The W.o.D Morphine
The W.o.D, Prostitution
The W.o.D Continuum Drug Use
It is an axiom of scientiªc medicine that particular diseases should be treated by particular medicines whose use has been justiªed by statistical studies.
However, the principle of therapeutic speciªcity did not emerge (and then only gradually) until the nineteenth century. For most of medical history, doctors regarded drugs simply as tools to achieve broad physiological effects. Through such actions as quickening the pulse or regulating the bowels, they supposedly helped the body regain its natural balance.
Seldom did physi cians restrict a particular drug to a single illness. Quinine, for example, was an all-purpose tonic, not just a speciªc treatment for malaria. New drugs with pronounced effects were almost automatic candidates for medical curiosity and enthusiasm.1
This was especially true if physicians could administer them in a variety of ways. The Seville physician Nicolas Monardes, a student of New World drugs who published a seminal and widely translated work on tobacco in 1571, wrote that, applied topically, tobacco could heal all manner of wounds, sores, and aches.
Taken internally, it acted as a vermifuge. Chewed, it allayed hunger and thirst; smoked, it overcame fatigue. Monardes noted that Indians also smoked as a “pastyme,” reveling in tobacco drunkenness and diabolical visions. He was emphatic in his disapproval of these practices.
From the start, moral lines were being drawn.2 Tobacco soon acquired a reputation as a “great Antidote against all venome and pestilential diseases,” able to cleanse the air and disperse the poisonous “vapors” responsible for plague.
“This day,” the diarist Samuel Pepys wrote on June 7, 1665, “much against my Will, I did in Drury-lane see two or three houses marked with a red cross upon the doors, and ‘Lord have mercy upon us’ writ there—which was a sad sight to me, being the ªrst of that kind that to my remembrance I ever saw.
It put me into an ill conception of myself and my smell, so that I was forced to buy some roll-tobacco to smell to [sic] and chaw—which took away the apprehension.” No London tobacconist, legend has it, ever succumbed to the Great Plague.
Paulli was a cosmopolitan with a wide knowledge of botany and many con tinental correspondents. He knew that tobacco was only one of many new drugs entering European medicine and commerce.
Crediting as sincere re ports that drinking chocolate, coffee, and above all tea produced healthful beneªts, he pointed out that only those who lived in the plants’ native re gions were likely to enjoy these beneªts.
“The natural Produce of any Coun try is best suited to the Constitution of its Inhabitants,” he argued, invoking an ancient medical maxim. Tea was best for the Chinese, coffee for Persians, chocolate for American Indians, and ale and wine for Europeans. Violating the natural order by mixing drugs and peoples had debilitating conse quences, sterility among them.
The importation of these products was waste ful as well as dangerous, as Europeans already had plants that yielded the de sired effects. Spending immense sums for stale and adulterated foreign equivalents was “raging epidemical Madness”—especially in a country like Denmark, which had no drug-producing colonies of its own.
Besides, why should Europeans ape base and cunning Asiatics, not to say the very Indian cannibals who had infected them with syphilis, and were doing so again with smoking? It was a shame, Paulli exhorted, “that we Europeans should thus brutally follow the Custom of the Barbarians, without listening to Reason, in which we so far excel them.
Within the pages of Paulli’s little book lie every one of the principal reasons why governments would one day assert control over or prohibit the use of certain drugs. They brought harm to those who abused them, misery to their families, and danger to their communities. They drained the resources of in dividuals and states.
They were vices which originated with demonic others. Even the notion that drugs did not travel well, and could disrupt societies un familiar with them, survived as a commonplace of social science, though for reasons more anthropological than Hippocratic.
Wine was among the most ancient of medicines, employed therapeutically in all societies possessing viticulture. Greek and Roman physicians recom mendedit as wounddressing, fever ªghter, diuretic, and restorative beverage. The Talmud says that “wine taken in moderation induces appetite and is beneªcial to health. . . .
Wine is the greatest of medicines.” Wine and beer were commonlyused as vehicles for other plant drugs, a practice that dates to the Ebers papyrus of about 1550 b.c. Medicated drinks were almost universal in medieval and early modern Europe.
“To Procure easie Labour,” ran a typi cal English recipe, “Take 3 spoonfulls of Oyle of Sweet Almonds in halfe a Pinte of white Wine every morning for 6 weeks together before the time of Delivery it is a most excellent thing.”
Cotton Mather, the Massachusetts cler gyman-physician, recommended pulverized Green Turtle’s penis in beer, ale, or white wine as a speedy cure for kidney stones.
Before the seventeenth century, distilled alcohol was expensive, typically sold in apothecaries’ shops, and reverently regarded as a life-giving “miracle,” capable of dispelling everything from plague to melancholy. Aqua vitae, as brandy was called, means “water of life.” (Likewise whiskey, which derives from the Gaelic uisge beatha.)
