by Lucy Inglis
‘This odious disease’: Early Addiction Theories in America and Britain
The close similarities, if not collaboration, between American and British physicians so soon after the American War of Independence may seem surprising, but it was far from unusual, and was particularly important in the early study of addiction. A large, self-improving middle class burgeoned in both countries in the 1740s and 50s, and many educated families had members on both sides of the Atlantic, with intertwined business interests and close personal ties. Debates on the American War in London’s inns and taverns had more often than not voted in favour of immediate peace, even if the colony was lost as a result. Exchange of information and commercial goods was by this stage well established, and many British businesses had an outpost on the East Coast of America, or had frequent contact with them. Many early American newspapers carry advertisements for stock arriving from their London shop, or purchased from London. In the Boston News-Letter of 26 November 1761, Charles Russell of Charleston advertised that ‘At his Shop at the Sign of GALEN’S HEAD opposite the Three Cranes and near the FERRY’, there were to be had all manner of ‘the latest Drugs, and Medicines, Chymical and Galenicals’ from London, including Bateman’s and Sloughton’s Drops, Lockyer’s, Hoopers and Anderson’s Pills, British Oyl and Daffy’s Elixir.61 These drugs were by this time known as patent medicines, and of wildly varying quality. Bateman’s Pectoral Drops were stock paregoric, and there was no Dr Bateman; Lockyer’s Pills were alleged to contain sunbeams, marketed by Lionel Lockyer, a quack in Southwark.
Americans were not only fans of prepared patent medicines, they also took opium in simpler forms. French-born J. Hector St John de Crèvecoeur travelled the East Coast and wrote a memoir titled Letters from an American Farmer, exploring what was then life on the frontiers and the American tenets of independence and self-reliance. Of Nantucket island, he wrote, ‘A single custom prevails here among the women at which I was greatly surprised and really am at a loss how to account for . . . They have adopted these many years the Asiatic custom of taking a dose of opium every morning, and so deep-rooted is it that they would be at a loss how to live without this indulgence.’62
As well as patent medicines and opium, early Americans were drinkers on a similar scale to their British counterparts of one hundred years before: rum from the West Indies was a popular strong drink, but small beer and cider were the most popular, taken at almost every meal. As pioneers moved to the Corn Belt their success at farming meant that, like the European grain gluts that contributed to the Gin Craze, Midwestern Americans began to make whiskey from their crop surplus, and ship it back east. From the late 1770s, there was a marked rise in the consumption of spirits, and the attendant addiction. East Coast clergy were the first to write on this alarming phenomenon, including the abolitionist and Quaker Anthony Benezet (1713–85), who in 1774 wrote The Mighty Destroyer Displayed, about the rising tide of alcohol abuse in Pennsylvania, where ‘Drops beget drams, and drams beget more drams, until they come to be without weight and without measure.’63
Benezet’s student and friend Benjamin Rush, a Founding Father of America, was also concerned about what he thought of as a rising tide of not only intoxication, but disease. Rush’s Inquiry into the Effects of Ardent Spirits on the Human Mind and Body of 1784 is a landmark work in the understanding of alcoholism, and was the beginning of the disease theory: ‘This odious disease (for by that name it should be called) . . .’64 Rush proposed that this disease should be properly treated by physicians, in the correct environment. The gravity of the work is belied in the opening pages, displaying a table of his own devising correlating certain drinks to the result in temperament, appearance, actions and outcomes. Small beer, for instance, results in ‘Serenity’ and cider in ‘Cheerfulness’, but rum in ‘Peevishness’, brandy, ‘Fighting and Horse Racing’ and gin, ‘Perjury’. Should the latter be taken morning and evening for a sustained period, the outcome can only be ‘Burglary’ and ‘Death’.65
Four years later, on 4 July 1788, Rush led 17,000 citizens on an Independence Day march, at the end of which they celebrated with beer and cider, but no distilled spirits. In a sad irony, Rush and Benezet watched their friend, Reverend Nisbet – who had brought his family to America from Montrose in Scotland – lose his son Tom to the most desperate alcoholism. After a series of misadventures involving debt and an aborted career at sea, Tom had walked away from a friend in New York ‘without a word’, drunk, confused, and injured, and trekked towards home for weeks, before taking a canoe trip down the massive Susquehanna River at the beginning of winter. Arriving home in an appalling state, he was eventually confined in Pennsylvania Hospital.66 The strain killed his father in 1804, and Tom followed him to the grave a few months later, insane, unrecognizable and still in Pennsylvania Hospital. Rush continued to campaign against distilled spirits, and went on to devise a ‘Plan for an Asylum for Drunkards to be called a Sober House’ in 1810, the first American to suggest such special care.
