What Killed Jane Austen?: And Other Medical Mysteries

by George Biro

  But no possible rationalisation could justify withholding penicillin after 1943 when it proved to be effective for syphilis.

  Public pressure led to an independent inquiry. A panel of nine (of whom five were black) damned the experiment as ‘ethically unjustified [even] in 1932’.

  Senator Edward Kennedy held hearings on human experimentation. Two survivors, Charles Pollard and Lester Scott, told their story of illiterate blacks trusting the educated whites who had betrayed them. Each had been told that his blood was bad; each had gone along for 40 years with doctors who said they were treating him.

  Outraged citizens of Tuskegee elected their first black mayor. Legislators passed tough regulations to protect subjects of medical experiments.

  Over a century ago, Boston physician Dr Oliver Wendell Holmes noted: ‘Medicine, professedly founded on observation, is as sensitive to outside influence, political, religious, philosophical, imaginative, as is the barometer to the atmospheric density.’

  Even today, the Tuskegee study should sound a warning to researchers who argue against the need for ethics committees to oversee medical research.

  (GB)

  8

  Addictions and Obsessions

  That drowsy numbness: opium and the poets

  Reports in the medical Press of the effects of hallucinogenic drugs on imagery and the spatial experience began early this century. But descriptions of similar blowouts had been part of literature long before that.

  It is no secret that opium, usually taken as laudanum, affected the writings of such luminaries as Samuel Taylor Coleridge, George Crabbe, Francis Thompson, even the sublime John Keats himself. Thomas De Quincey’s well-known narrative on the narcotic experience is brazenly entitled Confessions of an English Opium-eater (1822), and in it he describes its pleasures thus: ‘Thou hast the keys of Paradise, oh just, subtle, and mighty opium.’ Mind you, he also damns the pain as ‘An Iliad of woes’.

  Coleridge (1772–1834) is perhaps the best-known opium taker in this medley, and apparently it gave him the impetus to write his famous ‘Kubla Khan’. The story goes that during a drug-induced sleep the author imagined life’s impenetrable secret had been revealed to him. He woke, feverishly began to set it all down, was interrupted by an inopportune visitor, and never recaptured the mood when he departed. Nonetheless his last lines are significant:

  Weave a circle round them thrice,

  And close your eyes with holy dread:

  For he on honey dew hath fed,

  And drunk the milk of paradise.

  Keats, Crabbe and Thompson were all medically trained, and their recreational use of opiates is revealed in some of their verses, though none attempts an objective account of the definitive drug experience.

  Clinically, hallucinations vary with dosage and frequency of use. The most common is a distortion of space and time in which both can seemingly expand to infinity. Visual hallucinations are more common than auditory and olfactory ones, and can range from bright lights to bizarre but recognisable images. A sense of depersonalisation and terror can be identified in several poems. All in all, true addiction is more often seen in poorly socialised and dependent personalities than in well-structured ones, and in poets no less than in anyone else.

  George Crabbe (1754–1832) became a surgeon apothecary after apprenticeship in the country. Travel to London to pursue a literary career was the preferred choice, but eventually he became a parson. He began taking opium in 1790 after having been given it for vertigo, and continued to imbibe it daily for the remaining 42 years of his life. The resulting delusions were mainly concerned with terror and pursuit. Crabbe’s most famous literary work is The Borough, on which Benjamin Britten’s 20th-century opera Peter Grimes was based.

  Francis Thompson (1859–1907) was first given laudanum on prescription for ‘lung fever’ while a medical student at Manchester. He was a somewhat withdrawn and unstable person, and became habituated for the last 27 years of his life. He came from Preston, a cotton-spinning town in darkest Lancashire, seemingly a most unlikely place for a sensitive poet to emerge. Anyway, Thompson never enjoyed studying medicine, failed continually for as long as his doctor father would support him, until after six meaningless years he took himself off, together with a goodly supply of laudanum, to London. There he lived as a derelict, moving between monasteries, writing of his drug-induced fantasies until he died, not of opium poisoning but tuberculosis.

