Just What the Doctor Ordered | History | Smithsonian
(Cheryl Carlin)

Just What the Doctor Ordered

During Prohibition, an odd alliance of special interests argued beer was vital medicine

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In 1758, young George Washington decided to seek a seat in the Virginia House of Burgesses. He had been stymied in an earlier bid, he believed, by one crucial error: he had not "treated" the voters properly—which is to say, he had not provided them with sufficient alcoholic refreshment. This time, determined to correct his ways, he purchased some 144 gallons of wine, rum, hard cider, punch and beer for distribution to supporters. At more than two votes per gallon, Washington's effort proved successful, launching a rather distinguished career in American politics.

More than a century and a half later, after the American temperance movement had finally won its fight to prohibit alcohol, a considerable percentage of the nation's populace remained staunchly faithful to the founders' tradition, using their ingenuity to acquire any and all available alcohol. They drank hair tonic, flavoring extracts and patent medicine. They patronized speak-easies and bootleggers, helping to boost a nationwide industry of organized crime. They stole liquor from government warehouses. They posed as priests and rabbis to acquire sacramental wine.

And in the early months of 1921, a dedicated group of brewers, physicians and imbibers attempted to convince the U.S. Congress that beer was nothing less than vital medicine. Whatever craven thirsts might have inspired its advocates, the right of physicians to prescribe "medical beer" was the subject of intense national debate, drawing the attention of officials at the highest levels of government and provoking arguments within the American Medical Association and other professional groups.

The arguments had less to do with the number of likely prescriptions (nobody thought beer would replace castor oil) than with the long-term implications of legalizing the consumption of beer. It was what politicians today call a wedge issue: unimportant, even ridiculous, in itself, but with potentially vast legal and cultural consequences. (The U.S. Supreme Court has agreed to take up the far more medically significant question of medical marijuana by June of this year.)

As with all wedge issues, technical details masked a host of larger and more far-reaching concerns. Both supporters and detractors understood the so-called "beer emergency" as a referendum on Prohibition itself, a test of the federal government's right to regulate vice and dictate professional standards.

Prohibition, which became the law of the land in January 1920, was the product of enormous middle-class energy dedicated to eliminating sin—gambling, drinking, anarchy, sloth—through legislation. Within this crusade, beer was hardly a neutral substance. As the favored drink of the German and Irish working class, it was shorthand in temperance circles for disorderly taverns, abandoned wives, laziness, unemployment—even, during World War I, anti-Americanism. According to temperance advocates, Prohibition's destruction of the saloon marked nothing less than a triumph of order over disorder, self-control over dissipation.

Yet the 18th Amendment to the U.S. Constitution did not amount to a complete "prohibition" on all forms of alcohol. It banned only the manufacture, sale or transportation of alcohol "for beverage purposes"—in other words, for the pleasure and delight of socializing and inebriation. This directive covered a substantial proportion of the nation's imbibers, to be sure, but it also left open certain loopholes for the framers of the Volstead Act, the federal law that finally put the amendment into effect. It excluded all alcohol—mainly sacramental wines—consumed for religious purposes. Hair tonics, perfumes, toilet waters and other cosmetic products were similarly exempt. Not least, it excluded alcohol prescribed by physicians as a treatment for any number of acute and chronic ills. It was in the context of this last exemption that the fight over "medical beer" unfolded.

Temperance advocates denounced the "medical beer" campaign as an attempt to play fast and loose with the law—an effort, they said, that could lead only to "chaos" and "Bolshevism." Prohibition's opponents, by contrast, urged the measure as nothing less than a matter of life and death. "Since Prohibition went into effect I have been approached by a number of physicians who appealed to me for beer on the ground that it was absolutely necessary for the welfare of their patients," brewer Col. Jacob Ruppert, who owned the Yankees from 1915 until his death in 1939, told a New York Times reporter. "I was not in a position to help them."

The idea of alcohol as medicine was not new. As historian W. J. Rorabaugh wrote, Americans in the early 18th century classified whiskey, rum and other liquors as "medications that could cure colds, fevers, snakebites, frosted toes, and broken legs, and as relaxants that would relieve depression, reduce tension, and enable hardworking laborers to enjoy a moment of happy, frivolous camaraderie." Even the dour Puritan minister Cotton Mather, fearful enough of sin and subversion to help purge Salem of witches, believed that alcohol, used in moderation, could be "a Creature of God."

Once Prohibition took effect, many doctors championed alcohol as medicine. "I have always maintained that every family ought to have an alcoholic stimulant in the house all the time," one physician told the New York Times. "There is nothing more valuable in emergency." The doctor himself always took a drink at the end of the day—"It braces me up," he explained—and often prescribed it for patients stricken with "nerves." For pneumonia, he recommended a shot or two of whiskey.

