A Detestable Shrine: Alcohol Abuse in Antebellum Philadelphia

Between 1815 and 1850, American physicians greatly expanded their efforts to treat the consequences of alcohol abuse. Prior to about 1820, local authorities commonly confined incapacitated drunkards to almshouse cells, where they received little or no medical attention. But in 1815, a physician at the Philadelphia Almshouse published the first American description of delirium tremens, a form of insanity caused solely by heavy drinking. It quickly became a subject of intense interest in Philadelphia’s prestigious medical community, transforming how physicians and medical institutions responded to alcohol abuse. By mid century, many hospitals devoted entire wards to treating inebriates. These sweeping medical developments shaped new conceptions of poverty and failure in the early republic. Physicians’ interest in delirium tremens emerged at a historical moment in which alcohol abuse and economic instability constituted pressing social problems. Prominent Philadelphia citizens blamed the growth of poverty on