13 Dr. Pinel’s removal: Weiner, The Citizen-Patient; Ackerknecht, Medicine.
14 Neurology, as a clinical specialty: Anne Harrington, Medicine, Mind and the Double Brain (Princeton, N.J.: Princeton University Press, 1989); Harrington, The Cure Within: A History of Mind-Body Medicine (New York: W. W. Norton, 2008); and Stanley Finger, Origins of Neuroscience: A History of Explorations into Brain Function (New York: Oxford University Press, 1994).
15 Instead, they were critical tools: Fielding H. Garrison, History of Medicine, 4th ed. (Philadelphia: W. B. Saunders and Co., 1929), pp. 639–41; R. D. Shryock, The Development of Modern Medicine (New York: Alfred A. Knopf, 1949), pp. 151–69; and Ackerknecht, Medicine, p. 63.
16 A valued collaborator: Freud to Martha, October 21, 1885, Freud, Letters, pp. 175–77 (Letter 82); and Garrison, History of Medicine, p. 641.
17 But there was never a doubt: Gay, Freud, pp. 46–53.
18 To Sigmund’s great delight: Freud to Martha, October 21, 1885, Freud, Letters, pp. 175–76 (Letter 82).
19 He described Charcot: Ibid.
20 The young physician was bedazzled: Ibid.; and Jones, Life, vol. 1, pp. 187–88.
21 “I am really very comfortably installed now”: Freud to Martha, November 24, 1885, Freud, Letters, pp. 184–85 (Letter 86); and Gay, Freud, p. 49.
22 At the same time: In an unpublished letter Ernest Jones wrote to Siegfried Bernfeld on April 28, 1952, Jones confessed, “I am afraid that Freud took more cocaine than he should [during this period] though I am not mentioning that [in the biography].” When Bernfeld pressed him on this issue, Jones wrote another letter a few months later, on June 1, 1952, stating, “No I don’t think he ever had ill effects from cocaine.” These letters are in the S. Bernfeld Papers at the Library of Congress and are quoted by Peter Swales in his compelling essay “Freud, Cocaine and Sexual Chemistry: The Role of Cocaine in Freud’s Conception of the Libido,” in Sigmund Freud: Critical Assessments, ed. Laurence Spurling, vol. 1 (London: Routledge, 1989), pp. 273–301 (see, in particular, pp. 278–79, 290). For a description of the extent Freud, Martha, and Jones endeavored to minimize Freud’s cocaine use, and the letters he wrote to Martha documenting it, see Harry Trosman and Ernest S. Wolf, “The Bernfeld Collaboration in the Jones Biography of Freud,” International Journal of Psycho-Analysis 54 (1973): 227–33.
23 “[Charcot] invited me”: Freud to Martha, January 18, 1886, Freud, Letters, pp. 192–93 (Letter 91). Dr. Ricchetti was an Austrian physician who practiced in Venice. He and his wife befriended Freud during this period.
24 To complete the picture: Freud to Martha, January 20, 1886, Freud, Letters, pp. 193–97 (Letter 92); quote is from p. 195.
25 Sigmund swooned at the sight: Ibid.; quote is from p. 194; and Jones, Life, vol. 1, pp. 186–87. The “Gobelins,” of course, refer to the famous Parisian-made tapestries that often adorned the walls of the well-to-do during this period.
26 “The bit of cocaine”: Freud to Martha, February 2, 1886, Freud, Letters, pp. 200–204 (Letter 94); quote is from pp. 201–03.
27 Warmed by the glow: I am indebted to my colleague Professor Daniel Herwitz, director of the University of Michigan Institute for the Humanities, for helping me understand the importance of Sigmund’s “Temple” metaphor in his intellectual development.
28 “Thank God, it’s over”: Freud to Martha, February 2, 1886, Freud, Letters, pp. 200–204 (Letter 94).
