The tactics of the ASL, and support from the Protestant churches joined with support from wealthy business men as the dominant deciding force.

Further comparison could draw out the differences in working-class culture between the two countries temperance in the USA always accommodated working and lower- middle-class membership, rather than class specific organizations as in the UK ; or the development of rival attractions; of the absence in the USA of welfare reforms and legislation providing holidays with pay. Britain and the USA show us how social movements can have similar aims but achieve very different outcomes in different countries with different structures and traditions. Taking a wider international perspective shows further divergence.

For temperance was a significant social movement in a particular set of geographical areas—in Northern Europe and North America. It was not important in Southern European countries, which developed very different responses to drinking and to alcohol. The historian Sidsel Eriksen has argued that the Swedes were most influenced by Anglo-American traditions and the Danes by German and that this made a difference to the success of temperance in the two societies.

What about our other substances? Here we can see that social movements and pressure groups were much less important, at least initially. Although there was some concern about the use of opium and of tobacco, there was no mass movement in opposition. The anti-opium movement in Britain had little of a working-class component and came into existence later than temperance, in the s. It owed its origin to the efforts of a group of Quaker anti-opium campaigners and to the unwavering support of the Pease family of Darlington, who were also Quakers.

The Society initially ran a competition and prizes were offered for essays on the topic of British Opium Policy and its Results to India and China. Storrs Turner, an ex- missionary who was the first secretary of the Society won, and the book was published in This was the focus of the Society—not the situation in Britain, but in the Far East. Its main demands were for the abolition of the government monopoly of opium in India and the withdrawal of unfair pressure on the Chinese government to admit Indian opium.

Support for the Society came from Quakers with the addition of some Church of England and Evangelical support—Lord Shaftesbury became its president in Motions for the withdrawal of the government of India from the opium trade regularly came before parliament and were regularly lost. The anti-opium movement never achieved any broadly based provincial lobbying strength on the model of temperance.

The height of its influence came in the early s when it led calls for the ratification of the Chefoo Convention. The convention dealt with internal duties which could be imposed by the Chinese government and it allowed them to increase. In —3, there were meetings on the opium trade, three times as many as in the previous year. The convention was ratified and thereafter support again waned until the s. As with temperance, differences of opinion over strategy came into play. Some thought China should be the main focus, others thought India. In another anti-opium society came into being: Missionary influence was strong and it published its own journal National Righteousness.

As with temperance, the anti-opium cause had high hopes of the Liberal victory of But anti-opium MPs were outmanoeuvred. A Royal Commission on Opium was appointed; its report in was regarded as a whitewash, although in some respects it simply acknowledged the reality of opium use in India. Opium is extensively used for non-medical and quasi medical purposes, in some cases with benefit, and for the most part without injurious consequences. The non-medical uses are so interwoven with the medical uses that it would not be practicable to draw a distinction between them in the distribution and sale of the drug.

Most of the content dealt with China and India, although British example was occasionally drawn upon. De Quincey or Coleridge could illustrate opium eating. The Fens showed how opium could be used to treat malaria.

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  • Regulation in the two countries was also compared. The anti-opiumists made great play of the different legal frameworks for the availability and sale of opium. They had been badly brought up before she took them in hand; she now sends them tutors and Governors…and is in many respects a model step- mother … It certainly is a strange thing, if she had any love for them, that she should let them buy this opium to their hearts content.

    So the agitation, albeit limited in its successes, was preparing the ground for a different and more restrictive outlook on opium use. It was also, as we will see in Chapter 7, through its focus on the Far East rather than on Britain, paving the way for a significant divergence between alcohol and tobacco on the one hand and drugs on the other.

    What about anti-tobacco agitation? The British Anti-Tobacco Society was formed in Of the initial promoters, 38 were active scientists, the remainder moralists, evangelicals and social critics. Its secretary, Thomas Reynolds, was at times its only campaigner. Again there was a strong nonconformist element and support from manufacturers. Some temperance reformers were also anti-tobacco, but it was not until the anti-tobacco rhetoric became associated with fears about national decline in the late s and early twentieth century that it achieved anything at all significant, as we will see in Chapter 5.

    That cause illustrates the importance of the great campaigning movement—but also its limitations. Social movements by themselves cannot determine greater restriction or freedom. It did not achieve the aim of prohibition, for the cultural change which it also encompassed was accompanied by wider shifts in British social life, in particular among working people. But its influence can be seen in the fact that drink consumption did not rise as living standards did.

