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    An Anatomy of Addiction

    Page 35
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      The mention of De Quincey in the first paragraph of this document, of course, refers to the great English poet, journalist, and author of Confessions of an Opium Eater, Thomas De Quincey (1785–1859).

      17 “an abundance of putty-like material”: Samuel J. Crowe, Halsted of Johns Hopkins: The Man and His Men (Springfield, Ill.: C. C. Thomas, 1957), pp. 232–33.

      18 On August 21: Heuer, “Dr. Halsted,” pp. 70–78.

      19 Dr. Karl Schlaepfer, the surgeon: Karl Schlaepfer, M.D., to Matas, September 8, 1922; W. S. Halsted Papers, Box 59, Folder 13, Alan Mason Chesney Archives, Johns Hopkins Medical Institutions, Baltimore.

      20 “was certain that [Halsted]”: Heuer, “Dr. Halsted,” p. 25. Dr. Mont Reid died in 1943, leaving this particular thread untied.

      21 Halsted, Crowe claims: Halsted’s final illness and hospital chart are summarized in Crowe, Halsted of Johns Hopkins, pp. 232–33.

      22 Consequently, his patients: Ibid., p. 233.

      23 Conversely, there exists: Several scholars have suggested that Halsted may have been taking quite a bit more morphine at this time than he admitted. See, for example, Nuland, Doctors, p. 421.

      24 “Although it has been widely reported”: Emile Holman, “Sir William Osler and William Stewart Halsted—Two Contrasting Personalities,” Pharos 34, no. 4 (1971): 134–39, 144. Sprong, who became a professor of urology at UCLA, wrote the letter containing Welch’s statement to Holman on May 29, 1968. Sprong added, “I do not remember that Dr. Welch mentioned how long these relapses might last, or even how they occurred, but he felt pretty strongly that the facts should be on the record.” The original letter resides in the Emile Holman Papers, Box 13, Archives and Modern Manuscripts Division, History of Medicine Division, National Library of Medicine, Bethesda, Maryland; see also 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.

      25 “The real truth”: “Notes on Dr. Halsted from Harvey Cushing.”

      26 Such episodes also may have included: Before his premature death, the pathologist and medical historian Peter Olch worked on the life and addictions of Halsted. According to the journalist Scott Shane, during the 1960s Dr. Olch interviewed some of the living caretakers of Halsted’s North Carolina summer home. Shane writes that one of them suggested to Dr. Olch a suspicion that the surgeon was often incapacitated from drug use during his summer vacations. Unfortunately, Olch died prematurely, before he could process and publish such testimony. Scott Shane, “A Casualty of Cocaine,” Baltimore Sun Magazine, January 30, 1994, pp. 6–15; and J. Scott Rankin, “William Stewart Halsted: A Lecture by Dr. Peter D. Olch,” Annals of Surgery 243 (2006): 418–25. This account is also mentioned in a fine essay by Daniel B. Nunn, “Caroline Hampton Halsted: An Eccentric but Well-Matched Helpmate,” Perspectives in Biology and Medicine 42, no. 1 (1998): 83–93. In it, Nunn describes a correspondence with Dr. Olch, who interviewed Douglas Bradley, the former caretaker at High Hampton. Bradley recounted an episode where Mrs. Halsted became very upset when a package from Parke, Davis did not arrive at their home and, consequently, sent him to a local practitioner to procure some morphine. Parke, Davis, of course, sold both cocaine and morphine. Bradley also suggested to Olch in a phone interview that Mrs. Halsted may have been addicted to morphine. The proof of such a statement, however, has yet to be definitively found.

      27 Sadly, the ashamed, guarded, and lonely Halsted: Shane, “Casualty of Cocaine,” pp. 6–15; and “The Matter of Dr. Halsted’s Absence,” a list of board minutes regarding Halsted’s absences from the Johns Hopkins Hospital, Box 69A, W. S. Halsted Papers, Alan Mason Chesney Archives of the Johns Hopkins Medical Institutions, Baltimore.

      Epilogue

      1 His body progressively demands: N. D. Volkow, J. S. Fowler, G. J. Wang, and J. M. Swanson, “Dopamine in Drug Abuse and Addiction: Results from Imaging Studies and Treatment Options,” Molecular Psychiatry 9, no. 6 (2004): 557–69; N. D. Volkow, J. S. Fowler, G. J. Wang, J. M. Swanson, and F. Telang, “Dopamine in Drug Abuse and Addiction: Results from Imaging Studies and Treatment Options,” Archives of Neurology 64, no. 11 (2007): 1575–79; and J. S. Fowler, N. D. Volkow, C. A. Kassed, and L. Chang, “Imaging the Addicted Human Brain,” Science & Practice Perspectives 3, no. 2 (2007): 4–16.

