Milk of Paradise
Page 22
It had taken less than twenty years for the medical profession to realize the potential for harm the hypodermic presented, whereas previously they had seen the invention as one of the most important of the nineteenth century. ‘It is no exaggeration to say this abuse is becoming a gigantic evil, to the extent and dangers of which the medical profession should be fully aware,’ wrote Robert Bartholow, whose manual had helped not only doctors, but users to self-administer.20
The instant pain relief offered by the hypodermic injection of morphine was something neither doctors nor patients had experienced before. Freedom from pain, particularly chronic pain, had suddenly become possible through the simple prick of a needle. The dual nature of the hypodermic was now as stark as that of the morphine it contained, and by 1880 doctors across Europe and America had realized that ‘no therapeutic discovery . . . has been so great a blessing and so great a curse to mankind as the hypodermic injection of morphia’.21
Civil War
‘You don’t mean he must die, Doctor?’22
The Civil War of 1861 to 1865 put a brief halt on America’s headlong rush towards the future. In Louisa May Alcott’s Hospital Sketches of the time she spent as a night nurse at the Union Hospital at Georgetown, Washington DC, she writes extensively about the bravery of the men who arrived there, shattered by the new inventions in artillery and firearms. Particularly touching is the tale of John, the Virginia blacksmith with the beautiful face, who had been shot but appeared unwounded. Alcott asked the surgeon about his fate: ‘the poor lad can find neither forgetfulness nor ease, because he must lie on his wounded back or suffocate . . . It will be a hard struggle, and a long one.’ No mention is made of pain relief for John, only God, cleanliness and love. There is a brief mention earlier of the ‘merciful magic of ether’, but none for John, who ended up in the anonymous burial ground known as the Government Lot.23
The reality of the Civil War was that a soldier was eight times more likely to die when wounded than a soldier in the First World War, but ten times more likely to die of disease.24 An estimated 620,000 men died in the war, representing 2 per cent of the male population, and more than half died of disease while in prison or in hospital. The first Civil War field hospitals were tents or even open fields, soon moving into requisitioned houses or any building large enough to hold the grotesque number of casualties. Walt Whitman, the American writer, remembered visiting a field hospital in Fredericksburg, Virginia, after the battle there: ‘Out doors, at the foot of a tree, within ten yards of the front of the house, I notice a heap of amputated feet, legs, arms, hands, &c., a full load for a one-horse cart. Several dead bodies lie near, each cover’d with its brown woolen blanket.’25
The new technology deployed in the Civil War meant that loss of limbs and shattered bones were the common injuries. On arrival at the field hospital, the surgeon or assistant’s first job was to tourniquet what was left of the limb in an attempt to stop the bleeding. Drinking water was supplied and, as Federal surgeon W. W. Keen remembered, ‘Powdered morphine was administered freely, doled out with a pocket knife [sprinkled directly into the wound] without worrying about superfluous exactitude in doling out the blessed relief that morphine brings to men in pain.’26 They were often also offered whiskey.
Morphine powder was used liberally throughout the Civil War, with one Federal surgeon so hard pressed during a battle that he diagnosed from horseback, tipped it into his hand and had the men lick it from his palm. Medical science had not begun to catch up with the types of injuries that men could now inflict upon each other with heavy artillery, and the best that could be hoped for post-amputation or gunshot was a ready supply of morphine powder or pills, or opium for plasters. Any of these would also have helped with the terrible dysentery that was rife in both the camps and the hospitals. For the army surgeons, quinine for fevers and chloroform for anaesthesia were also vital.
The Union army was far better equipped in almost all ways than the Confederate forces, which were often reduced to smuggling in medication such as opiates. John S. Cain, a chief surgeon of a division in Tennessee, admitted they were ‘frequently overdrawn’ in the field.27 Not so the Union army, which issued almost 10 million opium pills and 2.841 million ounces of other opiates in 1865. And by the end of the war, the Union army had issued 2,093 syringes to about 11,000 surgeons, though probably fewer actually used the instrument, which was probably quite impractical in the utter chaos of a battlefield hospital, when a steady hand was needed to draw up solutions and concentration required to ensure the correct dosage.28
Experiencing the Civil War hospitals, with holes drilled through floorboards to catch the pints of blood that flowed from amputations and surgeries, the gangrene, the overcrowding, misery and despair, must have been horrifying.
