Elvin Morton "Bunky" Jellinek (15 August 1890 – 22 October 1963), E. Morton Jellinek, or most often, E. M. Jellinek, was an American biostatistician,

physiologist Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and ...

, and an

alcoholism Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World He ...

research Research is creative and systematic work undertaken to increase the stock of knowledge. It involves the collection, organization, and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness to ...

er, fluent in nine languages and able to communicate in four others. The son of Markus Erwin Marcel Jellinek (1858–1939) and Rose Jellinek (1867–1966), née Jacobson (a.k.a. the opera singer Marcella Lindh), he was born in

New York City New York, often called New York City (NYC), is the most populous city in the United States, located at the southern tip of New York State on one of the world's largest natural harbors. The city comprises five boroughs, each coextensive w ...

and died at the desk of his study at

Stanford University Leland Stanford Junior University, commonly referred to as Stanford University, is a Private university, private research university in Stanford, California, United States. It was founded in 1885 by railroad magnate Leland Stanford (the eighth ...

on 22 October 1963.

Academic career

Jellinek studied biostatistics and physiology at the

University of Berlin The Humboldt University of Berlin (, abbreviated HU Berlin) is a public research university in the central borough of Mitte in Berlin, Germany. The university was established by Frederick William III on the initiative of Wilhelm von Humbol ...

from 1908 to 1910. He then studied

philosophy Philosophy ('love of wisdom' in Ancient Greek) is a systematic study of general and fundamental questions concerning topics like existence, reason, knowledge, Value (ethics and social sciences), value, mind, and language. It is a rational an ...

philology Philology () is the study of language in Oral tradition, oral and writing, written historical sources. It is the intersection of textual criticism, literary criticism, history, and linguistics with strong ties to etymology. Philology is also de ...

anthropology Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, society, societies, and linguistics, in both the present and past, including archaic humans. Social anthropology studies patterns of behav ...

, and

theology Theology is the study of religious belief from a Religion, religious perspective, with a focus on the nature of divinity. It is taught as an Discipline (academia), academic discipline, typically in universities and seminaries. It occupies itse ...

for two years at the

Joseph Fourier University Joseph Fourier University (UJF, , also known as Grenoble I) was a French university situated in the city of Grenoble and focused on the fields of sciences, technologies and health. It is now part of the Université Grenoble Alpes. Importance ...

Grenoble Grenoble ( ; ; or ; or ) is the Prefectures in France, prefecture and List of communes in France with over 20,000 inhabitants, largest city of the Isère Departments of France, department in the Auvergne-Rhône-Alpes Regions of France, region ...

. He was also enrolled, apparently concurrently, at the

University of Leipzig Leipzig University (), in Leipzig in Saxony, Germany, is one of the world's oldest universities and the second-oldest university (by consecutive years of existence) in Germany. The university was founded on 2 December 1409 by Frederick I, Electo ...

from 25 November 1911 to 29 July 1913, and from 22 November 1913 to 2 December 1914 for classes in languages, linguistics and cultural history. During the 1920s, he conducted research in

Sierra Leone Sierra Leone, officially the Republic of Sierra Leone, is a country on the southwest coast of West Africa. It is bordered to the southeast by Liberia and by Guinea to the north. Sierra Leone's land area is . It has a tropical climate and envi ...

and at

Tela Tela is a town, with a population of 39,920 (2023 calculation), and a municipality in Honduras on the northern Caribbean coast. It is located in the Atlántida department, department of Atlantida. History Colonial era Tela was founded by th ...

Honduras Honduras, officially the Republic of Honduras, is a country in Central America. It is bordered to the west by Guatemala, to the southwest by El Salvador, to the southeast by Nicaragua, to the south by the Pacific Ocean at the Gulf of Fonseca, ...

. In the 1930s he returned to the U.S.A. and worked at the Worcester State Hospital,

Worcester, Massachusetts Worcester ( , ) is the List of municipalities in Massachusetts, second-most populous city in the U.S. state of Massachusetts and the list of United States cities by population, 113th most populous city in the United States. Named after Worcester ...

, from whence he was commissioned to conduct a study for the ''Research Council on Problems of Alcohol''. The eventual outcome of his study was the 1942 book, ''Alcohol Addiction and Chronic Alcoholism''. From 1941 to 1952, he was Associate Professor of Applied Physiology at

Yale University Yale University is a Private university, private Ivy League research university in New Haven, Connecticut, United States. Founded in 1701, Yale is the List of Colonial Colleges, third-oldest institution of higher education in the United Stat ...

. In 1941 he was managing editor of the newly established

Quarterly Journal of Studies on Alcohol The ''Journal of Studies on Alcohol and Drugs'' (JSAD) is a multidisciplinary peer-reviewed scientific journal that publishes articles on all aspects of the use and misuse of alcohol and other drugs; tobacco and e-cigarette use; the misuse of pres ...