  His terrifying dreams he described as ‘in part the worst realities of my life’. He wrote one poem which with touching frankness he called ‘The Poppy’. It is full of narcotic-induced fantasies where the poppy emerges as ‘the withered flower of dreams’.

  Of all the English poets who dabbled in drugs his was the talent it most profoundly affected, reaching its apotheosis in The Hound of Heaven, where, in his mind, he is pursued by God:

  I fled Him down the night and down the days;

  I fled Him down the arches of the years;

  I fled Him down the labyrinthine ways

  Of my own mind.

  In Thompson’s evocative piece ‘At Lords’, he describes a visit to watch his old county, Lancashire, play Middlesex at cricket at Lords. It finishes with these famous lines, which, notwithstanding the inferred symbolism, are very moving:

  The field is full of shades as I near the shadowy coast,

  And the ghostly batsman plays the bowling of a ghost,

  And I look through my tears on the soundless-clapping host

  As the run-stealers flicker too and fro,

  Too and fro:

  O my Horn by and my Barlow long ago!

  John Keats (1795–1824), the son of a livery-stable keeper, was an occasional laudanum taker, not an addict. He was apprenticed to a surgeon in Edmonton, Middlesex, but moved to Guy’s Hospital where he qualified as an apothecary in 1816. He abandoned medicine for literature after six months.

  In 1819 he was hit in the eye by a cricket ball, and his housemate, Charles Brown, wrote that he received opium after this event, as he had done on occasions before. The poet, though never admitting to taking the poppy, wrote the next day how he had slept in, felt languid, and was indifferent to pain and pleasure.

  If any of Keats’s poems imply the effect of opium, it is his ‘Ode to the Nightingale’. It was written within six weeks of the cricket-ball incident, and the first few lines are pretty explicit:

  My head aches and a drowsy numbness pains

  My senses, as though of hemlock I had drunk,

  Or emptied some dull opiate to the drains

  One minute past, and Lethe-wards had sunk.

  In a trance-like state he hears the nightingale—possibly an auditory hallucination and later pleads for escape:

  Fade far away, dissolve and quite forget.

  Later Keats has thoughts of death:

  Now more than ever seems it rich to die,

  To cease upon the midnight with no pain.

  And he concludes, as though rousing from an opium-induced sleep, confused over reality:

  Was it a vision or a waking dream?

  Fled is that music: Do I wake or sleep?

  William S. Burroughs, 20th-century author (The Naked Lunch) and self-confessed drug taker, has said that drugs heighten the awareness and imagination of a writer. Yet it seems to be a constant grievance of those who take hallucinogenic drugs that it is impossible to communicate in words the transcendental effects they produce. The great poets probably got nearer than anyone.

  (JL)

  Sigmund Freud and cocaine

  It makes you hyper and smarter, faster and better…you know, sort of like the Six Million Dollar Man (25-year-old male, in Dan Waldorf’s Cocaine Changes)

  In 1860 the German pharmacologist Albert Niemann isolated cocaine, one of the ingredients in the leaves of the South American coca plant. He wrote that it leaves ‘a peculiar numbness, followed by a sense of cold when applied to the tongue’.

  Despite this observation, Niemann overloo
ked cocaine’s potential as a local anaesthetic. Only a few years later, a French pharmacologist did suggest that cocaine might be a useful local anaesthetic. But he did not follow it up either.

  One of the first doctors to experiment with cocaine on humans was Dr Sigmund Freud. In 1884 he was only 28, a poor, little-known but ambitious doctor at the famous General Hospital in Vienna, when he wrote a letter to his fiancée Martha Bernays in which he enthused about cocaine, ‘which some Indian tribes chew to make themselves resistant to privation and fatigue’.

  Freud ordered one gram of cocaine, but was outraged to be charged about ten times the expected price. But before sending the cocaine straight back, he took one-twentieth of a gram. After a few moments, all his anger evaporated and he felt dramatically brighter: ‘nothing at all one need worry about’.

  One month later, Freud noted: ‘I take small amounts regularly against depression and indigestion and with the most brilliant results.’ He sent Martha cocaine to ‘make her strong and give her cheeks a rosy colour’.

