In October 1997, Alan Leshner, director of the US National Institute on Drug Abuse (NIDA), declared that addiction is ‘a chronic, relapsing brain disorder characterized by compulsive drug seeking and use.’ For Leshner, recent neuroscience proved that drug use changes brain structure and function and, consequently, ‘the addicted brain is distinctly different from the non-addicted brain’ (Science 278; 1997: 45, 46). Now known as the hijacked brain theory or the NIDA Paradigm, Leshner’s model informs research and directs funding around the globe. But the theory was not as novel as he claimed it was. It is strikingly similar to that proposed in the 1890s by Dr. Leslie E. Keeley, an American physician whose internationally franchised ‘Gold Cure’ for habitual drug and alcohol use was the most famous addiction treatment regime in the world. Today Keeley is nearly forgotten, but when he died in 1900 he was among the world’s most controversial physicians. The British Medical Journal wrote damningly that ‘Dr. Keeley was for many years an orthodox practitioner of medicine. Then he left the broad highway of legitimate practice, and took a short cut to fortune by a secret path.’ The piece was titled ‘The Nemesis of Quackery’ (BMJ 1900; i: 921).
‘Keeping Secrets’ asks why, and what it means to have forgotten such a popular and influential figure. It uses unexplored archival material to recover Keeley’s claims about addiction and medical practice, and it examines the historical irony of his dismissal as a quack. It engages questions of medical professionalization, the changing description of a persistent health problem, and the persuasive role of technology in medical explanation. In doing so, it moves beyond narrow conceptions of the history of medicine to think about what counts as history and its relevance for today’s policy and treatment initiatives.