What's so curious to me about the disaggregationist or
survey-research critique of the disease concept in the
1970s is that at the time Nobody seemed to pay much atten-
tion to it.  Survey research had definite utilities in
this clinically dominated period--esp. in providing
prevalence estimates that could dramatize the need for
expanded treatment services as well as providing a des-
criptive epidemiology that made useful copy for, say,
NIAAA's *Alcohol & Health* reports to Congress.  But the
*theoretical* significance of this same research seemed to
pass largely unnoticed.  In fact, the disease concept was
*not* often directly and aggressively assaulted in the
writings of contemporary sociologists (again it bears
noting that this was quite unlike the situation over in
the "mental illness" territory).  The few critical papers
that were written were published in out-of-the-way places
or even not published at all.  John Seeley (1962), for
example, wrote a penetrating critique of the disease con-
cept in Pittman & Snyder's *Society, Culture, & Drinking
Patterns*--an edited volume, I would guess, that most
disease advocates would be unlikely to read.  Robin Room
once mentioned to me that if he had read Seeley's paper
beforehand he might not have gone to the trouble to write
his own paper on this subject ("Assumptions and Implica-
tions of Disease Concept of Alcoholism" [1970])--itself a
splendid piece of analysis that did not get "published"
until it was cannibalized into a chapter of Room's 1978
doctoral dissertation.  Doubtless the most visibile
sociological critique published in the 1970s was British
sociologist David Robinson's "The Alcohologist's Addic-
tion: Some Implications of Having Lost Control Over the
Disease Concept of Alcoholism" (*QJSA* 33:1028-1042,
1972)--which paper drew a number of response commentaries
& (I suspect) was sufficiently on-target that it contribu-
ted to Edwards & Gross' motivation to begin crafting their
"alcohol dependence syndrome" conceptual alternative.  My
point is that there is relatively little published litera-
ture to support the seemingly widely held view that soci-
ologists early on swaggered into Alcoholismville to shoot
up the disease concept.  Much early "epidemiology"--e.g.,
Clark's classic paper ("Operational Definitions of Drink-
ing Problems and Associated Prevalence Rates," *QJSA*
27:648-668, 1966)--*could be read* as harboring serious
challenges to disease conceptualization, but by and large
was not perceived that way.  In an appreciative review of
the policy implications of Cahalan's work, published in
1975, sociologist Robert Straus (1975:128) argued:  "Despite
the obvious social usefulness of the disease concept, it is
clear from Cahalan's findings that the medical model has
outlived its usefulness as a unitary form of conceptualizing
alcoholism."  This was an unusually blunt assertion.  It
required an informed understanding of the theoretical
meaning of these survey findings.  Most readers with a
passing interest in epidemiological findings, it seems to
me, did not bring that sort of informed
appreciation to the survey research results.  And since
sociologists themselves by and large avoided making direct
challenges at the gate of the reigning paradigm--the
theoretical & policy implications of their work lay, for a
time, as merely latent, implicit, and uncharted prospects.
Also--and significantly--the survey research challenge to
disease orthodoxy made far better copy as a critique of
the reigning paradigm than as a new paradigmatic/policy
foundation in its own right.  END OF PART III