      2 The addict’s luck: Alan I. Leshner, “What We Know: Drug Addiction Is a Brain Disease,” in Principles of Addiction Medicine, 2nd ed., ed. Allan W. Graham and Terry K. Schultz (Chevy Chase, Md.: American Society of Addiction Medicine, 1998), pp. xxix–xxxvi; and Robert L. Dupont, The Selfish Brain: Learning from Addiction (Minneapolis: Hazelden Publishing, 2000).

      3 Even at this late date: For a superb account of a modern-day doctor trapped by addiction but with fatal results, see Abraham Verghese, The Tennis Partner: A Doctor’s Story of Friendship and Loss (New York: HarperCollins, 1998).

      Index

      References in italics refer to illustrations.

      Abbott, Maude

      Abel, John Jacob

      addiction. See also addiction to cocaine; addiction to morphine

      criminalization of agents of, 12.1, 12.2

      as difficult disease

      masturbation as (Freud), 9.1, 12.1

      substance abuse distinguished from

      as term

      contemporary use of, 12.1

      early uses of, prl.1, 12.1

      treatment by substituting another addictive drug, 4.1, 12.1

      addiction recovery

      difficulties of, 8.1, 11.1

      necessity of daily routines

      addiction to cocaine

      brain and, 6.1, 6.2, 6.3, 12.1, 12.2

      crash, 6.1, 7.1

      early warning by Prescott

      of Fleischl-Marxow, 4.1, 12.1

      of Halsted

      behavioral changes, 6.1

      at Bellevue Hospital, prl.1, 5.1, 6.1

      at Johns Hopkins Hospital, 10.1, 10.2

      and operating on patient in Santa Lucia, 6.1

      physicians and

      withdrawal from

      addiction to morphine, prl.1, 4.1

      of Fleischl-Marxow, 4.1, 4.2

      of Halsted, 12.1, 12.2, 12.3

      at Johns Hopkins Hospital, 10.1

      revealed to Osler, 10.1

      of Pappenheim (Anna O.), 9.1, 12.1

      treatment with cocaine, prl.1, 3.1, 7.1

      addictive personality

      Freud as candidate for

      alcohol

      in combination with cocaine, 3.1, 12.1

      Freud and, 9.1, 11.1

      Halsted and, 2.1, 12.1

      alcoholics, prl.1, 8.1

      Alcoholics Anonymous

      alienists, 8.1, 8.2, 8.3

      Allgemeines Krankenhaus, prl.1, 1.1

      description

      First Psychiatric Clinic, 4.1

      Freud at, 1.1, 1.2

      importance of diagnoses at

      patients’ living conditions

      professors at

      Anatomy: Descriptive and Surgical (Gray), 2.1

      Anna O. See Pappenheim, Bertha (Anna O.)

      Annual Reports of the Trustees and Superintendents of the Butler Hospital for the Insane, 8.1

      anti-Semitism in Vienna

      of Billroth, 1.1, 12.1

      professorial appointments and

      Aschenbrandt, Theodor

      aspirin

      asylums. See also Butler Hospital for the Insane

      Salpêtrière Hospital

      Baginsky, Adolf

      Baltimore, 8.1, 10.1

      Eutaw Place, 10.1

      Maryland Club, 8.1

      Barringer, Gertrude

      Bayer Company

      heroin and

      Bedlam

      Beeton’s Christmas Annual, 5.1

      Belle Vue Castle (hotel and spa), 9.1, 9.2

      Bellevue Hospital, 2.1, 2.2, 5.1

      accident room

      ambulance, prl.1

    &nb
    sp; entrance examination for interns

      Halsted at

      antiseptic operating theater, 5.1

      as intern, 2.1, 2.2

      as surgeon, prl.1, 12.1

      hierarchy at

      ledger on operations at

      main gate, 2.1

      mortality rates

      surgical operation, 5.1

      unsanitary operating procedures

      Bellevue Medical College

      Bentley, W. H.

