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Rum Maniacs

Alcoholic Insanity in the Early American Republic

Edgar Allan Poe vividly recalls standing in a prison cell, fearing for his life, as he watched men mutilate and dismember the body of his mother. That memory, however graphic and horrifying, was not real. It was a hallucination, one of many suffered by the writer, caused by his addiction to alcohol.

In Rum Maniacs, Matthew Warner Osborn reveals how and why pathological drinking became a subject of medical interest, social controversy, and lurid fascination in the early American republic. At the heart of that story is the disease that Poe suffered: delirium tremens. First described in 1813, delirium tremens and its characteristic hallucinations inspired sweeping changes in how the medical profession saw and treated the problems of alcohol abuse. Based on new theories of pathological anatomy, human physiology, and mental illness, the new diagnosis founded the medical conviction and popular belief that habitual drinking could become a psychological and physiological disease. By midcentury, delirium tremens had inspired a wide range of popular theater, poetry, fiction, and illustration. This romantic fascination endured into the twentieth century, most notably in the classic Disney cartoon Dumbo, in which a pink pachyderm marching band haunts a drunken young elephant. Rum Maniacs reveals just how delirium tremens shaped the modern experience of alcohol addiction as a psychic struggle with inner demons.

280 pages | 18 halftones, 1 table | 6 x 9 | © 2014

Culture Studies

History: American History

History of Science



“It is hard to imagine a better guide to the many meanings with which delirium tremens was freighted in nineteenth-century America than Rum Maniacs. This is a consistently fascinating account exhibiting an impeccably even-handed approach to its often disturbing subject matter.”

American Historical Review

"This important study explores the medicalization of alcohol abuse in the 19th-century US. Focusing largely on the experience of physicians and patients in Philadelphia, Osborn examines the social and economic climates in which heavy drinking came to be seen as a medical condition. . . . Highly recommended."


"Although history professor Matthew Werner Osborn concentrates on how alcohol influenced this country two centuries or more ago, perhaps the greatest virtue of his learned, intelligent study is the light it sheds on the phenomenon that continues to plague us right up to the present. Given the cost to society--in money and in so much else--of addiction to alcohol (and to other substances), it is salutary to learn about the roots of the problem."

Washington Times

“Osborn’s deep engagement with previously unstudied sources, medical and philosophical discourse, literary production, and social history are on bright display in this smart and pleasurable contribution to scholarship. If you want to grapple with the history of alcoholism, medicine, culture, and society in nineteenth-century America, then read and reckon with Rum Maniacs.”

Michael Sappol, author of A Traffic of Dead Bodies

“Osborn’s path-breaking book explains the largely ignored physician-based temperance movement in Philadelphia from 1820 to 1850 in an entirely new way. This work is a major contribution not only to the history of alcohol but also to the history of medicine and to the history of ideas. The author demonstrates that rising alcohol consumption, along with a concomitant rise in delirium tremens, coincided with a need to rethink the very meaning of medicine in Philadelphia during these years.”

William Rorabaugh | University of Washington

“A fascinating social and intellectual history of the medical profession in early America, Rum Maniacs traces the many ways in which a new disease of delirium tremens became visible — in newspapers, medical journals, hospital records, temperance activism, popular entertainment, and clinical practice.  In its detailed but wide-ranging attention to institutions, practices, theories, and aspirations shaping medical education, it offers a sophisticated casestudy of the interplay of learned and popular cultures by which pathological drinking came to be imagined by nineteenth-century Americans.” 

Thomas Augst | New York University

“This beautifully structured and persuasive cultural history argues that representations of alcoholic insanity as a terrifying disease allowed Americans to grapple with powerful anxieties about failure and its causes in a century of unprecedented economic uncertainty.”

Journal of American History

“Osborn’s book is richly documented and intellectually impressive . . . Alcohol abuse came to be seen as a medical problem, sadly one without a medical remedy, and Osborn impressively contextualizes this chapter in the history of medicine.”

Social History of Medicine

“The real verve of the book develops our understanding of how medical ideas seep into culture (and vice versa) and lend validity to the tropes they create and come to, or wish to, leave behind. This is an energetic and magpie text, embracing evidence from medical and popular literature, theater, case histories, official reports, lecture notes, and student dissertations. . . . Osborn is certainly a gifted communicator and a historian to watch.”

Bulletin of the History of Medicine

“Osborn offers a much needed update to the historiography of early-American temperance, revealing the central role played by the medical profession in furthering the movement. . . . Osborn’s analysis greatly enhances the historical literature on temperance by revealing the movement’s distinctly medical dimension, a feature that has hitherto remained obscured in the background of the political, social, and economic interpretations that dominate the historiography of alcohol and drugs in this period. But, Rum Maniacs is more than just a significant addition to the historiography of American temperance. As a social history of medicine, it also explains how the construction of a new disease underpinned the response of an emergent American middle class to the demographic, socioeconomic, and cultural realities of the market revolution.”

Journal of the History of Medicine

“This book is a most welcome addition to a surprisingly sparse strand of research in the realm of medical history. The story of delirium tremens is undoubtedly a fascinating one.”

H-Net Reviews

Table of Contents



1 Ardent Spirits and Republican Medicine

2 Discovering Delirium Tremens

3 Hard Drinking and Want

4 The Benevolent Empire of Medicine

5 The Pathology of Intemperance

6 The Drunkard’s Demons

Epilogue: Alcoholics and Pink Elephants


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