29 “all kinds of condescending remarks”: Freud to Martha, February 10, 1886, Freud, Letters, pp. 206–11 (Letter 96); quote is from p. 208.
30 “he rather taken aback”: Ibid.
31 The visitor’s name: Ibid., p. 209. See also H. Knapp, “On Cocaine and Its Use in Ophthalmic and General Surgery,” Archives of Ophthalmology 13 (1884): 402–48; and Daniel M. Albert, “Hermann Jakob Knapp,” in American National Biography, vol. 12, ed. John A. Garraty and Mark C. Carnes (New York: Oxford University Press, 1999), pp. 797–98.
32 “I greeted [Knapp] accordingly”: Freud to Martha, February 10, 1886, Freud, Letters, pp. 206–11 (Letter 96).
33 For Sigmund, this was one: Ibid., p. 209.
34 Sigmund never saw: Freud not only translated many of Charcot’s lectures and quoted the master as an authority in his own works, he also hung an engraving of the painting Une leçon du Docteur Charcot à la Salpêtrière, by Pierre André Brouillet, in his consulting room (see this page). The painting depicts Charcot demonstrating a female hysteric to his students at the Salpêtrière Hospital and was given pride of place by being hung over a bookcase filled with Freud’s treasured antique sculpture collection. Moreover, in 1889, Freud named his first son Jean Martin, after the French neurologist, in contradiction to the Jewish tradition of naming a child after a deceased family member. Sigmund Freud picked the names for all of his children and some of his grandchildren but chose to honor people he revered and liked rather than dead relatives. See Gay, Freud, pp. 52–53; and Louis Breger Freud, Darkness in the Midst of Vision (New York: John Wiley and Sons, 2000), pp. 88–89.
35 The sage teacher: Gay, Freud, p. 51.
Chapter 8. Rehabilitating Halsted
1 In the decades that followed: Butler Hospital’s first medical director, Dr. Isaac Ray, a pioneer in the American psychiatric profession, was well regarded for his humane and scientific views of caring for the insane; his successor, John Woodbury Sawyer, was equally revered by his colleagues around the nation. F. Wayland and H. L. Wayland, A Memoir of the Life and Labors of Francis Wayland, D.D., L.L.D. (New York: Sheldon and Co., 1867); W. E. Baxter and D. W. Hathcox, America’s Care of the Mentally Ill: A Photographic History (New York: American Psychiatric Publishing, 1994).
2 Many doctors practiced: Gerald N. Grob, The Mad Among Us: A History of the Care of America’s Mentally Ill (Cambridge, Mass.: Harvard University Press, 1994); Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (New York: John Wiley, 1997); and Benjamin Reiss, Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture (Chicago: University of Chicago Press, 2008).
3 More broadly, Americans considered: The separation of socially acceptable society from those deemed ill or dangerous is nicely described in Robert H. Wiebe, The Search for Order, 1877–1920 (New York: Hill and Wang, 1967). See also Allan M. Hamilton, Recollections of an Alienist: Personal and Professional (New York: G. H. Doran Co., 1916); Alex Beam, Gracefully Insane: Life and Death Inside America’s Premier Mental Hospital (New York: Public Affairs, 2001); David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Glenview, Ill.: Scott, Foresman, 1971); Robert Whitaker, Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill (New York: Basic Books, 2002); Nancy Tomes and Lynn Gamwell, Madness in America: Cultural and Medical Perceptions of Mental Illness Before 1914 (Ithaca, N.Y.: Cornell University Press, 1995); Nancy Tomes, The Art of Asylum-Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry (Philadelphia: University of Pennsylvania Press, 1994); Carla Yanni, The Architecture of Madness: Insane Asylums in the United States (Minneapolis: University of Minnesota Press, 2007); and Christopher Payne, Asylum: Inside the Closed World of State Mental Hospitals (Cambridge, Mass.: MIT Press, 2009).
4 Short-staffed, often filthy: For a fictional account of the sorry state of many insane asylums in the United States as late as the 1940s, see Mary Jane Ward, The Snake Pit (New York: Random House, 1946).
