What is it?
Silkworth, 1937
“…true alcoholism is an allergic state…”
Medicine today
“…a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”
NIAAA
“The inevitable conclusion is that true alcoholism is an allergic state, the result of gradually increasing sensitization by alcohol over a more or less extended period of time.”
Putting it in writing
By 1937, Dr. Silkworth had treated thousands of alcoholics at Towns Hospital and had watched Bill W. and a small band of ex-drunks stay sober. That year he put his theory before other doctors, in two papers in the Medical Record, a New York medical journal.
The first, in March, argued that true alcoholics are allergic to alcohol. Their bodies react to it in a way other people’s do not, and the craving starts only after they take a drink.
The second, in April, was about treatment. Drying a patient out was only the start. He had to understand his condition and accept it. Then he needed a real decision, not a promise to himself that would last only until the next urge to drink.
Two years later, AA’s first book would open with the same ideas, in a letter from the same doctor.
It’s 1937. Dr. Silkworth has spent years with alcoholics at Towns Hospital, and now a few of them, like Bill W., are staying sober. That spring he put his theory in a medical journal.
True alcoholism, he wrote, is an allergy. The alcoholic’s body reacts to alcohol in a way other people’s does not. The craving starts with the first drink, and only then. Even after years without a drink, the alcoholic is still allergic. One drink brings it all back.
So willpower was not the answer. A resolution to quit, he wrote, lasts only until the next urge to drink. The patient needed a decision, based on really understanding his condition. And he called that kind of decision an inspiration.
Doctors don’t call it an allergy anymore. But two years later, these ideas would open AA’s first book.