By the time Rush devised his plan for the Sober House, his pamphlets were selling in their thousands. In England, in the year Tom Nisbet and his long-suffering father died, Thomas Trotter, recently retired physician to the Fleet Prison, published An Essay, Medical, Philosophical and Chemical, on Drunkenness, and its Effects on the Human Body.
Unlike almost all those who had gone before him, Trotter studied inebriation alone, divorced from religion or morality. His subject was ‘the drunkard, exposed in the street and highway, stretched in the kennel . . . allowed to perish, without pity and without assistance; as if his crime were inexpiable, and his body infectious to the touch’. This level of intoxication, he averred, was classless, and ‘might be seen in all ranks and stations of life’. Trotter sets out his stall clearly from the start: ‘In medical language, I consider drunkenness, strictly speaking, to be a disease.’ The prison doctor is also convinced of the similar nature of dependence upon alcohol to that of cannabis and opium. ‘The effects of opium,’ he writes, are ‘nearly alike to those of ardent spirit’ and it ‘is well known that many of our fair countrywomen carry laudanum about with them, and take it frequently when under low spirits’.67
Trotter’s Essay is a work of great humanity, and although it was not the first to couch persistent drunkenness as a disease, it was the first to treat it without judgement and to compare it to the abuse of other substances. It was republished extensively in America, by that time firmly in the grip of whiskey fever, and inspired temperance preachers and physicians alike in the promotion of what would be known from this point forwards as Sobriety.
A Different Form of Experimentation: The Romantics
In a new age of empiricism and scientific thought, one of the greatest literary movements in Europe, Romanticism, flowered. Nostalgic, rebellious, intellectual and daring, the Romantic movement was a reaction to endless wars, radical changes in the pace of life and the relentless pace of invention and discovery in the latter part of the eighteenth century.
It was perhaps inevitable, with his theories of maintaining ‘excitability’ and experiencing stimuli, that the member of the Edinburgh school of doctors who ultimately influenced the main members of the Romantic movement was the erratic, self-medicating John Brown. Brown’s pupil and acolyte Thomas Beddoes (1760–1808), himself a controversial figure who introduced the notion of hypochondria in his essay Hygëia: or essays moral and medical, on the causes affecting the personal state of our middling and affluent classes in 1802, counted the prominent Romantic figures Thomas De Quincey, Samuel Taylor Coleridge and Tom Wedgwood among his friends and patients. All were opium addicts. Moreover, all the major Romantic poets except William Wordsworth are known to have experimented with or habitually taken opiates, namely, laudanum.
Laudanum and paregoric were by this time endemic in Britain, taken by people of all classes and incomes. The greatest consumers of opiates were those in the poor industrial county of Lancashire, and the poor rural counties of Lincolnshire, Cambridges
hire and Norfolk. In Lancashire, the predominant users were mothers managing long working hours with large families; in the Fenland counties, men used it to ward off the ‘severe ague’ associated with working in cold and wet conditions, and to allay the boredom of hours in the fields. In Manchester, where cotton-spinning predominated, ‘on a Saturday afternoon, the counters of the druggists were strewed with pills of one, two or three grains, in preparation for the known demand of the evening’.68 In the east of England, from the Wash south to Cambridge, demand for laudanum was huge, and it was known as ‘opic’ or ‘elevation’. The working people of the fens had traditionally cultivated white poppies to make poppy-head tea, imbibed to ward off the chills of the marsh and to settle children’s stomachs, but increasingly they were turning to shop-bought patent products. For the inhabitants of these poor communities, both urban and rural, laudanum was cheaper than alcohol, could be used by the whole family and bore little social stigma.
For the Romantic poets, removed from these mundane working lives, laudanum was a different means of elevation. Or at least so they believed initially. De Quincey, Coleridge and Wedgwood all began misusing laudanum in their teenage years, and their lifelong addictions display all the hallmarks of opiate abuse throughout the past two centuries.