Those who took a half spoonful of brandy every morning, declared one physician, would never be ill.
Though couched in less enthusiastic terms, modern epidemiological studies have shown that the antiseptic properties of spirits confer protection against food-borne dis eases like hepatitis
Drinking spirits as a form of dissipation was an entirely different matter, and recognized as such long before Hicks staggered across the ªnish line. The historian Ann Tlusty, who has studied Augsburg’s sixteenth- and seven teenth-century statutes on spirits, has shown how stubbornly authorities tried to enforce the distinction.
“Brandy is not a drink to be taken immoderately,” a 1614 regulation declared, “but only for strength or medicinal purposes.” Brandysellers’ customers had to take their medicine standing up and on the premises, rather like methadone patients three and a half centuries later.
They could not drink brandy in taverns or other recreational settings. The strictures on gin, suspect as a waste of grain as well as a potent source of intox ication, were tighter still. Only four licensed apothecaries could sell grain al cohol for medicinal purposes.
Popular demand, however, gradually under mined the regime. Soldiers demanded their brandy; widows and poor craftsmen distilled gin on the sly. Faced with persistent resistance and eva sion, the city council ªnally acquiesced to taxed, nonmedical consumption, ªrst of brandy, then of gin. Both were fully legal by 1683.
Alarms over national ªtness and security played a similar role in the fall of absinthe. Made by dissolving wormwood in alcohol with anise and other ºavoring agents, this pale emerald-green drink contained the hallucinogen thujone.
Although best remembered as a favorite tipple of poets and paint ers—Henri de Toulouse-Lautrec carried his supply with him in a custom built cane—absinthe enjoyed growing popularity during the nineteenth cen tury, particularly in France, where consumption reached 36 million liters a year by 1910. Advertising and mass production were the keys.
The Pernod fac tory at Pontarlier was so efªcient that only 170 employees, half of them women, could turn out 125,000 liters a day—bottled, corked, labeled, and packed in crates destined for ports as far-ºung as Valparaiso, San Francisco, and Saigon.
But temperance agitation and fears that absinthe drinking con tributed to tuberculosis, epilepsy, heritable insanity, and crime led to bans in Switzerland, the United States, and other countries.
The French govern ment, concerned with military readiness and morale, issued an emergency decree against sales in August 1914. The following year the Chamber of Dep uties formally outlawed all production, distribution, and sale.
Four medical developments in the nineteenth century accelerated the psy choactive revolution and increased anxieties about its social consequences.
These were the isolation and commercial production of psychoactive alka loids such as morphine and cocaine; the development of hypodermic medi cation; the discovery and manufacture of synthetic drugs such as chloral hy drate; and the discovery and manufacture of semisynthetic derivatives such as heroin.
Heroin is in the “semi” class because its basic ingredient is simply the morphine molecule, to which two small acetyl groups have been added, tri pling its potency and speeding the onset of its action.
Clinical trials of heroin and other experimental drugs demonstrated that small changes in molecular structure could produce large changes in effects. This principle revolution ized pharmacology and paved the way for the development of countless new medications, many with psychoactive properties.
Most synthetic and semisynthetic drugs originated in Germany, the center of pharmaceutical research and development during the late nineteenth and early twentieth centuries.
One ªfirm alone, Friedrich Bayer & Co. of Elberfeld, sold or licensed the manufacture of such sedatives and hypnotics as Luminal, Sulfonal, Trional, and Veronal, as well as its two best-known products, heroin and aspirin.
(The company immodestly titled one of its publications Materia Medica Bayer.) Grateful doctors avidly purchased the sleep-inducing drugs; one Canadian practitioner bought them in 5,000-tab let lots. They soon learned, however, that barbiturates and other new drugs could mean trouble.
One reason the word “drug” became associated with ad diction in the early twentieth century was that physicians needed a term of convenience to link together the proliferating substance-abuse problems, much the way “cancer” described disparate forms of malignancy.
“Drug habit” ªlled the bill Cut off from German supplies and technology, the British and American pharmaceutical industries experienced hothouse growth during World War I.
The American industry emerged as the world leader during and after World War II. More than 61 percent of new single-chemical drugs intro duced from 1941 through 1963 originated in the United States, compared with 8 percent for Switzerland, 6 percent for Germany, 5 percent for Britain, and 3.5 percent for France.
Whatever the country of origin, pharmaceutical companies marketed these products internationally, domestic sales being insufªcient to recoup the large research and development costs. Those that had pleasurable or libidinal effects followed a trajectory similar to that of their organic predecessors. As they leaked from medical to popular experi mentation and use, they engendered controversy and tightened control.
This was true of heroin, barbiturates, anabolic steroids, tranquilizers, hallucino gens, synthetic narcotics like Demerol, and even, to cite a recent instance, Viagra, which prompted editorial head-wagging the moment it went from a treatment for erectile dysfunction to an experimental aphrodisiac.