5 But it was hardly Bedlam: William Buchan, Domestic Medicine; or, the Family Physician: Being an Attempt to Render the Medical Art More Generally Useful, by Showing People What Is in Their Own Power Both with Respect to the Prevention and Cure of Diseases, Chiefly Calculated to Recommend a Proper Attention to Regimen and Simple Medicines (Edinburgh: J. Balfour and W. Creech, 1769); Charles E. Rosenberg, “Medical Text and Social Context: Explaining William Buchan’s Domestic Medicine,” Bulletin of the History of Medicine 57 (1983): 22–42.
6 Hence, it is not surpris
ing: Welch and Halsted’s mutual and close friends Samuel Vander Poel and George Munroe, both Bellevue physicians, were also aware of Butler and recommended it to Halsted many times in 1885 and 1886. William G. MacCallum, William Stewart Halsted, Surgeon (Baltimore: Johns Hopkins University Press, 1930), p. 56.
7 Medical doctrine held that: Vivian Nutton, “Humoralism,” in Companion Encyclopedia of the History of Medicine, vol. 1, ed. W. F. Bynum and R. Porter (London: Routledge, 1993), pp. 281–91.
8 That said, the Annual Reports: Annual Report of the Trustees and Superintendents of the Butler Hospital for the Insane, January 26, 1887 (Providence, R.I.: Angell and Co., Printers, 1887). See also the annual reports for 1874, 1876, 1877, 1878, 1882, 1883, 1886, and 1888, Collections of the University of Michigan Libraries, Ann Arbor. For further information, see A Century of Butler Hospital, 1844–1944 (Providence, R.I.: Butler Hospital, 1944).
9 “It has seemed to me best”: Annual Report of the Trustees and Superintendents of the Butler Hospital for the Insane, pp. 13–16; quote is from p. 16.
10 Nineteenth-century American alienists: George Rosen, Madness in Society: Chapters in the Historical Sociology of Mental Illness (Chicago: University of Chicago Press, 1968), pp. 172–228.
11 “Those who study”: Annual Report of the Trustees and Superintendents of the Butler Hospital for the Insane, p. 9; late-nineteenth-century dollars were converted into 2010 values using a formula based on the consumer price index from the economic history—focused website Measuring Worth, www.measuringworth.com/index.html (accessed February 25, 2010).
12 Typically, these pharmacological morality plays: For a superb discussion of this chapter of medical history, see Joseph E. Spillane, Cocaine: From Medical Marvel to Modern Menace in the United States, 1884–1920 (Baltimore: Johns Hopkins University Press, 2000).
13 Fleischl-Marxow’s addendum: Ernest Jones, The Life and Work of Sigmund Freud, vol. 1 (New York: Basic Books, 1955), pp. 90–91. For the original source, see Sigmund Freud, “Coca,” trans. S. Pollak, St. Louis Medical and Surgical Journal 47, no. 6 (December 1884): 502–05; see also Freud, Cocaine Papers, pp. 85–89.
14 “since the use of cocaine”: H. Obersteiner, “Über Intoxicationpsychosen,” Wein Med Presse 24, no. 4 (1886): 24. Translated and cited in Siegfried Bernfeld, “Freud’s Studies on Cocaine, 1884–1887,” Journal of the American Psychoanalytic Association 1 (1953): 581–613; quote is from p. 602.
15 Sounding an alarm: J. A. A. Erlenmayer, “Ueber die Wirkung des Cocain bei der Morphimentziehung,” Centralbaltt d. Nervenheiljunde 8 (July 1885): 288–99; J. A. A. Erlenmeyer, “Über Cocainsucht,” Deutsche Medizinalzeitung 7 (1886): 44, translated and cited in Bernfeld, “Studies,” 1 (1953): 602. See also Erlenmeyer’s full-length book on morphine addiction: Die Morphiumsucht und ihre Behandlung, 3rd ed. (Berlin and Leipzig: Louis Heuser, 1887; 1st ed. published 1885).
