3

PARADISE LOST?

On a dark and damp evening in December 1845 the novelist and poet Théophile Gautier arrived in front of the stone mansion known as the Hôtel Pimodan on the Ile Saint-Louis, one of two islands at the heart of Paris. A thick fog rose from the Seine, blurring everything save the reddish stains made by the occasional lantern – or so the author’s fictionalized account has it. Having tumbled out of his carriage, Gautier banged the gate’s sculpted knocker, and the solid, wooden panel opened. An old concierge pointed towards the back of the grass-grown courtyard beyond, and the poet waddled across the irregular paving. He found himself at the bottom of a curving staircase in the style of Louis XIV, an Egyptian chimera, holding a candle between its curved talons, gazing at him.

Gautier was on a call to a ‘mysterious convocation, drafted in enigmatic terms, understandable to those in the know, unintelligible to others’, an assignment that made the island look like ‘a distant place, a solitary oasis in the middle of Paris, isolated by the river from invading civilization’.1 On the walls hung Italian and Spanish old masters, and from the ceiling a mythological scene shone through the penumbra. The caller, having ascended, felt pulled two centuries back in time. At last: ‘I stepped towards the better-lit part of a hall, where a group of human forms appeared to busy themselves around a table. As the light, engulfing me, disclosed who I was, a vigorous hurrah arose, shaking the old building to its foundations. It is he! It is he! several voices cried at once; let him have his share!’

Presiding over them, the ‘doctor’ was waiting:

He stood by a sideboard on which had been placed a tray arranged with Japanese porcelain saucers. With the help of a spatula, he drew lumps of a green paste or jam, each about the size of a thumb, out of a crystal vase, and tossed them onto the saucers. The tiny plates were equipped with vermeil teaspoons. The doctor’s face beamed with glee . . . This will be deducted from your slice of heaven, he told me as he handed me my allocated dose. Everyone having eaten their share, coffee was served in the Arab style, sweet and half-filled with residue. We sat down to dinner.

The Hôtel Pimodan belonged to the Romantic painter Fernand Boissard de Boisdenier, but it was frequented by a bohemian population that included such leading literary lights as Honoré de Balzac and Charles Baudelaire, as well as the better-known artists Ernest Meissonnier and Eugène Delacroix.2 The doctor, on the night Gautier describes, was almost certainly Jacques-Joseph Moreau de Tours. Moreau had travelled to North Africa and the Levant, and he knew where to procure the green ‘jam’: hashish. A Paris alienist, he held as his principal interest the investigation of the causes of madness.

‘An honest philistine might have had a fright at the site of these long-haired, bearded or moustachioed guests, or shaved in singular fashion, flourishing sixteenth-century daggers, Malay Kris-knives, and Navajas, and bent over foods that, in the vacillating glow of the lamps, took on suspect appearances,’ continues the poet. Some struggled to bring a glass to their lips while others laughed with vacant eyes or cried out at nothing. Gautier himself began to feel warm, his brain addled.

‘An armchair beckoned to me by the mantelpiece, and I abandoned myself without resistance to the effects of the fantastic drug.’ Suddenly it was as if the lights shone anew, and the whole room, a panelled lounge with sculpted gilding and plaster friezes of satyrs pursuing nymphs, took on a splendid appearance. ‘An enigmatic figure appeared to me in a flash . . . It had a crooked nose much as a bird’s beak, green eyes circled three times in brown . . . As to its legs, they seemed made of mandrake root, bifurcated, black, rough and full of warts and nodes . . . The strange creature burst into tears and, briskly rubbing its eyes, told me in a doleful voice: “Today we must die of laughter!”’ A merry dance began, cherubs cackling in a circle around a troupe of half-human, half-animal creatures. One of the few guests not to have sampled the green paste began to play the piano, and Gautier enjoyed the finest musical sensations he had ever known.

Predictably, the dream turned to nightmare. The strange man reappeared, telling the poet he had an elephant’s head. Gautier promptly verified the fact in a mirror. ‘One could have taken me for a Hindu or a Javanese idol: my forehead had grown, my nose, elongated into a trunk, fell onto my chest, my ears beat at my shoulders, and to make things even more unpleasant, I had turned an indigo hue, like Shiva, the blue god.’ He recovered his head, only to find that the half-human master of ceremony was at the same time holding it in a handkerchief. Gautier tried to leave, but his legs felt as of marble. The house’s stairwell turned into an abyss. A demon barred the way beyond, growling and green-eyed, egged on by the host to bite Gautier. At last our poet made it into the courtyard. ‘The odious fiend entwined me within the net of its legs and, its hands clinging at me like clamps, pulled me back up and, to my despair, plunked me back into the lounge from which I had only escaped with so much anguish.’ Gautier lost consciousness. ‘Your carriage is waiting downstairs,’ he next remembered being told. Returning home, utterly lucid, he was surprised to find that the evening had barely begun.

Hashish, at the time of Gautier’s escapade, was a barely known, obscure product in Europe. The paste is derived from the cannabis plant, also known as hemp. It is obtained from the same bush as marijuana, the difference being that marijuana consists of the dried flowers and upper leaves, whereas hashish is a resin extracted by rubbing the plant, or specifically the tiny hairs (trichomes) found on it. While Europeans had long cultivated hemp, until the nineteenth century they had only known it as a source of fibre for cordage.

A contemporary horticultural journal describes how, in India, it was cultivated in a different manner: ‘Instead of being sown thick as it ought to be when intended for cordages, it is sown thin by the natives who afterwards transplant the young plants and place them at distances of 9 or 10 feet from each other. The effect of this is to expose them more freely to light, heat and air, by the agency of which the plant is enabled to perfect its secretions in a more complete manner.’3 The Indians understood that only the female plant was a source of intoxicant. Their variety, Cannabis indica, was also more potent than the European Cannabis sativa. Planting began in March or April. The peasants ploughed and ridged the field multiple times to place the saplings. They pruned the bushes of their lower shoots. In November an expert came to identify the male plants, which were weeded out. Female shoots were moved into the empty spots created, further spacing out the plants. Flowers sprouted in January. When they turned yellow or brown, the field was harvested.4

Though the first-century Greek botanist Pedanius Dioscorides listed cannabis in his medical classic De materia medica, it was the Indian variety that had entered European pharmacopoeias in the 1700s.⁵ In the United States the medical journals confirm it was used against such ailments as venereal disease, chorea, strychnine poisoning, insomnia and migraine.⁶ A British pharmaceutical manual dated 1813 wrote that cannabis leaves ‘are also sometimes given in cases of Diarrhoea and, in conjunction with Turmeric, Onions and Warm Ginglie oil, are made into an application for painful, swelled and protruded Piles’.⁷ In the 1840s the Irish doctor and inventor William Brooke O’Shaughnessy, based in India, found that it could be useful for treating menstrual pains and hydrophobia in rabies patients, as well as ‘cholera, delirium tremens, tetanus and other convulsive diseases’.⁸

