A Medical Breakthrough in 1939
Before the Big Book, alcoholics were viewed as morally weak. Dr. William D. Silkworth, who treated Bill W. (co-founder of AA), changed that. He wrote "The Doctor's Opinion," describing alcoholism as a two-fold illness: an allergy of the body and an obsession of the mind.
The Phenomenon of Craving
Silkworth observed that when an alcoholic puts alcohol into their system, a physical reaction occurs that is different from a normal drinker. They develop a "phenomenon of craving." They physically cannot stop. This explains why "just one drink" is impossible. As the saying goes, "One is too many, and a thousand never enough."
The Mental Obsession
If the body is allergic, why do we drink? Because of the mind. The "mental obsession" is the lie that tells us, "This time it will be different." It blanks out the memory of the pain and suffering from the last spree. This cycle—mental obsession leading to physical allergy—is the trap of addiction.
The Solution
Silkworth concluded that "entire abstinence" is the only solution, but admitted that medical science could not produce it. He endorsed the AA program because it produced a "psychic change" sufficient to overcome the mental obsession. This medical validation is the cornerstone of the modern disease model of addiction.