In the years that followed the Civil War, doctors across the country noticed a striking rise in the number of morphine addicts they were treating, and many of them had one thing in common: they were all veterans. Many had lost limbs that had been removed at speed and sometimes with little skill, badly healed and agonizing; the need for pain relief was obvious. But for others, there were no visible wounds at all, such as the anonymous writer who published Opium Eating: An Autobiographical Sketch in 1876. He had been sixteen when he had enlisted as a Union army drummer in 1861, but was soon carrying a gun. In 1863 at Chickamauga, his second battle, he was captured and forced to march to Richmond in Virginia. With 5,000 others he was kept in terrible conditions at Danville prison, then moved to the dreaded prisoner-of-war camp at Andersonville, Georgia. He was transferred once more and finally released in February 1865 as part of a prisoner exchange. Cared for by Union doctors, he suffered insomnia and was given a sleeping draught. At home, he suffered stomach cramps and ongoing headaches, and eventually went to see a doctor who was keen to inject him with morphine, which miraculously cured his ailments but cast him into the ‘wretchedness’ of addiction.
This story is by no means uncommon, and reflects the emotional hardship that many of the Civil War veterans had clearly been through. As late as 1919, at the morphine maintenance clinic in Shreveport, Louisiana, doctors treated an eighty-two-year-old Civil War veteran who, after being shot in the head, had been treated with morphine, and had taken it ever since.29
These stories are numerous, and morphine addiction came to be known as ‘the army disease’, which refers not only to the amount of narcotics that were administered during the war, but also the fact that hypodermic syringes were available for the first time. However, quite when it took that name is not clear, although it emerged in the early twentieth century when America was attempting to justify involving itself in opium prohibition. The first mention appears in 1914, in a paper by Jeanette Marks, a Yale historian, on the ‘Curse of Narcotism in America’, when she asked, ‘Did you know that there is practically no old American family of Civil War reputation that has not had its addicts? Did you know it was called “the army disease” because of its prevalence?’30
The ordinary doctors who saw these patients were certainly not unsympathetic, and many were mostly concerned to see the veterans maintained on the correct pension, as is echoed by the physician Thomas Crothers in his book on drug addiction: ‘The sufferings and hardships growing out of the perils of war often react in illness, nerve and brain instability, and feebleness, and the use of morphine is a symptom of the damage from this source which should be recognized as its natural entailment and sequel by the Pension Bureau.’31
Another soldier, but one only suspected of opiate addiction, was the Confederate veteran ‘Doc’ Pemberton. He was wounded at the Battle of Athens, Georgia, and later became a chemist in Atlanta, where he created a recipe of kola nuts and cocaine to try and prevent people drinking alcohol. It is known today as Coca-Cola.32
It has long been a popular myth that the Union and Confederacy demobbed an army of addicts, and estimates have been anywhere from 100,000 up to 300,000. Some argue that there was no such thing as lingering morphine habits a
fter the war, let alone an epidemic of addicted soldiers, but the sheer number of morphine pills handed out, probably for self-administration, would indicate otherwise, as would the amount of morphine bottles thrown down the latrines of the Civil War prison on Johnson’s Island, where they appeared not just in the hospital block. In addition, it took doctors until the early 1870s to make the association between the hypodermic and morphinism, and they were usually specialists in the needles themselves or in addiction. From the existing accounts, it seems the addicts came out and became opium eaters or remained dependent upon morphine. As Horace B. Day wrote in his 1868 book The Opium Habit, ‘Maimed and shattered survivors, from a hundred battle-fields, diseased and disabled soldiers released from hostile prisons . . . have found, many of them, temporary relief from their sufferings in opium.’33
The liberality with which doctors dosed their patients was addressed one year before the war had broken out, by the eminent doctor Oliver Wendell Holmes, in a speech to the Massachusetts Medical Society, in May, 1860, when he said that the population was ‘overdosed’, one of the first recorded uses of the word. ‘How,’ asked Holmes, ‘could a people . . . which insists on sending out yachts and horses and boys to out-sail, out-run, out-fight and checkmate all the rest of creation; how could such a people be content with any but “heroic” practice? What wonder that the stars and stripes wave over 90 grains of sulphate of quinine, and that the American eagle screams with delight to see three drachms of calomel given at a single mouthful?’34