As an intoxicant, nevertheless, cannabis remained something foreign. Hashish had come to French attention when Napoleon had invaded Egypt in 1798. The French, in the few years that they spent there, noticed that the locals had a secret for working hemp leaves into ‘marvellous compositions, prone to procure, during sleep, diverse imaginary pleasures and the dreams one desires’.⁹ The Egyptians ate it as a jam or smoked it mixed with tobacco.¹⁰ They even sold it in special shops: ‘All these preparations, of which both city and country dwellers made great consumption, are not to be found among druggists, like simple medicines; they are retailed in specialized shops, widespread among the Egyptian towns.’¹¹ Even so, as of the early nineteenth century, Western knowledge of the hemp drug remained minimal, basically limited to the medieval legend of the Old Man of the Mountain and his hashish-eating assassins – a story set in the Middle East and popularized by Marco Polo and John Mandeville. Gautier’s hosts at the Hôtel Pimodan had baptized their little society the Club des hachichins, and he eagerly explained that the green paste he had been handed by the ‘doctor’ was the same drug the medieval sage had once given to his faithful.¹²

More so than cannabis, opium was a widely used medicine in Europe, and it could even be described as a popular product. As early as the fourteenth century, Raymond Chalmel de Viviers is on record for having prescribed theriac, an opium-based preparation, to Pope Clement VII.13 In the 1660s the English physician Thomas Sydenham had invented an alcoholic opium tincture that became known as laudanum. By the early nineteenth century opium pills and laudanum were widely used as painkillers throughout Europe and the United States. Just as in China, opium was employed to treat a broad variety of ailments, including the catch-all categories that were fevers, inflammations and neuralgias, plus a long list of more specific conditions ranging from rheumatism to lockjaw.¹⁴

In Britain and the United States opium and its preparations were available everywhere, not just in pharmacies. Drugstores and even grocers sold opium, whose distribution, at the beginning of the century, remained unregulated. There were opium pills, lozenges, powders, plasters, enemas and liniments. Opium entered into a number of branded preparations, the precursors to modern pharmaceutical products, known as ‘patent medicines’. Long-famous preparations such as Dover’s Powder and Bateman’s Drops were joined from the mid-century by Collis Browne’s Chlorodyne, Godfrey’s Cordial, Dalby’s Carminative and Mrs Winslow’s Soothing Syrup, the last three explicitly aimed at the market for children.¹⁵

Nor were opiates an elixir for the rich. A Nottingham chemist reckoned that in 1808, upwards of 200 lb (91 kg) of opium and above 600 pints (340 l) of Godfrey’s Cordial were retailed to the poorer classes in his town. In the marshy region north of Cambridge known as the Fens, opium was widely consumed by people of limited means, who took it to deal with swamp fever.¹⁶ Some of this opiate consumption even stood at the border between medical and recreational: the housewife who gave Mrs Winslow’s Soothing Syrup to her infants to put them to sleep, the sufferer from toothache who had become accustomed to his or her daily draught of laudanum, the Fenland boatman who took opium pills to cure hangovers. The writer and chemist William Howitt observed, speaking of Lancashire mill workers:

I have contemplated with horror the rapid increase of the consumption of opium, and its spirituous laudanum, within the last ten years. The ravenous fierceness, with which opiumeaters enter the druggists’ shops, when want of money has kept them from their dose beyond their accustomed time of using it, and the trembling impatience with which they watch the weighing of the drug (every moment appearing to them an age), and the avidity with which they will seize and tear off their wonted dose, and swallow it – are frightful to be seen.17

Yet there was a difference between self-medication, even of the compulsive kind, and recreational drug taking. Perhaps some continued to eat their pills after the medical need had passed: taken for leisure, the perception was that drugs belonged in traveller’s tales from the Levant or the Far East. There had been attempts to cultivate the poppy in Britain and in parts of the United States, but in Europe as in North America, raw opium was essentially an Asian import. The vast majority of it arrived from Turkey, with smaller volumes coming from Persia and India.¹⁸ The drug retained a foreign identification, specifically an Oriental identification. The Baron de Tott described Turkish opium eaters in the eighteenth century: ‘The most experienced swallow four of these, larger than olives; and every one drinking a large glass of cold water upon it, waits in some particular attitude for an agreeable reverie, which, at the end of three quarters of an hour, or an hour at most, never fails to animate these machines, and make them gesticulate in a hundred different manners, but they are always very extraordinary and very gay.’¹⁹ While Turks might be known to chew opium for pleasure and Chinese people to smoke it in large volumes, such behaviour was not believed to involve Europeans or Americans.

The same could be said of hashish, and Gautier’s text was in this sense revolutionary. So was another, more substantial work destined to become a classic: Thomas de Quincey’s Confessions of an English Opium-Eater. A handful of personalities are known to have been opium devotees before the publication of De Quincey’s Confessions in 1821: the conqueror of Bengal Robert Clive, for example, and the antislavery campaigner William Wilberforce. So, notoriously, was the poet Samuel Taylor Coleridge. But what De Quincey did for opium, and after him Gautier for hashish, was different: they explicitly engaged with the use of drugs as intoxicants.

De Quincey’s Confessions, of novel length but written in autobiographical style, was a literary work, not a treatise. In many respects, including its allegiance to the confessions genre, it was a typically Romantic piece. Yet it delved in unprecedented detail into the relation between opium intoxication, the senses and the self. Physical bliss, inner exploration, an incomparable elevation of his artistic spirits: numerous were the pleasures of opium as De Quincey described them. Even the book’s section on the unavoidable pains associated with managing and eventually shaking his habit contained much to make the drug look beguiling, the source of intense poetic visions. The very title, with its mention of not just any opium eater but an English opium eater, itself highlighted the incongruousness of using opium for pleasure under a northern clime. De Quincey repeatedly played on the difference:

Under the connecting feeling of tropical heat and vertical sunlights, I brought together all creatures, birds, beasts, reptiles, all trees and plants, usages and appearances, that are found in all tropical regions, and assembled them together in China or Hindostan. From kindred feelings, I soon brought Egypt and her gods under the same law. I was stared at, hooted at, grinned at, chattered at, by monkeys, by paroquets, by cockatoos. I ran into pagodas, and was fixed for centuries at the summit, or in secret rooms; I was the idol; I was the priest; I was worshipped; I was sacrificed. I fled from the wrath of Brama through all the forests of Asia; Vishnu hated me; Seeva lay in wait for me. I came suddenly upon Isis and Osiris; I had done a deed, they said, which the ibis and the crocodile trembled at. Thousands of years I lived and was buried in stone coffins, with mummies and sphinxes, in narrow chambers at the heart of eternal pyramids. I was kissed, with cancerous kisses, by crocodiles, and was laid, confounded with all unutterable abortions, amongst reeds and Nilotic mud.20

The book’s reception, often quizzical, bore testimony to the novelty of its topic. The Lady’s Monthly Museum explained that until the publication of De Quincey’s work, the effects of opium were known only from reports out of Turkey and other Eastern countries. ‘Opium, however, neither brutalizes the faculties, nor injures the constitution, like vinous liquors or spirits. [Nevertheless] the philanthropic object of the author of these Confessions is to supply motives to avoid the habit of taking this inebriating drug: and this he has done by a forcible and vivid description of the complicated sufferings which he has incurred.’21 The British Review and London Critical Journal cautiously praised as proofs of the power of opium ‘the sublime pictures of ideal combinations which have been drawn upon his fancy, and engraved upon his pages’.²² The Eclectic Review’s appraisal was more double-edged: ‘The work is written throughout in the tone of apology for a secret, selfish, suicidal debauchery: it is the physical suffering consequent upon it, that alone excites in the Writer a moment’s regret. In a medical point of view, the work is quite worthless: in a moral point of view, it is truly affecting.’²³

Whatever the critics grasped or failed to grasp, the Confessions were a runaway publishing success. At first anonymously serialized in the London Magazine in 1821, they came out in book form within a year. They were soon reprinted and translated into multiple languages – into French, for example, in 1828.²⁴ They brought De Quincey over-night fame. His book had set the Western world alight with the idea, whether it was to be emulated or loathed, that drugs were to be taken recreationally.

