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Six months before the Senate passed the 18th Amendment banning "intoxicating liquors,” the American Medical Association proclaimed that alcohol’s "use in therapeutics as a tonic or stimulant or for food has no scientific value."1
Two years later, Prohibition had successfully lured millions of principled citizens into the highly lucrative, illegal liquor trade. That included physicians. Under the 1919 Volstead Act, doctors could easily procure special permits from commissioners, which allowed them to prescribe “Spiritus Frumenti” for medicinal purposes.2 There was no new study refuting the American Medical Association’s 1917 contention, and yet, during Prohibition, doctors wrote far more prescriptions for alcohol than ever before.
What was Nancy Rooker’s malady? Her prescription, which can be purchased for $295 from the Early American History Store, did not require such detailed information. Perhaps the resident of Baltimore, Maryland exhibited symptoms related to typhoid or heart disease. Lethargy, anxiety, or indigestion would have done just fine as well.3
Dr. Otto Prickhardt was more specific on a supplementary note in 1931, writing “This is to certify that the post-accident concussion of Hon. Winston S. Churchill necessitates the use of alcoholic spirits especially at meal times.”
A diagnosis cost $3, and in lieu of an actual complaint, a pocketbook full of dollar bills sufficed. After a three day waiting period, patients paid another $3 to file their prescriptions through the same doctor, or a pharmacist.
“He owned some drugstores, a lot of drugstores,” explained the sheltered Daisy Buchanan, but like her husband Tom, contemporary readers of F. Scott Fitzgerald’s The Great Gatsby found truth in that fiction. The number of registered pharmacists in New York State tripled during Prohibition, and bootleggers akin to Jay Gatsby found their stores to be a convenient front.
It’s unlikely that the spike in alcohol prescriptions can be solely attributed to opportunistic, greedy doctors, although they certainly got in on the action. The economy weakened under Prohibition, and the downturn had far-reaching effects; large segments of the population were unable to afford medicine.4 Alcohol was not much of a cure for anything, but doctors had relied on it for inexpensive relief since antiquity.5 Other doctors were likely tempted into profit sharing schemes by bootleggers, while mobsters simply relied on brute force to capture a share of the medicinal market.
In the end, the American Medical Association strongly objected to the state and federal government meddling in their profession. In 1927, they declared that “legislative bodies composed of laymen should not enact restrictive laws regulating the administration of any therapeutic agent by physicians legally qualified to practice medicine.” While the U.S. Treasury Department supplied doctors with special watermarked prescription pads, they attempted to control the amount of liquor prescribed to patients. In response, physicians defiantly meted out far more than the government deemed appropriate. They tried and failed to challenge government encroachment in the courts. Like everyone else, the American Medical Association was only freed of such regulation in 1933, when Prohibition was repealed.
1 In 1916, the AMA removed whiskey and brandy from The Pharmacopeia of the United States, a list of approved medicines.
2 There were no provisions related to prescription beer. Religious leaders were also allowed to purchase wine the services, and the flurry of new priests, ministers and rabbis suggests that this loophole was also exploited. Churches and Synagogues were suddenly packed with new believers.
3 Obvious connections can be made to medical marijuana in California and other states, but unlike Prohibition, there is no national or statewide agency in charge of regulating the legalized industry. In California, individual municipalities do set forth their own rules, and some do choose to prohibit dispensaries altogether—a move that usually bolsters delivery services.
4 When distilleries and breweries shut down, everyone from woodworkers to truck drivers were unemployed. Entertainment was curtailed, and when people stopped eating out and going to movies, cooks, servers, busboys, ushers, truck drivers, farmers, and even the woodworkers who built furniture, suffered financially. Work became sporadic, and given the increase in illegal activities and the overextended police force, far more dangerous. Medicine was expensive, and injuries and illnesses went untreated. The government was of little help. States relied on liquor sales to fund their budgets, and some states saw revenue drop by 75 percent during Prohibition. The Federal government was even harder hit, losing revenue while spending more than ever to enforce the 18th Amendment. Income tax was more important than ever.
5 During the Civil War, a doctor was far more likely to offer whiskey than opiates, the former plentiful and the latter rarely available.
Alexis Coe is now a writer living in San Francisco, but not long ago, she was a research curator at the New York Public Library. Her work has appeared in the Atlantic, Slate, The Millions, The Hairpin, and other publications. Alexis holds an MA in history. Follow her.