      Bernays, Martha. See also Freud’s letters to Martha

      family of, 1.1, 1.2, 12.1

      Freud’s proposal to

      pictures of, 1.1

      with Freud, 1.1, 9.1

      with Freud and Anna, 9.1

      Bernays, Minna

      Freud’s relationship with, 9.1, 11.1

      pictures of, 1.1, 9.1

      Bernfeld, Siegfried

      Bernhardt, Sarah, 7.1, 7.2

      Billings, John Shaw, 8.1, 12.1

      Billroth, Theodor, 1.1, 1.2, 1.3, 4.1

      bisexuality

      Freud’s borrowing ideas about from Fliess, 11.1, 12.1

      Block Island, 2.1, 2.2

      Bloodgood, Joseph Colt, 10.1, 12.1, 12.2

      on Halsted’s tachycardia

      use of rubber gloves

      B’nai B’rith men’s lodge (Vienna)

      Boehringer and Merck

      Bonaparte, Princess Marie, 11.1, 11.2, 12.1

      Bonpland, Aimé

      Booker, William D., 12.1, 12.2

      Bostick, Lucy

      Bradley, Douglas

      brain

      cocaine’s effects on, 6.1, 6.2, 6.3

      morphine’s effects on

      Brain (journal), 1.1

      Brainerd, H. G.

      breast cancer, Halsted’s operation for (radical mastectomy), 10.1, 12.1

      Brettauer, Josef

      Breuer, Joseph

      Fleischl-Marxow and

      pictures of, 9.1

      with Mathilde, 9.1

      relationship with Freud

      collaboration, 9.1

      early, 9.1

      end of, 9.1

      use of hypnosis on Bertha Pappenheim (Anna O.)

      Breuer, Mathilde, 9.1

      Brewer, George

      Brill, A. A., 11.1

      British Medical Journal, 12.1

      Broedel, Max

      Brouillet, Pierre André, 9.1, 12.1

      Brown, Nicholas, Jr.

      Bruce, Lenny

      Brücke, Ernst Wilhelm von

      interest in art

      professor of physiology at Vienna Medical School, 1.1, 1.2

      recommending Freud for Jubilee Fund grant

      and Vienna Institute of Physiology

      Buchan, William

      Bullitt, William, 11.1

      Bunting, Charles

      buprenorphine

      Butler, Cyrus

      Butler Hospital for the Insane, 6.1, 6.2

      facilities, 8.1, 8.2

      Halsted at

      handicraft class, 8.1

      medical directors of

      patients

      recommended to Halsted, 12.1, 12.2

      room at, 8.1

      Candler, Asa Griggs

      cataracts, surgical removal of

      cathexis, 11.1, 12.1

      Centralblatt für die gesammte Therapie, 4.1

      Centralblatt für die medizinischen Wissenschaften, 1.1

      Charcot, Jean-Martin, 7.1

      Freud and

      home of

      on hysteria

      medical texts translated by Freud

      neurology and

      at the Salpêtrière Hospital, 7.1, 7.2

      painting by Brouillet, 9.1, 12.1

      Charcot’s Archives, 9.1

      chloroform, 5.1, 5.2, 12.1

      cholecystectomy (surgical removal of gallbladder), 5.1, 12.1

      Churchman, John W., 12.1

      cigarettes, Halsted’s consumption of

      cigars, Freud’s consumption of

      Claus, Carl, 1.1, 1.2, 12.1

      Clinical Lesson with Doctor Charcot at the Salpêtrière Hospital, 1887, A (Brouillet), 9.1, 12.1