  Soon Freud was mailing cocaine to relatives, sharing it with colleagues, and prescribing it for digestive disorders, weight loss and asthma, for morphine and alcohol addiction, and even as an aphrodisiac. Just on the strength of ‘some dozen experiments’, he wrote an enthusiastic paper.

  His biographer Dr Ernest Jones called him a ‘public menace’ on cocaine.

  One of Freud’s friends, Dr Fleischl, had become a morphine addict. American doctors were treating morphine addicts with cocaine, and Freud did the same for his friend. Fleischl did well at first.

  Another friend, Dr Carl Koller, was searching for an effective local anaesthetic for eye surgery. He wrote about a colleague who ‘partook of some cocaine with me from the point of a penknife and remarked ‘How that numbs the tongue.’ The observation was not new, but it was Koller who took it further.

  Would cocaine numb the eye as it numbed the tongue?

  We [Koller and Freud] trickled the cocaine solution under the upraised lids of each other’s eyes. Then we put a mirror before us, took a pin in hand and tried to touch the cornea with its head … We could make a dent in the cornea without the slightest awareness of the touch …

  Soon Koller presented his findings to the Viennese Medical Association. As the news spread, wags called Dr Carl Koller ‘Coca Koller’.

  Freud’s own father was one of the first patients to enjoy a painless operation for glaucoma, with Koller and Freud giving a local anaesthetic of cocaine. An American cavalry officer even wanted Koller to sail for the United States and examine his horse!

  William Martindale, future president of the Pharmaceutical Society of Great Britain, advised the English to give up tea and take coca instead.

  But by July 1885, Freud’s addicted friend Dr Fleischl was taking a full gram of cocaine each day. Worse, he had convulsions and hallucinations of white snakes. Freud sometimes sat up all night with his friend.

  The man who had hoped to become the first European to be cured of morphine addiction by cocaine was now the first European cocaine addict.

  Freud may have believed that cocaine was not addictive because it did not produce the dramatic withdrawal crisis of opium or morphine. One critic called cocaine ‘the third scourge of mankind’. The fiasco shattered Freud’s early reputation. But he reportedly continued not only to use, but also to prescribe cocaine until at least 1895.

  Was Freud just unlucky in this early cocaine phase of his career? Had he, like Koller, concentrated on its anaesthetic effects, would he have become a famous anaesthetist instead of the father of psychoanalysis?

  In his last paper on cocaine, Freud finally admitted that it did harm morphine addicts and produce:

  … physical and moral deterioration, hallucinatory states of agitation similar to delirium tremens, a chronic persecution mania … hallucinations of small animals moving in the skin and cocaine addiction instead of morphine addiction.

  Four years after Fleischl’s death, Freud was still blaming himself: ‘I had been the first to recommend the use of cocaine … The misuse of that drug … hastened the death of a good friend’.

  But later, Freud omitted references to some of his early papers promoting cocaine. Was this deliberate? Did he just happen to forget? Or was the great Freud himself subject to Freudian slips?

  (GB)

  Percy Grainger’s and William Gladstone’s curious obsession

  The death in 1994 of a British politician who was found dressed in women’s stockings, and who had suffocated while allegedly engaging in some sort of solitary sexual burlesque brought attention to such goings on, especially when they involved prominent people. Such activities are almost certainly not as uncommon as we may think.

  Percy Grainger was born in Melbourne in 1882, and showed exceptional musical talent from early childhood. He became one of the foremost pianists of this century and probably Australia’s most highly regarded composer (‘Handel in the Strand’, ‘Country Gardens’, etc.). On top of this he at once led an eccentric private existence and extroverted public life.

  Grainger’s father, John, was an architect, but also an alcoholic and syphilitic. Percy himself did not have the disease, but his mother, Rose, did. Although she doted on the talented boy, Rose feared he would follow his father’s decline, so she horsewhipped him when he showed signs of straying from his piano practice.