Welcome to Dai Fou
The word coolie comes from the Chinese word k ’u-li, translated as ‘hard strength’, from their traditional work as physical labourers. These workers who came aboard the merchant ships bound for America after the end of the Second Opium War were often indentured, and, having left the money for selling their labour with their families, emigrated for a set period of time, often a considerable number of years, to another country. Peru, America and Australia were the main destinations for them in the middle of the nineteenth century, and many were deceived about just how long they would be away from home. Many were also kidnapped and placed in barracoons, or holding centres, until the ships were ready to sail. Mortality rates, for which there are no reliable figures, were high enough to make perishing on the journey a genuine risk.
Their main point of entry was on the West Coast of America at San Francisco, which they called Dai Fou. By the time many of the first Chinese immigrants arrived there, the California Gold Rush was beginning and there was work to be had in the mining communities, or in large San Franciscan construction companies. The San Francisco Chinatown was the first and most significant on the West Coast, and well established by the 1850s, when it had over thirty general merchandise stores, more than a dozen apothecaries, several restaurants and herb shops and three boarding houses. It had been put aside by the city as an area where the Chinese could own land, so had become an obvious place to settle, as well as providing the comforts and ties of home. The level of immigration was incredibly rapid, with only 325 Chinese recorded in San Francisco in 1849, but 25,000 by 1852.35 This was partly because ordinary workers, now free to leave China, booked their passage on the Pacific Mail Steamship Company boats. They soon made up 10 per cent of California’s population, and were making their way east to work not only in mining towns but other settlements, although many remained on the West Coast.
The Chinese presence was almost uniformly resented by the American press and the American people. It did not matter that they had been pressed out of their own country, either by force or financial necessity, by people who then charged them for their crossing. One of the problems was the Chinatowns, which created an alien presence inside large, predominantly white settlements. Another was the sheer difficulty of the cultural barrier. Another was that the Chinese workers brought with them their prime means of relaxation at the end of a long day: opium.
Soon there were opium dens in San Francisco, causing both social and political problems, ‘where heathen Chinese and God-forsaken women and men are sprawled in miscellaneous confusion, disgustingly drowsy, there. Licentiousness, debauchery, pollution, loathsome disease, insanity from dissipation, misery, poverty, profanity, blasphemy and death are there. And Hell, yawning to receive the putrid mass is there also.’36
Authors of this type of writing, such as B. E. Lloyd produced in 1870, had plenty to say on the unsavoury habits of the Chinese, and on the evils of opium smoking, and Lloyd dwells for a page and a half on a scene within an opium den in the same book. Mark Twain is less salacious in Roughing It (1872):
Smoking is a comfortless operation, and requires constant attention. A lamp sits on the bed, the length of the long pipe-stem from the smoker’s mouth; he puts a pellet of opium on the end of a wire, sets it on fire, and plasters it into the pipe much as a Christian would fill a hole with putty; then he applies the bowl to the hand and proceeds to smoke – and the stewing and frying of the drug and the gurgling of the juices in the stem would well-nigh turn the stomach of a statue.37
There were various attempts to stop Chinese immigrants bringing in opium or serving it to white people, but none of them worked. The habit for the Chinese was so ingrained that they would obtain the drug from whatever source necessary, although there were so many entering San Francisco it was unlikely they would have to venture out of the community. America was, by this time, in the grip of early morphinism and its attendant problems, and opium was seen as the root of the issue. This disregards the fact that few Chinese smokers changed from the pipe to another method of achieving the same effect; most tended to reach a plateau of use from which they did not increase or deviate. This is in direct contrast to morphine, which causes the user to crave an increased dose as tolerance is established. These facts were known at the time, but the chemical mechanism was not understood.
