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an ally against the chemistry of alcoholism
Hope for Alcoholics
Paul de Kruif
is still our main medicine for chronic alcoholics, though
actually they’re not criminals but sick people. That
they’re not inherently wicked has been proved by Alcoholics
Anonymous; after recovery the vast majority of AAs turn
out to be superior citizens. As to how alcoholics are sick,
science at last has a hot clue. In many cases their desperate
stages, such as delirium tremens, reveal them to be suffering
from a glandular deficiency--rapidly correctable by certain
hormones which seem to overcome the excessive desire for
promises to bring many more far-gone victims within reach
of the spiritual medicine of Alcoholics Anonymous. Such
is the double-barreled hope for some 750,000 sick human
beings still largely treated as pariahs and criminals
as well as for the almost three million excessive drinkers
who are in danger of someday becoming alcoholics. What sets
these unfortunates off from the 48-odd million social drinkers
who can take it or leave it alone?
real alcoholics start off as ordinary drinkers. Doctors
have no blood test to warn them of deadly future danger.
But sooner or later (social drinkers please note) the body
chemistry of some people goes haywire. Then they cannot
They fight it. Desperately they swear off--for an hour,
a day, a month, a year or more. Then they’re sure
they’ve got to have a drink. They do not really want
it, but take more and more until they’re insanely
this sickness doctors admit that until recently, they’ve
been largely powerless. Psychiatrists have failed to prevent
it from causing the insanity of 10 to 25 percent of our
hospitalized mental patients. Deaths? In addition to the
thousands caused by acute alcoholism and DTs, thousands
more masquerade as heart disease, pneumonia and suicide.
most effective agency for curing these sick people has been
not medical but spiritual. Alcoholics Anonymous has shown
that when men and women sincerely reach out for the help
of a Power greater than themselves, they can overcome the
craving for drink. For chronic alcoholism is a strange disease.
To recover from it you first have to go almost crazy or
nearly die. This was the discovery of Bill, Alcoholics Anonymous
No.1. In 1934 he had been given up by his doctor as hopeless.
Shaking and bleary-eyed, Bill was visited by an old drinking
crony who had got religion, gone dry, looked as if resurrected.
I don’t believe in God,” Bill argued.
not try your own idea of Him?” asked his friend “It’s
only being willing to believe in a Power greater than yourself."
powerless, that hit Bill where he lived He went back to
the hospital where they had failed to cure him, and again
went through what alcoholics call the de-goofing routine.
He lay on his bed absolutely helpless, hopeless and all
alone. Then he said out loud: “If there’s a
God, let Him show Himself now.” For the first time
in his life Bill knew he was nothing.
it was as if a horrible cloud had lifted; it was as if he
lay in warm, bright sunlight. Everything was okay. It scared
him. He rang for his physician, Dr. William D. Silkworth
of New York, who had given him up. “You said I was
going to go nuts, Doc. Is this it?” The doctor looked
at the new light in Bill’s eyes as he told the intensity
of his happiness.
happened to you, Bill,” he said. “I don’t
understand it. But if you’re nuts, you’d better
hang on to it.”
was a great man who had failed with all human science and
was humble enough to use God for a medicine. From now on
out for Bill it was God alone. That night Bill asked, “Aren’t
there thousands of hopeless drunks who might be glad to
have what’s been so freely given to me?” That
was 16 years ago. Bill had been saved to start Alcoholics
become medically respectable only when they pile up into
big statistics, scientifically authentic. By 1944 there
were about 20,000 active AAs, all former derelicts, all
now sober and working. What struck me then, and has since,
was not so much that the AAs I met were dry but that they
were a new kind of human being.
whom I’ve known intimately for years; is the founder
of a powerful AA fellowship in a large city. Unmarked by
his years in the gutter, he is serene and radiates reliability.
Busy with his work, he still spends half his time salvaging
drunks, never refusing calls day or night. He’s a
kind of Sermon on the Mount, walking.
did you get this way?” I asked.
isn’t only me, we all had to get this way to save
our lives,” said Earl, smiling.
cure didn’t begin like Bill’s at all. Earl had
no blitz conversion. Beat up by years of terrific drinking,
frantic, his brain revolving, sleepless, half-starved, in
black despair, snarling to himself that he’d lick
this thing, but now licked by it and on the ropes, Earl
met a man who had helped Bill found AA. This man, Dr. Bob,
gave Earl no pep talk, no piety. He only told him the tragicomic
story of his own sickness. "That's me, that’s
the way I drink, exactly,” said Earl. “You’re
first man I’ve ever met who really knows the score.”
Dr. Bob, Earl admitted for the first time that he was an
alcoholic, incurable by himself. Though he had been too
big for God, Earl now mumbled that a Power greater than
himself was all that might save him. Was it Dr. Bob? No,
Dr. Bob was only a man who understood him. So Earl began
confessing his years of cruelty to his wife, his little
girl, his father. He poured out his resentments that had
driven all his friends away. He ruthlessly wrote down his
crimes, like a dead beat who at last faces his debts.
he had half-recovered, Earl began to work to save hopeless
drunks who were going to die. He saw his own half-formed
faith help to drag doomed men from asylums and the undertaker’s
This made his alcoholic craving fade without his fighting
it; his hatred of others vanished automatically, without
his battling it. Dr. Bob, other AAs, Earl himself? They
were only instruments for something beyond human. Theirselves
Earl began to get humility. He hasn’t had a drink
for 13 years.
was AA No. 13 when his life was saved in 1937. Now there
are close to 100,000 ex-doomed who are active members of
AA in 3000 fellowships. Chronic alcoholism is unique as
a disease in that its successful doctors are simply its
ex-victims who have nearly died themselves. That’s
the secret of AA’s astonishing growth. They are only
laymen, but what doctors! They take their drunken patients
into their homes. They offer encouragement in getting jobs
and straightening out financial troubles. They do not complain
when saving a souse means losing their sleep, and then interrupts
their business next day. They comfort the drunks’
frantic wives. They make incessant trips to police courts,
jails, hospitals and asylums.
course the AAs have a secret weapon: it’s only by
curing all these others that they keep on saving their own
lives. They know they themselves are only one drink from
being drunkards; their helping others alone insures their
own sobriety. It builds up their faith--which they know,
without works, will die.
all good doctors they’re alert to danger signals.
