Museum of Health Care Blog

If you wanted to get blotto and you knew your onions, it was duck soup to go to a croaker and dip the bill without resorting to a blind tiger.

If that sentence was incomprehensible to you, congratulations, you’re probably not reading this during Prohibition. For most people, the word Prohibition refers specifically to the United States, conjuring up images of New York, speakeasies, the invention of jazz, and the Great Gatsby. But Canada had its own version which was both independent of and deeply intertwined with the American version.

Let’s get a wiggle on and I’ll give you the rumble.

Prohibition is simply the banning of something by an authority, but Prohibition with a capital P typically refers to the time period in the early 20^th century when alcohol was banned. Prohibitionists these days have a bit of a reputation as the fun police, but it’s important to note that for many of them, what they were protesting was not alcohol so much as it was saloons. In fact, many of the less extreme advocates were wets (i.e. drinkers) themselves. Many female-led temperance (alcohol abstinence) organizations in particular were specifically concerned with improving the lives of women; in their view, banning alcohol would stop husbands from drinking away the household’s money in saloons and then going home to abuse their families in drunken rages.

Down south, the temperance movement began in the mid-nineteenth century. Maine banned the selling and making of alcohol in 1851, though by 1855 the ban had been repealed. Temperance education ran rampant in schools in the latter half of the century. And then, January 16, 1920, the big one. In 1919, the Eighteenth Amendment had been ratified, banning the distribution of alcohol. In 1920, it came into effect. The United States would be officially dry (against alcohol) until the repeal of the Eighteenth Amendment by the Twenty-first in 1933. Enforcement during Prohibition was often brutal; organized crime rocketed up, as did police violence.

Meanwhile, in colonial era Canada, taverns were often the centre of Canadian society. They hosted trials, auctions, and voting, and sometimes served as de facto offices for itinerant doctors and dentists to see their patients. But as in the States, there was a strong temperance movement. Most of the justification was the same as it had been in the States – alcohol was dangerous, alcohol led to poor behaviour, saloons were a societal ill.

In 1878, Canada established the Canada Temperance Act (Scott Act), which allowed local governments to ban alcohol (the local option, as it’s called). Prince Edward Island went dry in 1901. For the rest of Canada, Prohibition was spurred by the First World War. Giving up alcohol so its components could be used for soldiers overseas seemed like a correct and noble sacrifice.

However, the idea was always that Prohibition would end when the war did. Widespread prohibition wasn’t popular. Most Canadian provinces quickly revoked the bans and instead moved to a system of government control (the origin of the LCBO, among other Crown corporations). Quebec was the first to go wet in 1919 (not that it had ever been particularly dry in the first place). PEI was the last, holding out for more than a decade after every other province had reintroduced liquor and only ending prohibition in 1948.

As a mostly wet country for much of American Prohibition, Canada was an important source of alcohol. Exporting booze into the United States wasn’t illegal until 1930, so bootlegging (illegal manufacture and distribution of alcohol) was rampant. Bootleggers would sneak alcohol into the States and if at risk of being caught, shoot back over the border to supposed safety (in fact, the two countries experienced a great deal of friction during this time, with Canada often pushing back against American law enforcement who disrespected Canadian borders). Canada was also a popular vacation destination. Montreal, in particular, was seen as a party town and some jazz greats played or got their start there.

Prohibition’s success is debatable; some argue that it failed because few people actually stopped drinking and it was eventually repealed, others that it was a success because it disrupted the saloon’s hold on social life and led to decreased drinking. However you want to count it, what is important to note is that Prohibition changed society. For one thing, it demonstrated the political power of women. Temperance and the women’s suffrage movement went hand in hand and the instatement of Prohibition proved just how much they could get done when they organized.

So, now that we have the general history down, where does the medical history come in? Well, if you wanted a drink during Prohibition (Canadian or American), you usually had options. You could make your own. You could purchase it illegally. Or, if you had a sympathetic physician, you could get a prescription for it.

Prohibition was never so complete in either Canada or the States that there were no exceptions and medicine was one of them.  Some estimates figure that doctors and druggists peddled as much alcohol legally as bootleggers did illegally. Ontario was officially dry until 1927, but in 1924, Ontario doctors allegedly wrote more than 800,000 prescriptions for alcohol. Some joked that flu was particularly bad right before Christmas parties.

Though this may seem like a gaping hole in the legislation, it was also unavoidable. Alcohol had been used as a medication for centuries. It was frequently a painkiller and had often been considered useful for aiding digestion and stimulating the appetite. It has even been prescribed for soothing fussy babies. It was also a popular ingredient in other medicines. Laudanum, for example, was ubiquitous in Victorian society, used for pain, sleeping problems, and “women’s troubles.” It was a tincture of alcohol and opium. Alcohol was also common in patent medicines. Alcohol is a drug, after all, and interacts with the nervous system, so its effects are powerful, if not necessarily benevolent.

