Consequences and behaviour problematised: The establishment of alcohol misuse as an object of empirical inquiry in late 18th-and early 19th-century European medicine

AIMS - This article discusses European medical thought on alcohol in the late 18th and early 19th centuries against the backdrop of concurrent transformations in the epistemological and social underpinnings of medicine at large. DESIGN - The article focuses on key medical works on alcohol written in the 1700s and early 1800s. The analysis draws on historical typologisations of medical practice and knowledge-formation (Ackerknecht, Jewson), and the notion of "working knowledges" (Pickstone). RESULTS - The defining feature of the era's medical thought on alcohol was that the issue began to be treated more rigorously in empirical terms. Doctors aspired to build an objective body of knowledge about diseases consequent on excessive drinking. The singling out of alcohol misuse as a special cause of diseases laid ground for viewing misuse itself as a phenomenon whose determinants and underlying dynamics were to be delineated in empirical terms. Remote causes of drinking were commonly traced to the socio-cultural sphere, which had a bearing on doctors' ideas on "alcohol addiction", too. CONLUSIONS - Earlier historiography has identified medical thought on alcohol at the turn of the 19th century as the starting point of individualising disease concept of alcohol addiction. The proper legacy of the era is rather the establishment of alcohol-related phenomena as objects of empirical inquiry, and the articulation of socio-cultural embeddedness of alcohol-related pathologies.