Gin Lane: did Hogarth know about fetal alcohol syndrome?

Ernest L. Abel*,

Departments of Obstetrics and Gynecology and Psychology, Wayne State University, Detroit, Michigan, USA

Received 8 May 2000; in revised form 19 September 2000; accepted 30 September 2000


    ABSTRACT
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 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
 REFERENCES
 
— Medical historians have searched for evidence that the characteristics of fetal alcohol syndrome (FAS) were recognized long before its modern description in 1973. This search has often focused on the ‘gin epidemic’ in 18th century London, and especially William Hogarth's Gin Lane, which some authors allege reflects an awareness of the facial characteristics of the syndrome. While the ‘gin epidemic’ undoubtedly resulted in the increased birth of weak and sickly children, claims about Hogarth's awareness of the stigmata of the FAS are unfounded. The birth of weak and sickly children, and the high infant mortality rates associated with this period, long preceded the ‘gin epidemic’ and were primarily due to disease, starvation, exposure, and deliberate infanticide.


    INTRODUCTION
 TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
 REFERENCES
 
Following recognition and identification in 1973 of fetal alcohol syndrome (FAS), a pattern of abnormalities occurring in children born to alcoholic women (Jones and Smith, 1973Go), some medical historians have looked for evidence that features of the syndrome have long been known. Much of this effort has focused on the ‘gin epidemic’, a dramatic increase in gin drinking which occurred during the second quarter of the 18th century in London. The contention is that gin drinking became so rampant that it necessarily resulted in a dramatic increase in the birth of children prenatally exposed to alcohol, and, as a result of so many children being affected, features of fetal alcohol syndrome (FAS) became widely recognized and were depicted by artists and writers of that period (e.g. Rosett, 1976; Pratt, 1981; Rodin, 1981; Warren and Bast, 1988).

The artist whose work is most frequently mentioned in this regard is William Hogarth (1697–1764). In fact, Hogarth's Gin Lane has become so closely associated with the syndrome's history that it is almost de rigeur to begin any lecture about it with a slide of his engraving. This article examines Gin Lane, and discusses what Hogarth was depicting and what he, and by implication, his audience, recognized by way of the features of the syndrome. It begins with a consideration of the context in which Hogarth drew Gin Lane, namely the ‘gin epidemic’ and the appalling living conditions experienced by the ‘inferior sort of people’ (a term widely used to describe the poor), whose gin drinking was blamed for the alleged increase in weak and sickly children.


    WEAK AND SICKLY CHILDREN
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 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
 REFERENCES
 
The ‘gin epidemic’ refers to a period between 1720 and 1751 when gin became very cheap and drinking increased in England, and primarily London, from about 2 million gallons annually to about 11 million (Coffey, 1966Go). Within a few years of the onset of the ‘gin epidemic’, concern was expressed that gin was inciting the ‘inferior sort of people’ to commit criminal acts, and was also destroying the health of the poor, rendering them unfit for work, and was debilitating their children, born and unborn (Wilson, 1736Go; Fielding, 1751Go; George, 1966Go; Haslam, 1996Go). ‘Unhappy mothers’, it was said, were habituating themselves to distilled liquors, and as a consequence, their ‘children are born weak and sickly, and often look shrivel’d and as old as though they had numbered many years' (George, 1966Go). In a lengthy polemic entitled Distilled Spirituous Liquors the Bane of the Nation (1736), Thomas Wilson (1703–1784) railed that gin drinking during pregnancy was resulting in the birth of shrivelled children, but acknowledged that neither he nor the authorities he refers to had actually seen such children. Wilson's remarks were, instead, based on the inference that prenatal exposure to ‘hot spirituous liquors’ could have no other result than ‘children coming into the world half burnt up’.