(now the Journal of Studies on Alcohol and Drugs). In 1950 he was engaged by the

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

in Geneva as a consultant on alcoholism, and made significant contributions to the work of the Alcoholism Sub-committee of the

WHO The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...

's ''Expert Committee on Mental Health''. Th
Second Report
of the Alcoholism Subcommittee, published in August 1952, have reproduced in its 2nd Annex, the text of an important communication that Jellinek gave to the first European Seminar on Alcoholism in Copenhagen in October 1951. In that conference, he exposed his work on the Phases of alcoholic addiction and he presented a detailed Chart (page 30) exposing the progressive nature of alcoholism. That chart is considered as the 1st version of the future Jellinek's Curve that some other people, including

Max Glatt Max Meier Glatt (26 January 191214 May 2002) was a German British psychiatrist and addiction expert. A survivor of the Dachau concentration camp, he went on to become a prominent expert in the treatment of addiction in the United Kingdom. He was ...

, would eventually draw from his work. Upon his retirement from the WHO in the late 1950s, he returned to the USA. In 1958 he joined the Psychiatry Schools of both the

University of Toronto The University of Toronto (UToronto or U of T) is a public university, public research university whose main campus is located on the grounds that surround Queen's Park (Toronto), Queen's Park in Toronto, Ontario, Canada. It was founded by ...

and the

University of Alberta The University of Alberta (also known as U of A or UAlberta, ) is a public research university located in Edmonton, Alberta, Canada. It was founded in 1908 by Alexander Cameron Rutherford, the first premier of Alberta, and Henry Marshall Tory, t ...

, and in 1962, he moved to Stanford University in California, where he remained until his death.

Works

Addiction researcher Griffith Edwards (2002, p. 98) holds that, in his opinion, Jellinek's ''The Disease Concept of Alcoholism'' was a work of outstanding scholarship based on a careful consideration of the available evidence.

Disease concept of alcoholism

In 1849, the Swedish physician

Magnus Huss Magnus Huss (22 October 1807 – 22 April 1890) was a Swedish physician and professor, knighted with his name retained. He is known for coining the term ''alcoholism'' in 1849, which he used to refer to the pathological changes in the body due to ...

(1807–1890) was the first to systematically classify the damage that was attributable to alcohol ingestion. Huss coined the term ''

'' and used it to label what he considered to be a chronic, relapsing disease. Jellinek coined the expression " the disease concept of alcoholism", and significantly accelerated the movement towards the

medicalization Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new evi ...

drunkenness Alcohol intoxication, commonly described in higher doses as drunkenness or inebriation, and known in overdose as alcohol poisoning, is the behavior and physical effects caused by recent consumption of alcohol. The technical term ''intoxication ...

and alcohol

habituation Habituation is a form of non-associative learning in which an organism’s non-reinforced response to an inconsequential stimulus decreases after repeated or prolonged presentations of that stimulus. For example, organisms may habituate to re ...

. Jellinek’s initial 1946 study was funded by Marty Mann and R. Brinkley Smithers (Falcone, 2003). It was based on a narrow, selective study of a hand-picked group of members of

Alcoholics Anonymous Alcoholics Anonymous (AA) is a global, peer-led Mutual aid, mutual-aid fellowship focused on an abstinence-based recovery model from alcoholism through its spiritually inclined twelve-step program. AA's Twelve Traditions, besides emphasizing anon ...

(AA) who had returned a self-reporting questionnaire. Valverde opines that a biostatistician of Jellinek’s eminence would have been only too well aware of the "unscientific status" of the "dubiously scientific data that had been collected by AA members". In his 1960 book he identified five different types of alcoholism, and defined them in terms of their abnormal physiological processes: :''In order to differentiate alcoholism not just

diachronic Synchrony and diachrony are two complementary viewpoints in linguistic analysis. A ''synchronic'' approach - from ,("together") + ,("time") - considers a language at a moment in time without taking its history into account. In contrast, a ''diac ...

ally, along a time line but also

synchronic Synchronic may refer to: * ''Synchronic'' (film), a 2019 American science fiction film starring Anthony Mackie and Jamie Dornan *Synchronic analysis, the analysis of a language at a specific point of time *Synchronicity, the experience of two or m ...

ally across groups of people, thus distinguishing types of alcoholics in a way that ran quite counter to the AA emphasis on the unity of all alcoholics, Jellinek came up with the idea of grouping different drinking patterns and naming them by giving each a Greek letter. One might think that the purpose of such a classification is to expand the range of alcoholism and include as many people as possible under the "disease concept"; but, contrary to what the title suggests, Jellinek's 1960 magnum opus in fact tries to limit the scope of the "disease concept", stating that most of the types described might be alcoholics, but they are not diseased – because they do not suffer from "loss of control".'' * Alpha alcoholism: the earliest stage of the disease, manifesting the purely psychological continual dependence on the effects of alcohol to relieve bodily or emotional pain. This is the "problem drinker", whose drinking creates social and personal problems. Whilst there are significant social and personal problems, these people can stop if they really want to; thus, argued Jellinek, they have not lost control, and as a consequence, do not have a "disease". * Beta alcoholism:

polyneuropathy Polyneuropathy () is damage or disease affecting peripheral nerves (peripheral neuropathy) in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain. It usually begins in the hands and feet and may prog ...