Also mentioned repeatedly were the Chinese prostitutes, who sat behind closed doors on various streets in Chinatown, only their faces visible, and the proportion of Chinese female immigrants who engaged in prostitution. Because Chinatowns contained drugs, women, drink and gambling, they had long been haunts for sailors and labouring white men, further denigrating them in the minds of middle-class Americans such as Lloyd. Later in the century, when young white men and women began to visit opium dens to smoke, the San Francisco and New York authorities were barraged with complaints. San Francisco’s attempt in 1880 to get a grip on the problem was to make a detailed map showing every opium den and brothel in the fifteen-square-block territory of Chinatown. How effective this was in solving anything is dubious, but it was an attractive way of displaying San Francisco’s sharp racial divides. The population had boomed after workers had returned from the finished Transcontinental Railroad in 1869 and things were reaching a crisis. ‘Thus, in San Francisco, it is but a step from the monuments of the highest type of American civilization, and of Christianity, to the unhallowed precincts of a heathen race,’ railed Lloyd.38
Part of the problem was that America had spent over a century placing enormous emphasis on the importance of family, home and domesticity. The advertising industry thrived on depictions of wives and mothers, or the moment father returns from work to be greeted by his loving children. The Chinese population had none of that. The men had left their homes and families and come to America, willingly or unwillingly, to earn money. From necessity they lived alone or in boarding houses, and they lived in the same area as each other because there was no possibility of integrating and there was comfort in familiarity, and because, mainly, they went where they were put. The majority of women who came at the beginning were indeed prostitutes, or involved in opium dens, or both. They were unfamiliar and their culture was alien. And the drug culture was a large part of their daily lives. All these things were ostensibly true, but ultimately, the reasons for American resentment of the Chinese immigrants were economic. The acute labour shortages that had seen the Chinese arrive on the West Coast in the 1840s had changed with the Gold Rush, demobbing
, and then the railroad. The railroad almost immediately attracted large numbers of Chinese labourers, for the single reason that few white people were prepared to do the physical labour required to build it.
In 1865 the Central Pacific Railroad Company of California hired fifty Chinese workers, of whom the company superintendent said, ‘They prove nearly equal to white men in the amount of labor they perform, and are much more reliable.’ By 1867, the company employed 12,000 Chinese workers, 90 per cent of the entire workforce.39 The railroad meant that Chinatowns, no matter how small, spread along the western arm of the Transcontinental Railroad under construction, and the Midwestern press reported on Chinese men taking away launderessing work from local white women, and in what conditions they lived, and how cheaply, which did not benefit local economies. As Lloyd had remarked, ‘So well do they understand how to make each cent extend their lease of life, that how they succeed in doing so is a matter of surprise and wonder to Americans.’40 Taking into account how little they were paid, this was not necessarily a matter of choice.
Another outstanding thorn in the side of the Americans heading up the anti-Chinese movement was that because they were single men they could afford to live and work so cheaply. This was also true, because they were not allowed to bring in their wives or families unless they were wealthy, and even then there was no guarantee of immigration being granted. As single men, they also represented a threat to the family unit, particularly when they were gathered together, as in opium dens. When young white women began to be seen entering or leaving opium dens, the San Francisco Board of Supervisors passed an anti-opium-smoking law in 1875. Still, the anti-Chinese feeling gathered. Henry Grimm’s 1879 racial drama ‘The Chinese Must Go’: A Farce in Four Acts caught the mood: ‘By and by white man catchee no money; Chinaman catchee heap money; Chinaman workee cheap, plenty work; white man workee dear, no work – sabee? . . . White man damn fools; keep wife and children – cost plenty money; Chinaman no wife, no children, save plenty money. By and by, no more white workingmen in California; all Chinamen – sabee?’41