Perpetuating its influence, the work would find many imitators. It even pioneered an entire genre, running from Gautier’s Club des hachichins all the way to William S. Burroughs’s Junky and the 1996 film Trainspotting. After De Quincey, the idea of drugs as intoxicants became established. There was a Hasheesh Eater, published in 1857 by an American.²⁵ George Eliot’s Middlemarch had one of its characters become dependent on opium, and so had Anne Brontë’s The Tenant of Wildfell Hall.²⁶ Dickens’s The Mystery of Edwin Drood featured opium smoking in the heart of London, and Wilkie Collins’s detective novel The Moonstone used opium’s intoxicating properties to drive the plot. Though for now confined to literary tradition and bohemian types, drug taking for pleasure was at last recognized as a practice liable to be taken up in Europe and America.

So far there was nothing fundamentally disruptive to the development. Characters who fell prone to the opium habit were rarely completely innocent, but their problems were their own. De Quincey’s and Gautier’s own texts were at heart Gothic fantasies, harmless and even comic in parts. Another landmark in the genre was Charles Baudelaire’s Les Paradis artificiels. Baudelaire’s text comprised, as its second half, a palimpsest of De Quincey’s ode, but its first part was an original appraisal of hashish – which the poet, an inveterate opium habitué, rated the more dangerous of the two drugs.27 (Of the hashish eater: ‘He wanted to be as an angel, he became a beast.’²⁸) Baudelaire’s text, at least in France, would, like De Quincey’s, enter the canon. This would prove significant, as the French literature in turn became influential in causing cannabis to be banned under the twentieth-century drug-control system. But Baudelaire’s book also anticipated, by a decade, another major shift. Like The Mystery of Edwin Drood (1870) and Collins’s novel (1868), it stood on the cusp of a second, yet more important tectonic change. Doctors were about to become involved, with quite a different outlook.

In 1872 the Berlin psychiatrist and pioneer of the German asylum system Heinrich Laehr published the case of a patient, a lady he had taken in at the sanatorium Asyl Schweizerhof, who had begun injecting herself with morphine regularly after an operation.²⁹ Deprived of her drug, Mrs H. began to behave very peculiarly.

She began to experience anxiety attacks. She turned on those around her, she shouted, she vomited blocks of a chocolate colour. Her stools thinned out. Her face turned bluish, her eyes sinking in their orbits. Her hands were cold, and she complained of chills and pains in the knees. Her pulse was barely to be felt . . . She abused her carer. She stood up to walk around at night, ran away from the nurse, and refused to be brought back. She managed to secret a knife into her room concealed in a pencil case, and she lacerated her wrists with it. Only the prospect of an upcoming injection could bring any calm.³⁰

After three weeks of treatment Mrs H. began to recover, and she was released after a few months. But this was not the only case Laehr had seen. Patients were increasingly taking morphine on their own. They administered themselves higher doses as the medicine’s effect dulled, with the risk of a resulting accident. It was correspondingly harder to wean them off the drug.

Morphine was invented sometime between 1803 and 1805 by the Hanover pharmacist Frederick William Sertürner, who, having isolated the white, crystalline substance from opium, called it ‘morphium’ after Morpheus, the god of sleep.31 It began to be produced on a commercial scale in the mid-1820s in Germany and Britain and in the 1830s in the United States. An alkaloid of opium, morphine is as a rule of thumb ten times stronger than the raw product, though morphine contents vary according to provenance (at the time, Turkish opium boasted a morphine content in the low to mid-teens, whereas Indian and Chinese opiums typically contained less than 10 per cent morphine). Though, like opium, it began to be employed to treat a wide variety of ailments – it was so powerful, and its range so great, that it came to be referred to as ‘God’s own medicine’ or even ‘GOM’ – morphine was particularly useful in appeasing acute pain, especially during or after surgery.³²

Morphine was at first administered orally or applied locally after the removal of a patch of skin where treatment was needed. A more effective method of administration suggested itself, however, with the invention of the hypodermic syringe in the 1850s. Crude forms of hypodermic administration had existed since at least the seventeenth century, but the syringe was effectively the invention of three men: Dr Francis Rynd of Dublin, Dr Alexander Wood of Edinburgh and Dr Charles Hunter of London. Rynd was the first to record making an injection by means of a hollow needle, in 1845; Wood was the first to use both syringe and needle, in 1853; and Hunter both improved the instrument’s design and demonstrated, in 1859, that the hypodermic method could have a systemic, not just a local, effect.³³ By the 1870s the hypodermic syringe had become a staple of the doctor’s bag. It could also be procured by patients, some of whom soon learned to use it on their own.

A whole corpus of research into drug dependence followed in the groove set by Laehr. The first key publications were also by German doctors. Eduard Levinstein, the director of the well-known Schoenberg-Berlin clinic, came out with a book-length study in 1877, complete with case analyses and suggestions for treatment. His book was translated into English the next year under the title Morbid Craving for Morphia. The neurologist, psychiatrist and journal editor Albrecht Erlenmeyer followed with another work in 1883. Their observations were picked up and added to by French, British and American researchers. Books and journal articles on the topic flourished. As more morphine cases fell under the lens, a new concept began to take shape: addiction.

This is not quite to say that doctors discovered such a thing as addiction in the 1870s, or that they coined the concept ex nihilo from that date. Observers had remarked on opium dependence before, and there can even be said to have existed, among those so aware, a layman’s notion of addiction. Travellers to Turkey and Persia had noticed that opium devotees took huge doses, and that they became restless when in need of the drug. The French traveller to Persia Jean Chardin thus wrote, in 1686: ‘It is certain, that if one should leave off Opium suddenly, he would die for Want of it . . . they dare only appear when the Drug affects them.’34 China was another example. The pamphlet campaign around the First Opium War evinced awareness of the addictive properties of opium. The term ‘addiction’ was itself rarely used, and it meant something different, akin to being dedicated to a thing or an activity, but commentators compared the opium habit to slavery.³⁵ The Foreign Quarterly Review observed: ‘Any one who is once enslaved by it, cannot, it is true, give it up without great difficulty . . . In this state they eagerly return to the cause of their suffering, and strive to drown the extent of their pain by increasing their daily quantum of the fatal drug.’³⁶

Some medical treatises touched on the basics of opiate dependence: tolerance, or the need for increasing doses, and the pains of withdrawal. John Jones, for example, in The Mysteries of Opium Reveal’d provided a list of ‘The Effects of sudden Leaving off the Use of Opium, after a long, and lavish Use thereof’, though nowhere does the book go into opium tolerance.³⁷ Samuel Crumpe observed in 1793 that ‘these doses, however, it generally becomes necessary to augment, and sometimes to very considerable quantities,’ though he showed no awareness of the dangers of withdrawal.³⁸ Doctors, however, had been reluctant to probe their own panaceas too critically, and such examples were the exception more than the rule.³⁹

Layman’s notions moreover lacked the vocabulary and authority of medical fact. The difference was that between folk wisdom and scientific dogma. Medical researchers, having set out to subject opiate dependence to experimental scrutiny, came to classify addiction as a disease.⁴⁰ A disease category opened the door to calls for treatment, voluntary or not, and for control of the drug’s distribution by or through doctors and pharmacists. Limiting drugs to the medical sphere in turn implied prohibiting recreational use.