The way some AAs have relapsed into deadly alcoholism confirms
the faith of all AAs that they are instruments of a higher
Power. When an AA thinks his abstinence has taught him to
handle his liquor, when he thinks he can run his own show,
he’s a goner. Yet AA’s record of recoveries
is amazing. Of those sincerely willing to stop drinking,
50 percent do so at once; 25 percent make solid recoveries
after a few elapses. Failures are most frequent among victims
who have been forced in by anxious relatives or employers.
Patients-open-minded as only the dying can be--must come
in on their own.
has the practically unanimous approval of the medical profession;
thousands of physicians now send patients who are beyond
medical help. Dr. Harry M. Tiebout, noted psychiatrist of
Greenwich, Conn., explains the character structure of alcoholics.
They’re egocentrics. He says their truly accepting
God changes their deep inner brain pattern and brings sobriety.
so, AAs admit they’ve only scratched the surface of
alcohol’s mass tragedy. They can tell of many heartbreaking
medical science bids fair to come to the rescue. While Dr.
James J. Smith was studying thousands of alcoholics brought
for emergency treatment (not cure) to Bellevue Hospital,
New York, he spied a chemical hope against delirium tremens.
What threatens the lives of DTs? Not merely their seeing
snakes or purple crocodiles. Dr. Smith found the blood of
DTs dangerously thick, their blood sugar perilously low.
About to die, they breathe extremely fast, have a feeble,
super-rapid pulse and a fever that may shoot up as high
dawned on Dr. Smith that these ominous signs somewhat resembled
the often fatal crisis of Addison’s disease. In this
disease there is a failure of the adrenal glands just over
the kidneys, mysterious little hormone factories absolutely
essential to human life. Not so long ago victims lived for
only a short while. But now they can be kept in pretty fair
health, even working, by injections of hormones from the
cortex, or outer layer, of the adrenal glands of slaughtered
Smith put two and two together. He shot big doses of adrenal
cortical extract (ACE) into DT victims in their terminal
stages. It was resurrection. Within 24 hours they lost the
nightmare visions that often drive DTs to suicide.
shakes disappeared and their hearts again beat strongly
and slowly. Their fevers rapidly cooled to normal. Dr. Smith
then shot ACE into victims of alcoholic insanity who suffer
neuritis and incessantly invent tall stories. Within 24
hours their pain, their crazy confabulations and their wild
excitement were down to zero.
of ACE soothed the hang-over heebie-jeebies that drive chronic
alcoholics to take a hair of the dog that bit them It calmed
the fearful tension that comes on before the new binges
of periodic alcoholics. In 1947, Dr. Smith reported the
good news that, in general, alcoholism seems chemical. By
last May Dr. Smith, as Director of Research on Alcoholism
at the New York University-Bellevue Medical Center, was
able to confirm his findings in a report at the annual meeting
of the Medical Society of the State of New York.
Dr. John W. Tintera of Yonkers, N.Y., and Dr. Harold W.
Lovell of New York, after an independent investigation,
had reported in 1949 that ACE practically eliminates the
agonizing drying-out period that baffles alcoholics who
are fighting to keep from drinking again In victims who
had been alcoholic for ten and even 20 years, injections
of ACE magically cut down the craving that is the Gethsemane
of these sufferers.
ACE treatment of alcoholism may be a two-edged weapon. It
may threaten Alcoholics Anonymous, who with their nearly
100,000 active members are right now the most successful
doctors of chronic alcoholism Shots of ACE seem so much
easier than the AA’s search for God.
Drs. Tintera and Lovell urge all their hormone-treated patients
to join AA And Dr. Smith does not consider ACE a cure for
alcoholism “Even with this treatment,” he says,
“the alcoholic cannot drink” (i.e., without
a relapse). The hormone treatment is still new and experimental,
while scores of thousands of AAs have been dry for years.
the AAs have a powerful ally in the adrenal hormones. They
know they are bodily sick. They’re the first to admit
that the new AA will fare better if doctors put him in such
physical condition that he can think straight and no longer
of the 25 percent of Alcoholics Anonymous who fail to keep
dry? What of the hundreds of thousands of chronic alcoholics
who will not admit their deadly peril and who refuse to
go to AA for help? They are inaccessible because they are
not thinking straight, the AAs say. ACE can begin to transform
the power of the adrenal cortex hormones--they clear the
fog out of alcoholic brains. Then the straight-thinking
upper brain has a chance to send its messages to the lower
brain This part controls the pituitary gland, which in turn
by its hormone secretion governs the wonderful life-boosting
little adrenals. Mens sana in corpore sano--a sound mind
in a healthy body. This slogan of the ancient philosophers
is now the joint battle cry of the hormone doctors and the
Although ACE is safe in the hands of any competent physician,
it is limited in amount and expensive. But an AA will tell
you that God is always on hand and will help for the asking.
Reader's Digest, October 1950)