Twenty-five years later, when Henry Fielding (1751) took up the subject of gin's effects on children, born and unborn, in An Enquiry into the Causes of the Late Increase of Robbers, his oft quoted question ‘What must become of the Infant who is conceived in Gin?’ was based on Wilson's earlier tract. Fielding's musings on the gin issue are much better known than Wilson's, and are widely credited for the passage of the Tippling Act of 1751, which imposed new regulations on gin retailing, but he acknowledged that his source for his comments about gin's effects on the unborn was Wilson's musings rather than any direct evidence.

During the ‘gin epidemic’ there were no doubt decreases in fertility and fecundity, as well as greater incidences of still-births and of the birth of weak and sickly children (Abel, 1998Go); however, most children in the 18th century died from poverty-related disease, starvation and infanticide, not gin drinking. The imbalance in the birth rate versus infant death rate attributed to the ‘gin epidemic’ began as early as 1540 (Clark and Slack, 1976Go), long before the ‘gin epidemic’. Pregnant women living on the edge of starvation were not prone to give birth to healthy children. If they did, they faced the extra burden of feeding those children and raising them in neighbourhoods where garbage was left to rot in the streets, where people lived in crowded houses, and where disposal of dead bodies was haphazard, resulting in the spread of contagious diseases due to the unsanitary conditions and contaminated water supply. Undoubtedly many children were prenatally exposed to gin and were born in a weakened condition, dying shortly thereafter, but most perished from starvation and diseases like measles, smallpox, tuberculosis and asthma, which were rampant (Hart, 1970Go). Even children born to well-to-do families had less than a 75% chance of surviving to age 5 years. Fielding's own daughter died in early childhood (Dudden, 1966Go).


    GIN LANE
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 ABSTRACT
 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
 REFERENCES
 
William Hogarth's Gin Lane, which he printed in 1751, the same year Fielding published his Enquiry, is set in the slum district of St Giles' Parish, Westminster. The fact that Gin Lane and Fielding's book were published the same year is more than a coincidence. Hogarth and Fielding were close friends. Hogarth's biographer, Ronald Paulson (1991), pointed out that the engraving represents almost point for point the issues Fielding raised in his Enquiry, and speculated that Fielding had urged Hogarth to provide a graphic representation of his (Fielding's) arguments.

The focal image in Gin Lane is a syphilitic and stupefied hag depicted with the top half of her dress open and an infant tumbling out of her arms. Elsewhere in the engraving, another child weeps, as someone, presumably a parent, is being put into a coffin; another is shown skewered on a staff held by a man with a bellows on his head who is presumably senseless because of his drinking; and a third is a baby being forced to drink gin by a woman pouring it down its mouth.

While these depictions presumably reflected actual conditions among the poor, the drunken woman in the foreground who is dropping the baby is not necessarily its mother. Beginning in the 1600s, affluent women who did not want to breast-feed their children began to employ wet nurses from the artisan classes of English Society (Fildes, 1986Go); by the 1700s, any woman with milk in her breasts was employed as a wet nurse. An article in The Spectator in 1711 described most of these wet nurses as indigent; later medical writers described them as ‘common people’ and ‘generally poor’ (Fildes, 1986, p. 156). Increasing demands for nurses during the 1700s (Fildes, 1986Go) meant that those who wanted them had to resort to more and more women from the poorer classes. Shortages were especially acute in large cities like London. Since infant mortality rates were very high, there was less concern as to who was being hired, and wet nurses often neglected the children put in their care regardless of whether they were drunk or not.

Writing in 1774, but referring to his infancy which coincided with the ‘gin epidemic’, J. G. Stedman describes why four of his wet nurses were ‘turned off’ (i.e. fired) by his father: ‘The first of these bitches was turn’d off for having nearly suffocated me in bed; she having slept upon me till I was smothered, and with skill and difficulty restored to life. The second had let me fall from her arms on the stones till my head was almost fractured, and I lay several hours in convulsions. The third carried me under a moulder'd old brick wall, which fell in a heap of rubbish just the moment we had passed by it, while the fourth proved to be a thief, and deprived me even of my very baby clothes' (quoted by Stone, 1977, p. 430).