    People earned more and had more leisure time but chose not to spend it on drink. The cultural impact in Britain was clear, although the political impact was more muted. Doctors and Pharmacists Pharmacists were the key professional group controlling access to opiates. Their oral history reminiscences make this clear.

    Here are some who worked in the s and s speaking about how they dispensed opium. We sold all of them over the counter. We sold a lot of paregoric and opiate squills in those days.

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    We could sell it over the counter. It was a bottle of nearly black stuff, with some laudanum in it, to put the kids to sleep. Mrs Copper who lived in North Kensington in London used to run errands for her father, who provided doctoring of an unqualified sort for the local poor area. She remembered, my father you know, he worked for a licensed vet, a very clever man.

    And when my dad was a boy he worked for him … but he learned a lot. Well that was for dysentery, diarrhoea and all that. The neighbours used to come to him for that. In the last chapter, we looked at how a social movement, in that case temperance, could operate to help change culture and regulation. Temperance as a movement helped to develop new ways of thinking about drinking and also arguments about the role of the state.

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    Those professionals increasingly looked to the state as a means of establishing their own professional credentials. Here we will look at how professionals became involved with opium and alcohol and the impact this had on deciding the paths these substances took within society—by contrast with tobacco, where there was, at this stage, relatively little professional involvement. As opium moved away from completely open sale, and the popular culture of consumption which we looked at in the previous chapter, it came initially to form part of a system of pharmaceutical regulation.

    Pharmacists, not doctors, were initially the lead professionals in managing access to the drug and this system of pharmaceutical regulation lasted really until the First World War. A separate profession called pharmacy was in the process of organization in the UK and elsewhere in the mid nineteenth century, taking on board the existing chemists and druggists and the apothecaries, whose main concern was dispensing drugs.

    In the UK the professional body was the Pharmaceutical Society, which was set up in It thereafter sought government backing for its unique educational qualifications and for restriction of trade in the interests of its pharmacist members. Pharmacy Acts were passed in and in which set pharmacy on the road to this professional status. These Acts also began a process of controlling the sale of drugs. The Arsenic Act had already controlled sale of that drug, and the Act took things further.

    It put fifteen selected poisons into a two-part schedule. Drugs like cyanide of potassium and ergot much used as an abortifacient were in the first part of the schedule and were quite restricted. They could be sold only if the purchaser was known to the pharmacist or to an intermediate person who was known to both of them.

    Drugs in the second part of the schedule had less restriction and only had to be labelled. Opium was placed in this less restrictive second part of the schedule; the struggle over where it was to be placed and how regulated gives an indication of its important role in popular culture at the time. Pharmacists wanted the right to control the sale of such a popular and lucrative item—but they did not want restriction to be at such a level that their sales would be affected—or would perhaps continue in an unregulated way.

    It was the classic debate about the relationship between regulation and the creation of a potential black market. In this case, the danger was that dealers outside pharmacy might continue to take part of the trade. Throughout the s and s, there were debates about various bills brought forward to control the sale of poisons which illustrated this dilemma. There was a division of opinion between public health interests, which almost uniformly called for greater restriction, and pharmacists, who saw the realities of their own position.

    Professor Arnold Taylor, leading pharmacologist, recognized the importance of small sales to working people. The way round, in his view, was a system—rather akin in some respects to the Gothenburg System we discussed in the previous chapter— whereby pennyworths to adults could still be sold without restriction but had to be drunk in the shop. It was later revealed that this was because of protests from within the pharmaceutical profession itself. There were other exclusions too. The former contained more than 1 per cent opium, but it meant that weaker popular preparations like paregoric could still be sold without restriction.

    Direct over-the-counter sales to members of the public continued, with the pharmacist rather than a general dealer in charge. Such was the interest in this regulation that in the novelist Anne Perry used the machinations round the Pharmacy Act as the plot line for one of her Victorian thrillers. There were many commercial cholorodynes on the market but the best-known product was Dr J. Collis Browne had been a doctor working in India, where he first used the preparation. In , while on leave, he went to the colliery village of Trimdon in County Durham to help fight an outbreak of cholera.

    Chlorodyne, his preparation, produced encouraging results. In , when he left the army, he went into partnership with J. Davenport, a chemist in Great Russell Street in London, who gained the sole right to manufacture and market the compound. The main ingredients were chloroform and morphine. Although it was sold as a patent medicine, Collis Browne had not in fact patented his product and so there were many attempts to find out the recipe and to market rival products.