, or

cirrhosis of the liver Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced ...

from alcohol without physical or psychological dependence. These are the heavy drinkers that drink a lot, almost every day. They do not have physical

addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use can ...

and do not suffer withdrawal

symptoms Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

. This group do not have a "disease". * Gamma alcoholism: involving acquired tissue tolerance, physical dependence, and loss of control. This is the AA alcoholic, who is very much out of control, and does, by Jellinek's classification, have a "disease". * Delta alcoholism: as in Gamma alcoholism, but with inability to abstain, instead of loss of control. * Epsilon alcoholism: the most advanced stage of the disease, manifesting as

dipsomania Dipsomania is a historical term describing a medical condition involving an uncontrollable craving for alcohol or other drugs. In the 19th century, the term dipsomania was used to refer to a variety of alcohol-related problems, most of which are k ...

, or periodic alcoholism. :''While Jellinek's classification draws a clear (if arbitrary) line between the garden-variety alcoholic and the truly diseased alcoholic, it does not draw such a clear boundary between alcoholism in general and normal drinking. This is Jellinek's

Achilles' heel An Achilles' heel (or Achilles heel) is a weakness despite overall strength, which can lead to downfall. While the mythological origin refers to a physical vulnerability, idiomatic references to other attributes or qualities that can lead to do ...

. . .'' :''By relying on cultural

norm Norm, the Norm or NORM may refer to: In academic disciplines * Normativity, phenomenon of designating things as good or bad * Norm (geology), an estimate of the idealised mineral content of a rock * Norm (philosophy), a standard in normative e ...

s to define several of his types, he implicitly gives up the project of providing a single, objective, universally valid clinical definition of alcoholism, and opens the door to anthropological

nominalist In metaphysics, nominalism is the view that universals and abstract objects do not actually exist other than being merely names or labels. There are two main versions of nominalism. One denies the existence of universals—that which can be inst ...

ic definitions along the lines of "whatever is normal drinking in that particular culture is normal drinking".'' (Valverde, 1998, p.112) The "Jellinek curve" is derived from this classification of Jellinek, and it was named out of respect for Jellinek’s work. Jellinek later completely dissociated himself from this chart's representations; however it is still known as the "Jellinek curve".

Recognition of placebo effect

In post-war 1946, various pharmaceutical chemicals were in short supply for making medicines. A headache remedy manufacturer found that supplies of one of its remedy’s three constituent chemicals was running out. They asked Jellinek, then at Yale, to test whether the absence of that particular chemical would affect the drug’s

efficacy Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as '' effectiveness'', and it has often been used synonymously, although in pharmacology a distinction is now often made betwee ...

in any way. Jellinek set up a complex trial – with 199 subjects, divided randomly into four test groups – involving various

permutation In mathematics, a permutation of a set can mean one of two different things: * an arrangement of its members in a sequence or linear order, or * the act or process of changing the linear order of an ordered set. An example of the first mean ...

s of the three drug constituents, with a

placebo A placebo ( ) can be roughly defined as a sham medical treatment. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures. Placebos are used in randomized clinical trials ...

as a

scientific control A scientific control is an experiment or observation designed to minimize the effects of variables other than the independent variable (i.e. confounding variables). This increases the reliability of the results, often through a comparison betwe ...

. Each group took a test remedy for two weeks at a time. The trial lasted eight weeks, by the end of which each group had taken each of the test drugs, albeit in a different sequence. Over the entire population of 199 subjects, 120 of the subjects (~60%) responded to the placebo, and 79 did not. The trial also demonstrated that the chemical in question significantly contributed to the remedy's efficacy. In the process of examining the data produced by his trial, Jellinek discovered that there was a significant difference in responses to the active chemicals between the 120 who had responded to the placebo and the 79 who did not. He (1946, p. 90) described the former group as being "''reactors to placebo''", and this seems to be the first time that anyone had spoken of either "''placebo reactions''" or "''placebo responses''".

Jellinek Award

The Jellinek Memorial Award, or Jellinek Award, is an award presented annually by the Jellinek Memorial Fund in Jellinek's honor. It is given to a scientist who has made an outstanding contribution to research on alcohol or alcoholism. Winners receive a cash prize of US$5,000, as well as a bust of Jellinek with a personalized inscription.