The second nurse in this description is not very different from the woman whose baby is falling in Gin Lane. The woman pouring gin down the baby's throat was also based on contemporary life. As early as 1689, wet nurses had no scruples about ‘giv[ing] wine or even brandy sweetened with sugar to newborn infants as often as they cry immediately, to pacify them, as they say, and keep themselves easy’ (quoted by Fildes, 1986, p. 237). In 1753, after the ‘gin epidemic’ was supposedly over, a James Nelson indicates that some mothers and wet nurses were still buying gin and were still in the habit of giving it to infants to keep them quiet: ‘There is a practice among the vulgar still more shocking ... that of giving drams to the children themselves, even while infants; they ... pour the deadly poison down the poor babe's throat even before it can speak’ (quoted by Fildes, 1986, p. 236). When these overdosing deaths were investigated, the most common explanation was ‘convulsions’ (George, 1966Go).

Many children born to the poor were either abandoned or deliberately killed after they were born. The justification for the creation of a Foundling Home in London in 1739, for instance, was infanticide: ‘No expedient has yet been found out for preventing the murder of poor miserable infants at their birth, or suppressing the inhuman custom of exposing newly-born infants to perish in the streets; or the putting of such unhappy foundlings to wicked and barbarous nurses who ... do often suffer them to be starved for want of due sustenance or care’ (quoted by Haslam, 1996, p. 128).

Ignoring the other children in Gin Lane, a number of medical historians have looked for, and have claimed to have found, features of the FAS in the falling child's facial features. The implication is that Hogarth, and by extension, his contemporaries, were well aware of the syndrome, although of course, they did not give it that name, or any name for that matter. Rodin (1981, p. 1239), for instance, described the child falling from the drunken woman's arms as having ‘a shorter than normal palpebral fissure (eye opening) resulting in relatively round, ‘Orphan Annie’ eyes.’ This is the only feature of the syndrome he refers to and he contends that this feature is not found in the faces of other infants in Hogarth's other engravings. This could have been purposeful, or, he cautioned, might have been a detail Hogarth inadvertently noticed without his being aware of the pathological condition. However, while short palpebral fissure size is a common feature of FAS, it is not a consistent feature and it is not easily determined in children who are not sitting still (Abel, 1998Go). Rodin did not refer us to any other children for comparison, nor did he consider a more likely possibility, namely that the wide eyes of the child in Gin Lane are due to its terror as it falls head-first to the ground.

A more declarative identification of the child as having the facial characteristics of the syndrome is Paditz's description of the infant's ‘deep set eyes, antimongoloid eye slant, sunken hypoplastic nose and hypoplastic philtrum (the groove from the nose to the upper lip).’ (Paditz, 1993Go). Paditz claimed that these same features are even more evident in the face of a servant who is escorting his drunk master home, in another of Hogarth's lithographs, Night (Shesgreen, 1973Go) (‘the eye constellation is outward and downward and the nostril constellation and the small lips are typical signs of alcoholic embryopathy’). The irony in this latter argument, which in turn offers a perspective into his conclusions about Gin Lane, is that it is not the servant who is drunk but his affluent master. Since the servant, who was sober, is said to bear the signs of FAS, whereas the master, who was drunk, does not, Paditz's conclusions would seem to reflect a bias not toward drinking, but toward social class. Paditz's discernment of the facial features of the syndrome in the tumbling infant in Gin Lane would be a remarkable feat of diagnostic acumen — if it were valid.

Paditz's inconsistencies aside, the question still remains whether Gin Lane reflects an awareness of alcohol-related birth defects. Hogarth himself attributed the high infant mortality rate in London to infanticide. The child skewered on the pike in Gin Lane is anything but subtle and the scene to the left of the hag, showing a woman pouring gin down an infant's throat, portrays the commonly used method for keeping infants quiet or for killing them (George, 1966Go).