16 That same year: E. W. Holmes, “Erythroxylum coca and Its Alkaloid Cocaine,” Detroit Therapeutic Gazette 10 (3rd ser., 2, no. 8) (1886): 531.
17 “All reports of addiction”: Sigmund Freud, “Contributions About the Applications of Cocaine. Second Series. I. Remarks on Craving for and Fear of Cocaine with Reference to a Lecture by W. A. Hammond,” Wiener medizinische Wochenschrift 28 (July 9, 1887): 929–32, in Sigmund Freud, Cocaine Papers, ed. Robert Byck (New York: Stonehill, 1974), pp. 169–76; quote is from pp. 173–75.
18 In 1888, Charles Bunting: Charles A. Bunting, Hope for the Victims of Alcohol, Morphine, Cocaine and Other Vices (New York: Christian Home Building, 1888).
19 Similarly, in 1891: H. G. Brainerd, “Cocaine Addiction,” Transactions of the Medical Society of the State of California n.s. 20 (1891): 193–201; quote is from p. 200.
20 Springthorpe poignantly recalled: J. W. Springthorpe, “The Confessions of a Cocainist,” Quarterly Journal of Inebriety 19 (1897): 55–59.
21 “the people in the house”: C. C. Stockard, “Some Cases of Drug Habit,” Atlanta Medical and Surgical Journal 15 (1898–99): 83.
22 “cocaine is probably”: T. D. Crothers, “Cocaine-Inebriety,” Quarterly Journal of Inebriety 20 (1896): 370.
23 With respect to cocaine: Sigmund Freud, “Contributions About the Applications of Cocaine,” pp. 929–32, in Freud, Cocaine Papers, pp. 169–76; and William A. Hammond, “Volunteer Paper,” Transactions of the Medical Society of Virginia (1887): 212–26, reprinted in Freud, Cocaine Papers, pp. 178–93.
24 But it is also important to note: “Treatment for Past Year Depression Among Adults,” The NSDUH (National Survey on Drug Use and Health) Report, January 3, 2008, U.S. Department of Health and Human Services/Substance Abuse and Mental Health Adminstration, www.oas.samhsa.gov/2k8/depression/depressionTX.htm (accessed May 28, 2008).
25 Furthermore, evidence is being uncovered: M. D. Li and M. Burmeister, “New Insights into the Genetics of Addiction,” Nature Reviews/Genetics 10 (2009): 225–31; G. R. Uhl and R. W. Grow, “The Burden of Complex Genetics in Brain Disorders,” Archives of General Psychiatry 61, no. 3 (2004): 223–29; N. Volkow and T. K. Li, “The Neuroscience of Addiction,” Nature Neuroscience 8, no. 11 (2005): 1429–30; and G. R. Uhl, “Molecular Genetic Underpinnings of Human Substance Abuse Vulnerability: Likely Contributions to Understanding Addiction as a Mnemonic Process,” Neuropharmacology 47, Supp. 1 (2004): 140–47.
26 Halsted made excellent progress: Some have suggested that Halsted may have continued to abuse cocaine while at Butler by bribing attendants to procure the drug for him; others have suggested that the morphine was not prescribed but also procured in a more illicit manner. I cannot find any definitive documentation for either of these claims. Given the state of treatment for drug addiction during this time as well as the fact that Halsted had few financial resources to draw upon while a patient at Butler, they appear unlikely. See, for example: A. P. Stout, “William Stewart Halsted,” Notes, Series II, June 9, 1924, Box 49, William Stewart Halsted Papers, Alan Mason Chesney Archives, Johns Hopkins Medical Institutions, Baltimore; Daniel B. Nunn, “Dr. Halsted’s Addiction,” Johns Hopkins Advanced Studies in Medicine 6, no. 3 (2006): 106–08; and Daniel B. Nunn, “William Stewart Halsted: Transitional Years,” Surgery 121, no. 3 (1997): 343–51.