Selected publications

* Haggard, H. W. & Jellinek, E. M., ''Alcohol Explored'', Doubleday, Doran & Company, Inc., (Garden City), 1942. * Jellinek, E. M. (ed), ''Alcohol Addiction and Chronic Alcoholism'', Yale University Press, (New Haven), 1942. * Jellinek, E. M. "Clinical Tests on Comparative Effectiveness of Analgesic Drugs", ''Biometrics Bulletin'', Vol.2, No.5, (October 1946), pp. 87–91. * Jellinek, E. M., "Phases in the Drinking History of Alcoholics: Analysis of a Survey Conducted by the Official Organ of Alcoholics Anonymous", ''Quarterly Journal of Studies on Alcohol'', Vol.7, (1946), pp. 1–88. * Jellinek, E. M., ''The Disease Concept of Alcoholism'', Hillhouse, (New Haven), 1960.

Notes

References

* Archibald, H.D., "Dr. Elwin icMorton Jellinek: (1891–1964)", ''American Journal of Psychiatry'', Vol.120, (June 1964), pp. 1217–1218. (Jellinek's obituary) * Beecher, H.K., "The Powerful Placebo", ''Journal of the American Medical Association'', Vol.159, No.17, (24 December 1955), pp. 1602–1606. * Edwards, G., ''Alcohol: The World's Favourite Drug''. 1st US ed. Thomas Dunne Books: 2002. . * Falcone, T.J., "Alcoholism: A Disease of Speculation", ''Baldwin Research Institute'', 2003

Greenberg, G., "The Creation of Disease", ''The New Yorker'', April 20, 2013.
* Jellinek, E. M., ''The Disease Concept of Alcoholism'', Hillhouse, (New Haven), 1960. * Levine, H.G., "The Discovery of Addiction: Changing Conceptions of Habitual Drunkenness in America", ''Journal of Studies on Alcohol'', Vol.39, No.1, (January 1978), pp. 143–174. (Reprint: ''Journal of Substance Abuse Treatment'', Vol.2, No.1, (1985), pp. 43–57.) Available a

* Page, P.B., "E. M. Jellinek and the Evolution of Alcohol Studies: A Critical Essay", ''Addiction'', Vol.92, No.12, (December 1997), pp. 1619–1637. * Peele, S., "R. Brinkley Smithers: The Financier of the Modern Alcoholism Movement", ''The Stanton Peele Addiction Website'', (not dated), retrieved fro

on 18 June 2006. * Ribot, T. (Snell, M. trans.), ''The Diseases of the Will: Authorised Translation from the Eighth French Edition'', The Open Court Publishing Company, (Chicago), 1894. * Rush, B., ''An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind: With an Account of the Means of Preventing, and of the Remedies for Curing Them'', Thomas Dobson, (Philadelphia), 1808. * Taylor, C.C.W., ''Plato: Protagoras'', Clarendon Press, (Oxford), 1976. * Trotter, T. (Porter, R., ed.), ''An Essay, Medical, Philosophical, and Chemical, on Drunkenness and Its Effects on the Human Body'', Routledge, (London), 1988. (This a facsimile of the first (1804) London edition. The book itself was based on the thesis "''De ebrietate, ejusque effectibus in corpus humanum''" that Trotter had presented to

Edinburgh University The University of Edinburgh (, ; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Founded by the town council under the authority of a royal charter from King James VI in 1582 and offi ...

in 1788.) * Valverde, M., ''Diseases of the Will: Alcohol and the Dilemmas of Freedom'', Cambridge University Press, (Cambridge), 1998.
Ward, J.H., Bejarano, W., Babor, T.F., and Allred, N., "Re-Introducing Bunky at 125: E. M. Jellinek’s Life and Contributions to Alcohol Studies", ''Journal of Studies on Alcohol and Drugs'', Vol.77, No.3, (May 2016), pp.375-383.

36th Annual SALIS Conference

External links

*
1964 obituary, ''The American Journal Of Psychiatry''.

* ttp://hindsfoot.org/BSV02Psy.html Origins of the Alcoholics Anonymous "Jellinek Curve".
"Jellinek Curve".

''Alcoholism: A disease of speculation'' (criticism of Jellinek's work, and the veracity of the concept of alcoholism as a disease).

A comprehensive bibliography of E. M. Jellinek’s publications. ''Journal of Studies on Alcohol and Drugs''.
{{DEFAULTSORT:Jellinek, E. Morton 1890 births 1963 deaths American Jews American medical researchers American physiologists American statisticians Researchers in alcohol abuse Substance dependence Academic staff of the University of Alberta