Editor’s note: We continue our celebration of the 40th anniversary of the publication of David F. Musto’s book with a contribution from cultural historian and American Studies scholar Timothy A. Hickman, whose first book, The Secret Leprosy of Modern Days, reconstructs (and deconstructs) the entrepreneurial therapeutics of the late 19th century historical world inhabited by Dr. Leslie Keeley, proponent of the famous “Gold Cure” for inebriety. Hickman recounts grappling with Musto’s capacious framework in the context of a post-Foucauldian intellectual moment.
Most historians of drugs and alcohol get used to the question, “So how did you get interested in THAT topic,” usually punctuated by a cocked eyebrow and an arch chuckle. My interest arose during the popular recovery movement of the late 1980s, when I read “As Sick as Our Secrets,” a Summer 1990 LA Weekly article by writer Helen Knode, who detailed her family’s troubles with substance dependence over the years. I was particularly taken by her claim that, if one were to multiply the number of “addicts” by the number of “co-dependents” asserted by recovery writers, the product would exceed the entire US population!
What fundamental beliefs might underwrite the diagnosis of the entire American population as “dysfunctional”? Whose interests were met in defining a whole population as a target for therapy? What institutions benefited? What did this state of affairs suggest about American society, and why did millions of people ‘Just Say Yes’ to the recovery movement’s call? Still more pressingly, what kind of a “disease” required confession as the first step to cure?
As coincidence had it, I was part of a first-year graduate core course in “History and Theory” at UC Irvine. That same week, we were required to read Michel Foucault’s introductory volume to The History of Sexuality. There I found a method that might help to answer some of my questions about the “disease” of addiction, and better still, to answer them historically. Foucault, of course, was interested in how bodily states like sexual desire become symptomatic of ways of being—in the way that what one does, or enjoys, might offer evidence of what one is.
To those whose expert knowledge enables them to define and identify a “pathological” condition belongs a peculiar power to produce Truth. Foucault’s search for an historical event to ground the existence of a particular science of sex led him to the Catholic confessional in early modern Europe. The demand for confession resonated with my understanding of the demand of the 1980s recovery movement. What I needed was a comparable event in US history—something that offered evidence of a widely accepted form of expert knowledge. And in America, that would be a science of addiction. If I could identify that, I could pin the question down to a time and place from which to work.
I set off to the library, where I found only three books. The first was H. Wayne Morgan’s Drugs in America, an intriguing overview on the popular culture of drugs over the long span of US history. The second was David Courtwright’s Dark Paradise, a rigorous monograph that used the methods of the new social history to show that anti-narcotic legislation did not create a new class of criminals from previously law-abiding citizens, but was instead embedded in a much longer process of demographic transformation. His insight that “what we think of addiction has everything to do with what we think of those addicted” remains an animating principle in our field. The third book, David Musto’s The American Disease, became the chart that would help me navigate this unknown terrain.
The American Disease gave me the landmark that I sought—the 1914 Harrison Narcotic Act—and offered evidence of an operational science of addiction from which to begin my research. But The American Disease had its greatest impact on my work because it was an essential guide to the primary documents that comprise the “official” discourse of drugs. Musto’s collection of legal, medical and journalistic accounts proved invaluable to my research, and in many ways, it still is. But the book’s documentary breadth and careful (if entirely plausible) narrative soon began to prove a hazard. Like any good chart, the terrain began to resemble the map.
It soon became clear to me that the book’s focus on the histories of policy and treatment had filtered its archive. Though there isn’t much that The American Disease doesn’t at least mention, there is not a lot on, for instance, the popular meaning of drugs and their use. Musto tended to read his texts as documents. His interest was in what they said, rather than what they did. From my Foucauldian perspective, that meant that how these texts produced meanings that resonated in the culture more broadly remained underexplored. This was the opening that I took to pursue my own work, particularly its interest in figures like the famous “quack” cure doctor, Leslie E. Keeley and the rhetoric of his “gold cure.”
Nonetheless, I feared that I could never really escape the orbit of The American Disease. This brings me to one last reflection. As I was finishing my dissertation in the spring of 1997, I attended a conference organized by Sarah Tracy and Caroline Acker at the College of Physicians of Philadelphia. My paper made extensive use of a 1920 AMA report on addiction, the existence of which I had discovered in the footnotes of The American Disease. David Musto was chairing my panel, and though by then I had met him several times, I trembled to think that I hadn’t moved far enough away from his own treatment of the AMA text. As it happened, David approached me after the paper and told me how glad he was that someone had finally done justice to that document.
Every time I pick up the book—and I still do pick it up—I remember that exchange. It was a model of the way that senior scholars ought to act to support and encourage younger scholars who seek entrance to the fields and research communities that their texts have helped to produce. Ultimately, The American Disease plays that constitutive role in our field. Because of its strengths, and also because of the openings it left us, the book retains a central role in the historiography of drugs and addiction. The American Disease both represents and still helps to constitute the field.
— Timothy A. Hickman