Medicine: Alcoholic Illness

“Last week was very heavy,” said the male nurse in an alcoholic ward at Manhattan’s Bellevue Hospital. “One night we took in 20. Usually they come between 3 in the afternoon and 8 the next morning, sometimes under their own power, sometimes with the police. A lot of other stews come around just looking for a place to sleep.”

From all parts of the country the story was the same: Americans were drinking harder than ever. A movieland 1945 Oscar went to the portrayal of a drunk; the book from which the story was taken was a bestseller. In a new sourcebook, Contemporary Criminal Hygiene (240 pp.; Oakridge Press; $4), Psychiatrist Robert V. Seliger of Johns Hopkins and Psychotherapist Victoria Cranford, a coworker, reported that there are 600,000 chronic alcoholics in U.S. institutions and no one knows how many outside; 2,000,000 heavy drinkers; about 38,000,000 “social drinkers,”

For practical purposes, Dr. Seliger defines an alcoholic as a person who is “handled by alcohol” to such an extent that it takes him out of one or more of the traffic lanes of life; he uses liquor as a narcotic. A “social,” or moderate, drinker, is one who is supposed to “handle liquor” successfully.

Alcoholism is a symptom of illness, not a disease in itself. A pathologic drinker gets that way for a number of reasons: as escape (from his job, a nagging wife, depression); because he cannot adjust his personality to the normal course of life; by the “one for the road” philosophy which leads him away from controlled drinking; through mental illness, physical pain or immature emotional makeup. No one is born an alcoholic; heredity is only an excuse.

For years Psychiatrist Seliger has been hammering away at one basic concept: moderate drinking is impossible for an alcoholic; he can no more handle liquor than a diabetic can handle sugar. The idea that he can get away with a small glass of wine, or even a beer, is sheer folly.

For a long time many American psychiatrists looked upon alcoholics as hopeless cases. A growing number now agree that pathologic drinkers can be treated medically—and a certain number cured—if they have 1) a genuine desire to be helped; 2) average intelligence; 3) some emotional maturity (a “brake power”); 4) an undamaged brain.

The Cure. Treatment begins with the immediate withdrawal of alcohol. Then the doctor must get the patient’s full story; he is advised that the road to cure is long and hard, requiring patience, determination and absolute honesty. He must report to the psychiatrist’s office regularly and be punctual in spite of hell, high water or “previous appointments.”

A man who should abstain, but does not want to, should be placed on an alcohol farm, or in a sanitarium or hospital. When an alcoholic’s supply is abruptly stopped, sedatives are often necessary to relieve the shakes or jitters. He must learn the importance of eating; carry chocolate bars to nibble between meals, take heavy doses of vitamin B.

In heart-to-heart talks with the psychiatrist, job adjustments, sexual incompatibilities and other strains are thrashed out; often wise guidance and constructive criticism help modify the troubles. The patient is advised to take up new hobbies, break away from his old drinking pals and their hangouts. His wife’s cooperation is sought. And the main theme is constantly reiterated: total abstinence.

Dr. Seliger has found that this approach brings “encouragingly satisfactory” results. But, he warns: “We are entering on an era which will probably be more chaotic, disruptive and emotionally disturbing than we have ever known. . . . The alcoholic in contemporary America is partly a product of our culture and its inherited and present strains and tensions; in addition to treating the alcoholic individual, we must help reorient our culture and social ways of thinking and living to a more decent, vital and spiritually productive level.”