Around the time readers first learned of Sherlock Holmes’ turning to cocaine after a tough case, two of the medical world’s great minds were getting a serious buzz on for research, fun and abuse.
These actual early cokeheads were Sigmund Freud (1856-1939) and US surgeon William Halsted (1852-1922), the subjects of Howard Markel’s colorful study An Anatomy of Addiction.
In the opening pages, we meet a young Halsted in May 1885 in a hospital dispensary. He “frantically searched the shelves” for cocaine, shot up and then bolted from the operating room where he was supposed to attend a compound fracture. He fled to his Manhattan home and “sank into a cocaine oblivion that lasted more than seven months.”
The drug wasn’t cheap then either, but Halsted was the scion of a dry goods and insurance fortune. A jock and a dandy at Yale, his medical interests surfaced only in his senior year after some unrequired light reading in Gray’s Anatomy. Following two years of study in Vienna and several German cities, Halsted returned to the US “a superbly trained surgeon, perhaps the best of his generation,” Markel writes.
Also in May 1885, we encounter Freud boasting in a letter to his fiancee about “how a dose of pure cocaine vanquished his migraine and inspired him to stay up until four in the morning writing a ‘very important’ anatomical study,” Markel writes.
Cocaine joined the Western pharmacopoeia in the 19th century after traveling from Peru via conquistadors, naturalists and popular writers like William H. Prescott. The tendency of doctors then to freely prescribe narcotics inspired commercialization by drug companies of the time, such as John Searle, E.R. Squibb, Boehringer & Merck, and Parke, Davis & Co.
A clever French chemist mixed it with wine for a drink called Vin Mariani. The Vatican gave the concoction a medal, Ulysses S. Grant drank it while finishing his autobiography, and Queen Victoria and US President William McKinley sang its praises.
Halsted and Freud both experimented with cocaine for legitimate medical purposes. Freud thought it would help a friend with his morphine addiction, while Halsted sought a local anesthetic.
Freud tended to go solo. The American initially had a cadre of students and young doctors providing research assistance and then some: “Halsted and his colleagues were quick to appreciate the sheer fun of ingesting cocaine. Theater events, dances, and even bowling matches at the University Club, a mere block away from Halsted’s home, were brightened by the white powder.”
Another key difference is that Freud kicked the habit around 1896. Halsted got it under control enough to excel and thrive in medicine — he once charged the equivalent of US$260,000 for the removal of bile duct stones — but he lapsed often. Markel writes that he was “a remarkably high-performing addict for almost four decades.”
The book’s chronology jumps around confusingly at times, and Markel’s writing has overheated moments. In Paris’ Pere- Lachaise Cemetery, he refers to “a large number of recumbent but great” Frenchmen. Even a contextually apt image can be too much: “Uncomfortable questions plagued [Freud’s] thoughts as sharply as the spiral-shaped syphilitic microbes burrowed into the brains and critical organs of his patients.”
Still, Markel, a professor of the history of medicine at the University of Michigan, has assembled an engaging, well-researched historical homily about fame and foible. It’s a brisk read, especially with more than 100 illustrations.
And its rather silly closing caveat — “Genius is not found in a bottle, pill, or potion” — is quickly offset by the sensible reminder that the two men’s legacies were in fact “ground out page by page, stitch by stitch, patient by patient, insight by insight, day after day, year after year.”
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