    Dawes, a country parson in Buckinghamshire, who gave free treatment to patients, wrote to Davenport in asking for fresh supplies. The trying weather lately having caused a large demand for this medicine, my stock is suddenly exhausted and I shall be particularly obliged by your sending me a pint and half of the Chlorodyne safely packed in a box by the Oxford coach.

    Here was an instance of a poor consumer who took too much. So by the end of the nineteenth century, opium and allied patent medicines came under a system of pharmaceutical regulation. This was a system which formalized access and sale, but did not aim to do anything further. Its roots lay in professional self- organization, but also in alliances between pharmacy, medical and public health interests who were concerned to do something about the problems of over-the-counter sale and consequent levels of accidental overdosing.

    In this system, opium was recognized as a self-help product, one with both medical and social uses, but it was essentially an item of consumption which needed relatively limited professional controls. Meanwhile a rather different system of control was emergent from a different professional grouping. This was the medical profession, which, like pharmacy, was establishing its professional standing in the nineteenth century, in its case in the UK through the Medical Act and the formation of the General Medical Council.

    Ideas about disease solidified in the second half of the century, in particular after the advent of germ theory, and it became possible to identify and categorize particular types of disease. In the early s the first professional British medical society aimed at promoting this idea and the role of professionals concerned with it came into being. Two months later, on 25 April , a luncheon at the rooms of the Medical Society of London formally inaugurated the newly established Society.

    The company was prestigious, including Lord Shaftesbury, the Bishop of Ripon, and nearly a hundred doctors, including the presidents of four medical societies. Inebriety is for the most part the issue of certain physical conditions, is an offspring of material parentage, is the natural product of a depraved, debilitated, or defective nervous organization.

    Whatever else it may be, in a host of cases it is a true disease, as unmistakeably a disease as is gout or epilepsy or insanity. Treatment in a hospital or inebriate asylum was to be actively promoted in opposition to confinement in prison. We shall be satisfied if we succeed in impressing on the public mind that inebriates are not necessarily scoundrels—that to treat the dipsomaniac as a criminal is not to cure but to confirm his inebriety, not to reform him but to make him worse—that no reproach should be cast on the inebriate for surrendering his freedom in the hope of cure-that no slur should be attached to residence voluntary or involuntary in a Home for Inebriates any more than in a hospital or asylum.

    Kerr was of the opinion that the state had a role in establishing a system of treatment in institutions and ensuring the pauper and working-class drinkers were able to gain access as well as those who were better off. Inebriety was the dominant concept in the UK and the USA at the end of the nineteenth century, bringing together alcohol and drugs. It had its origins in another organization, the Society for Promoting Legislation for the Control and Cure of Habitual Drunkards, which had been formed in by a group of doctors and a lawyer, and of which Kerr was also president.

    This was an objective which united the interest group around inebriety and there were high hopes that it could be achieved. On 19 September , a special train ran from Euston station in London to Rickmansworth, then a country town. It carried a mixed party of doctors, clergymen, temperance abstainers, and prohibitionists, many of whom were members of the Society for the Study of Inebriety.

    They were attending a reception at the Dalrymple Home, a licensed inebriates retreat run by the Homes for Inebriates Association. Public concern as we saw in the last chapter was expressed through the temperance movement, which had become by the late nineteenth century a substantial working-class movement in many countries, English speaking and Nordic ones above all.

    But public concern also took other forms, notably in the movement to provide medical state-funded treatment for inebriates. There were moves to reform this process and to insert medicine into it. Two years later, a parliamentary select committee on the control and management of habitual drunkards, of which Dalrymple was chairman, urged legislation to bring about the compulsory treatment of voluntary patients and of convicted drunkards. The results were initially disappointing. In , the Habitual Drunkards Act made treatment of non-criminal inebriates available only to those who could pay.

    A further act followed in The Inebriates Act of allowed the committal of criminal inebriates to state-funded reformatories if they were tried and convicted of drunkenness four times in one year. But what medical reformers wanted, the compulsory power to detain non-criminal inebriates, never became law.

    Even the small amount of change which was achieved in law translated only with difficulty into actual provision on the ground. Financial battles between the Home Office and the local authorities, charged with funding the reformatories, blighted the implementation of the Act. But the Acts brought drinking and drug taking together although not smoking. Inebriety was classified according to the intoxicating agent: Laudanum tippling was covered, but not drugs that were injected. A later departmental committee on the inebriates acts accepted that all drug taking should be included. It also proposed that an inebriate, thus defined, could apply to have an appointed guardian, a strategy derived from lunacy legislation, whereby the guardian would decide where the inebriate would live, deprive him of intoxicants, and warn sellers of drink and drugs against supplying him.