But if many doctors conceded the efficacy of hard liquor, the case of beer was rather more controversial. Beer's champions often pointed to its relaxing qualities, and to its nutritional value. In a lengthy ode to British ale, for instance, one writer suggested that beer was so chock-full of vitamins that it had saved the "British race" from extinction during food-scarce plague years.

Other healers questioned such claims. Dr. Harvey Wiley, a prominent physician and an architect of the nation's first food and drug laws, could barely contain his contempt for those who subscribed to such folk remedies. "There are no medical properties in beer, whatever may be said of it as a beverage," he pronounced in March 1921. "I never saw a prescription which contained beer as a remedial agent."

By 1921, Wiley could point to a great deal of recent scientific evidence to support his contention. In 1916, with Prohibition not yet enacted, the American Medical Association had declared alcohol's supposed medicinal properties entirely unsupported by research. "Its use in therapeutics, as a tonic or a stimulant or as a food has no scientific basis," read the AMA's resolution. The medical profession's official pharmacopoeia no longer listed alcohol as a medicine; to many doctors, and particularly to temperance advocates, this was as good as the final word. (Today, studies suggest that moderate drinking, particularly of red wine, may be beneficial to heart health.)

the man to whom fate and presidential politics bequeathed the duty of deciding the medical beer question was Attorney General A. Mitchell Palmer. By the time the beer problem crossed his desk in early 1921, Palmer was under attack from civil libertarians for his harsh deportation campaign against foreign-born Communists and anarchists, best known as the "Palmer Raids."

He was also on his way out of office. The previous November, voters had elected Republican Warren Harding to the presidency—a development that meant that Palmer, along with other Wilson appointees, was out of a job. Before leaving office, however, Palmer, under pressure from brewers, determined to make it possible, once and for all, for sick men to get their beer.

On March 3, 1921, shortly before his last day as attorney general, Palmer issued an opinion declaring that the "beverage" clause of the 18th Amendment entitled doctors to prescribe beer at any time, under any circumstances and in any amount they saw fit. Wholesale druggists could take charge of selling beer. He also suggested that commercial drugstores could sell it from their soda fountains—though "never again beer over the saloon bar or in the hotel dining room."

But rather than settling the debate, Palmer's opinion set off a new round of court challenges, squabbles and questions. "Will the druggists become bartenders and the drug store a saloon?" the New York Times asked that November. "Will the doctors become beer dictators and be overwhelmed by those who are thirsty because they are sick, or merely sick with thirst?"

Beer-makers, unsurprisingly, were sure that Palmer had hit upon a perfect fusion of virtue and science. "Brewers Jubilant over 'Medical' Beer," the New York Times reported on March 11. Doctors as a group were perhaps less so—"I don't think doctors are vitally interested one way or another in permission to prescribe medical beer," the counsel of the New York Medical Society explained—but as a group seemed to take satisfaction from Palmer's affirmation of their authority, seeing in it a victory of science over superstition.

Temperance reformers, by contrast, were furious at Palmer's betrayal—a first step, as they saw it, in undermining America's newfound self-control. "Many of the Anti-Saloon League sympathizers fear that the Palmer decision, if accepted, will lead to a loosening of the enforcement laws," read one news report. The Anti-Saloon League (ASL), one of the country's leading temperance groups, was particularly incensed at the suggestion that small children, seated cheerily at the neighborhood soda fountain, would be forced to witness beer's sale and consumption—a prospect which, according to ASL general counsel Wayne Wheeler, "makes clearer than ever the vice in this opinion." (He was joined in his lament by bootleggers, snake-oil salesmen and religious fakes who were loath to see pharmacists hone in on their trade.)

Had Palmer seen fit to restrict the consumption of medical beer in any way—by limiting the number of prescriptions, the amount that could be prescribed or the diseases for which it was sanctioned—organizations like the ASL might well have concluded that the handful of resulting prescriptions were not worth the fight. But the vision of giddy brewers reopening factories to produce millions of gallons of beer seemed too great an assault on their recent victory. "If beer is to be prescribed in any quantity for everybody who is ailing," predicted the New York Times, summarizing congressional opinion, "there will be no beer."

Within months of Palmer's decision, Congress had taken up the so-called beer emergency bill (officially, the Campbell-Willis bill), which limited wine and liquor prescriptions to not more than a half pint in ten days, and banned beer altogether. By the end of November 1921—much to the outrage of brewers and physicians who called the bill "a form of inhibition never before attempted in the history of legislative government elsewhere throughout the civilized world"—the bill had become law, putting an end to the strange brew known as medical beer.

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