A review of perspectives on alcohol and alcoholism in the history of American health and medicine.

This review of alcohol use and alcoholism in the history of American health and medicine reveals a range of ambiguous perspectives. In early America, alcohol was attributed with an array of medicinal uses, while habitual drunkenness was not accepted and was identified as a sin. The reformers of the temperance movement expanded upon what they regarded as the social problems associated with alcohol. In nineteenth century America, medical sectarians developed conflicting and contradictory views on health and healing, including the place of alcohol and how to address alcoholism. As the American hospital system evolved, approaches for the care and treatment that alcoholics received in hospitals had to develop as well. Progressive reforms in the early twentieth century impacted many areas of public health in the United States, but continued to embody moralism. These historical trends profoundly influenced the social and institutional responses to alcoholism that continue today, including the evolution of the modern addiction treatment system and the formulation and promulgation of the disease concept.