Addiction research focused initially on morphine and accessorily on anaesthetics such as ether and chloral. Opium and morphine were almost interchangeable, since the second was but a purer version of the first. (Heroin, a yet more potent derivate of morphine, was first commercialized by the German pharmaceutical company Bayer in 1898, but it did not come under scrutiny until later. Amazingly, doctors were at first unaware that it might be addictive, but in any case heroin taking did not take off until the 1910s.41)

Views and information circulated between the various national medical bodies, helping addiction theory quickly spread across borders. American and British journals kept close tabs on what appeared in German or French publications, and vice versa. The first pieces by Laehr, Levinstein and Erlenmeyer were followed by a flurry of comparable surveys in France and, with a small delay, in the United States and Britain. The volume of French addiction research was notably large, led by figures such as the Paris alienist Benjamin Ball and by Oscar Jennings, a British surgeon who practised in France. (If only for reasons of size, these four countries appear to have led the charge into the new discipline. Sweden had seen the first use of the term ‘alcoholism’, coined in 1849 by a doctor named Magnus Huss, yet it saw little professional discussion of drug addiction until the interwar period.⁴² In countries such as Italy, Austria or Poland, the topic attracted only minimal attention – though Austrian and Swiss medical men were known to air their data in German medical journals.⁴³)

The classic statement of addiction as disease was made by Erlenmeyer, who distinguished ‘chronic morphine poisoning’ from ‘morphine addiction’ as ‘two concepts which in no way overlap’.⁴⁴ Erlenmeyer defined the affliction as follows: ‘I understand under the disease “morphine addiction”, alongside the clinical symptoms which through chronic morphine poisoning gradually build up, the pathologically defined, unmotivated addiction of the individual to morphine taken as a pleasurable stimulant, not a medicine.’⁴⁵ Chronic morphine poisoning led to certain observable negative health effects, such as loss of appetite, pallor and so on, but compulsive morphine taking was something else, a disease in its own right.

Addiction theory was destined to live a long, influential life. From the 1880s the concept had integrated the mechanisms of opiate dependence that were tolerance and withdrawal.46 A single term was emerging in each language to designate the condition. In Germany this was Sucht and in France toxicomanie. In English ‘inebriety’, a term encompassing both alcohol and drug dependence, was the more common for a while, but in the early twentieth century it began to yield to ‘addiction’. Everywhere, crucially, addiction was accepted as a condition possessing identifiable symptoms and requiring that doctors interest themselves in its treatment.

What addiction was precisely, how it worked and what it meant to call it a disease was another matter. Addiction’s ultimate nature remained a point of debate, as it continues to be to this day. Was it, crucially, a form of chronic intoxication or a more deep-seated condition? Not everyone agreed with Erlenmeyer. For Levinstein, morphine addiction did not belong to the list of mental diseases, which were ‘caused by changes of the central nervous organs’, while chronic morphine poisoning ‘only causes functional derangements’.⁴⁷ A follower stated: ‘In my opinion, morphine addiction is only a symptom, a consequence of morphine poisoning.’⁴⁸ In France a group of Paris alienists around Benjamin Ball theorized addiction as a mental illness. The cornerstone of their work was to distinguish ‘morphinism’, namely the sum of the symptoms produced by prolonged morphine use, from ‘morphinomania’, a disease. The morphine habit brought ‘a paralysis of the will’. The ‘morphinomaniac’ was sick, and he or she needed to be treated, preferably indoors.⁴⁹ Ernest Chambard, another alienist and a student of the great Jean-Martin Charcot, was doubtful: ‘Why change the name of the morphine habit, whose symptoms, when craving awakens, amount to a veritable mania in the common but so telling sense of the term, in favour of another term describing only an extremely rare form of intoxication?’⁵⁰

One problem was how to explain why some patients seemed to become addicted and not others. Erlenmeyer describes the case of a lady who for fifteen years had suffered from paraplegia. She lay in bed and every day at 6 p.m. suffered a hysterical fit accompanied by acute pain. She was given morphine intravenously to ease the pain, daily, in the same dose of 0.5 grams. She never became addicted.⁵¹ Precisely because he observed such cases, Levinstein’s opinion was that ‘for this reason, the description “morphine disease” is not acceptable and even less so “morphiomania”.’⁵² Going further, the samples on which addiction theory was based contained an inherent selection bias. It relied on cases reported by doctors concerning patients admitted to the asylums they ran or treated within their private practices. By definition, these were people who had developed health problems. If others elsewhere took morphine over long periods of time without suffering from it, they were much less likely to come to attention. There was no control group.

In Britain and the United States, the waters were further muddied by the competing concept of ‘inebriety’ and the influence of temperance. Norman Kerr, a Scottish doctor and the president of a Society for the Study and Cure of Inebriety, wished to establish inebriety as a disease in opposition to notions of ‘moral vice’.53 This could lead into convoluted formulations: ‘If we try inebriety by Dr. Bristowe’s comprehensive and philosophical definition of disease there can be no doubt of the disease element, his definition being “a complex of some deleterious agency acting on the body, and of the phenomena (actual or potential) due to the operation of that agency”.’⁵⁴ Neither could Kerr quite adjudicate on the disease’s nature as a mental disorder: according to him, opium addiction involved both ‘mental prostration and moral perversion’.⁵⁵ Thomas Crothers, editor of the Journal of Inebriety on the other side of the Atlantic, criticized temperance moralists who saw inebriety as ‘a vice from a sin, the only treatment of which is prayer and conversion’.⁵⁶ He nevertheless thought that addicts suffered from a ‘double personality’, sometimes developing criminal tendencies.⁵⁷ According to a Journal of the American Medical Association contributor, finally, morphine addicts should be classified into three groups. The first comprised ‘normal individuals’ who had contracted the habit from pain treatment, but there were also ‘a second larger group of moral degenerates who indulge in the vice of morphinism, and a third, and much the largest group, recruited from among the neuropathic weaklings, from the victims of improper training and lack of early discipline; from the vast army of defectives, who, beginning to lose ground in the race of life, resort to drugs as a spur.’⁵⁸

A meta-study of 1,000 cases of morphine addiction came out in 1897. Everyone agreed on the phenomena of tolerance and withdrawal pains, and on the symptoms enabling diagnosis.⁵⁹ Doctors preferred treating opiate addicts in the hospital or clinic rather than at home, because this enabled them to control the supply of morphine under gradual withdrawal or the symptoms if the sudden method was employed.⁶⁰ Another shared concern was that so many of the addicts they identified came from their own profession: originating in data from multiple countries, the study showed that 50 per cent of male morphine users came from the medical or pharmaceutical profession, and that among women, 15 per cent were nurses, midwives or doctor’s wives.61 The caveat remained, the study recognized, that the nature of the disease itself remained disputed.