      coca. See coca leaves

      Coca-Cola

      advertisement for, 3.1

      cocaethylene, 3.1, 12.1

      cocaine. See also addiction to cocaine; cocaine, therapeutic uses of

      cocaine hydrochloride

      manufacture of, 3.1

      vial produced by E. Merck and Co., prl.1

      crack cocaine

      effects on the brain, 6.1, 6.2, 6.3

      freebasing

      in Freud’s dreams

      methods of taking, 6.1, 12.1

      Freud on, 8.1

      physical symptoms from use, 6.1, 8.1, 9.1

      price of, 4.1, 5.1

      reports on dangers of, 8.1, 8.2

      self-experimentation

      by Freud, prl.1, 4.1, 12.1

      by Halsted, prl.1, 5.1, 12.1

      source of

      cocaine, therapeutic uses of

      by Fliess, 9.1, 9.2, 9.3

      as local anesthetic

      experimenting by Halsted, 5.1

      not described in Über Coca, 4.1

      worldwide discussions about, 5.1

      scientific papers on, prl.1, 3.1, 12.1

      surgeon general’s catalog entry in 1883, 4.1

      as treatment for morphine addiction, prl.1, 3.1, 7.1

      coca leaves, 3.1, 3.2

      chewed by natives in South America, 3.1, 3.2

      cocaine alkaloid crystals derived from

      Humboldt on effect of chewing, 3.1, 12.1

      liquid preparations

      Coca-Cola, 3.1

      Vin Mariani, 3.1

      Prescott on appeal of

      research on

      shipping of

      codeine

      Conan Doyle, Arthur, 5.1, 5.2, 12.1

      “Confessions of a Cocainist, The” (Springthorpe)

      Councilman, William T., 8.1, 12.1

      Crothers, T. D.

      Crowe, Samuel J.

      Crowell, Kate

      Cullen, Thomas

      Cushing, Harvey, 12.1

      biography of Osler

      conversation with Fulton

      on Halsted

      addiction, 12.1

      bedside manner, 10.1

      comments to Cutler, 12.1, 12.2

      house, 10.1

      Cutler, Elliott Carr, 12.1, 12.2, 12.3

      Dalton, John Call, 2.1, 2.2

      Davis, George S., 3.1, 3.2, 3.3

      Davy, Humphrey

      DeBakey, Michael

      Detroit, industry in

      Dewey, John

      dogs, Halsted’s research on

      dopamine

      dreams of Freud

      “Irma’s Injection”

      Jacob Freud’s glaucoma operation and cocaine anesthesia

      at time of his father’s death, 9.1, 12.1

      du Bois-Reymond, Emil

      Duffield, Samuel P., 3.1, 12.1

      Eckstein, Emma (Irma), 9.1, 9.2

      Freud troubled by operation on

      Erlenmeyer, Johann A. A.

      ether, 5.1, 5.2, 12.1

      European universities

      Exner, Sigmund, 1.1, 4.1

      Ferenczi, Sándor, 11.1, 11.2, 11.3

      Finney, John M. T., 12.1

      “Fixed Period, The” (Osler)

      Fleischl-Marxow, Ernst von, 4.1, 4.2

      addiction to cocaine, 4.1, 12.1

      addiction to morphine, 4.1, 4.2

      beginning of, 4.1

      treatment with cocaine, 4.1

      Freud looking after, 4.1, 4.2

      pseudoaddiction and

      in Vienna Institute of Physiology

      Fliess, Wilhelm, 9.1, 11.1. See also Freud’s letters to Fliess

      as facilitator of Freud’s cocaine abuse

      operation on Eckstein’s nose

      relationship with Freud, 9.1, 11.1, 12.1, 12.2

      theories of

      Follis, Richard H., 12.1

      Four Doctors, The (Sargent), 12.1, 12.2, 12.3


      Francis, W. W.

      free association, beginning of technique of

      Freud, Anna

      Freud, Jacob, 1.1

      Freud, Sigmund. See also Freud’s letters to Fliess; Freud’s letters to Martha; Freud’s publications

      cocaine abstention

      depression and, 11.1

      necessity to pull away from Fliess, 11.1

      rigorous routine and, 11.1

      cocaine abuse, prl.1, 7.1, 7.2, 9.1

      curtailed in fall of 1896, 9.1

      and difficult relationships, 9.1

      Jones on, 12.1

      link with signature ideas, 11.1

      money and, 9.1

      physical symptoms of, 9.1

      used to explain new concepts, 12.1

      commitment to medicine

      disagreement over theories of

      dreams

      “Irma’s Injection”, 9.1

      Jacob Freud’s glaucoma operation and cocaine anesthesia, 4.1

      at the time of his father’s death, 9.1, 12.1

      Eckstein case and

      family, 1.1, 1.2

      fleeing Vienna in 1938, 11.1, 11.2

      health

      melancholy, 1.1, 4.1, 9.1, 11.1

      oral cancer, 12.1

      psychological constitution, 9.1

      and homosexuality

      as intern, 1.1, 1.2, 1.3

      invited to the United States by Hall

      Judaism and

      laboratory work

      letters to Ferenczi, 11.1, 11.2

      on cocaine, 11.1

      living accommodations

      Berggasse 19, 9.1, 9.2

      first apartment with Martha, 9.1, 12.1

      in Paris, 7.1

      room at Krankenhaus, 4.1, 4.2

     


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