The “epidemic” of alcoholism in 19th century America stemmed from the convergence of several factors. Economic changes resulting from industrialization led to a rapid urbanization of the country and the breakage of older ties to family, profession, and place. In an echo of the current opiate epidemic, many early proponents of the temperance movement highlighted alcoholism as a harbinger of a larger decline of the social order, and framed sobriety as part of a larger spiritual and personal transformation.

Another factor was the rise of modern medicine and psychiatry. Around the turn of the 19th century, social reformers and physicians like Benjamin Rush of Philadelphia began publishing clinical descriptions of longstanding behaviors. Rush’s 1784 essay on “the Effect of Ardent Spirits Upon Man” was one of the first efforts to pathologize alcohol dependence. Rush fused Enlightenment-era medical principles with Christian moralism to argue that overconsumption of distilled spirits led to madness and depravity. This psychological approach would eventually give rise to new terms like dipsomaniac (which first appeared in the 1840s) and alcoholic (a surprisingly recent word, dating back only to the 1880s).

(Rush became such a popular medical authority that he continued to haunt the field long after his death. Later in the century, a psychic medium named Sarah Danskin claimed to have been “the pupil” of the deceased Dr. Rush’s “spirit” for a period of 10 years.)

“A Moral and Physical Thermometer,” from Benjamin Rush’s “An inquiry into the effects of ardent spirits upon the human body and mind,” 1784.

Interestingly, the lines that were drawn by the early reformers allowed for a little wiggle room. In his 1784 treatise, Rush included an image of a “moral thermometer,” portraying the difference between alcoholic and non-alcoholic drinks literally as one of degrees. Wine and strong beer were included in the section labeled “Temperance.” Contrast that with the absolutist approach to temperance taken by reformers a century later.

Although they don’t align neatly with later campaigns for legal prohibition, these stock images of the “drunkard’s progress” signaled the beginning of a longtime reliance on mass media on the part of anti-addiction reformers. Their efforts coincided with the rise not only of mass literacy, but also of new media formats and distribution venues, like signage and proto-billboards. The antebellum era ushered in telegraphs, color lithography and photography, as well as national newspapers and periodicals (some of which, like The New York Times, Harper’s, and the Atlantic, persist to this day). All of these changes helped spread the message of temperance crusaders, who often proved to be canny with the slogan and archetypal image.

Advertisement for “Moral Panorama.” Waterbury, CT, September 1, 1859. (Winterthur Library)

It might be tempting to draw comparisons between the alcohol problem in 19th century America and the contemporary epidemic of opiate addition. But there are important differences between the two eras. Substance abuse today is still discussed in the language of medical pathology, but it is far less likely to be denounced as an indication of moral depravity. The earlier obsession with character has largely been superseded by narratives of recovery.

The Drunkard’s Progress as depicted in 19th century media inevitably led to the grave. Today, it is much more likely to lead to an AA meeting.