At the heart of the question was the extent and point at which the addict surrendered his or her free will. Was it from the outset, past a certain point, or never? Did it depend on the person and on his or her heredity? Was it permanent, or limited to times of withdrawal?⁶²

The stakes could be dramatic. In 1882 the prosecution of the young American doctor George Henry Lamson became an international press sensation. Lamson practised medicine in a seaside English resort. Married, he had a brother-in-law who had been paralysed for several years and who was also the owner of a fortune which, upon his death, his sister would inherit. Lamson had one day visited the invalid at the boarding school where he lived and administered to him a powder which he said was sugar. Half an hour later, the victim was shaken with spasms and bouts of vomiting, and he expired in the evening. Within a week Lamson was charged with murder. The inquiry revealed that he had administered aconite, a deadly vegetable poison, to his helpless relative. The evidence was overwhelming, and the court sentenced him to execution.⁶³

The case took a controversial turn when letters arrived from America testifying to the defendant’s addiction. Lamson had been injecting himself with large doses of morphine for some time, having begun to do so to treat neuralgias. He was known to take the drug up to sixteen times a day and had been seen handling his needle in the street. His behaviour had long been erratic, both during his time as an army doctor in Turkey and back home, where he had previously prescribed aconite in dangerous doses. One day, without motive or explanation, he shot a gun from his window. Lamson had returned from a trip to Paris to give himself up after having committed his crime, suggesting he did not quite realize what he had done. The American Secretary of State wrote in person to ask that his compatriot be allowed to plead insanity. Lamson’s fate fell hostage to medical controversy. The British Medical Journal, for one, found against him. The journal accepted that Lamson ‘was addicted to the use of narcotics’ but opined that ‘irresponsibility for criminal conduct cannot be admitted in anyone addicted to such drugs, unless a continuous state of mental disorder, abolishing the knowledge of right and wrong at the time of committing the act, has been set up by them . . . It is only when a mental state analogous to delirium tremens [arises] that insanity of such nature as to exempt from punishment can be said to exist.’64 The appeal failed. Lamson hanged. English justice was more severe than the French, commented Benjamin Ball. According to him, Lamson’s morphine habit ‘had perverted [his] moral sense while having left his intelligence sufficiently intact to conceive and execute a crime whose gravity and consequences he could not understand . . . It is regrettable that certain English medical press organs found it their duty to intervene and proclaim the defendant’s full responsibility, shutting the mouth to those who would have spoken up for him.’⁶⁵

More generally, questions of free will and addiction were fundamental to the long-term regulatory prospects of opiates and other drugs. If drugs deprived the user of his or her free will, there was a rationale for intervention by a higher power, be it a medical authority or the state itself. Robbing someone of their free will by selling them drugs might be construed as a crime. Deprivation from his or her capacity for choice potentially qualified the patient for medical confinement, though not, under the same logic, for imprisonment. Whether addiction was a ‘disease of the will’ was not a mere question of theory.

In the space of the last few decades of the nineteenth century, the medical bodies on either side of the Atlantic had coined a new term to characterize the drug habit: ‘addiction’, which they categorized as a disease. Modelled on the effects of opiates, especially morphine, this conceptualized the key mechanisms that were increased tolerance and acute withdrawal pains. The doctors also agreed on the symptoms on which to base their diagnosis and on the necessity for treatment. At the same time, the concept remained half-baked: it rested on incomplete and therefore skewed samples, it mixed unprovable moral assumptions together with its science, and it failed to reflect any agreement on the fundamental nature of the disease, if this was what it was. None of this would prevent it from becoming yet more firmly entrenched as another drug came under medical scrutiny: cocaine.

For centuries, the coca leaf had remained confined to the Andes, where the locals had chewed it for strength, endurance and enjoyment. Then, in 1859, a naturalist returning from Peru delivered a sheaf of it to the Göttingen chemistry professor Friedrich Wöhler. Wöhler passed this on to a student, Albert Niemann, thinking that it would be interesting if he could isolate its principal active agent as part of his doctoral thesis. The next year, Niemann announced that he had invented cocaine.66

Cocaine is a radically different substance from opiates. Rather than drowsiness, it induces wakefulness. A stimulant, it creates a sense of euphoria and energy that tends to peak rapidly. It nevertheless possesses the ability to dull pain locally. The Darmstadt-based company Merck, a pharmaceutical firm that also made morphine, began producing it a year after Niemann’s discovery. There was at first little uptake but this changed when in 1884 the Austrian ophthalmologist Karl Koller used it as an anaesthetic while performing eye surgery. Koller’s innovation immediately made medical news. The excitement was that local anaesthesia made accessible operations that had previously been hard or impossible to perform, such as on the eye but also the nose and throat. Before that, surgeons could either choose general anaesthetics such as chloroform or ether or use no anaesthetics at all. Cocaine enabled them to perform delicate operations, or operations in which the patient needed to be awake. By the end of the year, it was being adopted by doctors around the world.⁶⁷

The attention generated soon ensured that cocaine was taken up in other therapeutic areas. In November 1884 the American Medical Record described the contraction in the mucous membrane that followed an application of solutions of cocaine. Doctors began to use the drug against hay fever, asthma, catarrh and colds.⁶⁸ Its virtues as a stimulant were also discovered, and it became popular for treating nervous diseases such as neurasthenia. Another area where it appeared promising was in treating morphine addiction.

Notoriously, an early experimenter in this application was Sigmund Freud, a colleague of Koller at the same Vienna hospital. Freud was ambitious and eager to make a name for himself. He had befriended the pathologist Ernst von Fleischl-Marxow, who had taken to morphine after an operation. Freud decided to test cocaine on Fleischl-Marxow following morphine withdrawal, and he began to give the drug to his friend in 1884. ‘I expect it will win its place in therapeutics, by the side of morphine, but superior to it,’ Freud wrote. Without waiting for the results of his experiment, he published a piece entitled ‘Über Coca’, proposing the product as a stimulant as well as a remedy for indigestion, anaemia and depression. He also proceeded to try his panacea himself. ‘I am as strong as a lion, gay and cheerful,’ he announced. ‘I am very stubborn and reckless and need great challenges; I have done a number of things which any sensible person would be bound to consider very rash.’ Freud’s enthusiasm did not earn him the glory he expected. He soon became involved in a controversy with Erlenmeyer, who sounded the alarm over the risks of using cocaine to treat morphine dependence. Meanwhile Fleischl-Marxow, far from quitting morphine, began taking both drugs simultaneously. He died in 1891, his health probably not bettered by the experiment.69

At some stage, Freud had protested to Erlenmeyer that cocaine was not addictive and that the symptoms he observed and objected to were due to morphine. Freud had a point. A number of doctors tried cocaine on morphine addicts around that time. The data on cocaine were tainted, marred by the presence of so many morphine users within the samples. In 1886 Erlenmeyer published observations on thirteen patients who had been treated in this way: ‘He thus climbs onto ever higher doses. Now he wants to separate himself from cocaine of his own will, but it is not possible anymore . . . He needs cocaine in order to be able to work, he desires cocaine – he is a cocaine addict.’⁷⁰ Actually cocaine differs from opiates in that it involves sharply rising tolerance, but far less marked and more short-lived withdrawal symptoms.⁷¹ The case against it is probably in the far-from-negligible risk of overdose rather than in its addictive properties. But doctors looking for generalizations insisted on the hallucinations that sometimes characterized withdrawal, including the illusion that one had ants crawling under the skin, or ‘formication’. It was not the last time that a drug quite dissimilar to opiates would be made to fit an addiction model originally devised for them.