Samuel Taylor Coleridge (1772–1834) began using laudanum at nineteen, although his dependency took almost another decade to become problematic. In 1797 he composed his three greatest poems, The Rime of the Ancient Mariner, ‘Kubla Khan’ and Christabel. ‘Kubla Khan’ is famously the result of an opium-inspired dream. Coleridge related how he had ‘retired to a lonely farm house between Porlock and Linton, on the Exmoor confines of Somerset and Devonshire’ where he had been prescribed an anodyne for a ‘slight indisposition’. Sitting down to read, he chose Purchas, with its tales of the Mughal Empire and the magic of the East. He fell asleep reading the sentence, inspired by Marco Polo’s description of Xanadu, ‘Here the Khan Kubla commanded a palace to be built, and a stately garden thereunto: and thus ten miles of fertile ground were inclosed with a wall’. After a three-hour opiate vision, Coleridge woke and wrote down all he remembered, before he was interrupted by a person from Porlock. On returning to his desk, the vision had dissipated ‘like the images on the surface of a stream into which a stone had been cast’.69 But before the rude interruption, the immortal opening lines were already on paper.
In Xanadu did Kubla Khan
A stately pleasure-dome decree:
Where Alph, the sacred river, ran
Through caverns measureless to man
Down to a sunless sea.
So twice five miles of fertile ground
With walls and towers were girdled round:
And there were gardens bright with sinuous rills,
Where blossomed many an incense-bearing tree;
And here were forests ancient as the hills,
Enfolding sunny spots of greenery.
From this point on, Coleridge was a dedicated user of laudanum, although he would never again be as productive as he was in 1797. In his abuse of laudanum, he was joined by his great friend Tom Wedgwood, son of Josiah. The Wedgwood family supported Coleridge at a time when he was particularly impoverished, and the friendship between Tom and the poet remained a constant. Delicate and sensitive, Wedgwood passed most of his life in ill health and experimented with various drugs to cure himself. He was charming, if quiet and often despondent, and suffered long bouts of depression. His experimentations with silver nitrate and a camera obscura succeeded in producing images that were the first photographs. Unfortunately, they were sensitive to light and faded as fast as their creator. Tom did, however, also have time to experiment with a lot of drugs, something he and Coleridge obviously enjoyed together, as Coleridge’s words suggest: ‘We will have a fair trial of Bang. Do bring down some of the Hyoscyamine pills, and I will give a fair trial of Opium, Henbane, and Nepenthe. By-the-bye I always considered Homer’s account of the Nepenthe as a “Banging” lie.’70
At a high point in Coleridge’s use of opium, in 1805, Tom Wedgwood’s ‘poor, broken life’ came to an end.71 Alleged by his family to have passed away from a stroke, descriptions of his miserable death are more redolent of a drug overdose. ‘What a day for poor Jos,’ wrote his sister-in-law to her own sister, Emma, ‘watching him dying for 12 hours.’72
There is, ultimately, little wonder the Romantic poets began to turn upon themselves. Robert Southey, another prominent poet, savaged Coleridge’s selfishness: ‘Every person who had witnessed his habits, knows that for the greater – infinitely the greater part – inclination and indulgence are the motives.’73
Yet the Romantic notion of opium persisted. Thomas De Quincey (1785–1859), who first took opiates to treat trigeminal neuralgia, credited laudanum as the root of his creativity, referring to the ‘marvellous agency of opium’ the ‘true hero of the tale’.74 His work of 1821, Confessions of an English Opium-Eater, is central to the Romantic concept of opium as a font of creativity. Throughout his long life, De Quincey used laudanum, sometimes in mammoth doses; his periods of low usage were unproductive. Of all the Romantics, De Quincey’s affinity for opiates and their effects was genuine. The visions he experienced, which he noted were ‘chiefly architectural’, spent in Italianate landscapes, are remarkable:
The sense of space, and in the end, the sense of time, were both powerfully affected. Buildings, landscapes, &c. were exhibited in proportions so vast as the bodily eye is not fit to receive. Space swelled, and was amplified to an extent of unutterable infinity. This, however, did not disturb me so much as the vast expansion of time; I sometimes seemed to have lived for 70 or 100 years in one night; nay, sometimes had feelings representative of a millennium passed in that time, or however, of a duration far beyond the limits of any human experience.75