    After a warning had been given, any supply to a drinker or drug taker would be an offence. Provision for compulsion was in place if voluntary control proved insufficient. Plans to extend the law in this way were by then a faint hope. Even before the First World War, inebriates legislation fell into disuse.

    Only fourteen reformatories, dealing with 4, inmates, were then still in operation. Drinkers and drug takers were covered by legislation dealing with lunacy and mental deficiency. The power to commit offenders to inebriate reformatories was heavily implemented in cases of neglect and child cruelty. The Licensing Act enabled a magistrate to send an inebriate wife to a reformatory in place of a separation order.

    The Provision of Meals Act of and Prevention of Cruelty Act of provided for detention when neglect and cruelty were due to drink and were also used to commit drunken prostitutes and the poorest and most troublesome section of the male labouring classes. The mandate of the institutions encompassed reform, rehabilitation, and punishment.

    Offenders were kept away from the temptations of the city hence Rickmansworth, which was then a country town, for the Dalrymple Retreat and confined for a lengthy period—between one and three years—as compared with one to three months in prison. Cure involved physical, mental, and moral rehabilitation. In America, the temperance- based Washingtonian movement of the first half of the nineteenth century had founded small, private institutions dedicated to the moral treatment of voluntary patients.

    Promoters of the asylum model, some organized through the American Association for the Cure of Inebriety, wanted institutions that were large, public, rural, and capable of holding and disciplining the inmates. Public institutions specifically for drinkers did not gain ground in the USA.

    The Massachusetts State Hospital for Dipsomaniacs and Inebriates was plagued by patient escapes, rebellions, and the accumulation of chronic cases. The advent of prohibition in the s seemed to substitute prevention for cure. In English-speaking countries and in Germany, the popularity of inebriate institutions peaked in the years before In the Nordic countries, the peak of interest was later, from to There were inebriate asylums in Australia and South Africa.

    After the First World War, with restrictions on opening hours and reduction of the strength of alcohol, prosecutions fell in England. The alcohol problem was no longer the central question, and inebriate reformatories seemed less relevant. Different trends had emerged in psychiatry. The legacy in English-speaking countries was apparently minimal. Systems for handling alcoholism continued in Sweden and Switzerland, although these were less medically oriented. Both countries arrived in the period between the wars at a three-tiered system of community agencies, hospitals, and work camps.

    In practical terms, the emergent alliance between medical experts and the state over inebriety had achieved little by the outbreak of the war. But the theories which had been developed since the eighteenth century about the overuse of alcohol drugs to a lesser extent as a disease were of great importance and continued in medical and popular currency. In effect, with variations and modifications, they have continued to underpin dominant medical views about drink and, to a lesser extent, drugs, into the present day. Thomas Trotter was an English counterpart, often also hailed as the originator of disease views of alcoholism.

    In fact the key features of the concept had been developed throughout that century and were more or less in place by the s. They were part of ongoing debates about the relationship between the body and the mind and about the moral implications of the relationship. Drink provided an admirable case study for these discussions. Lettsom described the cycle, leading from tippling for stimulus, relief, or exhilaration; to low- spirits, which were the inevitable after-effects; which in turn could be obliterated only by further bouts of yet heavier drinking.

    He cited as an example those of delicate habits, who have endeavoured to overcome their nervous debility by the aid of spirits: What was different about the late eighteenth-century and early nineteenth-century declarations of Rush and Trotter, so the historian Roy Porter has persuasively argued, was not the theories themselves, but the fertile context in which theories found themselves.

    Evangelical Christianity, the moral movement of temperance, the expanding ambitions of the state, all provided fertile ground for ideas of disease to take root. One can track a path forward from these declarations. During the first half of the nineteenth century European theoreticians elaborated the disease concept in various ways. The connection with expanding theories about insanity was a strong one.

    The French alienist or mental illness specialist Esquirol contended in the s that there was a mental disease which manifested itself in the inability to abstain from intoxicating liquors. He classified it as a form of monomania, a category he had invented where the patient was unable to reason on one particular subject but was otherwise lucid. Early physiological enquiry into alcohol by investigators such as W.

    Carpenter, lecturer in physiology at the London Hospital, began to link research into the effects of alcohol with theories about habituation. Carpenter reported on trials of hard work where drink was either consumed or not—among farm workers and also among brickmakers, with productivity higher among the teetotallers.