Paradoxically, the poor data only helped cocaine gain a reputation as an addictive drug more quickly and surely. The Lancet warned of the danger as early as 1887: ‘To summarise. Cocaine may be toxic, sometimes deadly, in large doses. It may give rise to dangerous, or even fatal, symptoms in doses usually deemed safe. The danger, near and remote, is greatest when given under the skin. It may produce a diseased condition, in which the will is prostrate and the patient powerless – a true toxic neurosis, more marked and less hopeful than that from alcohol or opium.’72 According to the Philadelphia-based Medical and Surgical Reporter, the cocaine habit was already ‘one of the three scourges of mankind’. Borrowing information from the Therapeutische Monatshefte, it explained: ‘General mental weakness may set in rather early, to be observed in a loss of memory and unusual prolixity in conversation and correspondence. When the drug is withdrawn, besides the vaso-motor symptoms there may be seen depression, impairment of will-power, weeping, etc. The chronic form does not protect from acute intoxication.’⁷³

As with opiates, doctors were alarmed to find that many cocaine addicts came from among their own. The case of Dr Charles Bradley of Chicago made a strong impression. Bradley had begun experimenting with cocaine in 1885, having been led to believe that it was harmless. The drug ‘gave him such a sense of well-being as he had never experienced before, the sense of complete repose and self-satisfaction it produced being much more marked than that derived from opium’, according to a friend. Bradley increased his dose until he reached 1 gram per day, injected hypodermically. He gave cocaine to his family, much like Freud declaring that he would ‘revolutionize medicine generally, and become the world’s benefactor’. But he only ended up mortgaging his house, reducing his children to poverty. He began to decline physically, and an acquaintance persuaded a judge to commit him to an asylum. Bradley interrupted his stay and fled to Canada. In 1887 the police arrested him, back in Chicago, after he had turned on a gas jet at a drugstore where he had been refused the drug. According to a newspaper account, he was ‘suffering from acute mania, convulsions, and every distressing phase of violent insanity [and was] reduced to a skeleton’.⁷⁴

Cocaine had meanwhile found a profitable home within the unregulated, unsupervised patent medicines. Their range was broad: from low-concentration toothache drops, haemorrhoid remedies, habit cures for inebriety and lozenges for throat aid all the way to asthma and catarrh cures exhibiting a much higher pure cocaine content. There were Cocarettes, produced by a St Louis firm, Coca-Bola, a chewing paste with cocaine, and Lloyd’s Cocaine Toothache Drops. Catarrh cures – Agnew’s Catarrhal Powder, Birney’s Catarrh Powder, Coles’ Catarrh Cure – were to be taken by sniffing.75 All these products were widely advertised, as was pure cocaine, though in this case the target was not the end user but the doctor. The principal American producer of cocaine, Parke, Davis, & Co., used sales and marketing tactics prefiguring those deployed by Purdue Pharma and the opioid manufacturers at the turn of the twenty-first century. Parke, Davis owned a pharmacological laboratory whose researchers placed papers in the medical press. The firm had established a publishing enterprise to disseminate favourable information on its products, among which was cocaine. Its publications, the Medical Age, New Preparations, Bulletin of Pharmacy and Therapeutic Gazette, reprinted articles from New York and Philadelphia medical journals, but negative findings were less likely to make the cut.⁷⁶ How gullible the consumer was may be debated. In Chicago, ‘the proprietor of a large downtown drug store noticed several years ago that at noon numbers of the shop girls from a great department store purchased certain catarrh powders over his counter. He had his clerk warn them that the powders contained deleterious drugs. The girls continued to purchase in increasing numbers and quantity. He sent word to the superintendent of the store. “That accounts for the number of our girls that have gone wrong of late,” was the superintendent’s comment.’⁷⁷

All this would in due time badly harm cocaine’s reputation. Also responsible for the drug’s shooting-star trajectory from wonder cure to Devil’s dust was that coca itself had been enjoying a parallel turbulent career. Wöhler and Niemann’s interest in the coca leaf had not been entirely random. European botanists having catalogued the plant in the eighteenth century, from the 1820s travellers had been remarking on its Andean use as a stimulant.⁷⁸ In the 1860s such reports came to the attention of an enterprising chemist from Corsica, Angelo Mariani. Mariani was excited by the leaf’s potential as the basis for a consumer product. In 1871 he began commercializing a tonic made from Bordeaux wine and coca named Vin Mariani.⁷⁹ From France, Angelo Mariani sent his brother-in-law Julius Jaros to New York to open an American branch, and his Americanized version was an immediate success.⁸⁰ The firm also sold a Pâté Mariani, Pastilles Mariani and a non-alcoholic Thé Mariani. Mariani published lavish testimonies from personalities including famous writers, European kings and even the Pope. The fad for tonics based on coca, and therefore containing small amounts of its cocaine alkaloid, followed in his footsteps: Lambert Company’s Wine of Coca, with Peptonate Iron and Extract of Cod Liver Oil, and the Sutliff and Case Company’s Beef, Wine, and Coca were two examples of popular me-too products.81

Both the demand for tonics and patent remedies of various kinds and the medical appeal of pure cocaine induced a manufacturing boom. In Germany Merck was followed by Gehe, Knoll & Co., and by Böhringer.⁸² German and American firms alike suffered from quality problems because the leaf tended to decay in transit. In response, they began to move refining facilities to Peru. Skyrocketing demand fed a fast expansion in cultivation. Peruvian cocaine exports sextupled between 1890 and 1900 alone. The bonanza in turn encouraged a local pharmacist, Alfred Bignon, to develop a simplified method for producing cocaine using fewer and more readily available chemicals – namely kerosene and soda ash. In the twentieth century Bignon’s more easily portable method would become popular with Andean narcos; for now, it fed a Peruvian coca pride that manifested itself in a flurry of publications vaunting the drug.⁸³ Yet even the Peruvians were compelled to look over their shoulders: from 1883 the Dutch, finding the soil and climate propitious, began cultivating coca in Indonesia. Indonesian coca leaf exports took off in the early 1900s, and they briefly displaced the Andean variety, achieving a volume of 800 tons shortly before the outbreak of the First World War.⁸⁴ All this was purchased by the Nederlandsche Cocainefabriek, established in 1900 and by 1910 the largest single cocaine manufacturer in the world.⁸⁵

The most successful of the coca-based tonics, of course, was Coca-Cola. The future world-famous drink, too, may have originated in a case of morphine addiction. Its inventor, the druggist John Pemberton, had been shot and slashed with a sabre during the Civil War, and he suffered from various ailments. Pemberton is known to have become dependent on morphine. Though his interest in coca was long-standing, judging from the timing of his invention it is almost certain that he read of cocaine’s ability to relieve his condition. In 1885, taking his cue from Mariani, Pemberton advertised a Coca Wine as ‘infallible in curing all who are afflicted with any nerve trouble, dyspepsia, mental and physical exhaustion, all chronic and wasting diseases, gastric irritability, constipation, sick headache, neuralgia . . .’. His new drink was recommended to all ‘who require a nerve tonic and a pure, delightful, diffusible stimulant . . . a sure restorer to health and happiness’.86

Pemberton never got rich from the brand he created: he sold it in 1888, having removed wine from the formula two years before. By 1900 Coca-Cola had become a phenomenon in the hands of its new owner, the Coca-Cola Company, and its main shareholder and director, Asa Candler.⁸⁷ The cocaine content, though, attracted controversy. In 1898 a zealous evangelist named Lindsay arrived in nearby Marietta, Georgia, and became the minister of the local Baptist church. From the pulpit, Lindsay launched a virulent attack on Coca-Cola, the ingredients of which, he was certain, were two-thirds cocaine. Imbibing it, he asserted, was tantamount to ‘morphine eating’.⁸⁸ This being the post-Civil War South, the Atlanta Constitution wrote: ‘Use of the drug among negroes is growing to an alarming extent . . . It is stated that quite a number of the soft drinks dispensed at soda fountains contain cocaine, and that these drinks serve to unconsciously cultivate the habit.’⁸⁹ The Internal Revenue Service sued Coca-Cola based on its health claims, in a trial that lasted until 1902. This and the negative publicity convinced the company to remove the alkaloid from its drink: in 1903 Candler contracted with the Schaefer Alkaloid Works of Maywood, New Jersey, to de-cocainize the leaves before sending on ‘Merchandise No. 5’ to Atlanta.⁹⁰ In the long term at least, the controversy did not harm the drink. Alongside the boom in cocaine-based patent medicines and the other coca tonics, however, it confirmed cocaine’s reputation as a ubiquitous drug with an insidious reach.