Contrary to the previously mentioned claims made on his part, Hogarth was unaware of alcohol's prenatal effects. In a letter he wrote to a friend about Gin Lane and a companion piece, Beer Street, he listed the ‘horrid’ effects of gin-drinking, but did not mention its prenatal effects: ‘In Gin Lane every circumstance of its [gin's] horrid effects is brought into view in terrorem. Idleness, poverty, misery, and distress, which drives even to madness and death, are the only objects that are to be seen; and not a house in tolerable condition but the pawnbroker's and gin-shop. Beer Street, its companion, was given as a contrast, where the invigorating liquor is recommended, in order to drive the other out of vogue.’ (Quoted by Ireland, 1812, II, p. 345.)

We don't know for certain that Hogarth had no first-hand knowledge of alcohol's prenatal effects, but the inference that he had none is suggested by the absence of any mention of such effects in the above letter, and by his failure to mention them in a letter he wrote to the London Evening Post describing his purpose in creating Gin Lane: ‘... the subjects of these prints are calculated to reform some reigning vices peculiar to the lower class of people ...’ (Quoted by Paulson, 1991, p. 269). Admittedly, this is an argumentum ex silentio, but it is a loud silence. Had Hogarth meant to convey his knowledge about the prenatal effects of alcohol, he would certainly have mentioned them in his letter along with the other effects he listed. Given his silence on the subject of what later came to be called FAS and alcohol-related birth defects, and the voluminous contemporary evidence about the fate of children after they were born, the conclusion must be reached that Hogarth had no personal knowledge of the former. Instead, Gin Lane portrays the fate of newborns whose nurses gave infants gin either to quiet or to kill them (the nurse pouring gin down an infant's throat); deliberate infanticide (the skewered child); and the inability of drunken nurses to breast feed their own or the children put in their trust.


    CONCLUSIONS AND COMMENTS
 TOP
 FOOTNOTES
 ABSTRACT
 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
 REFERENCES
 
Against the argument that the gin epidemic was a major social event in English history, with respect to reproduction, is the total absence of any mention of its impact on pregnancy in the writings of later physicians or social commentators. In 1813, for instance, Thomas Trotter (1813), a well-known Scottish physician of his era, faithfully quoted a 200-year-old book by Robert Burton (1651) as to what the ancient Greek writers had to say on the effects of prenatal alcohol exposure, but made no mention of the more contemporary evidence of the gin epidemic.

Whatever claims were made about the prenatal effects of alcohol, such claims were based on inference, rather than observation. Lacking empirical support, these reports had no lasting impact. What Hogarth was portraying in Gin Lane was the appalling lives of the residents of St Giles. As he himself indicated, his purpose in printing Gin Lane and Beer Street was ‘to reform some reigning vices peculiar to the lower Class of People’. For that reason he said he was printing some in ‘the cheapest Manner possible’, at a price of one shilling as opposed to those printed ‘in a better Manner for the curious’ at one shilling and six pence each. In making such a statement Hogarth indicates that he was completely unaware of what the lives of those people he depicted were really like. A shilling in those days was a sizeable amount for the poor (Paulson, 1991Go) and hardly something that the ‘lower Class of people’, who couldn't afford to buy food, would buy. Nor would Gin Lane have been hung in taverns where its appearance might have discouraged drinking, unless customers took no offence because they did not see themselves being depicted.

The various attempts to see characteristics of FAS in Hogarth's works is an example of what historians call ‘presentism’ or ‘whig history,’ the interpretation of the past in terms of the present. Just as the attempts to find evidence of the FAS in the Bible (Abel, 1997Go), the works of the classical Greeks and Romans (Abel, 1999aGo) and Renaissance writers (Abel, 1999bGo) are without merit, so too are those efforts to find such prescience in William Hogarth's Gin Lane.


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 INTRODUCTION
 WEAK AND SICKLY CHILDREN
 GIN LANE
 CONCLUSIONS AND COMMENTS
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* Author to whom correspondence should be addressed at: Mott Center, 275 E. Hancock, Detroit, MI 48201, USA. Back


    REFERENCES
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 ABSTRACT
 INTRODUCTION
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