27 Less debatable was the enormous impact: D. B. St. John Roosa, “Thomas Alexander McBride: An Account of His Last Illness,” New York Medical Journal, October 2, 1886, pp. 265–66; Sherwin B. Nuland, Doctors: The Biography of Medicine (New York: Vintage Books, 1988), p. 398; Ralph Colp Jr., “Notes on Dr. William S. Halsted,” Bulletin of the New York Academy of Medicine 60, ser. 2 (1984): 876–87; and MacCallum, Halsted, p. 45.
28 “I’ve seen enough”: Arthur J. Beckhard and William D. Crane, Cancer, Cocaine and Courage: The Story of Dr. William Halsted (New York: Julian Messner, 1960), p. 154.
29 There, Welch was charged: Nineteenth-century dollars were converted into 2010 values using a formula based on the consumer price index from the economic history—focused website Measuring Worth, www.measuringworth.com/index.html (accessed February 25, 2010).
30 Underneath its spire: John S. Billings, Description of the Johns Hopkins Hospital (Baltimore: Publications of the Johns Hopkins Hospital/Press of J. Friedenwald, 1890). Billings was one of five experts asked by the trustees to help design the hospital in 1875, and his design was considered the best. He remained an adviser to the hospital through its opening in 1889. See also J. S. Billings, N. Folsom, J. Jones, C. Morris, and S. Smith, Hospital Plans: Five Essays Relating to the Construction, Organization and Management of Hospitals Contributed by Their Authors for the Use of the Johns Hopkins Hospital of Baltimore (New York: William Wood and Co., 1875); and Gert H. Brieger, “The Original Plans for the Johns Hopkins Hospital and Their Historical Significance,” Bulletin of the History of Medicine 39 (1965): 518–28.
31 Ever the benevolent puller of strings: Peter D. Olch, “William S. Halsted: The Antithesis of William Osler,” in The Persisting Osler, ed. J. A. Barondess, J. P. McGovern, and C. G. Roland (Baltimore
: University Park Press, 1985), pp. 199–204.
32 “Nobody knows where Popsy eats”: Michael Bliss, William Osler: A Life in Medicine (New York; Oxford University Press, 1999), p. 211. See also Bert Hansen, “Public Careers and Private Sexuality: Some Gay and Lesbian Lives in the History of Medicine and Public Health,” American Journal of Public Health 92, no. 1 (2002): 36–44; and Bert Hansen, “American Physicians’ ‘Discovery’ of Homosexuals, 1880–1900: A New Diagnosis in a Changing Society,” in Framing Diseases: Studies in Cultural History, ed. Charles E. Rosenberg and Janet Golden (New Brunswick, N.J.: Rutgers University Press, 1992). For further information, see D. R. Mendenhall Memoirs, Mendenhall Papers, Sophia Smith Collection, Smith College, Item 3, E, 25, Northhampton, Mass.; Hugh A. Young, A Surgeon’s Autobiography (New York: Harcourt, Brace, 1940), p. 65; and Simon Flexner and James T. Flexner, William Henry Welch and the Heroic Age of American Medicine (New York: Viking Press, 1949), pp. 162, 170.
33 For the next four decades: A. M. Harvey, G. H. Brieger, S. L. Abrams, and V. A. McKusick, A Model of Its Kind, vol. 1, A Centennial History of Medicine at Johns Hopkins (Baltimore: Johns Hopkins University Press, 1989); and Samuel J. Crowe, Halsted of Johns Hopkins: The Man and His Men (Springfield, Ill.: C. C. Thomas, 1957).
34 There, about a mile away: Flexner and Flexner, Welch, p. 155. Welch was so devoted to Mrs. Simmons that he moved with her twice, over the years, once to 935 St. Paul Street and later to 807 St. Paul Street.
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