How many drug users there may have been in the United States or the larger European countries at the time is difficult to ascertain, but the numbers are unlikely to have been very high. Some doctors blamed Germany’s 1860s wars of unification for having spread morphine use there. Soldiers given morphine to relieve the pain of battle wounds would have remained addicted as veterans. The evidence for this, though, is poor. Germany’s overall rate of opiate consumption remained low as of the turn of the century: between 225 grams and 545 grams (0.5 and 1.2 lb) raw-opium equivalent per 1,000 population, compared to 4.8 and 5.2 kilograms (10.5 and 11.5 lb) respectively for Britain and the United States.⁹¹ The overwhelming concern in the German literature was the spread of morphine addiction by doctors, whether among themselves or their patients. One survey found some military men among its sample of morphine users, but 46 per cent were doctors.92 Another reported that there were no known cases of opium overdose in the country.⁹³

This in turn sheds doubt on the notion that the Civil War was responsible for spreading morphine use in the United States.⁹⁴ Enthusiastic prescribing and straightforward availability are likely to have done much more. As most addiction was ostensibly iatrogenic (of medical origin), trying to calculate addict numbers is almost meaningless: most opiate-dependent users may well have been palliating chronic pain. Contemporaries nevertheless bandied around numbers varying from 80,000 to 200,000. The New York Times offered a number of 200,000 in 1878, while the specialist Thomas Crothers thought 100,000 approximately right in 1902.⁹⁵ The most serious attempt at an estimate has been made by the historian David Courtwright. Courtwright collated and compared information from different sources, including ratios of total opium imports to average use, surveys of doctors and pharmacists performed at various dates, and army enlistment data. His conclusion was that the U.S. addict population peaked in the 1890s, and that it cannot have exceeded 313,000.⁹⁶ Courtwright’s concern, however, has been to establish a conceivable maximum, not a probable mean. His data purposely assume nil medical consumption. Using the same basis to arrive at a reasonable average yields a total of perhaps 120,000, or 0.2 per cent of the country’s population – a number, incidentally, that is consistent with doctor and pharmacist surveys.⁹⁷ Courtwright’s point, moreover, stands that this population peaked well before the establishment of federal drug prohibition.

Estimates of the number of recreational cocaine users are even more tentative, but the total may have been around 25,000 at its maximum, around 1903.⁹⁸ Most of this consumption is likely to have come in the form of patent powders and catarrh cures, though there is tentative evidence of employers having distributed cocaine, with the goal of enhancing workforce performance, to stevedores and other dock labourers on the Mississippi River, in road construction and among Ohio mining communities.⁹⁹ This would place the total number of American recreational drug users, opiates plus cocaine, at just under 150,000 out of a population of 76 million. The combined peak would have occurred around 1900.

The legislator had by then taken steps to tighten availability. Britain passed a Poisons and Pharmacy Act in 1868 limiting the sale of a list of substances to pharmacies – though the law made no demand for medical prescriptions and left patent medicines out.100 Another Act dated 1908 placed cocaine on the list and asked that the buyer be known to the druggist. In the U.S. federal legislation would have to wait until 1909, but a number of states and municipalities began regulating opiates and, later, cocaine. Pennsylvania enacted the first anti-morphine law in 1860, and Illinois the first measures against cocaine in 1897. The District of Columbia caught up on both in 1906. (State anti-morphine laws differed, but they typically left patent medicines untouched while requiring that pure drugs be purchased at a pharmacy and with a prescription to be retained for inspection for a period of time.¹⁰¹ Cocaine laws likewise varied: Louisiana required affidavits that retailers were not selling to ‘any habitual user’, while Chicago merely limited packaging to small sizes.¹⁰²)

In France and in Prussia, opiates had from the early nineteenth century only been allowed for sale on prescription and at pharmacies, including the relevant patent medicines.¹⁰³ In 1872 the principle of the pharmacist’s monopoly on sales of opiates was extended to the whole of the German empire, and in 1890 this was expanded to include cocaine.¹⁰⁴ From 1896 the need for a prescription likewise became law throughout Germany.¹⁰⁵ The French rate of opiate consumption was even lower than the German: 240 grams (0.5 lb) per 1,000 population as of the early 1900s, or something like one-twentieth of the British and American rates.¹⁰⁶ The far higher levels of opium use observable in the UK and USA confirm that letting pharmaceutical manufacturers and distributors run wild does spread addiction, a lesson the USA would have to learn again with the twenty-first-century opioid epidemic.

The main point, however, is that incipient prohibition was not motivated by rising addict populations. Public concern and/or agitation spurred regulation, yet activism itself did not reflect growing drug use. The correlation between spreading anti-narcotic fears and user numbers was nil. International comparison confirms it. Britain, with a rate of opiate use that approached that of the United States and in all likelihood comparable addiction rates, saw remarkably few drug-related press cuttings. The odd affair in which drugs were involved appeared in the newspapers, such as the Lamson story, but any coverage of drug use as such, sensationalist or not, was extremely rare.107 By contrast, France, with its basically non-existent addict population, was the scene of a boisterous drug literature and feverish press interest.

The French literature grew around 1900 to remarkable proportions, to include both novels – Marcel-Jacques Mallat de Bassilan’s La Comtesse morphine (1885), Jean-Louis Dubut de Laforest’s Morphine (1891), Jules Boissière’s Fumeurs d’opium (1896), Pierre Custot’s Midship (1901), M. D. Borys’ Le Royaume de l’oubli (1909) – and nonfiction: Maurice Talmeyr’s Les Possédés de la morphine (1892), Fabrice Delphi’s L’Opium à Paris (1907) and Richard Millant’s La Drogue (1910), to list but a few.¹⁰⁸ Such interest seeped into the press, which developed a prurient attention to drug-related stories. ‘If you love life, fear morphine,’ Le Matin splashed on its front page in 1912. ‘Craving for morphine can push people to the worst expedients and the most shameful manoeuvres . . . A factor of depopulation and degeneracy, the morphine mania is a hateful vice destroying the best minds and degrading the strongest and most generous natures, especially as every morphine manic seeks to makes proselytes.’¹⁰⁹ For Le Petit Parisien, ‘“coco” [cocaine], as all night establishments have baptized it, is of every party, every orgy, and is master of all. Its victims have become innumerable.’¹¹⁰ The daily ran the story of Simone Floch, twenty years old, a former maid and ‘a pretty girl’. A victim of heartbreak, Floch had launched into ‘the world of gallantry’ and started to take morphine, then cocaine. Her discovery one morning, dead from an overdose, had led the police to her purveyor, Henri Jarzuel, aka ‘the coco merchant’, who in turn had been found, upon arrest, with three young women sleeping next to him . . .

