Pathological Gambling up to the Early Twentieth Century: Sins, Disease Metaphors, and Early Efforts at Medicalization

Abstract

In this chapter, we examine early conceptions of pathological gambling from the ancient world up until the early twentieth century, with a special emphasis on the early nineteenth century. In particular, we examine how the concept of addiction as a disease, with roots in the notion of sin, emerged during this time period. Popular as well as scientific accounts of problem gambling are discussed, along with nineteenth-century precursors for ailments such as obsessive-compulsive disorder, impulse control disorder, and addiction. Conceptual difficulties that still haunt us to this day are shown to have roots in early psychiatry. Esquirol’s conception of monomania, for example, was used as a catchall for assorted problems involving volition—and was subject to critiques that resemble current objections to the application of “addiction” to assorted behaviors. Finally, we discuss the early sciences pertaining to chronic drunkenness, the latter being our first well-studied addiction which in turn set the stage for our understanding of other substance addictions and, soon after, behavioral addictions such as pathological gambling.