Alcoholics in the early 1900s were looked upon as “chronic drunkards,” “hopeless inebriates,” “pitiful creatures, sinners,” and worse. But soon a handful of visionaries began to reshape the prism through which alcoholics were viewed by medical professionals and the public. In 1917, Charles B. Towns, Ph.D., who had founded a Manhattan hospital as a “drying-out” facility, wrote a groundbreaking article for The Modern Hospital magazine in which he asserted, “There is no such thing as ‘curing’ a case of alcoholism. There is nothing on earth you can do to prevent any human being from taking up the use of alcohol again if he wants to.”
In another article Towns wrote shortly afterward for Modern Hospital, he detailed the medical treatment given an alcoholic at Towns Hospital — basically a combination of barbiturates to sedate and belladonna to reduce stomach acids. Once the patient was medically stabilized, Towns advocated “physical conditioning” — a week or two of hydrotherapy, electricity and massage: “Get him ‘into shape’ physically, and you will then be able to get a definite line on both the physical and mental man.”
Decrying the concept of alcoholism as an inherited malady, Towns contended that “in many instances those about [the alcoholic] have been able to go back to the old family closet and haul out some alcoholic skeleton as the cause of his own drinking and as a ‘horrible example.'” At the time he scoffed at the concept of alcoholism as a disease, but allowed that “a man who has a poisoned father, whose system is thoroughly saturated with ‘booze’… could and probably would inherit a defective nervous system.”
Towns did emphasize that alcoholics “are poisoned patients.… they are sick.” He was beginning to see the alcoholic’s illness as more than one-dimensional. He believed that “lack of occupation is the greatest destroyer of men, whether the man be with means or without means, and you cannot expect to save either of these vagrant types… unless successful occupation has been found and responsibility in life has been created.” In other words, Towns maintained, “you have not only got to treat a patient, but deal with a man!”
A year later, in 1933, Bill W. entered Towns Hospital for the first time. Prohibition was winding down (it would be repealed in December 1933), and alcoholism was still viewed commonly as a mystery and a terrible shame. The prevailing view among physicians was that no matter what the treatment chronic alcoholics were doomed. For Bill, Towns was a revolving door that he would enter three times before he could stay dry.
His attending physician William Duncan Silkworth, M.D., a specialist in neurology who had joined the staff in 1930, had already formulated his theory of alcoholism as an “allergy.” But the treatment prescribed for the alcoholic at Towns had changed hardly at all. According to “Pass It On,” a biography of Bill, “someone who remembered the hospital described it simply as a place where alcoholics were ‘purged and puked.'” The purging likely resulted from liberal doses of castor oil the patients were given along with belladonna.
Once Bill was better physically, Dr. Silkworth talked with him. The doctor described alcoholism not as a lack of willpower or a moral defect, but as a legitimate illness. It was his view, unique at the time, that alcoholism was the combination of a mysterious physical allergy and the compulsion to drink.
William Duncan Silkworth, M.D., a specialist in neurology who treated Bill W. at Towns Hospital, formulated a pioneering theory of alcoholism as a physical allergy combined with a compulsion to drink.
In the chapter of the Big Book entitled “The Doctor’s Opinion,” written some 70 years ago, Dr. Silkworth expressed a view that has application today. “We doctors have realized for a long time that some form of moral psychology was of urgent importance to alcoholics,” he said, “but that its application presented difficulties beyond our conception. What with our ultra-modern standards, our scientific approach to everything, we are perhaps not well equipped to apply the powers of good that lie outside our synthetic knowledge.”
He broke down this concept into three phases of treatment that he outlined in a paper, “Reclamation of the Alcoholic,” published in the April 21, 1937, issue of the Medical Record: “1. Management of the acute crisis; 2. Physical normalization and cell revitalization so that craving is eliminated; and 3. Mental and normal stabilization, which naturally involves some ‘moral psychology.'”
As a consequence of his close contact with alcoholics (and he saw thousands in his lifetime), Dr. Silkworth believed that “something more than human power is needed to produce the essential psychic change” vital to sustained sobriety. Nor did he “hold with those who believe that alcoholism is entirely a problem of mental control.” For instance, he said, he had treated many men who had worked assiduously on an important business deal, only to have it fall apart because they picked up a drink. “Then the phenomenon of craving at once became paramount to all other interests. These men (by 1937 he would include women) were not drinking to escape; they were drinking to overcome a craving beyond their mental control.” When the chips are down, Dr. Silkworth concluded, “the only relief we have to suggest is entire abstinence.
The Charles B. Towns Hospital in Manhattan, founded as a drying-out facility, is where Bill W., during his third stay, experienced his sudden and electrifying “spiritual awakening.”
Meanwhile, as Bill was struggling to stay sober, the chain of events leading directly to the formation of A.A. may well have begun with Dr. Carl Jung. In the early 1930s, Rowland H., an alcoholic desperate to stop drinking, turned to the renowned psychiatrist for help. But when treatment failed to help Rowland stop drinking, Dr. Jung suggested that his only hope for recovery was in finding a vital spiritual experience of some kind; he recommended that Rowland place himself in a religious atmosphere and hope for the best.
Rowland did get sober, with the help of A.A.’s forerunner, the Oxford Group (circa 1928-1939). An important feature of group life was the practice of confession, or “sharing.” Members stood before audiences to tell about their failures in life and subsequent redemption.
Then Rowland met another hopeless drunk, Edwin “Ebby” T., a childhood friend of Bill’s who had stopped drinking with the help of the Oxford Group. Soon afterward a sober, glowing Ebby visited Bill, who by now had been through the Towns treatment regimen twice to no avail, and introduced him to the revolutionary idea that release from the bonds of alcoholism was possible through spiritual means. Almost eagerly Bill returned to Towns for the third time, and it was during this stay that he experienced his sudden and electrifying “spiritual awakening.” Shaken, he confided in Dr. Silkworth, who responded gently, “Something has happened to you I don’t understand. But you had better hang on to it. Anything is better than what had you only a couple of hours ago.”
Bill did hang on to it, stayed sober, and zealously went to work on other alcoholics, with no success at first. Dr. Silkworth straightened him out once again. “Stop preaching at them,” he said, “and give them the hard medical facts first. This may soften them up at depth so they will be willing to do anything to get well. Then they may accept those spiritual ideas of yours, and even a Higher Power.” Hearing the message from another alcoholic, Silkworth said, “maybe will crack those tough egos deep down.”Several months later, while in Akron, Ohio, on a business trip in June 1935, Bill was seized by a powerful urge to drink; remembering Dr. Silkworth’s words, he looked around for another alcoholic with whom he could share his experience, strength and hope. He connected with Dr. Bob, and the rest is A.A. history. ( For more information on BillW and Dr. Bob, read your Big Book) As in so many things, especially with we alcoholics, our History is our Greatest Asset!.. We each arrived at the doors of AA with an intensive and lengthy “History of Things That Do Not Work” .. Today, In AA and In Recovery, Our History has added an intensive and lengthy “History of Things That DO Work!!” and We will not regret the past nor wish to shut the door on it!!