  Out of this there developed a most unusual relationship of mutual dependency between mother and son. She managed both his professional and private life, and though an incestuous relationship has been speculated upon, the many letters each left seem to exclude this. Suffering from neurosyphilis, Mrs Grainger committed suicide in 1922.

  The harsh discipline and perverse ambience of his childhood, buoyed by a fancy for literature associated with cruelty, had directed Percy’s sexual urges along an abnormal path: sadomasochism. From the age of 16, ‘wildness, recklessness and unbridled savagery were the keynotes of his existence … guilt and shame had little place in his life’ as his biographer John Bird puts it.

  So diligent was he in beating himself—or getting others to do so—that blood usually flowed, and he laundered his own shirts to conceal the evidence. Girlfriends were drawn into these activities, and pleasure heightened by recording the excesses on film. As mute testimony, he would hold up to the camera a notice with details of the kind of whip used, number of lashes as well as type of film and exposure on which it had been recorded!

  In 1928 Grainger married Ella Strom, a Swedish artist and poet, the ceremony taking place at the Hollywood Bowl. Ella was under the impression that this was a kind of secluded glade and was astounded to find herself taking the vows in front of 28,000 people to the accompaniment of a 126-strong choir and orchestra performing her husband’s new piece, ‘To A Nordic Princess’. That’s style for you.

  The beatings continued, and shared sessions with his wife became so violent the musician felt it prudent to deposit a letter indicating that should death in either follow a bout of flogging, that, in fact, to him flagellation was the highest manifestation of love.

  Both survived the onslaught, however, and Percy died of carcinoma of the prostate at the age of 78.

  Quite apart from all this self-inflicted brutality, Percy Grainger showed a remarkable lack of proportion, an exaggerated emotionalism and a flamboyant eccentricity. He bequeathed his skeleton to the Percy Grainger Museum ‘for preservation and possible display’. Some of his whips are also in the museum’s collection.

  Such characteristics were quite unlike those displayed by our second flagellating VIP. Indeed, this second man was looked upon as the very model of Victorian virtue, piety and rectitude.

  He was William Ewart Gladstone, four times British prime minister, over 60 years in Parliament, unexcelled at verbal reticulation and master of the subordinate clause.

  In 1839, at the age of 29, Gladstone married Catherine Glynne. She was to bear him eight children and provide him with a secure home base. It was said she was
a woman of wit, charm and complete discretion, which is just as well for all his life Gladstone kept a diary in which he wrote about ‘wounds from his secret conflict’.

  In 1843, at the age of 34, he speculated in his diary as to ‘how far satisfaction … delighting in pain may be a true phenomena of the human mind’. And then on 13 January 1849 he confided, ‘having been much tempted … I made a slight application of a new form of discipline … how thankful ought I to be if I should find it to so continue’.

  Regrettably for him, gratification declined and he confessed it was becoming a convenient cover for ‘unabated impurity’. He tentatively recommended to himself, via the diary, that rescue work among prostitutes may lift the effect.

  So Gladstone became a member of an Anglo-Catholic group which did a variety of ‘good works’ among the underprivileged; the saving of ‘fallen women’ he saw as his contribution.

  Thus in 1851 he got out into the world of the demimonde, where, incredibly, he distributed copies of Uncle Tom’s Cabin as a suitably uplifting tract. Whether he partook of these women’s professional charms is not certain, and vehemently denied later by his children, but in July he noted he ‘trod the path of danger’.

  His thoughts not being always altruistic, he felt shame at their sexual content, a feeling he gratifyingly found best overcome by self-flagellation. Flogging sessions would be indicated in the diary not by a word, but a drawing of a whip.

  Gladstone particularly sought the company of a young woman called Elizabeth Collins, and she is written up many times with tantalising vagueness. For instance, on 13 July 1851 he enigmatically wrote of a two-hour ‘strange and humbling scene’. Naturally, it led to the scourge.

  To the statesman, Elizabeth was ‘lovely beyond measure’. Indeed, her attractions were enough to make him take early leave of a dinner given by Lord Palmerston in order to spend two hours with her; to be followed, of course, by the chastening whip. I wonder what Palmerston and his guests would have made of it if they had known.