Alcoholism and Hereditary Health in Dutch Medical Discourse, 1900–45: Biology versus Psychology in Coping with Addiction

Since the first constructions of alcoholism and drug addiction in the 19th century concepts of heredity have played an important role in framing substance use and abuse. In the linkage of alcoholism and drug addiction to themes of hereditary defects and biological and racial degeneration the often supposed dichotomy between “medical” and “moral” views of substance abuse was transcended. An analysis of alcoholism and hereditary health in Dutch medical discourses from 1900 until the end of the Second World War shows that the medicalization-moralization dichotomy fails to explain the complexity of historical dynamics around alcoholism and addiction. The discourses show a prevalence of a perspective of “biologization” (instead of strictly medical thoughts and practices) that closely follows German discourses. In the interwar period the rise of Mendelian genetics challenges the idea that alcohol poisons the hereditary material, leading to racial degeneration. Another conceptualization developed, in which alcoholism and drug addiction were seen not as cause but as the expression of a more general psychopathological hereditary condition. Though clearly having a medical condition, alcoholics and other addicts were also subjected to moral judgment. Different prevention options were discussed including sterilization and segregation, but political support for putting these options in practice was insufficient.