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Views & Reviews Between the Lines

In with the wrong crowd

BMJ 2008; 336 doi: (Published 26 June 2008) Cite this as: BMJ 2008;336:1509
  1. Theodore Dalrymple, writer and retired doctor

As Oscar Wilde so justly observed, work is the curse of the drinking classes. No one would have agreed more heartily than Charles Lamb, the essayist and friend of the Romantics. He hated his work in the offices of the East India Company and thought that it all but destroyed his literary gifts. When his office superior upbraided him for always arriving late at work, he replied, “Yes, sir, but to make up for it I always leave early.”

In his Last Essays of Elia, he wrote his Confessions of a Drunkard. There can hardly be a doctor in practice, at least in the United Kingdom, who does not recognise the truth of its opening assertions: “Dehortations from the use of strong liquors have been a favourite topic of sober declaimers of all ages, and have been received with abundance of applause by water-drinking critics. But with the patient himself, the man that is to be cured, unfortunately their sound has seldom prevailed.”

Having a partiality both for drink and, like most men, for himself, Lamb tells us that drinking is not a vice like any other. Other vices, such as stealing and lying, are easy to abjure, unlike drinking: “the hand to pilfer, and the tongue to bear false witness, have no constitutional tendency. At the first instance of the reformed will, they can be brought off without a murmur.”

Alas, Lamb had not had the opportunity to read the recent papers in the British Journal of Psychiatry concerning the white matter defects in the frontal lobes of pathological liars, nor to read the theory of forensic psychologists concerning the highly addictive nature of car theft.

But why did Lamb drink too much (if he did), or, as he put it himself, “commence sot?”

He was a friend of Coleridge, and Coleridge’s problems with drink were at least as important as his better publicised, and also self publicised, problem with opium. This, however, were so much more romantic than the strong liquors that had been the favourite topic of sober declaimers of all ages. In fact, descriptions of Coleridge’s symptomatology suggest the effect of drink more than that of drugs (see BMJ 2008;336:451; doi: 10.1136/bmj.39489.647998.59). The same goes for another of the Romantics, De Quincey.

Lamb’s explanation for the development of his own intemperance is simple. It is precisely what we have all heard a hundred times from the mouths of heroin addicts: he fell in with the wrong crowd: “About that time I fell in with some companions of a different order. They were men of boisterous spirits, sitters up a-nights, disputants, drunken: yet seemed to have something noble about them.”

Lamb threw over these friends, but not his drinking. Unfortunately, Lamb’s next set of friends introduced him to a new vice, as difficult to abjure as drink: “I should repel my readers, from a mere incapacity of believing me, were I to tell them what tobacco has been to me, the drudging service which I have paid, the slavery which I have vowed to it.”

And all this in the first quarter of the 19th century, without the tobacco companies having to mislead him about the addictive nature of their product.

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