There are also more practical reasons for alcohol to be used in medicine. Alcohol is a useful solvent (i.e. it makes things dissolve), especially in cases where the solute (stuff being dissolved) interacts poorly with water. It is used in a number of products even today for this reason, including perfume, mouthwash, and, yes, medication. These days the alcohol is usually there purely as a carrier for the real medicinal ingredients, or sometimes as a preservative or flavouring agent.

(Incidentally, alcohol in medication is another example of the importance of cultural sensitivity and diverse hiring in medical practice. Some religious beliefs – e.g. Islam, Mormonism – have strong proscriptions against alcohol consumption. While exceptions are often made for medicine, a good doctor is able to work with the patient to offer alternatives if possible). 

While some doctors were temperance advocates themselves, others no doubt rolled their eyes at Prohibition and were happy to flout it (bootleggers certainly used the justification that no one really wanted Prohibition anyway and their lawbreaking was akin to jaywalking or speeding – technically illegal, but who doesn’t do it at least occasionally?). Some may have been bribed. But some may have prescribed alcohol on compassionate grounds, reasoning that many of their patients were going to be drinking anyway so they might as well do it safely.

While the popular image of Prohibition involves a sultry speakeasy (illegal bar) full of sharply dressed people swigging cocktails and listening to jazz, those who were lower class or not located in urban centres didn’t have access to such places. Some quit. Others turned to more dangerous sources of alcohol.

Moonshine, or illegally brewed alcohol, had existed long before Prohibition, but production stepped up during this period. Some moonshiners were and are perfectly competent and produce drinkable alcohol. But improperly made moonshine can contain deadly components even today.

Alcohol was used in medicine. It was also used in industry, another source of drinks for those not interested in DIY booze. Industrial alcohols were denatured, meaning they were rendered unfit for human consumption. Denatured alcohols are still used today, mostly as a tax thing (it’s why you don’t drink the rubbing alcohol in your bathroom cabinet). But during American Prohibition, industrial alcohol was deliberately poisoned in an attempt to keep people from drinking it. Some bootleggers were able to process these deadly additives out but even with a skilled chemist working (and some bootleggers employed them!), denatured alcohol was often made safer rather than safe. And the whole thing was somewhat of an arms’ race, government chemists making industrial alcohol ever more dangerous as bootlegging chemists struggled to make it harmless.

Often moonshine and industrial alcohol contained methanol. Methanol is an alcohol (there are lots of different types), but it isn’t a drinking alcohol. When a person sits down with a beer, a glass of wine, or a martini, the alcohol they’re drinking is ethyl alcohol or ethanol. Pure ethanol is also poisonous, but in small doses, it is fairly safe to consume. Methanol is chemically similar, but the lethal dose is much lower. A quarter of a cup can kill you. Even smaller doses can blind you. And it’s hard to separate out once it’s been mixed with ethanol.

Some estimates suggest that this program of deliberately poisoning industrial alcohol killed 10,000 people before it was quietly discontinued. And that’s not even counting the further risks of improperly-brewed alcohol. So if you happened to be a medical provider, sworn to help, sworn to prevent harm – well, in that case, a winking prescription for a cocktail could start to look pretty good, couldn’t it?

Prohibition was a complicated time in both American and Canadian history. While the dry advocates weren’t wrong that alcohol could be dangerous, the wets weren’t wrong that people didn’t want to stop drinking. Some people quit during Prohibition, sure. Some ended up dying in a hospital bed or in shootouts with gangsters, hijackers, or the Coast Guard. And medical practitioners must have had a particularly interesting vantage point on the whole thing. They were, after all, some of the few able to make exceptions. They saw the harm that booze could do and the harm that its removal could. Some doctors believed they were helping their patients by banning alcohol, others by providing it. Some may have felt caught – that there was no way to, as their oath declared, first do no harm.

Prohibition pops up occasionally even today, sometimes for the aesthetics, recently in the discussions about legalizing cannabis. The lesson, some argued, was that you can’t stop people from imbibing, you can only protect them. There was no way to keep people both safe and sober; that medical exemption was crucial, but it also guaranteed a steady supply. And in that sense, I think Canada got it right. While we had our share of gangsters, our Prohibition was by and large a calmer and gentler one. Women got to show off their political power, saloons were closed, but no one went too long without a drink and we even got a bit of jazz in the mix. Moderation in all things.

And hey, if we ever decide to try the Great Experiment again, at least I know a few doctors who might be willing to hook me up with the occasional rosé. Purely for medicinal purposes, of course.

Oh, and a translation of the opening sentence: If you wanted to get blotto [drunk] and you knew your onions [knew what you were talking about], it was duck soup [easy] to go to a croaker [doctor] and dip the bill [have a drink] without resorting to a blind tiger [illegal bar].