It was not all creative bliss, however. In a bizarre encounter in 1816, recounted in his Confessions, he was living in Dove Cottage, Grasmere, in the English Lake District, when a ‘Malay’ knocked on the door. De Quincey’s maid fled, leaving her master to speak to the man. In a show of hospitality, De Quincey offered the man enough opium to ‘kill three dragoons and their horses’ and watched as the man ate the whole, and left. De Quincey struggled with the encounter for a long time, wondering if he had overdosed the man, but ‘I never heard of any Malay being found dead.’76 Despite a telling lack of evidence of the Malay’s existence at all, De Quincey continued to suffer with anxiety over the episode. Unlike Coleridge, whose readings of tales of the East were an inspiration, for De Quincey, they were the stuff of nightmare:
The Malay has been a fearful enemy for months. Every night, through his means, I have been transported into Asiatic scenery . . . in China or Hindustan . . . I was stared at, grinned at, chattered at by monkeys, by parquets, 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 the worshipped; I was the sacrificed . . . Thousands of years I lived and was buried in stone coffins, with mummies and sphinxes, in narrow chambers at the heart of eternal pyramids.77
From his late teenage years, De Quincey lived entirely through the spectrum of opiates. He neither wanted nor really attempted to cease using them. He married and had a family, although their existence was precarious. He believed opium accentuated dominant features of the personality, and ‘If a man “whose talk is of oxen” should become an opium-eater, the probability is that (if he is not too dull to dream at all) he will dream about oxen.’78 Yet for all his dreams of higher plains, he was also the man who, when called upon one day by his friend John Wilson, was wearing a ‘Sort of grey watchman’s coat, evidently made for a man four times his size, and bought probably at a pawnbroker’s shop’. Halfway through a rant on transcendentalism, the coat fell open to reveal a naked De Quincey beneath. ‘You may see I am not dressed,’ Thomas observed soberly. ‘I did see it,’ replied Wilson. De Quincey wrapped the coat back ‘round him and went on as before’.79
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Coleridge died in 1834, an unhappy addict confined to his doctor’s house in Highgate. Thomas Carlyle, the Victorian philosopher, visited him, hoping to discuss transcendentalism, but soon grew bored, for ‘To sit as a passive bucket and be pumped into, whether you consent or not, can in the long-run be exhilarating to no creature.’80 De Quincey lived to the age of seventy-four, managing short periods of abstinence, and died in Edinburgh, ending a life riven by disputes, nightmares, debt and drug dependence.
In the Arms of Morpheus: Friederich Wilhelm Sertürner
By 1800, European chemists had been advancing the causes of the natural sciences into various different modern disciplines. Organic analysis was a particular speciality for British, French and German chemists, as they sought to find out how various drugs work in the way that they do. The medical profession was becoming ever more structured, and it and the general public were calling for more specific and higher-quality medicines.
In 1804 – as De Quincey began his career in laudanum, Coleridge reached a high in consumption, and Tom Wedgwood went into terminal decline – the history of opium took another huge stride forward. Romanticism and Naturphilosophie developed in tandem at the beginning of the nineteenth century and played an important role in scientific, as well as literary, life. Friedrich Wilhelm Adam Sertürner, a twenty-year-old German pharmacist on the outskirts of what is now Paderborn, isolated meconic acid from opium latex, which he identified as the sleeping agent. The following year, and the year after that, his discoveries were published in a publication for practising apothecaries, Johann Trommsdorff’s Journal der Pharmacie. The result was, at the time, a damp squib. The field of organic chemistry was struggling to find the same sense of order that had prevailed in inorganic chemistry and botany and Sertürner was left to continue his experiments, but his work was disrupted by Napoleon’s invasion and he had to move to another pharmacy in Einbeck. At the same time, the Parisian chemist Armand Séguin was also working on opium latex, attempting to isolate the active ingredients. Despite conducting extensive experiments, many chemists and pharmacists did not really know what they were looking at, but in 1804, he reported to the Paris Institut that he had obtained from opium a plant acid and a white, crystalline substance that dissolved in alcohol and turned syrup of violets slightly green. The syrup of violets test was used to identify alkali substances. In the same year, French industrialist Charles Derosne had also obtained the white crystalline substance, but he did not understand its alkaloid nature. He called it a salt because ‘I do not know the proper name to assign to it.’81 In 1811, Sertürner published again on the substance he had discovered, and agreed with Derosne that it was salifiable, or capable of forming a salt.