Rather than France’s scarcely more than anecdotal prevalence rates, this intense interest reflected established anxieties. It was the imagined threat, seen through the prism of pre-existing dislikes, that made drugs seem dangerous. France had lost a war to Germany in 1871, and the perspective of revanche was slipping ever further as German demographic growth outran the French. Drugs were seen as a hindrance to national recovery. In 1907 a scandal had erupted over a blackmail and spying affair involving a young naval lieutenant, Charles Benjamin Ullmo, who had taken up opium smoking and had been prepared to sell military secrets to the Germans.¹¹¹ Another obsession was that the Indochinese colony’s reliance on opium was sullying France’s civilizing mission. In Paul Bonnetain’s L’Opium, the hero begins the novel by accepting a junior post as an administrator in Cochinchina. In Hanoi he is lured by a Chinese den keeper into trying the drug. His is a downward path of idleness and vice until he dies.112 French writers described opiates as a ‘social poisons’ whose spread threatened to reach Europe from Asia, one author even seeing in this process of contamination a form of revenge from the colonized on the colonizers.¹¹³

Racial prejudice likewise classically informed drug-related fears in the United States. Perceptions that Blacks were predominant among cocaine users, especially in the South, were common. In an article entitled ‘Negro Cocaine Evil’, the New York Times described how from a ‘dreamy state’ resembling an opium trance, the cocaine user passed to ‘one of wild frenzy’.¹¹⁴ In 1901 the Journal of the American Medical Association connected cocaine and the ‘coke habit’ with ‘negroes’ in a blatantly racist call for control.¹¹⁵ (Actually African Americans were unlikely to be proportionately large users of cocaine, if only for economic reasons. In 1914 the medical director of a Georgia asylum reported on 2,100 Black patients admitted in the past five years. Only two had been cocaine users, and they had not even been admitted for cocaine-related afflictions. The director explained that they generally were too poor to buy cocaine, and that reports of ‘cocainomania’ among Blacks published by the newspapers were myths.¹¹⁶) Chinese immigrants were otherwise blamed for the spread of opiate use. One newspaper suggested that Chinese people living in American cities were all ‘addicted more or less to the habit of smoking opium’.¹¹⁷ In 1875 San Francisco passed an ordinance against Chinatown opium dens.¹¹⁸ A magazine commented: ‘Dr. Anderson has witnessed the sickening sight of young white girls from sixteen to twenty years of age lying half-undressed on the floor or couches, smoking with their “lovers”. Men and women, Chinese and white people, mix indiscriminately in Chinatown smoking houses.’¹¹⁹

This newfound vocabulary for commenting on drugs in turn owed to the shifting medical discourse on them. It was addiction theory, and the scientific stamp of disapproval that accompanied it, that made the supposed progression of drug use so frightening and that enabled its resonance with racial bigotry. Both Six années de morphinomanie (1910), by Comte D’Almond, and Léon Daudet’s La Lutte (1907) purported to be based on medical research. The press was apt to quote doctors in distorted, sometimes extreme language: ‘Dr. Graeme Monroe Hammond, the neurologist, says that it is absolutely impossible to cure the cocaine fiend, once the habit has become fixed upon him. “There is nothing that we can do for the confirmed user of the drug,” says he.“The best thing for the cocaine fiend is to let him die. He is of no use either to himself or to the community.”’120 Both addiction disease theory and the compendiums of symptoms listed in medical journals made their way into the popular press, such as the magazine Current Literature:

The habit seems more a disease than a vice, for the whole nature of the victim undergoes a complete revolution, moral, mental, and physical . . . The flesh begins to fall away and the space around the eye becomes dark from being surcharged with blood; the skin loses its normal color and changes to a sodden gray, a blotched brown, or an unhealthy yellow. And then the victim shivers and perspires at the same time, and is easily moved to tears. When this stage is reached there is little hope of a cure. They must and will have the drug, and will resort to any device to procure it.¹²¹

Medical professionals themselves made public statements running far ahead of actual drug-user numbers. In the New York Times, a Dr Catherine Townsend claimed in 1897: ‘A word of warning must be sounded against the use and abuse of opium and its preparations, and of cocaine and chloral. In the United States alone there are 1,500,000 men and women who habitually use opium in some of its forms. The vice is increasing.’¹²² The doctor George Pichon, in an 1893 article, quoted a supposed authority to the effect that France possessed 100,000 morphine addicts. The incredible statistic that Paris hosted 1,200 opium dens somehow became common currency.¹²³

Gone were the highbrow effusions of De Quincey and Baudelaire. Calculated to shock polite society without offending it, these now looked quaint. William Rosser Cobbe complained in Doctor Judas, published in 1895: ‘The evils of the fascinating “Confessions of an English Opium-eater” have been beyond estimate and are daily luring innocents to eternal ruin.’¹²⁴ He warned: ‘The first work of the Judas drug is to double-lock the prison door of the will, so that successful struggle against the demoniac possession is impossible. During the subjection I fought nine times three hundred and sixty-five days against the diabolical master.’125 La Comtesse morphine, by Mallat de Bassilan, was prepared to be even more lurid:

A fresh access had just seized the countess. Plunged into an attack of erotic delirium, she rolled violently around her bed, calling in a pleading voice Hugues, Gontran, baron Slavini, all the men she had loved. She passionately begged for their kisses, fainting under the caresses of these invisible lovers.

Suddenly, pushing her bedding away and tearing off her shirt, she appeared to the assembled domestic staff, who had rushed in at the sound of her cries, stark naked, the decrepitude of her limp body visible to all, her sickeningly wan flesh stained by the blood of her ulcers and the taint of unconsciously loosened excrement.¹²⁶

The nineteenth century had seen opiates transformed, in Western consciousness, from something mysterious and remote into a terrible threat. The patchwork of beliefs that characterized them had coalesced and in the process taken a negative turn. From something chewed on Levantine shores or smoked in Chinese boudoirs, they had travelled, in the public imagination, to become menaces brewing in the heart of the European or American home.

The first step had been the revelation, under the Romantics, that recreational drug use need not be confined to oriental settings. The second had seen medical researchers assume authority over the drug habit. The isolation of morphine and the adoption of the hypodermic syringe had modified opiate use to suit it to the scientific age. This and the interest of an increasingly confident medical profession made it look all the more malign. From being cures, opium, morphine and their derivatives turned into the sources of a disease baptized ‘addiction’. Cocaine joined them into this new club of fallen medicines, or ‘drugs’, which also included such minor concoctions as ether and chloral. In part thanks to a brief boom in coca-based drinks, it helped them all morph from shadowy presence to clear and present danger.

The notion that indulging in intoxicants was a matter of private choice looked increasingly tenuous. Disease concepts of addiction encouraged the idea that the drug user ought to be made the doctor’s charge. In distorted form, they entered the public discourse, where they were found to be of useful service to racial prejudice and associated nostrums about contamination and miscegenation. Opiates, cocaine and other drugs had seen their reputations comprehensively trashed. Calls for official involvement were not far off. For that, nevertheless, a trigger was required. It would come, once again, from the Far East.